Medicine and Health Sciences Commons^™

The Effectiveness Of Disinfection Protocols In Osteopathic Family Medicine Offices, Riley Phyu, Harrison A Patrizio, Thomas Boyle, Todd Schachter

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: Healthcare-associated infections (HAIs) pose a substantial public health threat. Despite significant strides to curb HAIs in hospital environments, outpatient settings have not received the same degree of attention. Given their emphasis on holistic, patient-centered care, osteopathic family medicine offices are pivotal in both disease prevention and comprehensive patient treatment. The importance of simple yet effective disinfection protocols, such as thorough cleaning between patient appointments, cannot be overstated in these settings because they are integral to minimizing disease transmission.

OBJECTIVES: This study aims to assess the effectiveness of the current disinfection protocols in osteopathic family medicine offices.

METHODS: A cross-sectional …

A Tale Of Two Situations: A Case Report Of The Merger Between Dermatology Outcomes And Prescription Drug Access, Kara Ye, Yasseen Amellal, Will Evans, Theresa Rohr-Kirchgraber

Cooper Rowan Medical Journal

This case report illustrates a case of guttate psoriasis in a young adult and the logistical role dermatologists can play in patients acquiring their prescriptions and improving the quality of their care.

The Effectiveness Of Disinfection Protocols In Medical School Osteopathic Manipulative Medicine Labs., Harrison A. Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: In light of the COVID-19 pandemic, healthcare-associated infections have taken center stage. Healthcare has adjusted workflows to accommodate for more robust disinfecting regiments to help protect the community. This has resulted in the need for medical institutions to reevaluate the current disinfection protocols down to the student level. The osteopathic manipulative medicine (OMM) laboratory provides an optimal avenue for assessing the effectiveness of medical students' ability to clean examination tables. With OMM laboratories having a high level of interaction, adequate disinfection is important for the health and safety of students and teaching faculties.

OBJECTIVES: This study will evaluate the …

Addressing The Health Needs Of The (D/D)Eaf And Hard Of Hearing Community, Zainab Krayem, Rachel Jeff-Macauley, Nicolette Falco, Vanesa Pizutelli

Rowan-Virtua Research Day

Merriam-Webster’s dictionary defines deaf to describe an individual who has total or partial hearing loss. However, the term carries much more weight as it breeds its own culture, Deaf culture, to be exact. There’s an emphasis placed on the spelling where deaf, spelled with a lowercase d, refers to individuals who are born deaf and grew up within this deaf culture. Whereas, members who identify as Deaf with a capital D have lost their hearing later on in life, and did not necessarily grow up within deaf culture. There is often a discrepancy whereby members who identify as d/Deaf or …

Isolated Temazepam Overdose: A Unique Case Of An Unresponsive Female, Eric Doane

Rowan-Virtua Research Day

Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading …

Case Study Of Horner Syndrome Due To Internal Carotid Artery Dissection, Kajel Patel

Rowan-Virtua Research Day

Carotid artery dissection can occur either spontaneously or because of trauma. It is usually the most common cause of stroke in middle-aged patients. The symptoms can be transient or persistent and typically occur a few days after the inciting traumatic event.

Analysis Of Implementing Best Practices For Co-Prescribing Naloxone In Your Agency Online Cme Training Module Via Pre- And Post- Knowledge Assessment., Alicia Podwojniak, Arvind Venkataraman, Richard Jermyn

Rowan-Virtua Research Day

The opioid epidemic poses substantial risk to society. Providers must ensure that their patients understand the uses and risks of both opioids and naloxone. One way to analyze this concept is via metacognition. This refers to a person’s knowledge about cognitive phenomena, and thus it regulates self-awareness abilities in decision making, such as planning and evaluating. It is not only important for providers to have knowledge on best practices, but also to have self-awareness, and confidence in their decision making to ensure optimal patient outcomes. True-false confidence weighted scoring can be utilized, whereby various levels of confidence are assessed from …

The Effectiveness And Outcomes Of Oculomotor And Visual Field Deficit Rehabilitation Secondary To Ischemic Cerebrovascular Accident: A Literature Review, Maanas Chiplunkar

Rowan-Virtua Research Day

Visual field loss and oculomotor dysfunctions are two common vision deficits caused by cerebrovascular accidents. Oftentimes these deficits can result in a loss of independence for patients and depression. Neurovisual rehabilitation is a frequently overlooked aspect of stroke rehabilitation, so investigating the current rehab approaches and the factors that play a role in the effectiveness of these methods is crucial so that clinicians can provide more direct and focused treatment for their patients. This literature review research process used PubMed, NCBI, and EbscoHost as primary databases. Preliminary results showed that restitutive and compensatory rehabilitation approaches are effective for treating visual …

The Effectiveness Of Cleaning Protocols In Medical School Omm Labs By Medical Students, Harrison Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

Rowan-Virtua Research Day

In light of the COVID-19 pandemic, disinfection in healthcare has taken center stage. Healthcare has adjusted workflows to accommodate for more robust cleaning regimens to help protect the community. This has resulted in the need for medical institutions to reevaluate the current cleaning protocols down to the student level. Osteopathic Manipulative Medicine (OMM) lab provides an optimal avenue for assessing medical student’s examination table cleaning effectiveness. With OMM labs being an activity with a high level of interaction, the quality of examination table cleaning is important for the health and safety of students and teaching faculties. Our study highlights that …

Bedside Teaching In Emergency Medicine Brief Review And Practical Suggestions, James Espinosa, Alan Lucerna, Frank Wheeler, Sergey Medlenov, Robin Lahr, James Lee

Rowan-Virtua Research Day

Bedside teaching has been a tradtional practice and value in medicine. There is literature attesting the positive role of bedside teaching in medicine in general---and in emergency medicine in particular. The value proposition is centered around teaching overall clinical skills, communication skills and procedural skills. There is very little actual data concerning the outcomes of various bedside teaching approaches in EM. There are a number of very interesting suggestions In this review, we will discuss practical strategies to support bedside teaching in the speciality of emergency medicine.

Breaking Down Barriers: Investigating Structural And Systemic Factors That Contribute To Covid-19 Disparities In African American Communities In New Jersey, Fazal Choudhary, Suraj Pothineni

Rowan-Virtua Research Day

Background: The COVID-19 pandemic has affected the lives of millions of Americans; however, minority communities have been hit the hardest as infection rates continue to sky rocket and new variants arise. As of October 5, 2021, the CDC reports that African Americans make up a similar share of cases relative to the overall population, at about 12%, but have a significantly higher rate of deaths compared to the population, at approximately14%. African American communities are being disproportionately affected because of higher incidence of chronic diseases, inadequate access to health care, and poorer living and working conditions, which increases their vulnerability …

Biopsychosocial Impacts Of Social Distancing Due To Covid-19 In People Over 65: A Literature Review, Nicole Lacap

Rowan-Virtua Research Day

Background: Since the beginning of the Covid-19 pandemic in January 2020, elderly populations aged 65+ have been deemed at-risk for severe symptoms and poor prognosis. Because it is important to protect this vulnerable population, policies such as social distancing and shelter-in-place orders have been implemented in the United States in order to prevent the spread of Covid-19. However, many older citizens may live alone or may not have access to technology, and therefore may be limited in their ability to maintain important relationships and social interactions throughout shelter-in-place orders and social distancing. Therefore, it is important to understand the cost …

A Clinician's Guide To 23andme: A Survey-Based Study On People’S Attitudes And Actions Towards Direct-To-Consumer Genetic Testing, Julia Kiffel, Rifke Anolik, Alexander Kowalski

Rowan-Virtua Research Day

Background: While direct-to-consumer (DTC) at-home genetic testing like 23andMe provides users with potentially valuable information about their genetics and health risks, consumers might not have the background or knowledge to fully comprehend and interpret the results. This concept is a pressing issue because of the rise in popularity of these DTC genetic tests.

Purpose: The goal of this study is to elucidate the beliefs and attitudes of 23andMe users and determine the relationship between their test results and likelihood for taking medical action. The results from the study will give clinicians and primary care providers (PCPs) insight into how to …

The Correlation Between Traumatic Brain Injury And Incarceration Among Adult Males In The United States, Shadi Shams

Rowan-Virtua Research Day

The United States has one of the largest growing prison populations in the world. A large amount of social and economic resources go towards the cost and maintenance of correctional facilities each year. Additionally, the current correctional programs are insufficient in assisting inmates with getting back to society; especially those with traumatic brain injury (TBI) who often remain undiagnosed and are usually treated unfairly in the prison system instead of receiving the appropriate help. Prior scholarly work has shown that patients in the post-TBI stage are more likely to enter the judicial system. In the recent population-based cohort study, the …

The Correlation Between Serum C-Reactive Protein Level And Risk Of Future Cardiovascular Disease: A Neurodivergent Population Dilemma, Brandon Cunha, Andrea Iannuzzelli, Venkateswar Venkataraman

Rowan-Virtua Research Day

Extensive research on neurotypical (NT) populations has demonstrated that a chronically elevated level of serum C Reactive Protein (CRP) is a strong predictor of future cardiovascular disease (CVD). Interestingly, many neurodivergent (ND) populations experience chronically elevated CRP levels higher than NT controls. Current research is concerned with establishing the significance of this relationship to accurately predict CVD risk for potentially at risk ND patients. To contribute to this gap in knowledge, the Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population will be studied to identify trends in baseline serum CRP levels across a multitude of ND conditions. A clinical …

Case Report: Epinephrine-Containing Topical Anesthetic Gel Inducing Systemic Epinephrine Toxicity, Md Fateha, Philip Willsie

Rowan-Virtua Research Day

Systemic epinephrine toxicity is a rare complication following inadvertent or excessively large or rapid subcutaneous, intramuscular or intravenous administration. Signs and symptoms of epinephrine toxicity include rapid onset of transient agitation, hypertension, tachycardia, lactic acidosis, and dysrhythmias with potentially fatal consequences. In this case report, we present a 33-year-old female who experienced epinephrine toxicity following the use of a topical anesthetic cream containing lidocaine and epinephrine. The patient had multiple applications to her chest before and during tattoo placement which led to tachycardia, elevated blood pressure, headache, chest pain, nausea, vomiting, and anxiety. The patient was brought into the ED …

Characterization Of Antibiotic Susceptibility Profiles Of Extensively- And Pan-Drug Resistant Acinetobacter Baumannii Clinical Isolates, Rachel Carr, Justin Halim, Rebecca Fliorent, Henry Fraimow, Dejan Nikolic, Valerie Carabetta

Rowan-Virtua Research Day

Acinetobacter baumannii is an opportunistic pathogen common in intensive care units (ICUs), particularly among immunocompromised individuals. Nosocomial A. baumannii infections have become increasingly problematic in recent years, as these bacteria rapidly acquire antibiotic resistance, leading to the emergence of multidrug, extensively drug and pan drug-resistant (MDR, XDR, and PDR, respectively) isolates. Recently, Cooper University Hospital (CUH) experienced a large increase in highly drug-resistant A. baumannii infections, which had a mortality rate of 60%. Oftentimes, physicians had to turn to combinations of drugs with no experimental verification or historically shelved antibiotics, such as the polymyxins, in a desperate attempt to save …

A 5-Year Clinical Course Of Phenocopy Syndrome Of Behavioral Variant Frontotemporal Dementia: Case Report And Literature Review, Joseph Melillo, Keyur Patel, Christian White

Rowan-Virtua Research Day

Frontotemporal dementia is a neurocognitive disease which affects language, behavior, or executive functioning. This disease includes a spectrum of presentations which includes multiple variants. The phenocopy syndrome of behavioral variant frontotemporal dementia is one which mimics the behavioral variant of frontotemporal dementia. Patients with this condition show a decline in personality, social conduct and cognitive ability but often display no signs of neurological imaging and exhibit slow progression. This case focuses on a now 70-year-old male who has shown signs of behavioral changes with a slowly progressive clinical course and minimal findings on PET scan, but moderate changes seen on …

Case Report: The Challenge Of Balancing Stewardship And Advocacy, Samuel Thalathoti, Kishan Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 62-year-old female who presented with chief complaint of generalized weakness and was ultimately diagnosed with hypereosinophilia. This chief complaint is challenging for many EM physicians, and the differential diagnosis of generalized weakness is vast. Etiologies of generalized weakness in the adult population ranges from infection, dehydration, cardiovascular disease, to neurologic compromise. It is crucial for the Emergency Physician to put emphasis on proper history collection, detailed physical exam, and appropriate ancillary testing. In this case report we showcase the significance of the optimal evaluation of life-threatening disorders that presents as generalized weakness, as well …

Practicality In Pocus: Benefits Of Ultrasound Training In Medical Education, Robert Martin, Ho An Lau, Ryan Morrison, Kate Deiling

Rowan-Virtua Research Day

As point-of-care ultrasound (POCUS) becomes an integral component of healthcare, both undergraduate and graduate medical POCUS education is urgently necessary in curricula. Despite the apparent need of POCUS curricula, there remains a lingering question: Are there evidence-based benefits to POCUS training in undergraduate and/or graduate medical education settings? This systematic review utilized PubMed, Google Scholar, and Scopus to identify articles of interest that met the inclusion criteria and relevance to undergraduate and/or graduate medical education. Qualitative evaluation of research was conducted to identify common themes for benefits of POCUS and the requirements or characteristics for effective POCUS educational curricula. Results …

Evaluation Of Available Medical Interpretation Resources Available To Spanish-Speaking Patients In Nj Ahec Counties, Magdalene Lederer, Cindy Nativi, Madhav Patel, Joseph Mendoza, Nhi Tran, Yesha Patel, Melissa Vincent, Rebecca Moore

Rowan-Virtua Research Day

According to the US Census Bureau Spanish is the most common non-English language spoken in the US. Despite the growing population of Spanish-speaking individuals, most healthcare providers can only communicate in English. Linguistic differences between patients and providers have been identified to impact the quality of care received, therefore, it is not surprising that Spanish-speaking patients have been found to be less satisfied with healthcare. Language barriers in healthcare lead to poor compliance and underuse of services which eventually negatively impact health outcomes. Several studies found that the most effective communication tools are often underutilized, with healthcare providers relying on …

Challenges To Implementing Screening, Brief Intervention, And Referral To Treatment (Sbirt) For Substance Use In Primary Care Settings At Rowan-Virtua, Alissa Hochman, Kristy Straub, Nancy Chase, Samuel Damiri, Jenna Destefano, Allyson Distel, Sana Farhat

Rowan-Virtua Research Day

Background and Purpose: Implementing the SBIRT model for substance use in a primary care setting has many benefits including normalizing conversations about alcohol and other substance use into patients’ visits, thereby reducing harm, reducing consumption and its negative impact, and promoting system changes to overcome barriers to treatment access. The full scope of the current SBIRT project involves the recruitment, hiring, training, and integration of health educators in 9 primary care sites throughout South Jersey, as well as a project supervisor serving as implementation lead and liaison to medical and administrative staff at all 9 primary care sites. Initial barriers …

The Blurred Lines Between Medicine And Wellness: A Historical Approach Comparing Osteopathic Physicians, Chiropractors, And Physical Therapists, Heather Soled, Dylan Trawinski, Sonya Priven, Sheam Jahan

Rowan-Virtua Research Day

In modern society, there stands a large number of medical titles with nuances that complicate the layperson’s ability to differentiate standard of care and capabilities. As the world evolves, new job opportunities in the medical and related fields are being constructed to provide positions with various levels of certifications that qualify many caregivers to provide similar and often coexisting levels of care. Some disciplines may agree or disagree on principle; this is just one point of confusion for the mass. Furthermore, disciplines that disagree on principle may still apply analogous treatment models. Such confusion has yielded several challenges for less …

Correlation Between Gut Biomarkers And Depression, Jianle Gao

Rowan-Virtua Research Day

The correlation between the gut-microbiota- brain axis and mental state in the context of mental disorders such as Major Depressive Disorder (MDD), Schizophrenia, etc. has been well studied. Production of inflammatory and non-inflammatory metabolites by the gut- microbiota directly and indirectly affects the brain and mood. Therefore, colonization by maladaptive, pro-inflammatory bacteria may cause mood dysregulation and depressive features. Metabolites from these bacteria can be quantitatively analyzed for use as biomarkers of Major Depressive Disorder. Biomarkers studied include: serotonin, dopamine, butyrate, acetate, and propionate.

Comparative Outcomes Of Autologous Chondrocyte Implantation And Osteochondral Allograft Transplantation With Patellar Realignment For Patellar Instability With Associated Cartilage Defects, Adeeb Hanna, Michael Campbell, John Matthews, Gabriel Onor, Emma Johnson, Bradford Tucker, Kevin Freedman

Rowan-Virtua Research Day

Abstract Background: Articular cartilage pathology can stem from a spectrum of etiologies including osteochondritis dissecans, avascular necrosis, degenerative joint disease, and injury resulting from recurrent instability of the patella.

Hypothesis/Purpose: The purpose of this study was to identify differences in clinical and functional outcomes in patients treated with either ACI or OCA transplantation for chondral defects with concomitant MPFL reconstruction and tibia tubercle osteotomy.

Study Design: Retrospective Cohort Study

Methods: A retrospective review identified patients who underwent autologous chondrocyte implantation (ACI) or osteochondral allograft (OCA) transplantation with concomitant medial patellofemoral ligament (MPFL) reconstruction and tibia tubercle osteotomy (TTO). Outcome measures …

Standardizing Sti Screening In Child Sexual Abuse Cases At The Cares Institute, Usha Modukuru, Sarah Kleinle, Laura Brennan

Rowan-Virtua Research Day

Children who are sexually abused have a higher risk of contracting STIs and/or becoming pregnant. CDC STI testing guidelines should be adhered to in order to provide the safest outcomes for patients. Physician compliance with testing guidelines plays a significant role in ensuring patient safety, which highlights the importance of ensuring high physician compliance. Identifying ways physicians can improve compliance can enhance patient care. In order to determine compliance rates of the CARES Institute physicians, data was extracted from 275 patient charts from 2017 and 100 patients charts from 2021, before and after a continuing medical education (CME) training was …

Healthcare Disparities In The Lgbtqia+ Community: A Scoping Review Of Community Vs Provider Experiences, Uttara Hardikar, Alisha Vincent, Venkateswar Venkataman, Millicent Channell

Rowan-Virtua Research Day

Background: It is well-established that healthcare disparities exist in the LGBTQIA+ community. The divide is a growing concern exacerbated by recent changes in the healthcare and sociopolitical climate. To eliminate this divide and find ways to deliver better outcomes to the LGBTQIA+ is a dire need. This report analyzes the possible reasons from the community as well as the providers perspective, with a goal to find best practices that could be implemented in both components.

Methods: A scoping literature review was carried out as described below to collect perspectives from both sides: patients as well as providers.

Results: From patient …

Clinical Practice Workflow Implementation For The Improvement Of Diabetic Metric Compliance, Sugosh Anur, Sohil Khanna, Alison Mancuso, Alexander Kowalski

Rowan-Virtua Research Day

Recent guidance suggests the management of screen-detected diabetes can be optimized using multifactorial interventions to improve overall disease burden, patient outcomes, and cost-savings. We explored preventive diabetic care and implemented interventions to increase recommended testing compliance among patients with Type II Diabetes Mellitus. This study employed a multi-faceted approach beginning with the distribution of surveys to patients in the Stratford Family Medicine Office in order to gauge their health literacy level pertaining to Diabetes management. Patient electronic medical records were evaluated to determine baseline levels for all laboratory values. Data analysis was completed using Statistical Package for the Social Sciences …

Gestational Diabetes Among The South Asian Diaspora In The United States Of America: A Scoping Review, Anudeep Deevi, Mariam Sharobeem, Gabrianna Andrews, Rahul Ubrani, Venkateswar Venkataraman

Rowan-Virtua Research Day

Aim: The scoping review was conducted to review the current knowledge base regarding gestational diabetes mellitus (GDM) among South Asians in the United States. In addition, the review was meant to identify any gaps in knowledge, specifically about the current care received by South Asians as well as the associated adverse health outcomes.

Methods: A systematic search of PubMed, Web of Science, Embase, and Scopus was conducted. Key words ""gestational diabetes South Asians in the United States" were used as search terms. Search was restricted to U.S. articles published on or after 01/01/2013 with key words. Articles were screened by …

Is There An Association Between Preeclampsia/Eclampsia And Congenital Heart Disease Among The Neurodivergent Population?, Jasmine Emanuel, Venkateswar Venkataraman, Jennifer Lecomte, Andrea Iannuzzelli

Rowan-Virtua Research Day

Preeclampsia and eclampsia are very common gestational conditions among pregnant individuals worldwide. These individuals are diagnosed with high blood pressure (after 20 weeks of gestation), proteinuria/end-stage organ disease, and may include seizures. These conditions can put the mother and fetus at risk. A review of literature has shown that there is an association between cardiovascular defects among the neurodivergent population, where these individuals have a higher risk of developing atrial septal defects and ventricular septal defects. The Rowan-Virtua Integrated Special Needs (RISN) Center patient population will be used to investigate whether preeclampsia/eclampsia in mothers is indicative of higher congenital heart …