Medicine and Health Sciences Commons^™

Endovascular Intervention And Management Of Pediatric Mandibular Arteriovenous Malformation: A Case Report, Craig Schreiber, Hamza Shaikh

Research Day

Arteriovenous malformation of the mandible are a rare and potentially life threatening entity. Exsanguination from these lesions is a well documented event. Management of these lesions is unfortunately unclear and unstandardized due to their rare occurrence. Their presentation is wide and varied ranging from complaints of a loose tooth to acute hemorrhage and shock. Currently a multidisciplinary approach that typically involves input from oral maxillofacial surgeons (OMFS), otolaryngologists, and endovascular neurointerventionalists is required to manage these lesions. Often these lesions require both endovascular intervention and surgical resection. Due to the lesions high rate of recurrence and proximity to vital structures, …

A Case Of Persistent Median Artery Splitting The Median Nerve, Nicolette Alberti, Ilana Anmuth, Justin Canakis, David Bigley, Maryanne Lubas, Kevin Amuquandoh, Michael Mcguinness

Research Day

Introduction: Development of vascular abnormalities throughout the body are not uncommon. Little insight can be found regarding the clinical manifestations and development of these irregularities in the current data, indicating that further research needs to be done in order to gain full understanding of their implications. In the current case presentation, a persistent median artery (PMA) was identified in the left forearm of a cadaver. Normal vasculature of the forearm proceeds as follows; the brachial artery splits into the radial and ulnar arteries. The common interosseous artery branches off of the ulnar artery and then splits into an anterior and …

Evaluating The Neuropsychological Presentation Of Traumatic Brain Injuries, Eric Boxer, Sarah Levin Allen

Research Day

This Neurobehavioral Capstone focused on traumatic brain injury (TBI), which is one of the leading causes of death and disability in the United States for children and young adults. TBI refers to a disruption of the brain’s normal functioning as a result of an acute external force. The most common causes for a TBI include falls, vehicular accidents, struck by or against an object, and assaults. The incidence for each cause of a TBI changes with respect to age. Severity of a TBI is determined using the Glasgow Coma Scale, which monitors the patient’s eye movements, verbal response and motor …

Neurobehavior In Humans And Its Role In Alzheimer's Disease, Aghilas Belkadi, Sarah Levin Allen

Research Day

In a neurobehavioral lens, a human is defined as the balance of the mind, body, and brain. These systems function on their own and influence each other in a dynamic equilibrium. Interactions between these systems are observed in every aspect of life. A pathological example of this relationship is that depression, a state of mind, can increase the risk of developing cardiovascular diseases. By studying a neurobehavioral model of health, empirical links between psychology and neurobiology can be uncovered. The basis of this capstone is to understand how neurobehavior works in clinical practice. This capstone project involved observation of seniors …

Sluggish Cognitive Tempo In Latino Youth, Katie Binns Fabius, Susan Panichelli Mindel

Research Day

Sluggish Cognitive Tempo (SCT) is seen in some children and may include: daydreaming, inconsistent alertness, absentmindedness, behaving or thinking slowly, appearing tired after enough sleep, and lacking energy. The symptoms can be divided into two domains: cognitive and behavioral. SCT is associated with Attention Deficit Hyperactivity Disorder (ADHD). SCT can impact academic and social functioning and be associated with elevated anxiety and depression. Literature on SCT focuses mainly on Caucasian children.

Objectives: To examine the prevalence of SCT and external correlates in a case study of four Latino children.

Methods: A case study where parents completed questionnaires about their child’s …

Modulation Of Nitric Oxide Release In Cultured Human Umbilical Vein Endothelial Cells By Myristoylated-Pkc Epsilon Activator/Inhibitor Peptides, George Ajene, Tameka Dean, Chantel Thompson, Wesley Hwang, Francis Jenney, Robert J. Barsotti, Qian Chen, Lindon H. Young

Research Day

Protein kinase C epsilon (PKCε) is known to increase endothelial nitric oxide synthase (eNOS) activity and subsequent nitric oxide (NO) release via phosphorylation at serine 1177 of eNOS in previous in vitro and in vivo animal studies under normoxic conditions. However, the role of PKCε regulating eNOS activity and NO release is not well known in human endothelial cells. Moreover, understanding the role of PKCε in regulating eNOS activity would be essential in the clinical setting of myocardial infarction. Re-establishing blood flow after thrombus removal results in endothelial dysfunction and is characterized by decreased NO bioavailability and excess reactive oxygen …

Bioactive Peptides™ To Aid In Healing Of Chronic Skin Wounds And Tissue Repair, Elizabeth Brehman, Jonathan Mclaughlin, Stephanie Scianni, Charlotte H. Greene Phd, George Petito

Research Day

When wound healing of cutaneous tissue becomes problematic, it increases patient morbidity associated with increased infection, demand on medical resources, and asserts a profound detrimental effect on the individual’s quality of life. Currently, there are limited effective strategies for addressing chronic cutaneous wounds. The study reported here is based upon the understanding that individual skin wounds may preferentially require differing proteinaceous precursors during specific phases of skin wound repair and calls attention to the possibilities in the reexamination of traditional treatments such as plant and animal-derived substances among many others. This study aimed to determine if, and which, amino acid …

The Effect Of Caffeic Acid Phenethyl Ester (Cape) On H2o2-Induced Oxidative Stress In Cultured H9c2 Cells Compared To Common Antioxidants, Dylan Lefkowitz, Robinderpal Sandhu, Alisa Kim, Andrew Castellano, Peter Wieczorek, Robert J. Barsotti, Lindon H. Young, Qian Chen

Research Day

Caffeic Acid Phenethyl Ester (CAPE) is a natural compound that has previously exhibited anti-proliferative, anti-inflammation and antioxidant activities. However, CAPE’s effects have not been fully elucidated in myoblasts under oxidative stress. We compared the effects of 24 hour pretreatment of CAPE to several known antioxidants (caffeic acid, vitamin C, and trolox) in H9c2 cells following oxidative injury by hydrogen peroxide (H2O2). H9c2 cells incubated with H2O2 treatment (100-700 μM, n=4) for 24 hours dose-dependently reduced cell viability (assessed by a cell counting assay). Compared to the reduction in viability from H2O2 500 μM treatment (22 ± 4%), H9c2 cell viability …

Creating A Collaborative Space: Going From Drab To Fab, Pj Grier Jr, Matt Mcnelis

Research Day

In 2017 the PA-PCOM library transformed a space into a dynamic collaborative laboratory, a.k.a. “Collab”. Steps taken to transform space included:

• New mobile furniture
• Installation of 55” touchscreen computer and software
• New painting with accent wall
• Creation of digital user guide and accessory kit

Synergistic Effects Of Methylglyoxal And Hyperglycemia On Ros Generation And The Viability Of Cultured H9c2 Myoblast Cells, Robinderpal Sandhu, Dylan Lefkovitz, Al Ibe, Alisa Kim, Peter Wieczorek, Dean Delgado, Robert J. Barsotti, Lindon H. Young, Qian Chen

Research Day

Heart damage in diabetics may be closely related to the possible synergistic cellular damage from hyperglycemia and increased methylglyoxal levels. This study investigated the effects of glucose and/or methylglyoxal and/or metformin on H9c2 reactive oxygen species (ROS) generation measured by a dichlorofluorescein diacetate (DCFDA) assay and cell viability measured by a cell counting kit-8 assay after various treatments for 24 hours.

Glucose treatment (5 mM-40 mM) displayed similar cell viability (n=4) and ROS generation (n=7) when compared to control cells. By contrast, methylglyoxal (5 µM-1400 µM) decreased cell viability at higher concentration (1000 µM (51 ± 8%); 1200 µM (41 …

Liposclerosing Myxofibrous Tumor Of The Cranial Vault, Jillian Ploof, Hamza Shaikh, Jenny Melli, George Jour, Alan Turtz

Research Day

Background and Importance: Liposclerosing myxofibrous tumor (LSMFT) are rare benign fibro-osseous tumors most frequently occurring in the proximal femur. We report the first case of this rare tumor occurring within the calvarium.

Clinical Presentation: Our patient presented with a 2-year history of enlarging, painless, fixed mass over the left forehead. She underwent surgical resection and the mass was histologically confirmed to be a liposclerosing myxofibrous tumor.

Conclusion: LSMFT is a rare tumor that should remain on the differential for lesions of the calvarium. When diagnosed, this lesion can be removed with the goal of gross total resection and …

Epithelioid Glioblastoma Presenting As Aphasia In A Young Adult With Ovarian Cancer: A Case Report, Megan M. Finneran, Joseph Georges, Michael Kakareka, Ryan Moncman, Miriam Enriquez, Alan Turtz, Steven S. Yocom, H Warren Goldman, James Barresse

Research Day

Background: Epithelioid glioblastoma (eGBM) is a recent addition to the World Health Organization’s classification of central nervous system (CNS) tumors. This rare lesion has a predilection for younger patients, can mimic metastatic disease on preoperative imaging and intraoperative pathology, and portends a poor prognosis due to propensity for leptomeningeal dissemination.

Case Description: We discuss a case of a young woman with a history of ovarian cancer who presented with seizure and a new ring-enhancing left temporal brain lesion. The patient underwent gross-total surgical resection of this lesion, during which frozen section suggested metastasis. However, pathologic interrogation showed pleomorphic epithelioid cells …

Fluorescence-Guided Stereotactic Biopsy: A Proof-Of-Concept Study, Robert Lynagh, Joseph Georges, Mark Ishak, Brandon Boyer, Steven S. Yocom, Denah Appelt

Research Day

Introduction: Histopathological diagnoses are often necessary for treating neuro-oncology patients. However, stereotactic biopsy (STB), a common method for obtaining tissue from deep or eloquent brain regions, fails to yield diagnostic tissue in approximately 10% of cases. This can delay initiation of treatment and may result in further invasive procedures for patients. Here, we evaluate if coupling in vivo optical imaging with a STB system can identify diagnostic tissue at the time of biopsy.

Methods: A minimally invasive fiber optic imaging system was developed by coupling a 0.65mm diameter fiber optic fluorescence microendoscope to a STB system. Human glioma …

Penoscrotal Transposition: A Cadaveric Review, Paul Lecker, Dominic Parfianowicz, Jayaram Kumaraswamy, Sean Deangelo, Michael Mcguinness

Research Day

Introduction: With only 20 documented cases, the congenital malformation known as complete extreme penoscrotal transposition with an intact scrotum, midline raphe, and absence of hypospadias is an extremely rare abnormality. Penoscrotal transposition occurs when the scrotum fuses above the penis for a complete abnormality or does not fuse at all for an incomplete abnormality. This failure of the scrotum to descend below the penis occurs during development, when the genital swellings fail to descend below the penis and fuse. The irregularity has been known to follow an X-linked recessive pattern in some cases. In others, it results from a …

Strategies For Bridging Gaps Between Diversity, Academics, And Community/Clinical Partnerships, Joseph Morris Rn, Phd, Mary Dickow Mpa, Faan, Sharon Goldfarb Rn, Msn, Fnp

Community Engagement Theme

The academic‐practice gap has been well documented for over four decades in the literature, and current literature suggests the viewpoints of academic and practice leaders remain divergent. Closing this gap will require a dedicated and coordinated response from both academia and the clinical practice institutions. Additionally, diversity in the Nursing field is essential because it provides opportunities to administer quality care to patients. Goals: The panelists will share their unique perspectives and offer Strategies for Bridging Gaps between Diversity, Academics, and Community/Clinical Partnerships.

Fatal Case Of Ttp In Patient With Underlying Pulmonary Aspergillosis, Shimool A. Rabbani, Ankit Shah, Joan Wiley, Jay Kirkham

Rowan-Virtua Research Day

A 70-year- old Caucasian male with history of renal transplant on tacrolimus presented with 5-days of fevers, productive cough, and confusion. Patient was initially diagnosed with pneumonia, presumed bacterial, but soon noted to have worsening neurologic status, renal failure, and respiratory failure requiring mechanical ventilation. He further developed thrombotic microangiopathy (TMA); TMA along with the other clinical findings led to diagnosis of Thrombotic Thrombocytopenic Purpura (TTP). Despite aggressive treatment of TTP with plasmapheresis, patient expired on day five of his hospitalization. Fungal cultures from a bronchoscope performed on day three of hospitalization that resulted postmortem grew many aspergillus flavus and …

Gist- An Unusual Case Of Gi Bleeding, Lucy Joo, Justin Derosa, Drew Chiesa, Darshan Roy

Rowan-Virtua Research Day

This is a unique case of a female who was diagnosed and treated with a GIST (gastrointestinal stromal cell tumor) of the stomach.The purpose is to deliver awareness and education to clinicians of this rare malignancy by emphasizing its presentation and characteristics.

Effects Of Vitamin D Supplementation, Keith R. Anacker, Adarsh K. Gupta

Rowan-Virtua Research Day

Vitamin D (1,25-dihydroxycholecalciferol) is known to be a fat soluble vitamin. We hypothesized that losing weight would thus cause an increase in serum vitamin D levels. To investigate this, a retrospective chart review was performed in which data including sex, age, race, serum Vitamin D levels, body weight and more, of 200 Rowan SOM Family Medicine patients for up to 6 doctor’s office visits each were collected. These data were then analyzed using Microsoft Excel and IBM SPSS. We found while there was a significant positive correlation between weight loss and serum Vitamin D levels, there was not a significant …

A Case Of Signet Ring Cell Colon Carcinoma Initially Presenting As Acute Diverticulitis, Justin Derosa, Jonathan Foster, Drew Chiesa, Darshan Roy

Rowan-Virtua Research Day

This is a unique case of a female with an acute bout of diverticulitis who six weeks later on follow up colonoscopy, was found to have signet ring cell colon carcinoma. The purpose is to deliver awareness of this rare type of colon malignancy, emphasize the continued need for screening colonoscopy, and to provide the reader with a distinct and thought provoking spin on the conventional diagnosis of diverticulitis.

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Healthcare Provider Attitudes Toward Personalized Care Plan Development, Kafi Rudolph, Adarsh Gupta

Rowan-Virtua Research Day

Background: Prevention care plans are created by healthcare workers to direct patient care and are guidelines to optimize patient health. The care plans include actions patients can take to prevent worsening of chronic conditions and potentially decrease hospitalizations. The current research project was conducted to assess satisfaction of using automated personalized care plans among healthcare providers, which can increase office visit efficiency.

Myeloid Sarcoma: A Rare Cause Of Small Bowel Obstruction, Jonathan Sedeyn, Karlbuto Alexandre, Alan J. Sheinbaum, Adeshola Fakulujo

Rowan-Virtua Research Day

Myeloid sarcoma is a rare and aggressive tumor of myelogenous origin that uncommonly presents in the small bowel. Here we describe the case of a 29 year old male with a two week history of worsening abdominal pain associated with nausea and bilious vomiting. The patient displayed tenderness in the epigastric and periumbilical region with grossly normal lab values. On CT he was found to have a small bowel obstruction with a transition point in the pelvis. Exploration revealed a small bowel mass located approximately 12 cm from the ileocecal valve. Pathological analysis showed large malignant cells with a high …

A Case Of Synchronous Colorectal Carcinoma Manifested As Three Separate Colon Masses, Alyssa Imperatore, Linda Szczurek, Alan Shienbaum

Rowan-Virtua Research Day

Colorectal cancer is the second leading cause of cancer-related deaths in the United States amongst cancers that affect both genders. Synchronous colorectal cancer is greater than one primary lesion detected on initial presentation and occurs about 5% of the time.

This is a 78 year-old female with past medical history of left-sided breast cancer treated with neoadjuvant chemotherapy who presented with symptomatic anemia found to have a hemoglobin of five and positive fecal occult blood test. Patient was transfused and taken for EGD/colonoscopy, which showed three polypoid rectal lesions and three separate colon masses. Preliminary pathology showed high grade dysplasia …

Osteopathic Manipulative Medicine In Pregnancy, Xinhua Chen, Maria Nguyen, Sophia Vogiatzidakis

Rowan-Virtua Research Day

Women experience physiologic and structural changes during pregnancy. Osteopathic manipulative medicine (OMM) involves the examination of the whole patient, including body, mind, and spirit. This involves treatment of any stresses placed on the body, including the structural changes in the maternal body. Clinical studies thus far on OMM in pregnancy have shown when used during pregnancy, it improves musculoskeletal pain such as low back pain, and may positively affect some labor and delivery outcomes. The purpose of this study was to evaluate the effectiveness of OMM during pregnancy in reducing the rate of cesarean section and several other labor and …

Maps-Snma Shad.O.W D.O. Day Rowan Som Pipeline Program: A Pilot Study, Taiwo Ajumobi, K. Millar, Hina Mujadad, Yessica Manzo, Tashawni Channer, Cassandra Ramirez, Nkechiyere Eboka, Paula Watkins, Linda Boyd

Rowan-Virtua Research Day

Prior to being a medical student, a majority of pre-medical students have not encountered the course load intensity, academic rigor, and time management required by a medical school curriculum. Diversifying the workforce has been shown to have benefits, especially at the micro or patient level, since having racial or ethnic concordance between providers and patients has been associated with increased levels of satisfaction and improvements in certain clinical outcomes. The number of MDs increased to 841,321 or 91.8% versus 72,961 DOs or 8.0% creating the need for minorities to be knowledgeable of both MD and DO paths to becoming a …

A Rare But Life Threatening Case Of Labile Blood Pressures In Pregnancy, Kelsey Carrio, Aarti Aggarwal, Susan Mcgroarty

Rowan-Virtua Research Day

Pheochromocytoma is a rare but life threatening adrenal secreting tumor. The infrequency with which it is encountered makes pheochromocytoma, especially in pregnancy, a formidable diagnostic challenge.

Although a pheochromocytoma is rare, it is good to keep it in differential diagnosis as a possible cause of labile BP with headaches and significant orthostatic BP. It is critical to recognize this condition to institute an appropriate therapy & surgical intervention to prevent mortality.

Metastatic Breast Cancer Presenting As Painless Jaundice, Daniel S. Wilen, Donald J. Mcmahon, Brian J. Blair, Joanne Kaiser-Smith, Darshan B. Roy

Rowan-Virtua Research Day

Breast cancer is the most commonly diagnosed cancer in women in the United States. Treatment options are wide-­‐ ranging based on a multitude of factors, including extent of disease and receptor positivity. Following treatment, a relapse-­‐free interval ≥ 2 years carries a more favorable prognosis.

We present a case involving a female with history of breast cancer and relapse-­free interval of 15 years who unfortunately presented with metastatic disease involving the liver, bone, and lymph nodes.

Associations Of Maternal Plasma Free Fatty Acid Profiles With Markers Of Inflammation In Healthy Pregnant Women, Xinhua Chen, Thomas P. Stein, Theresa O. Scholl, Robert A. Steer

Rowan-Virtua Research Day

We investigated the relationship between maternal fasting plasma free fatty acid (FFA) profiles and markers of inflammation (MOI) (IL-6, 8, 10, TNF-α, granulocyte macrophage colony-stimulating factor (GMCSF) and resistin) in healthy pregnant women during early gestation (week 16).

These data suggested that maternal functional long-chain FFAs influence inflammatory response during normal pregnancy. Changes in specific FFA composition may reduce low-grade inflammation and inflammation related poor pregnancy outcomes and complications.

Development Of Novel Dual Inhibitor Of Chemokine Receptor 4 And Mcl-1 Against Multiple Myeloma, Kuntal Bhowmick, Kristy K. Patel, Suman Pathi, Subash Jonnalagadda, Tulin Budak-Alpdogan, Manoj K. Pandey

Rowan-Virtua Research Day

Multiple myeloma (MM) is a neoplastic plasma-cell disorder. This is characterized by clonal proliferation of malignant plasma cells in the bone-marrow (BM) microenvironment, monoclonal protein in blood or urine, and associated organ dysfunction. The treatment options approved by FDA are immune-modulatory agents, proteasome inhibitors, and autologous stem cell transplantation (ASCT). Unfortunately, MM remains uniformly fatal owing to intrinsic or acquired drug resistance and the median survival time is 3 to 5 years. Thus, there is a great need for novel strategies to combat MM.

The intimate relationship of myeloma cells to BM microenvironment is “hallmark of myeloma”. The homing of …

Dexmedetomidine (Precedex) Induced Fever, Patrick Dealmeida, Michael Matrale

Rowan-Virtua Research Day

Precedex is an intravenous, α-2 receptor agonist broadly used for analgesia, maintenance of sedation, and alcohol withdrawal treatment in the intensive care unit (ICU).

The most commonly reported adverse effects associated with precedex are hypotension and bradycardia1.

Fever has been reported with a 5-7% incidence rate. Our case shows a very impressive pyrexia in a 49 year old patient most likely associated to Precedex. When compared to the previously three reported cases his fever reached the largest value (T= 107ºF).

As its use becomes more and more common in the ICU, clinicians should be aware of this adverse effect especially …

Wearable Fitness Tracking Improves Self-Efficacy For Exercise, Adam Sturts, Adarsh Gupta

Rowan-Virtua Research Day

The present study was designed to determine the impact of wearable fitness tracking technology use on physical activity and self-efficacy for exercise among wearable fitness device users. This was a cross sectional study. A single questionnaire was administered to participants, providing patient data pertaining to wearable fitness tracking device use, exercise habits and intrinsic self-efficacy for exercise. Wearable fitness tracking device users were found to have higher levels of self-efficacy for exercise than non-users across all participating ages, genders and ethnicities. In addition, wearable fitness device users reported increased engagement in physical activity with the concomitant use of their devices. …