Medicine and Health Sciences Commons^™

Reframing The Ed–Hospitalist Admission As A Clinical Handoff: The Ed To Hospital Admission As A Cross-System Handoff In A Complex Adaptive Clinical Environment. The Case For Systems Approaches To Enhance Safe And Effective Transitions Across A True System Interface, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Background

Transitions from the Emergency Department (ED) to hospital medicine represent a high-stakes clinical handoff across systems. While often experienced as challenging, these interactions are better understood as occurring between services operating under different cognitive loads, operational priorities, and time horizons. Reframing the ED–hospitalist admission as a structured handoff aligns this process with broader patient safety efforts.

Objective

To characterize the ED–hospitalist admission as a cross-system clinical handoff and to identify practical strategies that enhance safety, clarity, and alignment during this transition.

Methods

Conceptual analysis informed by clinical experience, systems theory, and teaching observations. Key domains of potential misalignment were …

Title: Impact Of Hypertriglyceridemia ≥500 Mg/Dl On Acute Pancreatitis Outcomes: A Propensity Score–Matched Cohort Study, Jashanveer S. Johal, Bianca Patel, Mahmoud Al-Bataineh, Archana Salek, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Hypertriglyceridemia is a recognized cause of acute pancreatitis, but the prognostic impact of markedly elevated triglycerides (TG) on clinical outcomes remains unclear. We evaluated whether TG ≥500 mg/dL at presentation predicts worse pancreatitis outcomes.

Methods: Using the TriNetX multicenter electronic health record network, adults hospitalized with acute pancreatitis and a TG measurement within 48 hours of admission between 2018–2024 were identified. Patients with TG ≥500 mg/dL were compared with those with TG < 500 mg/dL after 1:1 propensity score matching on demographics and comorbidities (n=7,014 per group). Primary outcomes included ICU stay, pancreatic complications, need for procedure, and all-cause mortality. Secondary outcomes included acute renal failure, cardiovascular events, repeat pancreatitis, infection, and liver failure. Odds ratios (OR) with 95% confidence intervals were estimated.

Results: Compared with TG < 500 mg/dL, patients with TG ≥500 mg/dL had higher risks of ICU admission (25.3% vs. 17.2%; OR 1.63), pancreatic complications (5.3% vs. 4.5%; OR 1.19), and mortality (4.6% vs. 3.3%; OR 1.39). Need for procedural intervention was lower in the high-TG group (1.2% vs. 3.6%; OR 0.34). Secondary outcomes including acute renal failure (15.5% vs. 10.7%; OR 1.54), repeat pancreatitis (58.6% vs. 51.9%; OR 1.31), and infection (13.7% vs. 12.0%; OR 1.17) were all significantly elevated. Cardiovascular events and liver failure did not differ significantly.

Conclusions: TG ≥500 mg/dL in acute pancreatitis was associated with greater ICU utilization, complications, and mortality, but lower procedural intervention rates. Admission triglyceride …

Glp-1 Receptor Agonists And Neurocognitive Outcomes In Type 2 Diabetes: A Propensity-Matched Real-World Analysis Of Cognitive Impairment, Neurodegeneration, And Mortality, Om Patel, Shefali Waghray Do, Jashanveer S. Johal, Jason Hyman, Tatiana Gandrabura

Rowan-Virtua Research Day

Background: GLP-1 receptor agonists improve glycemic and cardiovascular outcomes in type 2 diabetes mellitus (T2DM), but their impact on neurocognitive and neurological outcomes remains incompletely characterized. We evaluated the association between GLP-1 agonist use and incident cognitive impairment, neurodegeneration, and healthcare utilization in T2DM patients without baseline cognitive deficits.

Methods: A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Adults (≥40 years) with T2DM and no prior cognitive impairment, Alzheimer's disease, Parkinson's disease, multiple sclerosis, or cerebral infarction were identified. Cohort 1 received a GLP-1 agonist (semaglutide, tirzepatide, liraglutide, or dulaglutide) after T2DM diagnosis; Cohort 2 received …

A Retrospective Comparison Of Dobhoff Nasogastric Feeding Tubes To Iris Feeding Tubes, Nishant Patel Oms-Iii, Justin Le Oms-Ii, Amy Glasofer Phd, Drnp, Rn, Emilio Mazza Md, Phd

Rowan-Virtua Research Day

Background

Postpyloric feeding is essential in critically ill patients. Traditional Dobhoff tube (DHT) placement, often performed blindly, is widely used due to low cost but carries risks of misplacement and reliance on radiographic confirmation. In contrast, Kangaroo™ IRIS (camera-guided) technology enables real-time visualization during placement, potentially improving accuracy and workflow, though at higher cost.

Hypothesis

IRIS-guided placement provides comparable safety and success to DHT, with similar procedural efficacy without increasing complications.

Methods

A retrospective cohort study was conducted using the electronic medical records from multiple Virtua Health hospitals (01/01/13, through 01/31/25), including 200 patients undergoing nasogastric tube placement with DHT …

In The Era Of The Smartphone: The Case For The Continued Role Of Mnemonics As Cognitive Scaffolds That Support Encoding, Working Memory Efficiency, And Rapid Cue-Dependent Retrieval, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: The ubiquity of smartphones and point-of-care digital references has prompted questions regarding the continued relevance of mnemonic devices in medical education. If information can be instantly retrieved, is memorization—and by extension mnemonic structure—still necessary? Objective: To reframe mnemonics not as relics of pre-digital pedagogy, but as cognitive scaffolds that support encoding, working memory efficiency, and rapid cue-dependent retrieval in time-pressured clinical environments. Discussion: Cognitive science demonstrates that working memory remains inherently limited regardless of technological access. Mnemonics function as structured chunks that reduce cognitive load, support pattern recognition, and facilitate transition from novice encoding to expert automaticity. In emergency …

Training Vs. Reality: The Challenges Of Preventing Heat-Related Illness In Migrant Farmworkers, Sonya Homami

Rowan-Virtua Research Day

Background: Heat‑Related Illness (HRI) is a major occupational hazard for migrant farmworkers, who are 35 times more likely to die from HRI than workers in other industries. Although HRI training aims to improve prevention knowledge, its effect on actual HRI outcomes is unclear.

Methods: Following PRISMA guidelines, a systematic review of PubMed, Embase, and Web of Science identified studies evaluating HRI training and reporting HRI prevalence or related symptoms. Fifteen studies met inclusion criteria.

Results: HRI training did not reduce HRI prevalence or provide protective effects. Training increased reporting of workplace injuries and concern about HRI. Despite high training uptake—over …

Worsening Obsessive Compulsive Disorder (Ocd) With New Onset Dementia, Melvin D. Ways Jr

Rowan-Virtua Research Day

Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition typically characterized by intrusive thoughts and repetitive behaviors with preserved insight. Dementia, a progressive neurocognitive disorder, is frequently associated with behavioral and psychiatric symptoms; however, its impact on pre-existing OCD is less well understood.

Subject of study includes evaluation of neurodegenerative processes to exacerbate pre-existing OCD symptoms. Evidence suggests that dysfunction in shared fronto-striatal circuits—particularly involving the orbitofrontal cortex and basal ganglia—may underlie this relationship. Additionally, cognitive impairment may reduce the ability to inhibit intrusive thoughts, further reinforcing compulsive behaviors. Emerging research also indicates a bidirectional association, with OCD linked to an …

Physician Bedside Communication Posture (Sitting Versus Standing) In Relation To Patient Satisfaction: A Focused Literature Review And Areas For Potential Research, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background:

Sitting during patient encounters is commonly recommended in communication training, with the assumption that it improves patient satisfaction. However, the empirical evidence supporting this recommendation in Emergency Department (ED) settings appears limited.

Objective:

To review the existing literature examining physician posture (sitting versus standing) and its association with patient satisfaction and perceived communication quality.

Methods:

Narrative review of ED and non-ED studies evaluating posture during clinical encounters, with attention to study design, sample size, setting, and outcome measures.

Results:

ED-specific evidence remains heterogeneous. Some studies demonstrate that sitting increases patients’ perception of time spent at bedside without increasing actual …

Case Study: 46-Year-Old Female With Auditory Hallucinations, Ahmed Aly, Tayeb Ahamed, Chien Y. Cepeda, Apn

Rowan-Virtua Research Day

The case study discusses a patient seen at a voluntary psychiatric unit. Patient has been prescribed benzodiazepine and bupropion; she became dependent on the benzodiazepine due to social difficulties that have not been addressed by her prescriber. The study highlights the dependency of benzodiazepine while being offered bupropion (which lowers seizure threshold), which can be deadly if accompanied with benzodiazepine withdrawal

Beyond Glycemic Control: A Comparative Analysis Of Dapagliflozin Vs Empagliflozin, Wesley Augustus Kim, Heaven Chu, Kayla Ancheta, Nicole Shellenbarger, Sophia Ginet, Akash Patel

Rowan-Virtua Research Day

SGLT2 inhibitors have emerged as a drug class with cardiorenal benefits beyond glycemic control in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). This review compares two widely used SGLT2 inhibitors dapagliflozin and empagliflozin across efficacy, safety, and cost-effectiveness outcomes in patients with comorbid CKD and T2DM. A systematic literature search of PubMed, Scopus, and Embase yielded 10 final articles after screening. Both agents demonstrated comparable cardiorenal benefits, with dapagliflozin showing advantages in weight, blood pressure, and glycemic markers, while empagliflozin proved more cost-effective for CKD-specific disease management. Neither drug demonstrated significant safety concerns over placebo …

Weight Loss Strategy Disparities Among Anti-Obesity Medication-Eligible Us Adults: A Cross-Sectional Nhanes Analysis, Harshal Parmar, Akhila Archakam, Hitesh Gowda, Leonard Powell

Rowan-Virtua Research Day

Background: Nearly half of US adults meet FDA criteria for anti-obesity pharmacotherapy (AOM), yet utilization remains low. Recent GLP-1RAs prescribing has intensified focus on access disparities, but how weight loss strategy selection varies by social determinants among AOM-eligible adults is poorly understood.

Hypothesis: Weight loss strategy selection among AOM-eligible adults varies by race/ethnicity and food security status, with food insecure populations likely to use maladaptive strategies.

Methods: Survey-weighted cross-sectional analysis of NHANES 2017–March 2020. AOM eligibility: BMI ≥30 or BMI ≥27 with cardiometabolic comorbidity. Among adults reporting past-year weight loss attempts (n=2,100; weighted N=59.5 million), 19 self-reported strategies were compared …

Irritability And Related Behavioral Adverse Events Associated With Levetiracetam: A Meta‑Analysis And Meta‑Regression Of Randomized Trials, Ana Leticia Fornari Caprara Md, Daarsh Goradia, Nishant Patel, Jarvish Shah, Pranaya Gade, Jamir Pitton Rissardo Md

Rowan-Virtua Research Day

Background: Levetiracetam is commonly used in epilepsy management but has been associated with irritability‑predominant aggressive behavioral adverse events, including irritability and aggression. Reported risks vary across trials, and the influence of comparator type and outcome definition remains unclear. We aimed to estimate the risk of irritability‑related aggressive behavioral adverse events associated with levetiracetam and to assess whether outcome definition or comparator subgroup modifies this risk. Methods: We searched ClinicalTrials.gov for interventional trials with posted results involving levetiracetam. Studies reporting irritability, aggression, agitation, or related irritability‑driven behaviors in comparisons with placebo or another antiseizure medication were included. Random‑effects Mantel–Haenszel meta‑analyses were …

Wearable And Technology‑Assisted Gait And Balance Interventions In Parkinson’S Disease: A Systematic Review And Meta‑Analysis, Jamir Pitton Rissardo Md, Nishant Patel, Jarvish Shah, Daarsh Goradia, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Background: Wearable sensors and cue‑based technologies are increasingly used to augment rehabilitation in Parkinson’s disease (PD). However, the magnitude of benefit across clinical domains remains uncertain. Objective: This meta‑analysis aimed to quantify the effects of technology‑assisted interventions in PD. Methods: Randomized controlled trials evaluating wearable‑assisted interventions were systematically identified from PubMed. Outcomes included motor severity (Movement Disorders Society Unified Parkinson Disease Rating Scale Part III), balance (Berg Balance Scale, Mini‑BESTest, POMA balance), gait speed, walking endurance, freezing of gait (FOG‑Q/NFOG‑Q), fear of falling, and quality-of-life (PDQ‑39/PDQ‑8). Meta‑analyses were performed using random‑effects models to account for between‑study heterogeneity. Statistical heterogeneity was …

Trends And Disparities In Mortality Involving Epilepsy And Aspiration Pneumonia Among Older Adults In The United States, 1999–2020, Pranaya Gade, Jarvish Shah, Daarsh Goradia, Nishant Patel, Jamir Pitton Rissardo Md, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Introduction: Epilepsy in older adults is frequently complicated by swallowing dysfunction, increasing the risk of aspiration pneumonia. Despite its clinical relevance, national trends and demographic disparities in deaths involving these conditions remain poorly characterized. Methods: We analyzed death certificate data from the CDC WONDER Multiple Cause of Death database (1999–2020) for individuals aged ≥65 years with epilepsy (ICD-10 G40, G41) and aspiration pneumonia (J69) listed as causes. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percentage changes (APCs) with 95% confidence intervals were calculated using Joinpoint Regression. Analyses were stratified by sex, race/ethnicity, census region, and state. Results: From 1999 …

Cerebrospinal Fluid And Serum Manganese Levels In Parkinson’S Disease: A Method‑Stratified Meta‑Analysis, Jamir Pitton Rissardo Md, Daarsh Goradia, Jarvish Shah, Nishant Patel, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Background: Manganese (Mn) exposure can cause parkinsonism, but circulating and cerebrospinal fluid (CSF) Mn levels in idiopathic Parkinson’s disease (PD) have been reported inconsistently. This study aims to determine whether Mn concentrations differ between patients with PD. Methods: A systematic review of PubMed/Medline studies reporting CSF/serum Mn concentrations in PD was done. Random‑effects models with inverse‑variance weighting were used to pool mean differences (MDs). Studies were stratified a priori by analytical method. Results: For CSF Mn, the overall pooled effect showed no significant difference between PD and controls (MD 0.08 μg/L, 95% CI −0.31 to 0.47; I2=85.7%). Subgroup analysis revealed …

Efficacy And Safety Of Levetiracetam For Essential Tremor: A Systematic Review And Meta‑Analysis, Jamir Pitton Rissardo, Daarsh Goradia, Nishant Patel, Jarvish Shah, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Background: Essential tremor (ET) is a common movement disorder with limited therapeutic options. Levetiracetam has been proposed as a potential treatment, but published studies report inconsistent efficacy and safety findings. We performed a meta‑analysis to quantify the efficacy and safety of levetiracetam in patients with essential tremor using pooled effect estimates. Methods: A systematic review of PubMed was performed to identify clinical studies evaluating levetiracetam for ET. Continuous efficacy outcomes were pooled using standardized mean differences (SMD) with inverse‑variance random‑effects models. Binary adverse events were pooled using risk ratios (RR) with Mantel–Haenszel random‑effects models. Heterogeneity was assessed using I2 statistics. …

Effects Of Subthalamic Nucleus Deep Brain Stimulation On Depressive Symptoms In Patients With Parkinson’S Disease: A Meta‑Analysis, Jamir Pitton Rissardo Md, Jarvish Shah, Nishant Patel, Daarsh Goradia, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Background: Depression is a prevalent non‑motor symptom of Parkinson’s disease (PD) and may adversely affect quality-of-life and overall treatment outcomes. Subthalamic nucleus deep brain stimulation (STN‑DBS) is an established therapy for motor symptoms, yet its impact on depressive symptoms remains controversial. This meta‑analysis aimed to evaluate the effect of STN‑DBS on depressive symptoms in PD. Methods: PubMed‑indexed studies meeting predefined eligibility criteria were identified and included. Random‑effects meta‑analyses were performed using REML. Mean differences (MDs) between STN‑DBS and control conditions were pooled separately for Beck Depression Inventory (BDI) and its revision (BDI-II), and the Hamilton Depression Rating Scale (HAMD). Heterogeneity …

Efficacy And Safety Of Droxidopa For Neurogenic Orthostatic Hypotension: A Systematic Review And Meta‑Analysis, Jamir Pitton Rissardo, Jarvish Shah, Nishant Patel, Daarsh Goradia, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Neurogenic orthostatic hypotension (nOH) causes disabling symptoms such as dizziness, impaired daily activities, and increased fall risk. Droxidopa is approved for symptomatic treatment, but individual trials have reported heterogeneous results across outcomes and populations. We aim to evaluate the efficacy of droxidopa on symptoms, functional impact, blood pressure, and safety outcomes in patients with nOH. Methods: We conducted a systematic review and meta‑analysis of randomized controlled trials comparing droxidopa with placebo in nOH. Continuous outcomes were pooled using random‑effects models with standardized mean difference (SMD) for symptom scales and mean difference (MD) for standing systolic blood pressure (SBP). Binary outcomes …

Rowan-Virtua School Of Osteopathic Medicine’S Planetary Pulse: Charting A Course For Planetary Health Excellence, Hope A. Beyer, Deborah Podolin

Rowan-Virtua Research Day

Objective: Despite international acceptance of climate change as the largest threat towards human health, American osteopathic institutions fall short of their allopathic colleagues in adopting a planetary health curriculum. This study (1) evaluates the desire of Rowan-Virtua School of Osteopathic Medicine (Rowan-Virtua SOM) students to learn about planetary health within their medical education, (2) assesses the current planetary health infrastructure supported by Rowan-Virtua SOM and their parent institution, Rowan University, and (3) proposes an adapted planetary health equity curriculum.

Methods: Medical student interest was gauged by use of a Qualtrics survey modeled off of Dr. Karly Hampshire’s 2020 survey of …

Comparative Efficacy Of Cognitive Behavioral Therapy And Intranasal Oxytocin In Adolescent Anorexia Nervosa, Nikhila P. Archakam, Akhila P. Archakam, Wesley A. Kim, Harshal Parmar, Iram Fatima

Rowan-Virtua Research Day

Anorexia nervosa (AN) is a severe and potentially life-threatening psychiatric disorder with the highest mortality rate among psychiatric illnesses affecting adolescents.¹ It is characterized by extreme restriction of caloric intake driven by an intense fear of weight gain or negative body image perception.¹ Mortality results from medical complications of starvation and an increased prevalence of suicide risk.¹ Although AN can occur at any point across the lifespan, it most commonly first presents during adolescence.¹ This developmental period is marked by significant hormonal, biological, and psychosocial changes. Early-onset AN is associated with stunted growth, pubertal delay, and long-term cognitive and emotional …

Barriers To Asthma Management And Specialty Care Among Low-Income Families In South Jersey, Sally Park, Courtney Ray-Fofana, Christal Onwuegbule

Rowan-Virtua Research Day

Asthma is a chronic respiratory condition that remains a significant public health concern, particularly among low-income and underserved populations. This poster presents a focused review of existing literature and publicly available data to examine barriers to asthma management and access to specialty care in South Jersey, with emphasis on counties such as Camden, Atlantic, and Cumberland.

Data were synthesized from sources including PubMed, the New Jersey Department of Health, and the National Institutes of Health to evaluate asthma prevalence, disease burden, and the impact of social determinants of health. Current estimates suggest that approximately 8.8%–9.0% of adults in New Jersey …

The Rowan University Wellness Village: An Innovative Community Advancing Health And Well-Being, Thomas Cavalieri Do, Brandi Dockett Ma, Matt Mclaughlin Bs

Rowan-Virtua Research Day

No abstract provided.

Pediatric Cannabis Exposure Rates In Southern New Jersey: One Hospital’S Experience, Shay Greco

Rowan-Virtua Research Day

Background:

Cannabis legalization in New Jersey (NJ), made recreationally available in April 2022, has increased accessibility through 254 dispensaries in state. The products distributed from these dispensaries often resemble candy and present a risk to the pediatric population. The pediatric endocannabinoid system's developmental characteristics, with CB1 receptors localizing in neurovegetative brainstem regions, make exposure to cannabis dangerous. Severe exposures may present with respiratory depression and coma.  Previous studies from other states demonstrated a five-fold increase in pediatric exposures following state recreational legalization.

Methods:

We conducted a retrospective epidemiological study of ED encounters for cannabis exposure using ICD-10 codes F12.1 and …

Determinants Of Successful Completion In The Rowan-Virtua Dual Cprs/Chw Program: Literature Review & A Work In Progress, Timothy Breiner, Donato F. Tassoni, Richard Jermyn, Venkat Venkataraman, Alexander Abbott, Kenneth Stagliano

Rowan-Virtua Research Day

Background: Certified Peer Recovery Specialists (CPRS) and Community Health Workers (CHWs) expand access to behavioral health and social care through training, credentialing, and community-based support. Although these programs improve knowledge, skills, and workforce readiness, retention and completion remain important barriers to program scale-up. Evidence on predictors of successful completion in dual-role CPRS/CHW pathways is limited.

Objective: To identify participant, programmatic, and contextual factors associated with successful completion of the Rowan-Virtua Dual CPRS/CHW Program.

Methods: This work-in-progress combines a focused literature review with ongoing program analysis. The review examined English-language studies from 2010 onward related to CPRS and CHW training, program …

Mental Health Vs Substance Misuse: Predicting Restraint Use In The Emergency Department, Chloe Lafosse Bs, Michael Witt Md, Mph

Rowan-Virtua Research Day

Introduction: Violence in the emergency department affects approximately 30% of hospital staff every 6 months. Presenting complaints may contribute to violence risk, particularly in those with mental health or substance misuse issue where there are heightened risks of cognitive impairment and involuntary holds.

Methods: We conducted a systematic review of literature published between 1957-2025 using multiple databases, identifying studies that observed physical restraint use on adult emergency department patients. All relevant data was recorded and imputed into SPSS for a chi-square test.

Results: Thirteen studies (2019-2025) met inclusion criteria, with sample sizes ranging from 58 to 1,035,522 participants. All studies …

What Are The Effects Of Exposure To Green Spaces On Attention, Adhd Symptoms, Depression, And Overall Mental Health?, Emily Marie Hackett

Rowan-Virtua Research Day

This poster is a literature review examining the relationship between green space exposure and mental health outcomes. Examples of green spaces include nature, hiking trails, city parks, tree cover, and gardens. This literature review finds that green space exposure has positive effects on the symptoms of ADHD, depression, and anxiety. Nature exposure may serve as a complementary intervention to improve patient well-being.

A Conserved Role For Cyclin C In Regulated Cell Death Across Yeast And Humans, Samar Emami, David Stieg, Daniel Smethurst, Justin Bauer, Randy Strich

Rowan-Virtua Research Day

Background: Programmed cell death (PCD) is a tightly regulated process that maintains tissue homeostasis and eliminates damaged, infected, or malignant cells. A key regulator of this process is Cyclin C (CCNC), which functions as a component of the mediator complex to regulate gene transcription. During cellular stress, CCNC translocates from the nucleus to the mitochondria, where it associates with Dnm1 to promote mitochondrial fragmentation and  apoptosis.

Objective: This study aimed to unravel conservation of CCNC’s function between yeast and humans by investigating whether human CCNC can induce apoptosis in yeast and whether it does so through interaction with …

Case Report: Dandy-Walker Malformation In An Adolescent Presenting With Aggressive Behavior, Kristen Arulsamy, Wayne Tamaska, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 15-year-old male who presented to the Emergency Department(ED) for agitation and was subsequently diagnosed with Dandy-Walker malformation (DWM). DWM is a rare congenital abnormality of the posterior fossa characterized by hypoplasia of the cerebellar vermis, cystic dilation of the fourth ventricle, and enlargement of the posterior fossa. It is typically diagnosed during infancy due to hydrocephalus, developmental delay, or neurologic abnormalities. Late presentations in adolescence are uncommon and may occur incidentally during evaluation for unrelated conditions.

Collet–Sicard Syndrome Secondary To Internal Carotid Artery Dissection Following Cervical Self-Manipulation, Ryan K. Alali, James Espinosa Md, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 40-year-old male presenting with progressive dysphagia who was ultimately diagnosed with Collet–Sicard syndrome secondary to internal carotid artery (ICA) dissection. While most reported cases are associated with trauma, this case highlights an atypical etiology following cervical self-manipulation. The patient presented with dysphagia to solids, liquids, and saliva, along with several days of ipsilateral headache and neck pain. Neurologic examination revealed tongue deviation, prompting advanced imaging. CTA demonstrated left ICA dissection, which was further characterized on MRI. The patient was managed with dual antiplatelet therapy and multidisciplinary care, including neurology, neurosurgery, and speech-language pathology, and …

A Stemi That Wasn’T: Staphylococcus Aureus Bacteremia Presenting With Troponin Elevation And Pericardial Involvement, Taqi A. Khan, Kelsey A. Murray, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

A 75-year-old female presented to the emergency department (ED) with vomiting, weakness, and altered mental status. Initial evaluation revealed a markedly elevated troponin level and an electrocardiogram (ECG) demonstrating diffuse ST-segment depressions with relative ST elevation in lead aVR, prompting activation of a STEMI alert. After cardiology consultation, emergent catheterization was deferred. Computed tomography (CT) imaging demonstrated an anterior mediastinal fluid collection extending toward the pericardial space with a loculated pericardial effusion. Splenic infarctions were also identified. Blood cultures later grew Staphylococcus aureus. The patient was treated with broad-spectrum antibiotics and transferred to a tertiary care center for further management. …