Medicine and Health Sciences Commons^™

Neuroactivational And Behavioral Correlates Of Psychosocial Stress-Induced Cocaine Seeking In Rats, Nicole M. Hinds, Ireneusz D. Wojtas, Desta M. Pulley, Stephany J. Mcdonald, Samantha De Guzman, Nicole E. Hubbard, Colin M. Kulick-Soper, Jessica J. Debski, Bianca Patel, Daniel Manvich

Rowan-Virtua Research Day

A prominent feature of cocaine abuse is a high risk of relapse even despite prolonged periods of abstinence. Psychosocial stress is thought to be a major contributor to the onset of cocaine craving and relapse in human substance abusers, yet most preclinical models of stress-induced relapse employ physical stressors (e.g., unpredictable footshock) or pharmacological stressors (e.g., yohimbine to elicit a drug seeking response) and do not rely upon psychosocial stress per se. Importantly, social stressors are well known to activate distinct neural circuits within the brain as compared to other stressors. It is therefore possible that currently available animal models …

A Terrible Prank Gone Horribly Wrong The Development Of Delusional Infestation As An Adjustment Reaction To A Traumatic Hoax, Timothy Wong, Nardin El-Shammaa, Munaza Khan, Stephen Scheinthal

Rowan-Virtua Research Day

Delusional infestation (DI) is a somatic type delusional disorder, characterized by a fixed belief that one is infested by living or nonliving pathogens (1,3) . DI is a relatively rare disorder (4,5), with an estimated 20-80 cases per million people annually (6). Effective management of patients suffering from DI is crucial, as patients may cause significant harm to themselves in their attempts to remove the pathogens (7,8). Regarding treatment options, antipsychotic medications such as pimozide and risperidone have been promising (8,10). However, there remain many barriers to care (11), and patients are hardly ever seen in psychiatry as they preferably …

Pain And Sleep Are Associated In Fibromyalgia Patients, Rahul Patel, Robert A Steer, Richard Jermyn, Venkat Venkataraman

Rowan-Virtua Research Day

This poster explores whether a correlation exists between lack of sleep and fibromyalgia pain.

Novel Technology Enables Diagnostic Ultrasound Machine To Treat Hepatocellular Carcinoma In Mice, Ryan Morrison, Mrigendra B. Karmacharya, Chandra M. Sehgal

Rowan-Virtua Research Day

An off-the-shelf diagnostic transducer (ULTRASONIX C5-2) was modified with custom-built circuitry to enable the transducer to produce therapeutic ultrasound in order to ablate hepatocellular carcinomas grown in immunodeficient athymic nude mice (25-35 g; Charles River Laboratories, Wilmington, MA, USA). The therapeutic antivascular ultrasound (AVUS) produced by the off-the-shelf abdominal transducer was unfocused, continuous 2.8MHz ultrasound targeting contrast-enhancing perflutren lipid microbubbles within tumor vasculature. Previous research with a dedicated physiotherapy ultrasound machine (D150 Plus, Dynatronics Corp., Salt Lake City, UT, USA) targeting similar hepatocellular carcinomas showed disrupted tumor neovasculature and irreparable dilation of tumor capillaries with subsequent intercellular edema and hemorrhage.1-3 …

Terson-Like Syndrome Associated With Familial Retinal Arteriolar Tortuosity (Frat) And A Spontaneous Spinal Hemorrhage, Peter Maduka, David R. Lally

Rowan-Virtua Research Day

Background: Familial retinal arteriolar tortuosity (fRAT) is an autosomal dominant disorder that is characterized by tortuosity of the second and third order retinal arterioles in the macular and peripapillary areas. The genetics of fRAT are incompletely understood but have been associated with a missense mutation in the COL4A1 gene in some cases. fRAT is not typically associated with visual loss and prognosis is good. However, the tortuous arterioles can bleed, causing intraretinal, preretinal, and/or subretinal hemorrhages.

Objective: To describe a case of Terson-like syndrome associated with familial retinal arteriolar tortuosity (fRAT) in the setting of spontaneous spinal hemorrhage.

Results: A …

Phyllodes Tumor Containing Invasive Ductal Carcinoma: A Rare Case Description & Review Of Literature, Kathryn Eckert, John Ground, Alyssa Imperatore, Victoria Tiedemann, Linda Szczurek

Rowan-Virtua Research Day

Phyllodes tumors are uncommon, often benign, malignancies of the breast and account for approximately 0.5% of all breast malignancies. These tumors were first described in 1838 by Johannes Muller as cystosarcoma phyllodes and were later more aptly renamed phyllodes tumors (as they were neither cystic nor sarcomatous).(1) As a mixed connective tissue and epithelial tumor, these behave similar to benign fibroadenomas, though their growth is much more rapid and they tend to occur in older patients.(2) Hallmarked by their large size at presentation, these tumors average between 4 and 7 cm at the time of diagnosis. The only known risk …

Persistent Neurocognitive Impairment And Neurological Complications Following Covid-19: Challenges Of The Long Covid Syndrome, Timothy Wong, Sung Kang, Munaza Khan

Rowan-Virtua Research Day

Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2).(1) As of April 23, 2021, there are close to 150 million cumulative cases, with over 3 million deaths worldwide.(2) In terms of clinical presentation, individuals afflicted with COVID-19 vary greatly in terms of their disease progression and symptomatology.(3,4) During the acute phase of COVID-19, patients may experience flu-like symptoms including fever, cough, dyspnea, headache,(5,7) though gastrointestinal, renal, hepatological, rheumatological, and neurological symptoms and complications have been reported.(8,9) Recently, there has been increasing interest in the chronic sequelae of COVID-19.(10). One …

Substrate-Dependent Modulation Of Sirt2 By A Fluorescent Probe, 1-Aminoanthracene, David Bi, Prashit Parikh, Jie Yang, Brian P Weiser

Rowan-Virtua Research Day

Sirtuin isoform 2 (SIRT2) is an enzyme that catalyzes the removal of acyl groups from lysine residues. SIRT2’s catalytic domain has a hydrophobic tunnel where its substrate acyl groups bind. Here, we report that the fluorescent probe 1-aminoanthracene (AMA) binds within SIRT2’s hydrophobic tunnel in a substrate-dependent manner. AMA’s interaction with SIRT2 was characterized by its enhanced fluorescence upon protein binding (>10-fold). AMA interacted weakly with SIRT2 alone in solution (Kd = 37 μM). However, when SIRT2 was equilibrated with a decanoylated peptide substrate, AMA’s affinity for SIRT2 was enhanced ∼10-fold (Kd = 4μM). The peptide’s decanoyl chain and …

Retinal Vasculitis: A Case Study, Peter Maduka, Sarah G. Bonaffini, Naman Shah, Deepika Malik

Rowan-Virtua Research Day

Purpose: To describe a case of idiopathic retinal vasculitis.

Methods: Case report and literature review.

Case: A healthy 25-year-old female presented with a one-week history of a large floater in her right eye. Patient’s subjective complaint of floaters, including the scotoma on VF and the FA findings were most consistent with retinal vasculitis displaying predominant venous involvement. However, findings for acute macular neuroretinopathy and multiple evanescent white dot syndrome (MEWDS) were present as well. Autoimmune and infectious disease panels were negative. Neuro consult and brain MRI showed nonspecific, non contributory findings. Several weeks later, following Medrol dose pack, patient reported …

A Peculiar Presentation Of Cardiac Sarcoidosis As Third-Degree Atrioventricular Heart Block Complicated By Right Ventricle Perforation, Yash Suthar, Pooja Patel, Nikhita Kothari, Kristofer Hillegas

Rowan-Virtua Research Day

• Cardiac sarcoidosis is a rare, inflammatory multisystem disorder that manifests as noncaseating granulomas of multiple organs.

• The clinical presentation of sarcoidosis is variable and may be underrecognized by clinicians.

• Individuals may be asymptomatic during their lifetimes and may be incidentally diagnosed with the disease for the first-time during autopsy.

• Patients with cardiac involvement of sarcoidosis may initially present with complications including arrhythmias, heart block, bundle branch block, congestive heart failure, pericardial effusion, pulmonary hypertension, and/or sudden cardiac death.

An Analysis Of Phenibut (Ss -Phenyl-Y-Aminobutyric Acid) Withdrawal, Michael Morris, James Espinosa, Robin Lahr, Alan Lucerna

Rowan-Virtua Research Day

Phenibut (ß -phenyl-y-aminobutyric acid) is a psychoactive GABA analogue marketed as a nutritional supplement and “nootropic” online. Phenibut consumption poses a high risk of potential abuse. Withdrawal from Phenibut mimics benzodiazepine and alcohol withdrawal. Without proper management, Phenibut withdrawal may be equally as dangerous as benzodiazepine and alcohol withdrawal. Baclofen can be prescribed for outpatient symptomatic relief of Phenibut withdrawal.

Assessment Of Factors Preventing Adequate Decline In Cervical Cancer Rates Amongst Minority Women In New Jersey, Rosie Wenrich, Jillian Baker

Rowan-Virtua Research Day

Background

• Nationally declining cervical cancer rates are still high amongst minority women in NJ, with Hispanic women being affected the most.

• The Human Papilloma Virus (HPV) is the most common sexually transmitted infection and can lead to cervical cancer

• Administration of the 9-valent HPV vaccine can prevent infection and progression to cancer

• Regular cervical cancer screenings allow for better outcomes

• Various barriers prevent people with a cervix receiving the vaccine

• Various barriers prevent people with a cervix aged >/= 30 from receiving regular cervical cancer screenings

Conclusions

• Improved physician recommendation is required for the …

Case Report: Repeated Use Of Tetrahydrocannabinol Associated With Severe Cerebral Vasoconstriction, Pooja Patel, Ryna Then, Dena Little

Rowan-Virtua Research Day

Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a rare neurological syndrome. The classic presentation consists of recurrent, severe, ”thunderclap” headaches with neuroimaging findings consistent with segmental vasoconstriction of cerebral arteries. Sympathomimetics including cannabinoids have been found to be triggers in many cases of RCVS. Complications include subarachnoid hemorrhage, intracerebral hemorrhage, cerebral edema and ischemic infarction.

This case highlights the potential devastating and irreversible effects of RCVS precipitated by exposure to a sympathomimetic agent. The case emphasizes the importance of patient counseling regarding abstinence from agents that may provoke RCVS.

Incidental Malrotation In Adolescent Diagnosed With Appendicitis, David Ho, Jinsy Jacob, Russell Mordecai, Adam Richards

Rowan-Virtua Research Day

17-year-old male patient with a history of autism presenting with right lower quadrant pain that started in the morning. The appendix was not able to be visualized by ultrasonography. An abdominal and pelvic CT with contrast showed a dilated appendix with surrounding inflammation. Malrotation was not identified on CT Scan. Patient was transferred to a nearby Children’s Hospital for laparoscopic appendectomy. During the procedure, the pediatric surgeon noted that initially, neither the appendix nor cecum was present in the right lower quadrant. This case represents an uncommon finding for a patient in the adolescent age group.

Case Report: Covid-19 Associated Guillain-Barre Syndrome, Matthew Aharonov, Neelesh Parikh, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 72-year-old female who presented to the emergency department with a complaint of generalized weakness. The patient was found to have ascending muscle weakness and subsequently diagnosed with Covid-19 related Guillain-Barre Syndrome. Our patient was negative for Campylobacter jejuni. It is noteworthy that the patient did not have fever, respiratory symptoms or loss of the sensation of taste.

Consequence Of Patient Education On Health Habits, Esha M. Patel, Adarsh Gupta

Rowan-Virtua Research Day

Hypothesis: Patients who participate in an specific health habit do so due to a lack of knowledge about the consequences of that choice.

Goal: Correlate patient participation in specific health habits with their knowledge of the consequences of these choices. Understand why patients continue to participate in specific habits and what influences their decision. The end goal of my project is to provide insight to encourage physicians to evaluate patient’s health education and get physicians to try to apply consequences of these habits on the patient’s life to help them understand health outcomes.

Conclusion: This study showed more correlations between …

Cushing’S Reflex And Bradycardic Arrest In Cryptococcal Meningitis, Scott Briggs, Trent Malcolm

Rowan-Virtua Research Day

Cushing’s reflex is a physiologic response to maintain cerebral perfusion pressure with elevated systolic blood pressure, widened pulse pressure, and bradycardia occurring in the setting of elevated intracranial pressure (ICP). The proposed mechanisms for reflexive bradycardia include ischemia to medullary brain tissue and compression of the intracranial segment of the vagus nerve leading to parasympathetic activation. (1) In acutely elevated ICP, bradycardia is a late finding of worsening intracranial pathology suggestive of impending herniation and cardiovascular collapse.

Cryptococcal meningitis has been identified by Infectious Disease Society of America for its association with elevated ICP. (2) Variety of pathogenic mechanisms occurring …

Dynamic Left Ventricular Obstruction Post Transcatheter Aortic Valve Replacement (Tavr): The “Suicide Lv” Phenomenon, Brian Chen

Rowan-Virtua Research Day

• The transcatheter aortic valve replacement (TAVR) has become a relatively common treatment option for aortic stenosis, especially given the growing number of older patients with severe degenerative aortic stenosis

• While the procedure is overall very safe, there are still a number of potentially serious complications including bleeding, stroke, and cardiac tamponade. One rare complication is a dynamic left ventricular obstruction post valve deployment, which has been called the “Suicide LV” phenomenon.

• Rapid hemodynamic compromise resulting from this can result in significant morbidity and mortality if not diagnosed in time.

• Given the increasing frequency of patients undergoing …

Mental Health Outcomes At A Student-Run Free Clinic, Jessica-Sophie Horoschak, Riya Tandra, Sahil Parikh, Shayna Peterzell, Roma Padalkar, Tara Pellegrino

Rowan-Virtua Research Day

In this project we aim to:

1. Assess the outcomes of screening, management, and diagnosis for patients at the Rowan Community Health Center (RCHC).

2. Compare the outcomes of screening, management, and diagnosis between different groups (gender, race, income, insurance status) using validated surveys.

3. There is a need for accessible and affordable primary care in the South Jersey area, which the RCHC is hoping to meet.

Hypothesis:

The quality of mental health care available to patients at the RCHC is comparable to that at other insured practices.

Nutrition Education Intervention For Children In Low Socioeconomic Neighborhoods, Archana Menon, Kasmier Viciosi, Joshua Nsubuga

Rowan-Virtua Research Day

Childhood obesity is a public health epidemic affecting 18.5% of children and adolescents in the United States. Children who are obese are more likely to obese as adults. Obesity leads to a number of comorbidities including chronic conditions like high blood pressure, Type II diabetes, and heart disease. Low socioeconomic status (SES), lack of healthy food access, and urban neighborhoods have been associated with childhood obesity. Additionally, convenience stores and other low-price stores tended to display and promote junk foods by the main entrance, whereas supermarkets and higher-income stores tended to display fruits and vegetables. We want to combat these …

Case Report: Post-Partum Headache, Alaleh Ebrahimi

Rowan-Virtua Research Day

Cerebral venous sinus thromboses are rare and occur in 5 people/1,000,000, more commonly in women that are pregnant at about 202/100,000 deliveries with an 11.63% mortality rate. It is believed that pregnancy being a hypercoagulable state is one of the main reasons that it is more common in pregnant and post-partum women. Common symptoms include sudden onset headache, blurry vision, focal neuro deficits, seizures and altered mental status.

Retrospective Analysis Of Post-Operative Sepsis Rates, Stone Composition, And Ureteral Stent Duration After Ureteroscopy And Laser Lithotripsy During Covid-19, Young Son, Julia T. Scali, Ian Madison, Paul Chialastri, Thomas Mueller

Rowan-Virtua Research Day

Ureteroscopy with laser lithotripsy is routinely used to remove stones but results in manipulation of the genitourinary mucosa and has a well-established relationship with post-operative sepsis under certain conditions. Postoperative sepsis represents a significant morbidity and mortality cost to patients and the healthcare system. Several studies to determine risk factors for sepsis after ureteroscopy have been completed. Such risk factors include positive preoperative urine cultures, female gender, prolonged preoperative stent time > 1 month, and patients with sepsis at the time of initial stenting. To improve sepsis rates, procedural alterations such as the use of disposable ureteroscopes have been introduced, as …

Rare Variant Of Porokeratosis: A Case Report, Nardin Awad

Rowan-Virtua Research Day

There are 5 clinically distinct variants of porokeratosis, including classic porokeratosis of Mibelli, disseminated superficial (actinic) porokeratosis, linear porokeratosis, punctate porokeratosis, and porokeratosis palmaris et plantaris disseminate. Porokeratosis ptychotropica (PP) is the sixth, lesser-known variant of the spectrum. PP is characterized by verrucous plaques, often resembling psoriasis plaques, that affect the buttocks, most commonly the gluteal cleft, and can also involve the extremities, most commonly the lower legs and feet. Due to its characteristic verrucous appearance, designations such as verrucous or hyperkeratotic porokeratosis are occasionally used. Besides its predilection for specific locations, PP also has a significant predilection for men …

The Coumadin Ridge: Incidental Finding Mimicking Thrombus On Echocardiogram, Keith Brown Jr., Matthew Everwine, Keith R. Anacker, Jose Nieves

Rowan-Virtua Research Day

The left atrial ridge or “coumadin ridge” is a cardiac anatomic structure located between the left pulmonary vein and the orfice of the left atrial appendage. Historically, patients were misdiagnosed with intra-atrial thrombus and were incorrectly placed on anticoagulation with warfarin, ultimately acquiring the name of the “coumadin ridge”. Fortunately this anatomical variant is now more commonly recognized, however when improperly identified can lead to unnecessary testing, cost, diagnosis anxiety, and inappropriate treatment for the patient. This purpose of this case is to bring awareness to this common clinical dilemma in an attempt to reduce ambiguity and unnecessary workups surrounding …

The Application Of Point-Of-Care Ultrasound In Ed Intubations And Airway Access: A Systematic Review, Frank Wheeler, James Espinosa, Alan Lucerna, Jeffrey Gardecki

Rowan-Virtua Research Day

Intubation is an essential procedure performed on a routine basis in the emergency room. Unsuccessful intubations are associated with deleterious outcomes. A systematic review was performed to investigate the accuracy of point of care ultrasound (POCUS) in successful Endotracheal Tube (ET) tube confirmation, utilizing ultrasonography, identification of the cricothyroid membrane utilizing ultrasound, and dynamically during use of ultrasonography in the process of intubation. This review demonstrated high sensitivity and specificity for ultrasound confirmation of ET tube placement, high success rate in ultrasound-guided intubation, and lower than expected accuracy in identifying the cricothyroid membrane. Ultrasonography should be considered for ET tube …

Spontaneous Conus Medullary Infarction In The Absence Of Cardiovascular Risk Factors, Bavica Gummadi, Jaffer Ahmed, Swarna Rajagopalan

Rowan-Virtua Research Day

Spinal cord infarction (SCI) is rare and most often occurs in individuals with predisposing cardiovascular risk factors and traumatic injuries

As there are no distinct diagnostic criteria for SCI, diagnosis is difficult in patients presenting without predisposing factors and is often mistaken for transverse myelitis.

Delay in early diagnosis contributes to the high case fatality rate of SCI.

This case highlights the importance of including SCI in the differential of a patient with acute paraparesis even in the absence of co-existing risk factors.

Case Of New Onset Alice In Wonderland Syndrome In Adolescent After Prolonged Hospitalization, Michaela Margolis, Timothy Wong, Richard Hadi

Rowan-Virtua Research Day

Alice in wonderland syndrome (AIWS) has been described as body image illusions involving distortions of the size, mass, or shape of the patient’s own body or its position in space, often occurring with depersonalization and derealization. Most cases typically affect young children.

Common distortions are micropsia, macropsia, metamorphopsia, and pelopsia.

The term was adopted from the book by Lewis Carroll, wherein the main character perceived her size and shape to change in different scenarios.

These distortions are often expressed as sensory perceptions rather than illusions or hallucinations, and are often distressing to the patient.

AIWS onset has been found to …

Evolutionary Conservation Of The Heterochronic Pathway In C. Elegans And C. Briggsae, Maria Ivanova, Eric G. Moss

Rowan-Virtua Research Day

Heterochronic genes control the sequence and timing of developmental events during four larval stages of Caenorhabitis nematodes. Mutations in these genes may cause skipping or reiteration of developmental events.

C. briggsae is a close relative of C. elegans. These species have similar morphology and share the same ecological niche. C. briggsae undergoes the same developmental pathway consisting of four larval stages before reaching adulthood. It also has the same set of heterochronic genes.

Lin-28 is one of the heterochronic genes that also exists in other animals from flies to humans. It conservatively blocks the maturation of let-7 miRNA, the process …

Flexor Tenosynovitis After Bite By Sugar Glider, Dominick Siconolfi, James Espinosa, Alan Lucerna, Russell Mordecai

Rowan-Virtua Research Day

Flexor tenosynovitis is one of the few orthopedic emergencies, often first identified in the emergency department. Pyogenic flexor tenosynovitis is an infection of the flexor tendon sheath of a finger causing local inflammation and tissue destruction. The pathognomonic symptoms of flexor tenosynovitis are known as Kanavel’s signs, a constellation of symptoms that include: pain with passive extension of the finger, tenderness over the flexor tendon sheath, fusiform swelling of the affected finger, and the finger held in passive flexion. The most common cause of flexor tenosynovitis is penetrating trauma into the flexion tendon sheath. Our case involves a 59-year-old male …

Retrograde Thromboembolism From The Proximal Descending Thoracic Aorta Leading To Recurrent Acute Cerebrovascular Events, Mark Staroelsky, Akash Patel, Gregory Holland, Nishant Parikh, Peter Bulik

Rowan-Virtua Research Day

In the United States, approximately 800,000 individuals experience a stroke every year

Nearly 25% of strokes are recurrent

Cryptogenic strokes, or those with unknown causes after testing, make up a significant portion of ischemic strokes, as many as 32%

Retrograde thromboembolic events originating from the proximal descending thoracic aorta should be considered as a potential etiology in cryptogenic strokes

The appropriate management of embolic events from aortic atheroma needs further research

Here, we present a case of a 55-year-old male who had recurrent cryptogenic strokes whose origin was discovered to stem from retrograde embolic phenomena from atheroma located within the …