Medicine and Health Sciences Commons^™

Bilateral Lower Extremity Ischemia Following Cardiac Catheterization, Moses Avedikian, Alan Lucerna, Trent Malcolm

Rowan-Virtua Research Day

Acute limb ischemia is a rare yet limb-threatening presentation where rapid diagnosis and intervention is warranted. Bilateral lower extremity ischemia can be a rare complication following procedures, such as a cardiac catheterization with access obtained in the groin. We describe a case of a 79-year-old female who presented with bilateral lower extremity ischemia following a cardiac catheterization 2 weeks prior. The patient underwent CT angiography, which demonstrated occlusion with no contrast present in the bilateral femoral arteries.

Breastfeeding Education Support Tool For Baby (Best4baby): Feasibility, Acceptability, And Preliminary Impact Of An Mhealth Supported Breastfeeding Peer Counselor Intervention In Rural India, Parth D. Lalakia, Vanessa L. Short, Roopa M. Bellad, Patricia J. Kelly, Yukiko Washio, Tony Ma, Katie Chang, Niranjana Majantashetti, Umesh S. Charantimath, Frances J. Jaeger, Shivaprasad S. Goudar, Richard J. Derman

Rowan-Virtua Research Day

Objective: To evaluate the feasibility of an mHealth-supported breastfeeding peer counselor intervention implemented in rural India and the preliminary impact of the intervention on maternal breastfeeding behaviors, including exclusive breastfeeding (EBF).

Methods: In this quasi-experimental pilot study, participants received either the intervention plus usual care (n = 110) or usual care alone (n = 112). The intervention group received nine in-home visits during and after pregnancy from peer counselors who provided education about and support for EBF and other optimal infant feeding practices and were aided with an mHealth tool. The control group received routine prenatal and postnatal health education. …

Case Presentation: Lower Back Pain Or Chronic Acetaminophen Overdose?, Meghan Whitt, Christopher Schwartz, Bhumi Shah

Rowan-Virtua Research Day

Unintentional ingestions can pose a difficult challenge to diagnose in the setting of the Emergency Department. Many may present with vague symptoms that are not consistent with classic overdose prodromes. Many patients do not identify or disclose over the counter medications, such as analgesics, with which acute/chronic ingestion in large quantities can result in life threatening medical emergencies. Their underlying symptoms may also cloud their clinical picture, further complicating workup within the ED.

A Case Of Spinal Epidural Lipomatosis Presenting As A Stroke Mimic, Jonas Salna Iv, James Lee, Eric Maddock, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Spinal Epidural Lipomatosis (SEL) an excess of normal adipose tissue in the epidural space of the spinal canal, typically becoming symptomatic when cord compression results. First described in 1975 by Lee et al (Lee M, 1975), it is a relatively rare disease. Unfortunately, it is often diagnosed once patients have developed marked symptoms and can have dire complications. Oftentimes SEL is completely asymptomatic, and symptoms on initial presentation are vague. Mostly commonly it presents as worsening chronic back pain (Daniel R. Fassett M.D. M.B.A., 2004) with progressive lower extremity weakness and occasional cauda equina syndrome (Wells AJ, 2014), but this …

Case Study Of Pulmonary Embolism With Unusual Chief Complaint, Kajel Patel

Rowan-Virtua Research Day

Pulmonary embolism (PE) is a serious diagnosis that needs to be made in the Emergency department (ED). There are different categories of PE ranging from massive to non-massive/sub-segmental. Regardless of the categorization, the patient will need to be placed on anticoagulation. It is important to catch this diagnosis in the ED so further complications do no arise. Here is a case from the ED with a patient coming in with the chief complaint of acute right lower quadrant abdominal pain and was diagnosed with a pulmonary embolism.

Ethnic Differences In Maternal Cytokines And Adipokines And Their Association With Spontaneous Preterm Delivery, Yelizavet D. Lomakova, Xinhua Chen

Rowan-Virtua Research Day

Spontaneous preterm delivery (SPTD, birth at <37 weeks’ gestation) is a leading cause of infant mortality in the United States [1]. Infants born prematurely are more likely to suffer from both short and long-term complications including neurodevelopmental delay, visual and hearing impairment, and chronic diseases such as heart disease, hypertension and diabetes in later life [2-4]. African American women have a 2-fold increased risk of preterm delivery compared to Caucasian women [5].The reasons for this disparity are poorly understood. This limits the ability to predict and prevent preterm delivery in the most high-risk populations.

Establishing A Resident-Lead High School Outreach Program To Improve Physician Community Engagement, Dylan Mcdivitt

Rowan-Virtua Research Day

New Jersey’s Cumberland County is home to a vastly diverse population of people, comprised of numerous racial, ethnic, economic, health, and educational backgrounds among its nearly 150,000 residents. Per U.S. Census data, about 15% of the population is below the poverty line, including about 20% of those below the age of 18. With economic hardship often come health problems and disparities, and Cumberland County’s rates of obesity, tobacco use, lung cancer, and drug-induced deaths are all above the national averages.

Notable student survey findings:

• 67 students reported a friend had shared thoughts of depression with them in the last …

Effects Of Wearable Devices On A Person’S Lifestyle, Krima Patel, Adarsh Gupta

Rowan-Virtua Research Day

Lifestyle of the general population is a genuine concern currently due to processed foods and sedentary lifestyles. Also, technology has geared the new generation towards introversion but, not all technology is bad. If used in the correct way, technology can be helpful in transitioning from an unhealthy lifestyle to a healthy lifestyle. Through the Summer Medical Research Fellowship (SMRF) research program, it addressed whether or not wearable devices have an effect on lifestyle.

During SMRF, everyone above the age of 18 was targeted. The hypothesis was to address if devices have an effect on lifestyle. During the first week of …

Do You K Now D.O.?: Pre Medical Students’ Knowledge Of Osteopathic Medicine And Its Relation To Burnout, Philip Collins, Laura Collins, Gianna Bowler Darrow, Jennifer C Sepede

Rowan-Virtua Research Day

It is estimated that in the near future there will be a shortage of physicians available to keep up with the needs of a growing older population. To try to account for this, medical schools are expanding class sizes and new schools are being created. While both allopathic and osteopathic schools are expanding, osteopathic schools are doing so a much faster rate. Unfortunately, it seems many students enter their undergraduate careers unaware of osteopathic medicine despite having an interest in medical school. Undergraduate student interest in becoming a medical doctor continues to rise, but so too does the difficulty of …

Lip Biopsy Trends In The United States: A 7-Year Review Of Medicare Provider Utilization And Payment Database, Nardin Awad, Fady Awad, Amanda Azer

Rowan-Virtua Research Day

Biopsy of the lip is a procedure most used by dermatologists in order to obtain histopathological evaluation of a lesion. It has remained the definitive method of diagnosis for many pathologies, including malignancy. However, although the incidence of lip malignancy has been relatively unchanged since 2012, the number of lip biopsies performed has not followed the same trend, but rather steeply declined since. In this study, the national trends in lip biopsies are evaluated. The Medicare Provider Utilization and Payment (MPUP) database was used to evaluate these practice trends in Medicare providers.

Kidney Rupture: An Unusual Cause Of Abdominal Pain, Flank Pain And Hematuria In A 72-Year-Old Female, Monica Diep, Neelesh Parikh

Rowan-Virtua Research Day

Flank pain, abdominal pain and hematuria are common complaints in emergency medicine. We describe the case of a 72-year-old female who presented to the emergency department for worsening left lower quadrant abdominal pain and left flank pain associated with new-onset hematuria. The patient reports the pain started immediately after she accidentally tripped on a rock while trying to avoid a mailman in an attempt to socially distance due to the COVID-19 pandemic, which resulted in a forceful twist of her body and catching herself with her hands without any direct impact to her body. The patient reports the pain gradually …

Initial Multiple Sclerosis Diagnosis In The Emergency Department, Adam Kandil, James Espinosa, Henry Schuitema

Rowan-Virtua Research Day

Multiple sclerosis is a chronic autoimmune disease consisting of inflammation, demyelination and loss of axon integrity in the central nervous system. Like many autoimmune diseases, its severity, initial presentation and symptomatology vary. MS is typically onset in young adults between twenty to forty years old, and has been found two-three times more likely in women than in men. As a chronic illness, like many others, it can present in the emergency department as an undifferentiated neurologic complaint. This is a case report of new onset multiple sclerosis in the emergency department, outlining the importance of a broad set of differential …

Identification Of The E3 Ligase That Directs The Degradation Of Proteins That Control Cell Fate Decisions In Yeast, Prasanna Tati, Stephen D Willis, Katrina F. Cooper

Rowan-Virtua Research Day

The ubiquitin–proteasome system (UPS) and autophagy pathways are distinct, highly conserved proteolytic systems that play important roles in maintaining cellular homeostasis in response to environmental cues [1]. The goal of this project is to identify the E3 ligase that mediates the degradation of cyclin C following nitrogen starvation in yeast using quantitative Western blot analysis of cyclin C-myc following nitrogen starvation in mutants of known Ubc4/5 interacting E3 ligases. No potential E3 ligases were identified as stable after 4 hours of nitrogen starvation, suggesting redundancy in function.

Further Understanding The Efficacy Of Music-Based Cognitive Remediation Therapy For Patients With Traumatic Brain Injury, Sruthi Nanduri

Rowan-Virtua Research Day

Objective

To further assess the efficacy of music-based interventions in patients with traumatic brain injury and its therapeutic application to cognitive, motor and sensory deficits due to neurological sequalae

Introduction

- Traumatic brain injury is a direct result of an external force disabling neurological and neurophysiological functioning

- Sensory, motor, emotional, language and cognitive functioning impaired

- Treatment is usually cognitive remediation therapy (CR)

- In correspondence, music enhances cognitive performance via neural plasticity

- Current literature shows preliminary evidence of the positive results of music in parallel with CR

Lipoxin A 4 (Lxa 4 ) Promotes Reduction And Antibiotic Efficacy Against Pseudomonas Aeruginosa Biofilm, Julianne M. Thornton, Jean Walker, Prem Yugandhar Kadiyam Sundarasivarao, Bernd Spur, Ana Rodriguez, Kingsley Yin

Rowan-Virtua Research Day

Pseudomonas aeruginosa (P aeruginosa) is an opportunistic bacterium commonly found in wound infections and airways of cystic fibrosis patients P aeruginosa readily forms biofilms which can reduce the efficacy of antibiotics used to eradicate the pathogen We have previously shown that a Specialized Pro resolving Mediator ( Lipoxin A 4 (LxA 4 is a quorum sensing inhibitor which can reduce P aeruginosa virulence In this study, we examined the direct actions of LxA 4 and RvD 2 on P aeruginosa biofilm formation and virulence gene expression The influence of LxA 4 on antibiotic efficacy and the combined effects on biofilm …

Lipid Profile And Admission/Discharge Locations As Predictors Of 60 Day Readmission In Adults 65 Or Older With Type 2 Diabetes Mellitus, Zac Dalton, Terrie Ginsberg, Matthew Mclaughlin

Rowan-Virtua Research Day

Introduction: Reducing 30 and 60 day hospital readmissions is critical to our healthcare systems. Older folks with type 2 diabetes mellitus (T2DM) account for a disproportionate amount of readmissions. Through recognizing factors that correlate to readmissions, patients at risk may be identified.

Objective: To conduct a retrospective review of electronic medical records (EMR) to determine if there is an association between the lipid profile and admission and discharge locations of hospitalized older adults and whether they were rehospitalized 60-days post discharge.

Methods: EMRs were reviewed of 86 randomly selected consenting participants who were admitted to a community hospital and were …

Metastatic Adenocarcinoma Of The Prostate To The Brain Initially Diagnosed As Meningioma By Craniotomy: A Case Report, Julia T. Scali, Young Son, Paul Chialastri, Thomas Mueller

Rowan-Virtua Research Day

Prostate cancer is the second leading cause of cancer death in men after lung cancer. The most common site of prostate metastasis is bone (84%), lymph node (10.6%), liver (10.2%), and thorax (9.1%), with 18.4% to multiple metastatic sites [1]. Prostate metastasis to the brain is rare, with less than 1% documented cases from M.D. Anderson Cancer Center [2]. It is estimated that 1%-6% of prostate cancer metastasis is found in post mortem examination [3]. Parenchymal brain metastasis has a mean survival of 9.2 months after discovery of brain metastasis [4]. Acute neurological symptoms of metastatic prostate cancer are observed …

Multiple Myeloma With Dual Expression Of Kappa And Lambda Light Chains, Monica Patel, Akash Patel, Yvette Wang

Rowan-Virtua Research Day

Multiple myeloma (MM) is a malignancy of plasma cells that accounts for approximately 1 to 2 percent of all cancers and about 17% of all hematologic malignancies.

Plasma cells normally produce antibodies and provide a defense mechanism for the body to fight infections.

Antibodies typically consist of two heavy chains (IgG, IgA, IgM, IgD and IgE) and two light chains (kappa and lambda).

Most cases of MM have malignant plasma cells producing monoclonal (M) proteins, most common being IgG about 52% of the time (1).

Only about 2% of these myeloma cases were also found to secrete more than one …

Physiological Response And Tissue Damage Following Different Depths Of Impact In A Rodent Model Of Mild Traumatic Brain Injury, Haven K. Predale, Christopher P. Knapp, Barry D. Waterhouse, Rachel L. Navarra

Rowan-Virtua Research Day

Mild traumatic brain injury (mTBI) is a serious public health concern that can result in significant neurological and behavioral deficit. mTBI results from impact to the head and can be repetitive in nature, especially in sports and domestic violence cases. Our laboratory studies the effects of repetitive mTBI on risky choice behavior in rodents using a closed-head controlled cortical impact (CH-CCI) model of injury and a well-established probabilistic discounting task that assesses risk-based decision-making behavior. We have recently found that females, but not males, display transient increases in risky choice behavior following three CH-CI’s delivered at 5.5m/s velocity and 2.5 …

Physician Perceptions Of Stress And Telemedicine, Jenna Guma, Katelyn Klimowich, Juming Pan, Danielle Cooley, Philip Collins

Rowan-Virtua Research Day

Telemedicine is an emerging field in which physicians are able to interact electronically with patients to improve health. Telemedicine can be performed through virtual platforms such as email, telephone and video, and can provide or augment care to a multitude of patients.

During the Novel Coronavirus (COVID-19) pandemic, the use of telemedicine has grown exponentially in an effort to continue to see patients and manage their care. The unprecedented era of social distancing and overloaded hospital systems has led many primary care providers and specialists alike to rapidly develop these capabilities in their practices.

Benefits of telemedicine include: increasing access …

Osteopathic Touch: The Best Diagnostic & Therapeutic Tool - Osteopathic Diagnosis & Treatment For Nephrolithiasis, Bilal Khan, Motasem Abul-Huda, Alexander King

Rowan-Virtua Research Day

Osteopathic Manipulative Therapy (OMT) is a set of osteopathic techniques that involves manipulation of the musculoskeletal system using the hands. It offers a supplement to standard modes of diagnosis and treatment, and is a key component of the osteopathic holistic approach to medicine.

Despite growing numbers of osteopathic physicians in the United States, OMT continues to be an underutilized asset in a plethora of medical conditions. With the merger of osteopathic and allopathic residency programs, restructuring of standardized curricula to a pass/fail format, and further changes uniting the two tracks of physician education, OMT remains one of the few facets …

Opioid Lifeline Community Service Project, Ekrem Cetinkaya, Cam'ron Klotz, Harvy Patel

Rowan-Virtua Research Day

The opioid epidemic has claimed the lives of thousands of people over the last decade due to overprescribing, synthetic opioids, and lack of treatment options. Project Opioid Lifeline was created as a mission to combat this issue by equipping the Camden County, NJ population with the necessary information to advocate for themselves and others. This project aims to find and centralize available resources for residents of Camden County by including addiction treatment centers, Narcan training and distribution, and unused medication drop off locations. Over the last nine months, partnerships were formed with community leaders and organizations, such as the Neuromusculoskeletal …

Omental Infarction: A Rare Cause Of Abdominal Pain, Eric Doane, Emily Nguyen

Rowan-Virtua Research Day

Omental infarction is a rare cause of acute abdomen pain first described by Eitel in 1899 and has been described in the literature with total numbers ranging from 250-400 worldwide with many coming from individual case reports. Risk factors for developing omental infarction are thought to be obesity, trauma, intense exercise or secondary to torsion from adhesions. Historically, the diagnosis of omental infarction was made incidentally in the operating room for patients with an acute abdomen with a different suspected diagnosis. Most often being appendicitis with associated right lower quadrant abdominal pain and smaller subset from suspected diverticulitis and cholecystitis …

Changes In Gene Sequence That Cause Discordances Involving Disease In Monozygotic Twins, Kacie Jacques

Thinking Matters Symposium

Identical twins or, monozygotic twins, occur when the egg in a mother is fertilized, but one zygote divides into two separate embryos. Monozygotic twins are considered to be genetically identical, but most twins often display discordances, some involving diseases or disorders. Some of these differences are due to environmental factors. For example, one twin may have diabetes due to diet. Recent literature has shown that some differences in monozygotic twins may be due to changes in gene sequence, as opposed to random, environmental or epigenetic factors. Identical twins from pedigrees with familial disease often show discordances. When looking at schizophrenia …

Educator Wellbeing During Covid-19: Caregivers Vs. Non-Caregivers, Elizabeth Larsen, Judy Gagnon, Yana Davis, Nicole Hudson

Thinking Matters Symposium

The phenomenon of the COVID-19 pandemic has dramatically changed the format of public education, putting stress on the educational system and its teachers. This research study aims to understand the impact of COVID-19 on the role of teachers in Maine, specifically focusing on the added responsibility that parents may experience while simultaneously meeting professional obligations. Researchers posed the question: “What is the relationship between caregiving responsibilities and emotional wellbeing of teachers during the COVID-19 pandemic among public school teachers in Maine?” Participants from K-12 public schools around the state were recruited through direct contact or via building administrators who distributed …

Inherited Bone-Marrow Failure Syndrome, James Joseph

Thinking Matters Symposium

The inherited bone marrow failure syndromes are heterogeneous group of rare genetic disorders characterized by bone marrow failure, congenital anomalies, and cancer predisposition. This includes disorders associated with pancytopenia, such as fanconi anemia and dyskeratosis congenita, as well as disorders with predominantly, but not exclusively, single lineage cytopenias. These syndromes are associated with mutations in 33 genes, and this has led to further understanding of hematopoiesis and how this is disrupted in patients with bone marrow failure. Other fundamental biological pathways were examined in patients, such as the DNA repair-fa/BRCA pathway. Fanconi anemia/ BRCA is a human tumor suppressor gene …

Examining The Effect Of Provider Bias On Pain Management In Black Patients: A Systematic Literature Review, John Massey, Monica Gambilado

Thinking Matters Symposium

Black Americans face unequal treatment for pain management when seeking care. The aim of this systematic literature review is to examine the impact of provider bias on Black patients receiving appropriate pain management interventions in the clinical setting. This review followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis guidelines. CINAHL and PubMed were searched with the following key search terms: Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control and analgesic. A self-developed Critical Appraisal Tool was used for quality assessment of the studies included in the review. A total of 101 probable …

Clinicians Use Of Mindfulness-Based Practices During The Covid-19 Pandemic, Leah Ridley, Samuel J. Giese, Shelby Cogan, Chelsea Hughes

Thinking Matters Symposium

Alternative mental health treatments like mindfulness hold a great deal of promise, but limited research exists on their success and application with the adolescent population. This study investigates the primary research question, “What are the experiences of clinicians providing mindfulness-based treatment to school-aged children in Maine during the COVID-19 pandemic?” This explanatory mixed methods study involves a quantitative survey of clinicians, and will be followed by a virtual focus group to further unpack the value of mindfulness-based practices when working with school-aged children. Survey data will be analyzed using descriptive statistics and qualitative content analysis; focus group data will be …

The Impact Of Female Sport Coaches: Role Models For The Next Generatio, Molly Wilkie

Thinking Matters Symposium

Gender equity in higher education settings, such as academic faculty and admission to graduate schools in medical and STEM fields has been well researched (Ceci & Williams, 2011; Cheryan, 2011; Moss & Racusin, 2012). Based on this previous research, there is a pattern of implicit bias towards female applicants for professorships, as well as admissions to graduate and research positions that results in an imbalance of men and women in these positions. However, less research has been conducted on the gender inequities that exist in another area of higher education, collegiate athletics. The purpose of this project is to identify …

App Development For Wearable Sensors, Connor Pittman, Christopher Chappie, Patrick A. Tetreault

Thinking Matters Symposium

The objective of this research project was to create a wearable device that monitors bodily functions for the user to view on their smartphone. Sensor data is processed using the Arduino Nano 33 BLE microcontroller. The sensors used in this project include: proximity, temperature, humidity, heart rate, pressure, and skin impedance. This project takes advantage of the Arduino's Bluetooth low energy (BLE) capabilities so that all the data can be transmitted to a smartphone. This presentation shows the challenges faced during the project and how they were overcome. Some of these challenges include: programming, how heart rate sensors work, and …