Medicine and Health Sciences Commons^™

Unbridled Healing: Identifying The Barriers Of Equine-Assisted Therapy, Sally A. Hamm

Human Development and Family Sciences Undergraduate Honors Theses

Despite the documented benefits of equine-assisted therapy (EAT) for mental health conditions, this complementary approach remains underutilized. This qualitative study investigated barriers preventing wider EAT implementation by examining challenges faced by clients, facilities, and volunteers. Data collected through open-ended surveys from 33 participants and the researcher's autoethnographic observations revealed eight common barriers: Accessibility (48 mentions), Money (43), Time (30), Awareness (23), Physical Factors (13), Relationships (13), Risk (13), and Weather (7). Clients identified financial constraints as their primary barrier, particularly insurance limitations. Facilitators struggled most with accessibility challenges, including lack of resources, trained staff, suitable horses, and appropriate facilities. Volunteers …

Parental Expectations On Pediatric Care For Children, Brenan Cash

Human Development and Family Sciences Undergraduate Honors Theses

Childhood pediatrics is a major factor for a full and healthy childhood for all children from adolescence to adulthood. However, the physical health aspect has been the main focus through most primary care clinics and hardly focuses on the mental health side. Mental health issues which involve anxiety, depression, and post-traumatic stress are more prominent than they have ever been, as up to 30% of children have experienced mental health issues such as posttraumatic stress disorder, especially in recent pandemic years (Meherali et al., 2021). This study employed a non-experimental, quantitative analysis utilizing online close-ended survey questions. The type of …

Patient Education And Health Literacy Effects On Statin Use And Adherence, Ian M. Smith, Richard G. Olarsch, Alison M. Mancuso

Rowan-Virtua Research Day

Background: While the use of statins (HMG-CoA reductase inhibitors) plays a significant role in the prevention of cardiovascular disease, it is estimated approximately 60% of patients who would benefit from a statin are receiving these medications. Current research suggests that a preference for life-style intervention over medical management, concern over medical adverse reactions, and a lower perceived risk of cardiovascular events is associated with statin non-adherence.

Methods: An IRB-approved paper survey was administered to patients aged 18 to 89 at an ambulatory primary care clinic for non-acute visits. Qualtrics was utilized to collect, store, and process data. Information elicited from …

Acetylcholine Release In The Dorsal Lateral Straitum During Social Approach Task, Taylor Good, Oyku Dinckol, Noah Wenger, Jake Caselli, Munir Gunes Kutlu

Rowan-Virtua Research Day

Nicotine Decreases ACh Release in the DS leading to a Serenic Effect during Social Approach Task

Acetylcholine (ACh) regulates attention, learning, and stress responses (Benarroch E. E., 2012). The dorsal striatum (DS), essential for stimulus-response learning, is also linked to anxiety and compulsivity (Casado-Sainz et al., 2021). We used behavioral pharmacology and in vivo fiber photometry to study ACh responses during social approach tasks in the dorsal striatum. Male and female C57BL/6J mice underwent stereotaxic surgeries to inject a fluorescent ACh sensor (ACh.Sn.Fr) and implant fiber optic cannulas in the DS. Using in vivo fiber photometry, we tracked ACh release …

The Ancient Remedy For Modern Ailments: Analysis Of Manual, Laser, And Electro-Acupuncture Therapy Usage On Carpal Tunnel Syndrome, Yue Chen, Austin J. Wong, Alexander King

Rowan-Virtua Research Day

In the United States, while acupuncture is still primarily used as a complementary therapy, consumer interest and usage are steadily increasing. Carpal tunnel syndrome (CTS), a condition where the median nerve is compressed in the wrist, can lead to numbness, tingling, weakness in fingers, and thus impaired hand function, possessing significant burdens to patients suffering from this chronic disease. Multiple acupuncture applications exist such as electroacupuncture, auricular acupuncture, laser acupuncture, moxibustion, and acupressure; very few comprehensive studies have been done in comparing their effectiveness in treating CTS.

In this study, we aim to conduct a literature review with the primary …

Hypoxia Induced Ribosomal Rna Fragmentation Mediated By Rnase L, Vanessa Kristina Pizutelli, Dimitri G Pestov

Rowan-Virtua Research Day

Ischemic injury contributes to a range of global pathologies. Ischemia/Reperfusion Injury (IRI) is a paradoxical phenomenon that involves an initial restriction of blood flow followed by a sudden restoration of perfusion. This type of injury takes place in conditions such as myocardial infarction, acute kidney disease, and ischemic stroke and often leads to cellular death. Additionally, IRI exacerbates post-surgical outcomes and plays a role in graft dysfunction and transplant rejection. Despite efforts to develop therapies targeting known IRI pathways, clinical trials have largely been unsuccessful, underscoring the need for alternative mechanisms and biomarkers associated with IRI-induced apoptosis. Reactive oxygen species …

Scoping Literature Review: The Role Of Leptin In Autism Spectrum Disorder (Asd) And Associated Obesity, Diana B. Riestra, Andrea Iannuzzelli

Rowan-Virtua Research Day

Overweight and obesity (OW/OB) are significant concerns among individuals with Autism Spectrum Disorder (ASD), yet the underlying causes remain unclear. Emerging evidence points to metabolic and hormonal factors—particularly leptin, a hormone involved in appetite regulation—as potential contributors. This scoping review examined five key studies from 2003 to 2024 that investigated the relationship between leptin and ASD in overweight populations. Across studies, individuals with ASD consistently exhibited elevated leptin levels compared to controls. While some findings also noted changes in other adipokines, such as lower resistin or progranulin, leptin was the most consistently dysregulated. These patterns suggest systemic alterations in energy …

Barriers To Care For Neonatal Abstinence Syndrome In Southern New Jersey, Gabriela Taslitsky, Hijab Zaidi, Nafisa Zalil

Rowan-Virtua Research Day

Neonatal Abstinence Syndrome (NAS) is a spectrum of clinical manifestations seen in newborns due to withdrawal secondary to intrauterine illicit and/or prescription drug exposure. Newborns with NAS present with common signs of withdrawal such as poor feeding, irritability, seizures, hypertonicity, low birth weight, loose stool, and premature birth. Maternal opioid use is the most common cause of NAS and with the increase in opioid use in the past decade the cases of NAS have also increased. This study examines the prevalence and challenges associated with NAS in Southern New Jersey. Our analysis reveals that Atlantic and Gloucester counties reported the …

Sex Differences In Insulin Resistance And Triglyceride/Hdl-Cholesterol Ratio In Human Subjects, Jiyoon Jung, James W. Bailey, Ashley Coleman, George J. Scott, Lakshman Segar

Rowan-Virtua Research Day

Background: Insulin resistance (IR) plays a major role in dyslipidemia and the associated cardiovascular disease risk. To date, it remains unclear as to how IR alters plasma lipid profile in males versus females. The present study is an initial step to determine sex-specific differences in IR and plasma lipid profile using 40 μL of capillary blood. Methods: 12 adults aged 30-64 were recruited from Rowan Medicine-Sewell clinics, with 7 participants (3 males, 4 females) consenting to the study. After collecting 40 μL of capillary blood via finger prick, the samples were analyzed for glucose, triglyceride (TG), and HDL-cholesterol …

The Effectiveness Of Ras Treatment In Improving Gait Patterns In Patients With Parkinson’S Disease: A Literature Review, Vivian Huang, Andrea Hunt, Alicia Chopyk

Rowan-Virtua Research Day

Parkinson’s Disease (PD) is a neurodegenerative disorder involving the loss of dopaminergic neurons leading to symptoms such as tremor and gait disturbance. This results in the classic shuffling gait: stooped posture, variation in stride length, variation in cadence, reduced gait velocity, inability to maintain a steady rhythm, and an increased fear of falling. This study’s objective is to review the current literature on the use of rhythmic auditory stimulation (RAS)Ⓡ as a treatment option for PD. Previous research has looked at RASⓇ as a potential non-pharmacologic treatment because researchers hypothesize that listening to music produces an external rhythm that the …

Modulation Of Opioid Receptor Expression In The Ventral Tegmental Area Following Stress Exposure In Rats, Maya Patel, John Tkaczynski, Jordan Riser, Nicole Shellenbarger, Jin Park, Daniel Manvich, Daniel J. Chandler

Rowan-Virtua Research Day

Background: The ventral tegmental area (VTA) contains dopamine-producing neurons projecting to various brain regions. VTA dysfunction is linked to addiction and depression. Delta opioid receptor upregulation relates to chronic pain, inflammation, cancer, and early adversity. Kappa receptors in the VTA influence stress, drug-seeking, mood, and reward. Notably, chronic substance abuse upregulates the κ-receptor/dynorphin system, and the opioid system regulates social interaction needs.

Hypothesis: Stress will upregulate opioid receptors.

Methods: We compared group-housed and individually-housed rats using stress tests, analyzing behavior and quantifying VTA opioid receptor expression.

Results: Social isolation upregulated delta and kappa opioid receptors in …

Case Report: Alpha Gal Syndrome, Eric Haljasmaa, David Parkes, Wayne Tamaska

Rowan-Virtua Research Day

We report a case of a 40-year-old male who presented with sensation of throat closing and shortness of breath while at work at a meat processing facility. The differential diagnosis of shortness of breath is throat closing includes, but is not limited to, allergic reactions to antibiotics in meat, allergy to food additives, Symptom triggers are useful in identifying causes and a good supporting history and exposures can help with diagnosis. In this case, the patient had a known diagnosis of Alpha-gal syndrome (AGS) which is a tick-bite associated, possibly life-threatening immunoglobin E-mediated (IgE) hypersensitivity to galactose-alpha-1,3-galactose (alpha-gal). The patient …

Case Report : Perilunate Fracture After A Fall On An Outstretched Hand, Meghna Kurup, Nicholas Tomasello, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 44-year-old male that presented to the emergency department (ED) with a fall on his outstretched hand and was subsequently diagnosed to have a trans-scaphoid perilunate dislocation. He underwent closed reduction of the dislocation in the ED and operative management ten days later. While wrist injuries are common in the ED, it is important to diagnose perilunate and lunate dislocations early as they can often be associated with avascular necrosis, neurological injury and poor functional outcomes if not managed in a timely manner.

Case Report: Heating Pad Usage Leading To Rhabdomyolysis And Acute Kidney Injury, Meghna Kurup, Swet Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 26-year-old male with a significant psychiatric and substance use history who came to the emergency department (ED) with deep partial second degree burns to his back subsequent to using a heating pad for unknown periods of time prior to presentation. Rhabdomyolysis and acute kidney injury that occurred in this patient due to his burns. It is important to understand that although beneficial, if heating pads are misused or overused, they can cause injury.

A Case Report Of Primary Central Nervous System Lymphoma Presenting With Diabetes Insipidus, Lan Ngo, Adam Kandil

Rowan-Virtua Research Day

Diabetes insipidus (DI) is characterized by decreased secretion or action of antidiuretic hormone (ADH), resulting in polyuria, polydipsia, and potential electrolyte disturbances. Severe hypernatremia secondary to uncontrolled DI can manifest with neurologic symptoms including seizure-like activity. This case report discusses a case of central DI arising from damage to the pituitary gland as the first presentation of a brain tumor, in the context of a 56-year-old patient who presented with seizure-like activity and sensory changes.

Case Report: Lamotrigine-Induced Rash In An Adult Patient, Dhruvin Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Lamotrigine (Lamictal®) is a commonly prescribed anticonvulsant and mood-stabilizing medication. One of the rare but serious adverse effects of lamotrigine is the development of a drug-induced rash, which can be potentially life-threatening. This case report highlights the occurrence of a drug-induced rash in a 33-year-old female patient who was prescribed lamotrigine for the management of bipolar disorder. The patient presented with a characteristic rash, and following timely intervention, the rash resolved without complications. This case emphasizes the importance of monitoring for early signs of rash in patients receiving lamotrigine and outlines management strategies.

Ultrasound-Guided Vs. Fluoroscopy Guided Steroid Injection For Lumbar Spine Pain On Functional And Pain Outcomes: A Systematic Review, Yashas Sattur, Akash Patel, Alec Birnbaum, Athena Nomula

Rowan-Virtua Research Day

Fluoroscopy-guided steroid injections are standard for lumbar spine pain but involve radiation. Ultrasound offers a safer, radiation-free alternative. Ultrasound-guided injections are non-inferior in improving pain and function. A systematic review of PubMed, Embase, Cochrane, Scopus, and Web of Science was conducted. Studies in adults comparing ultrasound and fluoroscopy-guided injections reporting VAS, NRS, or ODI were included. Fifteen studies showed both techniques significantly improved pain and function, with no consistent superiority. Ultrasound-guided injections are effective and safe, providing comparable outcomes to fluoroscopy while eliminating radiation exposure.

Case Report: Ruptured Infrarenal Abdominal Aortic Aneurysm, Jenna Rapone

Rowan-Virtua Research Day

A ruptured abdominal aortic aneurysm (AAA) is a life-threatening vascular emergency with high mortality rates. We report a case of a 79-year-old male with no reported past medical history but a significant lifelong smoking history who presented to the emergency department with generalized weakness, lower abdominal pain, hypotension, tachycardia, and a reported syncopal episode. Emergency medical services (EMS) found the patient at home during a welfare check, appearing pale and weak. Upon movement from his bed to a stretcher, he experienced a syncopal episode, became tachycardic, and was transiently hypoxic. Initial laboratory studies revealed a hemoglobin of 13 g/dL, hematocrit …

Case Report: Idiopathic Intracranial Hypertension With Venous Sinus Stenosis In A Young Female, Zain Raza

Rowan-Virtua Research Day

We report a case of a 19-year-old female who presented with transient, painless left eye vision loss and left-sided headache for 2 weeks. The patient, a known carrier of TTN mutation, which is a gene code for titin (mutations are inherited in an autosomal dominant pattern). The patient was diagnosed with idiopathic intracranial hypertension secondary to bilateral transverse sigmoid venous sinus stenosis. The differential diagnosis included ocular migraine, transient ischemic attack) and optic neuritis, but subsequent imaging and lumbar puncture revealed elevated intracranial pressure and significant venous stenosis. This case highlights the importance of an early identification and intervention to …

Unusual Path: Gallstone Ileus With Pneumobilia And Jejunal Obstruction, Kristine Rubi, Kelly Schuitema, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We present a case of a 48-year-old female with two-day history of diffuse abdominal pain, nausea and vomiting. She was diagnosed with small bowel obstruction due to gallstone ileus. Diagnosis is usually challenging due to its nonspecific presentation, but computed tomography reveals the classic findings of Rigler’s triad -- pneumobilia, bowel obstruction, and an ectopic gallstone. The patient underwent laparoscopy with enterolithotomy with subsequent resolution of symptoms. Prompt diagnosis through imaging and timely surgical intervention is critical for in preventing complications and improving patient outcomes.

Case Report: When Confusion Signals A Crisis: Rethinking The Diagnosis Of Meningitis In Geriatric Sepsis, Asma Zahid

Rowan-Virtua Research Day

We report the case of an 88-year-old female who presented with altered mental status, initially suspected to have urosepsis but ultimately diagnosed with streptococcal meningitis. The patient had a history of lethargy and anorexia over the past few days and was found to have sepsis. Despite initial focus on urosepsis, blood cultures revealed Streptococcus, and cerebrospinal fluid analysis confirmed bacterial meningitis. This case highlights the potential for meningitis to be overlooked in elderly patients with suspected sepsis, underscoring the importance of broad diagnostic considerations and early intervention. This case highlights the importance of considering meningitis in elderly patients presenting with …

Case Report: Todd’S Paralysis In A Patient With An Extensive Stroke History, Thuc Vu, Kishan B. Patel

Rowan-Virtua Research Day

Here we present the case of a 70-year-old patient who presented to the emergency department with altered mental status, left-sided gaze preference, left-sided hemineglect, and inability to follow commands. He had a past medical history of seizure activity and cerebrovascular accident (CVA) with residual dysarthria and was on apixaban. His symptoms began after seizure activity and improved gradually. He was ultimately diagnosed by stroke neurology as having had an episode of Todd’s Paralysis. The differential diagnosis for patients for altered mental status with neurological deficits can be vast, but, in general, Todd’s Paralysis can be an ischemic stroke mimic upon …

Anabolic Steroid Induced Cardiomyopathy, Oluwatomi Alade

Rowan-Virtua Research Day

Anabolic steroids including testosterone are commonly used as performance-enhancing agents. Its use is predominantly seen in young and middle-aged males. Endogenous testosterone is necessary for cardiac health; however, synthetic anabolic steroids are more potent and associated with adverse effects. These adverse effects include cardiomyopathy and coronary artery disease. The cardiomyopathy, however, can be reversible with discontinuation of the anabolic steroids. This case describes a middle-aged male who had new onset cardiomyopathy and ultimately went into cardiogenic shock secondary to anabolic steroid use.

Case: Pituitary Mass In A Pediatric Patient, Alyssa Baldini, Carla Calvo

Rowan-Virtua Research Day

We report a case of a 16-year-old female presented to the pediatric emergency department for intermittent visual disturbance and was diagnosed with a pituitary mass resulting in episodic complete bilateral vision loss. Pediatric neurologic complaints can be challenging for a number of reasons. It is important as much as possible to obtain a detailed history from the patient and parent, conduct a relevant chart review, and identify if there have been any recent medication changes. Seeking expert consultation may also be helpful in establishing a diagnosis.

Out Of The Blue: A Case Of Acute Limb Ischemia In A Healthy Young Woman, Julian Coz, Melanie Angelo

Rowan-Virtua Research Day

Acute limb ischemia (ALI) is a critical condition caused by arterial occlusion, often due to thrombotic or embolic events in atherosclerotic vessels. Early diagnosis and intervention are essential to prevent limb loss and complications. While typically seen in patients with known vascular risk factors, ALI can also affect individuals without them.

We present a case of a 49-year-old female with sudden-onset left foot pain and paresthesia, highlighting the importance of recognizing ALI in seemingly healthy patients. Despite the absence of typical risk factors, imaging revealed significant atherosclerosis and arterial occlusion, leading to the diagnosis of ALI. This case emphasizes the …

Case Report: Spontaneous Aortic Dissection In A 63-Year Old Male Presenting As Left Abdominal, Flank And Back Pain, Dean Austin Esma

Rowan-Virtua Research Day

Aortic dissection is a life-threatening condition in which the inner walls of the aorta tears, compromising its ability to supply blood to organs. The classic presentation involves sudden, severe, “tearing” chest pain, but subtle presentations are often overlooked as symptoms of another condition, leading to missed diagnoses. This report presents a case of spontaneous aortic dissection who presented with sudden onset of left upper abdominal pain, left flank and upper back pain while brushing his teeth.

Case Report: Recurrent Miller Fisher Syndrome, Devin Hoover, Andrew Vasta, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 47-year-old male who presented with numbness and difficulty speaking and was diagnosed with Miller Fisher Syndrome, a variant Guillain-Barré Syndrome. The differential diagnosis for numbness and speech difficulty is broad and includes brain stem stroke, Wernicke encephalopathy, botulism, myasthenia gravis, among others. Although Miller Fisher Syndrome is rare, certain factors such as the of tumor necrosis factor-alpha antagonists may predispose a patient to the disease and its recurrence. As discovery of new tumor necrosis factor-alpha antagonists continues it will likely result in more presentations of Guillain-Barré Syndrome and its variants to the emergency department.

Miller Fisher Variant Of Guillain- Barré Syndrome, Peter Killian, Kishan B. Patel

Rowan-Virtua Research Day

We present a case of a man in his 50s who was evaluated in the emergency department for right facial droop, myalgias, and right lower extremity weakness. The patient required multiple interdisciplinary specialists for treatment and diagnosis of Guillain-Barré Syndrome (GBS). The differential for weakness and facial droop is primarily aimed at ruling out an irreversible neurological cause while investigating a potential infectious etiology. Multiple variants of GBS exist and clinical presentations can vary, including the Miller Fisher Variant. This variant features a unique presentation, affecting the corticobulbar tract, evident with the ptosis commonly seen following a gastrointestinal infection.

Case Report: Herba Epimedium (Horny Goat Weed) Toxicity With Severe Muscle Spasms And Elevated Creatine Kinase And Creatinine, Tucker A. Ledo, Dhara Patel, Wayne Tamaska, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Here we present the case of a 33-year-old male who presented to the emergency department (ED) with a complaint of severe muscle spasms of a ten-hour duration. He noted that he took a supplement which he purchased over the internet called Epimedium, also known as Horny Goat Weed, for the purpose of improving his mood and sense of energy and reducing his sense of anxiety. He noted that he started this supplement one month prior to ED presentation, coincident with the first episodes of muscle cramps. In the ED, he had elevations of his CK and creatinine and required hospital …

Case Report: Pulmonary Infarction Following Recent Pulmonary Embolism, David Marconi, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

A 57-year-old man with chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, and a recent pulmonary embolism (PE) on anticoagulation presented with acute pleuritic chest pain and worsening dyspnea. Computed tomographic angiography (CTA) of the chest revealed a small distal segmental PE in the left lower lobe and an adjacent irregular consolidation, raising concern for pulmonary infarction versus pneumonia. The patient was empirically started on antibiotics for possible pneumonia and admitted for anticoagulation and supportive care. He left the hospital against medical advice (AMA) before completing treatment, but returned days later with exacerbated symptoms. This case highlights the diagnostic challenge …