Medicine and Health Sciences Commons^™

Characterization Of Antibiotic Susceptibility Profiles Of Extensively- And Pan-Drug Resistant Acinetobacter Baumannii Clinical Isolates, Rachel Carr, Justin Halim, Rebecca Fliorent, Henry Fraimow, Dejan Nikolic, Valerie Carabetta

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Acinetobacter baumannii is an opportunistic pathogen common in intensive care units (ICUs), particularly among immunocompromised individuals. Nosocomial A. baumannii infections have become increasingly problematic in recent years, as these bacteria rapidly acquire antibiotic resistance, leading to the emergence of multidrug, extensively drug and pan drug-resistant (MDR, XDR, and PDR, respectively) isolates. Recently, Cooper University Hospital (CUH) experienced a large increase in highly drug-resistant A. baumannii infections, which had a mortality rate of 60%. Oftentimes, physicians had to turn to combinations of drugs with no experimental verification or historically shelved antibiotics, such as the polymyxins, in a desperate attempt to save …

Chemical Restraints In The Emergency Department, Nicholas Noffsinger

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Chemical restraint is a critical intervention used in emergency departments to manage acutely agitated or violent patients. It involves the administration of medication to induce sedation and control behavior, with the goal of ensuring patient and staff safety while allowing necessary medical interventions to be performed. However, the use of chemical restraints necessitates close observation of vital signs and any potential side effects, as well as careful consideration of patient-specific considerations.

An Unusual Ed Case: Spontaneous Necrotizing Fasciitis Presenting As Hypoxic Pneumonia, Chetna Thawani, Kishan Patel

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We present a case of necrotizing fasciitis initially presenting as septic hypoxic pneumonia, and discuss imaging modalities and diagnostic evaluation. Necrotizing soft tissue infection (NSTI) is a rapidly progressive surgical emergency with a mortality rate of 30%. In approximately 80% of cases, it is introduced through a break in the skin. It can also occur after any invasive procedure or surgery. It is most commonly associated with skin flora including staph and strep, though polymicrobial infections are most common. It usually presents with signs of systemic infection, including fever, chills, sepsis, altered mental status - and signs of cutaneous involvement …

Congenital L-Transposition Of The Great Arteries In A 12-Year-Old: A Case Report, Muhammad Noman

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Levo-transposition of the great arteries, L-TGA, also known as congenitally corrected transposition, cc-TGA is a rare anomaly and accounts for less than 1% of all congenital heart diseases. It is characterized by both atrioventricular and ventriculoarterial discordance . It is considered a congenitally corrected transposition because the circulation is from right atrium to left ventricle leading to the pulmonary vasculature. The lungs then pump blood into the left atrium to the right ventricle and eventually to the systemic circulation via the aorta.

Importance Of Serial Ekgs In The Emergency Room Setting, Swet Patel, James Espinosa, Alan Lucerna

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Chest pain is one of the most common chief complaints that presents to the emergency department. More than 8 million patients with chest related complaints present each year with about 10% of all ED visits comprise of cardiovascular emergencies. Immediate evaluation is the standard of care to differentiate between life threatening conditions and non-life threatening ones with the use of 12-lead electrocardiograph (EKG) and bedside monitors. The 12 lead EKG remains gold standard for initial screening and evaluating patients with chest pain and angina equivalents. The test is fairly inexpensive and noninvasive with providing vital information about cardiac rhythm. The …

Brash Syndrome Case Report And Brief Review, Kelly Schuitema

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BRASH syndrome is an acronym that stands for bradycardia, renal failure, AV node blocker, shock and hyperkalemia. The syndrome is precipitated by synergism from AV nodal blocking agents and hyperkalemia. The combination of the AV nodal blockade and renal failure leads to a cycle of severe bradycardia and hyperkalemia. We will discuss a case of BRASH syndrome with a 68 year old female who presented with generalized weakness and was found to be hypotensive, bradycardia, in acute renal failure with hyperkalemia likely related to metoprolol and amlodipine use.

Release The Kratom: Post-Acute Withdrawal Syndrome In A 70 Year Old Male, Nardin El-Shammaa, Kyle Street, Narsimha Pinninti

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Centuries in Eastern medicine.. Kratom has been commonly used for chronic pain and opiate withdrawal symptoms with first reported cases in the United States in the early 2000s. It is a plant that consists of psychoactive alkaloids that target opioid receptors with different affinity. Effects from Kratom are dose-dependent, at lower doses, it acts as a stimulant, while at higher doses produces analgesia and euphoria. Although Kratom is legal and easily accessible over the counter, there have been increasing reports of potential for addiction and toxicity. Cessation of Kratom can result in withdrawal symptoms similar to opiate withdrawal. Here we …

Comparative Analysis Of The Effects Of Actual Versus Assumed Opioid Experience On The Regulation Of Ventral Striatal Opioid Receptor Gene Expression, Indu Mithra Madhuranthakam, Martin Job

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Rationale: We conducted experiments to assess the effect of prior opioid experience on gene expression changes. We compared the current experimenter-imposed short versus extended-access conditions of opioid self-administration and developed a new quantitative method to determine their effectiveness in identifying the role of opioid experience in regulating opioid receptor expression levels in the ventral striatum (VS) using an oxycodone self-administration/abstinence model.

Methods: In this study, male Sprague-Dawley rats (n=36) were trained for 20 days to self-administer oxycodone at 0.1 mg/kg/infusion under short access (n=15, or saline as controls n=3, for 3h/day) or extended access (n=15, or saline as controls n=3, …

Dancing Through Parkinson’S: Investigating The Impact Of Argentine Tango On Motor, Cognitive And Psychosocial Function, Suraj Pothineni, Fazal Choudhary

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Background: People with Parkinson’s Disease (PD) undergo progressive motor, cognitive, and psychosocial symptoms, which decrease their quality of life (QOL). Adapted tango (AT) has recently emerged as a promising approach to ameliorating functional mobility, balance, and gait seen in people with PD.

Methods: A comprehensive literature review is conducted using databases such as PubMed, SCOPUS, and Embase. A wide variety of search terms are used, including but not limited to Parkinson’s disease, exercise, dance, tango, motor, cognitive, psychosocial effects, freezing of gait, and balance.

Results: People with PD who have undergone AT have improved in certain motor, cognitive and psychosocial …

Global Comparison Of Health Policies Focused On Gestational Diabetes: Recognizing Pertinent Gaps, Muskanjot Kaur, Isvita Marfatia, Samarth Gupta, Swetha Sundaram, Anudeep Deevi, Venkat Venkataraman

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Introduction: Gestational diabetes mellitus (GDM) is a condition that affects 14.7% of women globally and occurs when a mother develops diabetes during the course of her pregnancy.1 Increased insulin resistance in pregnant mothers can lead to further complications, such as a larger baby, increased risk of the baby developing Type II diabetes, having low blood sugar, and even premature birth, which can lead to respiratory issues. The lack of policies in place to address GDM in various countries worldwide highlights the need for this literature. It is necessary to compile policies that are currently in place and to further discuss …

Addressing The Health Needs Of The (D/D)Eaf And Hard Of Hearing Community, Zainab Krayem, Rachel Jeff-Macauley, Nicolette Falco, Vanesa Pizutelli

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The term deaf refers to individuals with total or partial hearing loss. However, it encompasses much more, representing a culture—Deaf culture. The distinction in spelling is important: "Deaf," with an uppercase "D," refers to individuals born Deaf who have been raised within Deaf culture, while "deaf," with a lowercase "d," typically refers to those who lost their hearing later in life and may not have grown up in Deaf culture. People who identify as deaf, Deaf, or hard of hearing (d/D/hoh) are often mistakenly assumed to have cognitive impairments or are broadly categorized as disabled. However, many in the community …

Whole Body Cryotherapy As A Novel Treatment For Long Covid Syndrome Associated Brain Fog, James Mack, Brandon Goodwin, Paras Patel, Kyra Herman, Daniel Casal, Emily Levenson

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SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19), was first discovered in December 2019 in Wuhan, China when adults began presenting with severe pneumonia of an unknown cause. SARS-CoV-2 can cause a wide range of clinical manifestations. SARS-CoV-2 can penetrate the olfactory mucosa and may enter the brain through the cribriform plate along the olfactory tract, through vagal or trigeminal pathways, or pass through the blood-brain barrier. Once inside the brain, levels of inflammatory cytokines are increased and can lead to altered learning, memory, neuroplasticity, hallucinations, nightmares, cognitive and attention deficits, new-onset anxiety and depression, and psychosis. A theoretical treatment for …

The Effectiveness Of Cleaning Protocols In Medical School Omm Labs By Medical Students, Harrison Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

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In light of the COVID-19 pandemic, disinfection in healthcare has taken center stage. Healthcare has adjusted workflows to accommodate for more robust cleaning regimens to help protect the community. This has resulted in the need for medical institutions to reevaluate the current cleaning protocols down to the student level. Osteopathic Manipulative Medicine (OMM) lab provides an optimal avenue for assessing medical student’s examination table cleaning effectiveness. With OMM labs being an activity with a high level of interaction, the quality of examination table cleaning is important for the health and safety of students and teaching faculties. Our study highlights that …

Arthroscopic Treatment Of Shoulder Stiffness With Rotator Cuff Repair Yields Similar Outcomes To Isolated Rotator Cuff Repair, Ruchir Nanavati, Parker L. Brush, Adrian Santana, Gregory R. Toci, Tariq Z. Issa, Daniel J. Fletcher, Joshua Hornstein

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Purpose: To compare patient-reported and surgical outcome measures in patients with and without secondary shoulder stiffness (SSS) undergoing rotator cuff repair (RCR).

Methods: Patients undergoing rotator cuff repair from 2014 to 2020 with complete patient-reported outcome measures (PROMs) by the short-form 12 survey (SF-12) were retrospectively reviewed to identify if operative intervention for SSS was performed alongside the RCR. Those patients with operative intervention for SSS were propensity matched to a group without prior intervention for stiffness by age, sex, laterality, body mass index, diabetes mellitus status, and the presence of a thyroid disorder. The groups were compared by rotator …

The Virtues Of Osteopathic Manipulative Treatments In Patients With Opioid Use Disorder, Rachel Shmuts, Heather Soled, Kyle Street, David Abend

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As America continues to face the opioid epidemic, numerous people have made great strides in receiving formal treatment for their opioid use disorder (OUD). This research seeks to examine the effects providing OMT along with traditional OUD pharmacological methods in providing results for patients. By utilizing prior research on OMT techniques, we were able to uncover how effective OMT can be in reducing the time and discomfort associated with seeking opioid recovery. OMT in combination with traditional pharmacology was associated with reduction of somatic pain, higher success with MAT, as well as lowered costs. This research also highlights the importance …

Barriers To Colorectal Cancer Screening For Low-Income Hispanic Men In Urban Areas Between 50-75, Alex Vega

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Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Although CRC screening rates have improved in non-Hispanic whites (NHW), Hispanic adult males (HAM) aged 50-75 in urban areas continue to experience low screening rates and higher CRC morbidity and mortality. This review aims to identify the barriers to CRC screening among HAM and propose targeted interventions to increase screening rates. A comprehensive literature review was conducted using databases such as PubMed, Scopus, and Google Scholar. Key search terms included "colorectal cancer", "screening", "Hispanic adult males", "urban", "barriers", and "interventions". Factors identified include poverty, language …

Case Report: Nosocomial Digital Eczema From Surface Cleansing Bleach, James Espinosa, Umar Sannoh, Alan Lucerna

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We report the case of a healthcare provider who developed hand eczema, predominantly on the first digit and thumb of the right hand, in association with contact with the surface of a desk and mouse pad at work. The eczema abated on days off and was exacerbated within hours of work. The diagnosis was made of hand eczema from surface cleaning bleach. It was noted that several other healthcare providers had developed similar symptoms. The patient's eczema was confirmed by a dermatologist and was successfully treated with topical triamcinolone and emollient cream to the affected areas. Prevention by adhesive strip …

The Angiovac® Device Limits Lethal Complications Of Sepsis And Severe Infective Endocarditis With A Large Tricuspid Valve Vegetation: A Case Report, Dua Xiao, Raeann Dalton, Adam Fineman, Michael Benz, Antonios Tsompanidis

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Introduction: Infectious endocarditis of the tricuspid valve is a common complication of intravenous drug use. Endocarditis caused by viridans streptococci can lead to heart valve vegetations which may be life threatening due to the potential for embolism and obstruction. Management of large valvular vegetations is often difficult due to the risks involved with open heart surgery, especially in patients with comorbid conditions. The AngioVac® device has been shown in rare cases to be effective at debulking vegetations without the need for invasive surgery.

Case Presentation: We present a patient with a history of intravenous heroin use disorder, hepatitis C, spinal …

A Clinician's Guide To 23andme: A Survey-Based Study On People’S Attitudes And Actions Towards Direct-To-Consumer Genetic Testing, Julia Kiffel, Rifke Anolik, Alexander Kowalski

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Background: While direct-to-consumer (DTC) at-home genetic testing like 23andMe provides users with potentially valuable information about their genetics and health risks, consumers might not have the background or knowledge to fully comprehend and interpret the results. This concept is a pressing issue because of the rise in popularity of these DTC genetic tests.

Purpose: The goal of this study is to elucidate the beliefs and attitudes of 23andMe users and determine the relationship between their test results and likelihood for taking medical action. The results from the study will give clinicians and primary care providers (PCPs) insight into how to …

Identifying Co-Factors That Drive Tra-1 Activator Function, Jibran Imtiaz, Yongquan Shen, Ronald Ellis

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Gli proteins are involved in cell fate determination, proliferation, and patterning in many species and are major effectors of Hedgehog (Hh) signaling. There are three Gli proteins in humans, and mutations or errors in their regulation lead to a variety of developmental disorders or cancer. However, the mechanisms by which they interact with co-factors are poorly understood. We are analyzing co-factors of Gli proteins using TRA-1 in Caenorhabditis nematodes. The TRA-1 zinc fingers are structurally like those of other Gli proteins, and TRA-1 can be cleaved like other Gli proteins to form a repressor. However, its function has changed during …

Improving Access To Community Resources For Mothers In Southern New Jersey, Ariana Blake, Josalynn Maree, Nayarith Lopez, Vanessa Pizutelli

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Maternal mortality rates have skyrocketed across the nation. New Jersey specifically has one of the highest rates across all 50 states. According to the New Jersey Maternal Health Report, southern New Jersey has the highest maternal mortality ratio, with 91% of the maternal deaths throughout New Jersey between 2016-2018 being preventable. It is crucial that families are receiving support during pregnancy and postpartum from the health care system and their community in order to reduce this trend. Acenda Integrated Health’s Connecting NJ aims to provide community support by connecting expectant mothers and families with children under the age of 3 …

Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong

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We present a patient who is a 56-year-old female with a psychiatric history of anxiety disorder and a medical history of hypercholesterolemia and hyperthyroidism, who was admitted to the hospital after a witnessed seizure at an inpatient psychiatric facility. This patient’s family history is significant for her mother experiencing unspecified psychotic disorder that required psychiatric hospitalization. Our patient was first admitted to the psychiatric hospital after exhibiting worsening paranoid delusions and hallucinations that began several months prior. The patient had reportedly begun locking herself in the restroom and screaming “get out, they’re spying on me”, referring to her next-door neighbors …

The Blurred Lines Between Medicine And Wellness: A Historical Approach Comparing Osteopathic Physicians, Chiropractors, And Physical Therapists, Heather Soled, Dylan Trawinski, Sonya Priven, Sheam Jahan

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In modern society, there stands a large number of medical titles with nuances that complicate the layperson’s ability to differentiate standard of care and capabilities. As the world evolves, new job opportunities in the medical and related fields are being constructed to provide positions with various levels of certifications that qualify many caregivers to provide similar and often coexisting levels of care. Some disciplines may agree or disagree on principle; this is just one point of confusion for the mass. Furthermore, disciplines that disagree on principle may still apply analogous treatment models. Such confusion has yielded several challenges for less …

Evaluation Of Available Medical Interpretation Resources Available To Spanish-Speaking Patients In Nj Ahec Counties, Magdalene Lederer, Cindy Nativi, Madhav Patel, Joseph Mendoza, Nhi Tran, Yesha Patel, Melissa Vincent, Rebecca Moore

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According to the US Census Bureau Spanish is the most common non-English language spoken in the US. Despite the growing population of Spanish-speaking individuals, most healthcare providers can only communicate in English. Linguistic differences between patients and providers have been identified to impact the quality of care received, therefore, it is not surprising that Spanish-speaking patients have been found to be less satisfied with healthcare. Language barriers in healthcare lead to poor compliance and underuse of services which eventually negatively impact health outcomes. Several studies found that the most effective communication tools are often underutilized, with healthcare providers relying on …

Food Insecurity And Dietary Restrictions, Courtney Williams, Savana Rodriguez, Tiffany Guerrero, Stephen Acheampong, Vanesa Pizutelli

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According to the USDA Food Insecurity affects around 10.2 percent of the US population as of 2021. For families that have members with certain dietary restriction such as, but not limited to diabetes, hypertension, gluten intolerance, lactose intolerance, and food allergies, the challenge of securing food becomes an even greater burden with having to navigate food banks or discount stores that may not offer food items that meet their dietary requirements. Families with dietary restrictions often face greater food insecurity and less access to food. More research is needed to understand the challenges families with dietary restrictions face regarding food …

Swallowing Disrupts Tongue-Jaw Coordination During Chewing In A Rat Model Of Parkinson's Disease, Meejan Palhang, N. Charles, Francois Gould

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The primary motor symptoms of Parkinson’s disease, including bradykinesia, rigidity, and tremor, are associated with difficulties regulating transitions between motor behaviors due to basal ganglia dysfunction. Chewing and swallowing, which are disordered in most patients with Parkinson’s disease, are two complex motor behaviors which overlap in time and share some neuromuscular components. The objective of this study is to identify how Parkinson’s disease affects the coordination of chewing and swallowing. We hypothesize that as a result of impaired regulation of shift between motor patterns, chewing cycles that occur with a swallow will be more affected that chewing cycles occurring in …

Implementation Of Attending Narcotics Anonymous Meetings In Addiction Medicine Curriculum, Gabrianna Andrews, Krisha Darji, Natalyce Sanchez, Stephen Acheampong

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Following the COVID-19 pandemic in 2020, opioid-related deaths were augmented, highlighting an area of concern for the state of New Jersey. Although the state has taken steps to combat the number of opioid-related deaths, this continues to be a problem emphasizing the need for increased interventions to decrease the number of opioid-related deaths and to improve long-term healthcare outcomes. Rates of stigma surrounding addiction, and more specifically, opioid addiction, are high within the general population and amongst healthcare professionals.2,3 A national survey conducted in 2016 revealed that two-thirds of primary care physicians surveyed viewed people with opioid use disorder as …

Correlation Between Gut Biomarkers And Depression, Jianle Gao

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The correlation between the gut-microbiota- brain axis and mental state in the context of mental disorders such as Major Depressive Disorder (MDD), Schizophrenia, etc. has been well studied. Production of inflammatory and non-inflammatory metabolites by the gut- microbiota directly and indirectly affects the brain and mood. Therefore, colonization by maladaptive, pro-inflammatory bacteria may cause mood dysregulation and depressive features. Metabolites from these bacteria can be quantitatively analyzed for use as biomarkers of Major Depressive Disorder. Biomarkers studied include: serotonin, dopamine, butyrate, acetate, and propionate.

Cellular Metabolism Therapy Slowing Growth Rate Of Glioblastomas, Heet Patel

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Glioblastoma Multiforme (GBM), more commonly known as glioblastomas, are a form of specialized brain tumors called gliomas. Glioblastomas most commonly occur in glial cells of the central nervous system and the average age of diagnosis is 64. Treatment methods implemented currently are surgery of the removable masses followed by courses of chemotherapy and radiotherapy. These methods can only prolong the life span by a few months and as such, new research focused on tumor cell metabolism is being conducted to determine its impact on the progression of this tumor. Tumor masses, such as Glioblastomas, modify their metabolism via the Warburg …

Perinatal Experiences Of People With Autism Spectrum Disorders: A Preliminary Scoping Review, Tanvi Shah, Andrea Iannuzzelli, Venkateswar Venkataman

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Autism Spectrum Disorder (ASD) is a developmental disorder that is diagnosed in early childhood, typically in people who are assigned male at birth. However, this diagnosis and the sensory and behavioral divergence that comes with ASD stay with people throughout their lives. Based on the DSM-V diagnostic criteria and the history of how Autism and Autism Spectrum Disorders were first identified, many people who do not identify as male and/or present atypically do not receive a formal diagnosis until later in life or self-diagnose. This in turn has led to a lack of research in both populations that do not …