Diseases Commons^™

Quantifying Qtc Prolongation Risk At Scale: Cardiac Safety Implications Of Moxifloxacin-Based Tb Regimens, Wesley Augustus Kim, Nikhila Arcakam, Brandon Velazquez

Rowan-Virtua Research Day

Tuberculosis treatment is undergoing its most significant transformation in decades. In recent years, updated ATS/CDC/ERS/IDSA guidelines introduced a new 4-month drug-susceptible TB regimen that incorporates moxifloxacin as a core component. These landmark guideline shifts mean that moxifloxacin exposure among TB patients globally is set to expand dramatically. This drug replaces the ethambutol component of standard TB regiment commonly associated with optic neuritis as a side effect. Yet there is a critical blind spot: while individual studies have documented moxifloxacin’s QT interval-prolonging effects, no research has modeled what happens when this drug is rolled out to millions of patients who simultaneously …

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

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

Rowan-Virtua Research Day

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

Gram-Negative Infective Endocarditis : A Rare Case Of Escherichia Coli Pulmonic Valve Endocarditis, Caroline Nguyen, Philip Willsie, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Infective endocarditis (IE) is most commonly caused by gram-positive organisms, while Escherichia coli accounts for less than 1% of reported cases. Pulmonic valve involvement is particularly rare, representing fewer than 2% of IE cases. We report a case of E. coli infective endocarditis involving the pulmonic valve complicated by spinal epidural abscess and ascending cholangitis in a patient with intravenous drug use. Blood cultures demonstrated persistent E. coli bacteremia, and further evaluation with echocardiography and MRI revealed pulmonic valve vegetations and epidural abscess. This case highlights the importance of evaluating persistent gram-negative bacteremia for infective endocarditis and metastatic infection.

Case Report: Reverse Takotsubo Cardiomyopathy, Aveen Saed, Dhara Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Reverse Takotsubo cardiomyopathy (rTTC) is a rare variant of stress-induced cardiomyopathy characterized by basal and mid–left ventricular (LV) akinesis with apical sparing. It may mimic acute coronary syndrome and can present with cardiogenic shock. We present a 32-year-old female with substance use disorder who presented with severe abdominal pain and hypertensive emergency (SBP >240 mmHg), found to have reverse Takotsubo cardiomyopathy with an ejection fraction (EF) decline to 25% complicated by cardiogenic shock requiring inotropic support. Her course was notable for dynamic LV mid-cavity obstruction during recovery and complete normalization of LV systolic function (EF 65%) within two weeks. This …

Arrhythmic Syncope And Brugada Syndrome: Critical Identification Of High-Risk Patterns At The Ed Frontline, Kristine Rubi, Brittany Fera, Kelsey Murray, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Brugada Syndrome (BrS) is a premier cause of sudden cardiac death (SCD) in structurally normal hearts, particularly in Southeast Asia (SEA) where it is historically recognized as Sudden Unexplained Nocturnal Death Syndrome (SUNDS). We report the case of a 55-year-old male of Vietnamese descent who presented to the emergency department (ED) after a sudden, non-prodromal syncopal episode at rest. The event was significant for urinary incontinence and diaphoresis, classic red flags for arrhythmic syncope. Bedside electrocardiogram (EKG) demonstrated the pathognomonic Type 1 coved ST-segment elevation in leads V1 and V2. This symptomatic presentation following a six-year "follow-up gap" since a …

Case Report: Acute Cerebrovascular Accident With An Initial Absence Of Infarct Findings On Mri, Alyssa Baldini Md, Brittany Fera

Rowan-Virtua Research Day

We report a case of a 42-year-old female whose diffusion-weighted magnetic resonance imaging (MRI) performed 28 hours after symptom onset was negative for acute infarction. Repeat MRI 3 days later demonstrated left-sided corona radiata infarction.

Diffusion-weighted MRI imaging may not be sensitive or specific enough in early stages of acute stroke. Caution should be used in relying on imaging alone to make the diagnosis of ischemic stroke. Clinical assessment likely should be given priority in determining appropriate initial treatment and the need for secondary stroke prevention treatment when imaging is negative. Consideration should be given to the timing of initial …

A Rare Intervention: Emergency Ultrasound-Guided Pericardiocentesis Using A Central Line Kit, Alec Mirchandani, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Cardiac tamponade is a life-threatening emergency requiring rapid diagnosis and drainage.

Point-of-care ultrasound (POCUS) expedites recognition and guides pericardiocentesis. We report a case of acute large pericardial effusion with hemodynamic collapse in a previously healthy 46-year-old female, managed emergently with ultrasound-guided pericardiocentesis using a central line introducer and subsequent pigtail catheter exchange; the clinical course was complicated by presumed septic pulmonary emboli and death.

Brief Review: Quantifying The Risks Of Snow Shoveling: Cardiac, Musculoskeletal, And Environmental Hazards, James Espinosa, Swet A. Patel, James Lee, Alan Lucerna

Rowan-Virtua Research Day

Snow shoveling is a common winter activity in cold-weather regions, yet it uniquely combines intense physical exertion, cold exposure, and environmental hazards. Emergency Departments routinely observe seasonal increases in snow-shoveling–related musculoskeletal injuries, falls, and acute cardiovascular events. Despite this, the cardiovascular risk of snow shoveling is not well emphasized in medical education or patient counseling. Snow shoveling is associated with quantifiable and clinically significant risks, including musculoskeletal injury, falls, and acute cardiovascular events, which are reviewed here.

Ice Water Immersion–Associated Syncope: A Case Report With Mechanistic Review And Public Safety Implications, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Sudden ice water immersion can provoke syncope in otherwise healthy individuals, particularly during first-time exposure. We present a case of a 56-year-old man with mild hypertension and hyperlipidemia who experienced abrupt syncope during entry into cold water at a charitable group immersion event. Emergency department evaluation, including electrocardiography and cardiac biomarkers, was normal. Observation and cardiology consultation supported a diagnosis of provoked, immersion-related syncope. This case highlights the physiologic mechanisms of cold shock and autonomic conflict, the potential drowning risk associated with loss of consciousness during water entry, and the opportunity for improved discharge counseling and public safety messaging.

Effect Of Sauna On Cardiovascular Health In Patients With Heart Failure, Rikuto Abe, Piotr Domaszewski, Safe Elhakeem

Rowan-Virtua Research Day

Abstract

Heart failure (HF) is one of the hallmark diseases that represent a decline of cardiovascular function. Heart failure is characterized by a decrease in the ability of the heart to pump blood throughout the body, leading to symptoms such as fatigue, dyspnea, and swelling. HF is shown to decrease quality of life and increase mortality. Traditional treatments include pharmacology, lifestyle modifications, and surgery. Among the treatments, deliberate heat exposure in the form of dry saunas has been highlighted as a potential treatment option for HF. Dry saunas, especially infrared saunas, are shown to increase body temperature which improves circulation …

Determining The Impact Fitness Training Has On Cardiovascular Health Program For New Jersey Women With Socioeconomic Disadvantages, Aishwarya Muppoor, Amy Glasofer, Lisa Rosenberry, Emma Palma, Dawn Mcmath

Rowan-Virtua Research Day

WISEWOMAN is a 3-year federally funded program offered through Virtua Health to address lifestyle changes in women age 35-64 at risk for heart disease. The purpose of this project was to evaluate the additional of a fitness program to the standard nutrition program offered through Virtua Health’s WISEWOMAN program. Nutrition programming occurred during years 1 and 2 of the WISEWOMAN program, and fitness programming was offered to women in program year 3. Women who received nutrition + exercise (intervention) will have improved outcomes compared to those who receive nutrition programming only (control). We conducted a retrospective chart review to compare …

Mid- To Long-Term Durability Of Thoracic Endovascular Aortic Repair For Blunt Thoracic Aortic Injury: Outcomes In ≥ 45 Comparator Cohort, Andrew Lawrence Frankini, Gianna Rose Zanghi, Margaret Schwab, Valentina Sara Sica, Larry Andrew Frankini Md

Rowan-Virtua Research Day

Blunt traumatic thoracic aortic injury (BTAI) is a primary cause of mortality in blunt trauma injuries, with motor vehicle collisions representing the majority of cases.^1-4 Thoracic endovascular aortic repair (TEVAR) is the standard of care for managing this vascular emergency.⁵ While TEVAR demonstrates favorable short-term outcomes, there is an insufficient characterization of cumulative mid- to long-term reinterventions and device-related complications in BTAI patients.

We conducted a meta-analysis/systematic review of studies reporting outcomes after TEVAR for BTAI in patients ≥45 years. This review was conceptualized as a comparator to the previously reviewed outcomes in younger patients (< 45 years) performed by Frankini et al. (2026)⁶, …

The Impact Of Diet Modification And Physical Exercise On Chronic Htn Outcomes Compared To Typical Prescription Treatment Regimen, Artem Duda, Aishwarya Muppoor, Ahson Haider, Meshva Patel, Katherine Xie, Faiqa Ali

Rowan-Virtua Research Day

Hypertension remains a leading global cause of cardiovascular morbidity and mortality, affecting over one billion individuals worldwide. While pharmacologic therapy remains the standard of care, growing evidence supports the role of lifestyle modification as an effective strategy for hypertension control. This literature review evaluates the effectiveness of dietary interventions and physical exercise versus standard antihypertensive medication regimens in adults with chronic hypertension. Following PRISMA guidelines, a comprehensive search of PubMed and Embase (2015–2025) identified 5,178 citations, with 12 systematic reviews and meta-analyses meeting inclusion criteria. Across studies, structured exercise and dietary interventions consistently reduced systolic blood pressure by approximately 3–12 …

Hormonal Contraceptives And Menstrual Symptom Severity Among Women With Elevated Cardiovascular Disease Risk: Global And Daily Assessment, Maria Cox, Danielle Arigo, Gabrielle M. Salvatore

Rowan-Virtua Research Day

Hormonal contraceptive (HC) use is primarily for pregnancy prevention and may reduce menstrual symptoms in some individuals, though evidence is inconsistent. The aim of the study was to examine differences in symptom presence and severity among 64 menstruating women with ≥1 CVD risk factor (e.g., hypertension), including HC users (20.63%) and non-users (79.37%; sample M_age= 31.88 ± 9.89, M_bmi= 31.79 ± 7.6). Participants completed the global Premenstrual Screening Tool at baseline and then reported the presence and severity of 16 menstrual symptoms (1=Not Present to 4 = Severe) in end-of-day surveys over 45 days. In a …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

Isolated Giant Aneurysm Of The Acute Marginal Branch Of Right Coronaryartery Presenting As Nstemi: Successful Direct Surgical Repair Preserving The Native Flow, Sai Kumari Ms., Anbarasu Mohanraj Dr, Saranya Damodaran Ms

Journal Of Indian Physician Associates

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter^1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch …

Evaluation Of The Effectiveness Of Antihypertensive Therapy Chosen Through Maternal Hemodynamic Profile Analysis, Margaret Weimer

Poster Presentations

In treatment of emergent hypertension, the American College of Obstetricians and Gynecologists (ACOG) recommends both oral labetalol and nifedipine, with no preference shown between the two. These medications have different mechanisms of action. Studies have suggested that consideration of hemodynamic profile may be an effective way to determine medication, but have not considered the Rule of 55, a simple calculation to predict hemodynamic profile.

Goals: 1. Determine if tailoring the antihypertensive to patient’s hemodynamic profile is associated with better control of blood pressure. 2. Determine if the Rule of 55 is an accurate method to determine hemodynamic profile.

Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Poster Presentations

No abstract provided.

Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Honors Theses

In low- and middle-income countries (LMICs), cardiovascular diseases (CVDs) are prevalent and pose a major concern as the current healthcare systems are oriented primarily towards communicable diseases. The largest contributor to CVDs, hypertension, is a significant issue in Kenya, a model LMIC. Based on previous studies in this lab, high rates of hypertension are present in the region of Kasigau, Kenya. Kasigau is a small region within Taita-Taveta County, Kenya. Traditional risk factors are not necessarily predictive of hypertension in all regions of Kenya. This study aims to address the lack of tested risk factors for hypertension in Kenya and …

Clinical Case Study: The Effects Of Task Dynamics And Saltatory Pneumotactile Stimulation On Cerebral Oxygenation, Cognitive Performance, And Sensorimotor Function In An Adult Following Left Ischemic Mca Stroke, Bridget Slagle

College of Education and Human Sciences: Dissertations, Theses, and Student Research

In the chronic stage of stroke recovery, neuroplasticity is thought to require external influence, and is often considered to be experience-dependent, or “Hebbian,” plasticity. Current studies have been investigating multiple ways to induce plasticity to enhance recovery, including investigating the role of sensory stimulation in cortical priming to enhance the effects of rehabilitation interventions.

This case study of an 80-year-old female with aphasia after L-MCA ischemic stroke included 18 neurotherapeutic sessions over 10 weeks. Each session included pneumotactile somatosensory stimulation to the glabrous hand and perioral face, delivered to both the left and right side via the GALILEO, as well …

Adventitial Macrophage Accumulation Impairs Perivascular Nerve Function In Mesenteric Arteries With Inflammatory Bowel Disease, Elizabeth A. Grunz, Benjamin W. Jones, Olubodun Michael Lateef, Sidharth Sen, Katie Wilkinson, Trupti Joshi, Erika M. Boerman

Biomedical Sciences

Introduction: Inflammatory bowel disease involves aberrant immune responses and is associated with both cardiovascular disease risk and altered intestinal blood flow. However, little is known about how inflammatory bowel disease affects regulation of perivascular nerves that mediate blood flow. Previous work found perivascular nerve function is impaired in mesenteric arteries with Inflammatory bowel disease. The purpose of this study was to determine the mechanism of impaired perivascular nerve function.

Methods: RNA sequencing was performed on mesenteric arteries from IL10−/− mice treated with H. hepaticus to induce disease (inflammatory bowel disease) or left non-gavaged (Control). For all other studies, Control and …

Out-Of-Pocket Costs And Antihypertensive Medication Use Among Veterans: A Natural Experiment, Alexander R. Zheutlin, Alexander Chaitoff, Daniel Addo, Joshua A. Jacobs, Catherine G. Derington, Eric L. Stulberg, Peter A. Glynn, Bernardo Modenesi, Jordana B. Cohen, Adam P. Bress

Department of Neurology Faculty Papers

BACKGROUND: Blood pressure (BP) control remains suboptimal in the United States despite available low-cost antihypertensive medications. Even small out-of-pocket medication costs may contribute to adherence. We determined whether $0 versus >$0 out-of-pocket costs for antihypertensive medications is associated with differences in adherence, discontinuation, BP control, and cardiovascular outcomes.

METHODS: We included veterans with newly diagnosed hypertension who initiated antihypertensive medication in the Veterans Health Administration from 2004 to 2022. A fuzzy regression discontinuity design with 2-stage residual inclusion leveraged differences in medication copay policy at a 50% service-connected disability threshold (≥50% service-connected disability: $0 out-of-pocket cost versus < 50%: $8 monthly cost). Outcomes included 1-year medication nonadherence (proportion of days covered < 80%), 1-year medication discontinuation (no medication in the final 90 days of the study year), 1-year BP control (systolic BP/diastolic BP < 140/90 mm Hg and < 130/80 mm Hg) and cardiovascular disease events (myocardial infarction, coronary revascularization, peripheral artery disease, or stroke).

RESULTS: Among 417 …

Infective Endocarditis Hospitalizations In Kentucky, 2008-2018: Spatial And Temporal Trends, Meera Marji, Steve Browning, W. Jay Christian, Richard Charnigo, Steve W. Leung, Anna Kucharska-Newton

Journal of Appalachian Health

Introduction: Infective endocarditis (IE) hospitalization rates have increased significantly in the last decade, primarily due to the opioid epidemic. In 2016, Kentucky (KY) ranked among the top ten states for opioid-related overdose deaths, but limited data exist on IE trends in KY.

Purpose: This study seeks to examine county-level spatial and temporal trends in IE hospitalization rates in KY.

Methods: Hospital inpatient discharge data from 2008–2018 for KY residents aged 18 and older were analyzed. IE admissions and drug use status were identified using ICD-9 & 10 diagnosis codes. U.S. Census data calculated yearly IE hospitalization rates per 100,000 residents. …

Trends And Demographic Disparities In Septicemia-Associated Cardiac Arrest Mortality In The United States, 1999–2023, Muhammad Owais, Maham Mehfooz, Hamza Nazir, Preeti Advani, Roha Riaz, Khanij Arya, Javeria Nawaz, Syed Hadi Raza Rizvi, Murtaza Aslam, Usman Nazeer, Jairo Melo, Bravein Amalakuhan

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Recurrent Ventricular Tachycardia In Young Hcm Patient With Icd, Michael Rollins, Garza, Laura Preece

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Selfwrap-Assisted Arteriovenous (Save) Fistulas Study: Updates And Preliminary Safety Data, Sydney Parker, Ahmad Lambert, Shir Yelovitch, Mike Barakat, Tim Boire, Ryan Turley

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Structural Degeneration Of The Neoaortic Valve Leading To Pseudoaneurysm And Neurologic Complications Post-Ross Procedure, Cassandra Millan, Sarita Thanedar, Chandra Kunavarapu

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

The Future Of Right-Sided Endocarditis?: A Case Report Of Tricuspid Valve Endocarditis Treated With Angiovac And Review Of Current Literature, Saad Masud, Gongkai Liu, Hayyan Yousuf, Bravein Amalakuhan

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Statin Use In Pregnancy: Pilot Study In El Paso Texas Border Population, Margaret Klausmeyer, Mateo Rivera, Manuel Rivera-Alsina

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.