Diseases Commons^™

Myxedema Coma: Recognizing A Silent But Potentially Fatal Emergency, Aashna Chaudhry, Robin Lahr, James Espinosa, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Myxedema coma is an endocrinologic emergency that requires prompt recognition and treatment. It is described as severe hypothyroidism characterized by life-threatening slowing of metabolic processes, often occurring in the setting of precipitating factors such as trauma, infection, medications, or cold exposure. This case report presents a clinical case in which early suspicion of myxedema coma in an elderly female patient led to prompt treatment and life-saving measures.

An Elusive Diagnosis: Pheochromocytoma Presenting With Hyperglycemia And Hypertensive Crisis, Tucker Ledo

Rowan-Virtua Research Day

Pheochromocytoma is a rare catecholamine-secreting tumor that can present with a wide range of nonspecific symptoms, often mimicking more common medical conditions and making early diagnosis difficult. We report the case of a 40-year-old female with a history of hypertension and prediabetes who presented to the emergency department with hyperglycemia following an episode of lightheadedness. This case highlights the diagnostic challenge of pheochromocytoma in the emergency department, where initial symptoms may be subtle and easily attributed to more common conditions such as hypertension, diabetes, or menopause. Recognition of episodic sympathomimetic symptoms and unexplained hypertensive crises should prompt consideration of pheochromocytoma …

Case Report: Ascending Cholangitis Presenting As Sepsis With Encephalopathy In An Older Adult With Choledocholithiasis, David Marconi, James Espinosa, Alan Lucerna

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Acute cholangitis is a potentially life-threatening biliary infection usually precipitated by ductal obstruction. In adults ≥80 years, classic right upper quadrant pain and jaundice may be absent and delirium may predominate, increasing the risk of diagnostic delay.¹

An 82-year-old woman presented with generalized weakness and altered mental status. She was febrile (101.9 °F [38.8 °C]) and tachycardic (113 beats/min) without hypotension. Laboratory testing demonstrated leukocytosis and marked cholestatic liver injury (total bilirubin 2.8 mg/dL, alkaline phosphatase 660 U/L) with hyperbilirubinemia and acute encephalopathy consistent with sepsis-associated organ dysfunction. Computed tomography and ultrasound suggested biliary obstruction and cholelithiasis; magnetic resonance cholangiopancreatography …

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.

Molten Sugar Burn To The Dorsal Foot: A Case Highlighting Unique Thermal And Adhesive Injury Mechanisms, James Espinosa, Alan A. Lucerna

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This brief case report emphasizes injury mechanism and anatomic vulnerability rather than burn management, as treatment of deep partial-thickness burns is well established. The clinical value of this case lies in recognizing molten sugar as a uniquely hazardous thermal agent capable of producing deceptively deep injury, particularly when contact occurs on the dorsal foot.

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.

Refeeding Syndrome In A Person Experiencing Homelessness: A Case Report, James Espinosa, Jose Gerald Aragon, Md Fateha, Alan Lucerna

Rowan-Virtua Research Day

Refeeding syndrome (RFS) is a potentially life-threatening metabolic disturbance that occurs following nutritional reintroduction in severely malnourished individuals. It is characterized by rapid intracellular shifts of electrolytes—most notably hypophosphatemia—driven by insulin-mediated metabolic changes. Although commonly associated with eating disorders and chronic illness, RFS may also occur in socially vulnerable populations.

We report the case of a 64-year-old male experiencing homelessness who presented to the emergency department with weakness, muscle cramps, and confusion after resuming regular meals at a local shelter following prolonged minimal intake. Laboratory evaluation revealed severe hypophosphatemia (0.7 mg/dL), hypokalemia (3.0 mmol/L), and hypomagnesemia (1.2 mg/dL). Electrocardiogram demonstrated …

Shopping Cart–Related Injuries In Children: Brief Clinical Review And Public Health Implications, James Espinosa, Alan Lucerna

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Shopping cart–related injuries represent a common yet underrecognized mechanism of pediatric trauma. National estimates suggest approximately 24,000 children annually are treated in U.S. emergency departments for shopping cart–related injuries, with falls accounting for the majority of cases. Younger children, particularly those under 5 years of age, are disproportionately affected, and head and facial injuries predominate.

Objective:

To provide a concise clinical and public health review of shopping cart–related pediatric injuries, with emphasis on epidemiology, injury patterns, and opportunities for prevention within emergency department practice.

Methods

Narrative review of national injury surveillance data, prior epidemiologic studies, and consumer safety guidance addressing …

High-Intensity Interval Training And Circulating Brain-Derived Neurotrophic Factor In Healthy Young Adults: A Scoping Review, Rikuto Abe, Safe Elhakeem, Mohamed Elhakeem

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Abstract

Background: Brain-derived neurotrophic factor (BDNF) plays an important role in synaptic plasticity, neuronal survival, and cognitive function (1,2,3). High-intensity interval training (HIIT) has emerged as a time-efficient exercise modality capable of inducing neurotrophic adaptations (4,5). However, the magnitude and consistency of its effects on circulating BDNF remain unclear.

Objective: This scoping review evaluated the current evidence examining the effects of HIIT on circulating BDNF levels measured via enzyme-linked immunosorbent assay (ELISA) in healthy young adults.

Methods: A systematic search of PubMed, Embase, and Scopus was conducted for randomized and controlled clinical trials published between 2020 and 2025. Studies were …

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

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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 …

Gut Microbiota Dysbiosis In Down Syndrome: Implications For Gastrointestinal And Neurological Health, Ashlyn Mcclelland, Jennifer Lecomte, Wendy Aita, Andrea Iannuzzelli

Rowan-Virtua Research Day

Down syndrome (DS) is the most common autosomal aneuploidy and has strong associations with increased gastrointestinal, neurological, and immune disorders. Emerging evidence suggests that gut microbiota dysbiosis may play a prominent role in disorders of gut-brain interaction, including constipation and irritable bowel syndrome affecting over half of individuals with DS. This review examines how gut microbiota alterations can contribute to chronic systemic inflammation and neurological manifestations in DS. Included articles were published between 2014 and 2025 and evaluated microbiota composition, inflammatory markers, and gastrointestinal or neurological outcomes in human or animal models of DS.

Across seven studies, characteristic microbiome shifts …

From Confirmation To Guidance: Making The Case For Intraprocedural Pocus As The Next Developmental Step In Ultrasound-Supported Shoulder Reduction A Conceptual Practice Proposal And Research Agenda, James Espinosa

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Point-of-care ultrasound (POCUS) is well established for the diagnosis of shoulder dislocation and for the confirmation of successful reduction. However, its role during the reduction maneuver itself remains under-described. This conceptual practice proposal argues that intraprocedural POCUS represents the logical next developmental step in ultrasound-supported shoulder reduction. By introducing real-time visualization of humeral head translation during reduction attempts, clinicians may identify ineffective vectors earlier, adjust technique midstream, and potentially reduce repeated attempts or escalation of procedural sedation. This work does not present outcome data but instead proposes a practical framework, workflow model, and research agenda for intraprocedural implementation. Future study …

Rainfall, Air Quality, And Vaso-Occlusive Crisis In Adults With Sickle Cell Disease, James Espinosa

Rowan-Virtua Research Day

.Patients with sickle cell disease (SCD) frequently report that weather changes precipitate vaso-occlusive crises (VOC). While prior investigations have focused primarily on temperature, humidity, and seasonal variation, emerging data suggest that rainfall patterns may represent a more meaningful environmental signal. In a multi-hospital Emergency Department analysis, below-average rainfall days were associated with significantly increased adult VOC presentations (Ahmed et al., 2023). Rainfall may function as an atmospheric clearing mechanism; reduced precipitation may permit accumulation of airborne particulate matter and environmental pollutants, increasing oxidative stress and endothelial activation—mechanisms central to vaso-occlusion. Multiple epidemiologic studies demonstrate associations between particulate exposure and increased …

Designing For Difference: A Systems Approach To Sensory-Adaptive Care In The Emergency Department, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Children with genetic syndromes and other neurodevelopmental conditions frequently present to the Emergency Department (ED) with sensory vulnerabilities that complicate evaluation and treatment in high-stimulus environments. While experienced clinicians often adapt instinctively to meet these needs, such adaptations may be inconsistently applied and may also be highly individual provider dependent. We present a case involving a child with a genetic syndrome affecting auditory and visual systems to illustrate how small environmental, relational, temporal, and cognitive adjustments can prevent escalation and enable routine care delivery without specialized resources.

We propose reframing sensory-adaptive care not as an exceptional accommodation but as a …

The Physics And Biology Of High-Risk Falls: Biomechanical Analysis And Physics Assists In Understanding Why The Threshold For High-Risk Was Lowered To 10 Feet, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Recent revisions to the National Guideline for the Field Triage of Injured Patients lowered the high-risk fall threshold from >20 feet  to >10 feet for all ages. Guideline changes are multifactorial and typically reflect epidemiologic registry data, injury severity trends, and systems-level performance feedback. However, biomechanical analysis assists in understanding the importance of the change.

Objective: To demonstrate that a 10-foot fall generates sufficient kinetic energy and deceleration forces to exceed structural tolerance thresholds in multiple human tissues, and to show that fundamental physics independently supports the recent trauma protocol change.

Methods: Application of gravitational motion equations (v = …

The Epidemiology Of Sledding Injuries: Clinical Patterns And Public Health Prevention Strategies, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Sledding is a widely enjoyed winter recreational activity among children and adolescents. Although commonly perceived as low risk, sledding can result in extremity fractures, head injuries, and collision-related trauma. Emergency Departments frequently encounter sledding injuries during winter months, providing both clinical insight and opportunities for injury prevention counseling. An estimated 20,000–30,000 sledding-related injuries occur annually in the United States, most involving children and adolescents.

Objectives: To describe patterns of sledding injuries presenting to the Emergency Department and highlight practical safety recommendations physicians can communicate to families.

Methods: Conceptual review integrating Emergency Department observational experience with published literature on pediatric …

Obesity Paradox In Post-Cholecystectomy Outcomes: A Bmi Class–Based Trinetx Analysis At 6 Months And 1 Year, Jashanveer S. Johal, Mahmoud Al-Bataineh, Bianca Patel, Archana Salek, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Obesity is traditionally associated with higher perioperative risk, yet observational data suggest an "obesity paradox" in which obese patients experience comparable or better outcomes than non-obese peers. We evaluated the impact of obesity (BMI ≥30 kg/m²) and obesity class on post-cholecystectomy outcomes.

Methods: A retrospective cohort study was conducted using the TriNetX global federated network. Adults undergoing cholecystectomy with BMI < 30 kg/m² were propensity score–matched 1:1 to those with BMI ≥30 kg/m², yielding 81,048 patients per group. Primary outcomes included choledocholithiasis, procedural complications, need for ERCP, and ED/inpatient utilization; secondary outcomes included mortality, respiratory and cardiovascular complications, and upgrade of care. Outcomes were assessed at 6 months and 1 year. A prespecified subgroup analysis compared BMI 30–39 versus BMI ≥40 kg/m² (40,238 per cohort).

Results: Obese patients consistently demonstrated lower rates of major outcomes at both timepoints. At 1 year, BMI < 30 had higher risks of choledocholithiasis (9.1% vs. 8.0%; RR 1.13), procedural complications (3.8% vs. 3.1%; RR 1.22), ERCP (5.4% vs. 4.6%; RR 1.19), and ED/inpatient visits (30.3% vs. 28.8%; RR 1.05; all p< 0.001). Mortality was also higher in non-obese patients at 1 year (1.4% vs. 1.2%; RR 1.20). Within the obese subgroup, BMI 30–39 and BMI ≥40 had broadly similar complication and utilization rates, though 1-year mortality was lowest in class I–II obesity (0.8% vs. 1.0%; RR 0.85).

Conclusions: Obesity was associated with better post-cholecystectomy outcomes compared with BMI < 30 kg/m², supporting an obesity paradox in biliary surgery. BMI alone should not deter cholecystectomy, and perioperative risk stratification should incorporate factors beyond weight class.

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

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: 19 adults aged 30-64 were recruited from Rowan Medicine-Sewell clinics, with 13 participants (9 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 (HDL-C) using …

Bacteriophage Therapy Vs. Standard Antibiotics: A Review Of Treatment Efficacy For Recurrent Pediatric S. Pyogenes (Gas) Infections, Kartik Kannan Oms-I, Karina Malhotra Oms-I, Gabrielle Coccio Oms-I, Janhavi Belwalkar Oms-I, Jason Rienzo Oms-I, Samay Shukla Oms-I, Valerie J. Carabetta Phd

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Background: Antibiotic resistance poses a growing threat to pediatric infectious disease management, particularly in the treatment of Streptococcus pyogenes (GAS) infections.¹ While β-lactam antibiotics remain the first-line standard of care, their utility is limited by allergy prevalence and rising resistance among alternative antibiotic agents, such as macrolides, lincosamides, and tetracycline.^2,3 Given these trends, bacteriophage therapy has emerged as a promising adjunctive treatment modality, offering targeted bacterial lysis while sparing commensal microbiota.⁴

Methods: A systematic literature search was conducted across PubMed and Embase (2000–2025) using terms related to antibiotic resistance, Streptococcus pyogenes, bacteriophage therapy, and pediatric populations. …

Mental Health Comorbidities And Ibd Outcomes On Anti-Tnf Therapy, Jashanveer S. Johal, Mahmoud Al-Bataineh, Archana Salek, Bianca Patel, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes …

Risk Of Colorectal And Gastrointestinal Neoplasia In Inflammatory Bowel Disease Treated With Adalimumab Versus Vedolizumab And Ustekinumab: A 5-Year Multicenter Retrospective Cohort Study, Jashanveer S. Johal, Archana Salek, Mahmoud Al-Bataineh, Bianca Patel, Abdallah Hussein, Om Patel, Jason Hyman, Yecheskel Schneider

Rowan-Virtua Research Day

Background: Inflammatory bowel disease (IBD) is associated with increased colorectal cancer (CRC) risk, but comparative neoplastic risks across biologic classes remain uncertain. We evaluated 5-year risks of CRC and GI neoplasia in IBD patients treated with adalimumab versus vedolizumab and ustekinumab using real-world data.

Methods: Using the TriNetX Global Collaborative Network, two parallel 5-year propensity score–matched cohort analyses were conducted among adults with Crohn's disease or ulcerative colitis initiating adalimumab, vedolizumab, or ustekinumab between 2018–2024, excluding patients with prior CRC or colectomy. The adalimumab–vedolizumab analysis matched 13,292 patients per cohort; the adalimumab–ustekinumab analysis matched 14,591 per cohort. Primary outcomes were …

Impact Of Chronic Kidney Disease On Outcomes Following Endoscopic Retrograde Cholangiopancreatography (Ercp): A Propensity-Matched Cohort Study Using The Trinetx Database, Jashanveer S. Johal, Mahmoud Al-Bataineh, Archana Salek, Bianca Patel, Abdallah Hussein, Om Patel, Jason Hyman, Yecheskel Schneider

Rowan-Virtua Research Day

Background: Chronic kidney disease (CKD) is known to influence clinical outcomes across a range of procedures, but its impact on endoscopic retrograde cholangiopancreatography (ERCP) outcomes remains poorly characterized. We evaluated the association between CKD and post-ERCP survival and procedural complications.

Methods: A retrospective cohort study was conducted using the TriNetX database. Adults with CKD stages 1–5 undergoing ERCP between 2010–2024 were identified and compared to patients without CKD undergoing the same procedure. Propensity score matching (1:1) was performed to balance known demographic and clinical confounders. Primary outcomes included 30-day all-cause mortality, procedural complications, all-cause infections, and gastrointestinal bleeding. Adjusted hazard …

Anesthetic And Perioperative Challenges Of End-Stage Liver Disease In Non-Hepatic Surgery: A Case For Score-Triggered Perioperative Protocols, Katarina Rusinak Bs, Christopher Hoffman Do, Cory Levitt Md

Rowan-Virtua Research Day

Introduction: End-stage liver disease (ESLD) significantly increases perioperative morbidity and mortality during non-hepatic surgery. Although validated risk stratification tools, including the Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores, are available, their use frequently remains limited to quantifying risk without prompting standardized perioperative protocols. This case demonstrates that elevated cirrhosis-specific risk scores should function as triggers for enhanced preparation and multidisciplinary planning, following models established in other high-risk clinical contexts.

Case Report: A 43-year-old female with decompensated alcohol-related cirrhosis was scheduled for total thyroidectomy for papillary thyroid cancer, a procedure required for liver transplant eligibility. Preoperative evaluation revealed …

Glp-1 Receptor Agonists In Obstructive Sleep Apnea: Association With Fractures, Bone Health, And Clinical Outcomes In A Propensity-Matched Cohort, Shefali Waghray, Om Patel, Jashanveer Singh Johal, Jason Hyman

Rowan-Virtua Research Day

Title: “GLP-1 Receptor Agonists in Obstructive Sleep Apnea: Association with Fractures, Bone Health, and Clinical Outcomes in a Propensity-Matched Cohort”

Background: GLP-1 receptor agonists have demonstrated benefits beyond glycemic control, but their impact on musculoskeletal and clinical outcomes in obstructive sleep apnea (OSA) remains poorly defined. We evaluated the association between GLP-1 agonist use and fractures, osteoporosis, vitamin D deficiency, falls, hospitalizations, and mortality in OSA patients without baseline fractures, osteoporosis, vitamin D deficiency, or alcohol use disorder.

Methods: A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Adults (≥50 years) with OSA and BMI ≥18.5 kg/m² …

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 …

Effect Of Pcos Treatment On Mental Health Outcomes, Audriti Mazumder, Aubrey Olson

Rowan-Virtua Research Day

Abstract (250 words)

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with a range of physical symptoms, including hirsutism, acne, weight gain, insulin resistance, and infertility. While its metabolic and reproductive manifestations are well characterized, the impact of PCOS on mental health remains underexplored. This study aims to evaluate the relationship between PCOS and mental health outcomes, with a particular focus on changes in symptoms following treatment and the influence of demographic factors.

A survey-based study was conducted using a Qualtrics questionnaire distributed via QR code and social media platforms. Questions were modeled after validated screening tools, including …

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

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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, …

Efficacy Of Omalizumab And Exposure Immunotherapy In Reducing Allergic Immunological Response, Joshua James Novello, Michelle Lau, Josephine L. Miner, Mudassir A. Rahmani, Kimran Sandhu, Taha Umar

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Background: Food allergy negatively impacts numerous children in the United States. Oral immunotherapy (OIT) and biologic therapy (omalizumab) are emerging promising strategies for desensitization. This literature review aims to compare the effectiveness of omalizumab and oral immunotherapy in pediatric populations.

Hypothesis: If the use of omalizumab therapy is used to treat children with food allergies compared to OIT, then there would be higher desensitization, lower post-treatment IgE levels, higher IgG4 levels, and decreased chance of a positive skin prick test.

Methods: PubMed, Embase, and The Lancet databases were searched using PRISMA guidelines to locate peer-reviewed studies evaluating …

Holmes Tremor In A Patient With Multiple Sclerosis: A Case Report, Delaney Rowe

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Multiple Sclerosis (MS) is a neurologic condition characterized by demyelination of motor neuron axons. About a third of MS patients experience tremor, typically postural or intention type. This case study details a patient with a history of Multiple Sclerosis-associated therapy-resistant severe rubral tremor. Reviewed literature demonstrates an increased need for diagnostic tools specific to MS patients with Holmes tremors, as well as further investigation of dopamine-based pharmacologic therapy for such patients.