Diseases Commons^™

The Impact Of The Covid-19 Pandemic On Pediatric Obesity In School-Aged Children, Amaani Faizal, Maryanna Schweininger, Suzanna Hosein

Rowan-Virtua Research Day

The prevalence of childhood obesity in those aged 2-19 in the United States was 19.3% in 2017-2018. Childhood obesity is a major health concern with growing rates of incidence. Being overweight or obese put children at risk for developing several chronic conditions such as coronary artery disease, type 2 diabetes mellitus, hypertension and asthma at a younger age. Studies have shown that higher BMI numbers in childhood added an increased risk of being obese as an adult.

The pathophysiology of developing obesity includes several complex factors ranging from nutrition, physical activity, genetic background and lifestyle preferences. Among children, nutrition and …

The Impact Of Racial Disparities And Outcomes On Urinary Anastomotic Leak In Radical Prostatectomy, Young Son, Benjamin A. Fink, Lance Earnshaw, Brian Thomas, Fred Okoye, Ryan Moriarty, Kathryn Goettle, Thomas Mueller

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Prostate cancer is the leading malignancy and third most common cause of cancer death among men. In the United States, racial disparities exist in prostate cancer incidence and mortality rates. According to the National Cancer Institute, African American (AA) men have a significantly increased incidence of prostate cancer compared to Caucasians or Asians. Urinary leak at the urethrovesical anastomosis has been cited as a complication of radical prostatectomy (RP), with incidence rates as high as 23%. Urinary anastomotic leak is associated with increased rates of ileus, prolonged hospitalization rates, and longer time to achieve continence. The etiology of risk factors …

Trends In Pediatric Obesity Of School-Aged Children During The Covid-19 Pandemic, Maryanna Schweininger, Amaani Faizal, Suzanna Hosein

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Since the start of the COVID-19 pandemic, children have been more sedentary due to nationwide school closures resulting in classes being held virtually. Due to restrictions, children could no longer participate in physical education classes and after school activities at the same frequency. The pandemic also placed a disproportionate burden on low-income families thus, potentially amplifying food insecurity. The aim of this study was to identify the impact of the COVID-19 pandemic on childhood obesity.

Complications Of Fitz-Hugh-Curtis Syndrome In A Teenage Female: A Case Presentation, Marina Cugliari, Trupti Pandit

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Fitz-Hugh-Curtis Syndrome is a manifestation of Pelvic Inflammatory Disease (PID) associated with Chlamydia trachomatis infections and less frequently with Neisseria gonorrhea.

PID affects sexually active women (15-30 years old) and accounts for 750,000 cases each year.

The case presented illustrates a female who presented with a small bowel obstruction and appendicitis, who was incidentally found to have Fitz-Hugh-Curtis Syndrome on laparoscopic exam.

Appendiceal Diverticulum Masquerading As Acute Appendicitis, Aesha Patel, Asad Abbas, Ratul Bhattacharyya, Dana Galaktionova

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Appendiceal diverticula present as rare clinical findings and are most often confused with acute appendicitis due to similar presentation. The incidence in such cases is reported at a rate no greater than 1%.

We present a rare case of a 65-year-old female treated for acute appendicitis who was instead found to have acute sequelae of appendiceal diverticulosis.

Cpap And Epistaxis: Is There A Connection In Osa Patients?, Aesha Patel

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Nasal continuous positive airway pressure (CPAP) has become a standard form of therapy for patients with obstructive sleep apnea (OSA). There are reports of patients suffering from episodes of epistaxis within the initial few weeks of starting CPAP therapy, believed to be due to the high flow rate of air during use, nasal CPAP purportedly dries the nasal mucosa, leading to an increased risk of scabbing, ulceration, and ultimately epistaxis. This study seeks to analyze whether epistaxis is common in patients following CPAP initiation and then compare this rate of epistaxis amongst OSA patients that received upper airway stimulation (UAS) …

Plasmalogen Deficiency: A Risk Factor For Dementias And Potential Treatment Target, Mitchel A. Kling, Mallika Mendu, Rima F. Kaddurah-Daouk, Sheldon Jordan, Dayan B. Goodenowe

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Altered lipid metabolism is implicated in the risk of sporadic Alzheimer’s disease (AD) and related dementias (ADRD); however, the precise mechanisms accounting for findings from observational studies remains to be fully elucidated.

Plasmalogens are a subclass of integral membrane phospholipids with unique properties that appear to play important roles relevant to the pathophysiology of AD and ADRD, including vesicle fusion necessary for synaptic neurotransmitter release, modulation of membrane fluidity and microdomain dynamics, membrane antioxidant functions, and neuroprotection. Like the more familiar phosphatides, plasmalogens are synthesized on a 3-carbon glycerol backbone; however, they differ from phosphatides by the presence of a …

Foci Of Idc In Phyllodes Tumors: Should We Be Worried?: A Systematic Review Of The Literature, Kathryn Eckert, Victoria Tiedemann, Linda Szczurek

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Phyllodes tumors are rare, fast growing fibroepithelial tumors of the breast that account for less than 1% of all breast tumors globally. They were first characterized by Johannes Muller in 1838 and most often present in the 5th decade of life. Phyllodes tumors are histologically composed of a stromal component and an epithelial component. The stromal component has a widely accepted malignant potential in up to 30% of cases. Grading of the stromal malignant potential of phyllodes tumors has been defined by the World Health Organization (WHO) as benign, borderline, or malignant based on the presence and degree of stromal …

Morphine-Induced Hyperactivity Is Attenuated By Intra-Accumbens Administration Of The Highly-Selective Dopamine D3 Receptor Antagonist Vk4-40, Mansi Patel, Desta M. Pulley, Daniel Manvich

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Opioids exert their abuse-related effects by enhancing dopamine (DA) neurotransmission within the brain’s mesolimbic reward system, a neural projection involving DA neurons in the ventral tegmental area (VTA) that project to medium spiny neurons within the nucleus accumbens (NAc). Mu (MOR) are expressed by several populations of GABAergic neurons that tonically inhibit VTA DA neurons. By inhibiting these GABAergic neurons in a MOR-dependent manner, opioids indirectly enhance DA neurotransmission via disinhibition of DAergic neurons. Accumulating evidence indicates that selective pharmacological antagonism of the dopamine D3 receptor (D3R) attenuates the abuse-related effects of several opioids, but the neurobiological mechanisms mediating this …

A Brief Literature Review On Heparin: To Bolus Or Not To Bolus, That Is The Question, Alex Gechlik, James Espinosa, Alan Lucerna, Kishan Patel

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Heparin is an anticoagulant medication, used to inhibit the formation of thrombi that pose arteriolar and vein-occlusive risk. The choice between starting a heparin infusion with or without an initial bolus is case dependent based on whether a patient is already anticoagulated and if so, foregoing an initial bolus. In contrast, both anticoagulated and non-anticoagulated patients share the same goal when receiving Heparin for various thromboembolic syndromes, and that is to be within aPTT target range of 1.5-2.5 or 45 to 75 seconds. Falling below goal range leads to a 20-25% recurrence of VTE, and aPTT above goal range has …

A Case Report Of Suspected Choledocholithiasis 20 Years After Cholecystectomy, Maleeha Memon, Dhara Rana, Chandni Patel, Christine Leroy, Bijal Sheth

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Gallstones are a common prevalence in western societies where approximately 15% of Americans have gallstones. The mainstay treatment for symptomatic cholelithiasis is laparoscopic cholecystectomy. It is estimated approximately 650,000 to 700,000 cholecystectomies are performed every year. Most patients feel relief after a laparoscopic cholecystectomy, but a small number of patients experience post cholecystectomy syndrome, which presents as biliary colic pain. Although the pathophysiology of the post cholecystectomy syndrome is unclear, one theory proposes that it is due to the alteration in bile flow after the removal of the gallbladder, which serves as a reservoir for bile. This bile is thought …

A Case Of Acute Disseminated Encephalomyelitis In An Adult Male With Bipolar Disorder, Jinisha Patwa, Tracey Harris

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Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating disease characterized by inflammation of the brain and spinal cord. The rapidly progressive inflammation in the central nervous system is known to occur in response to a prior infection or immunization.

The clinical signs of ADEM may manifest up to 60 days post illness or vaccination. Some develop encephalopathy and neurologic symptoms which include confusion, psychosis, and tetraparesis. Paresthesia of the limbs and muscular atrophy indicate a worse prognosis and higher risk of relapse as opposed to those with only CNS involvement. A predominantly psychiatric presentation is also possible.

Risk factors include …

A Suspected Case Of Vaccine Induced Thrombosis With Thrombocytopenia Following Sars Cov2 Vaccine, Maryam Soliman

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With the new development of the SARS-CoV vaccine and the majority of the population receiving this vaccine, it is important to recognize some of the rare side effects associated with it.

VITT is a rare complication of the COVID vaccine

Diagnostic criteria: COVID vaccine 4-24 days prior to symptom onset, any venous or arterial thrombosis, thrombocytopenia < 150, positive PF4 HIT ELISA, markedly elevated D-dimer >4x ULN.

Vaccine Induced Thrombosis with Thrombocytopenia is a potentially life-threatening diagnosis that must be recognized and treated correctly to prevent poor outcomes.

Arterial Thromboembolism As A Sequela Of Mild Covid-19 Pneumonia With Resultant Gangrene Of The Right Lower Extremity, Sean Coulson, Brian Thomas, Christopher Chhoun

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Hypercoagulable states leading to stroke, pulmonary embolism, and acute limb ischemia are well documented phenomena secondary to moderate-to-severe COVID-19 infections that produce significant respiratory morbidity.

Incidence is largely unknown with additional emerging clinical manifestations including, but not limited to: Viral and secondary bacterial pneumonia, respiratory failure, sepsis, stroke, acute kidney injury, pulmonary embolism, disseminated intravascular coagulation (DIC), as well as arterial and venous thromboembolism.

An Herbal Liver Effect: Ashwagandha-Induced Hepatotoxicity, Mohammad Rattu, Eric Maddock, James Espinosa, Alan Lucerna, Neeharika Bhatnagar

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Ashwagandha is a popular Ayurvedic herb that is derived from the extracts of the roots of Withania somnifera, an evergreen shrub endemic to India and Southeast Asia. It is generally utilized as a tonic to increase one’s energy and reduce stress levels. Often referred to as “Indian ginseng”, it provides neuroprotective and anti-inflammatory properties that address stress, pain, and fatigue. Additionally, it may assist in dealing with rashes, diabetes, and arthritis. It has also been shown to counteract the effects of aging. Though these properties have not been shown in prospective studies, it has become a popular product among western …

Alternate Site Pacing And The Impact On Intracellular Calcium Handling During The Post-Extrasystolic Cardiac Cycle, Kent Ozcan, Lawrence Mulligan

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Objective: Previous work has shown that alternate site (RV apex) results in myocardial dysfunction. With the development of tools to place endocardial pacing leads in locations that create physiological pacing activation, we sought to evaluate how ventricular trans-septal or left ventricular apical placement pacing differs from right atrial pacing. We will evaluate how these chronic pacing modes impact the PR and RF at baseline, 0, and 16 weeks in the canine heart.

Methods: Quantitative analysis will be performed on previously generated data. The data set includes pacing of 15 dogs total (8 with trans-septal leads & 7 with left ventricular …

Association Of Perceived Early Adequate Analgesia And Chronic Pain Severity, Sean Coulson, Sameer Akhtar, Brian Thomas, Aleesa Mobley

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Purpose: Establish if early adequate pain control is protective in the development of chronic pain syndromes.

Data collected via survey to patients being treated for chronic pain at the Neuromuscular Institute at RowanSOM

Data (small n) suggests patients with chronic pain have poorly controlled pain levels at the time of the acute event.

Anticipate with increased sample size will see a correlation between chronic pain prevalence and severity and perceived early adequate analgesia following the acute event.

Bullous Pemphigoid With Excoriation Disorder In A 59 Year Old Woman, Kaitlin Mcgowan, Stephen Poos, Nguyen Vo

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Bullous pemphigoid is the most common autoimmune blistering disease. Classic symptoms include blisters overlying urticarial plaques on the torso and extremities. The condition can result in intense pruritus that begins during the prodromal period.

Excoriation disorder is related to obsessive compulsive disorder (OCD) and is characterized by recurrent skin picking that results in lesions, repeated attempts to stop or decrease the picking, and resultant mental distress or impairment in functioning.

We present a case of a 59-year-old Caucasian female who presented with diffuse rash on most of her body. This particular case is notable for its concurrent severe dermatological and …

A Case Of Akinetic Mutism In Patient With Unilateral Anterior Communicating Artery Stroke, David Ho, Or Shachar, James Espinosa, Alan Lucerna, James Lee

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Akinetic mutism, a rare neurological condition involving sensory, motor, language, behavior, and emotional changes, mimicking locked-in syndrome, should be considered in acute stroke patients presenting with speech deficits. This condition, although debilitating initially, does have prospects for recovery. In this case report, we present the case of a patient presenting to the ER for altered mental status, found to be in DKA, NSTEMI, suspected narcotic overdose, and unilateral acute ischemic stroke of the left anterior communicating artery (ACA), who was found to have Akinetic Mutism. In stroke patients presenting with aphasia and dysarthria, it is worth considering akinetic mutism in …

Case Report: Thyrotoxic Hypokalemic Periodic Paralysis, Kelly Schuitema, Wayne Tamaska, Robin Lahr

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Thyrotoxic crisis, or thyroid storm, is an acute, life threatening event caused by hyperthyroidism with mortality up to 8-25% that can present with multi-system organ involvement. It is a rare, but well studied complication in the emergency department but can lead to further, less common complications. In this study we will discuss a case of thyrotoxic hypokalemic periodic paralysis. Thyrotoxic hypokalemic periodic paralysis (TPP) most commonly affects Asian men. The key features of the syndrome include acute onset of hypokalemia and paralysis. The hypokalemic aspect of the disorder is secondary to the shift intracellularly by thyroid hormones’ sensitization of Na+/K+-ATPase …

Case Report: The Heart Breaking Tale Of Takotsubo In The Ed, Richard Baluyot, James Espinosa, Alan Lucerna, Sergey Medlenov, Joseph Pagano, Bhumi Shah

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Chest pain is one of the most common chief complaints that emergency room physicians deal with on a daily basis. Here we present a rare cause of chest pain on a patient diagnosed with takotsubo cardiomyopathy. This is a condition that has been on the rise since its initial discovery and therefore clinicians should consider this on their differential when assessing patients with chest pain, especially postmenopausal women.

Syncope Masquerading As Pulmonary Embolism, Melissa Itidiare Locke, Andrew Caravello, Melanie Angelo, Andrew Vasta

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Syncope is a clinical syndrome that occurs due to a period of inadequate cerebral blood flow that cause a transient loss of consciousness that usually resolves within 8-10 seconds) [1] Our case demonstrates a 56-year-old female who experienced syncope for the first time. The patient had an unwitnessed fall and subsequently had imaging studies performed. A discovery of a Sub-Massive Pulmonary embolism was revealed.

Celiac Artery Aneurysm: A Rare Cause Of Abdominal Pain, Duwayne Campbell, Wayne Tamaska, Kevin Dwyer

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Celiac artery aneurysm is a very rare vascular lesion accounting for only 5.1% of all splanchnic artery aneurysms. Etiology for celiac artery aneurysm includes, but not limited to, infectious diseases, atherosclerosis, trauma, congenital conditions such as median arcuate ligament syndrome and iatrogenic causes.

Etiology for abdominal pain is extensive. Patients should be evaluated for both intra-abdominal and extra-abdominal causes for pain, as presentations of a different pathophysiology vary widely. CT scan has become a mainstay part of the work for abdominal pain in the Emergency department, and often elicit pathologies that would otherwise be missed on blood work and other …

Effect Of Uracil Dna Glycosylase Activity On The Efficacy Of Thymidylate Synthase Inhibitor/Hdac Inhibitor Combination Therapies In Colon Cancer, Rashmi Kulkarni, Brian P Weiser

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Human uracil DNA glycosylase (UNG2) is responsible for removing uracil bases from DNA and initiates base excision repair pathways. Accumulation of uracil or its fluorinated analogs in DNA is one of the killing mechanisms of thymidylate synthase (TS) inhibitors in cancer cells, and depletion of UNG2 often enhances the toxicity of these anticancer drugs. We tested the effect of UNG2 KO on the efficacy of multiple TS inhibitors (5-fluorouracil, fluorodeoxyuridine, and pemetrexed) and we determined that, except for 5-fluorouracil, all other TS inhibitors were significantly more potent in UNG2 KO cells compared to wild-type HT29 cells. Interestingly, UNG2 protein levels …

Effect Of Osteopathic Manipulative Treatment In Patients With Postural Orthostatic Tachycardia Syndrome (Pots): A Literature Review, Sidharth Sahni, Harrison Jordan, Binoy Desai, Danielle Cooley, Alexander King

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Postural Orthostatic Tachycardia Syndrome (POTS) is characterized by autonomic dysregulation resulting in diminished blood flow and excessive tachycardia.

POTS has been scarcely studied in the clinical setting. A review of literature generated only four articles, only one of which met the established criteria.

A follow up study to evaluate the effect of OMT on the quality of life for patients with POTS is planned. The hypothesis is that osteopathic manipulation plays a role in the management of POTS, as patients should experience improvement in their symptoms and their overall quality of life.

Case Study Of Metformin-Induced Lactic Acidosis, Kajel Patel, Kishan B. Patel

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Metformin induced lactic acidosis is when high levels of metformin cause dangerously high levels of lactic acid. Here is a case report of a 72-year-old female who came in for nausea, vomiting, and diarrhea found to have a high suspicion for metformin induced lactic acidosis. She stabilized in the emergency department, nephrology and ICU was contacted, and she went for emergent dialysis. For many patients the prognosis of metformin induced lactic acidosis is poor. This patient was made comfort care by her family.

Incidental Finding Of Unusually Large Renal Cyst During Point Of Care Ultrasound, David Ho, Jeffrey Gardecki

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Renal cysts are common, and their frequency and size increase as patients age. Renal cysts are derived primarily from tubules and can occur anywhere between Bowman’s capsule to the renal papilla. The cysts are composed of abnormally differentiated epithelial cells encapsulating a cavity of fluid. These abnormally differentiated cells are due to defects in the structure and function of cilia, the structures responsible for detecting urine flow as well as the epithelial composition of the epithelial architecture and repair. According to Campbell Urology, there are three processes in which renal cysts increase in their size – proliferation of epithelial cells …

Interaction Of Fluorescent Probes With Sirtuin Proteins, James Fusco, Brian P Weiser

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Sirtuins are a class of proteins belonging to the Sir2 (Silencing information regulator 2) family of NAD+ dependent protein lysine deacylases. Different Isoforms (SIRT1-SIRT7) differ in their specific deacylase activity and cellular location. They have roles in DNA repair, glucose metabolism, and cellular proliferation which make them highly desirable targets for carcinoma therapeutics. We previously used 1-aminoanthracene’s (AMA) fluorescent properties when bound with SIRT2 (Kd of 37 μM) to develop a high-throughput screen to identify novel ligands that inhibit SIRT2’s enzymatic activities. We hope to reveal other potential probes for future high-throughput screening with all the sirtuin isotopes. 1-AMA’s fluorescence …

Management Of Late-Stage Ewingoid Dedifferentiated Liposarcoma Of The Spermatic Cord With Emergent Complications: A Case Report, Raeann Dalton, Abdullah Junayed, Brian Thomas, Young Son, Megan Donlick, Kathryn Goettle, Lance Earnshaw, Thomas Mueller

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Liposarcoma (LS), a malignant tumor of adipose origin, is the most common soft tissue sarcoma (STS), and can develop within any soft tissue. It rarely occurs in the paratesticular region, and accounts for 3-7% of spermatic cord tumors. Dedifferentiated liposarcoma (DDLS) and well-differentiated liposarcoma (WDLS) account for two of the five subtypes of LS, with dedifferentiation occurring in 20% of cases. There have been 66 cases of DDLS of the spermatic cord reported to date, but none present with a 22/22q trisomy without the fusion or rearrangement that commonly produces these aggressive tumors.

Accurate diagnosis of LS of the spermatic …

Long-Term Lithium Use In The Younger Population: Do The Benefits Outweigh The Risks? - A Case Report, Seema Shekar, Alexander Garcia, Rachel Shmuts

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For decades lithium has been the mainstay treatment for bipolar disorder. While its side effect profile is extensive and varied its most notable adverse effect, and one most feared by treating clinicians, is nephrotoxicity/ end-stage renal disease (ESRD). While the link between long-term lithium use and ESRD has been accepted by the medical community at large for many years, more recent scientific studies call the association into question. In fact, newer studies on the association between Li use and ESRD have shown a negative/inconclusive correlation. Despite this controversy the consensus still remains that ESRD secondary to long-term Li use is …