Pathological Conditions, Signs and Symptoms Commons^™

Janus Kinase (Jak) Inhibitors: A New Frontier In The Treatment Of Vitiligo, Catherine F. Alapatt, Amanda Greenspan, Mohammad Fardos

Rowan-Virtua Research Day

Up to 70 million people worldwide suffer from vitiligo, an autoimmune disease characterized by the destruction of melanin. Current treatment options vary in efficacy. The disease manifests clinically as white circular macules of depigmentation seen primarily on the face and appendages.1 The pathophysiology of vitiligo is multifactorial and still being studied. One proposed mechanism behind the pathophysiology of vitiligo involves the upregulation of interferon gamma (IFN-γ) with downstream effects on JAK/STAT pathways resulting in CXCL10 transcription.1,2 Here we discuss Ruxolitinib, a topical JAK inhibitor, that recently passed its clinical trial phase, and Ritlecitinib, an oral JAK inhibitor which is currently …

The Benefits And Risks Of Pudendal Nerve Block And Dorsal Root Ganglion Stimulation In Pudendal Neuralgia, Pooja A. Patel

Rowan-Virtua Research Day

Context: Pudendal neuralgia is a chronic neuropathic pain syndrome worsening throughout daily activities. Although temporarily relieved when standing or lying down, it is often misdiagnosed, improperly treated, and/or refractory to treatment leading to a negative impact on quality of life. The lack of research in proper diagnosis and interventional management (such as dorsal root ganglion stimulation (DRGS) and pudendal nerve block) further contributes to the delay in relief from the chronic pain. Objective: The goal of this scoping review is to assess if research exists on benefits and risks of pudendal nerve block and dorsal root ganglion and …

Effect Of Exercise Intervention On Facioscapulohumeral Muscular Dystrophy (Fshd), John Desrochers

Rowan-Virtua Research Day

Facioscapulohumeral Muscular Dystrophy (FSHD) is a common muscular dystrophy. The facial muscles, shoulder girdles, and upper arms are notably affected.¹ A common presenting symptom is asymmetrical scapular winging and further symptoms may include but are not limited to: loss of pectoral muscles, fatigue, severe pain, pathologic spinal curvatures, and foot drop.² It is a particularly debilitating muscular dystrophy, with 20% of people >50 y.o. requiring a wheelchair.³ With no approved therapeutics, patients are managed symptomatically.³ This review sought to determine the effect of different exercise interventions on patients with FSHD. It is hypothesized that exercise may …

Identifying Chewing Alterations In A Parkinsonian Model, Nicholas Zanghi, Taylor Good, Shivam Patel, Francois Gould

Rowan-Virtua Research Day

Patients suffering from Parkinson’s Disease will typically experience a range of motor and nonmotor symptoms. Characteristic signs of Parkinson’s include pill-rolling tremor, stooped posture, and shuffling gate. Patients with this disease can also develop oropharyngeal dysfunction, which can disable patients from meeting their physiologic needs. Understanding this disability and the changes in mastication kinematics can lead to potential future treatment. Our study induced Parkinson’s in rats with rotenone injections. Their jaw kinematics were identified through fluoroscopy of radio-opaque beads implanted into different areas of their jaws. The Parkinson’s induction altered mastication significantly with an increase in anterior/posterior range of motion …

Complications Following Hemivertebrectomy For Congenital Scoliosis, Sanjana Davuluri, Taemin Oh, Kyrillos Akhnoukh, Zachary Weingrad, Michael Lesgart, Terrence Ishmael, Joshua Pahys, Amer Samdani, Steven Hwang

Rowan-Virtua Research Day

Introduction:

Hemivertebrae are rare congenital anomalies that can cause severe scoliosis requiring surgical correction. We aimed to determine whether severity of deformities is associated with more long-term surgical complications following surgical correction.

Methods:

We performed a retrospective, single-institution review on patients who underwent hemivertebrectomy and spinal fusion for congenital scoliosis between 2008-2020. We extracted pertinent data on demographics, radiographic parameters, operative details, and complication rates. Subgroup analyses were also done by complication severity, deformity complexity, and construct length.

Results:

In our series, 30 patients underwent hemivertebrectomy and fusion. Mean age was 9±4.2 years and there was 2:1 male preponderance, with …

Morel Lavallee Lesion: A Shear Fascia-Nating Soft Tissue Injury, Isaac F. Su, James A. Espinosa, Alan A. Lucerna

Rowan-Virtua Research Day

Morel-Lavallée lesions (MLLs), first described by their namesake, French physician Victor-Auguste-François Morel-Lavallée, in 1863, represent a distinct category of soft-tissue degloving injuries. These injuries occur when a shearing force disrupts the connection between subcutaneous tissue and fascia, severing lymphatic vessels and capillaries, and leading to an encapsulated collection of lymph, blood, and necrotic fat. Because this space is deep and enclosed, the fluid accumulation cannot easily drain or resolve spontaneously and often an inflammatory capsule develops, further inhibiting resorption. Undiagnosed, patients go on to develop chronic pain, infection, skin necrosis, progressive neurovascular deficits, and, in severe cases, potential loss of …

Pneumocephalus – Epidural Injection Nightmare, Mohammad A. Rattu, Frank A. Wheeler

Rowan-Virtua Research Day

Pneumocephalus (pneumatocele or intracranial aerocele) is defined as the presence of air in the intracranial space and most commonly occurs after a traumatic event (most commonly head or facial injury), epidural injection, cranial surgery, However, it may also be spontaneous. Classified into simple and tension types, the presentation varies based on severity and progression. Pneumocephalus with onset less than 72 hours prior to presentation is defined as acute, in contrast to a delayed presentation greater than the given timeframe. Symptoms vary based on the amount of air that is present as well as the exact location within the cranial cavity. …

Auriculotemporal Nerve Block For Tmj: A Systematic Review, Hasan Zia, Usmaan Al-Shehab, Ahmed Gawash, Anthony Dipalma, Dale Johnson, Musa Dolley, David F. Lo, Ryan St. John, Zain Hassam, Don D. Shamilov

Rowan-Virtua Research Day

The purpose of this systematic review is to evaluate auriculotemporal nerve blocks for temporomandibular joint (TMJ) disorder management. 583 articles reviewed from five databases, selected four studies for pooled analysis on visual analog scale (VAS) and maximum mouth opening (MMO) outcomes. Pooled analysis showed significant improvement in VAS (-2.27, p < 0.001) and MMO (0.94, p = 0.03) post-auriculotemporal nerve blocks for TMJ disorder. Auriculotemporal nerve blocks demonstrate potential effectiveness in TMJ disorder treatment, warranting further research on long-term effects and side effects.

Splenic Artery Aneurysm Masquerading As Chest Pain: A Case Report Of A Rare Clinical Presentation, Emily Forester, Anjeanette Brown Md

Rowan-Virtua Research Day

Background: Splenic artery aneurysms most commonly present with vague epigastric or left upper quadrant abdominal pain that may radiate to the left shoulder. Chest pain associated with splenic artery aneurysm is an unusual phenomena. This case presents a rare occurrence of a splenic artery aneurysm originally presenting as atypical chest pain. Case Presentation: A 46 year old G3P2 AAF patient with family history of hypertension presented to the ER with pleuritic left chest pain, episodes of shortness of breath, and new onset hypertension. Chest x-ray and ECG were unremarkable. Pertinent labs included a hemoglobin of 10.6 and D-dimer of 4.10. …

Quincke’S Phenomenon – The Ace Inhibitor Culprit, Mohammad A. Rattu, Eric A. Maddock

Rowan-Virtua Research Day

Angioedema is defined as a non-pitting edema that involves the subcutaneous layer and additionally may include submucosal layers of tissue which pertain to the face, oral cavity, larynx, lips, extremities and gastrointestinal tract; this becomes a life-threatening situation particularly when there is involvement of the larynx. Angioedema may be classified as either histamine-mediated or bradykinin-mediated. Histamine-mediated, associated with mast-cell and basophil activation, is the most common. Bradykinin-mediated (secondary to hereditary, acquired C1-inhibitor deficiency, ACEI-associated angioedema) occur when an allergic reaction and hives will not trigger this reaction. The C1-inhibitor is a regular of the complement system and either dysfunction or …

Investigating The Link Between Preeclampsia/Eclampsia In Mothers And Cardiovascular Risk Among Their Neurodivergent Children, Jasmine Emanuel, Andrea Iannuzzelli, Venkateswar Venkataraman

Rowan-Virtua Research Day

Preeclampsia/Eclampsia are common gestational conditions among pregnant women. These individuals have hypertension after 20 weeks of gestation, proteinuria/end-stage organ disease, and may have seizures. These conditions can put the mother and fetus at risk.^1,2 A review of literature investigates whether an association exists between congenital heart defects (CHD), and maternal preeclampsia/eclampsia in the neurotypical and neurodivergent population. The Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population was used to investigate whether maternal preeclampsia/eclampsia is indicative of higher congenital heart disease (CHD) in their neurodivergent children to achieve better quality of care. As a first step towards exploring the …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Evaluation Of Unexplained Bone Fractures In A 3-Month-Old Infant – A Case Report, Hannah Ngo, Rachel Silliman Cohen

Rowan-Virtua Research Day

Child physical abuse is a significant cause of injury in infants and young children and can present in a variety of ways. Failure to recognize abuse in infants and young children can be life-threatening and is often recurrent until safety interventions occur. Consequently, it is of paramount importance that providers strongly consider child physical abuse on the differential, along with metabolic bone disease and accidental traumatic injury, when evaluating fractures in young children and infants. This case report will focus on the evaluation of a 3-month-old male infant who was admitted to the hospital with irritability and decreased right arm …

Clinical Outcomes For Patients With Nafld And Acute Hepatitis: An Analysis Of The National Inpatient Sample, Dakota B. Pastore, Tony Elias, Peter Senatore

Rowan-Virtua Research Day

Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in the United States and has been found to play a significant role in cardiovascular disease risk through several mechanisms including dyslipidemia, insulin resistance, coagulability, and inflammation. Acute-on-chronic liver disease continues to contribute to worse health outcomes via acute hepatitis.

Methods: This case-control study investigated the relationship between NAFLD and acute hepatitis using data extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS was searched for hospitalizations of adult patients with acute hepatitis with and without NAFLD. Using …

Case Report: Post-Obstructive Pneumonia Secondary To Foreign Body Aspiration, Aashna Chaudhry, Andrew Vasta

Rowan-Virtua Research Day

Post-obstructive pneumonia is described as a pulmonary infiltrate that occurs proximal to the site of an obstructed bronchus. Studies show that post-obstructive pneumonia most commonly secondary to obstruction caused by neoplasms. According to a study done on post obstructive pneumonia in lung cancer, most cases of post obstructive pneumonias are associated with advanced neoplasms with up to 50% of those with advanced cancer getting endobronchial compromise. While neoplasms are the most common cause of post obstructive pneumonia, research is scarce on other potential causes of post obstructive pneumonia. This case reports presents a unique clinical case in which an adult …

Effect Of Dosage On Severity Of Dysphagia In A Toxicological Rat Model Of Parkinson's Disease, Shivam Patel, Taylor Good, Nicholas Zanghi, Francois Gould

Rowan-Virtua Research Day

Parkinson’s Disease (PD) is a prevalent and devastating neurodegenerative disorder that causes progressively worsening motor symptoms affecting locomotor and oropharyngeal function. There is limited research in animal models on swallowing dysfunction in PD. To examine how neurodegeneration in PD produces progressive impairment in the oropharyngeal and locomotor processes, rotenone, a type II mitochondrial inhibitor, was injected into Lewis rat models to reproduce a parkinsonian phenotype. We hypothesized that the animal models injected with the rotenone will exhibit both oropharyngeal dysfunction and locomotor deficiency with an increased deficit that correlates with prolonged treatment. We utilized 18 rats receiving either 2.75 mg/kg …