Pathological Conditions, Signs and Symptoms Commons^™

Septic Arthritis With Concomitant Pseudogout, Ravin Patel, James Schuck, Nicole Zucconi, David Aderholdt

Rowan-Virtua Research Day

Monoarticular joint pain is a common complaint, however it demands a broad differential diagnosis. These differentials include fracture, dislocation, septic arthritis, gout, pseudogout and several others. The diagnosis of septic arthritis requires a high index of suspicion as early diagnosis is a vital part of initial treatment.

We present a case with multifactorial joint pathology contributing to a patient’s presentation, specifically septic joint and pseudogout. The incidence of these entities being present in the same patient, let alone the same joint, is not well documented in the literature.

The presentation of these diseases have a multitude of similarities and differences, …

An Unusual Ed Case: Scrotal Edema From A Thoracic Aortic Aneurysm In A 58-Year-Old Male, Yevgeniy Polunin, Emily Nguyen, Bhumi Shah

Rowan-Virtua Research Day

Scrotal edema is not an uncommon presentation in emergency medicine. We describe the case of a 58-year-old male with no prior medical history who presented to the emergency department (ED) due to progressive scrotal edema. The patient noted increased painless testicular enlargement, dry cough, and dyspnea on exertion over the course of several weeks. Scrotal edema was evaluated by an Ultrasound (US), showing bilateral testicular edema with concern for congestive heart failure (CHF). Computed tomography pulmonary angiography (CTPE) scan showed a large 6.51 cm thoracic aortic aneurysm (TAA), cardiomegaly with dilated left sided chambers, and a small pericardial effusion. Subsequently, …

Bilateral Lower Extremity Ischemia Following Cardiac Catheterization, Moses Avedikian, Alan Lucerna, Trent Malcolm

Rowan-Virtua Research Day

Acute limb ischemia is a rare yet limb-threatening presentation where rapid diagnosis and intervention is warranted. Bilateral lower extremity ischemia can be a rare complication following procedures, such as a cardiac catheterization with access obtained in the groin. We describe a case of a 79-year-old female who presented with bilateral lower extremity ischemia following a cardiac catheterization 2 weeks prior. The patient underwent CT angiography, which demonstrated occlusion with no contrast present in the bilateral femoral arteries.

Case Presentation: Lower Back Pain Or Chronic Acetaminophen Overdose?, Meghan Whitt, Christopher Schwartz, Bhumi Shah

Rowan-Virtua Research Day

Unintentional ingestions can pose a difficult challenge to diagnose in the setting of the Emergency Department. Many may present with vague symptoms that are not consistent with classic overdose prodromes. Many patients do not identify or disclose over the counter medications, such as analgesics, with which acute/chronic ingestion in large quantities can result in life threatening medical emergencies. Their underlying symptoms may also cloud their clinical picture, further complicating workup within the ED.

Case Study Of Pulmonary Embolism With Unusual Chief Complaint, Kajel Patel

Rowan-Virtua Research Day

Pulmonary embolism (PE) is a serious diagnosis that needs to be made in the Emergency department (ED). There are different categories of PE ranging from massive to non-massive/sub-segmental. Regardless of the categorization, the patient will need to be placed on anticoagulation. It is important to catch this diagnosis in the ED so further complications do no arise. Here is a case from the ED with a patient coming in with the chief complaint of acute right lower quadrant abdominal pain and was diagnosed with a pulmonary embolism.

Kidney Rupture: An Unusual Cause Of Abdominal Pain, Flank Pain And Hematuria In A 72-Year-Old Female, Monica Diep, Neelesh Parikh

Rowan-Virtua Research Day

Flank pain, abdominal pain and hematuria are common complaints in emergency medicine. We describe the case of a 72-year-old female who presented to the emergency department for worsening left lower quadrant abdominal pain and left flank pain associated with new-onset hematuria. The patient reports the pain started immediately after she accidentally tripped on a rock while trying to avoid a mailman in an attempt to socially distance due to the COVID-19 pandemic, which resulted in a forceful twist of her body and catching herself with her hands without any direct impact to her body. The patient reports the pain gradually …

Multiple Myeloma With Dual Expression Of Kappa And Lambda Light Chains, Monica Patel, Akash Patel, Yvette Wang

Rowan-Virtua Research Day

Multiple myeloma (MM) is a malignancy of plasma cells that accounts for approximately 1 to 2 percent of all cancers and about 17% of all hematologic malignancies.

Plasma cells normally produce antibodies and provide a defense mechanism for the body to fight infections.

Antibodies typically consist of two heavy chains (IgG, IgA, IgM, IgD and IgE) and two light chains (kappa and lambda).

Most cases of MM have malignant plasma cells producing monoclonal (M) proteins, most common being IgG about 52% of the time (1).

Only about 2% of these myeloma cases were also found to secrete more than one …

Physiological Response And Tissue Damage Following Different Depths Of Impact In A Rodent Model Of Mild Traumatic Brain Injury, Haven K. Predale, Christopher P. Knapp, Barry D. Waterhouse, Rachel L. Navarra

Rowan-Virtua Research Day

Mild traumatic brain injury (mTBI) is a serious public health concern that can result in significant neurological and behavioral deficit. mTBI results from impact to the head and can be repetitive in nature, especially in sports and domestic violence cases. Our laboratory studies the effects of repetitive mTBI on risky choice behavior in rodents using a closed-head controlled cortical impact (CH-CCI) model of injury and a well-established probabilistic discounting task that assesses risk-based decision-making behavior. We have recently found that females, but not males, display transient increases in risky choice behavior following three CH-CI’s delivered at 5.5m/s velocity and 2.5 …

Omental Infarction: A Rare Cause Of Abdominal Pain, Eric Doane, Emily Nguyen

Rowan-Virtua Research Day

Omental infarction is a rare cause of acute abdomen pain first described by Eitel in 1899 and has been described in the literature with total numbers ranging from 250-400 worldwide with many coming from individual case reports. Risk factors for developing omental infarction are thought to be obesity, trauma, intense exercise or secondary to torsion from adhesions. Historically, the diagnosis of omental infarction was made incidentally in the operating room for patients with an acute abdomen with a different suspected diagnosis. Most often being appendicitis with associated right lower quadrant abdominal pain and smaller subset from suspected diverticulitis and cholecystitis …

Criterion Validity Of The Ohio State University Traumatic Brain Injury Identification Method In A Criminal Justice Sample, Sarah M. Monaghan

Student Theses

The purpose of the current study was to determine the clinical utility of the Ohio State University Traumatic Brain Injury Identification Method (OSU-TBI-ID) in a criminal justice sample, by evaluating the criterion-related validity of this instrument. It was hypothesized that this tool could differentiate between incarcerated individuals with or without a history of Traumatic Brain Injury (TBI) on measures evaluating important TBI-related sequalae. The sample consisted of 95 incarcerated men detained at a private correctional facility in a Mid-Atlantic state. Measures used in this study to evaluate executive functioning difficulties, psychiatric difficulties, substance use problems, institutional misconduct and recidivism were …

The Impact Of Prolonged Estrogen Deficiency On Cardiac Hypertrophy Following Chronic Sympathetic Stimulation, Isabelle Krueger

Undergraduate Honors Theses

Cardiovascular disease (CVD) is the leading cause of death for both men and women in developed countries. Compared to age-matched males, premenopausal women experience lower rates of CVD but this increases after menopause. A central feature in CVD is changes in sympathetic regulation leading to pathological changes such as cardiac hypertrophy characterized by changes in cardiomyocyte size due to overcompensation of the muscle following injury. The goal of this research is to study the effect of prolonged estrogen loss on cardiac hypertrophy following chronic sympathetic stimulation. Female mice were ovariectomized at 10 weeks of age and treated with Isoproterenol to …

Relationship Between Global Cognition And Cardiovascular Risk Factors, Alexia Sebghati

Health, Human Performance and Recreation Undergraduate Honors Theses

Alzheimer’s disease (AD) is currently affecting the lives of 5.8 million Americans and is expected to double within the next 30 years. With an aging populace of baby boomers, this will place great economic strain on the U.S. creating a burden of almost $1 trillion in healthcare costs. Currently, there is no cure for AD. However, studies report that many individuals with AD experience changes in the brain up to 10-15 years before the disease’s onset. It is imperative to detect future risk of developing AD or mild cognitive impairment (MCI) before significant cognitive changes arise. Many of the risk …

Pde4 Inhibition: A Novel Therapeutic Strategy In Liver Fibrosis., Mohamed Elnagdy

Electronic Theses and Dissertations

Background: Liver fibrosis is accumulation of extracellular matrix (ECM) proteins due to chronic liver injury. Chronic hepatic damage can occur due to multiple causes including, alcohol, non-alcoholic steatohepatitis and chronic viral hepatitis. Liver fibrosis is a critical problem worldwide due to the extremely high incidence of alcohol associated liver damage and chronic viral hepatitis. Moreover, there is no FDA approved therapy for liver fibrosis. Activation and transdifferentiation of quiecent hepatic stellate cells (HSCs) to myofibroblasts (MFBs) is the main event contributing to liver fibrosis. This process involves two phases, the initiation and the perpetuation phases. Hepatocyte injury and inflammatory response …

Non-Selective Primary Human Tumor Cell Line Generation From Surgical Resections To Be Paired With Flash Frozen And Paraffin Embedded Tissue: Advancements In Democratizing Translational Research Materials To Rural Institutions, Jennifer Hawkins, Rebecca Russell, Logan M. Lawrence, Amrita Valluri, Jessica Wellman, Krista Denning

Marshall Journal of Medicine

Translational cancer research relies on the availability of human patient tissue demonstrating the specific disease process under investigation. Biobanks of human tissue have historically been and remain to date the primary access point for cancer research samples. Biorepositories routinely supply researchers with varying sample types for use in biomedical studies; most commonly formalin-fixed and paraffin-embedded (FFPE) tissue, or fresh snap-frozen tissue. In conjunction with preserved tissue samples, viable tumor cell lines derived from patient tissue have emerged to be a new gold standard in cancer research particularly in drug discovery and functional prognostic assays. Tissue banks providing these samples are …

Respiratory Pathogens In Patients With Acute Exacerbation Of Non-Cystic Fibrosis Bronchiectasis From A Developing Country, Shayan Shahid, Kausar Jabeen, Nousheen Iqbal, Joveria Farooqi, Muhammad Irfan

Medical College Documents

Bronchiectasis unrelated to cystic fibrosis (non-CF bronchiectasis) has become a major respiratory disease in developing nations. The dilated mucus filled airways promote bacterial overgrowth followed by chronic infection, bronchial inflammation, lung injury and re-infection Accurate pathogen identification and antimicrobial susceptibility allowing appropriate treatment, in turn, may break this vicious cycle. To study the spectrum and antimicrobial spectrum of pathogen yielded from respiratory specimens in adult patients with acute exacerbation of non-cystic fibrosis (CF) bronchiectasis. This cross-sectional study was performed at the pulmonology clinics of the Aga Khan University, Karachi, Pakistan from 2016-2019. Respiratory specimens were collected from adult patients with …

The Many Faces Of Solitary Fibrous Tumor; Diversity Of Histological Features, Differential Diagnosis And Role Of Molecular Studies And Surrogate Markers In Avoiding Misdiagnosis And Predicting The Behavior, Muhammad Usman Tariq, Nasir Ud Din, Jamshid Abdul Ghafar, Yong-Koo Park

Department of Pathology and Laboratory Medicine

Background: Solitary Fibrous Tumor (SFT) is a distinct soft tissue neoplasm associated with NAB2-STAT6 gene fusion. It can involve a number of anatomic sites and exhibits a wide spectrum of histological features.
Main body: Apart from diversity in morphological features seen even in conventional SFT, two histologic variants (fat-forming and giant cell-rich) are also recognized. In addition, a malignant form and dedifferentiation are well recognized. Owing to diverse histological features and involvement of diverse anatomic locations, SFT can mimic other soft tissue neoplasms of different lineages including schwannoma, spindle cell lipoma, dermatofibrosarcoma protuberans, liposarcoma, gastrointestinal stromal tumor (GIST), malignant peripheral …

Determining Bone Turnover Status In Patients With Chronic Liver Disease, Tayyaba Bukhari, Lena Jafri, Hafsa Majid, Aysha Habib Khan, Imran Siddiqui

Department of Pathology and Laboratory Medicine

Introduction: Hepatic osteodystrophy is an osteoporotic bone disease that occurs in chronic liver disease patients. The global prevalence of osteoporosis in patients with chronic liver disease is 30% to 40%. The pathogenesis of hepatic bone disease is not clear, but it occurs due to unstable bone remodeling with increased bone resorption and decreases bone formation. There has been an interest in determining the clinical utility of bone turnover markers (BTMs) in the assessment of osteoporosis in chronic liver patients.
Methods: This was a cross-sectional study conducted in patients with chronic liver disease at the section of chemical pathology, department of …

Metaplastic Breast Carcinoma: Clinicopathological Parameters And Prognostic Profile, Saroona Haroon, Shamail Zia, Umme Aiman Shirazi, Omer Ahmed, Ishaq Azeem Asghar, Asad Diwan, Anoshia Afzal, Muhammad Irfan, Syed Jawwad Ali, Atif A. Hashmi

Department of Pathology and Laboratory Medicine

Introduction: Metaplastic breast carcinoma (MBC) is defined as breast cancer with a heterologous non-glandular component. MBC is considered a special type of breast cancer with a prognosis that is worse than invasive ductal carcinoma (IDC) of the breast. MBC is the most common breast cancer with a triple-negative profile. Therefore, in this study, we evaluated the clinicopathological parameters, recurrence and survival of MBC in our population.
Methods: We conducted a retrospective observational study in the Department of Histopathology at Prince Faisal Oncology Centre, Buraidah, Saudi Arabia, over a period of five years. All cases diagnosed as MBC were included in …

Concordance Between Clinical And Pathological Response Assessment After Neo-Adjuvant Chemotherapy In Patients With Invasive Lobular Carcinoma, Aisha Shaikh, Muhammad Usman Tariq, Shaista Khan, Romana Idress, Lubna Mushtaque Vohra, Saira Fatima Shaikh, Hira Waheed

Department of Surgery Docs

Background: Neo-adjuvant chemotherapy (NAC) is frequently administered in breast carcinoma patients. The clinical response to NAC guides further treatment. The pathological response is not only an independent prognostic factor, but it also guides further treatment and prognosis.
Objectives: The aim of our study was to find the degree of concordance between clinical and pathological response assessments after NAC in Invasive lobular Carcinoma (ILC) cases by using World Health Organization (WHO) criteria and different pathological systems, respectively. We also tried to identify any useful parameter of clinical assessment that could better correlate with pathologic assessment and provide a better estimation of …

Long-Term Impacts Of Acute Stressor Exposure On Locus Coeruleus Function And Anxiety-Like Behavior In Rats, Olga Borodovitsyna

Graduate School of Biomedical Sciences Theses and Dissertations

Stress is a physiological state characterized by behavioral arousal that occurs during exposure to harmful or threatening stimuli, and usually facilitates an adaptive behavioral response. The persistence of stress sometimes causes it to become maladaptive, potentially contributing to disease development, including physiological complications with altered neuroendocrine signaling and impaired function of organ systems, and psychological conditions including depression and anxiety. Anxiety disorders in particular are associated with a history of stress and are the most common class of mental disorders, with a lifetime prevalence of 33.7% in the general population. The locus coeruleus (LC) is a major node in the …

A High-Throughput Approach To Characterizing Arv1 On The Regulation Of Lipid Homeostasis Uncovers A Novel Interaction With Epidermal Growth Factor Receptor, Nicholas Anthony Wachowski

Graduate School of Biomedical Sciences Theses and Dissertations

Acyl-CoA cholesterol acyl transferase related enzyme-2 required for viability 1 (ARV1) was first recognized in Saccharomyces cerevisiae in a study done in 2000 by Tinkelenberg et al. In yeast, the deletion of ARV1 results in numerous defects including abnormal sterol trafficking [1], the reduction of sphingolipid metabolism [2], synthesis of glycosylphosphatidylinositol (GPI) anchor [3], ER stress [4], and hypersensitivity of fatty acids leading to lipoapoptosis [5]. Arv1 germline deletion in mice displayed a lean phenotype with increased energy [6]. In humans, ARV1 mutations lead to epileptic encephalopathy [7].

Non-alcoholic fatty liver disease (NAFLD) consists of simple steatosis to non-alcoholic steatohepatitis …

Intestinal Dysbiosis Disguised As A Rectal Fistula Treated With Autologous Fecal Microbiota Transplantation, Nicolina Scibelli, Pratishtha Singh, Kathleen Raynor

South Atlantic Division GME Research Day 2021

No abstract provided.

Post Covid-19 Tuberculosis: An Emerging Threat Of Pandemic, Aqusa Zahid, Nousheen Iqbal, Sarosh Moeen, Muhammad Irfan

Section of Pulmonary & Critical Care

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) pandemic has hit the world hard. Millions of people have died due to the infection and several have suffered with what are now known as post COVID-19 squeal. Among these squeals one is immunosuppression which leaves patients prone to severe opportunistic infection. We here report a case of young female who was infected by COVID-19 and later developed cavitary pneumonia which upon investigation turned out to be due to mycobacterium tuberculosis. Through this report we aim to highlight the importance of high index of suspicion for infection like Mycobacterium tuberculosis after …

Serious Adverse Events And 30-Day Hospital Readmission Rate Following Elective Total Knee Arthroplasty: A Systematic Review And Meta-Analysis., Costas Papakostidis, Peter V Giannoudis, J. Tracy Watson, Robert Zura, R. Grant Steen

School of Medicine Faculty Publications

Background: Elective total knee arthroplasty (TKA) is a common surgery which has evolved rapidly. However, there are no recent large systematic reviews of serious adverse event (SAE) rate and 30-day readmission rate (30-dRR) or an indication of whether surgical methods have improved. Methods: To obtain a pooled estimate of SAE rate and 30-dRR following TKA, we searched Medline, Web of Science, Cochrane Library, and Google Scholar databases. Data were extracted by two authors following PRISMA guidelines. Eligibility criteria were defined prior to a comprehensive search. Studies were eligible if they were published in 2007 or later, described sequelae of TKA …

Determination Of Reference Interval (Ri) Of Spot Urinary Oxalate To Creatinine Ratio In Children Of Pakistani Origin Under Six Years Of Age: A Cross-Sectional Study, Syed Bilal Hashmi, Lena Jafri, Jamsheer Jehangir Talati, Hafsa Majid, Saqib Hamid Qazi, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

Background: The gold standard screening method of hyperoxaluria in children is using 24-hour urine collection. Urine collection may be cumbersome and challenging for children. Reference intervals (RI) of oxalate for the Pakistani population are not readily available. Therefore we aimed to determine the oxalate to creatinine ratio (Ox: Cr) for Pakistani children <6 years of age.
Materials and methods: A cross-sectional study was conducted at Aga Khan University from June 2018 to October 2019. Random urine samples from apparently healthy children < 6 years were collected and stored at -30°C until analysis after adding 6M HCl. Oxalate was measured on Micro lab 300 using a kit based on oxalate oxidase principle, while creatinine was measured by kinetic Jaffe reaction. Data was analyzed by EP evaluator and SPSS 23. Ox: Cr ratio was calculated and reported with 90% confidence interval (CI) and interquartile range (IQR).
Results: The mean age of study subjects (n=120) was 29 ±22.3 months with an M: F ratio of 1:1. Children of various ethnicities …

Clinicopathological Features Of Craniopharyngioma: A 15-Year Study From A Tertiary Care Center In Pakistan, Saroona Haroon, Anoshia Afzal, Shamail Zia, Syed J. Ali, Fazail Zia, Farozaan Shamail, Muhammad Irfan, Atif A. Hashmi

Department of Pathology and Laboratory Medicine

Introduction: Craniopharyngiomas (CPs) are benign neoplasms and most common suprasellar tumors. They are more frequent in children, contributing to a significant number of intracranial tumors in the pediatric population and are thought to be arising either from the epithelial remnant cells of the craniopharyngeal duct or from the adenohypophysis epithelium. Two subtypes of CPs exist, namely, adamantinomatous craniopharyngioma (ACP) and papillary craniopharyngioma (PCP). ACP is more common in children with a relatively aggressive clinical course and more frequent relapses than PCP. The study objective was to evaluate the clinicopathological features of CP in our population.
Methods: We conducted a retrospective …

Gastric Antral Diverticula: A Rare Diverticula With A Unique Presentation, Pratishtha Singh, Kathleen Raynor, Chadley Froes

Gastroenterology

Gastric diverticula are the least common gastrointestinal diverticula. Patients can be diagnosed incidentally on EGD or present with variable symptoms such as abdominal fullness, anorexia, and perforation. Gastric diverticula can be acquired from malignancy, peptic ulcer disease, or prior surgery or be congenital. Treatment varies based on symptomatology ranging from conservative medical management with proton pump inhibitors to surgical treatment with open or laparoscopic resection. We present a case of a 73-year-old female with acquired gastric diverticulum presenting as a gastric outlet obstruction who was successfully treated with conservative medical therapy.

Impact Of Acute Exercise On Micrornas Related To Concussion Symptoms, Emily Work

UNO Student Research and Creative Activity Fair

Impact of acute exercise on microRNAs related to concussion symptoms

Concussions, or traumatic brain injury (TBI), are a serious medical problem affecting approximately 1.7 million people in the United States each year. Current tools for analysis of concussion include the Glasgow Coma Scale, SCAT5, computerized topography (CT) and magnetic resonance imaging (MRI), however, these tools are typically not indicative of the range and severity of symptoms a patient may experience. Recent studies have explored the use of microRNAs as a biomarker for TBI severity in patients who have already experienced a TBI. We seek to investigate the microRNA levels in …

Ovarian Seromucinous Tumors: Clinicopathological Features Of 10 Cases With A Detailed Review Of The Literature, Romana Idress, Nasir Ud Din, Sabeehuddin Siddique, Saira Fatima, Jamshid Abdul Ghafar, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Background: The 2014 WHO Classification of ovarian neoplasms introduced a new entity of seromucinous tumors associated with endometriosis. These tumors encompassed a spectrum from benign to malignant and included seromucinous cystadenoma/ cystadenofibroma, seromucinous borderline tumor/atypical proliferative seromucinous tumor and seromucinous carcinoma. However, the 2020 WHO Classification of Female Genital Tumours removed seromucinous carcinomas as a distinct entity and recategorized them as Endometrioid carcinomas with mucinous differentiation. Here we describe clinico-morphologic features of seromucinous tumors recategorizing cases originally diagnosed as seromucinous carcinoma in light of 2020 WHO classification and present detailed review of literature.
Methods: Slides of seromucinous tumors were reviewed. …

Artificial Intelligence (Ai) In Medicine, Current Applications And Future Role With Special Emphasis On Its Potential And Promise In Pathology: Present And Future Impact, Obstacles Including Costs And Acceptance Among Pathologists, Practical And Philosophical Considerations. A Comprehensive Review, Zubair Ahmad, Shabina Rahim, Maha Zubair, Jamshid Abdul Ghafar

Department of Pathology and Laboratory Medicine

Background: The role of Artificial intelligence (AI) which is defined as the ability of computers to perform tasks that normally require human intelligence is constantly expanding. Medicine was slow to embrace AI. However, the role of AI in medicine is rapidly expanding and promises to revolutionize patient care in the coming years. In addition, it has the ability to democratize high level medical care and make it accessible to all parts of the world.
Main text: Among specialties of medicine, some like radiology were relatively quick to adopt AI whereas others especially pathology (and surgical pathology in particular) are only …