Medical Specialties Commons^™

Pembrolizumab In Patients With Advanced Miscellaneous Rare Cancers: Results From A Phase 2 Basket Trial, Mirella Nardo, Camila Braganca Xavier, Bettzy Stephen, Jeffrey A How, Justin Moyers, David S Hong

Faculty, Staff and Student Publications

Introduction: Rare solid tumors account for one-quarter of cancers among adults in the United States, but few resources have been devoted to their treatment. We evaluated the efficacy of pembrolizumab, a programmed cell death-1 inhibitor, in patients with rare solid tumors.

Methods: We conducted a phase 2 basket trial that included patients with rare, advanced tumors. Patients were enrolled in the study in nine tumor-specific and a 10th cohort of miscellaneous rare histologies. Patients received pembrolizumab 200 mg intravenously every 21 days. The primary endpoint was the non-progression rate at 27 weeks per immune-related Response Evaluation Criteria in Solid Tumors …

Prospective Clinical Trials Of Venetoclax And Hypomethylating Agents For Relapsed Bpdcn, Naveen Pemmaraju, Luan Hai Phan, Geoffrey Fell, Marlise R Luskin, Mahesh Swaminathan, Courtney Dinardo, Marina Konopleva, Andrew A Lane

Faculty, Staff and Student Publications

No abstract provided.

Clinical Outcomes For Patients Who Have Hyperlipidemia Who Underwent Mechanical Directed Thrombolysis For Pulmonary Embolism: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

Mechanical-directed thrombolysis for PE is a recently established therapy option for patients with sub-massive PE with hemodynamic instability. With limited availability on the impact of superimposed anemia on patients that undergo MDT treatment we sought to look more closely at the inpatient population.

Patient Perspectives On The Role Of Healthcare Providers In Addressing Food Insecurity In A Nj Primary Care Setting, Anna Flts, Lisa Huang, Aarsa Moosavi, Jha Stuti, Philip B Collins

Rowan-Virtua Research Day

Background:

Food insecurity is a critical social determinant of health, yet is rarely discussed with patients in primary care settings. The objective of this project is to explore patient perspectives on the physician role in addressing food insecurity as well as to identify factors associated with food insecurity among patients in family medicine clinics.

Methods:

A cross-sectional survey was distributed to patients (n=250) across two academic family medicine clinics in South New Jersey between May 2023 and December 2024. Demographics, self-reported health status, and comfort with discussing food insecurity were collected. Additionally, food insecurity status was determined based on the …

Clinical Outcomes For Patients With Ventilator-Associated Pneumonia In Octogenarians, Nonagenarians, And Centenarians: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to examine the national inpatient sample data-base to describe in-hospital outcomes among patients over seventy who acquire ventilator-associated pneumonia after being on the ventilator for over 48 hours.

Comparison Of Patient Retention Of Pcl-5 Vs. Caps-5 In A Study On Tracking Ptsd Symptoms After A Mobile App Intervention, Kaylea Shoulders, Deep Patel, Muntaha Rana, Anne C. Jones

Rowan-Virtua Research Day

Background: Due to mental health provider shortages, primary care providers are seeing more patients with mental health concerns.1 Due to the COVID-19 pandemic, mental health concerns increased requiring primary care to adapt new multidisciplinary interventions to assist patients.2 When assessing patients for PTSD, either the CAPS-5 or PCL-5 can be used, but they have different qualities that may affect retention.

Hypothesis: The PCL-5 will have a higher retention due to the ease of administration.

Methods: Providers identified eligible patients at the Rowan-Virtua family medicine office in Sewell. Upon consent, the CAPS-5 or PCL-5 was administered, and then the PTSD Coach …

Is Acupuncture At The Auricular Shenmen Point Effective In Treating Anxiety?, Nicole Vaiani, Alexander King, Venkateswar Venkataraman

Rowan-Virtua Research Day

Anxiety disorders are the most prevalent mental health condition in the United States and are often managed with pharmacological interventions, which can lead to adverse side effects. As a result, alternative therapies such as acupuncture are gaining attention. This study investigates the effectiveness of auricular acupuncture, specifically targeting the Shenmen point, in reducing symptoms of anxiety. We analyzed ten randomized controlled trials that included quantitative outcome measures. The results suggest that auricular acupuncture at the Shenmen point is an effective and well-tolerated adjunctive treatment for anxiety. While further research with larger sample sizes and extended follow-up periods is warranted, these …

Autoimmune Encephalitis Presenting As Pseudodementia (Case Report), Renita Ng, Christie Richardson

Rowan-Virtua Research Day

Patients with autoimmune encephalitis frequently present with psychiatric symptoms including psychosis, behavioral changes, and affective disorders. Because of this, misdiagnosis of a primary psychiatric disorder in a case of autoimmune encephalitis is not uncommon. We present a case of autoimmune encephalitis in a 72 year old who was initially thought to have psuedodementia or catatonia due to variable collateral who later on LP was found to have markers and responded to steroid treatment. This case highlights the importance of maintaining a broad differential with patients who present with psychiatric alterations and to consider other causes of behavioral change.

Child Sex Trafficking In Pediatrics: From Screening To Comprehensive Care, Victoria Shwe, Tracy Lin, Nicole M. Leopardi

Rowan-Virtua Research Day

Child sex trafficking is a significant issue in New Jersey, with minors making up 22% of trafficking victims in 2023. While screening tools exist to identify at-risk youth, there is a major gap in understanding the steps healthcare providers should take after identification to ensure appropriate care, support, and referrals. Current research highlights the lack of data on the use of trafficking screening tools and the absence of standardized post-screening protocols. Most pediatricians rely on referrals to social services or law enforcement, yet limited coordination between healthcare providers and these agencies complicates effective care. The shortage of child abuse pediatric …

Assessing The Impact Of The Covid-19 Pandemic On Health Literacy In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Krisha S. Patel, Ashlyn Mcclelland, Sarah Marotta, Rebecca Moore

Rowan-Virtua Research Day

Background

Health literacy as defined by the Center for Disease Control and Prevention (CDC), refers to an individual’s ability to find, understand, and use health information and services1. This definition has evolved with the onset of the COVID-19 pandemic and increasing emphasis on preventative healthcare. We aimed to observe the impact of the pandemic on the health literacy of patients in a free community clinic run by medical students.

Hypothesis

This study aims to assess the effect of various demographic and socioeconomic factors and the COVID-19 pandemic on health literacy levels estimated by the NVS assessment in the patient population …

Examining The Relationship Between Nutritional Access And Childhood Obesity In Low-Resource South Jersey Communities, Anastasiya Matveyenko, Saul Madrid-Flores, Arleen Fortuna, Kirsten Marie Carlberg

Rowan-Virtua Research Day

BACKGROUND: Childhood obesity is defined as a child considered to have obesity when their body mass index falls in the top 5% compared to other children of the same age and gender. Unhealthy eating habits formed during childhood have been associated with diseases such as obesity and diabetes. We aim to examine the relationship between childhood obesity and barriers to optimal nutrition in our local South Jersey community.

METHODS: We conducted a literature review through Google, Google Scholar, and PubMed utilizing the key terms, “low socioeconomic status (SES),” “Childhood obesity in NJ,” “Nutritional Intervention,” and “Health Risks.”

RESULTS: Our study …

Screening And Prevention Of The Female Athlete Triad, Lia Summer Goldberg, Kate Whelihan

Rowan-Virtua Research Day

Background The Female Athlete Triad—a syndrome of low energy availability, menstrual dysfunction, and decreased bone mineral density—poses a significant risk to female athletes, particularly those in sports emphasizing leanness or endurance. Despite its potential to impair both performance and long-term health, the Triad remains frequently underdiagnosed due to stigma, nonspecific symptoms, and limited screening practices. This review investigates current strategies for screening and preventing the Triad, aiming to identify best practices and areas needing improvement.

Methods A literature review was conducted using PubMed, focusing on studies published after 2005. Keyword searches included “female athlete triad screening,” “prevention,” “education,” and “awareness.” …

Analyzing Preventative Skin Care Practices Among Diabetic, Pre-Diabetic And Non-Diabetic Patients, Hetasvi A. Saraiya, Nils Brolis

Rowan-Virtua Research Day

Background and Hypothesis: Diabetes Mellitus refers to a chronic metabolic syndrome where patients have high blood glucose due to the body’s inability to produce adequate amounts of insulin. This hyperglycemia and other factors make diabetic patients more prone to a number of skin conditions such as dry skin, skin rashes, itchiness and bacterial or fungal infections. There are specific skin practices recommended to reduce the risk of these skin ailments including moisturizing regularly, avoiding hot showers, examining feet regularly for any changes, seeing a physician for major cuts/burns/infections amongst several others. However, there is no available literature that analyzes the …

Clinical Outcomes For Smokers With Early-Onset Colorectal Cancer: An Analysis Of The National Inpatient Sample, Matthew Ebrahim, Tony Elias, Sonika Vatsa, Yarin Trabelsi, Kyrillos Girgis, Taha Syed, Rafail Beshai

Rowan-Virtua Research Day

We sought to examine the national inpatient sample database to describe in-hospital outcomes among smokers with EOCRC. The NIS was searched for hospitalizations of adult patients with EOCRC, defined as all-cause colorectal cancer in patients 50 years old or younger. In this nationally representative population‐based retrospective cohort study, hyperlipidemia was associated with higher mortality.

Mechanisms Mediating The Protective Effects Of Caffeine On Alzheimer’S Disease Progression, Jessica Ivanov, Malky Bernat, Joshua Drawbaugh, Jeremy Mehta, Namira Rahmani, Saikumar Thellapally

Rowan-Virtua Research Day

Background: This review aims to examine the molecular mechanisms through which caffeine may exert neuroprotective effects against Alzheimer’s Disease (AD).

Methods: A literature review was done across PubMed and Embase to identify studies between 2000 and 2024, exploring the mechanism behind caffeine’s effects on AD. The criteria focused on peer-reviewed articles involving human or animal models. Information was gathered on study design, participant characteristics, caffeine consumption, proposed mechanisms, and effects on cognition.

Results: The studies support caffeine's potential as a therapeutic, neuromodulator against AD through six mechanisms: inhibition of adenosine A2A receptors, decreased amyloid-beta production and aggregation, promotion of amyloid …

Impact Of Language Barriers On Out-Of-Hospital Cardiac Arrest Recognition And Response, Kinjal Mody, Sophie Cherfane, Curt Cackovic

Rowan-Virtua Research Day

Out-of-hospital cardiac arrest (OHCA) causes nearly 350,000 deaths annually in the U.S., with survival largely depending on the timely recognition of cardiac arrest and the initiation of bystander CPR by emergency dispatchers. However, English-centric dispatch systems create barriers for individuals with limited English proficiency, potentially delaying critical responses. This study aims to synthesize research on how language differences impact OHCA recognition and CPR initiation in emergency dispatch settings. We hypothesize that language barriers cause significant delays.

PubMed, Scopus, and Web of Science databases were used to identify relevant studies, using search terms like "language barriers," "cardiac arrest," and "CPR." Inclusion …

A Better Road To Recovery- Effectiveness Of Osteopathic Manipulative Treatment Compared To Conventional Methods On Post-Concussion Patients, Joliana H. Eskandar

Rowan-Virtua Research Day

Background:

Concussion, a form of traumatic brain injury, often presents with sleep disturbances, headache, confusion, and memory impairment. Current treatment includes reduced screen time, physical activity, and increased rest. For decades, these treatment options have demonstrated improvement in symptoms. Recently, there is growing interest in whether using osteopathic manipulative treatment (OMT) to target structural dysfunctions is more effective. This review compares OMT to conventional treatment methods in post-concussion patients.

Methods:

This literature review uses data from clinical trials, randomized controlled trials, observational studies, and case reports within the past 10-15 years. It includes adolescents, adults, elderly, athletes, and non-athletes while …

A Broad Examination Of Sleep Issues In Pediatric Multiple Sclerosis And Other Conditions, Chaithanya Annaluru

Rowan-Virtua Research Day

Background: Poor sleep hygiene can lead to serious health consequences, including the development of health disorders and the worsening of chronic illnesses. Poor sleep quality or duration has been linked to neurocognitive changes such as inattention and lower IQ scores. Sleep disorders are especially prevalent among pediatric patients with neurologic and neuropsychiatric conditions; for example, children with epilepsy and ADHD exhibit higher rates of parasomnias, while patients with multiple sclerosis (MS) experience REM sleep behavior disorder and insomnia more often than the general population. Additionally, co-existing obstructive sleep apnea (OSA) and epilepsy can worsen seizure control, and uncontrolled epilepsy can …

A Ticking Time Bomb: An Overview Of A Case Report Of Neutropenic Fever Secondary To Tick-Borne Illness, Yasemin Galiboglu, Danielle Thor, Joann Ha, Kristine Wong, Cindy Hou

Rowan-Virtua Research Day

The advent of immunomodulatory therapies and their ever-expanding number of treatment indications necessitates the understanding of their associated complications. Neutropenic fever serves as an example of these complications often encountered in clinical practice. Although neutropenic fever can result from virtually any pathogen, episodes of the syndrome secondary to tick-borne illness remain relatively undocumented in the scientific literature. In the case presented, a 77-year-old female with a pertinent past medical history of smoldering IgG multiple myeloma on active immunosuppressive therapy presented with a first-time episode of neutropenic fever likely secondary to tick-borne illness. Through this overview of a broader report, attention …

Case Report: A Case Of Tracheal Perforation, Cyrus Davati, Eric Maddock

Rowan-Virtua Research Day

Here we present the case of a 93-year-old female with a past medical history of arthritis and dementia who came to the hospital for a change in mental status and decreased responsiveness at home. The patient was intubated at home by EMS secondary to continued respiratory distress. The patient had a history of a productive cough over the past three days. The patient arrived at the emergency department with continued respiratory failure. During the ED evaluation, the patient was noted to have tracheal rupture. The patient was admitted to the ICU for severe sepsis and continued on broad spectrum IV …

Case Report: Lamotrigine-Induced Rash In An Adult Patient, Dhruvin Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Lamotrigine (Lamictal®) is a commonly prescribed anticonvulsant and mood-stabilizing medication. One of the rare but serious adverse effects of lamotrigine is the development of a drug-induced rash, which can be potentially life-threatening. This case report highlights the occurrence of a drug-induced rash in a 33-year-old female patient who was prescribed lamotrigine for the management of bipolar disorder. The patient presented with a characteristic rash, and following timely intervention, the rash resolved without complications. This case emphasizes the importance of monitoring for early signs of rash in patients receiving lamotrigine and outlines management strategies.

Ultrasound-Guided Vs. Fluoroscopy Guided Steroid Injection For Lumbar Spine Pain On Functional And Pain Outcomes: A Systematic Review, Yashas Sattur, Akash Patel, Alec Birnbaum, Athena Nomula

Rowan-Virtua Research Day

Fluoroscopy-guided steroid injections are standard for lumbar spine pain but involve radiation. Ultrasound offers a safer, radiation-free alternative. Ultrasound-guided injections are non-inferior in improving pain and function. A systematic review of PubMed, Embase, Cochrane, Scopus, and Web of Science was conducted. Studies in adults comparing ultrasound and fluoroscopy-guided injections reporting VAS, NRS, or ODI were included. Fifteen studies showed both techniques significantly improved pain and function, with no consistent superiority. Ultrasound-guided injections are effective and safe, providing comparable outcomes to fluoroscopy while eliminating radiation exposure.

Case Report: A Case Of Transient Dress Syndrome (Drug Rash With Eosinophilia And Systemic Symptoms), Dip Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 41-year-old female with a history of hypertension who presented with fever and a diffuse erythematous rash after taking trimethoprim-sulfamethoxazole (TMP-SMX) for an ear infection. Due to her symptoms, mild eosinophilia, and elevated liver function tests, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) was suspected. Although the patient’s rash had resolved by the time of initial evaluation, it recurred overnight, reinforcing suspicion for DRESS syndrome. TMP-SMX was discontinued, and acetylcysteine was administered due to the patient’s high-dose use of acetaminophen in the days prior to her hospital presentation. Infectious and autoimmune workups were negative. …

Anabolic Steroid Induced Cardiomyopathy, Oluwatomi Alade

Rowan-Virtua Research Day

Anabolic steroids including testosterone are commonly used as performance-enhancing agents. Its use is predominantly seen in young and middle-aged males. Endogenous testosterone is necessary for cardiac health; however, synthetic anabolic steroids are more potent and associated with adverse effects. These adverse effects include cardiomyopathy and coronary artery disease. The cardiomyopathy, however, can be reversible with discontinuation of the anabolic steroids. This case describes a middle-aged male who had new onset cardiomyopathy and ultimately went into cardiogenic shock secondary to anabolic steroid use.

Case: Pituitary Mass In A Pediatric Patient, Alyssa Baldini, Carla Calvo

Rowan-Virtua Research Day

We report a case of a 16-year-old female presented to the pediatric emergency department for intermittent visual disturbance and was diagnosed with a pituitary mass resulting in episodic complete bilateral vision loss. Pediatric neurologic complaints can be challenging for a number of reasons. It is important as much as possible to obtain a detailed history from the patient and parent, conduct a relevant chart review, and identify if there have been any recent medication changes. Seeking expert consultation may also be helpful in establishing a diagnosis.

Case Report: An Unexpected Case Of Spinal Cord Infarction, Julian Coz, Brittany Fera

Rowan-Virtua Research Day

We report a case of an 89-year-old male who presented to the emergency department with acute bilateral lower extremity weakness after physical exertion. His clinical examination revealed paraplegia, and imaging studies suggested spinal cord infarction (SCI) secondary to presumed atherosclerotic embolism, despite the absence of traditional cardiovascular risk factors. The differential diagnosis for acute paraplegia in the elderly is broad, including conditions like stroke, spinal cord compression, transverse myelitis, and tick paralysis. This case highlights the diagnostic challenges of SCI, particularly when the patient lacks overt risk factors for vascular disease. Despite aggressive management, including permissive hypertension and anticoagulation, the …

Case Report: Spontaneous Aortic Dissection In A 63-Year Old Male Presenting As Left Abdominal, Flank And Back Pain, Dean Austin Esma

Rowan-Virtua Research Day

Aortic dissection is a life-threatening condition in which the inner walls of the aorta tears, compromising its ability to supply blood to organs. The classic presentation involves sudden, severe, “tearing” chest pain, but subtle presentations are often overlooked as symptoms of another condition, leading to missed diagnoses. This report presents a case of spontaneous aortic dissection who presented with sudden onset of left upper abdominal pain, left flank and upper back pain while brushing his teeth.

Case Report: Recurrent Miller Fisher Syndrome, Devin Hoover, Andrew Vasta, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 47-year-old male who presented with numbness and difficulty speaking and was diagnosed with Miller Fisher Syndrome, a variant Guillain-Barré Syndrome. The differential diagnosis for numbness and speech difficulty is broad and includes brain stem stroke, Wernicke encephalopathy, botulism, myasthenia gravis, among others. Although Miller Fisher Syndrome is rare, certain factors such as the of tumor necrosis factor-alpha antagonists may predispose a patient to the disease and its recurrence. As discovery of new tumor necrosis factor-alpha antagonists continues it will likely result in more presentations of Guillain-Barré Syndrome and its variants to the emergency department.

Miller Fisher Variant Of Guillain- Barré Syndrome, Peter Killian, Kishan B. Patel

Rowan-Virtua Research Day

We present a case of a man in his 50s who was evaluated in the emergency department for right facial droop, myalgias, and right lower extremity weakness. The patient required multiple interdisciplinary specialists for treatment and diagnosis of Guillain-Barré Syndrome (GBS). The differential for weakness and facial droop is primarily aimed at ruling out an irreversible neurological cause while investigating a potential infectious etiology. Multiple variants of GBS exist and clinical presentations can vary, including the Miller Fisher Variant. This variant features a unique presentation, affecting the corticobulbar tract, evident with the ptosis commonly seen following a gastrointestinal infection.

Unusual Path: Gallstone Ileus With Pneumobilia And Jejunal Obstruction, Kristine Rubi, Kelly Schuitema, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We present a case of a 48-year-old female with two-day history of diffuse abdominal pain, nausea and vomiting. She was diagnosed with small bowel obstruction due to gallstone ileus. Diagnosis is usually challenging due to its nonspecific presentation, but computed tomography reveals the classic findings of Rigler’s triad -- pneumobilia, bowel obstruction, and an ectopic gallstone. The patient underwent laparoscopy with enterolithotomy with subsequent resolution of symptoms. Prompt diagnosis through imaging and timely surgical intervention is critical for in preventing complications and improving patient outcomes.