Diagnosis Commons^™

Case Report: Varicella Zoster Virus Encephalitis Presenting With Monochorea, Chetna Thawani, Frank Wheeler

Rowan-Virtua Research Day

Meningoencephalitis is a broad range of symptoms as a sequela of inflammation of the CNS system. It is a diagnosis that is often missed, especially in atypical presentations. We describe a case of HSV encephalitis that presented to the ER afebrile with atypical arm movements, most similar to a monochorea, and discuss other cases in the literature of atypical presentations of this disease.

Wellen’S Syndrome: An Infamous Example Of Occlusive Myocardial Infarction (Omi), Joseph Maxwell Piraneo, Joseph Pagano, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Wellen’s syndrome is a condition with characteristic ECG changes that can be highly specific for acute myocardial infarction involving the left anterior descending (LAD) artery. Acute myocardial infarctions are one of the leading causes of death in the developed world. Its estimated annual prevalence is nearly 3 million worldwide, with more than 1 million in the United States [1]. The importance of timely diagnosis cannot be understated. Here we describe a case of myocardial infarction secondary to LAD occlusion which presented with the atypical ECG pattern known as Wellen’s syndrome.

Case Report: Babesiosis Presenting To The Emergency Department, Daniel M. Zaayenga, Daniel A. Weeks

Rowan-Virtua Research Day

Babesiosis is a tick-borne illness caused by the parasitic protozoa Babesia transmitted by the Ixodes tick. Babesia infect the red blood cell of its host and requires the cell for its replication. It is a disease process that can range from asymptomatic infection to organ failure and death. This case presentation reviews a 68-year-old male who presented to the emergency department with flu like symptoms and was found to have babesiosis.

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 Case Of Esophagogastric Junction Outflow Obstruction Resulting To Megaesophagus In A 37-Year-Old Male, Dean Esma, Robin Lahr, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Esophagogastric junction outflow obstruction (EGJOO) is a major motility disorder characterized by an increase of > 15 mmHg in the integrated relaxation pressure (IRP) with or without problems in esophageal motility. This presents as dysphagia, chest pain, regurgitation, heartburn, cough, and a globus sensation, with dysphagia. Severe cases may lead to a megaesophagus causing compression of mediastinal structures.6 Its similarity to other esophageal disorders urge an investigation to improve its identification and treatment. This report presents a case of EGJOO in a 37-year-old cachectic male patient with dysphagia and vomiting, eventually determined to be EGJOO with diagnostic manometry.

Case Report: Pneumoperitoneum In The Setting Of Altered Mental Status, Aloysius C. Ibe, Neelesh Parikh, Robin Lahr

Rowan-Virtua Research Day

We report a case of an 80-year-old female who presented to the emergency department as altered mental status and diagnosed with pneumoperitoneum requiring immediate surgical intervention. The differential for altered mental status is vast but for a patient who was initially hypoglycemic on ED arrival, suspected drug overdose was at the forefront until the patient was intubated for airway protection and chest radiograph for confirmatory endotracheal tube placement showed pneumoperitoneum.

A Rare Presentation: Intracranial Hemorrhage As A Symptom Of Acute Leukemic Transformation In A 23-Year Old Male, Kelsey M. Murray, Kishan B. Patel

Rowan-Virtua Research Day

This case highlights the urgency of considering acute leukemic transformation in young patients presenting with neurological deficits, emphasizing the importance of prompt evaluation and management to optimize patient outcomes. The case depicted is a tragic complication of Chronic Myeloid Leukemia (CML) and its acute blast crisis. Remarkably, the patient exhibited none of the typical constitutional symptoms associated with CML.

Cut The Pressure: Blood Pressure Screening In A Community Based Setting, Harold Kareem Knight Jr., Katharine Milani

Rowan-Virtua Research Day

This study addresses the pressing issue of cardiovascular health disparities in African American males through community-based interventions, specifically blood pressure screenings and surveys conducted in a local barbershop setting. Despite a preference among participants for clinical settings, an overwhelming 97.7% expressed high comfort levels in the community-based environment, highlighting the importance of culturally sensitive approaches in healthcare delivery. With 92.5% indicating willingness to return for future screenings, the study underscores the efficacy of non-traditional settings in fostering healthcare engagement. Findings suggest the potential for broader impact through scalable, community-centric initiatives, offering promising avenues for improving health outcomes in underserved populations.

Sdrnas Participate In The Maintenance And Onset Of Prostate Cancer, Neil Chaudhary

Poster Presentations

What is an sdRNA? Noncoding RNA (ncRNA) is a class of RNA that includes microRNA (miRNA) and small nucleolar RNA (snoRNA). Fragments excised from ncRNAs are known as noncodingderived RNA (ndRNA). A certain class of ndRNAs that are derived from snoRNAs have been denoted as Small Nucleolar Derived RNAs (sdRNAs). Our lab has previously hypothesized and demonstrated that sdRNAs display regulatory functions on target genes, similar to the functions of miRNAs. sdRNAs are almost identical to microRNAs and differ mainly in their source of origin.

Our lab has shown that sdRNA-93 is frequently misexpressed in breast cancer cell lines and …

A Meta-Analysis For Laboratory Diagnostics For Coccidioidomycosis, Mary C. Cowen

Biological Sciences Undergraduate Honors Theses

Coccidioidomycosis, commonly referred to as Valley Fever, is a fungal infection found in arid regions of the southwestern United States and Mexico. Infection occurs through inhalation of airborne spores from Coccidioides species, Coccidioides immitis and/or Coccidioides posadasii, and proceeds in both pulmonary and disseminated fashions. Approximately 60% of patients with coccidioidomycosis remain asymptomatic, while 40% will experience symptoms. Within the literature, there are no papers that summarize sensitivity and specificity values between different tests; therefore, this paper presents sensitivity and specificity results across different tests and companies (Meridian, IMMY, and MiraVista).

3d-Printed Microfluidic Devices For Electrochemiluminescence Detection Of Mirna, Oscar Clement

Honors Scholar Theses

This thesis outlines the research conducted over the past two years on the production and application of microfluidic devices (MFDs) in electrochemiluminescent-based bioanalytical assays. The work is categorized into two main projects: designing and manufacturing MFDs and developing electrochemiluminescent (ECL) assays for detecting Alzheimer's disease (AD) associated microRNAs (miRNAs) using CRISPR technology. The process of learning to design MFDs involved acquiring proficiency in computer-aided design (CAD) software, stereolithography (SLA) 3D printing, and iterative design techniques. The development of the ECL-based assay for AD miRNA was a multidisciplinary endeavor, combining elements of inorganic and biological chemistry. Although the research on the …

Inclusion Of Adoption As A Pregnancy Management Option In Prenatal Genetic Counseling Practice, Emma Billings

Dissertations and Theses (Open Access)

Prenatal genetic counselors are essential to providing education, psychosocial support, and guidance on pregnancy options to patients who receive a fetal diagnosis of an anomaly or genetic condition. Therefore, genetic counselors should be well-educated on comprehensive pregnancy management options consisting of parenting, abortion, and adoption. The landscape of adoption education in genetic counseling practice was last characterized in 2010 by Perry and Henry, revealing substantial variability in both the inclusion of adoption-specific education in genetic counseling program (GCP) curricula and the discussion of pregnancy options with patients in prenatal practice. As a result, the authors published a call to action …

The Case For Using Composition Tomography To Evaluate Perirectal Necrotizing Fasciitis: Is It Really Necessary?, Tyler Bayliss, David Denning

Marshall Journal of Medicine

Clinical reviews of Fournier’s Gangrene state that diagnostic protocol includes interpreting CT, MRI, or Ultrasound imaging along with clinical symptoms and lab findings. We think that the use of imaging techniques as a diagnostic tool is no longer needed as Fournier’s Gangrene is specific enough of a disease that clinicians can diagnose using labs and physical examination alone.

Cases of perirectal necrotizing soft tissue infection recorded at St. Marys Medical Center were reviewed. Results of physical exams and imaging were compared along with measurements of severity upon admittance and length of stay. Due to the COVID-19 pandemic, we investigated if …

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …

Determination Of Initial Hepatitis B Surface Antigen (Hbsag) Cutoff Index (Coi) Threshold For Reporting Hbsag Reactivity, Piya Wongchampa, Arkom Chaiwongkot, Rangsima Reantragoon

Chulalongkorn Medical Journal

Background: The Hepatitis B surface antigen (HBsAg) commercially-available screening test suggests a confirmatory testing in all cases that are reactive, but this will take a long time to reporting of results and increase the total test cost.

Objectives: To investigate the correlation between cutoff index (COI) values of initial HBsAg screening test and their corresponding confirmatory neutralization results in order to identify a COI value for distinguishing samples that truly need confirmatory neutralization testing.

Methods: A retrospective study of 72,496 HBsAg screening test results using the Elecsys HBsAg II kit of patients at King Chulalongkorn Memorial Hospital, the Thai Red …

Dysexecutive Difficulty And Subtle Everyday Functional Disabilities: The Digital Trail Making Test, David J Libon, Rod Swenson, Sean Tobyne, Ali Jannati, Daniel Schulman, Catherine C Price, Melissa Lamar, Alvaro Pascual-Leone

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Digital neuropsychological tests reliably capture real-time, process-based behavior that traditional paper/pencil tests cannot detect, enabling earlier detection of neurodegenerative illness. We assessed relations between informant-based subtle and mild functional decline and process-based features extracted from the digital Trail Making Test-Part B (dTMT-B).

METHODS: A total of 321 community-dwelling participants (56.0% female) were assessed with the Functional Activities Questionnaire (FAQ) and the dTMT-B. Three FAQ groups were constructed: FAQ = 0 (unimpaired); FAQ = 1-4 (subtle impairment); FAQ = 5-8 (mild impairment).

Results: Compared to the FAQ-unimpaired group, other groups required longer pauses inside target circles (p < 0.050) and produced more total pen strokes to complete the test (p < 0.016). FAQ-subtle participants required more time to complete the entire test (p …