Pathological Conditions, Signs and Symptoms Commons^™

Identifying Predictors For Inflammation-Induced Preterm Birth: A Murine Study, Tzu Ning Liu Bs, Jose Galaz Md, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Introduction: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. A large proportion of preterm deliveries is affected by intra-amniotic inflammation, which can occur in the presence (intra-amniotic infection) or absence (sterile intra-amniotic inflammation) of microbes. Studies have shown an association between intra-amniotic inflammation, cervical shortening, and changes in the cervicovaginal microbiome. However, their causal relationships are unknown. This study aims to determine the causality of intra-amniotic inflammation, cervical shortening, and cervicovaginal microbiome alterations.

Methods: Pregnant C57BL/6 dams received an ultrasound-guided intra-amniotic injection of an endotoxin lipopolysaccharide (LPS) or the alarmin interleukin-1 alpha (IL-1 alpha) on ...

The Role Of Age Ligand And Rap1a In Myofibroblast Signaling Cascade In Type 2 Diabetes Mellitus-Induced Cardiomyopathic Conditions, Camilla Puglia

Honors Theses

Diabetes is one of the leading causes of death in the United States, taking more than 90,000 lives annually. Type 2 diabetes mellitus-induced cardiac fibrosis is a common condition seen in diabetic patients. The AGE/RAGE signaling cascade has been strongly associated with this supposed cardiac fibrosis along with hyperactive myofibroblasts which excessively remodel extracellular matrix tissue, leading to damaged and enlarged heart muscle tissue. In diabetic patients, Advanced Glycation End Products (AGEs) are produced in abundance and accumulate in the extracellular matrix of heart tissue. To investigate the role of of the AGE ligand on fibroblast behavior, increasing ...

A Case Of Intracranial Empyema After Bacterial Sinusitis, Eric Doane, Bhumi Shah, Robert Belfer

Stratford Campus Research Day

Acute sinusitis in the pediatric population is a common presentation in the emergency department. Most cases are viral and can be managed conservatively and will resolve spontaneously in 7-10 days. Even in cases of bacterial sinusitis, patients can typically be discharged with oral antibiotics and close follow up with the pediatrician.

There is however a small subset of patients who will develop a rare lethal complication, an intracranial empyema. While the incidence in the developed world has decreased as antibiotics become more available, it is still estimated to occur in up to 5% of severe cases requiring hospitalization (1) . In ...

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

Stratford Campus Research Day

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

Stratford Campus Research Day

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 ...

A Case Report On Causes Of Covid-19 Induced Psychosis And Treatments, Jennifer Pires, Steven Sarner

Stratford Campus Research Day

COVID-19 is a viral infection that is caused by an RNA virus in a subfamily of Coronaviridae named severe acute respiratory syndrome (SARS CoV 2). The family also includes severe acute respiratory syndrome coronavirus (SARS CoV) and middle east respiratory syndrome coronavirus (MERS CoV) which have previously been shown to cause respiratory symptoms and psychosis with immunoreactivity to IgG.

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

Stratford Campus Research Day

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.

A Preliminary Report: The Hippocampus And Surrounding Temporal Cortex Of Patients With Schizophrenia Have Impaired Blood-Brain Barrier, Eric L. Goldwaser, Randel L. Swanson, Edgardo J. Arroyo, Venkat Venkataraman, Mary C. Kosciuk, Robert G. Nagele, L. Elliot Hong, Nimish K. Acharya

Stratford Campus Research Day

Schizophrenia (SZ) is one of the most severe forms of mental illness, yet mechanisms remain unclear. A widely established brain finding in SZ is hippocampal atrophy, and a coherent explanation similarly is lacking. Epidemiological evidence suggests increased cerebrovascular and cardiovascular complications in SZ independent of lifestyle and medication, pointing to disease-specific pathology. Endothelial cell contributions to blood-brain barrier (BBB) compromise may influence neurovascular unit and peripheral vascular function, and we hypothesize that downstream functional and structural abnormalities may be explained by impaired BBB.

A Puzzling Case Of Normal Pressure Hydrocephalus In The Outpatient Setting, Shadi Shams, Asim Shafique, Marym Khan, James Bailey

Stratford Campus Research Day

Normal Pressure Hydrocephalus (NPH) is a disease of adulthood characterized by the triad of gait disturbance, dementia, and urinary incontinence. Since NPH shares a lot of characteristics with other disorders including neurodegenerative disorders and degenerative-dystrophic spine, it is usually underdiagnosed and undertreated. Combination of ventriculomegaly seen on a computerized tomography (CT) scan or magnetic resonance imaging (MRI) with clinical findings could be used in diagnosis of NPH. However, improvement of symptoms post spinal tap procedure would be a better indication of diagnosis. Currently, shunt placement is the best available modality of treatment for NPH. Here we present a case of ...

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

Stratford Campus Research Day

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 ...

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

Stratford Campus Research Day

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 ...

Bells Palsy: A Late Complication Of Sars-Cov-2 Infection, Rohan Umrani, Sameer Akhtar, Sean Coulson, Brian Thomas, Yvette Wang

Stratford Campus Research Day

A 60 year old male with a PMH of SARS-CoV-2, OSA and primary hypogonadism presented with a chief complaint of left sided facial numbness and weakness.

Bells Palsy is commonly caused by HSV, VZV, Lyme disease and less commonly ischemia or local compression. It presents with facial paralysis and loss of taste in anterior 2/3 of tongue.

In the absence of definitive Lyme serologies despite history of tick bite, it is likely that this patient had Bell’s Palsy as a late manifestation of COVID-19.

Atypical Presentation Of Ankylosing Spondylitis, Chandni Patel, Milvin Shroff, Maleeha Memon, Shideh Doroudi, Christine Leroy

Stratford Campus Research Day

Radiographic axial spondyloarthritis axSpA ) or typical ankylosing spondyloarthritis (AS) is a classification of axial spondyloarthritis with the classic radiographic features of sacroiliitis. Axial spondyloarthritis is a disabling spondyloarthropathy of the spine that presents with chronic back pain usually before the age of 45. It may be associated with extraspinal features including dactylitis , synovitis, and enthesitis in addition to other nonarticular signs. Chronic back pain is one of the most common presenting symptoms for AS , but frequently there is a 5-7 year delay between the onset of symptoms and diagnosis of the disease . A standard AP plain radiograph demonstrating changes to ...

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

Stratford Campus Research Day

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.

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and ...

Paratesticular Solitary Fibrous Tumour Mimicking Cellular Angiofibroma: An Unusual Morphology And Rare Site, Madiha Bilal Qureshi, Muhammad Usman, Qurratulain Chundriger, Nasir Uddin

Department of Pathology and Laboratory Medicine

Solitary fibrous tumour (SFT) is a ubiquitous benign mesenchymal tumour of fibroblastic origin, which occurs most often in middle-aged adults. It usually presents as lung mass originating from pleura, but extrapleural occurrence is also common. Tumour is characterised by hypo- and hyper-cellular areas of spindle-shaped cells, arranged in haphazard manner with dispersed staghorn-shaped vessels. Surgical excision is the curative treatment. SFTs of the primary testicular or paratesticular region are extremely rare, but they exhibit histologic findings similar to SFTs originating at other body sites. Here, we report the case of a paratesticular SFT in a 37-year male, who presented with ...

Multisystem Inflammatory Syndrome In Children (Mis-C) Possibly Secondary To Covid-19 Mrna Vaccination, Zoon Wangu, Hannah Swartz, Meaghan Doherty

COVID-19 Publications by UMass Chan Authors

Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 is a postinfectious condition identified during the COVID-19 pandemic with specific Centers for Disease Control and Prevention and WHO criteria. Theoretical concerns have been raised whether MIS-C might also occur after COVID-19 vaccination, as the pathogenesis of MIS-C is not yet entirely understood. We present a woman in her late teens who developed MIS-C after having received two doses of Pfizer BioNTech COVID-19 vaccine 12 weeks prior, in the setting of documented anti-spike SARS-CoV-2 IgG positive, antinucleocapsid SARS-CoV-2 IgG negative, and multiple negative surveillance SARS-CoV-2 PCRs done in the 12-week period ...

Aphasias And Other Cortical Syndromes, Juliana Coleman

PEER Liberia Project

This presentation is Lecture 3 in the PEER Liberia Neurology Lecture Series. It provides an overview of cortical neurology, including: cognition and hemisphere dominance, normal language, aphasias (Broca’s (non-fluent), Wernicke’s (fluent), transcortical motor and sensory, conduction), disorders related to aphasias, parietal syndromes, and occipital syndromes.

Response Of Eltrombopag In Immune Thrombocytopenia And Acquired Idiopathic Aplastic Anemia: A Single-Center Experience, Abdul Muqtadir Abbasi, Mohammad Usman Shaikh, Natasha Bahadur Ali, Maria Khan, Salman Muhammad Soomar

Section of Haematology/Oncology

Eltrombopag has been used in ITP and found its use in AA armamentarium recently. We retrospectively analyzed 61 patients at a tertiary care center in Pakistan from January 2015 to January 2021. They included patients with severe AA who were refractory to at least one course of immunosuppressive therapy and persistent/chronic ITP who have received at least one previous treatment for ITP. Responses to Eltrombopag in our population were comparable to real-world experiences while tolerable hepatotoxicity and GI issues were notable. We found Eltrombopag to be a safe and efficacious agent for treating patients with ITP and AA.

Emergency Medicine Journal Club, David Gibbs, Dylan Norton, Kyle Barbour

Advances in Clinical Medical Research and Healthcare Delivery

In this column, we provide a brief review of important papers recently published that relate to the field of Emergency Medicine. The goal is to provide the busy clinician a bullet-like summary of the study, focusing on the research question, methods, results, limitations and bottom line interpretation.