6501 research outputs found
Sort by
Case Report: Cold Urticaria Diagnosed in the Emergency Department
Get PDFCold urticaria can be primary (idiopathic) or can be due to underlying hematologic or infectious diseases. Here we present the case of a young female patient with no past medical history who was diagnosed with cold urticaria in the emergency department setting, using a cold stimulation test. Most cases are idiopathic. The reaction can be triggered in individual cases by exposure to cold objects or to generalized cold ambient temperatures, as was the case in the patient presented here. The physical response is most commonly pruritic wheals (urticaria). However, more severe symptoms may occur up to angioedema with hoarseness and wheezing. This patient had mild symptoms, affecting skin only. The treatment is essentially symptomatic for mild cases, involving non-sedating histamines. Patient education concerning avoiding cold aquatic activities is important. Anaphylaxis is treated as indicated. ED management of mild cases may include steroid administration. Several sources refer to consideration of the use of omalizumab in chronic cases
Effectiveness of Exercise After Meals in Reducing Blood Sugar in People Who Are Overweight, Obese, or Have Type 2 Diabetes: A Systematic Review and Meta-Analysis
Get PDFStudies investigating the acute effect of postprandial exercise (PPE) on glucose responses exhibit significant heterogeneity in terms of participant demographic, exercise protocol, and exercise timing post-meal. As such, this study aimed to further analyze the existing literature on the impact of PPE on glycemic control in overweight individuals and individuals with obesity and type 2 diabetes (T2DM). A literature search was conducted through databases such as PubMed, CINAHL, and Google Scholar. Thirty-one original research studies that met the inclusion criteria were selected. A random-effect meta-analysis was performed to compare postprandial glucose area under the curve (AUC) and 24 h mean glucose levels between PPE and the time-matched no-exercise control (CON). Subgroup analyses were conducted to explore whether the glucose-lowering effect of PPE could be influenced by exercise duration, exercise timing post-meal, and the disease status of participants. This study revealed a significantly reduced glucose AUC (Hedges’ g = −0.317; SE = 0.057; p \u3c 0.05) and 24 h mean glucose levels (Hedges’ g = −0.328; SE = 0.062; p \u3c 0.05) following PPE compared to CON. The reduction in glucose AUC was greater (p \u3c 0.05) following PPE lasting \u3e30 min compared to ≤30 min. The reduction in 24 h mean glucose levels was also greater (p \u3c 0.05) following PPE for ≥60 min compared to \u3c 60 min post-meal and in those with T2DM compared to those without T2DM. PPE offers a viable approach for glucose management and can be performed in various forms so long as exercise duration is sufficient. The glucose-lowering effect of PPE may be further enhanced by initiating it after the first hour post-meal. PPE is a promising strategy, particularly for patients with T2DM
Scoping Literature Review: The Role of Leptin in Autism Spectrum Disorder (ASD) and Associated Obesity
Get PDFOverweight and obesity (OW/OB) are significant concerns among individuals with Autism Spectrum Disorder (ASD), yet the underlying causes remain unclear. Emerging evidence points to metabolic and hormonal factors—particularly leptin, a hormone involved in appetite regulation—as potential contributors. This scoping review examined five key studies from 2003 to 2024 that investigated the relationship between leptin and ASD in overweight populations. Across studies, individuals with ASD consistently exhibited elevated leptin levels compared to controls. While some findings also noted changes in other adipokines, such as lower resistin or progranulin, leptin was the most consistently dysregulated. These patterns suggest systemic alterations in energy metabolism or inflammation in ASD, though results are limited by small sample sizes, heterogeneous study designs, and unaccounted confounding variables like medication use and physical activity.
The literature reveals a strong association between elevated leptin levels and ASD, but the underlying mechanisms and clinical implications remain unclear. Leptin dysregulation may contribute to obesity in ASD either through impaired satiety signaling or leptin resistance. Future research should focus on larger, more diverse populations and consider hormonal, behavioral, and lifestyle factors. To further explore this relationship, I plan to collect leptin data from neurodiverse patients at the RISN Center at Rowan-Virtua. Whether leptin is found to be low or high, both scenarios could help explain the high prevalence of obesity in this population and potentially guide targeted interventions
A Rare Case of Diffuse Alveolar Hemorrhage in the Setting of IgA Nephropathy, Vasculitis and Atypical Hemolytic Uremic Syndrome in a Previously Healthy Young Adult
Get PDFIgA Nephropathy, also known as Berger disease, can precipitate acute renal failure in patients. IgA Nephropathy (IgAN) is deposition of protein from IgA into the renal tissue with subsequent renal dysfunction. IgA vasculitis (IgAV) is another condition where similarly the protein of IgA is deposited into the vessels. There are some cases of co-existing atypical hemolytic uremic syndrome (aHUS) with IgAN. However, rare combinations seen with all three IgAN, IgAV, and aHUS without any pre-existing conditions nor medical history. Patients that develop any one of these conditions are looking at life long changes with hemodialysis (HD) and organ transplants being the definitive treatment. Hemolytic Uremic Syndrome (HUS) is a multitude of thrombocytopenia, microangiopathic hemolytic anemia, and renal failure. In this case, we focus on 27 year old male with the complement overactivation type, known as aHUS, where omplement regulatory proteins that are attacked by autoantibodies. Precipitating events or triggers are needed for dysregulation of these proteins leading to fulminant renal failure
A Twist of Fate: A Case of Spiral Humerus Fracture After Arm Wrestling
Get PDFFractures of the humerus are relatively uncommon, with spiral fractures typically resulting from rotational forces. This case report describes a 25-year-old male who sustained a right-sided spiral humerus fracture during an arm-wrestling match. The diagnosis was confirmed through radiographic imaging, and the fracture was successfully managed with closed reduction and posterior long arm splinting. This case highlights the importance of recognizing less common mechanisms of injury, like arm wrestling, in the context of humeral fractures. It also emphasizes the effective non-operative treatment of such fractures in young, healthy individuals
KS151 Synergizes with Venetoclax and ABT-737 in AML: Efficacy in Both FLT3-Wildtype and FLT3-Mutant Models
Get PDFAcute myeloid leukemia (AML) is the most common leukemia in adult patients, with a 5-year survival rate of less than 30 percent. Therefore, more effective therapeutic strategies are required to prolong the survival of AML patients. Importantly, anti-apoptotic proteins, especially B-cell lymphoma 2 (Bcl-2), overexpression in AML is associated with uncontrolled growth as well as chemoresistance. Unsurprisingly, Bruton’s tyrosine kinase (BTK) overexpresses in AML and associated with poor prognosis and chemoresistance. The FDA-approved BTK inhibitor, ibrutinib, has been successful in treating other hematologic malignancies, but a proportion of patients relapse mainly because of acquired mutations at Cys481Ser (C481S) in the kinase domain of BTK. If we are to develop effective BTK-based therapeutic regimens, it is critical that we account for these likely mutations and avoid agents that target the kinase domain. To develop a more selective and effective BTK inhibitor, we modified our first-generation BTK inhibitor to avoid the C481S mutation in the BTK kinase domain. This advance allowed us to develop a second-generation BTK inhibitor, KS151, that shows in vitro potency against C481S mutants. Because BTK and Bcl-2 are critical in chemoresistance and poor prognosis, combination therapy targeting BTK and Bcl-2 is a more viable option for AML patients to achieve better therapeutic outcomes. We propose the combination of KS151 with venetoclax (ABT-199) or ABT-737 in resistant AML cells. We employed a panel of three AML cell lines: Kusami-1, U937, and THP-1. Remarkably, KS151 was able to induce AML cell death with an average IC50 of 4 μM. Furthermore, KS151 showed a significant increase in both venetoclax and ABT-737 efficacy against AML cells. Western blot analysis demonstrated that Kusami-1 cells have the highest expression of both BTK and Bcl-2 proteins. Taken further, flow cytometry (Annexin V staining) demonstrated that KS151 combined with inhibition of Bcl-2 by venetoclax synergistically induced apoptosis (approximately 95%) of Kusami-1 cells. Collectively, the combination therapy showed promising and synergistic in vitro anti-leukemic activity against AML cell lines and represents a new viable treatment for AML patients. Future studies will apply the combination strategies in AML-resistant cell lines and include assessment in patient samples and in vivo studies
Examining the Relationship Between Nutritional Access and Childhood Obesity in Low-Resource South Jersey Communities
Get PDFBACKGROUND: 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 determined that the percentage of overweight and obese children in Camden, Trenton, and Vineland is higher than national data from NHANES. Moreover, all students in Camden, NJ public schools exceed the U.S. national average for childhood obesity percentages. Critically, most parents in Camden, NJ do not think their child is overweight or obese when asked about their child’s weight status.
CONCLUSION: This literature review demonstrates that the lack of acceptance from parents poses a barrier to acknowledging the existence of the problem and accepting any offered help. Interventions should be aimed at designing a comprehensive nutrition intervention program to address dietary challenges like access to fresh fruits and vegetables and ways to incorporate them into daily meals planning to reduce childhood obesity rates. One of the potential programs can help create a partner buddy program where high schoolers educate middle schoolers about nutrition using fresh produce
Pancreatic Ascites: Update on Diagnosis and Management
Get PDFPancreatic ascites is a rare condition characterized by the accumulation of high-amylase ascitic fluid in the peritoneal cavity. This condition is often associated with chronic pancreatitis, pancreatic trauma, or pseudocyst rupture. Because of its rarity and ill-defined clinical presentation, pancreatic ascites is often a diagnostic and therapeutic challenge in clinical practice. The current diagnostic criteria include an amylase level \u3e1000 mg/dL, a protein level \u3e3 g/dL, and a serum ascites albumin gradient \u3c 1.1 g/dL. The clinical features vary, but may include progressive abdominal distension, diffuse abdominal pain, weight loss and peritonitis. The management of pancreatic ascites remains controversial, and there is no consensus regarding the optimal approach. Conservative medical management, which includes nutritional support, pain control, therapeutic paracentesis and the use of somatostatin analogs, has been associated with a high failure rate and significant morbidity. Interventional therapies, such as surgery and endoscopic transpapillary stenting, have shown more promising outcomes. However, the choice between these methods is still debated, with some advocating for endoscopic approaches, because of their minimally invasive nature and reduced morbidity compared with surgical options. Endoscopic approaches remain underutilized in practice, probably because of the need for repeated interventions, the potential risks associated with endoscopic retrograde cholangiopancreatography, or a lack of skilled personnel. Although they show significant perioperative morbidity and mortality, surgical options provide definitive resolution of pancreatic ascites. Herein, we provide an updated review of pancreatic ascites, highlighting advances in diagnostic techniques and therapeutic approaches, and summarizing insights from recent clinical cases and retrospective studies
HEAT PUMPS AND SUSTAINABLE BUILDING OPERATIONS: AN ANALYSIS OF ENERGY EFFICIENCY, EMISSIONS, AND LIFE CYCLE COSTS
Get PDFHeating, ventilation, and air conditioning (HVAC) systems are a major contributor to energy demand. Heat pump technologies, particularly Ground Source Heat Pumps (GSHPs) and Air Source Heat Pumps (ASHPs), have emerged as key solutions to reduce energy use worldwide. However, their adoption is challenged by economic, operational, and environmental trade-offs. This dissertation develops a comprehensive framework for evaluating the energy efficiency, lifecycle emissions, and cost-effectiveness of GSHP and ASHP systems in sustainable building operations. Through advanced energy modeling, lifecycle assessments (LCA), and lifecycle cost (LCC) analyses, this research provides data-driven insights to optimize heat pump system selection. This study is structured around five interrelated research papers, each addressing a critical aspect of heat pump performance and implementation. The first paper validates energy simulation models by assessing the accuracy of peak demand estimates for office buildings using eQUEST, ensuring the reliability of subsequent analyses. The second paper evaluates the energy and emissions savings potential of GSHP and ASHP systems when integrated with photovoltaic (PV) panels, highlighting GSHPs’ long-term sustainability advantages despite higher installation costs. The third paper conducts a comprehensive LCA of heat pump technologies, quantifying embodied carbon emissions and their impact on long-term sustainability. The fourth paper presents an economic and operational analysis of GSHP and ASHP systems across various building scenarios, identifying cost trade-offs, payback periods, and financial feasibility. The fifth paper expands on these findings by developing a generalized decision-making framework that considers heating system selection based on cost, emissions, and energy efficiency. The findings indicate that GSHPs consistently outperform ASHPs in terms of energy efficiency and emissions reduction, particularly in heating-dominant climates. However, high capital costs remain a significant barrier to widespread GSHP adoption. ASHPs, while more cost-effective and easier to retrofit, exhibit performance degradation in extreme temperatures and contribute to higher peak electricity demand. Integrating PV with heat pumps enhances sustainability by reducing grid dependence, though seasonal energy mismatches present a challenge. Economic analyses highlight that ASHPs are more viable for medium-scale applications, but scaling advantages might favor GSHPs for large buildings or clusters of buildings. This dissertation culminates in the development of a generalized decision-making framework for selecting optimal heating systems based on cost, energy performance, and environmental impact. By integrating real-world operational conditions, system scalability, and embodied carbon considerations, the framework serves as a practical tool for engineers, policymakers, and building owners. These findings contribute to the broader goal of sustainable building operations, providing actionable insights for selecting HVAC systems that will improve operations and reduce the impact of the built environment
The Role Full-Time Faculty Play in Retaining Students with New Initiatives Implemented by the Administration: A Qualitative Case Study
Get PDFThis qualitative study explored the role full-time faculty play in supporting student retention within the context of new administrative initiatives at a New Jersey community college. Grounded in the framework of faculty as institutional agents, the research investigated how faculty understood their role, engaged with retention efforts, and perceived their alignment with institutional goals. Data were collected through semi-structured interviews with full-time faculty involved in or impacted by retention initiatives. Thematic analysis revealed that while faculty were committed to student success, they experienced limited involvement in the development and communication of these initiatives. Participants expressed a need for consistent communication, improved collaboration, and better support structures that align faculty work with broader administrative initiatives. This study underscores the importance of recognizing faculty as essential partners in advancing retention goals. Findings suggest that enhancing communication and engagement between faculty and administration may strengthen morale, improve program effectiveness, and contribute to improved student outcomes