Digital Commons Network^™

Effects Of Equine Assisted Activity On Children And Adolescents With Autism Spectrum Disorder, Briana Ciampi, Jeffrey M. Roy

Physician Assistant Capstones, 2016 to 2019

Background: Autism spectrum disorder (ASD) encompasses a spectrum of disorders which are characterized as having impaired communication skills, social skills and repetitive behaviors or body movements.^1,2 Since every individual with ASD presents with different challenges, treatment modalities for ASD are quite diverse. Equine Assisted Activities (EAA) to include therapeutic horseback riding (THR) is a treatment modality that has been utilized more in recent years for children and adolescents with ASD, as it is thought the connection between the individual and the horse can facilitate emotional, behavioral, and cognitive growth.³ Objective: To determine the effectiveness of Equine Assisted Activity …

Effect Of Npo Status On Aspiration Risk In Pediatric Patients Undergoing Procedural Sedation, Stacey Waldron, Kelsey Woycik

Physician Assistant Capstones, 2016 to 2019

Objective:To conduct a review of literature to determine if no solid food or liquids by mouth for more than or less than six hours impacts the incidence of pulmonary aspiration during procedural sedation in pediatric patients. Methods: A PubMed search was conducted utilizing the following terms: “sedation, fasting, and aspiration” and “NPO, pediatrics, and pre-procedural.” Filters included: “within five years,” “review articles,” and “English.” Articles were then screened and assessed for eligibility based on pediatric population, NPO status, procedural sedation, and risk of pulmonary aspiration. Results: Two prospective observational studies and one retrospective review were selected. Beach et al. …

The Effect Of Opioid Overdose Education And Naloxone Distribution Programs On Opioid-Related Mortality, Blake Rogers, Sharon P

Physician Assistant Capstones, 2016 to 2019

Objective: To determine the effectiveness of opioid overdose education and naloxone distribution (OEND) program implementation in reducing opioid-related overdose mortality. Methods: A PubMed search was conducted using the terms “opioid overdose prevention community naloxone,” yielding 80 records, 36 of which were screened. The remaining 44 articles were reviewed for eligibility, resulting in three articles chosen for the study. Results: An interrupted time-series analysis by Walley et al., and two retrospective cohort studies by Albert et al. and Rowe et al. were analyzed. Conclusion: Studies by Walley et al. and Albert et al. demonstrated a positive association between OEND program implementation …

Long Term Outcomes Of On-Pump Cabg Versus Off-Pump Cabg, Christopher Fetrow, Jessalyn Dickerson

Physician Assistant Capstones, 2016 to 2019

Objective: Assess the long-term outcomes including mortality, revascularization and myocardial infarction events to determine whether off-pump CABG is more effective for patients compared to on-pump CABG procedures.

Methods: Studies were found using PubMed with the search term, “on and off pump CABG” which yielded 1736 studies. After assessing for records within 5 years the search was narrowed to 370 articles and then down to 353 because some articles were not available in full-text. Our search was then divided into first looking at randomized control trials and meta-analysis availability from the 353 articles meeting our criteria. After narrowing our search for …

Long-Term Proton Pump Inhibitor Use And Effect On Risk Of Fractures, Hannah Messer, Alison K. Conforto

Physician Assistant Capstones, 2016 to 2019

Objective: To conduct an analysis of literature that examined the effects of long-term proton pump inhibitors (PPIs) in adults 50 years and older on fracture risk. Methods: A literature search of the PubMed database using the terms “long-term use of PPIs” AND “fractures” Results: All 3 studies reported a statistically significant increased risk of fracture associated with long-term use of PPIs in both men and women over 50. None of the studies showed an increased risk of fracture with short-term PPI use. Conclusions: Health care providers should be informing their patients of the potential risk associated …

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Probiotics As An Adjunct Treatment To Standard Therapy In Ulcerative Colitis, Melissa Maloof, Grace Berardini

Physician Assistant Capstones, 2016 to 2019

Objective: To determine the effectiveness of probiotics in addition to traditional therapy for patients with ulcerative colitis (UC) using a systematic review. Methods: PubMed and Cochrane Library databases were queried to evaluate patient clinical trials within the past five years using the search terms probiotics and ulcerative colitis. Results: Three trials met inclusion criteria. Two of three studies found no significant improvement in their primary endpoint with probiotics. Yoshimatsu, et al. found that after one year 56.6% of the placebo group remained in remission, whereas 69.5% of the probiotic group remained in remission (p>0.05).⁹ Tursi, et …

Vitamin C In The Treatment Of Septic Shock, Alyson O. Shaughnessy, Matthew Tieszen

Physician Assistant Capstones, 2016 to 2019

Objective:To assess the efficacy of improving outcomes of septic shock treatment with the addition of Vitamin C to standard treatment compared to standard therapy alone. To assess whether or not Vitamin C has a favorable outcome in the treatment of septic shock in terms of decreasing duration of vasopressor usage, reducing duration of intensive care unit (ICU) stay, and improving mortality.

Design: Systematic literature review.

Methods: Searches were conducted in PubMed and Google Scholar using the terms ascorbic acid, sepsis, septic shock, and vasopressors. In PubMed the following filters were used: humans only, clinical trials, studies within the past …

Ethyl Chloride Spray For Injection Site Analgesia, Ryan T. Pyles, Mackenzie N. Kappe

Physician Assistant Capstones, 2016 to 2019

Objective: To determine if ethyl chloride spray provides adequate analgesia prior to injections. Design: Systematic literature review. Methods: A search was conducted in both Pubmed and Scopus using search terms ethyl chloride and injection. The Pubmed search was narrowed to include studies within a 10-year publication range. Articles were excluded based on: population age range, date of publication, and if ethyl chloride was used in conjunction with another analgesic. There were no relevant articles in the Scopus search. Results: Franko O, Stern P. demonstrated that there was no statistically significant improvement in anxiety or pain perceived with ethyl chloride treatment …

Diagnostic Effectiveness Of Lead Avr As A Stemi Equivalent, Phung Vu, Karen Hayes

Physician Assistant Capstones, 2016 to 2019

Background: Acute coronary syndrome (ACS) encompasses a collection of three acute processes related to myocardial ischemia. These include: unstable angina, non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI). The 12-lead electrocardiogram (ECG) is a crucial tool in the diagnosis and risk stratification of ACS. Unlike the other 11 leads, lead augmented Vector Right (aVR) has been long neglected until recent years. Recent investigations have shown that an analysis of ST-segment shift in lead aVR provides useful information on the coronary angiographic anatomy and risk stratification in ACS. This implies that the use of lead aVR can be …

Effects Of A Robotic Cat On Agitation And Quality Of Life In Individuals With Dementia In A Long-Term Care Facility, Jillian Nicole Marsilio, Samantha Virginia Mckittrick, Lisa Renee Umbell, Melissa Ann Garner, Sharon Maiewski, Jeanne Wenos

Physician Assistant Capstones, 2016 to 2019

Study Objective: The purpose of this study is to determine whether introducing a robotic companion cat into a long term care facility may improve affect and, subsequently, increase participation for residents with dementia, and to determine potential benefits for caregiver roles and relationships with individuals with dementia.

Background: The number of people with dementia is growing, and the behavioral and psychological side effects are negatively affecting the quality of life for these people as well as their caregivers. Additional research is needed to help develop and confirm the use of nonpharmacological treatment for dementia with therapeutic robots.

Study Subjects: Research …

The Mckenzie Method And Treatment Of Low Back Pain, Sylvia Meyer, David Harrison

Physician Assistant Capstones, 2016 to 2019

Objective: To compare the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) exercise program to other treatment modalities for reducing pain, disability, and improving function in patients complaining of low back pain. Design: Systematic literature review. Methods: Searches were conducted in PubMed and Google Scholar using terms “McKenzie Method”, “mechanical diagnosis and therapy”, “low back pain”, “spinal manipulation”, “physical therapy”, and “placebo”. Results: In Machado et al., a statistically significant difference was found between MDT and using a first line approach (advice, reassurance, and over the counter (OTC) analgesics) regarding pain; however, it did not meet the pre-established level of …

Comparison Of The Rowland Universal Dementia Assessment Scale And Mini-Mental State Examination For Dementia Detection, Lauren Fry, Daniel Wolfe

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the ability of the Rowland Universal Dementia Assessment Scale (RUDAS) in comparison to the Mini-Mental State Examination (MMSE) to detect signs of dementia in a diverse elderly population. Design: Systematic literature review. Methods: Searches were done in PubMed, utilizing the terms MMSE, RUDAS, and dementia. Results: Using the keywords mentioned on PubMed,two articles met the inclusion and exclusion criteria: Limpawattana et al and T. R. Nielsen et al. One other article was found by searching under the “Related Articles” section on PubMed: D. Basic et al. Conclusion: The RUDAS performs just as well as …

Cervical Cytology Versus Primary Hpv Testing As Screening Tests For Cervical Dysplasia, Erin Shea, Biniam Abraham

Physician Assistant Capstones, 2016 to 2019

Background: Cervical cancer is the fourth most common cancer among women, accounting for 10% of all female cancers and 7.5% of all cancer deaths worldwide.^1,2 Human papillomavirus (HPV) has been detected in up to 99.7% of cervical cancers, making it the primary risk factor for the development of cervical cancer.³ Current guidelines recommend a screening test which includes a combination of cervical cytology as well as HPV co-testing in women over the age of 30, with HPV testing not recommended in women younger than the age of 30.¹¹ The Food and Drug Administration has approved primary HPV …

Curcumin Supplementation For Relief Of Pain Associated With Osteoarthritis, Kelly M. Schatzlein, Keely Tietjen

Physician Assistant Capstones, 2016 to 2019

NSAID Nonsteroidal Anti-inflammatory drug

OA Osteoarthritis

WOMAC Western Ontario and McMaster Universities Osteoarthritis Index

VAS Visual analogue scale

LPFI Lequesne Pain and Function Index

KOA Knee osteoarthritis

ROS Reactive oxygen species

ADL Activity of daily living

BMI Body mass index

Objective: To determine if curcumin supplementation compared to nonsteroidal anti-inflammatory drugs (NSAIDs), placebo, and rescue medications is an effective treatment of arthritic symptoms in males and females between the ages of 50 and 80 with a diagnosis of osteoarthritis.

Design: Systematic Literature Review

Methods: Searches were done in PubMed, Google Scholar, and Scopus utilizing the terms “turmeric”, “curcumin”, “osteoarthritis”, …