Digital Commons Network^™

Effects Of Ketamine Versus Morphine In The Treatment Of Acute Pain In The Emergency Department, Dakoda Farrington, Amber Knowlton

Physician Assistant Capstones, 2016 to 2019

No abstract provided.

Effects Of Prehospital Vs. In Hospital Therapeutic Hypothermia On Neurological Status After Cardiac Arrest, Cassandra Johnson, Ingrid Brown

Physician Assistant Capstones, 2016 to 2019

Objective: To conduct an analysis of literature that examines whether the use of prehospital therapeutic hypothermia (TH) results in significant changes in neurologic outcomes that are in adults that experienced out of hospital cardiac arrest (OHCA). Methods: Systematic searches were conducted through PubMed at the James Madison University Library. The inclusion criteria included human adults who experienced out of hospital cardiac arrest and were treated by Emergency Medical Services (EMS) with and/or without prehospital TH by means of intravenous cold fluids and surface cooling. Results: Three studies involving 2180 cases were included. This review indicated that prehospital TH after …

Chlorhexidine Gluconate Vs Povidone-Iodine In The Prevention Of Clean-Contaminated Surgical Site Infections, Erin Layne, Abigail Stone

Physician Assistant Capstones, 2016 to 2019

Abstract

Background:

A patient’s skin is the major source of pathogens that can cause post-operative complications such as surgical site infections (SSIs). Optimization of pre-operative skin antisepsis is obtained with chlorhexidine gluconate (CG) and povidone-iodine (PI). These two solutions are the most widely used antiseptics for pre-operative purposes.

Objective:

Among surgical patients greater than 18 years of age undergoing clean-contaminated surgery, which antiseptic, iodophors or chlorhexidine gluconate, is more effective at reducing postoperative surgical site infections?

Methods:

A search was done in PubMed utilizing the terms chlorhexidine, infection control, iodophors, and surgical site infection. The limits applied included randomized …

The Use Of Probiotics To Prevent Ventilator-Associated Pneumonia In Adults, Michael Roper, Paige Douthett

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy and safety of preventing the acquisition of ventilator- associated pneumonia with the use of probiotic supplementation, as compared to a placebo, among hospitalized adult men and women receiving more than 24 hours of mechanical ventilation. Design: Systematic Literature Review. Methods: Systematic searches were conducted through PubMed and Scopus using the search terms “ventilator”, “probiotics”, and “prevention”. Records were excluded from the analysis if they were published before 2015, full text was not available, studies other than randomized control trial or cohort studies, and if the study population was less than 18 years old. Results: Of …

Effects Of Stem Cell Therapy On 6-Minute Walk Test Distance And Left Ventricular Ejection Fraction In Patients With Nonischemic Cardiomyopathy, Kayleigh Hunt, Alexa Maziuk

Physician Assistant Capstones, 2016 to 2019

Objective

To assess the efficacy of stem cells in the improvement of functional capacity and quality of life in the setting of nonischemic dilated cardiomyopathy.

Design

Systematic literature review

Methods

A literature search of PubMed was conducted utilizing the following search terms: “stem,” “cell,” “nonischemic,” and “cardiomyopathy.” The following limits were used: “2015-2018,” nonischemic cardiomyopathy, results of LVEF and 6MWT, randomized controlled trials, pilot studies, and sample size >22.

Results

Butler et al. found that within the itMSC group, 6MWD increased by an average of 27.40 m (95% CI 0.28–54.52; P=0.05), but it decreased by an average of 10.83 m …

Corticosteroid Vs Platelet Rich Plasma Injections In The Treatment Of Chronic Plantar Fasciitis, Elizabeth J. Meaney, Emma W. Adelman

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the effectiveness of platelet rich plasma (PRP) injections in the treatment of chronic plantar fasciitis compared to traditional corticosteroid injections. Design: Systematic literature review. Methods: A literature search was performed in Pubmed using the search terms “plantar fasciitis” and “platelet rich plasma”. Inclusion criteria included publication within 10 years, randomized control trial, human study, and containing the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scoring system. Results: Our literature search resulted in the review of three randomized- control trials. Mahindra et al. showed that PRP was superior to corticosteroid injections in the treatment of chronic plantar …

Crystalloids Or Colloids… What’S In Your Iv? Determining Fluid Type For Septic Shock Resuscitation, Eleanor L. Jordan, Amy K. Lansing

Physician Assistant Capstones, 2016 to 2019

Objective: To compare the efficacy of crystalloid versus colloid solutions, specifically normal saline versus albumin, in decreasing mortality among patients with septic shock requiring resuscitation fluids in the intensive care unit (ICU) setting. Design: Systematic literature review. Methods: Research was conducted in PubMed and UpToDate, utilizing the search terms sepsis, septic shock, fluid resuscitation, colloids and crystalloids. Specifically, in PubMed, the following limits and terms were used: randomized control trial, human subjects, English, and within the last 7 years. Results: The Annane et al study found no significant difference in colloid fluid resuscitation versus crystalloid fluid resuscitation in the decreasing …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

Comparing Effectiveness Of Colonoscopy Versus Fecal Immunochemical Testing In Screening For Colorectal Cancer, Hannah Vanrooyen, Lindsay Burns

Physician Assistant Capstones, 2016 to 2019

Introduction: Colorectal cancer (CRC) is deadly neoplasm that takes many lives in the United States and is a leading cause of cancer worldwide. If CRC is detected early through screening, there is a higher chance of remission which makes screening an important tool in CRC prevention. Currently, colonoscopy is the gold standard, but due to the undesirable preparation needed for a colonoscopy, patient compliance is low. Giving patients a screening option that requires less preparation may help to increase the compliance for CRC screening. Fecal Immunological testing has been shown to have higher compliance rates among patients as compared to …

Effect Of Metformin On Adolescent Obesity, Mackenzie Mcnamee, Victoriya Eggen

Physician Assistant Capstones, 2016 to 2019

Objectives: Metformin is the first line treatment for type 2 diabetes mellitus (T2DM) in both adults and children and has been shown to result in weight loss. Pediatric obesity is a major risk factor for the development of T2DM as well as several other diseases. Recently, physicians have reported using Metformin off-label to treat obesity in adolescent patients. The purpose of this study is to investigate whether Metformin is effective in reducing BMI in obese adolescents.

Methods: Studies were found using PubMed, MeSH, Medline, and CINAHL. The search terms used were: “obesity,” Metformin,” “adolescents,” “children,” “metformin and weight,” …

Effect Of Postpartum Protocols On Maternal Outcomes, Kelsey Grimm, Emily Harnish

Physician Assistant Capstones, 2016 to 2019

Objective: To determine whether postpartum hemorrhage (PPH) protocols lead to decreases in maternal morbidity and mortality.

Design: Systemic literature review.

Methods: The clinical question investigated is whether the implementation of PPH protocols has measurable impact on maternal morbidity and mortality. Searches were done through PubMed using the keywords: “maternal hemorrhage postpartum protocol.” Studies were eliminated if they were more than 10 years old, conducted outside the United States, published in a non-English language, used other animal subjects besides humans, used non-female subjects, if they did not answer the clinical question, or were review articles. Eventually, three cohort …

Exclusive Enteral Nutrition And Corticosteroids: Two Effective Methods Of Induction Treatment In Crohn’S Disease, Sarah E H Hutchison, Rachel L. Stottlar

Physician Assistant Capstones, 2016 to 2019

Objective: To compare the effectiveness of corticosteroids (CS) versus exclusive enteral nutrition (EEN), as induction therapy of Crohn’s disease to induce remission. Design: Systematic literature review. Methods: Searches were done in PubMed utilizing the terms: enteral nutrition therapy, exclusive enteral nutrition, inflammatory bowel disease, Crohn’s disease, corticosteroids, pediatric, nutrition, and steroids. Articles were excluded with patients > 18 years of age, confounding variables, inclusion of other treatment options, or physician discretion bias in selecting a treatment option. Results: Ultimately, three articles were included in our review. Two of three studies examined showed a statistically significant improvement in remission rates in …

The Effect Of Yoga On Fatigue In Breast Cancer Patients Undergoing Radiotherapy, Magdalene Bredehoeft, Karli Ribsam

Physician Assistant Capstones, 2016 to 2019

Objective: Assess the effect of yoga on levels of fatigue among women with breast cancer currently undergoing radiotherapy. Design: Systematic literature review. Methods: Searches were done on PubMed, utilizing the terms “yoga,” “fatigue,” “breast cancer,” and “radiotherapy.” Limits that led to inclusion of studies included: published after 2008, studies researching breast cancer, and studies that were randomized controlled trials. Results: Randomized controlled trials studied were by Chandwani et al. (2010), Chandwani et al. (2014), and Vadiraga et al. (2009). Conclusion: Yoga can improve quality of life among women with breast cancer undergoing radiotherapy, specifically by decreasing levels of fatigue. We …