Digital Commons Network^™

Photodynamic Therapy With Topical Aminolevulinic Acid Vs Placebo In The Treatment Of Actinic Keratosis, Michelle Nguyen, Katherine Shook

Physician Assistant Capstones, 2020-current

Objective: Assessing the effectiveness of photodynamic therapy with aminolevulinic acid versus placebo in the complete clearance rate of actinic keratosis.Design: Systematic literature review. Methods: An initial literature search was performed using Google Scholar using terms “photodynamic therapy”, “aminolevulinic acid,” “randomized control trial”, “actinic keratosis”, “clearance efficacy”, “safety”, “field treatment”, and “placebo”. An additional search using PubMed was performed using the same terms. Studies were excluded if they were performed on non-human subjects, did not use aminolevulinic acid as their photosensitizer, used organ transplant recipients, compared efficacy to alternate treatment modalities, used alternative light source such as laser or daylight, …

Effects Of Subthalamic Deep Brain Stimulation On Treating Motor Symptoms In Early Parkinson's Disease, Emily Reale, Gina Legaluppi

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of subthalamic nucleus deep brain stimulation (STN DBS) versus solely optimal pharmacological use in early Parkinson's Disease to improve motor dysfunction. Design: Systematic Literature Review. Methods: Searches were completed on PubMed utilizing the MeSH terms: “subthalamic, deep brain stimulation, and early parkinson.” Using PubMed the following limits and terms were used: published in the last 10 years, randomized controlled trial, English, human, and removing duplicates. A total of three studies resulted after the search. Results: All three studies showed statistically significant results in reduction in disease progressive motor symptoms. Additionally, at the end of each study …

Breakthroughs In Hormonal Male Contraception, Alexander Patton, Seth Vann

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of a nestorone plus testosterone gel at suppressing progestin levels and spermatogenesis.

Design: Systematic literature review.

Methods: Searches were done in PubMed and Dartmouth library using the terms nestorone, randomized control trial, human, and male. Limits used while searching included published in the last 10 years, randomized control trials, and English.

Results: Using the search criteria the following three studies were found that met the inclusion/exclusion criteria of this study: Ilani et al, Zitzmann et al, and Anawalt et al. All three studies were found on PubMed and reference the Ilani et al study.

Conclusion: Nestorone …

Effectiveness Of Tpa At Reducing Amputations In Patients With Severe Frostbite, Kylie Gravatt, Meredith Mahen

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of tissue plasminogen activator (tPA) therapy in reducing the number of limb and digit amputations in patients with severe frostbite.

Introduction: Current treatment regimens for frostbite consist mainly of rapid rewarming measures and wound care. This regimen is unfortunately many times not sufficient in cases of severe frostbite and frequently leads to delayed amputations.

Methods: A search was conducted in Pubmed using the terms "Frostbite"[Mesh]) AND "Tissue Plasminogen Activator"[Mesh]. Articles were chosen based on relevancy to the research question and having a publication date after 2005. Case reports were excluded.

Results: All three studies reported …

Are Polypills A Viable Option To Improve Health Outcomes In Those With Cardiovascular Disease?, Alexander Voytovich, Cara Mckee

Physician Assistant Capstones, 2020-current

Objective: Does the use of polypill therapy improve systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) levels more than usual care in adults with established cardiovascular disease (CVD) or with 10-year atherosclerotic cardiovascular disease risk >10%. Design: Systematic literature review. Methods: Searches were performed in PubMed and UpToDate using the following search terms polypill and cardiovascular. Other limits included: randomized control trials, adults, published in the last 10 years, LDL-C and systolic blood pressure. Results: Analysis of articles to ensure similar design, intervention and fit with the other inclusion/exclusion criteria yielded three studies: Labefer et al, Muñoz et al, and …

Sglt2 Inhibitors In The Management Of Heart Failure With Reduced Ejection Fraction, Susannah Jackson, Meghan Mathis

Physician Assistant Capstones, 2020-current

Objective: to assess whether SGLT2 inhibitors significantly reduce the risk of hospitalization for heart failure (HAHF) and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF). Design: systematic literature review. Methods: searches were conducted in PubMed with the terms "SGLT2 Inhibitors,” “heart failure with reduced ejection fraction (HFrEF),” and "hospitalization” and the following limits: publication within the last 5 years, clinical trials, meta-analyses, randomized control trials, humans, and English. These criteria determined the selected literature: randomized control trial (RCT), use of an SGLT2i compared to placebo, and outcomes including HAHF and/or cardiovascular related death. Results: DAPA-HF: 27% …

Effects Of Cannabidiol As Adjunct Therapy For Management Of Treatment-Resistant Epilepsy, Harry Gray, Molly Anadale

Physician Assistant Capstones, 2020-current

Background. Lennox-Gastaut Syndrome (LGS) and Dravet Syndrome(DS) are two types of childhood epilepsy syndromes that are often resistant to traditional anti-epileptic drug (AED) regimens. With the development of a pharmaceutical grade purified cannabidiol (CBD), there has been increasing interest in its utility for treatment of epilepsy. We conducted a systematic review to explore the efficacy of CBD in reducing seizure frequency when added to traditional AED regimens in those who are considered to have treatment resistant epilepsy (TRE).

Method. A search of PubMed was performed in September 2020 using the terms “cannabidiol”, “Lennox-Gastaut Syndrome”, “Dravet Syndrome”, and “epilepsy” with …

Paracetamol Compared To Nsaids As Treatment For Patent Ductus Arteriosus In Neonates, Toné Boykins, Carly Anne C. Wilson

Physician Assistant Capstones, 2020-current

Objective: To evaluate the use of paracetamol in the treatment of closure of patent ductus arteriosus (PDA), as well as to investigate the amount of adverse side effects. Design: Systematic literature review. Methods: Searches were done in PubMed and Google scholar, using the search terms Paracetamol for patent ductus arteriosus and alternative treatment patent ductus arteriosus. In PubMed the following limits and terms were used: randomized control trial, English, and secondary endpoints. Results: Randomized control trial studies by Dash et al., El-Mashad et al., and El-Farrash et al. were included based on inclusion/exclusion criteria of the meta-analysis and with secondary …

Baseline Bmi, Gender, & Age As Predictive Factors For Intragastric Balloon Weight Loss Outcomes, Nirali Shah, Miranda A. Myers-Burton

Physician Assistant Capstones, 2020-current

Objective: To determine whether obese and morbidly obese patients aged 18-75 with a lower baseline BMI (BMI 30-39.9 kg/m2) who received an intragastric balloon (IGB), have a higher percentage of total body weight loss (%TBWL) and percentage of excess weight loss (%EWL) compared to those with a higher baseline BMI (BMI > 40 kg/m2). Secondary objective was to ascertain whether gender and age are also predictors of weight loss outcomes following an IGB procedure.

Design: Systematic literature review

Methods: Literature searches of PubMed and SpringerLink were conducted using the search terms: “intragastric balloon, weight loss, and “BMI” and then limited to …

Peer Support Wellness Groups In Physician Assistant School, Allison Pingston, Alexa Wagoner

Physician Assistant Capstones, 2020-current

Objective: To investigate the effect of peer support wellness groups on the perceived stress, anxiety, and depressive symptoms encountered in Physician Assistant (PA) school in order to implement a wellness program for James Madison University (JMU) PA students. Design: Systematic literature review. Methods: Searches were done in PubMed and Google Scholar using the search terms: “wellness,” “peer support,” “small group(s),” “medical school,” and “PA school.” The limits used were: randomized controlled trials, meta-analysis, and completed in the past 10 years. Results: Search results revealed three articles that met inclusion and exclusion criteria. Conclusion: No articles showed statistical significance. However, all …

The Effect Of Hydroxychloroquine On Mortality In Hospitalized Covid-19 Patients, Misha Suresh, Jeff Abraham

Physician Assistant Capstones, 2020-current

As of October 2020, there are no commonly accepted or proven effective treatments for coronavirus disease 2019 (COVID-19). Hydroxychloroquine (HCQ) is an established anti-malarial drug with demonstrated action against SARS-CoV-2 (the virus that causes COVID-19) in-vitro and early observational studies and anecdotal evidence supported its use in treatment of COVID-19. In this review, three of largest and most statistically powerful studies to date (two cohort studies and one randomized controlled trial [RCT]) are synthesized for the purpose of determining whether HCQ is effective in reducing mortality in patients hospitalized with COVID-19. All three studies found no statistically significant difference in …

The Necessity Of Implementing A Wellness Curriculum Into Physician Assistant Programs, Jessica K. Erim, Darryl Bines Jr.

Physician Assistant Capstones, 2020-current

Purpose: In response to the decline of mental health and wellness of students within medical school programs, recent research has been exploring the effects of implementation of wellness curriculums. The purpose of this review is to highlight the research that has been conducted in the medical school environment and to establish the need for further research. This review will specifically discuss the implementation of a student-led wellness curriculum at James Madison University’s Physician Assistant Program and its impact on students. Methods: A thorough search was conducted using Google Scholar using specific inclusion and exclusion criteria (see Table 1). …

Unscrambling Egg Allergies: Examining The Impact Of Introduction Timing Of Egg Protein On The Development Of Food Allergies, Emily Sherald, Mark Peterson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of early egg protein introduction in the reduction of later childhood egg allergy development. Design: Systematic literature review. Methods: Searches were done using PubMed and cross referenced with articles on UpToDate, using the search strings ‘egg‘, ‘allergy‘, ‘randomized controlled trial‘, ‘early‘, and ‘introduction‘. Our inclusion criteria included: published in the last 5 years, human trial, randomized controlled trials only. Results: Our selection process yielded 3 quality studies: the “Beating Egg Allergy Trial” (BEAT)¹, “Start time of egg protein to prevent egg allergy” (STEP)², and “Two-step Egg Introduction for Prevention of Egg …

Dm Ii Bugging You? Probiotics May Help Reach Your Glycemic Goals, Robert Kime, Kayla Siford

Physician Assistant Capstones, 2020-current

Objective: To determine the effects of probiotics on glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) in patients with Type II Diabetes (T2DM) controlled with oral medications. Design: Systematic Literature Review. Methods: Searches were conducted on PubMed using the terms: prebiotic, probiotic, type 2 diabetes, non-insulin dependent, and microbiota. Searches refined with parameters for Randomized Control Trials, written in English, and available texts. Results: Firouzi et al. did not show a significant change in the FBG between groups and a decrease in the HbA1c in the intervention group. Ejtahed et al. showed a significant decrease in …

The Effect Of Platelet Rich Plasma On The Treatment Of Androgenetic Alopecia Compared To Placebo, Mackenzie D. Comstock, Hannah E. Stephenson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of plasma rich proteins (PRP) compared to placebo in the treatment of androgenetic alopecia (AGA).

Design: Systematic literature review

Methods: Searches were done in PubMed utilizing the terms PRP, plasma rich protein, autologous activated PRP, autologous activated plasma rich protein, androgenetic alopecia, placebo, hair count, hair density, hair follicles, hair loss, therapeutic effect, growth factors, dermatology, and regenerative medicine. Articles were excluded if they were published before 2013, involved animal studies, compared minoxidil only in their research, included only female participants, non-English articles, studies with no quantifiable data, review research articles, and injections besides the …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …