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Physician Assistant Scholarly Project Papers

Theses/Dissertations

2020

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Treatment Option Decision Making For Low-Grade Prostate Cancer, Janene Caldwell Witherite May 2020

Treatment Option Decision Making For Low-Grade Prostate Cancer, Janene Caldwell Witherite

Physician Assistant Scholarly Project Papers

Prostate cancer (PCa) is the second most common cancer, behind skin cancer, among men, in the United States (Centers for Disease Control and Prevention [CDC], 2019.). PCa is defined as low-grade or low risk if the neoplasm grows slowly or not at all. According to the Institute for Quality and Efficiency in Health Care, (2020), to make the conclusion that a PCa is low-grade, several tests are performed including a prostate specific antigen (PSA) level, a Gleason score, and a TNM score, which refers to tumor size, lymph node involvement, and metastasis outside the prostate. Low-grade PCa is further defined …


Implementation Of Mental Health Resources To Decrease Depression And Suicide In Healthcare Professional Students, Matthew Knealing May 2020

Implementation Of Mental Health Resources To Decrease Depression And Suicide In Healthcare Professional Students, Matthew Knealing

Physician Assistant Scholarly Project Papers

The intent of this review of literature is to determine if implementing mental health resources in graduate healthcare programs decreases the rate of depression and suicidal ideations. In this review of literature, five databases were searched. Databases included: PubMed, PsycInfo, CINAHL Complete, Clinical Key, and the Cochrane Library from September 15 to January 3, 2020. Due to the topic being dynamic and receiving more acknowledgment in recent years, articles reviewed were restricted to the last six years within the United States. Works chosen were peer-reviewed, which included meta-analysis, cross-sectional, systemic reviews, longitudinal and, survey method studies. Sources excluded included opinion-based …


Comparison Of Anterior Cruciate Ligament Graft Materials And Risk Of Rupture/Reinjury In Young Athletes, Matthew Hockert May 2020

Comparison Of Anterior Cruciate Ligament Graft Materials And Risk Of Rupture/Reinjury In Young Athletes, Matthew Hockert

Physician Assistant Scholarly Project Papers

The anterior cruciate ligament tear is a standard surgical injury seen with young athletes competing at elite, amateur, and recreational capacities. The purpose of this literature review is to determine the rehabilitation guidelines and risks associated with anterior cruciate ligament reconstruction, as well as determining the role of rehabilitation in graft rupture. This literature review also serves to determine if graft choice for surgical repair plays a role in an increased risk of rupture or reinjury. This literature review used various online databases, including Dynamed, Cochran, and Pubmed, with the utilization of MeSH terms listed below in “keywords” in order …


Catheter Ablation Of The Accessory Pathway In The Asymptomatic Patient With Wolff-Parkinson-White, Erin Breann Mondry May 2020

Catheter Ablation Of The Accessory Pathway In The Asymptomatic Patient With Wolff-Parkinson-White, Erin Breann Mondry

Physician Assistant Scholarly Project Papers

Wolff-Parkinson-White (WPW) is a condition in which an accessory conduction pathway exists within the heart. This accessory pathway may or may not cause symptoms, in fact, the first manifestation of the condition may be sudden cardiac death. The management of this condition in asymptomatic individuals is controversial. The purpose of this research and literature review is to analyze the safety and efficacy associated with invasive catheter ablation of the accessory pathway, in comparison to risk of sudden cardiac death and malignant arrythmias in non-ablated, asymptomatic individuals with WPW. In this review, five databases were searched including CINAHL, Clinical Key, PubMed, …


Low-Dose Naltrexone For Treatment In Crohn’S Disease And Fibromyalgia, Hannah Rachel Tkach May 2020

Low-Dose Naltrexone For Treatment In Crohn’S Disease And Fibromyalgia, Hannah Rachel Tkach

Physician Assistant Scholarly Project Papers

The United States has experienced a dramatic increase in opioid abuse and overdoses, leading to a national epidemic. Contributing to this epidemic is the use of opioid therapy for complex chronic inflammatory and neuropathic conditions that remain difficult to treat. Many traditional treatments are ineffective or have intolerable side effects, forcing providers to utilize opioid therapy as a last resort. Recently, there is increased interest in the use of partial opioid antagonist naltrexone to treat Crohn’s disease and fibromyalgia. Previous research suggests the potential for naltrexone to provide analgesic effects when administered in low doses via its unique interaction with …


The Gut-Brain Axis: Treating Depression Through Microbiome Alterations, Alexandra Bachman-Williams May 2020

The Gut-Brain Axis: Treating Depression Through Microbiome Alterations, Alexandra Bachman-Williams

Physician Assistant Scholarly Project Papers

The purpose of this research and literature review is to explore the possible role that gut microbiome alterations have in the treatment of neurobehavioral diseases; specifically, anxiety and depression. This literature review searched PubMed, CINAHL, and Clinical Key. A variety of key terms were used during the search. Due to the field of research being relatively new and limited, studies from the last ten years and animal models were included in the study. Studies were excluded due to poor design or if the studies did not include anxiety or depression in the research. The research shows that there are the …


Efficacy Of Antibiotic Therapy In Those Diagnosed With Chronic Lower Back Pain, Alexander Marcel Lee May 2020

Efficacy Of Antibiotic Therapy In Those Diagnosed With Chronic Lower Back Pain, Alexander Marcel Lee

Physician Assistant Scholarly Project Papers

Chronic back pain affects approximately eight percent of the American population, yet no treatment has been agreed upon universally. Recent studies suggest that between 20-30 percent of lower back pain cases are caused by a low-virulence bacterial infection of the intervertebral disks in those who suffered disc herniation. This scholarly project is to investigate: In patients with chronic lower back pain and Modic changes after disc herniation, what is the effect of antibiotic therapy on reducing pain symptoms compared to placebo. This literature review used the following electronic databases: ClinicalKey, Cochrane Library, Embase, and PubMed. Keywords and mesh terms refined …


Use Of Marijuana In Those With Anxiety And Depression, Heather Brooke Flaa May 2020

Use Of Marijuana In Those With Anxiety And Depression, Heather Brooke Flaa

Physician Assistant Scholarly Project Papers

The purpose of this research and literature review is to compare the use of marijuana to Selective Serotonin Reuptake Inhibitors (SSRIs) in reducing anxiety and depression symptoms. The safety of marijuana in those with psychiatric disorders such as, general anxiety disorder and major depressive disorder, was also analyzed. The literature review searched databases Cochrane, PubMed, Clinical Key, PsycINFO, and DynaMed Plus. A variety of key terms were used when searching. Studies excluded were due to narrowed sub topics on anxiety disorders or poor design. Due to limited research, the study time frame was extended to studies completed in the last …


The Effects Of Initiating Metformin, To Prevent Or Delay Type 2 Diabetes, In Patients With Prediabetes, Kelsey Abraham May 2020

The Effects Of Initiating Metformin, To Prevent Or Delay Type 2 Diabetes, In Patients With Prediabetes, Kelsey Abraham

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to explore metformin’s role in the treatment of patients with prediabetes within the primary care setting. The efficacy of metformin versus lifestyle modifications will be compared as well as metformin, as adjunctive therapy, to lifestyle modifications. Along with efficacy, a systematic analysis will examine the three abovementioned therapies regarding diabetes risk reduction. Lastly, this review will examine the safety and tolerability of metformin, specifically in patients with prediabetes. The data presented shows evidence that lifestyle modifications are first-line treatment for prediabetes while metformin use should be reserved for those who fail lifestyle modifications …


Surgical Innovations For Gerd: Comparing Outcomes Of Magnetic Sphincter Augmentation And Nissen Fundoplication, Steffani Nicole Johnston Mack May 2020

Surgical Innovations For Gerd: Comparing Outcomes Of Magnetic Sphincter Augmentation And Nissen Fundoplication, Steffani Nicole Johnston Mack

Physician Assistant Scholarly Project Papers

Gastroesophageal reflux disease (GERD) is a common chronic upper gastrointestinal disease with both objective and subjective components. It is defined as a reflux of gastric contents into the esophagus, which causes symptoms such as heartburn, regurgitation, and dysphagia. Severity of the disease is dependent on both severity of the symptoms and severity of the mucosal damage done by the reflux. While many cases of GERD can be managed with oral medication, persistent and refractory cases require surgical intervention. The purpose of this literature review is to compare the efficacy of GERD’s gold standard surgical technique, the Nissen fundoplication, with a …


The Effect Of Proton Pump Inhibitors On Normal Gastrointestinal Flora Leading To Weight Change, Emi L. Binstock May 2020

The Effect Of Proton Pump Inhibitors On Normal Gastrointestinal Flora Leading To Weight Change, Emi L. Binstock

Physician Assistant Scholarly Project Papers

The goal of this literature review was to determine what effects proton pump inhibitors (PPIs) have on the normal gastrointestinal (GI) flora and how that may lead to weight loss or weight gain. A literature search was performed using the database PubMed. Only articles from the last ten years (2009-2019) were included in this review. Keywords used in the search are listed below. After exclusion criteria was applied, 30 articles were relevant and used in this review. Five themes were identified in the literature review. An investigation of normal GI flora associated with weight loss and weight gain identified a …


Comparing Romosozumab And Alendronate In The Treatment Of Osteoporosis In Postmenopausal Women, Taylor Johnshoy May 2020

Comparing Romosozumab And Alendronate In The Treatment Of Osteoporosis In Postmenopausal Women, Taylor Johnshoy

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to determine if there is a statistical difference in the safety and efficacy between romosozumab, the prototypical drug in the new drug class sclerostin inhibitors, versus alendronate, the prototypical bisphosphonate, in the treatment of postmenopausal osteoporosis. A comprehensive literature review was performed searching three databases, including PubMed, EMBASE, and Access Medicine from the last five years. Works chosen for review were limited to articles published in English, full-text articles, clinical trials, randomized control trials, systematic reviews, and meta-analyses. Items were excluded after reviewing abstracts due to material not directly comparing the treatment modalities. …


The Safety And Efficacy Of Antidepressant Use In The Adolescent Population, Jason Marcello May 2020

The Safety And Efficacy Of Antidepressant Use In The Adolescent Population, Jason Marcello

Physician Assistant Scholarly Project Papers

This literature review was conducted to determine the safety and efficacy of antidepressants in the adolescent population based on the currently available research. Specifically, are antidepressants safe and efficacious in treating depression in adolescents and is their use associated with increased risk of suicide. Data was collected by searching medical databases including: Clinical Key, CINAHL Complete, PsycINFO, PubMed, DynaMed Plus, and Cochrane Review. The review of the literature included systematic reviews, meta-analysis, cross-sectional, longitudinal, randomized control trials, and survey methods. All literature works selected were published within the past 14 years. A focused search was performed to gather information on …


Review Of Anticoagulation Therapy In Unprovoked Pulmonary Embolism To Prevent Recurrence, Christopher Klucas May 2020

Review Of Anticoagulation Therapy In Unprovoked Pulmonary Embolism To Prevent Recurrence, Christopher Klucas

Physician Assistant Scholarly Project Papers

The purpose of this research was to identify the best course of action in response to a diagnosis of unprovoked pulmonary embolism. This meta-review was compiled through a systematic query of four databases: Pubmed, Embase, CINAHL Complete, and Cochrane Review. The search was limited to peer-reviewed systematic reviews published between October 1, 2014, and October 1, 2019. 17 reviews were included in this research which evaluated relevant trials of FDA-approved anticoagulation therapies. Key search terms that were used included anticoagulation, unprovoked, and duration. MeSH terms applied on PubMed included anticoagulation, therapy, and duration. The evidence demonstrates non-inferiority status of new …


Comparison In The Effectiveness Of Mat In Patients With Oxycodone Vs Heroin Opioid Use Disorders, Casey Myklebust May 2020

Comparison In The Effectiveness Of Mat In Patients With Oxycodone Vs Heroin Opioid Use Disorders, Casey Myklebust

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine if there is a measurable difference of effectiveness in medication assisted treatment (MAT) in patients with oxycodone and heroin use disorders, retention in treatment, and sustained sobriety. In this review, the databases searched included CINAHL, Clinical Key, and Embase. A variety of key terms and MeSH terms were used to define a set of literature discussing the topic. The works chosen for review were published between 2015 and 2019 were peer reviewed, and included randomized control trials, pilot studies, and systematic reviews. Sources that were excluded, included those …


Cannabis Effectiveness On The Motor Symptoms Of Parkinson’S Disease, Austin Fridrich May 2020

Cannabis Effectiveness On The Motor Symptoms Of Parkinson’S Disease, Austin Fridrich

Physician Assistant Scholarly Project Papers

Fueled by news media reports, cannabis use has been ever growing in popularity for the treatment of both motor and non-motor symptoms of Parkinson’s disease (PD). The purpose of this literature review is to evaluate the safety and efficacy of using cannabis to treat the motor symptoms and levodopa-induced dyskinesia of PD. In this literature review electronic databases were searched and included PubMed, CINAHL, Embase, DynaMed Plus, Cochrane Library, Academic Search Premier, and Clinical Key. A variety of keywords and MeSH terms, as listed below, were used to define a set of literature. There were 16 studies chosen for review …


The Safety, Accuracy, And Cost-Effectiveness Of Confirmatory Penicillin Allergy Testing In The Outpatient Setting As A Means Of Reducing Patient Morbidity And Mortality, Mitchell Mimbach May 2020

The Safety, Accuracy, And Cost-Effectiveness Of Confirmatory Penicillin Allergy Testing In The Outpatient Setting As A Means Of Reducing Patient Morbidity And Mortality, Mitchell Mimbach

Physician Assistant Scholarly Project Papers

The purpose of this review is to investigate the prevalence of documented penicillin (PCN) allergies in health care and any negative outcomes associated with being labeled as such. Additional topics researched included the safety and accuracy of PCN allergy testing, the cost-effectiveness of PCN allergy testing versus using non-PCN related antibiotics, and barriers to confirmatory PCN allergy testing implementation. A complete review of the aforementioned topics included meta-analysis’, systematic reviews, cohorts, clinical trials, and cross-sectional studies from the last five years. Databases utilized for this research included PubMed, Cochrane Review, Embase, Dynamed Plus, and ClinicalKey. Sources that were excluded from …


Evaluation Of Hyperbaric Oxygen Therapy In The Treatment Of Traumatic Brain Injuries, Jordan Wiedmann May 2020

Evaluation Of Hyperbaric Oxygen Therapy In The Treatment Of Traumatic Brain Injuries, Jordan Wiedmann

Physician Assistant Scholarly Project Papers

Traumatic brain injuries (TBIs) affect approximately 2.5 million people each year (Brain, 2014). The most current treatment options for TBIs include extensive long-term rehabilitation and therapy services, in which many only gain little improvement of their overall health (Traumatic, 2019). New trends in treating TBIs with hyperbaric oxygen therapy (HBOT) are emerging due to increased accessibility to hyperbaric oxygen chambers. The purpose of this research and systematic literature review is to evaluate the safety and efficacy of using HBOT to improve the treatment outcomes of TBIs. This review included the search of four databases including PubMed, Cochrane Review, Clinical Key, …


Methamphetamine: A Potential Risk Factor For Neurodegenerative Conditions, Katelyn Sarlette May 2020

Methamphetamine: A Potential Risk Factor For Neurodegenerative Conditions, Katelyn Sarlette

Physician Assistant Scholarly Project Papers

Methamphetamine (METH) is a highly addictive substance that persists to be a major drug of abuse within the United States, particularly the Midwest regions. While some of the major health ramifications are well documented, its neurological impact is not fully understood. Neurodegenerative conditions like multiple sclerosis (MS), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS) continue to increase in frequency, particularly in the Midwest, yet there is no identifiable cause. The purpose of the study was to determine if METH use can contribute to the development of neurological conditions such as MS, PD, and ALS. A literature review was conducted …


Analysis Of Tech-Based And Telemental Health Approaches Within The Adolescent And Young Adult Populations Of Rural America, Audrey Smeenk May 2020

Analysis Of Tech-Based And Telemental Health Approaches Within The Adolescent And Young Adult Populations Of Rural America, Audrey Smeenk

Physician Assistant Scholarly Project Papers

Background: The incidences of depression and anxiety among adolescent and young adult populations are intensifying, and resources remain limited for the management of these diseases within rural America. Objective: The purpose of this literature review is to evaluate evidence-based practices regarding telemedicine and tech-based mental health interventions. Evaluation of different interventions will demonstrate the ability of access, efficacy, and patient adherence with the hope of decreasing the incidence of disease and increase the availability of resources to rural areas. Methods: A comprehensive literature review was completed by assessing journal articles and scientific databases from the last fifteen years using a …


Resting Heart Rate And Its Effect On Cardiovascular Disease, Peter Tronset May 2020

Resting Heart Rate And Its Effect On Cardiovascular Disease, Peter Tronset

Physician Assistant Scholarly Project Papers

The purpose of the presented research and systematic review is to determine the associated impact resting heart rate has on development of cardiovascular disease. A literature review was conducted through electronic databases: PubMed, Clinical Key and Dynamed Plus. No limitation of timeframe was used when researching as few studies are available correlating resting heart rate and its associated development of cardiovascular disease. Research points to limitations of lowering resting heart rate due to adverse effects on blood pressure. Additionally, tachycardia is addressed through several methods including lifestyle modification and pharmacologic therapy. Comorbidities such as obesity, low body mass index (BMI), …


Efficacy Of Bariatric Surgery Compared To Non-Surgical Treatments For Morbid Obesity, Erica L. Donovan May 2020

Efficacy Of Bariatric Surgery Compared To Non-Surgical Treatments For Morbid Obesity, Erica L. Donovan

Physician Assistant Scholarly Project Papers

The purpose of this research is to show the efficacy of Roux-en-Y gastric bypass and sleeve gastrectomy as compared to traditional diet and exercise models. Morbid obesity is related to increased blood pressure, incidence of diabetes, high cholesterol, and incidence of obstructive sleep apnea, all of which contribute to increased incidence of myocardial infarction, stroke, and vascular compromise. Finding ways to combat morbid obesity has resulted in invasive surgical techniques because traditional diets and exercise work infrequently and often fail. Systematic reviews, meta-analysis, randomized controlled trials, and retrospective studies were found using the database of CINAHL, SportsDiscus, PsycInfo, Embase, and …


Treatment Of Clostridioides Difficile With Fecal Microbiota Transplantation, Brenton Green May 2020

Treatment Of Clostridioides Difficile With Fecal Microbiota Transplantation, Brenton Green

Physician Assistant Scholarly Project Papers

Research was performed to discuss the epidemiology and current guidelines of Clostridioides difficile infection (CDI), recurrent C. difficile infection (rCDI), the different modalities of fecal microbiota transplantation (FMT), the donor screening process, as well as the safety and efficacy of treatment. Utilizing Clinical Key, NCBI database, Dynamed Plus, Cochrane Review, and the websites for the CDC and FDA, a literature review was produced, encompassing recent research and human studies related to CDI. Recent studies were preferred, however since C. difficile has sparsely changed, older data was utilized with updates applied accordingly. Articles excluded were due to not meeting the themes …


Comparison Of Buprenorphine-Naloxone And Buprenorphine Monotherapy In Opioid Dependent Pregnant Women, Ellie Gillund May 2020

Comparison Of Buprenorphine-Naloxone And Buprenorphine Monotherapy In Opioid Dependent Pregnant Women, Ellie Gillund

Physician Assistant Scholarly Project Papers

Opioid use disorder during pregnancy has continued to rise, and more primary care providers are being encouraged to prescribe opioid agonist pharmacotherapy. Such medications include methadone, buprenorphine, and naloxone. Many studies have been done to compare these medications’ role in medication assisted treatment (MAT) in pregnant women with opioid use disorder. The purpose of this literature review is to compare the use e of buprenorphine, with and without naloxone, as MAT for opioid dependent pregnant women. Specific outcomes compared in this study include maternal and neonatal safety, neonatal abstinence syndrome, and peripartum pain management. This review included three electronic search …


Cyp2d6 Enzyme Polymorphisms And Their Effect On Opiate Metabolism, Blair Camille Runde May 2020

Cyp2d6 Enzyme Polymorphisms And Their Effect On Opiate Metabolism, Blair Camille Runde

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine if pharmacogenetic testing for the CYP2D6 enzyme responsible for the metabolism of several opiates leads to differences in serum levels, side effects, and treatment outcomes for patients with acute or chronic pain. In this review, the Pubmed and Embase databases were searched from January 1, 2014, to November 1, 2019. Exclusion criteria included studies published before 2014 and those not peerreviewed. For this review, 11 studies were included with designs such as prospective and retrospective cohorts, randomized control trials, systematic reviews, and meta-analyses. Much of the presented research …


An Analysis Of The Incidence And Severity Of Drug-Drug Interactions Between Prescribed Pharmaceuticals And Cannabinoids, Jennifer Lee Mcrae May 2020

An Analysis Of The Incidence And Severity Of Drug-Drug Interactions Between Prescribed Pharmaceuticals And Cannabinoids, Jennifer Lee Mcrae

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to identify the incidence and severity of drug-drug interactions between commonly prescribed medications and cannabinoids. In this review, four databases were searched including PubMed, CINAHL, and Embase from October 1 to January 5, 2019. A variety of key terms were used when searching. Works chosen for review were published after the year 2014, were peer reviewed, and included randomized control trials (RCTs), systematic literature reviews, and meta-analyses. For this review, 9 resources were selected. Much of the research presented shows evidence that medications that are substrates for CYP2C19, CYP2C9 and …


Early Intervention: Addressing Opioid Use Disorder With Emergency Department Initiated Buprenorphine Therapy, Dustin Peter Voss May 2020

Early Intervention: Addressing Opioid Use Disorder With Emergency Department Initiated Buprenorphine Therapy, Dustin Peter Voss

Physician Assistant Scholarly Project Papers

The subsequent review evaluates opioid use disorder (OUD) as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, including the use of buprenorphine in the process of induction, its efficacy for the management of OUD, and barriers to its initiation. The outcomes of the initiation of office-based buprenorphine treatment are compared to emergency department-initiated buprenorphine treatment for the management of OUD. This project is a review of current meta-analysis, systematic reviews, cross-sectional, longitudinal, and survey methodologies were analyzed. The medical research databases PubMed, Embase, Cochrane Review, CINAHL Complete, and PsychINFO, have been utilized in obtaining peer-reviewed …


Hpv Vaccine In Adolescents: How To Increase Uptake, Natasha Richesin May 2020

Hpv Vaccine In Adolescents: How To Increase Uptake, Natasha Richesin

Physician Assistant Scholarly Project Papers

The human papillomavirus (HPV) is a sexually transmitted virus that affects both males and females of all ages. An HPV vaccine was developed to help protect against harmful infections caused by the virus. This literature review focuses on the relationship between the HPV vaccine and its low uptake from untoward events, misinformation surrounding the vaccine, and different education methods. PubMed, Clinical Key, and Cochrane electronic databases are used for the literature review. A comprehensive literature review was conducted, and articles utilized were based on the age of the population being 11 to 29 years old, the HPV vaccine’s involvement in …