Medicine and Health Sciences Commons^™

Prophylactic Intravenous Prehydration With Sodium Bicarbonate Or Sodium Chloride In The Prevention Of Contrast Induced Acute Kidney Injury, Briana Lockett, Caroline Dong

Physician Assistant Capstones, 2020-current

Introduction: Iodinated contrast media is a crucial component in the diagnostic work up of many life-threatening illnesses. However, it has been reported to cause acute kidney injury after administration, especially in patients with pre-existing renal disease. Several prophylactic treatments have been studied in hopes of minimizing these adverse events. The current standard of care in this patient population is prophylactic intravenous volume administration with either sodium chloride or sodium bicarbonate. Objective: The goal of this literature review is to determine if prophylactic intravenous volume administration with either saline or sodium bicarbonate prior to contrast administration decreases the incidence of contrast …

The Use Of Autologous Prp Gel For The Treatment Of Diabetic Foot Ulcers, Erin Klein, Dominic E. Paoletti

Physician Assistant Capstones, 2020-current

The purpose of this systematic literature review is to examine the efficacy of platelet rich-plasma (PRP) gel as a therapy for diabetic foot ulcers (DFUs). Infections in patients with diabetes, especially diabetic foot ulcers, are challenging to treat due to neurovascular compromise. Searches were done in PubMed utilizing the terms “diabetic foot ulcer”, “platelet rich plasma” and “autologous”. In PubMed, the following limits and terms were used: randomized control trial (RCTs), sample size greater than 30 participants, foot ulcers, and English. A meta-analysis revealed three studies meeting inclusion/exclusion criteria: Li et al, Gude et al, and Ahmed et al. The …

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 …

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% …

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 …

Honey Vs. Silver Sulfadiazine In The Reepithelialization Of Partial-Thickness Burn Wounds, Andi Diamond, Monica Bowler

Physician Assistant Capstones, 2020-current

Objective: To determine whether silver sulfadiazine (SSD) should remain the gold standard of initial burn wound treatment or if it should be replaced with an alternative treatment that allows for faster skin cell regrowth. Methods: Database search of PubMed and Google Scholar were used to evaluate patient clinical trials with the search terms “burn”, “honey”, and “silver”. Results: Three trials met inclusion criteria. All three of the studies found significant improvement in their primary endpoint with the use of honey. The first study showed the honey group to have healing time of 13.47 ± 4.06 days and …

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 …

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,” …

Novel Reversal Agents For Non-Vitamin K Oral Anticoagulants, Kimberly Hoilman, Melanie Reyer

Physician Assistant Capstones, 2016 to 2019

Background Non-vitamin K oral anticoagulants have become an appealing alternative treatment for the prevention of stroke in non-valvular atrial fibrillation and in treatment of venous thromboembolism. The major limitation to the use of these drugs is the lack of reversal agents. The purpose of this review is to investigate the development and efficacy of novel agents for reversal of NOACs. Methods Two separate literature searches were conducted in the PubMed database using the terms “prothrombin complex concentrate” and “idarucizumab”, respectively. Only in vivo clinical trials involving human subjects within the last five years were included for possible analysis. Studies with …