Medicine and Health Sciences Commons^™

Differential Diagnostic Considerations In A Patient With New Onset Apathy: A Case Study On Frontal Lobe Glioblastoma Multiforme, Joy Zarandy, Sarah Yoon, Sharnikha Saravanan, Sanjana Das, Sarah Thomas

The Journal of Integrated Primary Care

This case study involves a 50 year-old previously healthy female presenting with a two-week history of clinically significant apathy. The patient and her family assume her symptoms are due to a potential underlying psychiatric condition; however, neurologic and systemic disorders should also be considered when evaluating a patient with sudden personality change. After a thorough history and physical exam, further evaluation with neuroimaging is performed due to suspicion of neurological etiology. A sizable ring-enhancing lesion in the frontal lobe is noted on MRI, and a diagnosis of glioblastoma multiforme (GBM) is confirmed with biopsy. GBM, or grade 4 astrocytoma, is …

How Effective Is Acupuncture In Treating Cancer-Related Fatigue In Adult Cancer Patients?, Anita Elizabeth Kurian

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is an effective course of treatment for improving cancer-related fatigue in adult cancer patients.

DESIGN: Review of three English language primary randomized controlled studies published from 2006-2012.

DATA SOURCES: Three randomized controlled trials studying the effects of acupuncture therapy on cancer-related fatigue were found using PubMed and Cochrane databases.

OUTCOMES MEASURED: Each of the three trials assessed the efficacy and clinical improvement of cancer-related fatigue after acupuncture therapy. Results were measured on the Functional Assessment of Chronic-Illness Therapy-Fatigue Subscale (FACIT-F) or the Multidimensional Fatigue Inventory …

Does Physical Activity, When Combined With Androgen Deprivation Therapy, Yield A Better Quality Of Life In Prostate Cancer Survivors?, Nicholas J. Ridolfi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not physical activity, when combined with androgen deprivation therapy, yields a better quality of life in survivors of prostate cancer.

STUDY DESIGN: Three randomized, controlled trials (RCTs) were found using the PubMed and Cochrane databases. The studies compared regular physical activity in men undergoing androgen deprivation therapy for prostate cancer.

OUTCOMES MEASURED: The outcomes measured were self-reported quality of life surveys at different time intervals.

RESULTS: Two out of the three studies demonstrated statistically significant improvement in reported quality of life during the exercise programs. The third …

The Influence Of Matrix Stiffness On Extracellular Matrix Protein Expression In 3d Encapsulated Mammary Fibroblasts, Kathryn Woods

PCOM Biomedical Studies Student Scholarship

A disease that transcends all races is breast cancer, the second leading cause of death among women with cancer. One factor, which participates in breast tumor progression, is the extracellular matrix (ECM), an acellular, protein-rich entity, which drives several cell, processes shown to promote tumorigenesis. Specifically, abnormal expression patterns and cross-linking of matrix fibers induces a more dense tissue structure, which has been reported to drive breast cancer progression. Alterations in ECM expression and cross-linking are in part due to carcinoma-associated fibroblasts (CAFs), activated fibroblasts which deposit copious ECM in the breast tumor environment. The goal of this study is …

Is Collagenase Clostridium Histolyticum A Safe And Effective Treatment For Adult Patients With Dupuytren’S Contracture?, Heather N. Bailey

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not collagenase clostridium histolyticum is a safe and effective treatment for adult patients with Dupuytren’s contracture.

STUDY DESIGN: Review of two double-blind, placebo-controlled randomized controlled trials and one cross-sectional study. All of these studies are published in English between 2009-2013.

DATA SOURCES: Two double-blind, placebo-controlled randomized controlled trials and one cross-sectional study found using PubMed.

OUTCOMES MEASURED: Each randomized controlled trial measured the ability to meet the primary end point and all secondary endpoints, percent decrease in degree of contracture, increase in range of motion, patient satisfaction, …

Will The Addition Of Oxaliplatin To 5-Fluorouracil (5fu), And Leucovorin Improve Disease Free Survival Of Patients With Stage Iii Colon Cancer Who Had Surgical Resection Of The Tumor?, Sarah Cotter

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not the addition of oxaliplatin to 5FU and leucovorin will improve disease free survival of patients with stage III colon cancer who had surgical resection of the tumor.

Study Design: Review of three published, double blind randomized control trials in the English language in 2004, 2007, and 2009.

Outcomes Measured: The outcome is disease free survival of colon cancer. It is measured using periodic patient follow-up. History and PE, neuro assessment, liver and kidney function tests, CEA test, CBC, and imaging studies such as colonoscopy or barium …

Is Tamoxifen Prophylaxis Effective In Reducing The Incidence Of Breast Cancer In Women Who Are At High Risk?, Maria Deveau

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not Tamoxifen prophylaxis is effective in reducing the incidence of breast cancer in woman who are at high risk.

STUDY DESIGN: Review of three English language primary studies published from 2005 to 2007.

DATA SOURCE: Three double-blind randomized control trials found using the PubMed and Cochrane database.

OUTCOME MEASURED: The primary outcome by all three studies included incidence of breast cancer.

RESULTS: Three double- blind randomized controlled trials were included in this review. Study by Powles et al showed statistically significant reduction in the incidents of breast cancer …

Do Braf Inhibitors Improve Survival In Patients With Braf V600e Mutant Melanoma?, Sarah E. Stamm

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Do BRAF inhibitors improve survival in patients with BRAF V600E mutant melanoma?”

STUDY DESIGN: Review of primary literature sources that examined survival rates in BRAF V600E mutant melanoma patients receiving treatment with a BRAF inhibitor.

DATA SOURCES: Two randomized controlled trials and one cohort study evaluating the use of BRAF inhibitors in patients with BRAF V600E mutant melanoma were found using OVID, Medline, and PubMed.

OUTCOMES MEASURED: Overall survival and progression free survival were the outcomes measured to determine survival rates in patients with BRAF V600E …

Is Temozolomide In Combination With Interferon Alpha-2b A Safe And Effective Treatment For Malignant Melanoma?, Kathleen Vincento

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not temozolomide in combination with interferon alpha-2b a safe and effective treatment for malignant melanoma.

Study Design: Review of three randomized controlled trials published in the United States and Britain between 2003 and 2005.

Data Sources: Three non-blind randomized controlled trials were found via Cochrane library and PubMed.

Outcomes Measured: Efficacy was measured by survival greater than or equal to 12 months, with one (experimental) group receiving treatment with oral temozolomide (TMZ) and subcutaneous interferon alpha-2b (IFN-∝2b) and the other (control) group receiving oral TMZ alone. Safety …

Is Pomalidomide Plus Low Dose Dexamethasone An Effective And Safe Treatment For Patients With Relapsed Or Refractory Multiple Myeloma?, Matthew Westervelt

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not pomalidomide plus low dose Dexamethasone is an effective and safe treatment for patients with relapsed or refractory multiple myeloma (RRMM).

Study Design: Review of three open-label clinical trials with one published in 2012 and two published in 2013.

Data Sources: Two randomized, open-label, phase 2 clinical trials and one open-label phase 3 clinical trial evaluating efficacy of pomalidomide plus low dose dexamethasone and its safety were found using the PubMed database.

Outcomes Measured: Efficacy of pomalidomide plus low-dose dexamethasone was measured by overall response rates (ORR) …

Chemopreventive Effects Of Pterostilbene In Metastatic Prostate Cancer Cells, Phillip A. Zook

PCOM Biomedical Studies Student Scholarship

Recent studies find that pterostilbene (PTS) exhibits more favorable drug properties and similar chemopreventive effects to its structural analogue resveratrol (RSV). However, few studies describe the activity of PTS in prostate cancer (PCa). Here, we conducted cell count experiments to assess the effects of PTS on metastatic PCa cell viability and to compare the potency of PTS to RSV in this respect. We also performed experiments to assess the effects of PTS on the androgen receptor (AR) and AR-mediated events. We used qPCR to measure the mRNA levels of the androgenresponsive gene (ARG), prostate-specific antigen (PSA), and Western blots to …

Effect Of Heme Oxygenase-1 On Matrix Metalloproteinase-3 Expression In Human Fibroblasts, Theresa A. Stangl

PCOM Biomedical Studies Student Scholarship

Heme oxygenase-1(HO-1) is an enzyme that plays a very important role in the resolution of inflammation. HO-1-based therapies are effective in a number of disease conditions. However, HO-1 also increases tumor growth, angiogenesis, metastasis and chemoresistance. Matrix metalloproteinase-3 (MMP-3) is an enzyme involved in physiological and pathophysiological tissue remodeling. Unbalanced expression of MMPs is a key feature of connective tissue destruction in chronic inflammatory conditions. Previously shown in this laboratory, the HO-1 inducer, hemin, increased MMP-3 mRNA expression in some HGF cultures. To assess whether HO-1 and/or its products regulate expression of MMP-3 in human fibroblasts, the effect of HO-1 …

Is Massage Therapy An Effective Treatment For Improving Sleep Quality In Women Age 50-80 Diagnosed With Cancer?, Alexander M. Chase

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not massage therapy is an effective treatment in improving sleep quality among women age 50-80 diagnosed with cancer.

STUDY DESIGN: Review of two English language randomized control trials published in 2004 and 2011 and one English language quasiexperimental pretest-posttest comparison study publishEd in 2002.

DATA SOURCES: Data sources were articles published in peer reviewed journals found using PubMed and EBSCOhost.

OUTCOMES MEASURED: Sleep quality was measured using the Verran and Snyder-Halpem Sleep Scale and the Richards-Campbell Sleep Questionnaire.

RESULTS: Soden et al …

Is Bevacizumab (Avastin) Safe And Effective As Adjuvant Chemotherapy For Adult Patients With Stage Iiib Or Iv Non-Small Cell Lung Carcinoma (Nsclc)?, Ashley R. De Kleine

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not bevacizumab (avastin) is safe and effective as adjuvant chemotherapy for adult patients with stage IIIb or IV non-small cell lung carcinoma (NSCLC).

STUDY DESIGN: Review of three randomized controlled trials (RCT) published in 2006, 2009, and 2011, all English language.

DATA SOURCES: Two randomized, double-blind, controlled clinical trials comparing bevacizumab to placebo as adjunctive chemotherapy, and one RCT comparing bevacizumab as adjunctive chemotherapy versus the use of no adjunctive chemotherapy. All articles were found using PubMed, Medline, and OVID.

OUTCOMES MEASURED: Overall …

Is Music Therapy Effective In Improving Emotional Health In Pediatric Cancer Patients?, Elizabeth F. Matesa

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidence based medicine review is to determine whether music therapy is effective in improving emotional health in pediatric cancer patients

STUDY DESIGN: Two randomized controlled trials and a prospective cohort study were reviewed and selected based on their relevance to the clinical question and their inclusion of patient oriented outcomes (POEMS).

DATA SOURCES: Each study was obtained by searching PubMed database.

OUTCOMES MEASURED: The outcomes measured included pain scores measured using a NRS pain scoring scale, anxiety scores were measured using the Spielberger State-Trait Anxiety Inventory (STAI)and visual analog score …

Does Yoga Aid In The Reduction Of Short-Term Anxiety In Adult Female Breast Cancer Patients?, Lora K. Brown

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not yoga aids in the reduction of short-term anxiety in adult female breast cancer patients.

STUDY DESIGN: Review of three English language primary studies, published between 2007 and 2010.

DATA SOURCES: Two randomized controlled trials (RCTs) and one before and after comparison study were found using PubMed, Medline, and OVID. These studies analyzed yoga intervention in adult female breast cancer patients suffering from anxiolytic effects.

OUTCOMES MEASURED: The main outcomes measured were anxiety state level and symptom severity and distress experienced by patients through use of the …