Medicine and Health Sciences Commons^™

Clinical Research Challenges: Insight From A Pilot Study At An Academic Healthcare Center, Gretchen E. Maurer

PCOM Biomedical Studies Student Scholarship

An investigational clinical research study was conducted at an academic healthcare center evaluating memantine as an adjunct to opioid therapy for treatment of chronic low back pain. The N-Methyl-D-Aspartate (NMDA) receptor is located in pain signaling neuronal synapses of the central nervous system. The receptor binds the excitatory neurotransmitter glutamate in addition to NMDA, to increase the magnitude of the perception of pain. Memantine (Namenda©) is a highly tolerated NMDA receptor antagonist which is currently prescribed in the treatment of Alzheimer’s disease. The purpose of the non-randomized pilot study without placebo was to evaluate the use of adding memantine as …

Comparison Of Electrogustometrically Determined Taste Threshold And Phenylthiocarbamide Sensitivity Between Non-Diabetic Subjects With First Degree Relatives With Type 2 Diabetes And Non-Diabetic Subjects Without Type 2 Diabetic First Degree Relatives, Matthew E. Joseph Do

PCOM Biomedical Studies Student Scholarship

Diabetes is a systemic degenerative disease, having adverse effects on many different organ systems. Nerve conduction specifically related to taste is one of the affected functions and can lead to altered taste perceptions and taste thresholds. Electrogustometry was used in this study to evaluate taste thresholds, and taste sensitivity was tested using phenylthiocarbamide-impregnated testing strips. Healthy non-diabetic subjects were divided into two experimental groups: One with a first degree relative with Type 2 diabetes and the other matched controls having no family history of Type 2 diabetes. The hypotheses: 1). There is a significant difference in taste threshold values and …

Resveratrol Induced Apoptosis In A Human Adenosquamous Carcinoma Cell Line (Cal-27 Cells), Saquib A. Siddiqi

PCOM Biomedical Studies Student Scholarship

Radiotherapy and surgery are the two principal modalities in the treatment of head and neck cancers, and both therapies can result in severe adverse effects and ultimately lower the quality of life. It is of paramount importance to develop reagents that target the cancer cell specifically without affecting the normal non-cancer cells. Using the tongue cancer cell line Cal 27 as a model system, we dissected the molecular mechanism of the resveratrol-induced cancer cell apoptosis. After demonstrating that resveratrol induces the cancer cell apoptosis in a dose- and time-dependent manner, a systemic apoptosis protein array was conducted to identify the …

Nutri One-On-One: The Assessment And Evaluation Of A Single One-On-One Nutritional Coaching In Patients Affected By Metabolic Syndrome, Jennifer L. King

PCOM Biomedical Studies Student Scholarship

The Nutri One-on-One Program's aim was to positively modify participants' nutritional habits and lifestyles through a brief one-on-one health coaching session, which was conducted within a primary healthcare setting at the Philadelphia College of Osteopathic Medicine's Clinics. It is documented that 70% of deaths in the U.S. result from complications secondary to chronic diseases of metabolic syndrome. The participants were selected by physicians and classified as suffering from one or more of the five indicators of metabolic syndrome: abdominal obesity, elevated serum triglycerides, low HDL-cholesterol, elevated blood pressure, and insulin resistance. Evidence shows that health coaching positively assists individuals in …

The Effect Of Nerve Growth Factor (Ngf) Incorporation Into Swine Intestinal Submucosa (Sis) Suture Material On The Healing Process In Gastrocnemius Muscle, Nicole K. Alexander

PCOM Biomedical Studies Student Scholarship

The repair of gastrocnemius muscle incisions were evaluated histologically in a rat model. Comparisons were made between carbon dioxide laser and scalpel incisions closed with sutures prepared from Swine Intestinal Submucosa (SIS) with and without added Nerve Growth Factor. This study was conducted in conjunction with two other studies, one comparing epidermal repair and the other comparing kinesthetic changes post-operatively in the same animal model. Thirty-five days post-surgery the animals were euthanized and an area of muscular tissue encompassing the operative site was excised and evaluated microscopically for the following: presence of macrophages, integrity of the muscle, leukocytes present within …

Regulation Of Alpha Synuclein Following Chronic Methamphetamine Administration In Guinea Pigs: Correlation With Memory And Synaptic Plasticity, Adnouse Blanc

PCOM Biomedical Studies Student Scholarship

Methamphetamine (METH) is a highly addictive drug of abuse that has a severe impact on neuronal changes in the brain including modulations of plasticity, cognitive dysfunction, as well as memory impairment. These changes can be seen as modifications in the expression of biochemical markers associated with synaptic plasticity. One such marker associated with memory impairment is alpha synuclein (α-syn). Alteration of α-syn expression has been linked to memory impairment in patients with Alzheimer’s disease (AD) and Parkinson’s disease (PD). Here we assess the effect of chronic METH treatment in correlation to cognitive functions.

Twenty-nine guinea pigs (male, 150-250 g) were …

Molecular Mechanisms Related To Endotoxemia In Primary Human Cardiomyocytes In Culture, Atijah J. Collins

PCOM Biomedical Studies Student Scholarship

Cardiovascular disease (CVD) is the leading cause of death in the United States and has been for the past 80 years. Development of novel therapeutic agents to address the large number of CVD deaths requires an in depth understanding of the structural and functional properties of human cardiomyocytes. Over the last few years we have been developing an in vitro paradigm to assess molecular cardiodynamics in Primary Human Cardiomyocyte in culture (PHCC). We tested the hypothesis whether endotoxemia would exhibit a marked decrease in contractile proteins and cause apoptosis in PHCC. In the current series of experiments, we induced endotoxemia …

Cardioprotective Effects Of Mitochondrial-Targeted Antioxidants In Myocardial Ischemia/Reperfusion (I/R) Injury, Regina Ondrasik

PCOM Biomedical Studies Student Scholarship

Reactive oxygen species (ROS) generated during myocardial I/R contribute to post-reperfused cardiac contractile dysfunction. Damaged cardiomyocyte mitochondria are major sites of excess ROS generation during reperfusion. We hypothesized that reducing mitochondrial ROS formation should attenuate myocardial I/R injury and thereby improve function of isolated perfused rat hearts subjected to I(30min)/R(45min) compared to untreated I/R hearts. Mitoquinone (MitoQ, MW=579g/mol; complexed with cyclodextrin (MW=1135g/mol) to improve water solubility, total MW=1714g/mol), a coenzyme Q derivative, and SS-31 (Szeto-Schiller) peptide ((D-Arg)-Dmt-Lys-Phe-Amide, MW=639g/mol, Genemed Synthesis, Inc., San Antonio, TX), an alternating cationic-aromatic peptide, are selective mitochondrial ROS inhibitors which significantly improved post-reperfused cardiac function compared …

Teachers' Awareness And Skills In Addressing Students With Anxiety Symptoms, Looyee Figueroa

PCOM Psychology Dissertations

This study explored teachers' awareness toward students who may have mental-health needs, specifically with anxiety issues. This study also examined whether the teachers' training backgrounds, acquired degrees, stress levels, and years of teaching influenced their awareness and use of strategies in addressing students with attitudinal and behavioral issues and anxiety issues. In addition, this study examined teachers' perceptions on the importance of building relationships with students who have behavioral and attitudinal issues and anxiety issues. Results from the study found that teachers' awareness levels were inconsistent when teaching students who may have anxiety issues, and they were more consistent in …

Is Local Infiltration Analgesia (Lia) A Safe And Effective Method For Post-Operative Pain Management After A Unilateral Total Knee Arthroplasty (Tka)?, Brooke A. Bonnette

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not local infiltration analgesia (LIA) is a safe and effective method for post-operative pain management after a unilateral total knee arthroplasty (TKA).
STUDY DESIGN: Review of three English language primary studies published in 2010 and 2011.

DATA SOURCES: Three randomized controlled trials comparing local infiltration analgesia to three separate controls: epidural analgesia, placebo infiltration and femoral nerve block found using PubMed.

OUTCOMES MEASURED: Clinical outcome was measured by total morphine use postoperatively and average knee pain intensity at rest and upon movement postoperatively. Total morphine use …

What Is The Effectiveness Of Onabotulinumtoxina (Botox®) In Reducing The Number Of Chronic Migraines (Cm) In Patients 18-65 Years Old?, Kristin A. Beddingfield

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not onabotulinumtoxinA (Botox®) is effective in reducing the number of chronic migraines (CM) in patients 18-65 years old? Study Design: Review of three published, double blind randomized controlled trials were used for this review, which were found on PubMed; were selected based on their relevance to the clinical question and if they included patient oriented outcomes.

OUTCOMES MEASURED: The outcomes measured were headache/migraine free days measured by >50% responder rate analysis, the Treatment Responder Rate based on Physician Global Assessment, and total adverse events reported by …

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 …

Does The Use Of Varenicline For Smoking-Cessation Therapy Create Or Increase Depression In Patients Without Existing Depressive Illness?, Brett R. Brown

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of varenicline for smoking-cessation therapy creates or increases depression in patients without existing depressive illness.

STUDY DESIGN: Review of two randomized controlled trials published in 2011 and one observational cohort study published in 2009, all English language.
DATA SOURCES: Two randomized, double-blind, controlled clinical trials comparing varenicline to placebo in smoking cessation, and one observational cohort study comparing varenicline use within subjects. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: Changes in depression was evaluated using the MontgomeryÅsberg Depression Rating Scale …

Is Modafinil (Provigil®) Effective In Improving Cognitive Function In Adults With Narcolepsy?, Stephanie V. Bui

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not modafinil (Provigil®) is effective in improving cognitive function in adults with narcolepsy.

STUDY DESIGN: Review of all English language primary randomized controlled trials from 1996 to 2010.

DATA SOURCES: Double-blind, randomized controlled trials that compared modafinil (Provigil®) to a visually matched placebo were found using OVID, MEDLINE, and Cochrane Databases.

OUTCOME(S) MEASURED: Each of the three trials assessed the effect of modafinil on cognitive and executive function by Low-Resolution Brain Electromagnetic Tomography (LORETA), and the following assessment tools: Epworth Sleepiness Scale (ESS), Multiple Sleep …

Is Yoga An Effective Management Strategy For Disordered Eating?, Patricia G. Byrne

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether yoga is an effective management strategy for disordered eating.

STUDY DESIGN: Review of three English language primary studies published in 2007, 2009, and 2010.

DATA SOURCES: Three randomized control trials that evaluated yoga as a treatment intervention for disordered eating found using Medline@OVID and PubMed.

OUTCOME MEASURED: Outcomes were interpreted by eating disorder severity as measured on the Eating Disorder Examination, Eating Disorder Diagnostic Scale, and Binge Eating Scale. Secondarily, there was an assessment of associated attitudes and behaviors towards eating, including body satisfaction, physical activity level, …

In Adults With Acute Diarrhea, Which Treatment Is More Effective Between Loperamide And Racecadotril?, Lorena A. Castillo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine which treatment is more effective between loperamide and racecadotril to treat acute diarrhea in adults.

STUDY DESIGN: Review of three English language primary randomized controlled studies published from 1999-2005.

DATA SOURCES: First study was a RCT that was double blinded, double placebo, parallel study group and second and third study was RCT single blinded, comparative parallel group that all compared efficacy of loperamide and racecadotril. These were all found by using PubMed, COCHRANE and NCBI.

OUTCOMES MEASURED: Each of the studies measured the efficacy of each …

Is Horticultural Therapy A Safe And Effective Treatment In Reducing Agitation For Dementia Patients In Nursing Homes?, Renee J. Chiodo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not horticultural therapy is a safe and effective treatment in reducing agitation for dementia patients in nursing homes.

STUDY DESIGN: Review of three English language primary studies published between 2008 and 2010.

DATA SOURCES: Two randomized control trials and a case series, which compare horticultural therapy to the use of traditional therapy methods.

OUTCOMES MEASURED: The primary outcome measured in all three studies focus on the level of agitation in dementia patients. Secondary outcomes also included efficacy of sleep as well as level of cognition. …

Is Noninhaled Intranasal Carbon Dioxide Gas A Safe And Effective Treatment For Improvement Of Nasal Symptoms Of Allergic Rhinitis?, Andrew R. Couchara

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not noninhaled intranasal carbon dioxide (CO2) gas is a safe and effective treatment for improvement of nasal symptoms of allergic rhinitis.

STUDY DESIGN: Systematic review of three randomized controlled trials published in 2008, 2011, and 2011.

DATA SOURCES: Three randomized controlled trials published after 2007 were obtained using PubMed.

OUTCOMES MEASURED: Number of sneezes and severity of nasal symptoms (nasal congestion, rhinorrhea) were recorded by subjects using an ordinal scale to obtain a Total Nasal Symptom Score (TNSS). Scores recorded before and after treatment were compared to …

Does N-Acetylcysteine Supplementation Alleviate Compulsive Behavior In Adults With Impulse Control Disorders?, Tova Diamond

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not “Does N-acetylcysteine supplementation alleviate compulsive behavior in adults with impulse control disorders?”

STUDY DESIGN: Review of three English primary studies published between 2007 and 2009.

DATA SOURCES: One double-blind RCT, one open label trial followed by double-blind RCT, one case study. Studies were found using PubMed, Cochrane Systematic Reviews, OVID and Ebsco databases.

OUTCOMES MEASURED: Primary outcomes measured include severity of trichotillomania symptoms measured by MGHHPS, reduction of pathological gambling symptoms measured by YBOCS-PG, and reduction of compulsive grooming urges measured by patient reports.

RESULTS: In …

Does Nicotine Replacement Therapy Reduce The Withdrawal Symptom Of Craving, Or Urge To Smoke, In Dependent Adult Smokers During Smoking Cessation?, Theresa Dijoseph

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not nicotine replacement therapy reduces the withdrawal symptom of craving, or urge to smoke, in dependent adult smokers during smoking cessation.

STUDY DESIGN: Systematic review of three English language and peer-reviewed randomized-controlled trials published in 2009, 2010, and 2011.

DATA SOURCES: One single-blinded randomized-controlled crossover trial, one double-blinded, placebo controlled, randomized-controlled crossover trial, and one single-blinded, placebo controlled, randomized-controlled crossover trial

OUTCOMES MEASURED: Withdrawal symptoms of craving, irritability, difficulty concentrating, and restlessness were measured on a 100mm visual analog scale (VAS). Adverse effects (AEs) of mouth and …

Is Omalizumab A Safe And Effective Treatment For Chronic Urticaria?, Ashley L. Davis

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not omalizumab is a safe and effective treatment for chronic urticaria.

STUDY DESIGN: Review of two randomized controlled studies and one crossover study. All three studies are published in English between 2008-2011.

DATA SOURCES: Two randomized, double blind, placebo controlled studies and one crossover study found using PubMed and EBSCOhost.

OUTCOMES MEASURED: Each trial measured the duration, size, number and/or intensity of wheals. This was done by using the urticaria activity score (UAS). Quality of life was also measured using Dermatology Life Quality Index (DLQI), …

What Is The Effectiveness Of Roxithromycin In Management Of The Signs And Symptoms Of Rheumatoid Arthritis?, Adriana Distanislao

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not roxithromycin is effective in management of the signs and symptoms of rheumatoid arthritis.

STUDY DESIGN: Review of three primary studies in the English language published in 2006, 2009, and 2011.

DATA SOURCES: Randomized, controlled and double blind clinical trials testing the effectiveness roxithromycin in management of inflammation and signs and symptoms of rheumatoid arthritis were found using the PubMed and Ovid databases.

OUTCOMES MEASURED: Improvement in the signs and symptoms of tenderness/inflammation using the American College of Rheumatology-20 (ACR-20) scoring approach, improvement of quality of …

Is Fentanyl Pectin Nasal Spray Safe And Effective For Patients With Breakthrough Cancer Pain?, Salina G. Elengical

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether fentanyl pectin nasal spray (FPNS) is safe and effective treatment for patients with breakthrough cancer pain.

STUDY DESIGN: Review of three English language primary randomized controlled trials published 2010-2011.

DATA SOURCES: Multicenter, randomized, double-blind, double-dummy, placebo-controlled trials comparing fentanyl pectin nasal spray, immediate-release morphine sulfate, and/or nasal spray placebo were found using PubMed, COCHRANE, and Medline databases.

OUTCOME MEASURED: All three studies essentially used similar parameters to measure effectiveness and safety of fentanyl pectin nasal spray compared to oral immediate-release morphine sulfate and/or placebo. Baseline pain intensity …

Do Mechanical Pressure-Equalizing Devices Such As Otovent® And Prep Relieve Or Reduce Ear Pain And Pressure In Aircraft Passengers During Flight?, Michael Ferentino

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not mechanical pressure-equalizing devices relieve or reduce ear pain and pressure in aircraft passengers during flight.

STUDY DESIGN: A review of two double-blind control trials and one case control study published between 1988 and 2010 in the English language.

DATA RESOURCES: Double-blind control trials focused on the use of pressure-equalizing ear plugs (PREP) and a case control study on the Otovent® auto-inflation device for the prevention of barotrauma in aircraft passengers were found using Cochraine Library, Medline, and PubMed.

OUTCOMES MEASURED: Outcomes measured …

Is Mechanical Traction A Safe And Effective Treatment For Patients With Chronic Neck Pain?, Shawn D. Giacobbe

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not mechanical traction is a safe and effective treatment for patients with chronic neck pain.

STUDY DESIGN: Review of three English-language randomized clinical trials (RCTs) published in 2008, 2009, and 2011.

DATA SOURCES: Two double-blind randomized clinical trials and one single-blind randomized clinical trial were found using PubMed.

OUTCOMES MEASURED: Decrease in neck pain was measured through subjective pain rating scales performed prior to and after treatment of both those receiving mechanical traction and those not receiving mechanical traction.

RESULTS: While patients …

Is Whole Body Vibration (Wbv) A Safe And Effective Adjunctive Therapy For Reducing Fall Risk In The Elderly?, Harry J. Guarino

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not whole body vibration (WBV) is a safe and effective adjunctive therapy for reducing fall risk in the elderly.

STUDY DESIGN: A review of English language randomized controlled blinded trials published within peer-reviewed journals from 2005-2010 evaluating the effectiveness of WBV in reducing fall and fall risk. The studies included elderly participants age 60 and older.

DATA SOURCES: Randomized controlled blinded trials were found using PubMed, Medline and OVID databases.

OUTCOMES MEASURED: Outcomes measured were reduction in fall number and reduction in fall risk. Fall number …

Is Starting Antiretroviral Therapy (Art) In Hiv Positive Adults With Cd4 Cell Count Of <300 Cells/Μl Within Four Weeks Of Initiating New Tuberculosis (Tb) Therapy More Effective In Reducing Mortality Rates Than Starting Art Four Weeks Or Later After Initiating New Tb Therapy?, Janna Erlien

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not starting antiretroviral therapy (ART) in HIV positive adults with CD4 cell count of /µl within four weeks of initiating new tuberculosis therapy more effective in reducing mortality rates than starting ART four weeks or later after initiating new tuberculosis therapy.

STUDY DESIGN: Systematic review of three English language primary studies published in the New England Journal of Medicine in 2011.

DATA SOURCES: Three open label, randomized, controlled trials published in 2011, comparing the timing of ART for HIV+ adults with confirmed or suspected new TB …

Are Sodium Alginate Solutions Effective In Reducing Postprandial Symptoms In Adults With Gastroesophageal Reflux?, Kristi L. Hackman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not sodium alginate solutions are effective in reducing postprandial symptoms in adults with gastroesophageal reflux?

STUDY DESIGN: A review of three English language studies published from 2006-2011. Includes two randomized, double-blind, controlled trials and one controlled case series.

DATA SOURCES: Randomized, placebo-controlled studies evaluating the effectiveness and safety of sodium alginate solutions (Gaviscon) for managing gastroesophageal reflux disease (GERD) symptoms in adults were located using the PubMed, CINAHL, and Cochrane Library databases.

OUTCOMES MEASURED: The primary measures of effectiveness used were the Reflux Severity Index Questionnaire …

Does Daily Intake Of Glucosamine Supplements Prevent The Need For Knee Replacements Later In Life For Adult Patients Predisposed To Osteoarthritis?, Nancy Helmy

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not daily intake of glucosamine supplements prevents the need for knee replacements later in life for adults predisposed to osteoarthritis.

STUDY DESIGN: Review of three English language primary randomized controlled trial studies published between 2001 and 2008

DATA SOURCES: Three double blind randomized control trials comparing glucosamine supplements to placebo were found using PubMed.

OUTCOMES MEASURED: Outcomes were measured using radiographic studies of the knees, joint space measurements, and symptoms were evaluated using Lequesne and WOMAC indexes.

RESULTS: The Reginster (2001) and Pavelka (2002) studies demonstrated no …

Is Dabigatran Superior To Warfarin In Treating Patients With Atrial Fibrillation?, Kelly Higgins

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Dabigatran is superior to Warfarin in patients with atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published in 2007, 2009, and 2010.

DATA SOURCES: Three randomized control trials found using Cochrane Database.

OUTCOME(S) MEASURED: Outcomes measured were presence or absence of stroke or systolic embolism and intracranial hemorrhage. The absence of these events preserved neurologic function in patients with atrial fibrillation.

RESULTS: In both VKA-naïve and VKA-experienced patients, Dabigatran 150 mg was superior to Warfarin in both the prevention of stroke …