Medicine and Health Sciences Commons^™

Letrozole Vs. Clomiphene Citrate For Infertility In Polycystic Ovarian Syndrome, Kailey Potratz

Physician Assistant Scholarly Project Posters

Purpose

To determine if letrozole is an equal or better alternative to clomiphene citrate for infertility treatment in PCOS patients.

Literature Review

Letrozole was found to have higher ovulation rates, fewer twin pregnancies/more single births, higher pregnancy rates, and higher live birth rates compared to clomiphene citrate. There were conflicting results for endometrial thickness and single follicle stimulation. Neither letrozole or clomiphene citrate was superior to the other for ovarian hyperstimulation syndrome. There were no significant differences between letrozole and clomiphene citrate regarding congenital abnormalities and miscarriage rates. The results regarding ectopic pregnancies were comparable between both groups.

Conclusion

The …

Comparing Prevalence Of Medication-Related Osteonecrosis Of The Jaw (Mronj) Due To Denosumab And Bisphosphonates As A Side Effect Of Osteoporosis Treatment, Kendra Apland

Physician Assistant Scholarly Project Papers

As the baby boomer generation continues to age, the diagnosis of osteoporosis and its side effects will continue to increase. Denosumab and bisphosphonates (BPs) are some of the most common medication classes used to treat osteopenia and osteoporosis, but it is believed that both medications have the possible side effect of medication-related osteonecrosis of the jaw (MRONJ). The purpose of this paper is to uncover if MRONJ is a side effect of osteoporosis treatment and which medication carries the highest incidence rate. Through a review of several electronic databases and several peer reviewed research articles, a wide range of reported …

Letrozole Vs. Clomiphene Citrate For Infertility In Polycystic Ovarian Syndrome, Kailey Potratz

Physician Assistant Scholarly Project Papers

Polycystic Ovarian Syndrome (PCOS) is the leading cause of anovulatory infertility and the most common endocrinopathy in women of reproductive age (Rosenfield & Ehrmann, 2016). It has been recognized that women with PCOS often struggle with infertility and require medication to stimulate ovulation to become pregnant. Currently, the first-line treatment for infertility associated with PCOS is clomiphene citrate, which was introduced in the 1960s (Morad & Farag, 2015). However, it has been proposed that an aromatase inhibitor, specifically letrozole, should become the first-line treatment for these patients due to a decreased adverse effect profile, a lower incidence of simultaneous multiple …

Comparing Prevalence Of Medication-Related Osteonecrosis Of The Jaw (Mronj) Due To Denosumab And Bisphosphonates As A Side Effect Of Osteoporosis Treatment, Kendra Apland

Physician Assistant Scholarly Project Posters

As the baby boomer generation continues to age, the diagnosis of osteoporosis and its side effects will continue to increase. Denosumab and bisphosphonates (BPs) are some of the most common medication classes used to treat osteopenia and osteoporosis, but it is believed that both medications have the possible side effect of medication-related osteonecrosis of the jaw (MRONJ). The purpose of this paper is to uncover if MRONJ is a side effect of osteoporosis treatment and which medication carries the highest incidence rate. Through a review of several electronic databases and several peer reviewed research articles, a wide range of reported …

The Efficacy And Safety Of Statins In The Primary Prevention Of Cardiovascular Disease, Kayla M. Ashton

Physician Assistant Scholarly Project Posters

Atherosclerotic plaques can form in the blood vessels from particles of cholesterol. These plaques are a major cause of cardiovascular disease and have the ability to result in fatal cardiovascular events. In researching this topic, PubMed, the Cochrane Library, DynaMed, and ClinicalKey were all utilized in finding articles published from 2002 to 2018. There are several organizations with conflicting guidelines recommending the use of statin medications in the primary prevention of cardiovascular disease. The research evaluated discovers data is inconclusive on the benefit of statin medications in this primary prevention as well as the safety of long-term statin use. Some …

Associations Among Acne Vulgaris And Western Diet, Kate Meredith Suda

Physician Assistant Scholarly Project Posters

Acne vulgaris is one of the most common dermatologic conditions, especially among the adolescent population.

The pathogenesis of acne is largely multifactorial, with heredity and hormones strongly contributing to one’s risk of developing the chronic inflammatory skin condition.

High prevalence rates of acne in the adolescent population cannot be attributed to heredity alone, but by the influence of Western diet (WD) that overstimulates insulin-like growth factors (IGFs).

The purpose of this scholarly project is to determine if there is an association between the presence of acne vulgaris and the consumption of WD, and if a physiological link between the high …

The Efficacy And Safety Of Statins In The Primary Prevention Of Cardiovascular Disease, Kayla M. Ashton

Physician Assistant Scholarly Project Papers

Atherosclerotic plaques can form in the blood vessels from particles of cholesterol. These plaques are a major cause of cardiovascular disease and have the ability to result in fatal cardiovascular events. In researching this topic, PubMed, the Cochrane Library, DynaMed, and ClinicalKey were all utilized in finding articles published from 2002 to 2018. There are several organizations with conflicting guidelines recommending the use of statin medications in the primary prevention of cardiovascular disease. The research evaluated discovers data is inconclusive on the benefit of statin medications in this primary prevention as well as the safety of long-term statin use. Some …

Screening Techniques For Alzheimer’S Disease, Christina Nicole Brooks

Physician Assistant Scholarly Project Papers

Alzheimer’s disease is a neurodegenerative disease that affects more than 55 million Americans. By the year 2050, experts project this disease will have increased three fold. Many screening techniques have been investigated to detect this disease early and begin treatment to slow its progression. The purpose of this study was to explore which medical modalities are the most effective for screening of Alzheimer’s disease. This literature review includes three databases, including PubMed, CINHAL, and Cochrane Database of Systematic Reviews. Topics that were researched include: cognitive screening tests, neuroimaging, laboratory diagnostic testing, DNA, and combined studies. Research was conducted from October …

The Neuroprotective Effects Of Targeted Temperature Management On Post-Cardiac Arrest Patients, Timothy Hovde

Physician Assistant Scholarly Project Papers

Novel methods of ensuring survival following cardiac arrest and resuscitation are of supreme importance to the medical community. Targeted temperature management (TTM) has become increasingly utilized pre-hospital, in emergency departments, and within intensive care units to increase the likelihood of survival to hospital discharge. TTM has further been used to attempt to improve neurological functioning. The efficacy and mechanism behind TTM remains poorly understood. In several patient populations it also remains unproven. The purpose of this study is to assess the physiological mechanism, survival, neurological recovery and methodology of TTM use and implementation.

Literature review was utilized to assess the …

Limb Salvage For Diabetic Patients With Peripheral Arterial Disease, Jamie Jesse Johnson

Physician Assistant Scholarly Project Papers

Diabetes is rapidly increasing throughout the United States. According to the Center for Disease Control (CDC) (2017), the total number of patients diagnosed with diabetes is 23.1 million, patients with undiagnosed diabetes are 7.2 million, for a combined total number of patients with diabetes exceeding 30.2 million and growing.

According to the CDC (2016), approximately 8.5 million people in the United States have peripheral artery disease (PAD), which includes 12-20% of individuals who are older than age 60. According to a study performed by Swaminathan et al. (2014), 186,000 patients underwent lower extremity amputation (LEA). Data also shows that patients …

Comparing The Effectiveness Of A Low Carbohydrate Diet And Metformin On Glycosylated Hemoglobin Reduction In Type Two Diabetes Mellitus, Ashley Schultz

Physician Assistant Scholarly Project Papers

In this study, a low carbohydrate diet and metformin pharmacotherapy were compared to determine their effect on HbA1c in the type two diabetic patient. Several high quality studies were examined along with each treatment's effect on mainly HbA1c, but also other parameters such as body weight, cholesterol, and fasting and post prandial blood glucose levels. The study showed that both the low carbohydrate diet and metformin pharmacotherapy were effective at lowering HbA1c in the type two diabetic patient. The low carbohydrate diet showed a 0.2% increase in HbA1c all the way to a 2.2% decrease in baseline HbA1c in the …

Pre-Participation Physical Examination: Are Current Cardiovascular Recommendations Enough?, Steven Jacob Pietrusza

Physician Assistant Scholarly Project Papers

Inclusion of screening electrocardiograms (EKGs) during pre-participation physical examination has been a topic of debate for some time. There is unquestioned usefulness in the ability of a well-trained health care provider in using EKG to identify cardiac abnormalities. Further, there have been several contemporary EKG criteria published that increase specificity and sensitivity of detection of disease. However, these criteria do not account for athletes less than 14 years of age, and that demographic represents a large portion of patients seeking pre-participation screenings in the United States. The lack of research into pediatric cardiac remodeling secondary to activity, coupled with the …

The Impact Of Circadian Misalignment On Cardiometabolic Health, Cynthia Marie Mills

Physician Assistant Scholarly Project Papers

The circadian system is important in all living organisms because it generates a 24-hour rhythm for physiological and behavioral processes enabling anticipation and adaptation to daily changes in the environment. The prevalence of cardiometabolic diseases, which are linked to lifestyle choices, has been rising at an alarming rate. Modernization and globalization are two of many factors to blame for lifestyle changes resulting in circadian disruption. The purpose of this literature review is to explore circadian misalignment with regards to its mechanism and impact on cardiometabolic health and to determine possible interventional measures. The primary focus is on lifestyle change, particularly …

Systemic Therapy Versus Catheter Directed Techniques For The Treatment Of Acute Massive Pulmonary Embolism, Lawrence Duane Lee

Physician Assistant Scholarly Project Papers

Acute massive pulmonary embolism is characterized by obstruction of the pulmonary arterial tree that exceeds 50% of the cross-sectional area causing acute and severe cardiopulmonary failure from right ventricular overload. Systemic thrombolytic therapy is recommended as standard, first-line treatment in patients with massive pulmonary embolism unless contraindicated and catheter directed therapies, including low dose thrombolytic administration directly into thrombus and mechanical thrombectomy can be adjunctive or used as an alternative to systemic treatments. This literature review researched articles looking both systemic thrombolysis and endovascular techniques for the treatment of acute massive pulmonary embolism with an emphasis on long term clinical …

Associations Among Acne Vulgaris And Western Diet, Kate Meredith Suda

Physician Assistant Scholarly Project Papers

Acne vulgaris is one of the most common dermatologic conditions, especially among the adolescent population. The pathogenesis of acne is largely multifactorial, with heredity and hormones strongly contributing to one’s risk of developing the chronic inflammatory skin condition; it is related to excess sebum production by sebaceous glands, inflammation within comedones, and hyperproliferation of Propionibacterium acnes. High prevalence rates of acne in the adolescent population cannot be attributed to heredity alone, but by the influence of Western diet that overstimulates a key conductor of metabolism, the growth factor-sensitive kinase known as mTORC1. Many investigations show associations between acne and Western …

Screening Techniques For Alzheimer's Disease, Christina Nicole Brooks

Physician Assistant Scholarly Project Posters

Alzheimer’s disease is a neurodegenerative disease that affects more than 55 million Americans. By the year 2050, experts project this disease will have increased three fold. Many screening techniques have been investigated to detect this disease early and begin treatment to slow its progression. The purpose of this study was to explore which medical modalities are the most effective for screening of Alzheimer’s disease. This literature review includes three databases, including PubMed, CINHAL, and Cochrane Database of Systematic Reviews. Topics that were researched include: cognitive screening tests, neuroimaging, laboratory diagnostic testing, DNA, and combined studies. Research was conducted from October …

Pre-Participation Physical Exams: Are We Doing Enough?, Steven Jacob Pietrusza

Physician Assistant Scholarly Project Posters

•Inclusion of screening electrocardiograms (EKGs) during pre-participation physical examination has been a topic of debate for some time. There is unquestioned usefulness in the ability of a well-trained health care provider in using EKG to identify cardiac abnormalities.

•Further, there have been several contemporary EKG criteria published that increase specificity and sensitivity of detection of disease. However, these criteria do not account for athletes less than 14 years of age, and that demographic represents a large portion of patients seeking pre-participation screenings in the United States.

•The lack of research into pediatric cardiac remodeling secondary to activity, coupled with the …

Comparing The Effectiveness Of A Low Carbohydrate Diet And Metformin On Glycosylated Hemoglobin Reduction In Type Two Diabetes Mellitus, Ashley Schultz

Physician Assistant Scholarly Project Posters

In this study, a low carbohydrate diet and metformin pharmacotherapy were compared to determine their effect on HbA1c in the type two diabetic patient. Several high quality studies were examined along with each treatment's effect on mainly HbA1c, but also other parameters such as body weight, cholesterol, and fasting and post prandial blood glucose levels. The study showed that both the low carbohydrate diet and metformin pharmacotherapy were effective at lowering HbA1c in the type two diabetic patient. The low carbohydrate diet showed a 0.2% increase in HbA1c all the way to a 2.2% decrease in baseline HbA1c in the …

Treatment Options For Hidradenitis Suppurativa: Efficacy, Risks, Benefits, Katherine A. Hennager

Physician Assistant Scholarly Project Posters

Hidradenitis suppurativa is a chronic, recurrent follicular occlusion disease with painful, sometimes debilitating, cutaneous draining lesions and subcutaneous abscesses (DynaMed Plus, 2016). Hidradenitis suppurativa is understood to be a multifactorial disease that is hard to treat in some patients, especially those with a severe form of the disease. For this project, the efficacy of adalimumab for hidradenitis suppurativa was assessed and whether it is more beneficial than traditional treatments used. Adalimumab is a TNF-alpha inhibitor which belongs to the biologic DMARDs drug class. Kimball et al. (2012) found that at week 16 of their trial 3.9% of the placebo patients, …

The Neuroprotective Effects Of Targeted Temperature Management On Post-Cardiac Arrest Patients, Timothy Hovde

Physician Assistant Scholarly Project Posters

Novel methods of ensuring survival following cardiac arrest and resuscitation are of supreme importance to the medical community. Targeted temperature management (TTM) has become increasingly utilized pre-hospital, in emergency departments, and within intensive care units to increase the likelihood of survival to hospital discharge. TTM has further been used to attempt to improve neurological functioning. The efficacy and mechanism behind TTM remains poorly understood. In several patient populations it also remains unproven. The purpose of this study is to assess the physiological mechanism, survival, neurological recovery and methodology of TTM use and implementation.

Literature review was utilized to assess the …

Limb Salvage For Diabetic Patients With Peripheral Arterial Disease, Jamie Jesse Johnson

Physician Assistant Scholarly Project Posters

•According to the Center for Disease Control (CDC) (2017), the total number of patients diagnosed with diabetes is exceeding 30.2 million and rapidly increasing.

•According to the CDC (2016), approximately 8.5 million people in the United States have peripheral artery disease (PAD), which includes 12-20% of individuals who are older than age 60.

•According to a study performed by Swaminathan et al. (2014), 186,000 patients underwent lower extremity amputation (LEA). Data also shows that patients undergoing LEA have a mortality rate of 20% noted within one year, and a 40% to 50% mortality rate indicated within 18 months.

•The review …

Systemic Therapy Versus Catheter Directed Techniques For The Treatment Of Acute Massive Pulmonary Embolism, Lawrence Duane Lee

Physician Assistant Scholarly Project Posters

•Acute massive pulmonary embolism is characterized by obstruction of the pulmonary arterial tree that exceeds 50% of the cross-sectional area causing acute and severe cardiopulmonary failure from right ventricular overload.

•Systemic thrombolytic therapy is recommended as standard, first-line treatment in patients with massive pulmonary embolism unless contraindicated and catheter directed therapies, including low dose thrombolytic administration directly into thrombus and mechanical thrombectomy can be adjunctive or used as an alternative to systemic treatments.

•This literature review researched articles looking at both systemic thrombolysis and endovascular techniques for the treatment of acute massive pulmonary embolism with an emphasis on long term …

The Impact Of Circadian Misalignment On Cardiometabolic Health, Cynthia Marie Mills

Physician Assistant Scholarly Project Posters

The circadian system is important in all living organisms because it generates a 24-hour rhythm for physiological and behavioral processes enabling anticipation and adaptation to daily changes in the environment. The prevalence of cardiometabolic diseases, which are linked to lifestyle choices, has been rising at an alarming rate. Modernization and globalization are two of many factors to blame for lifestyle changes resulting in circadian disruption. The purpose of this literature review is to explore circadian misalignment with regards to its mechanism and impact on cardiometabolic health and to determine possible interventional measures. The primary focus is on lifestyle change, particularly …