Digital Commons Network^™

Is A Vitamin Supplement Effective In Treatment Of Recurrent Aphthous Ulcers?, Annalyse Grayson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not a daily vitamin supplement is effective treatment for recurrent aphthous ulcers.

STUDY DESIGN: A review of 3 randomized control trials. All three trials are in English between 2009-2014.

DATA SOURCES: 3 randomized double blind placebo-controlled parallel-arm single center trials were found using PubMed.

OUTCOMES MEASURED: Each of the RCTs measured the efficacy of treatment for RAU in patients with aphthous ulcer outbreaks for at least a year or at least one to three outbreaks a month. This was performed by subjects of the study reporting on efficacy …

Is Botulinum Toxin A Safe And Effective For The Treatment Of Trigeminal Neuralgia In Adults?, Bryan Frank

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidence based medicine review is to determine whether or not Botulinum Toxin A is safe and effective for the treatment of trigeminal neuralgia in adults.

STUDY DESIGN: Three double blind, randomized controlled trials 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 NCBI and PubMed database.

OUTCOMES MEASURED: The outcomes were measured using the Visual Analog Scale (VAS), Quality of Life (QoL), Patient Global Impression of Change Scale (PGIC), Last Observation Carried Forward (LOCF), and detected …

Does Temporal Lobe Resection Cure Seizures In Epileptics?, Alyssa Hall

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not temporal lobe resection cures seizures in epileptics.

Study Design: Systematic review of three English language, peer-reviewed randomized controlled trials, published between 2001 and 2012

Data Sources: Two randomized controlled trials comparing temporal lobe resection surgery to antiepileptic drugs in the treatment of epileptic seizures, and one randomized controlled trial comparing 3.5 cm temporal lobe resection to 2.5 cm temporal lobe resection in the treatment of epileptic seizures. Studies were obtained by the author through the PubMed database.

Outcomes Measured: Primary outcome measured by the three studies was …

Is Desvenlafaxine Effective For Reducing Hot Flashes In Postmenopausal Females?, Maria Graziano

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine whether or not Desvenlafaxine is effective in reducing daily hot flashes in postmenopausal females.

STUDY DESIGN: Review of three primary randomized controlled trials (RCTs) published after the year 2000 in the English language.

DATA SOURCES: Three double-blind, randomized controlled trials were found using PubMed and EBSCOhost Web. All trials selected compared treatment with Desvenlafaxine to a visually matched placebo.

OUTCOMES MEASURED: Patients completed daily diary cards on which they recorded the number and severity of daily hot flashes from the screening period through the 12 weeks …

Is Aprepitant Effective In Preventing Postoperative Nausea And Vomiting?, Rebeccah M. Gomberg

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aprepitant is effective in preventing postoperative nausea and vomiting.

STUDY DESIGN: Review of three English language primary randomized controlled trials from 2012-2014.

DATA SOURCES: Three double-blind, randomized controlled trials comparing oral aprepitant with placebo. All articles were found using PubMed.

OUTCOMES MEASURED: The three studies measured nausea severity using a verbal rating system and number of episodes of nausea and vomiting recorded by a blinded study investigator.

RESULTS: Vallejo et al found that 29.7% of the patients in the placebo group vomited compared to 9.3% of …

Is Polidocanol Foam Sclerotherapy Effective In Treating Varicose Veins As Compared To Conventional Treatments?, Sachi Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Polidocanol foam sclerotherapy is effective in treating varicose veins as compared to conventional treatments.

STUDY DESIGN: Review of three randomized controlled trials. All three studies are published in English between 2008 – 2012.

DATA SOURCES: Three randomized control trials were found using PubMED and Medline. The sources were selected based on the outcomes measured and how the studies and outcomes mattered to patients (POEMS).

OUTCOMES MEASURED: The patients’ assessment for quality of life analyzed by logistic regression model, Chronic Venous Insufficiency Questionnaire (CVIQ), EQ-5D model, Visual …

Is Enbrel (Etanercept) Safe And Effective In Treating Patients With Sciatic Nerve Pain Resulting From Lumbar Disc Herniation Or Spinal Stenosis?, Abigail Lee Ferry

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Enbrel (etanercept) is safe and effective in treating patients with sciatic nerve pain resulting from lumbar disc herniation or spinal stenosis.

STUDY DESIGN: Review of three English language primary randomized controlled trials from 2012- 2013.

DATA SOURCES: One triple-blind, placebo-controlled randomized clinical trial, one double-blind, placebo-controlled randomized clinical trial, and one prospective randomized clinical trial were found using PubMed. These studies compared treatment with etanercept to treatment with saline and steroids (dexamethasone or methylprednisolone).

OUTCOMES MEASURED: Clinical outcomes of leg and back pain were measured using …

Do Botulinum Toxin Injections Improve The Freezing Of Gait (Fog) Episodes Experienced By Parkinson’S Disease (Pd) Patients?, Caroline R. Poole

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not botulinum toxin injections improve the freezing of gait (FOG) episodes experienced by patients diagnosed with Parkinson’s disease (PD).

STUDY DESIGN: This review is based on three randomized controlled trials published in 2004, 2005, and 2007. All of the studies compared the efficacy as well as safety of using botulin toxin injections to treat FOG episodes experienced by PD patients.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and were found using PubMed searches.

OUTCOMES MEASURED: For all studies, the safety and efficacy …

Is Acupuncture An Effective Treatment For Women With Chronic Migraine?, Elham Oumer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is effective in treating chronic migraine in women between the ages of 18-65.

STUDY DESIGN: Review of two randomized controlled trials and one prospective controlled trial published in English language between 2009 and 2014.

DATA SOURCES: Two PCTs and one prospective CT published in peer reviewed journals, searched through PubMed, EBSCOhost.

OUTCOMES MEASURED: The outcome measured included improvement in quality of life, reduction in intensity and number of headache days. This were measured using 50% responders analysis, self reporting by participants, short form 36 (SF-36) …

Does Resistance Training Improve Mobility In Patients With Parkinson’S Disease?, F. Joe Yorio

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM is to determine whether or not resistance training is effective in improving mobility for patients with Parkinson’s disease.

Study Design: Review of four English language randomized control trials (RCT) published between 2012-2013.

Data Sources: Articles used were RCTs and published in peer reviewed journals and found using Pubmed, JAMA, and NCBI.

Outcomes Measured: Effectiveness was measured by comparing a sham, or non-resistance based exercise group, to a resistance based group. Improvement in mobility was measured using UPDRS-III scores.

Results: Patients with Parkinson’s have slow and weak movements which should be improved with resistance …

Is Vitamin D Supplementation Effective At Reducing Idiopathic Musculoskeletal (Mss) Pain?, Darra O. Markland

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine “Is Vitamin D supplementation effective at reducing idiopathic musculoskeletal (MSS) pain?”

Study Design: Review of primary studies published between the years 2012-2014.

Data Sources: One double blind randomized controlled trial (RCT), one semi-crossover RCT, and one before and after observational study. These were found using Cochrane Review and PubMed databases.

Outcomes Measured: Clinical outcomes were measured in these studies utilizing the Visual Analogue Scale for Pain, the 5-point Likert Pain Scale, the Standard Nordic Questionnaires and numerical grading of pain level, and number of pain sites before and after …

Is Tetrahydrocannabinol (Thc)/Cannabidiol (Cbd) Oromucosal Spray An Effective Adjuvant Therapy For Multiple Sclerosis Patients Who Suffer From Central Neuropathic Pain?, Evan Taxin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Tetrahydrocannabinol (THC)/Cannabidiol (CBD) oromucosal spray an effective adjuvant therapy for Multiple Sclerosis (MS) patients who suffer from central neuropathic pain (CNP)?”

STUDY DESIGN: Systematic review of three randomized controlled trials published between 2005-2013, all English language.

DATA SOURCES: Three randomized controlled studies were obtained using PubMed and MedLine.

OUTCOMES MEASURED: The outcome of each study was the subject’s incidence and severity of central neuropathic pain compared to their baseline at the beginning of the study. Outcomes were measured using an 11-point pain scale at various …

Is Pancrelipase Delayed Release Capsule (Creon) Safe For Use In Patients’ ≥7 Years Old Who Suffer From Pancreatic Insufficiency Due To Cystic Fibrosis?, Iman Shamloul

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Pancrelipase Delayed Release Capsule (Creon) is safe for use in patients’ ≥7 years old who suffer from pancreatic insufficiency due to cystic fibrosis.

Study Design: Systemic review of 3 English language primary studies, published between 2000-2010.

Data Sources: Two double blind randomized controlled trials (RCTs) as well as an open label phase study with a double blind phase comparing the safety of Pancrelipase Delayed Release Capsule (Creon) in treating pancreatic insufficiency in those suffering from Cystic Fibrosis. These studies were found using Cochrane Systematic Reviews and …

Is The Addition Of Vitamin D In Treatment For Asthma Effective In Children Less Than 18 Years Old?, Danielle M. Read

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of vitamin D in treatment for asthma is effective in children less than 18 years old.

STUDY DESIGN: Review of three English language, randomized, controlled, double blind studies after 1999.

DATA SOURCES: Randomized, controlled double blind studies comparing the addition of vitamin D with an inhaled corticosteroid in treatment of asthma with a control group of inhaled corticosteroid alone. All articles were found in PubMed.

OUTCOMES MEASURED: Each study assessed the number of asthma exacerbations or symptoms in the control group and in the …

Do Epidural Injections With Local Anesthetic With Steroids Have Superiority Over Injections With Local Anesthetic Alone When Treating Chronic Back Pain Due To An Intervertebral Disc Herniation In Men And Women Over 18 Years Old?, Julia S. Ross

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not, “Do epidural injections with local anesthetic with steroids have superiority over injections with local anesthetic alone when treating chronic back pain due to an intervertebral disc herniation in men and women over 18 years old?”

STUDY DESIGN: Review of three, double blind, randomized controlled trials (RCTs) published between 2011-2014, all in English language. The articles compared epidural injections containing local anesthetic with steroids to epidural injections containing local anesthetics alone.

DATA SOURCES: Three Randomized controlled trials found using PubMed. All articles were published in peer-reviewed journals …

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 …

Does Cooling Therapy Improve Functional Mobility In Heat-Sensitive Adults Diagnosed With Multiple Sclerosis?, Jordan Robinaugh

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cooling therapy improves functional mobility in heat-sensitive adults diagnosed with MS.

STUDY DESIGN: Systematic review of three randomized controlled trials published between 2007 and 2011, all in the English language.

DATA SOURCES: Three randomized controlled trials were found using the PubMed/MEDLINE database.

OUTCOMES MEASURED: Functional mobility as measured by the Multiple Sclerosis Functional Composite (MSFC), postural control, exercise duration, walking speed, and timed up and go examinations.

RESULTS: In one study, MeyerHeim, et al. demonstrated significant improvements with the experimental intervention on the 25-foot walk, 9-hole …

Is Narrowband Uvb Phototherapy In Combination With Nonsteroidal Topical Medications More Effective At Repigmentation Of Vitiligo Lesions When Compared To Narrowband Uvb Therapy Alone In Healthy Men And Women Between The Ages Of 11 And 69?, Cassandra Baier

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not narrowband UVB (NB-UVB) phototherapy in combination with nonsteroidal topical medications is more effective at repigmentation of vitiligo lesions when compared to NB-UVB therapy alone in healthy men and women between the ages of 11 and 69.

STUDY DESIGN: Review of three peer-reviewed randomized controlled trials written in English, two of which were published in 2014, and one in 2011.

DATA SOURCES: Studies were selected based on the method of study, the randomized- control structure of the studies, and the relevance to the clinical question, and all …

Is Topical Phenytoin Effective In Healing Diabetic Foot Ulcers In Patients Over Age 18?, Jordan Byrd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not topical phenytoin is effective in healing diabetic foot ulcers in patients over age 18.

STUDY DESIGN: Systematic review of three randomized controlled trials, published in 2011, 2013 and 2014.

DATA SOURCES: Three randomized controlled trials comparing the effectiveness of topical phenytoin to placebo in healing diabetic foot ulcers. Data sources found using PubMed and Google Scholar.

OUTCOMES MEASURED: Greater than 50% reduction in ulcer area measured via graph paper tracings and area reduction calculations, discontinuation of slough and discharge from ulcers via blind observer decision, complete …

Does Nebulized Hypertonic Saline Solution Decrease Hospital Admission Rates When Compared To Nebulized Normal Saline In Children Less Than Or Equal To 24 Months Old With Bronchiolitis?, Korie Alecxih

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not nebulized hypertonic saline solution reduces hospital admission rates when compared to nebulized normal saline solution in children less than or equal to 24 months of age diagnosed with acute bronchiolitis in the emergency department setting.

STUDY DESIGN: Systematic review of three randomized, double-blind, placebo controlled trials in the English language all published in 2014.

DATA SOURCES: Data sources obtained for this review were articles published in peerreviewed journals found using PubMed Database.

OUTCOMES MEASURED: The outcome measured was hospital admission rate. Hospital admission rate is calculated …

Is Laser Therapy An Effective Alternative Treatment For Women With Fibromyalgia?, Michelle B. Astrove

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not, “Is the use of laser therapy an effective alternative treatment for women with fibromyalgia?”

STUDY DESIGN: Review of three English language primary studies, published between 2002 and 2013.

DATA SOURCES: Three randomized controlled trials (RCTs) were found using Cochrane Systematic Reviews. These studies analyzed the effectiveness of laser therapy in women with fibromyalgia.

OUTCOMES MEASURED: Main outcomes measured were improvement in pain, number of tender points, muscular spasm, skinfold tenderness, sleep disturbance, fatigue and morning stiffness measured by an ordinal likert scale, Pain and FM impact …

What Is The Efficacy Of Peppermint Oil In Reducing The Symptoms And Improving The Quality Of Life In Patients With Irritable Bowel Syndrome (Ibs)?, Danielle Farnell

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not peppermint oil reduces the symptoms and improves the quality of life in patients with irritable bowel syndrome (IBS).

STUDY DESIGN: Review of three randomized, double-blind, placebo controlled clinical trials were used in this review. The articles were found on PubMed, and selected based on outcomes measured and relevance to the objective.

OUTCOMES MEASURED: The outcomes measured were based on Quality of life and Reduction in Symptoms. Quality of life was measured using the Persian translation of the SF-6 form for assessment of quality of life before …

Does Routine Use Of Medical Cannabis (Marijuana) Decrease The Intensity Of Chronic Neuropathic Pain In Adults?, Ben Arpin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM was to investigate the question, “Does routine use of medical cannabis (marijuana) decrease the intensity of neuropathic chronic pain in adults?

STUDY DESIGN: systematic review of 3 English language primary studies, published between 2005 and 2009.

DATA SOURCES: Three Randomized Controlled Trials (RTC’s) published on or after 2005 were selected based on their relevance to the proposed question via PubMed. All three RTC’s compared cannabis use vs. placebo for chronic neuropathic pain, with two RTC’s focusing on HIV neuropathic pain and the third focusing on MS.

OUTCOMES MEASURED: The outcomes measured in these …

Is Viscosupplementation Effective In Reducing Osteoarthritis Knee Pain?, Amalia Antonoplos

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not viscosupplementation is effective in reducing osteoarthritis knee pain

STUDY DESIGN: Review of three randomized, double blind, placebo control trials between 2009- 2010

DATA SOURCES: Three randomized, double blind, placebo control trials were found via PubMed and NCBI

OUTCOMES MEASURED: Each randomized control trial measured knee pain and/or patient satisfaction following their intervention (placebo or hyaluronic acid) in patients with knee osteoarthritis, which was measured via WOMAC pain scale and patient global assessment forms.

RESULTS: (P<0.05) for change in pain at 14-26 weeks after injection (NNT=6- 8 for Chevalier et al and 4 for Kul-Panza & Berker). Patient satisfaction was higher in the experimental groups as compared to the control with conclusions of NNT between 11 and 20 for Chevalier et al and Kul-Panza & Berker respectively. Chavelier et al found adverse events such as arthralgias and joint effusion in <10% of their study population (NNH=39). No dichotomous data was presented in Diacoglu et al; however an ANOVA was deemed statistically significant (p<0.01).

CONCLUSION: Review of these articles concludes that the use of hyaluronic …

Is Glyceryl Trinitrate An Effective Treatment For Reducing Visibility Of Anal Fissures In Patients Without Heart Disease Compared To Placebo?, Christopher Deneault

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not topical glyceryl trinitrate is an effective treatment for reducing visibility of anal fissures in patients without heart disease compared to placebo.

STUDY DESIGN: Evidence based review of three randomized controlled trials published in 1999, 2001, and 2007.

DATA SOURCES: Three randomized controlled trials each evaluating the effectiveness of topical glyceryl trinitrate in the treatment of anal fissure, published in the English language, and containing exclusion criteria disqualifying participants with a history of heart disease.

OUTCOMES MEASURED: Healing was measured via visibility of fissure through examination and structured …

Modulation Of Body Weight By Intestinal Flora In Orphan Nuclear Receptor Shp-/- Mice, Ryan Mifflin

Williams Honors College, Honors Research Projects

The whole-body deletion of small heterodimer partner (SHP) in mice is associated with protection from diet-induced obesity and hepatic steatosis upon feeding of a western diet. This protection was reported to be mediated through decreases in hepatic gene expression for lipogenesis, as well as increases in gene expression for fatty acid oxidation. SHP has been known to regulate the expression of the CYP7A1 gene, encoding the rate-limiting enzyme for bile acid synthesis, thereby altering the bile acid pool. The effects of this altered bile acid profile on the gut microbiome are unknown, as some bacteria in the gut are responsible …

Difference In Knowledge Of Mrsa Regarding Sophomore And Senior Baccalaureate Nursing Students, Payton T. Lloyd, Daniel B. Whited, Lori N. Crimaldi

Williams Honors College, Honors Research Projects

Abstract

Background

The risk of infection by antibiotic resistant organisms is a common problem in hospital settings. Methicillin-resistant Staphylococcus Aureus (MRSA) is the most common type of resistant bacteria that can have serious consequences or even lead to death. Nurses' knowledge of how to prevent and treat this problem is essential for patient safety. The purpose of this study is to determine the differences in level of knowledge of MRSA in sophomore and senior level baccalaureate nursing students.

Methods

This descriptive, comparative study will examine differences in knowledge of MRSA between sophomore and senior baccalaureate nursing students and determine if …

Two Related Occupational Cases Of Legionella Longbeachae Infection, Quebec, Canada, Marianne Picard-Masson, Élisabeth Lajoie, Judith Lord, Cindy Lalancette, Geneviève Marchand, Éric Levac, Marc-André Lemieux, Patricia Hudson, Louise Lajoie

Études primaires

Two patients with no exposure to gardening compost had related Legionella longbeachae infections in Quebec, Canada. Epidemiologic investigation and laboratory results from patient and soil samples identified the patients’ workplace, a metal recycling plant, as the likely source of infection, indicating a need to suspect occupational exposure for L. longbeachae infections.

Molecular Basis Of Sex Differences In Cardiac Hypertrophy And Heart Failure, Maya James

Online Theses and Dissertations

Transforming growth factor beta ligands and receptors are known to be pro-hypertrophic and pro-fibrotic factors in the heart, and are known to contribute to the development of cardiac hypertrophy and heart failure. It is well established that premenopausal females possess a lower incidence of these pathologies. We and others have observed a greater level of fibrosis in male hearts compared to female hearts in rodent models of cardiac hypertrophy. It is well established that estrogen is cardioprotective in that it can prevent the development of cardiac hypertrophy, as well as abrogate the development of heart failure following sustained cardiac hypertrophy. …

Development And Evaluation Of A Firefighter Physical Performance Program For Undergraduate Fire And Safety Students, Jessica Ann Moody

Online Theses and Dissertations

The number one on-duty cause of death in the fire service is heart attacks. The International Association of Firefighters and the International Association of Fire Chiefs teamed up to create the Candidate Physical Ability Test (CPAT). Fire departments across the nation will have consistent physical performance tests to hire more physically capable candidates as part of the Wellness-Fitness Initiative (International Association of Fire Fighters, 2014).

Eastern Kentucky University is a nationally recognized school for its fire science program; however students are not required to take educational classes to better prepare them for physical performance tests. Students starting in a training …