Digital Commons Network^™

Pharmacologic Therapy Versus Catheter Ablation For Atrial Fibrillation, Jahkarius Hargrove

The PA Department Journal of Medical Science

Introduction- Atrial fibrillation is a common type of cardiac arrythmia that affects many people across the world. Patients with atrial fibrillation are at high risk for complications and poor outcomes. Stroke is the most prominent complication of atrial fibrillation if left untreated. The purpose of this clinical review is to analyze which modality is a better first line treatment, antiarrhythmic drug therapy or catheter ablation for long term management of this arrythmia.

Methods- Pubmed was searched with a specific search strategy using key terms “cardiac”, “Arrythmia”, “Antiarrhythmic agents”, “radiofrequency ablation”, and “surgical operation”. Operators and filters such as …

Comparing Autografts And Bioengineered Skin Equivalents In The Management Of Severe Burns, Madison Hill

The PA Department Journal of Medical Science

INTRODUCTION: Severe burns are associated with high morbidity, mortality, and treatment costs, often requiring surgical intervention to restore the skin barrier and prevent complications like infection and hypothermia. Autologous skin grafting is the current gold standard for burn wound closure but may not be feasible in cases of large TBSA injuries with limited donor sites. Bioengineered skin equivalents, including acellular dermal substitutes and cell-based therapies, offer potential benefits in wound healing and scar quality while reducing donor site morbidity. This review evaluates the effectiveness of autografts compared to bioengineered skin equivalents in severe burn management, with a focus on healing …

Extracorporeal Shockwave Therapy For Plantar Fasciitis Pain Reduction, Nathan J. Lopez

The PA Department Journal of Medical Science

Introduction: Plantar fasciitis (PF), aka plantar heel pain (PHP), is a degenerative and debilitating musculoskeletal condition that is prevalent across various populations. There is some debate concerning the hierarchy of second-line treatment options. The purpose of this article is to compare the efficacy, as it relates to pain reduction, of extracorporeal shockwave therapy (ESWT) and other invasive, non-surgical interventions (injections, dry needling, etc.).

Methods: PubMed was searched using a specific search strategy with key terms "extracorporeal shockwave therapy" and "plantar fasciitis". Operators and filters were then applied to narrow results to 4 relevant and quality articles for review. …

Prevention Of The Recurrence Of Skin Cancer With The Use Of Nicotinamide, Ryan A. Reibling

The PA Department Journal of Medical Science

Introduction: Skin cancer is the most common form of cancer worldwide, caused by the accumulation of UV ray exposure that people are exposed to daily. The treatment options for skin cancer are costly and inconvenient, with a high chance of recurrence in different sun-exposed areas. Nicotinamide, a form of vitamin B3, has shown promising outcomes in reducing the chance of recurrent in high-risk individuals. The purpose of this review is to examine recent literature on the effectiveness of nicotinamide supplementation in lowering the risk of skin cancer recurrence compared to individuals who do not take it.

Methods: A comprehensive PubMed …

Post-Surgical Prognostic Outlook Comparison Of Off-Pump Vs. On-Pump Cabg Procedures, Tanner A. Hendricks

The PA Department Journal of Medical Science

Introduction: Coronary artery disease in the United States had 680,981 deaths in 2023 alone with 400,000 CABG procedures being done. Coronary artery bypass grafting is a procedure in which coronary arteries occluded by fatty plaques are revascularized to restore blood flow to the myocardium. There are two effective options for this procedure, one being the on-pump approach, and the other being off-pump. Both methods carry risks, such as stoke and MI, as well as benefits, but the question of which carries the better outlook on mortality and complications is up for debate. The purpose of this paper is to study …

Safety And Efficacy Of Stroke Prevention With Warfarin Vs. Direct Oral Anticoagulants In Patients With Atrial Fibrillation: A Clinical Review, Kenneth L. Gentry

The PA Department Journal of Medical Science

Introduction: Atrial fibrillation is one of the most common cardiac arrhythmias in adults. This condition greatly increases a patient’s risk for ischemic stroke and is responsible for one-third ischemic strokes. Current international guidelines recommend the use of oral anticoagulants for stroke prevention in patients with atrial fibrillation. The purpose of this review is to analyze the current literature directly comparing the safety and efficacy of direct oral anticoagulants and warfarin at preventing stroke.

Methods: The PubMed database was searched for the following key terms: vitamin k antagonist, direct oral anticoagulants, stroke, and atrial fibrillation. Boolean operators and MeSH terms …

Efficacy Of Metformin Compared To Insulin In The Management Of Gestational Diabetes, Sarah Mchale

The PA Department Journal of Medical Science

Intro: Gestational diabetes (GDM) is a condition in which pregnant women are unable to use insulin effectively, leading to increased levels of glucose in the body. Although insulin has traditionally been a first-line pharmacologic treatment for GDM, metformin is increasingly being explored as an alternative. The purpose of this clinical review is to analyze whether metformin could be a safe and effective oral antihyperglycemic option compared to insulin in the treatment of GDM.

Methods: PubMed was searched with a specific search strategy using the key terms “insulin,” “metformin,” “gestational diabetes,” and “blood glucose.” Operator and filters narrowed results to 19 …

Efficacy Of Zuranolone Use For Postpartum Depression, Diana G. Welliver

The PA Department Journal of Medical Science

Introduction: Postpartum depression is a major form of depression that occurs anytime within the first year after a woman gives birth. It is characterized by low moods, increased feelings of sadness and anxiety, and a decreased interest in one’s baby. It is commonly treated with the use of selective serotonin reuptake inhibitors (SSRIs), which present with negative side effects and have a long duration of onset. The purpose of this study is to evaluate the efficacy of zuranolone, a fast-acting neuroactive steroid and GABA-A receptor modulator, on its ability to reduce symptoms of postpartum depression.

Methods: The PubMed database was …

Deep Brain Stimulation For The Management Of Non-Motor Symptoms Related To Parkinson’S Disease, Kyla A. Wallaszek

The PA Department Journal of Medical Science

Introduction: Deep brain stimulation (DBS) is a modern neurosurgical technique where electrodes are implanted in specific brain areas and deliver electrical impulses in order to help regulate abnormal brain activity. DBS is used for the management of several neurological conditions and was approved by the FDA for the treatment of Parkinson’s disease in 2003. The purpose of this review is to analyze the effectiveness of DBS for the management of the non-motor symptoms related to Parkinson's disease.

Methods: PubMed was searched using the key terms “Parkinson disease,” “deep brain stimulation,” “voice,” “sleep,” “mood,” “cognition,” and “dysphagia.” Operators and filters narrowed …

Labor Induction Versus Expectant Management In Postterm Pregnancy: A Clinical Review, Marisa Putrasahan

The PA Department Journal of Medical Science

Introduction: Postterm pregnancy is associated with increased morbidity and mortality of infant and mother. Current practice varies in the management of late- and postterm pregnancies, with much discussion surrounding the risks and benefits of the intervention options provided to pregnant patients. This study aims to review literature comparing the effectiveness of induction of labor (IOL) with elective management (EM) in reducing adverse perinatal and maternal outcomes for pregnant patients approaching postterm.

Methods: A literature search was performed on PubMed using key terms “late term pregnancy,” “induction of labor,” and “expectant management.” Operators and additional search filters narrowed results …

Outcomes Of Surgical Versus Transcatheter Aortic Valve Replacement: A Clinical Review, Grace Stang

The PA Department Journal of Medical Science

Introduction: Surgical aortic valve replacement (SAVR) has been the predominant

treatment for aortic stenosis (AS) for decades. However, transcatheter aortic valve replacement (TAVR) is becoming increasingly popular. Originally, TAVRs were only performed on patients who were deemed high-risk for surgery and would have died without the valve replacement. The purpose of this paper is to determine if TAVR or SAVR has better health outcomes for all patients no matter their surgical risk.

Methods: A search via PubMed database was done using the key words “aortic stenosis”, “surgical aortic valve replacement”, “transcatheter aortic valve replacement”, and “mortality.” Additional search filters were …

Efficacy And Safety Of Semaglutide In Adults Without Diabetes Who Are Overweight Or Obese, Rebecca Petty

The PA Department Journal of Medical Science

INTRODUCTION:

Obesity is associated with an increased risk of cardiovascular and metabolic disorders and contributes to the leading cause of death in the US — heart disease. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) have recently emerged as a treatment option for obesity. The purpose of this clinical review is to evaluate the efficacy and safety of semaglutide in adults without diabetes who are overweight or obese.

METHODS:

PubMed was searched using a precise search strategy and the key terms “semaglutide,” “weight loss,” and “without diabetes.” Results were filtered and narrowed using specific inclusion and exclusion criteria. Four high-quality studies were …

“Ecmo Anticoagulation: Should We Consider Bivalirudin Over Heparin?”, Confidence Paul

The PA Department Journal of Medical Science

Introduction: Extracorporeal membrane oxygenation (ECMO) requires systemic anticoagulation to prevent thrombotic events within the circuit. The use of unfractionated heparin has been the traditional anticoagulant of choice. Bivalirudin, a direct thrombin inhibitor, offers an alternative that has theoretical and observed benefits. The purpose of this clinical review is to evaluate whether bivalirudin provides superior safety and efficacy compared to UFH in ECMO patients.

Methods: PubMed was searched with a specific search strategy using key terms “Extracorporeal membrane oxygenation” AND “indirect anticoagulants” AND “deep vein thrombosis”. Operators and filters narrowed the results to four relevant, quality articles for review.

Results: In …

Effects Of Angiotensin-Converting Enzyme Inhibitors And Angiotensin Receptor Blockers On Covid-19 Outcomes In Severely Ill Patients, Madison L. Edwards

The PA Department Journal of Medical Science

Introduction: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the virus SARS-CoV-2 and can cause debilitating illness in vulnerable patient populations. The purpose of this clinical review is to analyze the effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the clinical course and severity in COVID-19 adult patients.

Methods: PubMed was searched with a specific search strategy using key terms “adult,” “COVID-19,” and “RAAS inhibiting medications.” Specific operators and filters narrowed the results to a total of five relevant, quality articles for review.

Results: Two articles were randomized controlled trials that directly compared the continuation of …

Comparison Of Vagal Maneuvers And Antiarrhythmics On Adult Patients Presenting With Supraventricular Tachycardias (Svt), James S. Ng

The PA Department Journal of Medical Science

INTRODUCTION: SVT is a well-known and potentially life-threatening arrhythmia, with vagal maneuvers and/or antiarrhythmic drugs often attempted for first-line conversion. The purpose of this clinical review is to analyze the relative effectiveness and success rates of these specific maneuvers and medications.

METHODS: The following PubMed database search was performed:“((vagal maneuver*) OR (valsalva)) AND (pharmacologic) ((medication) OR (medical therapy) OR (adenosine) OR (beta blocker*) OR (calcium channel blocker*) OR (anti-arrhythmic*) OR (anti arrhythmic*) OR (antiarrhythmic)) AND ((SVT) OR (supraventricular tachycardia))”. Filters were then applied and article titles/abstracts reviewed, resulting in a final selection of five articles for review.

RESULTS:. The most …

The Effects Of A Gluten-Free Diet On Patients With Hashimoto’S Thyroiditis, Chandler Blackburn

The PA Department Journal of Medical Science

Introduction: Hashimoto’s thyroiditis is a chronic autoimmune inflammatory condition of the thyroid gland. Hashimoto’s occurs in five percent of the American population and is the most common cause of hypothyroidism in the US. There are various comorbidities associated with Hashimoto’s, which treatment can help mitigate some of those risks. The purpose of this paper is to evaluate if a gluten-free diet, as an adjunct treatment, can lower autoimmune related antibodies while improving thyroid labs levels.

Methods: PubMed was searched for clinical reviews using key terms “Hashimoto’s disease”, “hypothyroidism”, “gluten”, and “anti-TPO antibodies”. Operators and additional filters narrowed down search results …

Monotherapy Versus Combination Levothyroxine And Liothyronine In The Treatment Of Hypothyroidism, Anne F. Thomas

The PA Department Journal of Medical Science

Introduction: Primary hypothyroidism is a common condition where the thyroid gland cannot produce free thyroxine (T4), leading to low serum levels of it. For this reason, it is often treated directly with monotherapy synthetic T4 or as a combined synthetic T4/T3. The purpose of this clinical review is to analyze the effectiveness of T4 monotherapy versus T4/T3 combination therapy in normalizing TSH values and improving symptoms in adults with hypothyroidism.

Methods: A specific search strategy in PubMed was used to conduct the research, incorporating key terms such as “hypothyroidism,” “levothyroxine,” “liothyronine,” and “TSH.” Four quality articles were left for final …

Modern Approaches To Mental Health: App-Based Cbt Versus Traditional Psychotherapy, Samira Shende

The PA Department Journal of Medical Science

Background: Digital mental health tools are becoming widely used as flexible alternatives to in-person therapy. A key question is how effective they are compared to traditional therapy for people with depression and anxiety.

Objective: To compare how effective digital interventions, like app-based CBT or telehealth, are compared to in-person psychotherapy in reducing symptoms of depression and anxiety in adults.

Methods: A structured PubMed search was conducted using specific search terms, limited to English-language randomized controlled trials, systematic reviews, and meta-analyses published between 2020 and 2025. After screening 116 articles, four high-quality studies were selected for review.

Results: Of the four …

Epinephrine In Cardiac Arrest: Is It Enough?, Zachary Gusler

The PA Department Journal of Medical Science

Introduction: Epinephrine has long been the clinical mainstay of pharmacologic treatment for cardiac arrest management. It provides both α- and β-adrenergic receptor activation. However, at higher dosages, it may lead to sympathetic overload, oxidative stress, and cardiac myocyte apoptosis. The purpose of this paper is to evaluate the rates of ROSC (return of spontaneous circulation) with in-hospital cardiac arrest between epinephrine monotherapy and VSE (vasopressin, steroid, and epinephrine).

Methods: A search via PubMed database using the keywords “Cardiac arrest” AND “VSE” AND “Vasopressor monotherapy” with additional specifiers resulted in 30 articles. 26 articles were removed due to study type and …

Efficacy Of Catheter Ablation Compared To Antiarrhythmic Drug Therapy In Atrial Fibrillation, Sarah Mckinney

The PA Department Journal of Medical Science

Introduction: A-fib occurs when the electrical signals in the heart become unorganized and unsynchronized, resulting in an irregularly irregular heart rate. This can increase the risk of blood clots and stroke. The purpose of this paper is to explore two of the most common treatment options, comparing the efficacy of catheter ablation to AAD (antiarrhythmic drug) therapy in adults diagnosed with atrial fibrillation.

Methods: PubMed was searched using the keywords “atrial fibrillation,” “catheter ablation,” and “antiarrhythmic.” Operators and filters yielded a final result of 159 articles; four articles that most closely aligned with the focus of this research were reviewed. …

Hyaluronic Acid Versus Corticosteroids In Osteoarthritis Of The Knee, Victoria B. Short

The PA Department Journal of Medical Science

Introduction: Osteoarthritis is a very common degenerative disease seen in older adults that is typically due to repetitive movements of the joints over time. Without treatment, osteoarthritis can progress and cause individuals to have decreased function and quality of life. The purpose of this review is to evaluate the effectiveness of hyaluronic acid injections compared to corticosteroid injections in treating osteoarthritis of the knee.

Methods: PubMed was searched with a specific search strategy using key terms “knee osteoarthritis”, “hyaluronic acid”, and “corticosteroids”. Operators and filters were applied to narrow 572 results down to 40. 15 articles were reviewed and 4 …

Injection Or Ingestion: A Comparative Review Of Antipsychotic Delivery Methods And Patient Outcomes In Schizophrenia, Jeffrey K. Fear

The PA Department Journal of Medical Science

Introduction: Schizophrenia is a chronic psychiatric disorder that causes significant functional impairment and decreased quality of life for those who suffer from it. The purpose of this review is to compare the use of long-acting injectable (LAIs) antipsychotics with oral antipsychotic medications and to evaluate which treatment modality provides more favorable outcomes in terms of symptom control, adherence, and relapse prevention.

Methods: PubMed was searched to find articles examining the efficacy of both long-acting injectables and oral antipsychotics, and why long-acting injectables are becoming the preferred method of delivering treatment to patients suffering from schizophrenia. Four articles were selected for …

Glp-1 Agonists For Pediatric Obesity: A Clinical Review, Grace Burgin

The PA Department Journal of Medical Science

Introduction: Pediatric obesity is a chronic disease with multiple complex causes and many potential consequences if carried into adulthood. Lifestyle modifications alone have not been effective for all patients in the treatment of pediatric obesity. GLP-1 RAs already being prescribed in the adult population were also recently approved for pediatric patients. The purpose of this clinical review is to analyze the efficacy of GLP-1 RAs in decreasing markers associated with obesity, such as BMI, cholesterol, etc. in pediatric patients diagnosed with obesity.

Methods: PubMed was first searched using synonyms of the keywords “pediatric obesity,” “GLP-1 agonists,” “lifestyle modifications,” and “biomarkers …

The Gut Microbiome’S Effect On Metabolic Syndrome, Kayla Turner

The PA Department Journal of Medical Science

Introduction: Metabolic Syndrome (MetS) is a chronic condition characterized by insulin resistance and low-grade inflammation. The purpose of this review is to focus on pre-/pro/symbiotic supplementation as a means of improving MetS parameters in place of pharmacological intervention.

Methods: PubMed was searched with the terms “metabolic syndrome”, “obese”, “obesity”, “overweight”, “insulin resistance”, “insulin sensitivity”, “probiotic”, “symbiotic”, and “bifidobacter*”. Operators and filters narrowed the results down to 55 results, 4 of which were picked due to their relevance and quality.

Results: The 4 articles chosen were RCT and a systematic review that explored the Bifidobacterium genus in relationship to the MetS …

Pharmacological Management Of A Spinal Cord Injury: A Review, Victoria A. Sumner

The PA Department Journal of Medical Science

Introduction

A spinal cord injury results from damage to the cord itself. People who experience such an injury often live with pain for the rest of their lives. This review aims to compare the effectiveness of gabapentin versus tramadol in managing post-spinal cord injury pain.

Methods

A search using the key terms “spinal cord injury,” “gabapentin,” and “tramadol” was conducted on PubMed. Five relevant results were identified after applying operators and filters to narrow down the articles. Of those five articles, four were reviewed in this analysis.

Results

All four articles directly compare gabapentin to a test substance. Three of …

Understanding The Efficacy Of Photodynamic Therapy In Comparison To Topical Therapies In Treating Actinic Keratosis In Those At Increased Sun Exposure Risk, Tatum R. Mcbride

The PA Department Journal of Medical Science

Introduction: Actinic keratoses are precancerous skin lesions that arise secondary to increased sun exposure. These lesions have a propensity to transform into non-melanoma skin cancers, mainly squamous cell carcinoma, if left untreated. There are a multitude of different treatment options for the prevention and clearance of these lesions. Among these options is photodynamic therapy (PDT). The purpose of this paper is to investigate the effectiveness of PDT when compared to other options for AK treatment.

Methods: A search was conducted using PubMed for studies to analyze the efficacy of PDT when compared to other treatment options. 3 articles were selected …

Psilocybin Treatment For Refractory Depression: A Clinical Review, Hailey A. Jensen

The PA Department Journal of Medical Science

Introduction:

Depression is a widespread mental illness that affects a large portion of the world population and many of those who suffer from depression are resistant to treatment currently available. The purpose of this review is to compare the efficacy of psilocybin to the current available methods for the treatment of refractory depression.

Methods:

PubMed was searched with the key search terms: resistant depression, psilocybin therapy, and adults. Operators and filters narrowed down the search to 43 results. Four articles were then chosen based on quality and specificity with this review.

Results:

The articles included in this review compare the …

Hyaluronic Acid For The Treatment Of Knee Osteoarthritis: A Clinical Review, Victoria G. Morrison Cerda

The PA Department Journal of Medical Science

Introduction: Osteoarthritis of the knee (KOA) is a progressive degenerative disease of the knee joint characterized by knee pain and limited knee function which negatively impacts activities of daily living. Effective and safe IA treatments are needed to meet the needs of an ever-increasing population of those living with KOA. This clinical review aims to assess the effectiveness of IA hyaluronic acid compared to corticosteroids for pain management in KOA.

Methods: PubMed was searched using the key terms “hyaluronic acid injection”, “knee osteoarthritis”, “corticosteroid injection”, and “pain relief”. Modifiers and operators were applied, and results were narrowed to four relevant …

Beyond Steroids: A Head-To-Head Review Of Hyaluronic Acid And Prp In Knee Osteoarthritis, Phillip A. Sekander

The PA Department Journal of Medical Science

Introduction: Osteoarthritis of the knee is one of the most common primary complaints in the US. Newer injectable therapies that target specific cartilage degeneration are being developed. The purpose of this review is to compare the efficacy of PRP and HA injections for the management of knee osteoarthritis.

Methods: PubMed was searched using the key terms “osteoarthritis of the knee,” “hyaluronic acid,” “platelet-rich plasma,” and “management of pain.” This search was refined using MeSH terms, Boolean operators, and applied filters (English, free full-text, publication date between 2020-2025). Four articles were selected for in-depth review of the efficacy of platelet-rich plasma …

Gluten-Free Diet For Patients With Hashimoto's Thyroiditis: A Clinical Review, Sallie Young

The PA Department Journal of Medical Science

Introduction: Hashimoto’s thyroiditis (HT) is the most common cause of hypothyroidism worldwide. Although levothyroxine remains the standard treatment for hypothyroidism caused by HT, interest has grown in dietary interventions, particularly gluten-free diets (GFDs), as a means of reducing thyroid autoimmunity and improving clinical outcomes. The purpose of this clinical review is to analyze the effectiveness of GFD on improving thyroid autoantibodies in patients with HT.

Methods: PubMed was search with a specific search strategy using key terms “Hashimoto’s thyroiditis”, “autoimmune hypothyroidism”, “Hashimoto’s” and “diet”. Operators and filters narrowed results to sixteen. Four studies met the inclusion criteria, including …