Medicine and Health Sciences Commons^™

Is Apixaban Effective For The Prevention Of Stroke In Patients With Non-Valvular Atrial Fibrillation?, Amira Moore

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not Apixaban is effective for the prevention of stroke in patients with non-valvular atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published all published in 2011.

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

OUTCOME(S) MEASURED: Outcomes measured were occurrence of stroke (TIA or CVA), systemic embolism, major bleeding or clinically relevant non-major bleeding, and incidence of death.

RESULTS: Apixaban 2.5mg and 5mg were both superior to Warfarin in the prevention of stroke or …

Is Acupuncture Effective In The Prophylaxis Of Recurrent Urinary Tract Infections In Adult Women?, Caitlin E. Mumford

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is effective in the prophylaxis of recurrent urinary infections in adult women.

STUDY DESIGN: Systematic review of three English language primary studies, published between 1998 and 2003.

DATA SOURCES: Three randomized, controlled trials published after 1996, comparing acupuncture to placebo in the prophylaxis of urinary tract infections were obtained using EBSCOhost and PubMed.

OUTCOMES MEASURED: All three studies measured incidence or absence of urinary tract infections, as defined by distal urinary symptoms and/or bacteriuria of ≥ 105 cfu/ml.

RESULTS: Three …

Does Autologous Conditioned Il-1 Antagonist (Acs) Reduce Pain In Patients With Oa Or Lumbar Radiculopathy?, Jonathan Mitchell

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine whether or not Autologous conditioned IL-1 antagonist (ACS) reduces pain in patients with OA or lumbar radiculopathy.

STUDY DESIGN: Review of 3 randomized, double-blind controlled clinical trials in 2007, 2008, and 2009, all in English.

DATA SOURCES: Two randomized, double-blinded controlled clinical trials comparing the effectiveness of intra-articular injections of an autologous IL-1 receptor antagonist solution versus a control in OA and one randomized, double-blinded controlled clinical trials comparing autologous IL-1 receptor antagonist epidural injection versus 5 and 10 mg triamcinolone in patients with lumbar radiculopathy.

OUTCOMES MEASURED: The outcomes in this study …

The Affects Of Music Therapy On Management Of Pain And Anxiety During Burn Dressing Changes, Kush S. Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy improves pain management and anxiety during burn dressing changes.

STUDY DESIGN: Review of three English languages primary randomized controlled trial studies published from 1992-2010.

DATA SOURCES: Three randomized controlled trials studying the affects of music therapy during burn dressing changes were found using PubMed, OVID and Cochrane databases.

OUTCOMES MEASURED: Outcomes measured were level of pain and anxiety experienced by the patients. The severities of these symptoms were measured using a numeric scale system. An analyses of anxiety was measured …

Is Minoxidil Efficacious And Safe For The Treatment Of Androgenetic Alopecia (Aga) In Men, And If So, What Is The Optimal Strength And Means Of Delivery?, Anhthu P. Pickart

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not minoxidil is efficacious and safe for the treatment of androgenetic alopecia (AGA) in men, and if so, what is the optimal strength and means of delivery.

STUDY DESIGN: Review of three double-blind randomized controlled trials studying men (18-49 y/o) with androgenetic alopecia published in English from 2007-2009.

DATA SOURCES: Three articles of double-blind randomized controlled trials found via PubMed.

OUTCOMES MEASURED: Outcomes measured included the efficacy and safety of minoxidil as well as the optimal strength and means of delivery of the …

Is 2% Pirenzephine Gel Effective In Slowing The Progression Of Myopia In Children Aged 7-12 Years Old?, Melissa J. Rivera

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not 2% pirenzepine gel is effective in slowing the progression of myopia in children aged 7-12 years old?

STUDY DESIGN: Systemic review of three primary randomized controlled trials, which were published in 2008, 2004, and 2005.

DATA SOURCES: Multicenter, randomized double masked, placebo controlled, randomized controlled trials (RCT) were found using PubMed, COCHRANE, and OVID databases.

OUTCOMES MEASURED: The outcome, slowing of myopia progression, was measured similarly in all three trials. Progression of myopia was measured via changes in refractory status and spherical …

Is Polydextrose A Beneficial Supplement For Gastrointestinal Health And Maintenance Of A Healthy Body Weight?, Katharine Reilly

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine if polydextrose is a beneficial supplement for gastrointestinal health and maintenance of a healthy body weight

STUDY DESIGN: Review of three English language primary randomized controlled studies published from 2000-2011.

DATA SOURCES: All studies were double blind randomized control trials and found using one search+ and EBSCO host through the PCOM library webpage.

OUTCOMES MEASURED: The outcomes measured in each study were based on subjective evaluations of ease of defecation, ease of stool passage, and feelings of fullness.

RESULTS: Only one of the three …

Are Linoleic Acid Supplements Beneficial In Increasing Growth In Pediatric Cystic Fibrosis Patients?, Sarah M. Saporito

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Are linoleic acid supplements beneficial in increasing growth in pediatric cystic fibrosis patients?”

STUDY DESIGN: Review of three English primary studies published between 1995 and 2000.

DATA SOURCES: Two randomized control trial and one controlled clinical trial were used. Studies were found using PubMed and Cochrane Databases.

OUTCOMES MEASURED: Primary outcomes measured include the taste, smell, and appearance of the supplement and the growth of the cystic fibrosis patients.

RESULTS: In Steinkamp G, Demmelmair et al., the treatment group grew in its weight-for-height; whereas, …

Does The Injection Of Botulinum Toxin Improve Symptoms In Patients With Gastroparesis?, Jillian Solomon

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selected EBM review is to determine whether or not the injection of botulinum toxin improves symptoms in patients with gastroparesis.

STUDY DESIGN: Review of two published, double blind randomized controlled trials and one published, open label pilot study were used for this review, which were found on PubMed.

OUTCOMES MEASURED: The outcome was the change in gastroparesis-associated symptoms, which was measured using the Gastroparesis Cardinal Scale Index (GCSI) and Gastroparesis Questionnaire. In the two double blind, randomized controlled trials by Arts et al. and Friendenberg et al., symptoms were quantified using the …

Does Treatment With Amantadine Increase The Rate Of Improvement Of Cognitive Function In Patients Suffering From Traumatic Brain Injury?, Matthew Voit

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine, “Does treatment with amantadine improve the rate of cognitive function in patients with Traumatic Brain Injury?”

STUDY DESIGN: Review of three English language randomized controlled trials from 1999-2012

DATA SOURCES: Three randomized, placebo-controlled, double blind cross-over trials comparing amantadine to placebo were found using Pub-Med and Cochrane Databases.

OUTCOMES MEASURED: The trials measured the effects of amantadine on command-following, object recognition, functional object use, intelligible verbalization, reliable yes-or-no communication, sustained attention, orientation, attention, memory, executive flexibility, and behavior and used the following assessment tools: Neurobehavioral Rating Scale and DRS (Disability Rating Scale).

RESULTS …

Is Glycolic Acid Safe And Effective In The Treatment Of Mild To Moderate Acne?, Brittany Stokes

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EMB review is to determine whether or not the use of glycolic acid is effective in the treatment of inflammatory and non-inflammatory acne.

STUDY DESIGN: The review of three randomized, double-blind, controlled trials all published in English language between the years of 2008-2010.

DATA SOURCES: Three randomized, double-blind, controlled trails comparing glycolic acid to a visually matched placebo or pharmaceutical therapy in improvement of acne. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: The improvement of inflammatory and non-inflammatory acne and tolerance/ safety of the intervention. Efficacy was …

Is A Low Glycemic Index Diet An Effective Treatment Regimen For Acne Vulgaris In Adolescents And Young Adults Ages 15-30?, Gina C. Tomkus

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a low glycemic index (Low GI) diet is an effective treatment for acne vulgaris in adolescents and young adults ages 15-30.

STUDY DESIGN: Systematic review of two randomized, double blind, placebo controlled clinical trial and one parallel clinical trial published in peer-reviewed journals.

DATA SOURCES: Two randomized double blind clinical trials and one parallel clinical trial published in 2007, 2012, and 2010 respectively. The sources studying the use of a low glycemic index diet as a therapeutic intervention for acne vulgaris were obtained …

Is Dexamethasone Epidural Injection Effective In Relieving Radicular Pain In An Adult Population?, Christine M. Unger

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not dexamethasone epidural injections are effective in treating radicular pain in an adult population.

STUDY DESIGN: Review of three randomized controlled trials, two of which were published in 2012 and one in 2010, all English language.

DATA SOURCES: Three randomized controlled trials comparing dexamethasone epidural injections to saline injections. All articles were found using PubMed, Medline, and OVID.

OUTCOMES MEASURED: Researchers measured pain associated with radicular pain using the Short McGill Pain Questionnaire, Numeric Pain Scale, and Oswestry Disability Index.

RESULTS: All …

Is The Addition Of A Topical Agent To Narrowband Uvb Treatment More Effective In Treating Male And Female Adults With Psoriasis Than Narrowband Treatment Alone?, Colleen M. Wagner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of a topical agent to narrowband UVB treatment is more effective in treating adults with psoriasis than narrowband UVB treatment alone.

STUDY DESIGN: Review of three English language primary randomized trials that were published between 2003 and 2012.

DATA SOURCES: A randomized left-right comparison, placebo controlled clinical trial, a randomized trial, and a randomized placebo controlled, blinded clinical trial each comparing the addition of a topical agent to narrowband UVB treatment to narrowband UVB treatment alone were found using PubMed and …

The Role Of Angiotensinogen In Atherosclerosis And Obesity, Congqing Wu

Theses and Dissertations--Nutritional Sciences

Angiotensinogen is the only known precursor in the renin-angiotensin system, a hormonal system best known as an essential regulator of blood pressure and fluid homeostasis. Angiotensinogen is sequentially cleaved by renin and angiotensin- converting enzyme to generate angiotensin II. As the major effector peptide, angiotensin II mainly function through angiotensin type 1 receptor.

Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and more recently renin inhibitors are widely known as the 3 classic renin-angiotensin system inhibitory drugs against hypertension and atherosclerosis. Here, we developed an array of regents to explore the effects of angiotensinogen inhibition. First, we demonstrated that genetic deficiency of …

Listeria Monocytogenes Can Utilize Both M Cell Transcytosis And Inla-Mediated Uptake To Cross The Epithelial Barrier Of The Intestine During An Oral Infection Model Of Listeriosis, Hilary Denney

Theses and Dissertations--Medical Sciences

The invasive pathways, InlA- and InB-mediated uptake and M cell transcytosis, that Listeria monocytogenes uses to invade the intestine have mainly been studied using infection models that do not truly replicate what occurs during a natural infection. Recently, our lab has developed an oral infection model that is more physiolocally relevant to what occurs during food borne listeriosis. We have sought to evaluate the relative roles of the previously defined invasive pathways, in our oral model of infection. We have done this by utilizing an InlAmCG Lm strain that is able to bind murine E-cadherin, knockout Lm strains, ΔinlA Lm …

Assessing Prevalence Of Known Risk Factors In A Regional Central Kentucky Medical Center Heart Failure Population As An Approach To Assessment Of Needs For Development Of A Program To Provide Targeted Services To Reduce 30 Day Readmissions, Christeen Ivy Broaddus

DNP Projects

Abstract

Objectives:

1. Determine demographic, physiologic, and laboratory characteristics at time of admission of the heart failure (HF) population in a regional acute care facility in Central Kentucky through review of patient electronic medical records.
2. Determine which HF population characteristics are significantly associated with readmissions to the hospital.
3. Provide identification of the statistically significant common characteristics of the HF population to this facility so that they may work towards development of an electronic risk for readmission predictive instrument.

Design: Retrospective chart review.

Setting: Regional acute care facility in Central Kentucky.

Participants: All patients (n = 175) with a diagnosis or history …

Protective Effects Of Aqueous Extract Of Terminalia Arjuna Bark Against Doxorubicin-Induced Cardiotoxicity, Sarah Elizabeth Bishop

Honors Theses

The bark of Terminalia arjuna (TA), a tropical tree, has been used in Ayurvedic medicine for treatment of cardiovascular disease. TA bark is known to contain various antioxidants, and recently it has been suggested to enhance function of the normal heart as an over-the-counter supplement in the USA. The mechanism underlying cardiac actions of TA bark are unknown. Doxorubicin (DOX), a commonly-used anticancer drug, is known to cause cardiotoxicity, a major concern in chemotherapy. The aim of this study is to investigate whether aqueous extracts of TA bark (TAaq) protect the heart from DOX treatment by …

Evaluation Of Tissue-Engineered Tendon Enthesis Polymer Constructs, Joshua A. Bundy Bs, Mary Beth Wade Phd, Hitomi Nakao Md, Phillip Mcclellan Phd, Qing Yu Phd, Robin Jacquet-Childs Ms, William J. Landis Phd

Williams Honors College, Honors Research Projects

Both scientists and clinicians have proposed tissue engineering as the future of medicine. The possibilities for tissue engineering, that is, fabrication of tissues and organs in the laboratory and their translation to patients, appear to be endless, and many believe that this new approach in medicine will result in abolishing many common ailments, injuries, and congenital defects. Injuries to a tendon enthesis, the normal tissue connection between tendon and bone, are of particular concern to clinicians because of their frequency and failure to repair as a result of surgery. While these injuries may not be life threatening, they can certainly …

Does Electroanalgesic Therapy Decrease Neuropathic Pain In Diabetic Patients?, Michelle A. Lee

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not use of electroanalgesic therapy decreases neuropathic pain symptoms in diabetic patients

STUDY DESIGN: Review of a 2 randomized control trial published in 2013 and 2011 published in the English language and an observational study published in 2010 in the German language translated into English.

DATA SOURCES: One randomized, double-blind control trial comparing frequency-modulated electromagnetic stimulation vs placebo in reduction of diabetic neuropathic pain, one randomized, control trial comparing microcurrent transcutaneous electric nerve stimulation vs placebo in reduction of painful diabetic neuropathy and a observational …

Is Aztreonam Lysine For Inhalation Effective In The Treatment Of Patients With Cystic Fibrosis And Pseudomonas Aeruginosa Airway Infection?, Christine Shevchenko

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aztreonam lysine for inhalation is effective in the treatment of patients with cystic fibrosis and Pseudomonas aeruginosa airway infection.

STUDY DESIGN: Review of three English language primary randomized controlled trials published in 2008, 2009, and 2011.

DATA SOURCES: Three randomized, double-blind, placebo-controlled studies using Cochrane and Pubmed databases.

OUTCOMES MEASURED: Patient oriented outcomes measured included change in respiratory symptoms measured by the Cystic Fibrosis Questionnaire-Revised and need for additional anti-pseudomonal antibiotics indicative of pulmonary exacerbation.

RESULTS: In both cystic fibrosis (CF) …

Attenuating Trigeminal Neuropathic Pain By Repurposing Pioglitazone And D-Cycloserine In The Novel Trigeminal Inflammatory Compression Mouse Model, Danielle N. Lyons

Theses and Dissertations--Physiology

Approximately 22% of the United States population suffers from a chronic orofacial pain condition. One such condition is known as trigeminal neuropathic pain frequently reported as continuous aching and burning pain, often accompanied by intermittent electrical shock-like sensations. Dental procedures or trauma are known causes of peripheral trigeminal nerve injury and inflammation. Patients who have this type of facial pain also suffer from emotional distress. For these reasons, trigeminal neuropathic pain needs to be studied in more detail to improve the understanding of the etiology and maintenance of this condition, as well as to develop effective treatment strategies. The first …

Examination Of The Snsag Surface Antigen Gene Family In Sarcocystis Neurona, Ablesh Gautam

Theses and Dissertations--Veterinary Science

Sarcocystis neurona is a protozoan parasite that causes the serious neurologic disease equine protozoal myeloencephalitis (EPM). The life cycle of S. neurona progresses through multiple developmental stages that differ morphologically and molecularly. The S. neurona merozoite surface is covered by multiple related proteins, which are orthologous to the surface antigen (SAG) gene family of Toxoplasma gondii. The SAG surface antigens in T. gondii and another related parasite Neospora caninum are life cycle stage-specific and seem necessary for parasite transmission and persistence of infection. The present research was conducted to explore the gene family of SnSAGs in S. …

The Effects Of Lipoxin A4 (Lxa4) On Neutrophil Biology In Sepsis, Benedict Wu

Graduate School of Biomedical Sciences Theses and Dissertations

During sepsis, neutrophils are inappropriately activated and have prolonged lifespans, thus becoming dysfunctional. Excessive neutrophil activation can lead to tissue injury while neutrophil dysfunction can lead to decreased free radical production and reduced phagocytosis, preventing the host from clearing preexisting infections. Lipoxin A4 (LXA4) is a specialized pro-resolution mediator which reduces neutrophil migration and expression of proinflammatory mediators. Intact neutrophil functions are critical for the host to efficiently clear invading pathogens. The effects of LXA4 on neutrophil function in sepsis have not been established. Using the cecal ligation and puncture (CLP) model of sepsis, LXA4 administered 1 h after sepsis …

Application Of Marginal Structural Models In Pharmacoepidemiologic Studies, Shibing Yang

Theses and Dissertations

Background: Inverse-probability-of-treatment-weighted estimation (IPTW) of marginal structural models was proposed to adjust for time-varying confounders that are influenced by prior treatment use. It is unknown whether pharmacoepidemiologic studies that applied IPTW conformed to the recommendations proposed by methodological studies. In addition, no previous study has compared the performance of different analytic strategies adopted in IPTW analyses. Objectives: This project aims 1) to review the reporting practice of pharmacoepidemiologic studies that applied IPTW, 2) to compare the validity and precision of several approaches to constructing weight, 3) to use IPTW to estimate the effectiveness of glucosamine and chondroitin in treating osteoarthritis. …

Sildenafil And Celecoxib Interact To Kill Breast Cancer Cells, Brittany Binion

Theses and Dissertations

Breast cancer is the second most commonly diagnosed cancer among American women and is responsible for the second highest number of cancer-related deaths. Targeted therapeutic agents sildenafil, a phosphodiesterase type 5 inhibitor, and celecoxib, a cyclooxygenase-2 inhibitor, have been used individually in conjunction with other chemotherapeutic agents to enhance cell killing in a variety of cancers. Sildenafil when combined with traditional chemotherapeutic drugs, such as the taxanes and anthracyclines, or celecoxib combined with traditional hormone therapies have been used to increase cytotoxicity and cell killing. The data presented here demonstrates that the novel combination of sildenafil and celecoxib work together …

Comparison Of Two Different Sprint Interval Training Work-To-Rest Ratios On Acute Metabolic And Inflammatory Responses, Christopher R. Harnish

Theses and Dissertations

High intensity exercise is believed to yield greater results on health and human performance than moderate intensity exercise. Extensive research indicates that not only do high-intensity interval training (HIT) and sprint interval training (SIT) produce significant improvements in cardiovascular fitness and disease, they may be more effective at improving long-term metabolic function, including insulin sensitivity (Si), by producing more mitochondria. Moreover, compliance rates for HIT and SIT participation are reported to be the same or better than traditional moderate intensity exercise. Because lack of time is often cited as major hindrance to exercise participation, SIT is also seen as a …

Novel Therapeutic Strategies For Pancreatic Cancer, Bridget A. Quinn

Theses and Dissertations

Pancreatic cancer is a devastating disease that leaves patients with a very poor prognosis and few therapeutic options. Many of the treatment options available are the same that have been used for almost 2 decades. There is a dire need for both novel treatments for this disease as well as novel strategies of treatment. This body of work will introduce and provide evidence in support of a novel combination therapy for pancreatic cancer treatment, a novel strategy of modifying currently used chemotherapeutics for pancreatic cancer therapy, and a novel transgenic preclinical mouse model of pancreatic cancer. Sabutoclax, an antagonist of …

Evaluating The Antibody Response Against Ospa, Ospc, And Ospe Recombinant Proteins Over Time In Borrelia Burgdorferi Positive Serum Samples, Bridget Dillon

Theses and Dissertations

Lyme disease is the most common tick-borne illness in North America. It can be hard to detect using blood tests, especially in the early stage. Due to the number of significant complications from untreated or undertreated Lyme disease, better methods need to be found to detect the disease. Some surface lipoproteins may be used to detect early disease due to their early expression. Others are maintained for the duration of the infection and can be used to detect chronic Lyme disease. Antibody responses to OspA, OspC and OspE were measured in sera from experimentally infected dogs. The response to OspA …

Ajulemic Acid Induces Cell Death In Retinoblastoma Cells, Emily A. Evans

Honors Theses

Retinoblastoma is a cancer of the retina affecting one in every 15,000-20,000 births. It is normally diagnosed in infancy or early childhood and although it is treatable, enucleation is commonly required. Other treatments include radiation, photocoagulation, or cryotherapy and are often followed by chemotherapy. In an attempt to find an alternate method of treatment that lowers the frequency of enucleation and the serious side-effects resulting from current treatments, ajulemic acid (AJA), a synthetic derivative of Cannabis, has been used to treat retinoblastoma cells. Thus far, significant cell death has occurred among retinoblastoma cells that have been treated with AJA concentrations …