Medicine and Health Sciences Commons^™

Obesity: Modern Medicine Vs. Lifestyle, Jenny Christianson

Physician Assistant Scholarly Project Papers

Obesity is a rising epidemic, and is one of the most common, costly and preventable health problems the world is experiencing today (Center for Disease Control and Prevention, [CDC], 2017). From this, it is important to establish an effective treatment plan that can be implemented across the nation for maximum patient benefit. Lifestyle changes such as diet and exercise are important to any health care plan and are equally necessary to reduce health risks. However, in certain patients, lifestyle changes are not enough due to the maladaptive biologic process in their brain. From this, additional treatment options need to be …

Integrative Medicine In Primary Care, Ashley M. Bjornerud

Physician Assistant Scholarly Project Posters

Integrative medicine (IM) is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health (Rakel, 2017). Commonly, IM is associated with complementary and alternative medicine therapies (CAM). These are two separate entities. CAM is one of the modalities used in integrative medicine.

Glycemic Control And Type 1 Diabetes Mellitus: Current Standard Treatment Vs. Closed-Loop Insulin Pumps, Kelsey Daley

Physician Assistant Scholarly Project Posters

As of 2015, 9.4% of the US population had a diagnosis of Diabetes Mellitus (DM). Although most of the data sets studied encompass type 1 (T1) and type 2 (T2) DM data in all ages of patients, the focus of this project will be primarily on T1DM.

There are effective methods currently available for the management of T1DM patients. These methods include: closed-loop insulin pumps that integrate a continuous glucose monitor (CGM) and insulin pump into one effective system that calculates the needed insulin doses through complicated algorithms, CGM with self-blood glucose monitoring calibrations (SBGM) and insulin administration, and SBGM …

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 …

Superior Capsular Reconstruction In The Active Population With A Massive Irreparable Rotator Cuff Tear, Hernandez Emmanuel

Physician Assistant Scholarly Project Papers

The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Early diagnosis and identification of rotator cuff injuries are paramount for the appropriate treatment to be facilitated. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and is a challenging procedure. Historically, treatment options have been limited …

A Bridge Too Far? Risks And Benefits Of Perioperative Bridging Therapy, Jordan Buchholz

Physician Assistant Scholarly Project Posters

The long-term use of oral anticoagulants is common among certain high-risk patient populations for the prevention of thromboembolic events such as stroke, pulmonary embolism (PE), and other systemic events. According to Garwood et al. (2017) it is estimated that 15-20% of chronically anticoagulated patients will undergo a surgery or procedure that will require anticoagulation interruption annually. During this interruption period, “bridging” anticoagulant therapy is often utilized with unfractionated heparin or low-molecular weight heparin to ensure adequate anticoagulation is achieved (Ayoub et al., 2016). However, there has been an ongoing debate whether or not the benefits of perioperative anticoagulant bridging therapy …

Decreased Mortality Of Pulmonary Arterial Hypertension In Duchenne Muscular Dystrophy And Down Syndrome, Mitchell Volin

Physician Assistant Scholarly Project Papers

The genetic cause of significant disorders like Down syndrome (DS) and Duchenne muscular dystrophy (DMD) is well documented. Pulmonary arterial hypertension (PAH), a co-morbid condition, is tied to mortality among these groups. If undetected or untreated, in DS, this condition can lead to complications with coronary and lung disease later in life. If undetected or untreated in DMD it can hasten the inevitable prognosis of the disease. Individuals with the ability to communicate their symptoms and actively participate in treatment are at an advantage with subsequent benefit. DS and DMD significantly decrease physical ability and communication capacity.

Genetic research has …

Integrative Medicine In Primary Care, Ashley M. Bjornerud

Physician Assistant Scholarly Project Papers

Integrative medicine (IM) is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health (Rakel, 2017). Commonly, integrative medicine is associated with complementary and alternative medicine therapies (CAM). These are two separate entities. CAM is one of the modalities used in integrative medicine.

The review of the literature on IM analyzed studies in primary care settings in all parts of the world. Definitions of IM and CAM are evaluated. Defining what IM is and how to incorporate this approach in …

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 …

Glycemic Control And Type 1 Diabetes Mellitus: Current Standard Treatment Vs. Closed-Loop Insulin Pumps, Kelsey Daley

Physician Assistant Scholarly Project Papers

As of 2015, 9.4% of the US population had a diagnosis of Diabetes Mellitus (DM). Although most of the data sets studied encompass type 1 (T1) and type 2 (T2) DM data in all ages of patients, the focus of this project will be primarily on T1DM patients. A thorough review of the current literature reveals that there are effective methods currently available for the management of T1DM patients. These methods include: closed-loop insulin pumps that integrate a continuous glucose monitor (CGM) and insulin pump into one effective system that calculates the needed insulin doses through complicated algorithms, CGM with …

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 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 …

Antibiotic Therapy In Preventing Exacerbations Of Severe Chronic Obstructive Pulmonary Disease, Jamie Trautner

Physician Assistant Scholarly Project Posters

• Chronic obstructive pulmonary disease (COPD) is a progressive disease that has no cure but is treatable. The treatment goal is to have adequate symptom control, decreased exacerbations, prevent hospitalizations and maintain an independent quality of life.

• The review of literature is to determine if the benefits of long-term antimicrobial therapy outweigh the risks in the treatment of severe COPD.

• The gold standard for pharmacotherapy consists of inhaled corticosteroids and bronchodilators (long-acting beta2agonist (LABA).

• Adding azithromycin to standard therapy for patients with frequent exacerbations showed a 27% reduction in exacerbation frequency.

• With prolonged use of antimicrobials …

A Bridge Too Far? Risks And Benefits Of Perioperative Bridging Therapy, Jordan Buchholz

Physician Assistant Scholarly Project Papers

The long-term use of oral anticoagulants is common among certain high-risk patient populations for the prevention of thromboembolic events such as stroke, pulmonary embolism (PE), and other systemic events. According to Garwood et al. (2017) it is estimated that 15-20% of chronically anticoagulated patients will undergo a surgery or procedure that will require anticoagulation interruption annually. During this interruption period, “bridging” anticoagulant therapy is often utilized with unfractionated heparin or low-molecular weight heparin to ensure adequate anticoagulation is achieved (Ayoub et al., 2016). However, there has been an ongoing debate whether or not the benefits of perioperative anticoagulant bridging therapy …

Allergen Specific Immunotherapy And The Effect On Allergy Induced Asthma, Cord Tanner Landrum

Physician Assistant Scholarly Project Papers

Allergies are a major public health problem affecting over 300 million people worldwide (Asamoah et. al). An allergic response can occur when a harmless substance, such as tree pollen, is inhaled into the body and mistakenly identified as a harmful substance. Antibodies then bind to the allergen causing a release of chemicals that leads to symptoms such as nasal congestion, runny nose, itchy eyes or skin reactions. For some people, this reaction can also affect the lungs and airways leading to asthma symptoms.

This review analyzes articles from PubMed, Cochran, Clinical Key and references found from UpToDate articles to assess …

The Effectiveness Of Oral Non-Steroidal Anti-Inflammatories Versus Steroid Injections In Patients With Shoulder Pain, Darren Scott Pledger

Physician Assistant Scholarly Project Papers

Shoulder pain is the third most common musculoskeletal complaint in primary care. Therefore, it is important that we have quality evidenced based treatments to guide clinicians in treating shoulder pain. I examined in this review whether corticosteroid injection into the glenohumeral joint or oral NSAIDs was more effective in reducing shoulder pain as well as the side effects associated with each treatment modality. Search methods included the PubMed and Cochrane databases. Only studies comparing corticosteroid injection and oral NSAIDs were included and not each treatment individually. In conclusion, corticosteroid injections into the glenohumeral joint accelerate pain relief but have equal …

Antibiotic Therapy In Preventing Exacerbations Of Severe Chronic Obstructive Pulmonary Disease, Jamie Trautner

Physician Assistant Scholarly Project Papers

Chronic obstructive pulmonary disease (COPD) is a progressive disease that has no cure but is treatable. The treatment goal is to have adequate symptom control, decreased exacerbations, prevent hospitalizations and maintain an independent quality of life. The above are attainable by lifestyle changes and pharmacotherapy. The review of literature is to determine if the benefits of long-term antimicrobial therapy outweigh the risks in the treatment of severe COPD. The search included PubMed, Cochrane and Clinical Key databases. Keywords searched include: chronic obstructive pulmonary disease, antibiotics, macrolides, antibacterial, azithromycin, bronchodilators, standard therapy, COPD exacerbations, adverse effects, and long-term. The gold standard …

Superior Capsular Reconstruction In The Active Population With A Massive Irreparable Rotator Cuff Tear, Emmanuel Hernandez

Physician Assistant Scholarly Project Posters

The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and can be extremely challenging. Historically, treatment options have been limited for the young population to invasive surgical intervention or conservative measures such as physical therapy and pharmacologic …

The Effectiveness Of Oral Non-Steroidal Anti-Inflammatories Versus Steroid Injections In Patients With Shoulder Pain, Darren Scott Pledger

Physician Assistant Scholarly Project Posters

- The fact that shoulder pain is the most common musculoskeletal complaint in primary care shows that clinicians must have an arsenal of quality interventions to treat this problem.

- The need for quality research and evidenced based guidelines are necessary to educate clinicians on their treatment options, the efficacy of those treatments, and their safety profiles.

Decreased Mortality Of Pulmonary Arterial Hypertension In Duchenne Muscular Dystrophy And Down Syndrome, Mitchell Volin

Physician Assistant Scholarly Project Posters

The genetic cause of significant disorders like Down syndrome (DS) and Duchenne muscular dystrophy (DMD) is well documented. Pulmonary arterial hypertension (PAH), a co-morbid condition, is tied to mortality among these groups. Individuals with the ability to communicate their symptoms and actively participate in treatment are at an advantage with subsequent benefit. DS and DMD significantly decrease physical ability and communication capacity. Genetic research has allowed for earlier identification of, or predisposition for, the development of PAH. Work has also progressed toward manipulation at the genetic level to decrease the severity and even eradicate the cardiopulmonary disorder. This information is …