Medicine and Health Sciences Commons^™

In Patients With Cardiac Arrest, Does Early Defibrillation Reduce Mortality?, Nicholas Lueddecke

Theses and Graduate Projects

Background: Cardiac arrest is a devastating disorder that affects millions of people each year. Often having a sudden onset, cardiac arrest is almost certainly lethal if prompt treatment is not started. In hopes to both better understand how treatment of cardiac arrest has evolved and to quantitatively measure the outcome of defibrillation, multiple pieces of literature have been reviewed.

Methods: Articles were found that were pertinent by using PubMed and Google Scholar. Literature was obtained that researched a wide spectrum of topics relating to defibrillation and cardiac arrest that did not focus on traumatic cardiac arrests as it is beyond …

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft In The Treatment Of Multivessel Coronary Artery Disease On Diabetes Mellitus Patients, Nguyen Vu

Theses and Graduate Projects

Objectives: This systemic review is conducted to compare between Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG) in the revascularization strategy of patients with diabetes mellitus (DM) and multivessel coronary artery disease (CAD) based on clinical outcomes.

Background: Diabetes mellitus approached epidemic proportions globally and was recognized as a risk factor of aggressive and multivessel CAD [1,2]. The controversy over the optimal revascularization strategy for patients with DM and multivessel CAD has been hotly debated for more than 10 years. Numerous studies and data analysis were conducted to compare between PCI and CABG based on clinical outcomes of …

What Is The Most Effective Management For Patients With Concomitant Gallstones And Bile Duct Stones?, Stephanie Mccarney

Theses and Graduate Projects

Background: Gallstone disease is common with a high prevalence in developed nations and is expected to rise as the obesity and metabolic syndrome epidemic worsens. The associated relationship between gallstone and biliary tract disease is complex. The most effective treatment approach for patients with concomitant gallstones and bile duct stones is controversial. Multiple different combinations of one-step and two-step endoscopic and/or surgical techniques exist. Advancements in laparoscopic and endoscopic methods have paved the way for a minimally invasive approach to managing cholecystocholedocholithiasis (CCL).

Methods: A literature review was conducted via systematic search of Google Scholar and PubMed to …

Does Transitioning To An Omi/Nomi Model For The Evaluation Of Acute Coronary Syndrome In Adult Emergency Department Patients Improve Outcomes Compared To Contemporary Stemi/Nstemi Model?, Ismar Terzic

Theses and Graduate Projects

Acute coronary syndrome (ACS) continues to be the most common cause of death in the United States, and nearly every 34 seconds one American has a coronary event. Based on 12- lead electrocardiogram (ECG) findings myocardial infarction (MI) patients are treated, according to guidelines, emergently with reperfusion therapy if presenting with ST elevation myocardial infarction (STEMI), versus delayed revascularization if presenting with non-ST elevation myocardial infarction (NSTEMI). However, the evidence shows there is a lack of recognition of which patients require immediate catherization utilizing the current guidelines. In recent years, approximately 70% of acute MI (AMI) patients are classified as …

Platelet-Rich Plasma Vs. Traditional Surgical And Nonsurgical Interventions For Rotator Cuff Tendinopathies, Nick Slingerland

Theses and Graduate Projects

Background: Rotator cuff tendinopathies present as one of the most common musculoskeletal injuries of the upper extremity. The rotator cuff consists of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis with the supraspinatus the most injured of the group. Over time, variations regarding treatment through surgical or nonsurgical interventions have remained constant. In recent years, the use of platelet-rich plasma (PRP) as an additional alternative has become popular to promote healing and improve functionality of the shoulder. The purpose of this clinical review using various study designs is to assess if the platelet-rich plasma injections are more effective when …

What Are The Most Effective Risk Factor Management Strategies For The Prevention And Control Of Hypertension?, Sherlyne Barasa

Theses and Graduate Projects

Hypertension (HTN) affects millions of people globally. With the rising burden of HTN in primary care and its associated morbidity and mortality, it is necessary to explore effective risk factor management to control and prevent it in people most at risk. This research addressed both modifiable risk factors such as obesity, smoking, alcohol, and diet as well as non- modifiable risk factors such as age, race/ethnicity, and family history. The aim of this paper was to examine the most effective risk factor management strategies to control and prevent hypertension. The studies reviewed indicate that there are various risk factor management …

Continuous Glucose Monitoring: Optimizing Type 1 Diabetes Management In Older Adults, Alyssa Clements

Theses and Graduate Projects

Introduction: Type 1 diabetes (T1D) impacts many individuals around the world. Treatment goals of T1D include lowering hemoglobin A1c (HbA1c) values while minimizing the time spent in hypoglycemia. Frequent glucose monitoring is required to achieve optimal glycemic control.

Background: HbA1c has been used for many years to track glycemic control. When discussing care of older adults, hypoglycemia is a more important marker to track. The risks associated with hypoglycemia are higher among older adults with T1D than the general population. Multimorbidity, polypharmacy, and age-related mental decline increase the likelihood and danger of severe hypoglycemic episodes. Self-monitoring blood glucose (SMBG) provides …

What Treatment And Prevention Options Are The Most Effective For Elbow, Knee, And Plantar Tendinopathies?, Cody Lawson

Theses and Graduate Projects

Objective: Tendinopathies of the upper and lower extremity are one of the most common injuries in athletes and non-athletes in the United States. This literature review aimed to determine the most effective preventions and treatments for patients with tendinopathies.

Methods: A literature search was conducted primarily through Google Scholar and PubMed, for articles related to effective preventions and treatments for tendinopathies.

Discussion: Based on the literature review, there were multiple effective treatments and preventative measures for tendinopathies in the upper and lower extremity. The most effective preventative measures consisted of risk factors, dynamic warmups, and prevention programs. Treatments were broken …

Pain Reduction In Chronic Lumbar Patients Using Spinal Cord Stimulation, David Botros

Theses and Graduate Projects

Background: Spinal cord stimulation (SCS) is commonly used to treat chronic neuropathic pain. A common indication for the SCS is failed back surgery syndrome (FBSS). There are many interventional approaches to treating lumbar pain; however, the SCS may provide the greatest benefit in terms of health care utilization and overall pain relief to the patient.

Objective: The goal of this paper is to assess the effectiveness of SCS compared to conventional therapies such as physical therapy, oral medications, radiofrequency ablations (RFA), epidural steroid injections (ESI), and intrathecal pain pumps (IT pain pump) in patients with chronic lumbar pain due to …

What Is The Effect Of Physical Activity On The Reduction Of Macrovascular Complications In Patients Diagnosed With Type 2 Diabetes Mellitus?, Rachael M. Gordon

Theses and Graduate Projects

The increasing prevalence and healthcare burden of type 2 diabetes is a worldwide concern. It is the seventh leading cause of mortality and a significant cause of morbidity. While both the macrovascular and microvascular complications of diabetes can have a profound impact on overall health and quality of life, cardiovascular events are the leading cause of mortality in patients with type 2 diabetes. Adults with diabetes have a two to four-fold increased risk of cerebrovascular events and myocardial infarctions. Oral medications combat insulin resistance and aid in the control of hemoglobin A1c, blood pressure, and cholesterol, therefore, contributing to a …

Umbilical Cord Clamping: How Timing Affects Infant Health Outcomes, Lauren Snell

Theses and Graduate Projects

The timing of umbilical cord clamping is commonly seen as an innocuous act. Many providers simply cut the cord as soon as they see fit without consideration as to what the impacts of this may be. Early umbilical cord clamping was initially considered a preventative measure for postpartum hemorrhage, but this myth has since been debunked. Now, the practice is still commonly implemented, but for reasons unknown. Delaying the clamping of the umbilical cord is thought to not only provide no risk to the mother but provide benefit to the newborn in relation to their fetal to adult physiologic transition. …

Outcomes Of Elective Abdominal Aortic Aneurysm Management: Open Surgical Versus Endovascular Repair, Chelsea Armbruster

Theses and Graduate Projects

Introduction: Abdominal aortic aneurysm (AAA) is a disease with high mortality and morbidity. Evidence-based screening guidelines and elective repair options are crucial to mitigate the risk of rupture. Two primary techniques exist in the treatment of AAA. The open surgical repair method was standard of care until introduction of endovascular aneurysm repair in the 1990s. Endovascular aneurysm repair has become the mainstay of treatment of abdominal aortic aneurysms due to its minimally invasive approach and improved perioperative outcomes. Long-term overall survival outcomes are similar between the two approaches.

Methods: A systematic search of PubMed was conducted to review relevant articles …

In Patients With A Ruptured Anterior Cruciate Ligament, Does An Autograft Versus Allograft Reconstruction Provide Superior Post- Operative Outcomes?, Aaron Karo

Theses and Graduate Projects

Background: The literature surrounding anterior cruciate ligament (ACL) reconstruction (ACLR) exhibits the most commonly used grafts for a ruptured ACL are bone-patellar tendon-bone (BPTB) autografts, quadriceps tendon (QT) autografts, hamstring tendon (HT) autografts, and allografts. This paper was designed to compare the postoperative outcomes between autografts and allografts to determine which graft is superior.

Methods: A literature review of studies were searched and selected based on inclusion and exclusion criteria using Augsburg University Interlibrary loan system, PubMed, and Elsivier.

Results: The research demonstrates superior outcomes for autografts compared to allografts. Additionally, the research delineates outcomes based on the type of …

In Adults Suffering Acute Large Cerebral Vessel Occlusion, Is Direct Mechanical Thrombectomy More Effective Than Treatment With Tpa For Reducing Long-Term Morbidity?, Collin Barry

Theses and Graduate Projects

Background: Discussion whether intravenous tPA or mechanical thrombectomy is the ideal choice for treatment of acute ischemic strokes has been debated around the medical community for last three decades. However still, after several clinical trials, it is still unclear if one is superior to the other.

Methods: This meta-analysis pooled several different results from studies revolving around treatment of acute ischemic stroke. The goal of this paper was to evaluate whether previous clinical trials favoring mechanical thrombectomy had sufficient research to prove it is superior to treatment with tPA in reducing long-term morbidity. Primary outcomes measured were the modified Rankin …

How Do Modifiable Risk Factors Impact The Progression Of Alzheimer’S Disease?, Shamso Jama

Theses and Graduate Projects

Alzheimer’s disease remains a significant health burden that affects millions in the United States. This research pursued to shed light on the modifiable risk factors and help individuals at high risk for Alzheimer’s disease minimize the chances of cognitive decline. A search of literature was conducted on databases such as PubMed, Google Scholar, and Medline. Randomized control trials, longitudinal studies, systematic reviews, and meta-analyses were identified and included in the paper. The modifiable risk factors that play a role in the onset and progression of Alzheimer’s disease include stress, inadequate physical exercise, lack of sleep hygiene, and lack of social …

An Overview Of Individualized Management Of Neuropsychiatric Symptoms In Dementia, Megan B. Knoll

Theses and Graduate Projects

Background: It is estimated that about 11% of adults 65 and older have dementia in the United States. Neuropsychiatric symptoms are common in the presentation of dementia. These symptoms often result in increased morbidity and mortality, negative patient outcomes, caregiver burden, institutionalized care, and diminished quality of life. The focus of this paper is to analyze the therapeutic effectiveness of nonpharmacologic interventions in the management of neuropsychiatric symptoms of dementia.

Methods: A literature review was conducted to critique current evidence on the use of nonpharmacologic interventions in managing neuropsychiatric symptoms in older adults with dementia. Searches were performed using PubMed, …

Promoting Wellness For College Athletes Through Mindfulness Meditation, Lisa R. Braatz

Theses and Graduate Projects

The practice of mindfulness meditation may be beneficial for college athlete’s mental health and wellness. College athletes are in a period of significant personal growth and experience high amounts of stress related to athletic performance, academics, and peer relationships. Integrating mindfulness meditation for college athletes has been linked to improving relaxation, concentration, and performance while decreasing fatigue and negative emotions related to fear or anxiety. This scholarly project explores the implementation of four mindfulness meditation sessions on perceptions of stress, mental focus, athletic performance, and presence in female college track and field athletes. The participants were attending an urban college …

Occupational Radiation Exposure Health Risks And Radiation Safety Practices Relative To Interventional Cardiology Providers, Brandon Young

Theses and Graduate Projects

Background: Occupational radiation exposure is a health risk for many healthcare professionals working in interventional cardiology. As technology has progressed, interventional procedures have become more complex and subsequently longer in radiation exposure duration, resulting in a need for radiation safety practices to meet the ever growing demands of the interventional team and ideally outpace these demands.

Methods: A comprehensive systematic literature review was conducted using PubMed. Articles on the health risks of occupational radiation exposure were selected to demonstrate the breadth of potential adverse effects of radiation exposure with less focus on the depth of these effects. Articles covering occupational …

Ethically Addressing Vaccine Hesitancy In Pediatric Populations, Tommie L. James Iii

Theses and Graduate Projects

Vaccines are highly regarded in the scientific and medical community for their efficacy in the prevention of disease; yet the prevalence of misinformation and mistrust surrounding vaccines is growing in communities around the world. Specifically observed in the United States (US) as an increase in vaccination exemption rates, this trend of vaccine hesitancy is leading to an increasing number of parents and caregivers to either refuse or delay vaccinations from the recommended schedule. As a result, an increasing number of outbreaks of diseases such as measles and pertussis, thought to be on the verge of elimination, have spiked. While health …

A Literature Review: An Analysis Of The Widespread Effects Of Solitary Confinement/Social Isolation On Mental Illness And Mortality, Taneasha Muonio

Theses and Graduate Projects

Solitary confinement or isolation is widespread globally and has been used as a form of punishment, reform, reflection, and cleansing throughout time. The devastating impacts of not having social interactions for extended periods of time have been documented and noted.1 These impacts include severe mental health disorders such as schizophrenia, bipolar disorder, anxiety, depression, post-traumatic stress disorder (PTSD), suicide, motor disturbances, biological changes, and increased mortality.1-3 The analysis of how the United States became the country with the largest prison system and mentally ill population is addressed in this thesis including understanding how the prison-industrial complex was built. Understanding how …

New Treatment Options For Concussions Using Hyperbaric Oxygen Therapy, Crystal Amundson

Theses and Graduate Projects

Background: Millions of Americans experience concussions every year. With new attention from the media looking into the long-term sequela of concussions, more research and studies are initiated to find an effective treatment. Concussions happen after an impact to the head or body that causes a pathologic disruption in normal brain function. Symptoms most commonly associated with the trauma are headaches, emotional distress, vestibular disturbances and sensitivity to light. Historically, treatment has been physical and cognitive rest.

Methods: A systematic search of PubMed was performed to identify articles pertaining to the use of hyperbaric oxygen therapy in concussions and traumatic brain …

The Presence And Prognosis Of Acute Kidney Injury And Renal Abnormalities In Hospitalized Sars-Cov-2 Patients, Mara Waaraniemi

Theses and Graduate Projects

SARS-CoV-2, a novel coronavirus reached pandemic status by the World Health Organization in the spring of 2020. As a novel virus, analysis of the early literature on the clinical manifestations of SARS-CoV-2 is imperative to help guide clinical practice and inform future research. Early studies about the clinical manifestation of the virus showed a proportion of hospitalized patients developing renal abnormalities and AKI. This paper analyzed literature through searching the PubMed database to assess whether renal abnormalities and AKI were present in hospitalized SARS-CoV-2 patients, how the renal abnormalities manifested themselves in patients, and the associated treatment and prognosis of …

The Great Flood: An Exploration Of Fluid Resuscitation In Sepsis, Adam Olsson

Theses and Graduate Projects

Sepsis and septic shock continue to be major causes of in-hospital mortality. The World Health Organization (WHO) declared sepsis as a global health top priority as of 2017. To combat sepsis mortality, the Surviving Sepsis Campaign (SSC) released the first set of guidelines in 2004 and continues to publish treatment guidelines, updating the guidelines every four years based on emerging evidence. The 2018 update to the 2016 guidelines contains an Hour-1 Bundle released by the SSC, which includes a rapid infusion of a 30 ml/kg fluid bolus as a strong recommendation with low quality evidence. Recently, studies have challenged this …

Does An Acl Autograft, Allograft Or Synthetic Graft Lead To Improved Long Term Knee Stability?, Parker Lanoue

Theses and Graduate Projects

Current literature surrounding anterior cruciate ligament (ACL) reconstruction outlines four primary classes of grafts used to replace the existing ACL. These classes include bone-patellar tendon-bone (BPTB) autografts, hamstring tendon (HT) autographs, allografts and synthetic grafts. Research has been conducted on each of these primary ACL reconstruction strategies and through this research we are looking to answer the question on which of these classes of ACL grafts in turn leads to the most improved long-term knee stability. In addition to analyzing these classes of grafts we will also inspect options along the non-surgical route to ACL repair, a more conservative approach, …

Medical Treatment Of Diabetes Compared To Bariatric Surgery, Daniel Thornley

Theses and Graduate Projects

In this retrospective review, metabolic factors present in diabetic patients who underwent bariatric surgery were compared against those who were treated with medical therapy alone. These factors include: diabetes remission, glycosylated hemoglobin levels, medication use, changes in beta cells function, insulin sensitivity, incretin levels, weight loss, lipid profiles and blood pressures. Following bariatric surgery, patients observed superior changes in diabetes remission rates, glycosylated hemoglobin levels, medication use, beta cell function, insulin sensitivity, incretin levels, and weight loss when compared to those who were treated with medical therapy alone. Blood pressure changes were not significantly different among the two treatment groups. …

Does Administration Of Antipsychotic Medications Reduce The Incidence And Duration Of Delirium In Critically Ill Adult Patients?, Ellen Brateng

Theses and Graduate Projects

Background: Acute delirium is a common complication among critically ill patients. Besides the manifestation of distressing symptoms, delirium can result in negative patient outcomes. Several studies show that antipsychotics such as haloperidol are one of the most commonly used interventions for delirium despite large variability and lower quality of evidence available to advocate for their use.

Methods: A literature review was conducted to investigate current evidence on the use of antipsychotic agents for preventing and treating delirium in the intensive care unit.

Discussion: There is conflicting data concerning the prophylaxis and treatment of delirium in critically ill patients. For prophylaxis …

Does The Use Of Extracorporeal Cardiopulmonary Resuscitation Improve Neurologically Favorable Survival In Patients With Refractory Out-Of-Hospital Cardiac Arrest?, Timothy Lund

Theses and Graduate Projects

In this retrospective review, the use of extracorporeal cardiopulmonary resuscitation (ECPR) using extracorporeal membrane oxygenation (ECMO) was assessed in the management of refractory ventricular fibrillation (VF) and ventricular tachycardia (VT) out-of-hospital cardiac arrest (OHCA). Multiple factors were evaluated such as the duration of manual or mechanical cardiopulmonary resuscitation (CPR), ECPR protocols and the rate of favorable neurologic outcomes for these OHCA patients. Survival with a favorable neurologic outcome is defined as cerebral performance categories (CPC) 1 or 2. Although CPR remains and will continue to be a critical component in the management of cardiac arrest, the persistently high mortality rate …

Factors That Impact Glycemic Control In Adolescents With Type 1 Diabetes, Kelsey Mcfarling

Theses and Graduate Projects

The incidence of Type 1 Diabetes (T1D) is increasing worldwide and is diagnosed disproportionately in adolescent populations. Additionally, studies show that adolescents with T1D experience worse glycemic control during this developmental period. Maintaining glycemic control in patients with T1D decreases the risk of developing future diabetic-related complications. Factors such as race, ethnicity, gender identity, sexual orientation, socioeconomic status, and medical comorbidities influence disparities in maintaining glycemic control in adolescents. The recognition of these factors on the management of T1D through an integrative team approach leads to increased glycemic control and decreased diabetic- related complications. This paper explores the effects of …

Vitamin C As An Adjunct Therapy In Sepsis Management, Nicholas Becker

Theses and Graduate Projects

In the United States, sepsis afflicts nearly one in three ICU patients, is associated with monumental healthcare costs, and is among the leading causes of death. The burden of sepsis is felt globally, and efforts are underway to discover an effective adjunctive therapy. Vitamin C is a novel treatment showing promising early evidence. Additionally, vitamin C's use in combination therapy with hydrocortisone and thiamine has been postulated. These components are thought to work congruently to attenuate the pathophysiologic process of sepsis.

To answer whether vitamin C improves septic patient outcomes, a variety of methods were used to obtain information. Primarily, …

The Role Of Temperature Management In Neurologic Outcomes Of Adult Cardiac Arrests:, Trenton Christensen

Theses and Graduate Projects

Background: Targeted Temperature control for post cardiac arrest patients has a long history dating back to the ancient Greeks. In the last twenty years there has been a push to define and implement a protocol for targeted temperature control for post cardiac arrest patients, specifically those with ventricular fibrillation arrests, to improve neurological outcomes and post-arrest quality of life. In this review, literature from the last twenty years and beyond was examined to attempt to determine whether populations treated with therapeutic hypothermia experienced improved neurological results.

Methods: Literature searches were preformed using the PubMed database as well as Google Scholar. …