Medicine and Health Sciences Commons^™

Investigating The Effectiveness Of Prehospital Recognition And Administration Of Intravenous Antibiotics In Septic Patients, Laura Keane, Ian Peterson

Physician Assistant Capstones, 2020-current

Objective: To compare the 30-day mortality rate of suspected sepsis patients who received prehospital (Emergency Medical Services- EMS) antibiotic administration in an ambulance as compared to antibiotic administration in the hospital. Design: Systematic literature review. Methods: Research was conducted in PubMed and Google Scholar with the search terms: sepsis, antibiotics, prehospital, EMS, ambulance. The 3 articles selected were chosen after removing articles not from a randomized control trial, no antibiotic administration, and not a free article. Results: From our meta-analysis of the three studies, we concluded that providing antibiotics before arriving at the hospital for patients with suspected septic infections. …

Use Of Cardiomems Hf Sensor In Management Of Nyha Class Iii Heart Failure, Trevor Andrunik, Anne Eady

Physician Assistant Capstones, 2020-current

Objective: Assess the ability of continuous pulmonary artery pressure monitoring via implantable CardioMEMs HF device to reduce hospitalization in New York Heart Association (NYHA) Class III heart failure patients over the age of 18. Design: Systematic literature review. Methods: Searches were conducted via PubMed and ClinicalTrials.gov using the single search term “CardioMEMs.” Inclusion criteria narrowed results to studies performed in the last 10 years, randomized control trials, cohort studies, and utilizing heart failure related hospitalization as the primary endpoint. Results: The current data unanimously asserts that the CardioMEMs HF device is effective at reducing heart failure related hospitalizations, with secondary …

The Safety And Efficacy Of Pravastatin In The Treatment Of Preeclampsia, Miranda Shelly, Tara Riley

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of pravastatin in the prevention or treatment of preeclampsia in women who are at risk. Design: Systematic literature review. Methods: A search was performed using Pubmed utilizing the terms preeclampsia and pravastatin. The results were limited to studies that were double blind and placebo controlled and that occurred in the last 5 years. Results: None of the studies found statistical significance in the rate of preeclampsia between the experimental and control groups. Only one study found statistically significant differences in fetal birth weight and age at delivery. The other two studies found no differences between groups …

The Use Of Kernig’S And Brudzinski’S Sign In Determining Meningitis: A Review, Crystal T. Duong, Ashton Hughes, Kerem Yilmaz

Physician Assistant Capstones, 2020-current

Objective: Assess the diagnostic value of Kernig’s and Brudzinski’s signs in determining meningitis among individuals aged 18 to 64. Design: Systematic literature review. Methods: Searches done in PubMed utilizing the terms Kernig and Brudzinski. In PubMed, studies were excluded if not in English, older than 2000 or done on animals, and meta-analyses. Results: Three studies were found including Nakao JH, et al, Thomas KE, et al, and Waghdhare S, et al. Conclusion: Kernig’s and Brudzinski’s signs have high specificity but yield a low sensitivity in determining meningitis. They are great tools to be utilized by medical providers, but only support …

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine In Hiv Maintenance Therapy, Andrea K. Ferrero, Nabil Naim

Physician Assistant Capstones, 2020-current

To determine if long-acting injectables cabotegravir and rilpivirine are non-inferior to oral antiretroviral therapy at maintaining viral load suppression below 50 copies per milliliter of serum. Design: Systematic literature review. Methods: A search was done in PubMed using the terms “HIV + cabotegravir” or “HIV + cabotegravir, rilpivirine drug combination.” Limitations included non-randomized control trials, comparison of injectable regimens directly or injectables to placebo, studies that evaluate compliance or side effects only, and studies with small sample sizes. Results: Meta-analysis revealed that continued use of injectables was sufficient in maintaining viral suppression at 93.6%, 92.5%, and 94% in each of …

Is A Lumbar Puncture Necessary? Identifying The Need For A Lp With A Negative Ct Scan When Diagnosing A Non-Traumatic Subarachnoid Hemorrhage, Carlee Raymond, Erin S. Lang

Physician Assistant Capstones, 2020-current

Objective: To assess the current standard for the detection of non-traumatic subarachnoid hemorrhage (SAH), and evaluate the need for a lumbar puncture with a negative head CT. Is a negative head CT thorough enough to definitively rule out a SAH?

Design: Systematic literature review

Methods: Our research began on the PubMed database using the search terms Subarachnoid Hemorrhage and Lumbar Puncture. We filtered our data with filters including; data in the last ten years, primary research, and full text articles.

Results: Retrospective studies include; Bianchi et al. (2021), Chee et al. (2020) and Tulla et al.(2018). All three studies showed …

Prophylactic Intravenous Prehydration With Sodium Bicarbonate Or Sodium Chloride In The Prevention Of Contrast Induced Acute Kidney Injury, Briana Lockett, Caroline Dong

Physician Assistant Capstones, 2020-current

Introduction: Iodinated contrast media is a crucial component in the diagnostic work up of many life-threatening illnesses. However, it has been reported to cause acute kidney injury after administration, especially in patients with pre-existing renal disease. Several prophylactic treatments have been studied in hopes of minimizing these adverse events. The current standard of care in this patient population is prophylactic intravenous volume administration with either sodium chloride or sodium bicarbonate. Objective: The goal of this literature review is to determine if prophylactic intravenous volume administration with either saline or sodium bicarbonate prior to contrast administration decreases the incidence of contrast …

Effect Of Mesenchymal Stem Cells On Osteoarthritis Of The Knee, Brendan Avery, Jessica Gray

Physician Assistant Capstones, 2020-current

Osteoarthritis of the knee is one the most common sources of chronic pain due to altered joint function.¹ Current treatment modalities offer short term relief of symptoms but lack long term aid and regenerative properties.¹ Mesenchymal stem cells (MSC) offer regenerative and anti-inflammatory properties and can be collected from umbilical cord blood, adipose tissue, or bone marrow.⁴ The three studies included were all randomized controlled trials within the past 10 years that each utilized more than 30 participants who had a diagnosis of osteoarthritis and a mean age above 50 years old. MSCs were compared to corticosteroid …

The Effect Of A Wellness Curriculum On First Semester Jmu Pa Students, Abigail Larson, Jeanine Aberbook

Physician Assistant Capstones, 2020-current

Physician Assistant (PA) programs are rigorous graduate-level medical programs that achieve a Master’s degree but complete an equal number of credits as a Doctorate degree. They are notorious for triggering high levels of stress pre-matriculation as well as upon matriculation. While this is a well-known topic discussed between students and incoming students, it is an under-researched topic. As a result of the lack of research in physician assistant education regarding implementing a wellness curriculum and the desire to reduce stress, anxiety, and depression symptoms in first semester PA student, the faculty and students at James Madison University (JMU) implemented a …

The Use Of Autologous Prp Gel For The Treatment Of Diabetic Foot Ulcers, Erin Klein, Dominic E. Paoletti

Physician Assistant Capstones, 2020-current

The purpose of this systematic literature review is to examine the efficacy of platelet rich-plasma (PRP) gel as a therapy for diabetic foot ulcers (DFUs). Infections in patients with diabetes, especially diabetic foot ulcers, are challenging to treat due to neurovascular compromise. Searches were done in PubMed utilizing the terms “diabetic foot ulcer”, “platelet rich plasma” and “autologous”. In PubMed, the following limits and terms were used: randomized control trial (RCTs), sample size greater than 30 participants, foot ulcers, and English. A meta-analysis revealed three studies meeting inclusion/exclusion criteria: Li et al, Gude et al, and Ahmed et al. The …

Injuries In Manual And Mechanical Cpr, Macon Spruill, Malik Bangura

Physician Assistant Capstones, 2020-current

Objective: To compare the rate of injuries during cardiopulmonary resuscitation (CPR) using manual versus mechanical chest compressions with the Lund University Cardiopulmonary Assist System (LUCAS™).

Design: Systematic literature review

Methods: We investigated the use of 2 different CPR methods, manual and mechanical, in order to determine if one was more likely to cause injury in individuals during a cardiac arrest. PubMed searches were conducted using the terms “cardiopulmonary resuscitation,” “adverse effect,” “classification,” “method,” “mortality,” “statistical and numerical data,” “trends,” “complication,” “epidemiology,” and “etiology.” Studies were excluded if they took place before the year 2000, included individuals under 18 …