Medicine and Health Sciences Commons^™

The Effect Of Statins In Primary Prevention On All-Cause Mortality, Brian Adams

Physician Assistant Scholarly Project Posters

During routine yearly physicals, primary care providers often evaluate serum laboratory lipid levels. Many of these patients have no past medical history of cardiovascular events related to atherosclerotic disease. Some patients do not have secondary risk factors, such as diabetes mellitus or smoking history.

Previous cardiovascular events provide stronger indications for the use of HMG-CoA reductase inhibitors (statins). In the absence of these, the provider may turn to current guidelines, in this case the 2013 the American College of Cardiology and the American Heart Association published the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular …

The Effectiveness, Benefits, And Challenges Of Fertilityawareness-Based Methods Of Family Planning, Annette M. Larson

Physician Assistant Scholarly Project Posters

The aim of this scholarly project was to evaluate data regarding the efficacy, challenges, and benefits of fertility awareness-based methods (FABMs) of family planning, in order to determine whether there are methods that may be considered effective and beneficial options. After reviewing the available literature regarding current FABMs, it became evident that there are, in fact, current methods available which are viable choices. The most effective methods according to this data are the ovulation and Sympto-Thermal methods, which have actual-use efficacy ratings that, when compared to the commonly prescribed oral contraceptive pill, would recommend them for use. The FABMs, as …

Metformin And Vitamin B12 Deficiency: Consequences And Patient Monitoring, Kathryn Dietz

Physician Assistant Scholarly Project Posters

• The incidence of type 2 diabetes has been increasing at a rapid rate in the United States.

• Metformin is recommended as the first line treatment to be started at the time of diagnosis in all patients without contraindications and has been associated with vitamin B12 deficiency.

• There are currently no clinical guidelines for the routine monitoring of B12 levels in this population.

• The purpose of this scholarly project is to determine if there are consequences of this deficiency and to make recommendations for screening patients.

• It includes current research that focuses on the pathophysiology of …

Proton Pump Inhibitors (Ppis): A Review Of The Efficacy, Usage, And Current Literature Recommendations, Travis M. Booke

Physician Assistant Scholarly Project Posters

• As Klepser, Collier, and Cochran (2013) noted, PPIs are a class of agents that reduce acid secretion by parietal cells in the stomach by irreversibly blocking H+/K+ adenosine triphosphate. They are commonly prescribed for many gastrointestinal (GI) conditions including gastric and duodenal ulcers, gastroesophageal reflux disease (GERD), upper gastrointestinal bleeding, and Helicobacter pylori infections. They are frequently utilized in the primary care setting. The purpose of this study was to examine the efficacy, usage, and current literature on PPIs.

• There were several complications noted with PPI usage. Gomm et al. (2016) found that that use of PPI is …

Analysis Of Metabolic Syndrome As A Modifiable Risk Factor For Prostate Cancer, Michael Butler

Physician Assistant Scholarly Project Posters

• Prostate cancer and metabolic syndrome are both prevalent among men in developed countries with peak incidence after age 50.

• Prostate cancer has no known modifiable risk factors.

• Most risk factors for metabolic syndrome are modifiable.

• If metabolic syndrome is identified as contributing to the risk of prostate cancer it would give an element of self determination to men at risk for prostate cancer.

• Past studies provide conflicting results in the correlation between these two conditions.

• A literature review was performed to evaluate consistencies in current literature.

• Metabolic syndrome or its components do not …

Prophylactic Use Of Metformin To Decrease The Incidence Of Breast Cancer In High Risk, Predisposed Women, Aly Dahl

Physician Assistant Scholarly Project Posters

• Breast cancer is one of the most common types of cancer in American women and is the second leading cause of mortality.

• In 2015, 234,190 new diagnoses were made and 40,730 deaths from breast cancer.

• Along with a thorough history from the patient, there are also several risk assessment models that should be utilized, such as the common Gail-2 model.

• Any women with a significant family history should also be educated on genetic counseling and/or testing to detect a BRCA1 or 2 mutation.

• Numerous individuals who are positive for this gene elect to undergo prophylactic …

Type 2 Diabetes In Native Americans: The Influence Of Historical And Cultural Factors On Incidence, Prevalence, And Strategies For Patient Education, Disease Prevention, And Management, Tim Olsen

Physician Assistant Scholarly Project Posters

Type 2 diabetes (DM2) was virtually nonexistent among Native American, Alaska Native, and Canadian First Nations people prior to the 1950s. Due to historical, cultural, environmental, and psychosocial factors, Native people suffer disproportionately higher rates of DM2 than other populations. This literature review aims to examine the influence of these factors and investigate whether insight and knowledge into them, as well as culturally sensitive approaches to disease education, prevention, and self-management can be beneficial to providers working among Native communities. The results suggested that culturally sensitive approaches are indeed of value in promoting more effective care, and that lack of …

Early Antibiotic Exposure And Childhood Obesity, Agatha J. Ottem

Physician Assistant Scholarly Project Posters

Obesity is becoming a growing concern in today’s population. Over the last thirty years, obesity rates have doubled in adults and quadrupled in adolescents. One of the more recent theories is that childhood obesity is influenced by early exposure to antibiotics. The purpose of this project is to discuss how antibiotics alter the human gut microbiota and how this affects nutrient consumption, which can lead to childhood obesity. There is a focus on the current research studies that address if, indeed, there is a link between childhood obesity and early antibiotic exposure. Through a review of several electronic databases and …

Brugada Syndrome; Preventive Screening Measures To Decrease Associated Cardiac Deaths, Matthew Ryba

Physician Assistant Scholarly Project Posters

• Brugada syndrome is a sodium channel deficiency in the myocardium that can cause arrhythmias and sudden cardiac death. The myocardium deficient sodium channels can be inherited or affected by environment factors such as fever or medications.

• Screening for this syndrome can be challenging because many times the first symptom of Brugada syndrome is cardiac arrest. Though incidents of sudden cardiac deaths are low, sudden cardiac death can impact families and communities.

• In Italy, screening ECG’s is claimed to have reduced sudden cardiac events by 85% (Maron, 2014). Preventing sudden cardiac death in these patients through sensible, reasonable …

Alpha-1 Deficiency: Better Detection May Improve Outcomes For Copd Patients, Angela Schuster

Physician Assistant Scholarly Project Posters

Alpha-1 antitrypsin deficiency (AATD) is a genetic disorder that results in debilitating illnesses like: emphysema, COPD, liver disease, and panniculitis. AATD is highly under-diagnosed based on epidemiologic and population studies that suggest that fewer than 10% of the 60,000-100,000 individuals in the U.S. suspected to have severely deficient alleles have been identified ( Rahaghi et al., 2012). This study examines strategies aimed at improving detection of AATD. The findings indicate that utilizing flags to alert providers of the need for AATD testing initiated by RTs or automated within EMR systems are effective strategies for increasing testing rates and potentially improving …

The Association Between Antipsychotic Medication And Weight Gain, Brian Steen

Physician Assistant Scholarly Project Posters

• Antipsychotic medications are utilized for patients with many mental health problems including schizophrenia, attention deficit hyperactivity disorder, autism, bipolar mania, and psychotic depression. The antipsychotic medications treat the symptoms associated with these mental health disorders.

• Antipsychotic medications, while being efficacious to these symptoms, can have unwanted side effects, including weight gain. The purpose of this study was to determine if there is a strong relationship with antipsychotic medication use and weight gain.

• The review of literature was conducted with an online search of Cochrane, PubMed, and PsycInfo for journal articles, research studies, and other scholarly reviews. Articles …

Pharmacogenetic Testing In The Treatment Of Major Depressive Disorder, Brianna Strube

Physician Assistant Scholarly Project Posters

• Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders in the United States and is a large cause of disability. Antidepressants take weeks/months to become effective which can lead to noncompliance. Treatment has a high failure rate which increases medical costs and leads to decreased patient outcomes.

• Pharmacogenetic testing is the practice of analyzing genetic differences to predict a patient’s response to medications to improve efficacy and decrease adverse side effects. The purpose of this study was to investigate if pharmacogenetic-guided treatment, specifically in the use of antidepressants in MDD, has resulted in improved patient …

Prenatal Screening For Aneuploidy: Should Cfdna Replace Traditional Methods?, Rachel Watson

Physician Assistant Scholarly Project Posters

In 2011, advances in research in medical genetics led to the advent of prenatal cell-free DNA (cfDNA) or also known simply as non-invasive prenatal screening or testing (NIPS). This screen consists of analyzation of placental DNA circulating in maternal blood. NIPS has had a major impact on prenatal screening for aneuploidy. Mixed opinions and data exist as to whom this test is most appropriate for. The sensitivity and specificity of this screen in detecting common fetal aneuploidies has been well documented as superior to other screens in high-risk populations, but less so in low-risk obstetric populations. This paper will compare …

Anticoagulation Therapy For The Elderly With Atrial Fibrillation, Rebecca Hoistad

Physician Assistant Scholarly Project Posters

• Atrial fibrillation increases in occurrence as we age with about 9% of patients developing it by age 90. When a patient is diagnosed with atrial fibrillation, one of the drugs that they are prescribed is an anticoagulant. The purpose of this drug is to prevent thrombus formation in addition to preventing an ischemic stroke. Today, there are many options available for anticoagulation therapy. The options include aspirin, vitamin K antagonists like warfarin, factor Xa inhibitors like rivaroxaban and apixaban, direct thrombin inhibitors like dabigatran, and antiplatelet agents such as clopidogrel.

• A review of the literature was done of …

Opioid Maintenance Treatment: Methadone, Buprenorphine, And Naltrexone, Nicole Lemieux

Physician Assistant Scholarly Project Posters

Opioid dependence plagues the United States with millions of people suffering from the effects. Throughout recent years, there has been a surge in research in treatment options for patients suffering from opioid dependence. Three medications have stood out: methadone, buprenorphine, and naltrexone. The purpose of this study was to investigate the three and decipher which provides the best outcomes for patients. Research was conducted by reviewing literature via PubMed, PsychInfo and Cochrane. A review of the literature found that methadone has been used the longest and has been shown to be efficacious, but can be severely limiting for patients due …

Effectiveness And Safety Of The Bronchial Thermoplasty Procedure, Kathy Mohammadi

Physician Assistant Scholarly Project Posters

• Asthma: a heterogeneous disease characterized by chronic airway inflammation resulting in respiratory difficulty.

• Bronchial Thermoplasty (BT): a bronchoscopy procedure that delivers radiofrequency energy to the tissues of airway walls thus heating the tissue, causing ablation to reduce the mass of the airway smooth muscle (ASM), hence attenuating bronchoconstriction.

• BT was designed to decrease, de-bulk or partially eliminate excess smooth muscle tissue in the distal airways, with a subsequent decrease in the number of severe asthma attacks.

• BT is an alternative treatment for patients with severe, uncontrolled asthma in which the airway smooth muscle is eliminated using …

Effectiveness Of Different Styles Of Diabetic Education On Outcomes Of The Type Ii Diabetic Patient, Emil Trutwin

Physician Assistant Scholarly Project Posters

•The purpose of this project is to determine if there is a significant advantage to certain diabetic education strategies that yield better outcomes in regards to control of diabetes.

Fructose And Its Contribution To Cardiovascular Disease And Metabolic Syndrome, Jessica Anderson

Physician Assistant Scholarly Project Posters

The incidence of obesity, cardiovascular disease, and combination of symptoms classified as “metabolic syndrome” that eventually leads to type 2 diabetes have risen dramatically over the past few decades. The current dietary guidelines that advised patients to avoid dietary fats were originally developed in the 1960’s. This led the way for food manufacturers to remove fats in processed foods and replace them with sugars, particularly fructose. At the time there was no clinical trial data that definitively supported these guidelines.

The increased use of fructose as a food additive has dramatically increased the per-capita consumption of this sugar. More recent …

Sucrase-Isomaltase Deficiency, An Under Considered Diagnosis, Lindsay Venn

Physician Assistant Scholarly Project Posters

• Persistent gastrointestinal (GI) complaints are a common problem in patients presenting to family practice for care.

• Irritable bowel syndrome (IBS) is a diagnosis that adult patients are labeled with when clinicians have exhausted their differential list and no other cause of their GI symptoms can be confirmed.

• Sucrase-isomaltase deficiency (SID) has been historically shown to present early in life as a congenital disorder, but researchers are now recognizing occurrence later in life as a mild or secondary disorder.

• The literature emphasizes the disconcerting prevalence of sucrase-isomaltasedeficiency (SID), the persistent symptoms associated with it, and the need …

Use Of Mesenchymal Stem Cells For The Treatment Of Osteoarthritis, Dennis W. Stewart

Physician Assistant Scholarly Project Posters

• Healthy articular cartilage protects and provides smooth functioning of the joint. The deterioration of the articular cartilage leads to the crippling disease known as osteoarthritis (OA).

• OA is a leading cause of disability in the United States. Although some of the current treatment modalities, along with pharmacological treatment, may offer short term improvement with pain and function, they do not offer long term relief, and are ineffective in preventing the progression of OA.

• In advanced stages, surgery in the form of total knee arthroplasty (TKA), is sometimes needed. This is an invasive procedure and typically requires hospitalization. …

Curcumin And Fish Oil: Potential Alternative Or Adjunctive Treatments To Nsaids And Immune Modulating Medications For The Treatment Of Chronic Inflammation, Vicki Andvik

Physician Assistant Scholarly Project Posters

The aim of the present review is to evaluate the efficacy and safety of curcumin and fish oil as alternative or adjuvant treatments to NSAIDs and immune modulating medications for the treatment of chronic inflammation.

An online search of CINAHL, PubMed, Cochrane and Alt Healthwatchdatabases was conducted. It was limited to peer-reviewed articles and clinical trials in academic journals within the last ten years.

Current research suggests that curcumin may be efficacious in the treatment of chronic inflammation. It is generally regarded as safe up to 12 gm/day with mild gastrointestinal effects but poor bioavailability has limited its clinical application. …

Evaluating Internet Based Cognitive Behavioral Therapy In Adults With Depression, Togan Cottrell

Physician Assistant Scholarly Project Posters

• Depression is one of the most prevalent and costly mental health issues worldwide.

• Cognitive Behavioral Therapy (CBT) has been a long-standing treatment for patients with depression. CBT has been proven to reduce or eliminate depression symptoms while increasing quality of life.

• Due to lack of access to care and a deficiency of mental health providers throughout the United States, the frequent and lengthy visits that are required for traditional CBT may not be an option.

• The use of internet based CBT has been studied as an alternative to traditional therapy and may serve to fill a …

Prolotherapy: Applications, Mechanism Of Action, Controversy And Evidence, Boris M. Davydov

Physician Assistant Scholarly Project Posters

Merriam-Webster defines prolotherapy (PROLO) as “an alternative therapy for treating musculoskeletal pain that involves injection of irritant substance (as dextrose) into a ligament or tendon to promote the growth of new tissue”. Experimental research and multiple clinical trials have generated evidence suggesting that PROLO is effective at treating a variety of musculoskeletal conditions, including tendinopathies, joint instability and ligament laxity. PROLO may also hold a potential to delay or avoid joint replacement and rotator cuff surgeries. Further research is needed to demonstrate the therapeutic effect of PROLO unequivocally.

Prescription Opioids: A Band-Aid For Chronic Low Back Pain, Rebekah Dunn

Physician Assistant Scholarly Project Posters

Pain is one of the most common reasons patients seek medical care in the outpatient clinic and emergency department setting.

 • In the last decade, per the Centers for Disease Control (CDC), prescription drug abuse and overdose, specifically opioids, has become the leading cause of injury and deaths in the United States.

• “Opioids—primarily prescription pain relievers and heroin—are the main driver of overdose deaths and were involved in 28,647 deaths in 2014…opioid overdoses have quadrupled (an increase of 200%) since 2000” (Rudd et al. 2016).

• In 2016 the CDC established guidelines of clinical practice regarding management of …

Introduction Of Peanuts To The Pediatric Patient, Leslee Graff

Physician Assistant Scholarly Project Posters

Peanut allergies have been diagnosed exponentially over the last ten-years and are more severe now than ever before. (DuToit et al. 2106) Some of the latest statistics are citing more than double the amount of peanut allergies diagnosed in the last few years. Guidelines set forth in 2010, by the American Academy of Allergy, Asthma, and Immunology stated that peanut, milk, soy, wheat, egg, and other tree nuts were to be avoided until three years of age, unless these patients have other chronic illnesses such as asthma or other atopic conditions. If so, the patient is to abstain from these …

Language Concordance: Overcoming Language Barriers, Pamela Flavin-Lee

Physician Assistant Scholarly Project Posters

• Language discordance is a growing problem facing health care today. Communication barriers can be cultural or language based and are commonly cited as a major contributor to poor patient compliance and health outcomes.

• This research project seeks to identify promising developments aimed at overcoming language discordance through analysis of different translation implementation methods and correlating these with health outcomes.

Folate As An Adjunctive Therapy For Treatment Resistant Depression, Katherine Mcfarland

Physician Assistant Scholarly Project Posters

Numerous medications are available to treat depression, yet many patients do not achieve remission or recovery of their symptoms with traditional therapies alone. Folate supplementation has been shown to be beneficial in the treatment of depression when used in addition to traditional prescription therapy. A literature review was conducted to determine the effect of low folate levels on depression and if supplementation with either folic acid or L-methylfolate benefits this patient population. Key search terms including folate, folate deficiency, methylfolate, nutrition, and depression were used to perform searches of multiple databases and journals including PubMed, CINAHL, PsycInfo, and the American …

Treatment Options For Patients With Irritable Bowel Syndrome & Comorbid Depression, Elizabeth Morton

Physician Assistant Scholarly Project Posters

• Irritable bowel syndrome & depression are common comorbidities, however there is a wide variability regarding the appropriate treatment regimens for these patients.

• IBS is classified as a functional bowel disease in which patients suffer from recurrent abdominal pain or discomfort associated with alterations in bowel habits.

• While the cause of IBS is multifactorial, studies have revealed that the dysfunction of the brain-gut pathways are a culprit to disease appearance and progression, as seen in the biopsychosocial model of IBS. This model proposes that abdominal symptoms secondarily impact anxiety & depression symptoms and that psychological factors influence physiologic …

The Postnatal Management Of Gestational Diabetes, Savannah Prodzinski

Physician Assistant Scholarly Project Posters

• Diabetes mellitus is growing substantially in our nation. Between its natural progression and effects on other body systems, this epidemic is costing us billions of dollars a year.

• Although gestational diabetes typically resolves after pregnancy, women who have had gestational diabetes in the past have a largely increased risk for the development of diabetes mellitus in the future.

• Several things contribute to the development of GDM and DM: decline in β-cell function, lower adiponectin levels and HgbA1C levels in the third trimester.

• Intervening during the critical time after delivery in women with gestational diabetes, will theoretically …

Association Between Proton Pump Inhibitor Use & Dementia: A Two-Fold Approach, Lisa Steers

Physician Assistant Scholarly Project Posters

An observational study of data derived from the German Study on Aging, Cognition and Dementia indicated that proton pump inhibitor use was associated with dementia risk (Benmassaoud, McDonald, & Lee, 2016). The purpose of this study is to explore a two-fold approach between proton pump inhibitor use and dementia. This two-fold approach will first investigate the association between dementia and proton pump inhibitor use and secondly, the proposed pathophysiology behind it. This approach to proton pump inhibitor use and dementia will allow for providers to utilize the association and make decisions to avoid chronic proton pump inhibitor use in effort …