Medicine and Health Sciences Commons^™

Basic Principles Of Chronic Wound Care Management, Mahi-Ruhi Ladhani Jain

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This CME article aims to address the basics of chronic wound management, especially related to chronic venous insufficiency, peripheral arterial disease, and diabetes. Many providers do not know how to treat or manage chronic wounds and may use outdated methods to treat the wounds. There are many wound care supplies and resources available for providers when it comes to wound care management. However, the information is spread out across different resources. This article aims to create a resource that allows one to have a basic understanding of wounds and the different ways to manage them. In the article, I will …

Emerging Unconventional Therapies For Glioblastoma Multiforme, Danielle Morang

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Glioblastoma multiforme (GBM) is the most prevalent and aggressive primary malignant brain tumor occurring in adults with a median survival of less than two years. It is a highly invasive tumor characterized by genetic heterogeneity, angiogenesis, and rapid proliferation. Patients undergo a multimodal treatment regimen consisting of surgical resection and chemoradiation therapy, yet GBM tumors almost always recur with a worsening prognosis. The molecular and genetic complexities of GBM pose a significant challenge for developing effective therapeutics. Thus, it is imperative to identify new therapeutic targets and explore novel treatment strategies to improve patients’ overall survival time and quality of …

The Role Of Primary Care Providers In Maintaining Weight Loss By Preventing Behavioral Relapse, Hayden R. Blanchard

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Supporting patients in optimizing health by treating obesity remains a relevant goal for primary care providers. While weight loss is frequently achieved with behavioral modification, maintaining weight loss by avoiding behavioral relapse is much more difficult. Patient may lose weight by reducing overall energy intake, incorporating intensive behavior change programs, utilizing pharmacotherapy as needed and, in certain cases, undergoing bariatric surgery. With a focus on behavior change and maintenance, primary care providers can support patients by planning more frequent follow up appointments, at least every one to three months. In these visits, PCPs can: focus on reenforcing lifestyle change principles …

Herniated Nucleus Pulposus Radiculopathy In Athletes, Elizabeth G. Massel

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Herniated nucleus pulposus (HNP), commonly referred to as intervertebral disc (IVD) herniation, is the second most common cause of neck and back pain, and most common cause of radiculopathy. The purpose of this CME article is to provide guidance on the medical management and secondary prevention of HNP in athletic populations, and highlight the pathophysiological process of mechanical overload putting athletes at a proportionately higher risk of the disease. It will address the unique pathophysiology of overuse-related HNP, as opposed to underuse, with the mechanical overload on vertebral discs associated with many sports. It will also review, with more emphasis …

Migraine Treatment In Primary Care, Vivian Tran

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Migraines are a common problem that medical providers encounter, especially in primary care, neurology, and the emergency department. Given that 15% of the population suffers from migraines annually, it is important for providers to know how to diagnose migraines. Migraines may also present as a symptom of another disorder, so being able to recognize whether symptoms are alarming is crucial to start the correct workup. The mainstay abortive therapy for migraines is ibuprofen, and for prophylactic therapy is topiramate. However, CGRP targeted medications like gepants and CGRP mAbs may be the new treatment of choice for abortive and prophylactic treatment …

One In Every Twenty-Six, Rey'na Riggans

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There is a disorder that is rather common within the world and yet is not well known. It is a something that affects one in every twenty-six individuals. It is called epilepsy. Epilepsy is a neurological disorder in which a person to experience bursts of random electrical activity within their brains, these bursts being called "seizures." This article discusses this disorder and goes into detail about the forms of it, procedures that are done to try and help those living with epilepsy, and artwork that is inspired by this disorder.

Vitamin D Enhanced Vitamin D Receptor (Vdr) Inhibition Of Nlrp3 Inflammasome Activation Can Attenuate The Development Of Autoimmune Thyroiditis, Alexzon Mandac

Capstone Showcase

Autoimmune Thyroiditis (AIT) is a prevalent autoimmune disease affecting approximately 2% of the population. Characterized by the gradual loss of thyroid function through an autoimmune attack on the thyroid gland, the disease manifests symptoms that negatively affect one’s quality of life. The mechanisms behind the disease’s pathophysiology are not fully understood; however, researchers are examining the involvement of the NLRP3 inflammasome in the disease. This thesis will address the question of whether Vitamin D can act as an inhibitor of the NLRP3 inflammasome and attenuate the progression of AIT in mouse model. Current investigations explore the effects of NLRP3 inhibition …

High Energy Blue Light Induces Oxidative Stress And Retinal Cell Apoptosis, Jessica Malinsky

Capstone Showcase

Blue light (BL) is a high energy, short wavelength spanning 400 to 500 nm. Found in technological and environmental forms, BL has been shown to induce photochemical damage of the retina by reactive oxygen species (ROS) production. Excess ROS leads to oxidative stress, which disrupts retinal mitochondrial structure and function. As mitochondria amply occupy photoreceptors, they also contribute to oxidative stress due to their selectively significant absorption of BL at 400 to 500 nm. ROS generation that induces oxidative stress subsequently promotes retinal mitochondrial apoptosis. BL filtering and preventative mechanisms have been suggested to improve or repair BL-induced retinal damage, …

Inpatient Management Of An Intravenous Drug User With Tetanus, Nina Paris

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Tetanus is rare in the United States now due to the tetanus vaccine but there is still the potential too see patients with tetanus. IV drug users, neonates, and geriatric populations are at an increased risk of developing tetanus. Tetanus is caused by Clostridium tetani, a spore forming and exotoxin releasing anaerobic bacteria. The symptoms of tetanus are caused by the exotoxin tetanospasmin which inhibits the release of inhibitory neurotransmitters, leading to sustained neuronal stimulation. The classic symptoms of tetanus are lockjaw (trismus), neck stiffness, back arching, and fever. Patients can be febrile, tachycardic, tachypneic, and hypertensive on exam. …

The Safety Of Covid-19 Vaccines In Pregnancy, Lauren Zacharias

Capstone Showcase

SARS-CoV-2 has caused over 800,000 deaths in the United States since it was first detected here in 2020. Despite there being 3 available COVID-19 vaccines in the US, and recommendations by the CDC and countless other public health agencies that any potential risks are outweighed by the benefit of the vaccines, only 31% of pregnant women in the US are vaccinated against COVID-19 due to unfounded claims by an anti-vaccination movement that COVID mRNA vaccines cause infertility. This presentation explores where these claims originated, why they are untrue, the risks of COVID-19 infections in pregnancy, and the potential benefits of …

Does Administration Of Probiotics To Women Aiming To Get Pregnant Reduce The Risk Of Pregnancy Complications?, Olivia Kreider

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This paper aims to assess the role of the vaginal and uterine microbiota in pregnancy complications, specifically miscarriages. With 1% of women experiencing recurrent miscarriages, the need to further research risk factors for miscarriages is evident. The findings of this research revealed there may be a place for probiotics in the prevention of pregnancy complications. Studies have shown that there is an impact of various bacteria within the uterine and vaginal microbiota on conceiving and maintaining healthy, full-term pregnancies. Considering these findings, it is recommended that healthcare providers consider recommending probiotic supplements to anyone aiming to conceive, especially those who …

Clinical Pearls To Diagnosing Lyme Arthritis, Chandelle Keller

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Arthritis is one of the most common long term sequelae of Lyme disease infection in humans. Although the pathophysiology for Lyme arthritis is not concretely understood, there are several key features that are helpful in diagnosing Lyme disease as the culprit for the arthritic symptoms that an individual is experiencing. With a thorough history of an individuals’ age, geographic location, recent travel history and common outdoor recreational activities engaged in, a differential can be narrowed down. With the knowledge of how various arthritides present in the body, along with the use of diagnostic testing with ELISA and Western immunoblot, any …

A Case Of Irritable Bowel Syndrome In The Setting Of Generalized Anxiety Disorder, Stephen Driscoll

Capstone Showcase

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by a relapsing-remitting course of abdominal discomfort and change in stool form and/or frequency in the absence of any structural or biochemical abnormalities. Currently there is debate on its pathogenesis but there is no definitive conclusion. Treatment consists of primarily playing symptomalogic catch-up with anti-spasmodics, anti-diarrheals, stool softeners, or laxatives depending on which symptoms the patient is currently experiencing. Patients with IBS typically struggle to control their symptoms long term, like the patient described in this case study. This case study explores a possible link between IBS and its’ most …

Treatment Of Hypothyroidism: Desiccated Thyroid Extract, Aimee Fong

Capstone Showcase

The treatment of hypothyroidism with Levothyroxine (T4) has been well studied and FDA approved. However, many patients continue to have signs and symptoms of hypothyroidism while on Levothyroxine treatment despite reaching appropriate thyroid levels. An additional thyroid treatment known as desiccated thyroid extract (DTE) is made from dried pig thyroid glands and is advertised as a “natural” alternative to Levothyroxine. Despite lack of FDA approval and studies surrounding DTE, clinicians have prescribed DTE to patients, many of whom reported relief of their symptoms. The following poster highlights the approach to the treatment of hypothyroidism with Levothyroxine and DTE and outlines …

Understanding One Dietary Supplement For Pcos, Eva Schofield

Capstone Showcase

Poly Cystic Ovarian Syndrome (PCOS) is the most common condition in women of reproductive age, yet nearly 70% of individuals with PCOS remain undiagnosed. For many women who do receive a diagnosis, it takes experiencing symptoms for two years or longer and receiving care from an average of 3 different providers before a diagnosis can be established. In an environment where prevalence is high, diagnosis rate is low and delayed, and dissatisfaction is prevalent regarding the health care women receive, many patients may turn to self-diagnosis and online resources to find their own therapeutic options. This CME article aims to …

Safety, Efficacy, And Reversibility Of Novel Male Contraceptives For Improved Pregnancy Prevention, Danielle Anton

Capstone Showcase

Unintended pregnancy is a global issue that can result from contraceptive failure or from a lack of contraceptive use. A literature search was conducted to explore novel methods of male contraceptives being developed for improved pregnancy prevention. Seven articles were selected, reporting on either oral contraceptive pills, transdermal gel, injectable hormonal, or bilateral intravas deferens polymer injection. The most common adverse events reported across all studies include changes in libido, mood, weight gain, acne, and headache. After reaching hormone and sperm concentration levels sufficient for pregnancy prevention, authors reported complete reversibility of contraceptive effects. Four studies described changes in various …

Antibiotics May Be Unnecessary In The Treatment Of Acute Uncomplicated Diverticulitis, Madison Gump

Capstone Showcase

Acute diverticulitis is one of the most common gastrointestinal diseases worldwide and is increasing in prevalence. Symptoms include abdominal pain, fever, changes in bowel habits, nausea, and vomiting. Traditionally, this disease has been treated with antibiotics, but new research has emerged that has provided evidence that it may be safe to treat acute uncomplicated cases without antibiotics. This represents an area of medicine where it may be possible to reduce the use of unnecessary antibiotics and, therefore, contribution to bacterial antibiotic resistance. The current research studies do have some limitations and future studies with larger, more diverse patient populations and …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Efficacy Of Pcsk9 Inhibitors Compared To Standard Of Care In Improving The Low-Density-Lipoprotein Cholesterol And Lowering The Risk Of Cardiovascular Events In Patients With Familial Hypercholesterolemia, Nichole Warshany

Capstone Showcase

Familial hypercholesterolemia is an inherited condition that causes patients to have significantly increased levels of LDL cholesterol, which often leads to coronary artery disease. Statin medications are typically prescribed to treat this condition, however these medications have adverse side effects and often subpar efficacy in this patient population. Evidence collected in this literature review yielded evidence that the use of PCSK9 inhibitors in the treatment of patients with familial hypercholesterolemia may be efficacious. Many of these studies were able to show statistically significant improvement of LDL-C and decrease in cardiovascular risk when compared to placebo. In addition, this medication was …

The Efficacy Of In Vitro Fertilization In Treating Infertility Due To Anovulatory Pcos In Comparison To Ovulation Induction Via Letrozole, Amanda Salay

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Abstract:

Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder found in women of reproductive age that often causes infertility. The first-line treatment for infertility in anovulatory PCOS patients is ovulation induction. In vitro fertilization (IVF) is a third line treatment often used as a last resort. PCOS patients have higher failure risks of first- and second-line medications. Therefore, this review analyzes if adverse pregnancy outcomes (O) are reduced more with IVF (I) versus using letrozole for ovulation induction (C) in women aged 20-30 struggling with infertility due to anovulatory PCOS (P).

Methods: A literature search on Pubmed and EBSCOhost …

Outcomes Of Neuropace Rns Vs Surgery Among Patients With Epilepsy In Eloquent Foci, Erica Hartmann

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Say What You Mean To Say: Unpacking The Complexities Of Communication Between Patients And Their Providers, Kate Timony

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A Comparative Policy Analysis Of The United Kingdom And India Regarding The Reuse Of Medical Devices., Shamaa Vora

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Hospital Characteristics And Hospital Acquired Infections In The United States, Cassidy Prewitt

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Cassidy Prewitt's Oral Presentation given at the 2020 APHA Annual Meeting

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Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

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ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Ketamine Vs Placebo For Depression, Austin Strosser

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Depression is a disease that effects millions of patients and has a variety of symptoms. It is primarily defined by depressed mood and anhedonia. The first line treatment for depression is SSRI medications. These medications have several side effects and are not effective for a large number of patients. Therefore, this study was done to review ketamine as a new treatment option for depression and see how it compares to a placebo.

The Efficacy Of Ketamine In Adult Patients With Obsessive Compulsive Disorder With Symptoms Refractory To Standard Of Care Treatment., Brooke Thornton

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First line pharmacologic treatments for adult patients with Obsessive Compulsive Disorder (OCD) involve selective serotonin/norepinephrine reuptake inhibitors (SSRI/SNRIs). These drug classes often fail to deliver timely relief of symptoms as well as maintain longevity of symptom recurrence. This research analyzed the use of ketamine in adult patients suffering with OCD for the purposes of more efficacious management of symptoms. Although ketamine demonstrated a timelier relief of symptoms in some small clinical studies, its effects were ultimately unable to be sustained long term. Additionally, a wide range of adverse effects including dissociation, and rebound symptoms were observed. As a result, large …

The Comparative Efficacy Of Amantadine Vs. Lcig Therapy For The Treatment Of Levodopa-Induced Dyskinesia In Patients With Advanced Parkinson's Disease, Katelynn Timony

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Introduction: Though levodopa-carbidopa therapy remains the gold standard of Parkinson’s disease (PD) treatment to this day, patients often experience increased dyskinetic activity as a result of long-term treatment; known as levodopa-induced dyskinesia (LID); the mechanism of which is not completely understood. In this review, the efficacy of two adjunct treatments for LID are compared: 1) the concomitant administration of amantadine, an antiviral medication with antidyskinetic properties; and 2) a new form of levodopa administration in the form of an intestinal gel delivered straight via a device much like an insulin pump.

Methods: Two systematic literature searches of primary, peer-reviewed articles …

Manipulation Of Ar-V7 In Castrate Resistant Prostate Cancer, Sean Simpson

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Abstract

Introduction: Prostate cancer is the leading cancer affecting men of all races in the United States, and the second leading cause of cancer death in men. If caught early, many have had success in combating the disease, but if the cancer metastasizes, the 5-year survival rate drops to only 30%. Current treatment options heavily involve hormone therapy, radiation therapy, chemotherapy, and surgery. While these treatments can be effective for early stage prostate cancer, they can fall short in preventing the spread of the cancer to other parts of the body. This review analyzes a new potential way of preventing …

The Efficacy Of Aquablation In The Treatment Of Large Volume Benign Prostatic Hypertrophy, Jessica Greenwood

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Introduction:

Benign Prostatic Hypertrophy (BPH) is a condition affecting adult males causing symptoms including urinary frequency, incontinence, and urinary retention. While first line treatment methods include lifestyle modifications and pharmacologic therapies, many patients elect for surgical procedures for symptomatic relief. In patients with extremely large volume prostates the surgical method most commonly used has been an open prostatectomy, which is associated with both long-term efficacy and more surgical complications than minimally invasive techniques. Therefore, this review analyzes Aquablation (I) for symptom management (O) in patients diagnosed with BPH (P) compared to open prostatectomy (C).

Methods:

A literature search was conducted …