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 Many providers do not know how to treat or manage chronic wounds and may use outdated methods to treat the wounds.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 …

Diagnosis And Management Of Cyclic Vomiting Syndrome, Sara Read

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Cyclic vomiting syndrome (CVS) is a chronic and debilitating condition that can be encountered in a multitude of clinical settings. It is classified as a functional gastrointestinal disorder and is often misdiagnosed. Proper identification and management of this condition are crucial to patient care and quality of life. This article reviews the hypothesized etiologies, clinical presentation, and diagnosis of CVS as well as recommendations for management in a variety of settings. As an understudied and underdiagnosed condition, it is important that clinicians have a basic understanding of this disorder.

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.

Cme: Vitamins, Antidepressants, And The Placebo Effect - How To Help Your Patients, Nicko Inocencio

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Depression affects roughly 280 million people globally. The disease puts patients at increased risk for stroke, cardiovascular disease, hypertension, and diabetes. The psychosocial causes of depression are well-known, but the biochemical causes are multifactorial. Theories range from homocysteine excess, calcium modulation at the neuron, inflammation, cortisol elevation, and disruption of the HPA axis. At the center, however, is serotonin, norepinephrine, and dopamine. Pharmacologic treatment directly aims at modulation of serotonin, norepinephrine, and dopamine. First-line treatment is a combination of SSRIs/SNRIs with cognitive behavioral therapy. If patients do not see improvement with the above therapy other agents such as bupropion, mirtazapine, …

A Case Of Protein Losing Enteropathy After Fontan Operation, Gina Kim

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Protein Losing Enteropathy (PLE) is a condition in which an excessive amount of proteins are lost through the gastrointestinal tract leading to hypoproteinemia and manifesting as edema, ascites, and diarrhea. While in most cases PLE is a treatable disorder with good outcomes, the morbidity and mortality of the disorder is significantly elevated in patients with a history of Fontan surgery–an operation used to palliate patients born with a single ventricle by rerouting venous blood return directly to pulmonary circulation. After failure of first-line therapeutics of diuretics and steroids, this case study explores the successful treatment of a 5-year-old patient with …

Management Of Adult Growth Hormone Deficiency Related To Hypopituitarism, Kellie Jamin

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The treatment of growth hormone deficiency (GHD) is well-established in childhood but less understood in adults, given the more complex role that growth hormone (GH) assumes in this population. Decreased functionality of the pituitary gland, otherwise known as hypopituitarism, can present with an isolated GHD in adulthood, which may result from a number of factors including neoplasm, ischemia, infection, traumatic injury, or systemic disease. Adult GHD may be definitively diagnosed with a stimulation test, the insulin tolerance test (ITT) being the study of choice. With a positive ITT, the disorder can be treated with growth hormone replacement therapy (GHRT), which …

Percutaneous Coronary Intervention Using Second Generation Drug-Eluting Stents Vs Coronary Artery Bypass Graft In Left Main Coronary Artery And Multivessel Coronary Artery Disease, Eric Kim

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Many of the studies that are used in reference to the clinical decision making between PCI vs CABG use BMS or first-generation DES as a comparison. With the advancement of stent technology, second-generation DES have emerged with improved efficacy and overall outcome rates compared to BMS and first-generation DES. Some of the newer studies such as EXCEL1-2 , demonstrated noninferiority of second-generation DES to CABG but there are limited studies that support this conclusion. Currently, the studies remain divided in the impact of newer-generation PCIs, and 10-year follow up studies may be required to further validate noninferiority before it can …

Altitude Illness, Kali Hepner

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With an increasing number of individuals traveling to high altitudes, it is important to address the risk these individuals face of developing altitude related illnesses. An example of high altitude related illness might be the elevation transition of travelers flying into Denver, Colorado (1,673 m) with the intention to then drive up to Rocky Mountain National Park’s Alpine Visitor Center (3,595 m) in the same day. This poses increased risk of unacclimatized visitors experiencing altitude illness in remote areas of the national park. This poster summarizes the diagnosis, prevention, and treatment of altitude illnesses so that clinicians and travelers may …

Management Of Refractory Ventricular Fibrillation With Double Sequential Defibrillation, Kaitlyn A. Brown

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Patients experiencing cardiac arrest are treated according to ACLS protocols, however current protocols lack recommendations for the treatment of refractory Ventricular Fibrillation which persists after more than 3 cycles of CPR and defibrillation. One potential intervention for these cases that is being researched is the use of simultaneous or sequential activation of two defibrillators. This literature review analyzed the results of several studies to determine if double sequential defibrillation (DSD) is a viable treatment to achieve return of spontaneous circulation (ROSC) and improved patient survival. The results of the studies were mixed with some showing positive outcomes, and others showing …

Efficacy Of Platelet-Rich Plasma (Prp) Injections Vs Topical Minoxidil In Adults With Androgenetic Alopecia, Yuan-Jane Qiu

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Androgenetic alopecia is a condition mediated by androgen (specifically DHT) and genetic factors that causes hair loss and thinning of the scalp in men and women. The hairs’ anagen phase is shortened and terminal hairs transition into vellus hairs. Although this condition is considered cosmetic in nature, it has psychologically detrimental effects. There are medical treatments available to prevent further hair loss but there is currently no cure. Topical minoxidil (Rogaine) is the most commonly used medication for androgenetic alopecia that stops hair loss and, in some cases, helps hair regrowth. However, it can cause an allergic contact dermatitis, local …

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

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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 …

The Efficacy Of Mirnas As A Diagnostic Tool For Endometriosis, Maura Franey

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Abstract

Introduction: Endometriosis is a chronic inflammatory gynecological condition. Laparoscopic abdominopelvic exploration is the gold standard of diagnosis, but is not performed until patients experience severe symptoms. This review analyzes the levels of circulating micro-RNAs (miRNAs) (I) for diagnosis of endometriosis (O) in women diagnosed with endometriosis (P) compared to laparoscopic exploration (C).

Methods: A literature search was conducted through PubMed and Cochrane Library in November 2019. A total of nine articles consisting of case-control or systematic reviews were selected based on publication date, main outcome, and the use of miRNAs or laparoscopy for diagnosis of endometriosis.

Results: The eight …

The Efficacy Of Yoga As An Adjunctive Therapy To Standard Multidisciplinary Care In The Treatment Of Female Patients Presenting With Cognitive Eating Disorder Symptoms, Cassidy Nagle

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Introduction: Current treatment of patients exhibiting cognitive eating disorder symptoms is standard multidisciplinary care (SMDC) involving behavioral therapy, medical management and dietetics. Because these symptoms often persist or relapse despite treatment, research has begun to explore adjunctive therapies like yoga for this population. This review will explore seven studies in order to analyze the effect of yoga (I) on cognitive eating disorder symptoms (O) in teenage and adult females (P) when added to SMDC compared to symptom reduction with SMDC alone (C).

Methods: A literature search was conducted in PubMed, Academic Search Ultimate and Google Scholar starting November 2018. Seven …

Renoprotective Effect Of Sglt-2 Inhibitors Vs ​ Ace Inhibitors In Type 2 Diabetes, Duncan Pickett

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Abstract

Introduction: Type 2 diabetes mellitus (DM2) is one of the most prevalent diseases worldwide today, and consistently growing over the years. The illness is marked by progressively increased insulin resistance in the body’s cells, leading to glucose overload, and eventually cell and organ damage and death. One end result of DM2 is nephropathy. The current first-line treatment for DM2 is a class of drugs called angiotensin-converting-enzyme inhibitors (ACE inhibitors). ACE inhibitors are considered reno-protective, but eventually nephropathy occurs in patients taking the drug regardless. This paper will address the efficacy of a new alternative diabetes drug, sodium-glucose cotransporter-2 inhibitors …

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 …

The Efficacy Of Acute Normovolemic Hemodilution Compared To Cell Salvage As A Blood Transfusion Alternative, Julia Yu

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Blood transfusions are currently the treatment of choice for significant blood loss. However, there are a variety of reasons for which they cannot be utilized. Current alternatives are acute normovolemic hemodilution (ANH) and cell 1 This study analyzes whether ANH or cell salvage is more effective in minimizing blood loss in perioperative or trauma patients. Multiple different studies involving either ANH or cell salvage were compared to each other. However, due to the lack of research conducted in either method, results obtained were largely inconclusive.

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 …