Medicine and Health Sciences Commons^™

Efficacy Of Second Generation Antipsychotics As An Adjunct Therapy For Major Depressive Disorder, Gina Russo

The PA Department Journal of Medical Science

INTRODUCTION: Major depressive disorder is a debilitating mental health condition for many US adults. Traditional therapies may not be effective for many patients. The purpose of this paper is to evaluate the effectiveness of brexpiprazole, a second generation antipsychotic medication, as an adjunctive treatment for resistant MDD.

METHODS: PubMed was searched with a specific search strategy using key terms “brexpiprazole” and “major depressive disorder.” This search resulted in 21 results in which four articles were chosen based on the availability of free full text and the included content. Of the articles selected, three were a systemic review and meta-analyses, …

Efficacy Of Low-Level Laser Therapy For Osteoarthritis Of The Knee, Emily Drummond

The PA Department Journal of Medical Science

Introduction: Osteoarthritis (OA) is a disease associated with numerous effects on quality of life (QoL) and activities of daily living (ADLs). In recent years, low-level laser therapy (LLLT) has been evaluated as a symptom management option for KOA due to its non-invasive mechanistic properties. The purpose of this paper is to assess the efficacy of LLLT as a modality of treatment to help reduce mild to moderate symptoms associated with KOA.

Methods: A search via PubMed database was made using the keywords “LLLT” AND “osteoarthritis” AND “knee” with additional specifiers resulting in 10 articles for review. Four articles were chosen …

Buprenorphine As An Adjunctive Therapy For Pain Management In Opiate Use Disorder, Zane Hogston

The PA Department Journal of Medical Science

Introduction: Buprenorphine, a partial opioid agonist, has gained significant attention for its potential to address both opioid use disorder (OUD) and pain management. Offering an alternative to traditional opioids, buprenorphine is seen as a promising option, particularly for patients with a history of opioid misuse. Despite its increasing use in treating OUD, the evidence supporting its effectiveness in pain management remains limited, especially among broader patient populations. This review aims to explore current research findings and highlight buprenorphine’s role in managing pain among individuals with OUD.

Methods: A comprehensive search of PubMed was conducted using keywords such as “pain,” “buprenorphine,” …

The Impact Of Proton Pump Inhibitors On Cardiovascular And Bleeding Outcomes In Coronary Heart Disease Patients Undergoing Percutaneous Coronary Intervention, Melanie R. Stelling

The PA Department Journal of Medical Science

Introduction: Coronary heart disease (CHD) is a leading cause of mortality worldwide, with percutaneous coronary intervention (PCI) as the primary therapeutic approach. This review evaluates the effect of proton pump inhibitors (PPIs) on gastrointestinal (GI) bleeding risks and cardiovascular outcomes in patients with CHD who are undergoing PCI.

Methods: A systematic search using the PubMed database was conducted. Included in the search terms were: “dual antiplatelet therapy,” “proton pump inhibitors,” “percutaneous coronary intervention,” and “clopidogrel.” The search was narrowed down to include only systematic reviews, meta-analyses, and randomized control trials (RCTs) that were published in English within the last 10 …

Efficacy Of Collagenase Injection In Dupuytren’S Contracture, Janson Witcher

The PA Department Journal of Medical Science

Introduction: Dupuytren's contracture is a debilitating hand condition characterized by progressive contracture of the palmar fascia. The use of collagenase clostridium histolyticum injections has emerged as a minimally invasive alternative to surgical interventions, with varying degrees of efficacy and safety compared to traditional methods like limited fasciectomy and percutaneous needle fasciotomy.

Methods: A comprehensive literature review was conducted using PubMed to assess the efficacy and safety of collagenase injections for treating Dupuytren's contracture. The search focused on peer-reviewed randomized controlled trials, systematic reviews, and meta-analyses published in the last five years. Five relevant studies were selected based on the robustness …

Cardiovascular Event Reduction In Adults With Hypertension: Comparing Arbs And Other Antihypertensive Medications, Anna Macaluso

The PA Department Journal of Medical Science

Introduction: Hypertension is a leading cause of heart disease and stroke worldwide. There are various medications available for effective management of hypertension. This paper aims to evaluate the efficacy of antihypertensive medications on cardiovascular events in adults with hypertension, explicitly investigating angiotensin II receptor blockers (ARBs).

Methods: PubMed was searched with filters using key terms “angiot*” AND “hypertens*” AND “antihyp*” and key terms "arb" AND "hyper*" AND "cardiovasc*" to identify articles underlining the efficacy of ARBs and other antihypertensives in the reduction of cardiovascular events in adults with hypertension. Four articles, chosen by their direct comparison of antihypertensive medications and …

Apixaban Vs. Warfarin For Stroke Prevention In Patients With Atrial Fibrillation, Quinn Payne

The PA Department Journal of Medical Science

Introduction: Atrial fibrillation is a cardiac arrythmia that increases risk of stroke. The prevention strategy for this is anticoagulation, historically with the medication warfarin, but more recently with the factor Xa inhibitor apixaban. The purpose of this paper is to compare the efficacy of apixaban and warfarin for stroke prevention.

Methods: PubMed was searched using the key terms “atrial fibrillation,” “stroke prevention,” “warfarin,” and “apixaban.” Only relevant articles comparing apixaban to warfarin were included among RCTs, systematic reviews, and meta-analyses from the last 5 years. Four were chosen for review based on content and data quality.

Results: Three articles were …

Lateral Vs. Medial Parapatellar Approach Efficacy In Total Knee Arthroplasty, Savannah Howard

The PA Department Journal of Medical Science

Introduction: Total knee arthroplasties are the mainstay of treatment in patients with osteoarthritis and can be completed in a lateral parapatellar surgical approach or a medial parapatellar surgical approach. The purpose of this review is to compare if the lateral parapatellar approach has superior clinical outcomes to the medial parapatellar approach.

Methods: PubMed was searched using MeSH terms and Boolean operators “lateral” AND “medial” AND “knee replacement” AND “outcomes”. Filters were applied to narrow the results to four articles directly related to the comparison of clinical outcomes. Four articles were selected for clinical review.

Results: In all articles reviewed it …

Efficacy Of Hyperbaric Oxygen Therapy On Diabetic Foot Ulcer Healing, Steven Dang

The PA Department Journal of Medical Science

Introduction: Diabetic foot ulcers (DFUs) are a serious complication of diabetes, associated with high morbidity, recurrence, and amputation, driving up healthcare costs. While standard care includes topical treatments and debridement, hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunct. This study evaluates HBOT’s efficacy in enhancing DFU healing based on current clinical evidence.

Methods: A PubMed search using the terms ((Hyperbaric oxygenation*) AND (Diabetic foot*)) AND ("Wound Healing") returned 226 results. After filtering for recent articles (2019-2024), nine were reviewed, with five selected for analysis.

Results: The studies reviewed demonstrated significant improvements in wound healing outcomes with the use …

The Role Of Continuous Glucose Monitoring In Quality Of Life And Glycemic Control In Type 1 Diabetes, Brooke Strickland

The PA Department Journal of Medical Science

Introduction: Type 1 diabetes is an autoimmune disorder caused by the destruction of pancreatic beta cells which produce insulin, leading to the need for exogenous insulin to maintain glycemic control. Continuous glucose monitoring (CGM) has become a pivotal piece of technology in treating T1D. The purpose of this clinical review is to analyze the role of CGM in improving glycemic control and quality of life in T1D patients.

Methods: PubMed was searched with a specific search strategy using key terms “continuous glucose monitoring,” “type 1 diabetes,” “quality of life,” “glycemic control,” and “hbA1c.” Operators and filters narrowed results to 4 …

Steroid Injections Versus Hyaluronic Acid In Knee Osteoarthritis, Jessica Dawn Alley

The PA Department Journal of Medical Science

Introduction: Osteoarthritis is a degenerative disorder that affects more than 300 million individuals. Individuals with osteoarthritis have limitations in function and quality of life due to knee pain, swelling, difficulty walking, tightness, and neurologic symptoms. There have been increasing efforts to treat the condition, including corticosteroids, hyaluronic acid, PRP, and other injectables. The purpose of this review is to evaluate the effectiveness of corticosteroids or hyaluronic acid in the treatment of knee osteoarthritis

Methods: A search via PubMed database was completed using the keywords “knee osteoarthritis” AND “hyaluronic acid” AND “intra-articular” with an additional search completed using “knee osteoarthritis” AND …

Antibiotics Vs Appendectomy In Acute Uncomplicated Appendicitis, Elizabeth Wilson

The PA Department Journal of Medical Science

Introduction: Acute appendicitis is a common cause of the acute abdomen, and the current standard of care is surgical removal of the appendix. The purpose of this review is to compare the long-term efficacy of antibiotics in the treatment of acute uncomplicated appendicitis.

Methods: PubMed was searched using the key terms “anti-bacterial agents” AND “appendicitis” AND “appendectomy”. Operators and filters narrowed results to four relevant articles for review.

Results: Of the four articles, 3 were meta-analyses of the same RCTs comparing the efficacy of antibiotic therapy to appendectomies. The fourth reviewed 12 RCTs comparing antibiotic therapy to appendectomies.

Discussion: …

Computed Tomography Pulmonary Angiography Versus Ventilation-Perfusion Scanning For Pe During Pregnancy, Grace Perkins

The PA Department Journal of Medical Science

Introduction: Pregnant women who are diagnosed with a pulmonary embolism (PE) face a high rate of mortality due to its significant compilations. Timely and accurate diagnosis of PE is essential for appropriate management. Diagnostic imaging modalities, such as computed tomography pulmonary angiography (CTPA) and ventilation-perfusion (V/Q) scan, are required to confirm the PE. This study aims to determine the most optimal early diagnostic imaging for PE in pregnancy.

Methods: This study searched the PubMed database for research comparing diagnostic imaging modalities used in PE for pregnant women from 2018 to 2024. Keywords searched included “pulmonary embolism,” “pregnancy,” “computed tomography pulmonary …

Efficacy Of Pharmacotherapy Vs Psychotherapy For Insomnia: A Clinical Review, Logan Lovell

The PA Department Journal of Medical Science

Introduction: Insomnia is a widespread sleep disorder with significant impacts on public health, economics, and vulnerable populations including the elderly and those with chronic health conditions. This review examines current literature comparing pharmacologic and non-pharmacologic treatments for insomnia.

Methods: A comprehensive literature search was conducted via PubMed using the keywords “insomnia,” “cognitive behavioral therapy,” and “pharmacotherapeutics” which was refined using MeSH terms, Boolean operators, and specific parameters (English, free full-text, published between 2019 and 2024). Six articles were selected for an in-depth review of pharmacotherapeutic and psychotherapeutic treatments for insomnia.

Results: The selected articles from the PubMed search were …

Letrozole Vs Clomiphene Citrate For Treating Anovulation In Women With Pcos, Britney Landis

The PA Department Journal of Medical Science

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, often leading to infertility. First line treatment for ovulation induction is currently clomiphene citrate, a selective estrogen receptor modulator (SERM), but some patients with PCOS have become resistant. The purpose of this paper is to evaluate if letrozole is a safe and effective alternative to clomiphene citrate for ovulation induction in women with PCOS.

Methods: PubMed was searched with a specific search strategy using key terms “letrozole,” “clomiphene citrate,” and “PCOS”. Operators and filters narrowed the results to 3 relevant and quality articles for review. …

Aspirin Use For The Prevention Of Preeclampsia: A Clinical Update, Megan Murray

The PA Department Journal of Medical Science

Introduction: Preeclampsia is a serious and deadly complication in pregnancy that affects thousands of women every year. The purpose of this clinical review is to analyze the efficacy of aspirin therapy to prevent the occurrence of preeclampsia in high-risk pregnancies.

Methods: PubMed was searched using the key terms “pregnant,” "aspirin," “high-risk,” "preeclampsia," and “prevention”. Operators and filters narrowed results to 21 quality articles with 5 relevant to the topic for review.

Results: One article is an RCT comparing the prevention of preeclampsia with aspirin therapy to no therapy. Four articles are meta-analyses of multiple RCTs. Three of …

The Efficacy And Safety Of Baricitinib In The Treatment Of Alopecia Areata, Ireny Sharkawy

The PA Department Journal of Medical Science

Introduction: Alopecia Areata (AA) is an autoimmune disorder that causes inflammatory circular, coin-shaped patches of hair loss on the scalp and other body parts. Baricitinib, a Janus Kinase (JAK) inhibitor, is a new medication approved for the treatment of AA. This review paper evaluates the effectiveness and safety of baricitinib in treating hair loss in patients with alopecia areata compared to no intervention.

Methods: The efficacy and safety of baricitinib in treating AA patients were evaluated by utilizing five (5) clinical articles, including randomized controlled trials, systematic reviews, and meta-analyses, sourced from PubMed.

Results: Baricitinib JAK inhibitor was shown …

Semaglutide Vs Liraglutide For Weight Loss In Adults With Obesity, Orian Bar

The PA Department Journal of Medical Science

Introduction: Obesity is a growing chronic condition worldwide with limited effective and safe treatment options. Semaglutide and liraglutide are two GLP-1a medications with encouraging outcomes for the treatment of obesity. The purpose of this paper is to compare semaglutide to liraglutide for weight loss and obesity

Methods: Pubmed was searched for randomized controlled trials, systematic reviews, and meta- analyses from 2019 to 2024 to assess efficacy of semaglutide and liraglutide. Five articles were selected for clinical review.

Results: In 4 out of the 5 studies there was a greater reduction in weight in patients receiving semaglutide compared to liraglutide. Statistically …

Do Oral Contraceptives Increase Breast Cancer Risk In Adult Women?, Melinda Behney

The PA Department Journal of Medical Science

Introduction: Breast cancer ranks as the most frequently diagnosed cancer globally. These numbers are on the rise annually, possibly influenced by changes in shifts in women’s lifestyles including sedentary lifestyle, obesity, consumption of alcohol, and oral contraceptive use. This paper aims to assess whether the use of oral contraceptives elevates the risk of breast cancer in adult women.

Methods: A search via PubMed using the key terms “contraceptives, oral” AND “breast neoplasms” resulted in 1,398 articles. After applying operators and filters for the last five years (January 2019 through June 2024), the results were narrowed down to five high-quality studies, …

Combined Low/Moderate-Intensity Statin With Ezetimibe Vs High-Intensity Statin Alone: A Comparison, Haden Baker

The PA Department Journal of Medical Science

Introduction: Hyperlipidemia is a continually rising global health crisis and is one of the leading contenders in chronic disease, with traditional statin monotherapy being at the foundation of LDL lowering treatment interventions. The purpose of this review is to compare two different therapy options, 1.) combined low/moderate-intensity statin with ezetimibe, and 2.) monotherapy high- intensity statin, and assess their efficacy in reducing LDL values in patients with hyperlipidemia.

Methods: PubMed was searched using the search "high intensity" statin AND "ezetimibe" AND "lipid.” Operators and filters were added to narrow the results to four relevant, quality articles for review.

Results: Three …

Dual Antiplatelet Vs Monotherapy As Secondary Prevention For Myocardial Infarction In Coronary Artery Disease, Ana Patricia Dorado

The PA Department Journal of Medical Science

Introduction: Coronary artery disease (CAD) is the leading cause of death globally, with myocardial infarction (MI) being the biggest contributor. While aspirin monotherapy is standard for preventing ischemic events in CAD patients, dual antiplatelet therapy (DAPT) combining aspirin with P2Y12 inhibitors may offer greater efficacy. This review examines whether DAPT reduces MI incidence compared to aspirin monotherapy (AM), weighing the benefits against potential bleeding risks to guide optimal treatment strategies.

Methods: Inclusion criteria included studies in English, published between 2019 and 2024, randomized controlled trials (RCTs), systematic reviews, and meta-analyses. The following key terms we used in the PubMed database, …

A Clinical Review Of The Efficacy Of Masks In Preventing Spread Of Sars-Cov-2, Harrison Nobles

The PA Department Journal of Medical Science

Introduction:

The COVID-19 pandemic, caused by SARS-CoV-2, has sparked debate over the effectiveness of masks in reducing viral transmission. This clinical review aims to evaluate the efficacy of cloth masks, medical masks, and N95 respirators in preventing COVID-19 transmission.

Methods:

A literature search was conducted on PubMed for articles published between January 2020 and August 2024. Out of 27 screened articles, 5 met the inclusion criteria, focusing on mask efficacy in preventing SARS-CoV-2 transmission.

Results:

Of the 5 studies included, three were systemic reviews, one was a metanalysis and one was a systemic review and meta-analysis. The largest …

Efficacy Of Virtual Reality Incorporation In Post-Stroke Rehabilitation, Chloe Lissauer

The PA Department Journal of Medical Science

Introduction: Stroke is one of the leading causes of death and morbidity in the United States, with one of the largest concerns being persistent neurological deficits. Traditionally, conventional rehabilitation has been initiated as soon as possible in post-stroke patients in attempt to improve function and neuroplasticity either back to patient baseline levels or to a new maintained baseline. Recently, virtual reality (VR) supported rehabilitation has been studied in comparison to traditional therapy to determine if there is potential for its utilization in patient care.

Methods: A PubMed database search was used and narrowed down to 6 articles to be interpreted …

Ablation Vs Drug Therapy For Long-Term Outcomes Of Atrial Fibrillation, Taylor Yaw

The PA Department Journal of Medical Science

Introduction: Atrial fibrillation (AF), a rapid and irregular arrhythmia, is the most common cause of cardiac-related stroke and other serious complications for those affected. The first-line treatment for long-term rhythm control of AF remains in question and simplification of therapy would be a significant development. This review aims to determine the efficacy of ablation versus antiarrhythmic drug therapy for the treatment of AF.

Methods: A search via PubMed using the keywords ablation* AND drug therapy* AND atrial fibrillation* AND long-term effects produced 770 results. Results were consolidated by excluding those without full text. Filters were set to randomized control trials …

End-Stage Renal Disease: A Clinical Review On Renal Replacement Therapy Outcomes, Mckenzie T. Lawrence

The PA Department Journal of Medical Science

Introduction: End-stage renal disease (ESRD) is a worldwide issue that occurs when the kidneys fail to filter out harmful waste from the blood. The only treatment options for patients with this diagnosis are kidney transplant, hemodialysis (HD), and peritoneal dialysis (PD). HD involves surgical prep with vascular access and is only performed in clinic. HD is also the most commonly used form of renal replacement therapy (RRT). Peritoneal dialysis is performed through the peritoneum and can be done in clinic or at home. The purpose of this paper is to investigate the overall patient outcomes in those undergoing HD compared …

Mohs Surgery Versus Surgical Excision: A Clinical Review Of Skin Cancer Recurrence Rates, Gabriella H. Malone

The PA Department Journal of Medical Science

Introduction: Skin cancer is a serious, yet preventable disease that impacts individuals worldwide. Skin cancer is treated through both surgical and non-surgical interventions. Designed to preserve healthy skin tissue, Mohs surgery has shown favorable outcomes in lessening skin cancer recurrence. The purpose of this paper is to evaluate whether Mohs surgery is superior to traditional surgical excision in reducing recurrence rates in patients with skin cancer.

Methods: PubMed was searched for clinical trials to assess the effectiveness of Mohs surgery compared to surgical excision in cancer recurrence. Five articles were selected for clinical review.

Results: In 5 studies, there was …

Investigating Synovial Fluid Electrochemical Properties Against Orthopaedic Alloys, Bailey Thomas Bond

Theses and Dissertations (ETD)

Introduction. Cobalt-chromium-molybdenum (CoCrMo) femoral components are widely used in total knee arthroplasty (TKA). However, recent retrospective clinical trials associate moderate adverse local tissue reactions (ALTRs) with CoCrMo release in the knee. Additionally, gaps persist in our understanding of the fundamental corrosion processes that occur at the CoCrMo-synovial fluid interface. The first study investigates the electrochemical behavior of CoCrMo in human synovial fluid obtained at the time of primary TKA, using CoCrMo in phosphate-buffered saline (PBS) as a comparison. The second study compares the synovial fluid properties, both physical and electrochemical, in necropsy TKA and contralateral (native) knee specimens. Methods. In …

Occupational Therapy Practitioner Perspectives On Leadership In Everyday Practice: A Descriptive Qualitative Study, Mary E. Spores

Occupational Therapy Doctorate Capstone Projects

Background: Leadership is a topic of interest for rapidly evolving healthcare professions and a cornerstone of the American Occupational Therapy Association (AOTA) Centennial Vision. The history of leadership in the profession has a robust foundation and yet calls to action for leadership in the profession remain focused on traits, behaviors and transformative processes. Occupational therapy practitioners (OTPs) are positioned to be leaders of change with the use of leadership influence however, practitioner views on their enactment of leadership in everyday practice are sparse in the literature.

Purpose: The purpose of this qualitative descriptive study was to capture the perspectives of …

Perceptions Of School-Based Occupational Therapists Regarding The Access To Educator Credential Pathways In Kentucky, Jill Edlin

Occupational Therapy Doctorate Capstone Projects

Background: In Kentucky public schools, occupational therapists are employed as classified staff without access to educator credential pathways. This study explores occupational therapist’s perceptions of how those state-level structures impact recognition, collaboration, leadership, and day-to-day practice within the educational system context. Purpose: This qualitative descriptive study examines school-based occupational therapists’ perceptions of how the absence of educator credential pathways influences their professional practice, collaboration, and leadership in Kentucky public schools. Research objectives focus on describing Kentucky school-based occupational therapists’ perceptions of leadership opportunities as shaped by state educator credentialing. Objectives also focus on exploring how credentialing influences interprofessional collaboration with …

Optimizing Advance Care Planning: Leveraging An Electronic Medical Record Prompt To Impact Advance Directive Documentation, Annette L. Meares

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Advance Directives (ADs) support patient-centered care by documenting preferences for future medical treatment. While the Centers for Medicare & Medicaid Services (CMS) incentivizes AD documentation through billing codes, national adoption remains low.

Local Problem: A rural Northern Illinois primary care practice had electronic referral capabilities for ACP; however, referrals remained low and inconsistent during Medicare Annual Wellness Visits (AWVs), limiting opportunities for AD completion.

Methods: This quality improvement project targeted Medicare AWV patients without ADs documented in the electronic medical record (EMR). During a 10-week pre-intervention period, baseline data were collected. In the subsequent 10-week intervention phase, an …