Medicine and Health Sciences Commons^™

Is Low-Level Laser Therapy An Effective Treatment For Patients With Primary Raynaud’S Phenomenon?, Adriana S. Ruiz

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not low-level laser therapy is an effective treatment for patients with primary Raynaud’s Phenomenon.

STUDY DESIGN: Review of three randomized, double blind, placebo controlled trials, published between 2002-2004.

DATA SOURCES: Randomized, double blind clinical trials comparing low-level laser therapy with a placebo treatment were found using the Cochrane databases, and PubMed.

OUTCOME MEASURED: Reduction in frequency and severity of Raynaud’s attacks. Outcomes were measured and recorded with daily diaries of attacks before and after the intervention, and thermographic studies.

RESULTS: Three RCTs were included in this review. …

Is Methylphenidate Transdermal System (Daytrana®) Safe And Effective For Managing Attention Deficit Hyperactivity Disorder Symptoms In Children?, Pamela Cassidy

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not methylphenidate transdermal system (Daytrana®) is safe and effective for managing attention deficit hyperactivity disorder symptoms in children.

STUDY DESIGN: A review of three English language studies published from 2006-2010. Includes two randomized, double-blind, controlled trials and one randomized, controlled crossover study.

DATA SOURCES: Randomized, placebo-controlled studies evaluating the effectiveness and safety of methylphenidate transdermal system (MTS) for managing attention deficit hyperactivity disorder (ADHD) symptoms in children were located using the PubMed, CINAHL, and Cochrane Library databases.

OUTCOMES MEASURED: The primary measures of effectiveness used were the …

What Is The Efficacy Of Finasteride Therapy In Reducing Or Reversing Hair Loss?, Olisa K. Obi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Finasteride is effective in reducing/reversing the symptoms of androgenic alopecia.

STUDY DESIGN: Reviewed three English primary studies published in 2006, 2008, and 2009. DATA

SOURCES: All Studies were randomized controlled trials comparing Finasteride to placebo or other hair loss treatments were found using PubMED, EBSCO, MEDLINE, and Cochrane research databases.

OUTCOME MEASURED: Overall reduction in size of balding area based on measurements of total hair counts. Measurements were based on macrographical analysis of test subjects’ balding area, as well as global photographical analysis carried out …

Is Weight Lifting Effective In Reducing Lymphedema In Breast Cancer Survivors?, Diana Petrucello

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not weight lifting is effective in reducing lymphedema in breast cancer survivors.

STUDY DESIGN: Systematic review of three English language primary studies published in 2009 and 2010.

DATA SOURCES: Three single blind, randomized controlled trials comparing progressive weight lifting and other treatments in breast cancer survivors were found using the Cochrane Database of Systematic Reviews and PubMed.

OUTCOMES MEASURED: Incidence of breast cancer-related lymphedema onset measured by blinded certified lymphedema therapists using a standardized clinical evaluation derived from the Common Toxicity Criteria version 3.0, comprising of interlimb …

Will The Use Of Fiber Be As Effective As Laxatives In Relieving Constipation In The Geriatric Population?, Saunders Batunkyi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of fiber can be as effective as laxatives in relieving constipation in the geriatric population.

STUDY DESIGN: Review of three journals published in English in peer-reviewed journals.

DATA SOURCES: Two randomized controlled trials and one parallel interventional trial investigating the effectiveness of supplemental dietary fiber in managing constipation in elderly populations that are presently reliant on prescription laxatives.

OUTCOMES (S) MEASURED: The outcomes were measured by the frequency of defecation, ease of bowel movement, patient discomfort, patient well being, and undesired effects …

Is Massage Effective As A Non-Pharmacologic Treatment For Individuals Suffering From Migraines?, Kristin J. Kirby

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not massage therapy is effective as a non-pharmacologic treatment for individuals suffering from migraines.

STUDY DESIGN: Review of all English language primary randomized controlled trials from 1996-2011.

DATA SOURCES: Three randomized controlled trials were found using Pubmed, CINAHL, and Cochrane databases. These compared massage therapy trials in patients suffering from migraine headaches.

OUTCOMES MEASURED: Each trial measured the outcomes in slightly different ways. The Hernandez et al study used the VITAS pain scale, symptom checklist, headache log, and a sleep log to record outcomes. The Lawler et …

Is There A Benefit To Suturing Vs. Stapling In Cesarean Section Closure When Comparing Postoperative Pain And Patient Satisfaction?, Jennifer Pilchman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE:The objective of this selective EBM review is to determine whether or not there is a benefit to suturing vs stapling in cesarean section closure when comparing postoperative pain and patient satisfaction.

STUDY DESIGN: Review of three English language primary studies published in 2009 and 2010.

DATA SOURCES: Three randomized control trials (RCTs) comparing the surgical closures for cesarean section delivery. All RCTs were found by the author using MEDLINE, PUBMED, and COCHRANE databases. They are all published articles written in English.

OUTCOME MEASURED: Outcomes were measured by assessing patient satisfaction, postoperative pain, cosmetic appearance and wound complications. Rousseau …

Is The Use Of Apixaban Or Enoxaparin, More Effective In The Prophylaxis Of Venous Thromboembolism Post-Orthopedic Surgery?, Jolene Bohensky

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of Apixaban or Enoxaparin is more effective in the prophylaxis of venous thromboembolism post-orthopedic surgery.

STUDY DESIGN: Review of three English language randomized, double-blind, placebo-controlled clinical trials from 2009-2010.

DATA SOURCES: Randomized, double-blind placebo controlled, clinical trials comparing the effectiveness of Apixaban and Enoxaparin in the prophylaxis of Venous Thromboembolism (VTE) post-orthopedic surgery were found using PubMed, the Cochrane Database of Randomized Controlled Trials, and the Cochrane Databases of Systematic Reviews.

OUTCOMES MEASURED: Development of venous thromboembolism (VTE) post-orthopedic surgery including Total …

Does Reiki Therapy Decrease Pain During Chemotherapy And Radiation Treatment In Patients With Gynecological And Breast Cancer?, Samantha L. Ciaccia

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Reiki therapy decreases pain during chemotherapy and radiation treatment in patients with gynecological and breast cancer.

STUDY DESIGN: Review of two randomized control trials and one randomized prospective cross-over study published in 2003, 2004, and 2011.

DATA SOURCES: One double blind randomized control trial, one 2-arm single blind randomized control trial and one randomized, prospective, 2-period crossover intervention study comparing Reiki therapy to placebo. Articles were found using PubMed and Medline.

OUTCOMES MEASURED: Pain by BPI (brief pain inventory linear analog scale), SF-36 questionnaire, …

Does Mucosal Or Serosal Side Approximation Affect The Efficacy Of Native Small Intestinal Submucosa Graft Repair Of Neurotmesis?, Ferro Nguyen

PCOM Biomedical Studies Student Scholarship

FDA approved, commercial, modified porcine small intestinal submucosa (SIS) is utilized clinically for peripheral nerve repair. However, if measures can be put in place to insure its safety, native SIS prepared from locally available porcine resources would provide easy access to an inexpensive alternative. Both forms of this material lack antigenicity, have inherit properties which provides a favorable growth environment, and have been successfully used experimentally as a natural conduit in peripheral nerve repair. Successful recovery from a peripheral nerve injury is dependent on the efficiency and speed of axonal regeneration to the point of distal interruption of the nerve. …

Effects Of Cross-Fostering On Alcohol Preference And Correlated Responses To Selection In High- And Low-Alcohol Preferring Mice, G. D. Barrenha, Julia Chester

Department of Psychological Sciences Faculty Publications

Background: Selectively bred rodent lines are valuable tools for investigating gene x environment interactions related to risk for alcoholism in humans. Early maternal environment is one particular factor known for critically influencing neural, hormonal, and behavioral outcomes in adulthood. Cross-fostering is a procedure that may be used to explore the role of genotype-dependent maternal influences on phenotypic variability in adulthood. The purpose of these experiments was to examine the effects of cross-fostering on free-choice alcohol drinking and correlated responses to selection for alcohol preference in mice selectively bred for high- (HAP2) and low- (LAP2) alcohol preference. Methods: Mice were assigned …

Design And Synthesis Of Hiv-1 Integrase Inhibitors, Sarah Chajkowski Scarry

Electronic Theses and Dissertations

In recent years, HIV-1 integrase (IN) has emerged as an attractive target for the treatment of human immunodeficiency virus type 1 (HIV-1), the causative pathogen of acquired immuno-deficiency syndrome (AIDS). Several classes of IN inhibitors are known but many of these compounds are toxic, do not show antiviral activity or display decreased potency. Therefore, new classes of potent IN inhibitors are desperately needed. The b-diketo (b-DK) class of compounds has emerged as one of the most successful classes of IN inhibitors. Although several b-DK inhibitors with potent antiviral activity are known, compounds containing b-DK motifs have limitations in drug development. …

Development And Evaluation Of An Instrument To Measure Mother-Infant Togetherness After Childbirth, Carol Lawrence

Electronic Theses and Dissertations

No existing measure to date captures mother-infant togetherness. A valid measure of togetherness is essential to engage in evidence-based practice, evaluate obstetric delivery models and nursing interventions, and measure the level of togetherness which promotes optimal maternal-infant outcomes. When together and in close proximity, a women and her infant have access to one another to allow for mutual caregiving or caregiving on cue. A new measure entitled the Mother-Infant Togetherness Scale (MITS) was developed based on a review of the literature and conceptual framework of Mother-Newborn Mutual Caregiving. The MITS is a 35- item instrument composed of four subscales that …

Creating A Patient Navigation Model To Address Cervical Cancer Disparities In A Rural Hispanic Farmworker Community, Kristen Wells, Maria Rivera, Sara Proctor, Gloria Arroyo, Shalanda A. Bynum, Gwendolyn Quinn, John S. Luque, Marlene Rivera, Dinorah Martinez-Tyson, Cathy Meade

Community Health: Faculty Publications

This report describes the implementation of a pilot patient navigation (PN) program created to address cervical cancer disparities in a predominantly Hispanic agricultural community. Since November 2009, a patient navigator has provided services to patients of Catholic Mobile Medical Services (CMMS). The PN program has resulted in the need for additional clinic sessions to accommodate the demand for preventive care at CMMS.

The Effects Of Two Group Counseling Interventions On Arab-American High School Students' Perceptions Of Their Primary Relationships (Parent, Teacher, Peer), Nuzmeya Bader Elder

Wayne State University Dissertations

This study specifically investigated the effects of two group counseling interventions on Arab-American high school students' perceptions of the strength of their primary relationships (parent, teachers, and peers). It was designed to help high school students increase their acceptance of the culture of their host society and develop a sense of comfort so they can retain some of their own culture and Arab identity without feeling they will totally lose them. One approach was Choice group theory grounded in the reality of making choices concerning thoughts and behaviors. Choice Theory is described as the idea that people have mental images …

Identifying Sm22 As A Key Player In Arterial Diseases, Jianbin Shen

Wayne State University Dissertations

Background : Expression of vascular smooth muscle cell (VSMC) cytoskeleton markers including SM22 is down-regulated in arterial diseases including atherosclerosis where inflammation and osteochondrogenesis are present. However, the role of this downregulation in arterial pathogenesis is unknown. Hypothesis : Downregulation of SM22 may actively contribute to arterial pathogenesis. Methods : Five Sm22 knockout (Sm22^-/-) mice and their wild type littermates were subjected to carotid artery denudation, an artery injury model. Analyses were conducted on carotid arteries 2 weeks after injury. Primary VSMCs were isolated from mouse aortas and investigated individually at passage 2 to 4. Sm22 knockdown was …

Identification Of Transcriptional Mechanisms Downstream Of Nf1 Gene Defeciency In Malignant Peripheral Nerve Sheath Tumors, Daochun Sun

Wayne State University Dissertations

Malignant peripheral nerve sheath tumor (MPNST) is a type of soft tissue sarcoma that occurs in carriers of mutations in the neurofibromatosis type I gene (Nf1) as well as sporadically. Plexiform neurofibromas in NF1 patients have a significant risk of developing into MPNSTs leading to increased morbidity and mortality from this syndrome. Surgery is the primary intervention but it is not always effective due to the tendency of MPNSTs to infiltrate the surrounding tissue or grow in an inoperable location. Neurofibromin, the protein coded by the Nf1 gene, functions as a GTPase activating protein (GAP) whose mutation leads to constitutive …

Understanding The Gender-Based Mechanism Of Mso In Als Mice: A Metabolic Characterization Of The Sod1-G93a Mouse Model, Monica Ann Bame

Wayne State University Dissertations

Amyotrophic Lateral Sclerosis (ALS) is a devastating neurodegenerative disease characterized by motor neuron death and a corresponding loss of neuromuscular connections resulting in muscle atrophy. Patients become paralyzed shortly after symptom onset and typically die within one to five years of pulmonary complications. ALS is a relatively rare disease, with an overall incidence of approximately 2 in 100,000 people per year and a prevalence of about 5 in 100,000 people. It is typically associated with increasing age and has a slight male prevalence, with a male to female ratio of approximately 3:2. ALS is classified as either familial (the less …

Longitudinal Outcomes Of Distortion Product Otoacoustic Emissions And Wideband Reflectance In Infants, Virginia Ramachandran

Wayne State University Dissertations

Clinical practice has shown that some infants are born with, or develop a temporary conductive hearing loss characterized by the absence of measurable otoacoustic emissions (OAEs) but normal sensorineural hearing. This transient situation interferes with the process of universal newborn hearing screening and identification.

The purpose of this prospective, longitudinal study was to describe outcomes of distortion product OAE (DPOAE) screening in infants at birth, and one, four, eight, and twelve weeks of age. In addition, wideband reflectance (WBR) measures, which have the potential to help characterize outer-ear canal and middle-ear function, were examined to determine their potential utility in …

Role Of Thromboxane Receptor-Alpha In Prostate Cancer Progression, Prasanna Ekambaram

Wayne State University Dissertations

Thromboxane A2 (TXA2) is a major arachidonic acid metabolite that signals through TXA2 receptors (TP) to induce platelet aggregation and smooth muscle contraction. TXA2 receptors are expressed as two different isoforms in humans, namely TP-alpha (TPα) and TP-beta (TPβ), which have common and distinct signaling pathways. Of the two TP receptor isoforms, studies have shown that TPα impacts tumor growth and progression of lung cancer. Previously our studies demonstrated that activation of Thromboxane receptor by TXA2 agonists could regulate prostate cancer (PCa) cell motility and cytoskeletal reorganization through activation of Rho-A. The primary objective of this study is to investigate …

A Role For Reactive Oxygen Species In Photodynamic Therapy, Michael Price

Wayne State University Dissertations

Photodynamic therapy (PDT) is based on the ability of certain photosensitizing agents to selectively localize in neoplastic cells and their vasculature. Subsequent irradiation at a wavelength corresponding to a photosensitizer absorbance band excites the photosensitizer molecules, leading to energy transfer reactions and fluorescence. It was initially concluded that the phototoxic effect occurred when energy from the excited state of the photosensitizer was transferred to dissolved oxygen to form singlet oxygen. This product has a very brief half-life and will cause cellular damage only in the immediate vicinity of its formation. But an excited-state photosensitizer can also interact with oxygen to …

Hdm2 Small-Molecule Inhibitors For Therapeutic Intervention In B-Cell Lymphoma, Angela Sosin

Wayne State University Dissertations

Lymphomas frequently retain wild-type (wt) p53 function but overexpress HDM2, compromising p53 activity. Therefore, lymphoma is a suitable model for studying therapeutic value of disrupting HDM2-p53 association by small-molecule inhibitors (SMIs). HDM2 SMIs have been developed and are currently under various stages of preclinical and clinical investigation. This study examined various molecular mechanisms associated and biological effects of two different classes of HDM2 SMIs: the spiro-oxindoles (MI-219) and cis-imidazoline (Nutlin-3) in lymphoma cell lines and patient-derived B-lymphoma cells. Surprisingly, results revealed significant quantitative and qualitative differences between these two agents. At the molecular level, effect of Nutlin-3 was generally more …

Predicting Vision Loss In Healthy Aging With Manganese-Enhanced Mri Of The Rat Eye, David Bissig

Wayne State University Dissertations

In healthy aging, visual function declines throughout adulthood. Age-related changes in neuronal ion homeostasis -- specifically, increased Ca2+ influx through L-type voltage gated calcium channels (L-VGCCs) -- are believed to contribute to certain functional declines, but this possibility has not yet been tested in the neural retina. In young, mid- and old adult Long-Evans rats, we compared visual function (optokinetic tracking), as well as retinal physiology and eye morphology (Mn2+-enhanced MRI (MEMRI), which uses neuronal Mn2+ uptake as a marker of Ca2+ influx). We documented significant age-related decreases in visual performance and increases in retinal ion influx. We confirmed that …

Substance P And The Host Immune Response, Megan Elizabeth Foldenauer

Wayne State University Dissertations

This body of work examined the mechanism by which SP regulates host immunity, specifically, its control of growth factors and TLR expression in the P. aeruginosa-infected cornea. The role of mTOR and VIP in corneal infection and inflammation also was tested.

SP has a dual role in bacterial infection, unexpectedly upregulating growth factor production. This was accompanied by macrophage-specific upregulation of pro-inflammatory cytokines, downregulation of anti-inflammatory cytokines, and upregulation of anti-apoptotic genes, as well as a decrease in arginase-producing macrophages (M2 cells), important in stromal healing in these mice. All of these lead to worsened disease, despite the stimulatory effects …

Ethics Of Clear Health Communication: Applying The Clean Look Approach To Communicate Biobanking Information For Cancer Research, Alexis Koskan, Mariana Arevalo, Gwen Quinn, Shalwea Noel-Thomas, John S. Luque, Kristen Wells, Cathy Meade, Clement K. Gwede

Community Health: Faculty Publications

Cancer innovations, such as biobanking technologies, are continuously evolving to improve our understanding and knowledge about cancer prevention and treatment modalities. However, the public receives little communication about biobanking and is often unaware about this innovation until asked to donate biospecimens. It is the researchers’ ethical duty to provide clear communications about biobanking and biospecimen research. Such information allows the public to understand biobanking processes and facilitates informed decision making about biospecimen donation. The aims of this paper are 1) to examine the importance of clear communication as an ethical imperative when conveying information about cancer innovations and 2) to …

Refinement Of An Educational Toolkit To Promote Cervical Cancer Screening Among Hispanic Farmworker Women In Southeast Georgia, Lisa C. Watson-Johnson, Jigar Bhagatwala, Claudia Reyes-Garcia, Andrea Hinojosa, Mondi Mason, Cathy Meade, John S. Luque

Community Health: Faculty Publications

Cervical cancer incidence and mortality continue to affect Hispanic women in the U.S. disproportionately. Our project sought to refine a cervical cancer intervention designed for use by community health workers, or promotoras, in rural southern Georgia. We collaborated with Hispanicpromotoras to refine a Spanish language educational flipchart featuring cervical cancer topic areas for use in screening promotion.

Formative Research On Perceptions Of Biobanking: What Community Members Think, John S. Luque, Gwendolyn P. Quinn, Francisco A. Montel-Ishino, Mariana Arevalo, Shalanda A. Bynum, Shalewa Noel-Thomas, Kristen J. Wells, Clement K. Gwede, Cathy D. Meade, Tampa Bay Community Cancer Network Partners

Community Health: Faculty Publications

Preparing healthy community members with timely communications prior to engaging them in a request to donate biospecimens promises to improve the experience of biobanking participation. To this end, a qualitative study was conducted to assess community member knowledge, attitudes, beliefs, and informational needs about cancer-related biospecimen collection in a large metropolitan area in southwest Florida. The study utilized purposive sampling techniques to recruit a total of 95 participants to participate in 12 focus groups, segmented by race/ethnicity and language preference (mixed race, African American only, and Spanish speaking) and age (18–29, 30–54, and 55 and older). Focus group interviews were …

Evaluation Of Elevated Bait Trays For Attracting Blackbirds (Icteridae) In Central North Dakota, George M. Linz, Jamison B. Winter, William J. Bleier

United States Department of Agriculture Wildlife Services: Staff Publications

Sunflower (Helianthus annuus L.) became an economically important crop in North Dakota in the 1970s, providing a major source of food for post-breeding blackbirds (Icteridae). Reducing local blackbird populations with rice grains treated with an avicide is one proposed alternative for reducing sunflower damage. In fall 2007 and 2008, we evaluated the idea of attracting blackbirds to rice-baited trays attached to wire cages supplied with live blackbirds. During our observations (1011 h), we saw 3888 birds, consisting of 25 species and 12 families, on the bait trays. Blackbirds made up 90.4% of the bird observations, whereas sparrows (Emberizidae) made …

Design Synthesis And Biological Evaluation Of Non-Peptide Neuropeptide Ff Ligands, Jessica Valentinas Mankus

Electronic Theses and Dissertations

Neuropeptide FF is an endogenous RF-amide with two receptor subtypes originally described as having anti-opioid characteristics. While peptide work helped to elucidate key features for targeting the subtypes of the neuropeptide FF receptor, non-peptide small molecules offer a more refined tool to discover features that affect selectivity and affinity. Improvements in small molecule ligands for neuropeptide FF support lead development and offer a clearer understanding of the binding pocket of each receptor subtype. Previous work on the lead 4–anilindopiperidine structure clarified a key feature between agonist and antagonist behavior. Early modifications of substituents of the piperidine nitrogen were tolerated and …

Discovery, Isolation, And Identification Of Antimalarials From Fungal Endophytes, Andrekeus Lee

Electronic Theses and Dissertations

We examined fungal endophytes for their ability to inhibit bacterial, fungal and protozoal pathogens. Once antimalarial activity was discovered and confirmed, we sought to isolate and identify the active constituent(s) of our extracts. Bioassay-guided fractionation techniques were used to isolate our active compound, the structure of which was elucidated using 1H- and 13C-NMR. 2D-NMR and LC-MS analyses helped confirm that our endophytes were indeed producing artemisinin. Growth versus production studies were conducted to optimize our growth and extraction conditions while several other variables, like temperature and culture medium, were evaluated in an effort to improve our yields. Artemisinin production under …