Medicine and Health Sciences Commons^™

A Bridge Too Far? Risks And Benefits Of Perioperative Bridging Therapy, Jordan Buchholz

Physician Assistant Scholarly Project Papers

The long-term use of oral anticoagulants is common among certain high-risk patient populations for the prevention of thromboembolic events such as stroke, pulmonary embolism (PE), and other systemic events. According to Garwood et al. (2017) it is estimated that 15-20% of chronically anticoagulated patients will undergo a surgery or procedure that will require anticoagulation interruption annually. During this interruption period, “bridging” anticoagulant therapy is often utilized with unfractionated heparin or low-molecular weight heparin to ensure adequate anticoagulation is achieved (Ayoub et al., 2016). However, there has been an ongoing debate whether or not the benefits of perioperative anticoagulant bridging therapy …

Exercise In The Treatment Of Major Depressive Disorder, Larissa Ann Haug

Physician Assistant Scholarly Project Papers

Objective

The purpose of this research and systematic literature review is to determine how exercise can be incorporated into the treatment of major depressive disorder (MDD) and its efficacy.

Methods

In this review, four databases were searched including SportDiscus, Pubmed, Cochrane Database of Systematic Reviews, and PsycInfo from October 1 to January 5, 2018. A variety of key terms were used when searching. Works chosen for review were published after the year 2000, were peer reviewed, and included randomized control trials (RCTs), pilot studies, systematic reviews, and meta-analyses. Sources that were excluded included those published prior to the year 2000, …

Superior Capsular Reconstruction In The Active Population With A Massive Irreparable Rotator Cuff Tear, Hernandez Emmanuel

Physician Assistant Scholarly Project Papers

The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Early diagnosis and identification of rotator cuff injuries are paramount for the appropriate treatment to be facilitated. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and is a challenging procedure. Historically, treatment options have been limited …

The Neuroprotective Effects Of Targeted Temperature Management On Post-Cardiac Arrest Patients, Timothy Hovde

Physician Assistant Scholarly Project Papers

Novel methods of ensuring survival following cardiac arrest and resuscitation are of supreme importance to the medical community. Targeted temperature management (TTM) has become increasingly utilized pre-hospital, in emergency departments, and within intensive care units to increase the likelihood of survival to hospital discharge. TTM has further been used to attempt to improve neurological functioning. The efficacy and mechanism behind TTM remains poorly understood. In several patient populations it also remains unproven. The purpose of this study is to assess the physiological mechanism, survival, neurological recovery and methodology of TTM use and implementation.

Literature review was utilized to assess the …

Examination Of Venous Thromboembolism Prophylaxis In Patients Undergoing Total Knee Arthroplasty, William Kucera

Physician Assistant Scholarly Project Papers

Elective total knee arthroplasty (TKA) is the most frequently performed inpatient surgical procedure in the United States (Kurtz, Ong, Lau, Mowat, & Halpern 2007). Complications of this procedure include deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively referred to as venous thromboembolism (VTE). Various pharmacological agents exist for VTE prophylaxis. Warfarin and low-molecular-weight heparin (LMWH) were commonly used for VTE prophylaxis in the past, but with the emergence of novel anticoagulants including factor Xa inhibitors and direct thrombin inhibitors (DTIs), warfarin is used far less frequently. Aspirin is also approved for VTE prophylaxis. The purpose of this study was …

Pre-Participation Physical Examination: Are Current Cardiovascular Recommendations Enough?, Steven Jacob Pietrusza

Physician Assistant Scholarly Project Papers

Inclusion of screening electrocardiograms (EKGs) during pre-participation physical examination has been a topic of debate for some time. There is unquestioned usefulness in the ability of a well-trained health care provider in using EKG to identify cardiac abnormalities. Further, there have been several contemporary EKG criteria published that increase specificity and sensitivity of detection of disease. However, these criteria do not account for athletes less than 14 years of age, and that demographic represents a large portion of patients seeking pre-participation screenings in the United States. The lack of research into pediatric cardiac remodeling secondary to activity, coupled with the …

Comparing The Effectiveness Of A Low Carbohydrate Diet And Metformin On Glycosylated Hemoglobin Reduction In Type Two Diabetes Mellitus, Ashley Schultz

Physician Assistant Scholarly Project Papers

In this study, a low carbohydrate diet and metformin pharmacotherapy were compared to determine their effect on HbA1c in the type two diabetic patient. Several high quality studies were examined along with each treatment's effect on mainly HbA1c, but also other parameters such as body weight, cholesterol, and fasting and post prandial blood glucose levels. The study showed that both the low carbohydrate diet and metformin pharmacotherapy were effective at lowering HbA1c in the type two diabetic patient. The low carbohydrate diet showed a 0.2% increase in HbA1c all the way to a 2.2% decrease in baseline HbA1c in the …

Treating Peri And Postnatal Depression And Anxiety, Emily M. Stevenson

Physician Assistant Scholarly Project Papers

While diagnoses of depression and anxiety are not uncommon for women during pregnancy and after delivery, one of the greatest challenges in the plan of treatment is to ensure that the offspring are kept safe while the psychological well-being of the mother is appropriately cared for. The objective of this literature review is to evaluate the commonly prescribed treatment methods for prenatal and postnatal depression, focusing on the efficacy of antidepressant medications and nonpharmacologic treatments while evaluating the effects these medications have on the fetus/breastfeeding infant. The method of research included 15 studies completed within the past ten years on …

Allergen Specific Immunotherapy And The Effect On Allergy Induced Asthma, Cord Tanner Landrum

Physician Assistant Scholarly Project Papers

Allergies are a major public health problem affecting over 300 million people worldwide (Asamoah et. al). An allergic response can occur when a harmless substance, such as tree pollen, is inhaled into the body and mistakenly identified as a harmful substance. Antibodies then bind to the allergen causing a release of chemicals that leads to symptoms such as nasal congestion, runny nose, itchy eyes or skin reactions. For some people, this reaction can also affect the lungs and airways leading to asthma symptoms.

This review analyzes articles from PubMed, Cochran, Clinical Key and references found from UpToDate articles to assess …

Comparing Prevalence Of Medication-Related Osteonecrosis Of The Jaw (Mronj) Due To Denosumab And Bisphosphonates As A Side Effect Of Osteoporosis Treatment, Kendra Apland

Physician Assistant Scholarly Project Posters

As the baby boomer generation continues to age, the diagnosis of osteoporosis and its side effects will continue to increase. Denosumab and bisphosphonates (BPs) are some of the most common medication classes used to treat osteopenia and osteoporosis, but it is believed that both medications have the possible side effect of medication-related osteonecrosis of the jaw (MRONJ). The purpose of this paper is to uncover if MRONJ is a side effect of osteoporosis treatment and which medication carries the highest incidence rate. Through a review of several electronic databases and several peer reviewed research articles, a wide range of reported …

The Efficacy And Safety Of Statins In The Primary Prevention Of Cardiovascular Disease, Kayla M. Ashton

Physician Assistant Scholarly Project Posters

Atherosclerotic plaques can form in the blood vessels from particles of cholesterol. These plaques are a major cause of cardiovascular disease and have the ability to result in fatal cardiovascular events. In researching this topic, PubMed, the Cochrane Library, DynaMed, and ClinicalKey were all utilized in finding articles published from 2002 to 2018. There are several organizations with conflicting guidelines recommending the use of statin medications in the primary prevention of cardiovascular disease. The research evaluated discovers data is inconclusive on the benefit of statin medications in this primary prevention as well as the safety of long-term statin use. Some …

Screening Techniques For Alzheimer's Disease, Christina Nicole Brooks

Physician Assistant Scholarly Project Posters

Alzheimer’s disease is a neurodegenerative disease that affects more than 55 million Americans. By the year 2050, experts project this disease will have increased three fold. Many screening techniques have been investigated to detect this disease early and begin treatment to slow its progression. The purpose of this study was to explore which medical modalities are the most effective for screening of Alzheimer’s disease. This literature review includes three databases, including PubMed, CINHAL, and Cochrane Database of Systematic Reviews. Topics that were researched include: cognitive screening tests, neuroimaging, laboratory diagnostic testing, DNA, and combined studies. Research was conducted from October …

A Bridge Too Far? Risks And Benefits Of Perioperative Bridging Therapy, Jordan Buchholz

Physician Assistant Scholarly Project Posters

The long-term use of oral anticoagulants is common among certain high-risk patient populations for the prevention of thromboembolic events such as stroke, pulmonary embolism (PE), and other systemic events. According to Garwood et al. (2017) it is estimated that 15-20% of chronically anticoagulated patients will undergo a surgery or procedure that will require anticoagulation interruption annually. During this interruption period, “bridging” anticoagulant therapy is often utilized with unfractionated heparin or low-molecular weight heparin to ensure adequate anticoagulation is achieved (Ayoub et al., 2016). However, there has been an ongoing debate whether or not the benefits of perioperative anticoagulant bridging therapy …

Exercise Therapy For Chronic Low Back Pain, Jeanmarie Dahl

Physician Assistant Scholarly Project Posters

Chronic low back pain (CLBP) is currently ranked as the 13th most frequent diagnosis in family practice (DynaMedPlus, 2017). The severe nature of the pain in this condition often leads providers to prescribe narcotics. While effective in the short term, opiates have significant side effects when used chronically. Other forms of management for CLBP need to be identified and utilized. The purpose of this review was to determine the role exercise therapy plays in the management of CLBP.

Four databases were searched in order to find high quality systematic reviews, meta-analyses, and randomized controlled trials (RCT) looking at exercise therapy …

Exercise In The Treatment Of Major Depressive Disorder, Larissa Ann Haug

Physician Assistant Scholarly Project Posters

Objective

The purpose of this systematic literature review is to determine how exercise can be incorporated into the treatment of major depressive disorder (MDD) and its efficacy.

Methods

In this review, four databases were searched including SportDiscus, Pubmed, Cochrane Database of Systematic Reviews, and PsycInfofrom October 1 to January 5, 2018. A variety of key terms were used when searching. Works chosen for review were published after the year 2000, were peer reviewed, and included randomized control trials (RCTs), pilot studies, systematic reviews, and meta-analyses. Sources that were excluded included those published prior to the year 2000, had poor study …

Superior Capsular Reconstruction In The Active Population With A Massive Irreparable Rotator Cuff Tear, Emmanuel Hernandez

Physician Assistant Scholarly Project Posters

The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and can be extremely challenging. Historically, treatment options have been limited for the young population to invasive surgical intervention or conservative measures such as physical therapy and pharmacologic …

Systemic Therapy Versus Catheter Directed Techniques For The Treatment Of Acute Massive Pulmonary Embolism, Lawrence Duane Lee

Physician Assistant Scholarly Project Posters

•Acute massive pulmonary embolism is characterized by obstruction of the pulmonary arterial tree that exceeds 50% of the cross-sectional area causing acute and severe cardiopulmonary failure from right ventricular overload.

•Systemic thrombolytic therapy is recommended as standard, first-line treatment in patients with massive pulmonary embolism unless contraindicated and catheter directed therapies, including low dose thrombolytic administration directly into thrombus and mechanical thrombectomy can be adjunctive or used as an alternative to systemic treatments.

•This literature review researched articles looking at both systemic thrombolysis and endovascular techniques for the treatment of acute massive pulmonary embolism with an emphasis on long term …

Letrozole Vs. Clomiphene Citrate For Infertility In Polycystic Ovarian Syndrome, Kailey Potratz

Physician Assistant Scholarly Project Posters

Purpose

To determine if letrozole is an equal or better alternative to clomiphene citrate for infertility treatment in PCOS patients.

Literature Review

Letrozole was found to have higher ovulation rates, fewer twin pregnancies/more single births, higher pregnancy rates, and higher live birth rates compared to clomiphene citrate. There were conflicting results for endometrial thickness and single follicle stimulation. Neither letrozole or clomiphene citrate was superior to the other for ovarian hyperstimulation syndrome. There were no significant differences between letrozole and clomiphene citrate regarding congenital abnormalities and miscarriage rates. The results regarding ectopic pregnancies were comparable between both groups.

Conclusion

The …

Cannabinoid Therapy In Chronic Pain Management, Breanna Joy Privratsky

Physician Assistant Scholarly Project Posters

In 1996, the state of California was the first in the union to allow for the use of medical marijuana. Since then, 28 more states have enacted similar laws (National Conference of State Legislatures, [NCSL], 2017). With the ever-growing opiate problem that has now been classified as an epidemic by the Centers for Disease Control and Prevention, medical marijuana could be a viable alternative to this problem.

As of 2014, the CDC reported opioid deaths were up 369%, which is more than 91 deaths per day from overdose (Centers for Disease Control, [CDC], 2017). The purpose of this study is …

Treating Peri And Postnatal Depression & Anxiety, Emily M. Stevenson

Physician Assistant Scholarly Project Posters

- The objective of this research is to evaluate the commonly prescribed treatment methods for prenatal and postnatal depression, focusing on the efficacy of antidepressant medications and nonpharmacologic treatments while evaluating the effects these medications have on the fetus/breastfeeding infant.

- The method of research included 15 studies completed within the past ten years on women who were pregnant or who had delivered a baby within the past 12 months. One study did evaluate long-term effects on offspring, which included a participant number of 3,342 children who were exposed to antidepressants during pregnancy. The total number of participants in the …

The Effect Of Barefoot Running On Navicular Drop: A Randomized Controlled Trial, Corrie Fredericks, Alison Cygan, Robert Plemel

Physical Therapy Scholarly Projects

Background and Purpose: Gaining knowledge of the change in navicular drop/over-pronation of the foot in response to barefoot running training may allow sports medicine professionals, coaches, athletes, and others in the healthcare field to decrease the amount of injuries that may be caused by these motions. Effects of a running retraining program with conversion from a rearfoot strike pattern (RFSP) to forefoot strike pattern (FFSP) to determine impact on navicular drop is lacking in literature. Due to the increased correlation of over-pronation and lower extremity injuries, the purpose of this study was to determine if barefoot running training, with …

Treatment Post Total Knee Arthroplasty With Common Peroneal Nerve Palsy, Megan Berndt

Physical Therapy Scholarly Projects

Introduction. With more than 600,000 knee replacements performed each year in the United States, functional exercise is necessary post-surgery. Patients who undergo knee replacements often attend physical therapy after surgery, which has been found to have significant effects on functional outcomes. In rare cases, patients experience a post-surgical complication of common peroneal nerve palsy (CPNP), and interventions must be adjusted based on the patient's specific needs.

Purpose. This is a case report describing the interventions for a patient with a right total knee arthroplasty ([R] TKA), multiple co-morbidities, and a post-surgical complication of CPNP.

Methods. A 78-year-old …

The Combined Effects Of Physical Therapy And Music Therapy For An Older Adult With Chronic Left-Sided Hemiparesis: A Case Report, Nicholas Holkup, Scott Syverson

Physical Therapy Scholarly Projects

Background and Purpose: Stroke and other disorders that involve the neurological system can have adverse effects such as hemiparesis, spasticity, hypertonicity, and gait and balance deficits. Due to neurological disorders being so prevalent, proper rehabilitative treatments are necessary to return to a functional lifestyle. Multiple approaches across the therapy spectrum have been utilized, but rarely are these therapeutic approaches completed concurrently among different disciplines. The purpose of this case report is to address the interdisciplinary co-treatment by students of music therapy and physical therapy for a patient exhibiting chronic left-sided hemiparesis.

Case Description: This case report describes a …

The Inherently Flawed Relationship Between Physicians And Pharmaceutical Companies’ Gifts: Tanstaafl*, David P. Paul Iii

Atlantic Marketing Journal

Pharmaceutical companies frequently give practicing physicians and physicians-in-training an assortment of free “gifts,” ranging from pens to stethoscopes to continuing medical education. In an ideal world, these gifts would not compromise, or even seem to compromise, physicians’ decision-making. Unfortunately, as we live in a non-perfect world, this paper examines how physicians have been shown to perceive such gifts, the pharmaceutical companies’ position regarding these gifts, what the theory of gift-giving and gift-receiving tells us about this behavior, and what the future may hold as healthcare becomes more transparent.

Can Adding Black Raspberries To The Western Diet Reduce Factors That Lead To Colorectal Cancer?, Tess Armbrust, Canyon Neal

Research on Capitol Hill

• Americans with leaky gut, or increased intestinal permeability, often develop chronic inflammation (colitis) and are at a greater risk for developing colorectal cancer (CRC).
• A poor diet, high in processed foods but low in fruits and vegetables, is another notable risk factor for CRC.
• Micronutrient supplementation reduces colitis and prevents progression to colitis associated colorectal cancer (CAC).
• Due to their high concentration of anthocyanins, black raspberries have demonstrated protective effects against inflammation in the body.
• Certain antibodies are indicative of inflammation which leads to CRC.

Colon Epithelial Microrna Network In Fatty Liver, Paule V. Joseph, Sarah K. Abey, Dan Wang, Nicolaas H. Fourie, Natnael D. Kenea, Tatyana G. Vishnyakova, Jeffrey M. Robinson, Kristen R. Weaver-Toedtman Phd, Acnp, Anp, Christina M. Boulineaux, Hannah R. Davidson, Leeanne B. Sherwin, Onyinyechi Ozoji, Ana F. Diallo, Paul A. Smyser, Amy P. Patterson, Wendy A. Henderson

Publications

Background & Aims. Intestinal barrier alterations are associated with fatty liver (FL) and metabolic syndrome (MetS), but microRNA (miR) signaling pathways in MetS-FL pathogenesis remain unclear. This study investigates an epithelial-focused miR network in colorectal cell models based on the previously reported MetS-FL miR trio of hsa-miR-142-3p, hsa-miR-18b, and hsa-miR-890. Methods. Each miR mimic construct of MetS-FL miR trio was transfected into human colorectal cells, CRL-1790 or Caco-2. Global miRNome changes posttransfection were profiled (nCounter® Human v3 miRNA, NanoString Technologies). Changes in barrier (transepithelial electrical resistance, TEER) and epithelial cell junction structure (Occludin and Zona Occludens-1/ZO-1 immunofluorescence staining-confocal microscopy) were …

Evolution Of Occupational Therapy Practice: Life History Of Christina Frank, Otr/L, Paige Mccullough, Mimi Yunker

Oral History Student Papers

The purpose of this project is to gather information about the history and evolution of occupational therapy(OT) practice through the life history of many influential individuals, including Christina Frank. The aim of this study is to provide more knowledge for current occupational therapists about the history of OT and how it has changed over time. Christina Frank was selected through purposive sampling. A semi-structured interview was conducted where OT students transcribed, coded, categorized, and created themes from the information from the interview. The OT students gathered a final assertion summarizing the findings: life as an occupational therapist for Christina Frank …

Evolution Of Occupational Therapy Practice: Life History Of Catherine (Catie) Sondrol, Mot, Otr/L, Molly Maudal, Lydia Swanson

Oral History Student Papers

This is a qualitative research study using a life history approach. It was one of 31 life histories conducted as part of a larger study.

Objective: To learn about the impact that an Arizona-based occupational therapist with ties to North Dakota has had on the profession.

Method: A video conference call was conducted to interview Catie Sondrol. Additional information was found in her curriculum vitae, which was shared by the participant.

Results: After transcribing and analyzing the data gathered during the interview, the researchers were able to place an emphasis on the following key aspects of Catie’s professional career: resiliency, …

Evolution Of Occupational Therapy Practice: Life History Of Diane Mccormack, Karen Jaspers, Alyssa Turner-Strong

Oral History Student Papers

The purpose of this study was to examine the life and legacy of occupational therapist Diane McCormack. The participant was selected through purposive sampling and was interviewed for an hour and a half via a semi-structured interview. Data was collected via a participant interview and document review. Data was analyzed via coding of the interview transcription. Interview questions were pre-formatted by the project directors. The student researchers had the freedom to edit or add interview questions as deemed necessary after gaining approval from the project directors. Through transcription coding, four categories emerged from initial codes: education, experiences, relationships, and career. …

Evolution Of Occupational Therapy Practice: Life History Of Sue Morrison, Ashton Hudspeth, Colton Peltier

Oral History Student Papers

This qualitative study gathered information regarding the evolution of occupational therapy in North Dakota and Wyoming. Its purpose was to provide a view of what practice looked like from the beginning of Sue Morrison’s occupational therapy career until now by uncovering her life history. She has played an influential role in pediatric occupational therapy in Wyoming. The goal of this study was to provide more knowledge for current occupational therapists about the history of occupational therapy and how it has changed over time. This was done by interviewing individuals who have impacted the occupational therapy profession in the states of …