Medicine and Health Sciences Commons^™

Botulinum Toxin For The Treatment Of Leg Spasticity In Children With Cerebral Palsy, Kathleen Matzke

Physician Assistant Scholarly Project Papers

Cerebral palsy affects 3 out of every 1000 children in the United States. It is multifactorial and not fully understood. What is known is that most of the cerebral palsy cases are congenital and the majority of motor dysfunction is classified as spastic. Over the last 25 years botulinum toxin has been a part of the first line treatment in children with spasticity. The purpose of this literature review is to determine if botulinum toxin is as safe and effective compared to a placebo or therapy alone in children. Key words and mesh terms were used in AccessMedicine, Cochrane Review, …

The Role Of Ketamine In The Management Of Chronic Pain, Hugh W. Cline Iii

Physician Assistant Scholarly Project Papers

Chronic pain diagnoses are on the rise amongst people within the United States and thought to be an epidemic. It is estimated to affect millions of patients who have suffered trauma, injury, or complications from surgical procedures. The treatment of chronic pain, defined as pain lasting longer than 3 months, can be complicated. There are no definitive treatment options that have garnered a consensus among medical professionals. Treatment usually involves several medical specialties and pharmacological options. Reliance on the use of multiple pharmacological options can cause patients increased hospitalizations, and a reliance on opioids can potentially cause other illnesses due …

Vitamind D Concentrations And Covid-19 Outcomes, Bennett A. Leitch

Physician Assistant Scholarly Project Papers

In March 2020, the World Health Organization declared COVID-19 a pandemic. Now, with over five million deaths the pandemic continues to cloak the globe. As of November 2021, 49.1% of the world population has received at least one dose of the COVID-19 vaccination according to ourworldindata.org/covid-vaccinations. In the United States, the CDC reported 57.6% of the population is fully vaccinated. With much of the population unvaccinated, potential protective factors are needed to help diminish infection. This literature review aimed to investigate a correlation between low serum vitamin D concentrations and outcomes of COVID-19 infections. A total of 27 research articles …

Obstetrical Morbidity And Mortality In Women Of Color, Shacara Pratt

Physician Assistant Scholarly Project Papers

Non-Hispanic black women are three to four times more likely to die from pregnancyrelated complications when compared to their Caucasian equivalents, however more than half of these deaths are considered potentially preventable.The purpose of this research and systematic literature review is to analyze why obstrictrical morbidity and mortality is significantly higher amongst women of color, and determine if racial disparities play a role. Healthcare measures used to reduce or prevent maternal morbidity and mortality are also accomplished in this article. A comprehensive literature review was performed using electronic databases, including CINAHL, PubMed, Clinical Key, Cochrane Library, and Dynamed Plus. Results …

Biomarkers In The Detection Of Alzheimer’S Disease, Karen Kenny

Physician Assistant Scholarly Project Papers

Alzheimer’s Disease (AD) is a progressive form of dementia that affects memory, cognition, and functional ability. Although there are diagnostic tests being used to aid in the clinical diagnosis of AD, the only definitive method of diagnosis is through post-mortem biopsy of the brain. The purpose of this project and literature review is to investigate the most effective biomarkers when clinically evaluating AD. The main biomarkers of investigation include positron emission tomography (PET) imaging, cerebral spinal fluid (CSF), and blood-based biomarkers. The role of the apolipoprotein E (APOE4) gene as a genetic influence on AD was also evaluated within this …

Epigenetics As Primary Prevention Of Coronary Artery Disease, David Majewski

Physician Assistant Scholarly Project Papers

This systematic literature review intended to ascertain if epigenetic testing for the primary prevention of Coronary Artery Disease (CAD) decreases mortality compared to the current standard of care. This systemic review used PubMed and Cochrane medical databases to assess epigenetic variances and their association with CAD. The Medical Subject Headings (MeSH) terms used were as follows: CAD, genetics, epigenomics, diabetes, hypertension, obesity, dyslipidemia, primary prevention, and standard of care. Further limiting the search results to Randomized Control Trials (RCT’s), meta-analysis, peer-reviewed, and published within the last 10 years. Exclusion criteria included publications before 2011, articles that did not compare genetic …

Combination Thyroid Hormone Therapy In The Treatment Of Hypothyroidism, Jessica Johnson

Physician Assistant Scholarly Project Papers

The nature of this systemic literature review and research is to explore the use of thyroxine (T4) monotherapy versus T4 and triiodothyronine (T3) (combination) therapy for the treatment of hypothyroidism. A literature review was conducted using electronic search databases which included PubMed, CINHAL, and Clinical Key. Mesh terms included hypothyroidism/drug therapy, hypothyroidism/diagnosis, thyroid hormones/physiology, and thyroxine. Filters applied to the search included clinical study, clinical trial, guideline, journal article, meta-analysis, randomized controlled study, and systematic review. The search was tapered by limiting results to the last ten years, human species, and adults 19+. The articles were further narrowed by excluding …

The Indications And Potential Complications Of Supplementing With Fat-Soluble Vitamins, Krista Thielges

Physician Assistant Scholarly Project Papers

There is a seemingly infinite list of available formations of over-the-counter supplements, including vitamins. According to Grand View Research, the nutritional supplement industry has grown in popularity in recent years, increasing its worth to an estimated 140 billion dollars in 2020 globally, with vitamins accounting for 31.4% of the revenue. An estimated half of Americans take a daily vitamin or supplement. With the increasing number of people supplementing, the incidence of disease should be trending down. This literature review focuses on fat-soluble vitamins, vitamin A, D, E, and K. Supplementation of these vitamins proposes the prevention of chronic diseases such …

Incidence Of Coronary Artery Disease And Testosterone Replacement Therapy, Stephen Leard

Physician Assistant Scholarly Project Papers

In the United States, males see a decrease in testosterone levels around the age of 40, potentially leading to a condition known as hypogonadism. Testosterone administration is the leading treatment for symptomatic hypogonadism. Testosterone Replacement Therapy (TRT) has increased in popularity amongst practicing healthcare providers. This literature review aims to investigate differences in incidence rates of cardiovascular events in males receiving testosterone therapy compared to untreated males with hypogonadism. Given the conflicting evidence regarding the association between exogenous testosterone and cardiovascular risk, published studies and meta-analysis were reviewed to prove this relationship. A comprehensive literature review was performed using electronic …

The Genetic Link To Postpartum Depression, Kelsey Krueger

Physician Assistant Scholarly Project Papers

Postpartum depression affects an estimated 12% of women following delivery and it is believed that 50% of those women will go undiagnosed. It is well accepted in the scientific community that genetics play a role in the development of many mental health disorders. Recent research has demonstrated that this may also be the case with postpartum depression. There is a 50% incidence rate among women who have a first-degree relative diagnosed with postpartum depression (Guintivano et al., 2018). A literature review was conducted focusing on the research of epigenetics within the last five years, specifically investigating DNA methylation and single …

The Impact Of Continuous Glucose Monitoring In The Management Of Type Ii Diabetes, Benjamin Graf

Physician Assistant Scholarly Project Papers

According to the American Diabetes Association (ADA), approximately 36 million Americans have a diagnosis of type II diabetes (T2D). Among these patients with T2D, nearly forty percent have glycated hemoglobin A1c (Hgb A1c) values above the target goal of 7%. Many patients with T2D utilize self-monitoring blood glucose (SMBG) systems to monitor day-to-day fluctuations in blood glucose values. However, SMBG systems can be cumbersome and may result in lower patient compliance. With many patients struggling to achieve their target Hgb A1c, methods to improve glycemic control are needed to prevent long-term diabetes-related complications. This literature review aims to investigate the …

Comparing Clozapine And Electroconvulsive Therapy In Refractory Schizophrenia, Anthony Alan Beaty

Physician Assistant Scholarly Project Papers

Schizophrenia is a complicated problem that millions of Americans struggle with and unfortunately, about 50 percent of schizophrenics become resistant to medication. It is common practice to try multiple drugs to combat this resistance and many patients are placed on clozapine or given electroconvulsive therapy (ECT) as a last resort. Research has shown that many are not receiving the benefits of these treatments due to adverse effects, negative public opinion, and difficulty executing high quality research studies particularly when it comes to ECT. As a result, a significant number of patients that would benefit from these interventions are suffering with …

Antimicrobial Stewardship And Its Effects On Resistant Organisms, John D. Seifert

Physician Assistant Scholarly Project Papers

Antimicrobial stewardship has been found to have an impact on resistant organisms, but it has been unclear the importance of how strong those recommendations should be and if more strict or numerous guidelines equals fewer or less resistant organisms. “Antimicrobial stewardship (AMS), an organizational or system-wide health-care strategy, is designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health. (Majumder et al., 2020)” In reviewing recent peer-reviewed research it can be shown that medical facilities that utilize antimicrobial stewardship guidelines when prescribing antibiotics have …

Efficacy Of Probiotic Supplementation For Weight Loss In Overweight And Obese Adults, Kelsie Tescher

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to assess current studies investigating the efficacy of using probiotic supplementation to promote weight loss in the overweight and obese adult populations. Three databases were used including PubMed, ClinicalKey, and Embase with a time frame of 15 years. A total of 17 studies met the research criteria and were therefore reviewed. Body weight loss and decrease in BMI were used as measurements of efficacy. Studies used were peer reviewed, randomized-control trials, double-blind, and placebo-controlled. Current research shows insufficient evidence to support the use of a specific genus and/or species of probiotic to promote …

Anxiety Treatment In Health Science And Medical Students, Rachel Sperl

Physician Assistant Scholarly Project Papers

No abstract provided.

Non-Pharmacologic And Alternative Management Of Chronic Pain In Multiple Sclerosis, Kylie Patian

Physician Assistant Scholarly Project Papers

Chronic pain associated with multiple sclerosis (MS) is prevalent in many phenotypes. Pharmacologic therapy of this pain often fails to provide analgesia. This research is intended to determine which nonpharmacological interventions may be recommended for treatment of chronic extremity pain in individuals with MS. This research was primarily conducted through a comprehensive literature review of publications within the past five years on three databases, PubMed, EMBase, and CINAHL. Additional resources were added from “similar” sections of the databases, directly from included studies, and when used to inform background information, for a total of 26 resources. Studies were excluded if not …

Epidemiology Of Children With Adhd In Rural Versus Metropolitan Settings, Miranda Nygaard

Physician Assistant Scholarly Project Papers

Attention deficient disorder with hyperactivity (ADHD) is an increasing psychiatric disorder affecting children across the world. With significant debate on diagnosis, ADHD is commonly underdiagnosed in children, even today. Approximately 4.6 million children are diagnosed with ADHD, but more than two thirds of these children are untreated. Primary care providers remain the responsible stakeholders for assessing, diagnosing, and treating children with ADHD appropriately. This literature review is aimed to investigate the correlation between the assessment and early diagnosing of ADHD among children in rural settings compared to that of the metropolitan/urban communities. Providing children with ADHD symptoms an early diagnosis, …

Evaluation Of Early Primary Care Implementation Of Point Of Care Ultrasound In Outcomes Of Patients With Dyspnea As Compared To Standard Diagnostic Exams, Mcglinchey Chase

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is to evaluate the applicability of point of care ultrasound (POCUS) in rural primary care. More specifically, the review seeks to evaluate the use of POCUS regarding outcomes in patients with dyspnea. Six of the most common and potentially life-threatening causes of dyspnea were chosen to review. They are asthma, heart failure, chronic obstructive pulmonary disease (COPD), pneumonia, pneumothorax, and pulmonary embolism. In this review, a literature search was performed using the following electronic databases: PubMed, Cochran Review, and Google Scholar. Only articles since 2011 were selected for review with the majority being …

Monotherapy Vs. Polypharmacy: Snris For The Management Of Mood Disorders And Chronic Pain, Rachel Levy

Physician Assistant Scholarly Project Papers

Chronic pain and mood disorders represent two of the most common disorders managed by primary care providers. Chronic pain management is costly, not only with direct medical costs but through loss of work and productivity. The incidence of mood disorders continues to increase, and disorders such as anxiety and depression coexist with chronic pain in many patients. Meanwhile, polypharmacy presents an increased risk for drug-drug interactions and patient harm. The purpose of this systematic literature review is to explore the potential of reducing polypharmacy in individuals with depression and chronic pain through monotherapy via serotonin-norepinephrine reuptake inhibitors (SNRIs). A literature …

Ketamine Use In Refractory Depression, Mckenzie K. Kemmet

Physician Assistant Scholarly Project Papers

Despite pharmacological advancements, depression continues to be considered the third leading cause of disability in the world. Although depressive symptoms may decrease within a few weeks after beginning typical antidepressants, there are still about one-third of individuals that fail to respond and do not achieve recovery. The symptoms not resolved by antidepressant therapy ultimately leads to decreased quality of life, decreased productiveness of the individual, increased hospitalizations, higher health care costs, and increased rates of suicide. As a result, the clinical use of ketamine in refractory depression is increasing because of the antidepressant properties found in a multitude of studies. …

How Does Access To Primary Care Affect The Latino Population, Brandon Harthan

Physician Assistant Scholarly Project Papers

Healthcare disparities by race or ethnicity across the United States are becoming more evident as the population continues to grow, none being more evident than that of the Latino population. The purpose of this research is to determine the effects that access to primary healthcare has on the comorbidity and mortality of the Latino population. Much of the research supports the theory that Latino’s are at greater risk of comorbidity and mortality from diabetes, chronic liver disease, and cirrhosis due to their decreased access to primary healthcare services. However, evidence also supports the “Hispanic Mortality Paradox” in which Latinos have …

Long Term Outcomes Of Anti-Retroviral Treatment Vs. Additional Nutritional Supplementation For Hiv Patients, Michael P. Gillispie

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is not to determine the best treatment for human immunodeficiency virus HIV but to analyze additional supplementation that can prolong the progression of the disease process. Zinc, vitamin A, D, and E will be evaluated additionally with the antiretroviral treatment ART. The cost of an ART Regimen can be very expensive and challenging for patients to afford. The goal is to find an acceptable option to complement ART with a sensible cost to prolong disease progression and minimize additional costs of health care. With the advances of ART, more and more patients can …

Is Mdma A Safe And Effective Adjunct For Treatment Of Posttraumatic Stress Disorder, Angela Emerson

Physician Assistant Scholarly Project Papers

Background: Post-traumatic stress disorder (PTSD) is a common mental health disorder that affects many Americans and leads to considerable morbidity and mortality. While there are a range of therapies to treat PTSD, treatment resistance is high, leading to a chronic condition in many patients. In recent years, attention has been turned to the use of novel drugs, such as 3,4,- methylenedioxymethamphetamine (MDMA) as a treatment for PTSD.

Aim: The purpose of this literature review was to assess the safety and efficacy of MDMA use in the treatment of PTSD.

Results: MDMA is a schedule I drug, therefore research into its …

Migraine With Aura Versus Seizure: Diagnosis And Treatment, Jessica Gifford

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine if obtaining an electroencephalogram (EEG) in patients presenting with migraine with aura would result in better and/or more prompt symptom management compared to empiric migraine treatment. In this review, the electronic databases; CINAHL, PubMed, Clinical Key, Cochrane Library and Dynamed Plus were used. Both keyword and mesh terms were used related to the pathophysiology of migraines and seizures along with guidelines for work-up and treatment of migraines and seizures. All articles chosen for review were published after 1999, except one. All articles were peer reviewed, and include randomized …

In Adults With Gastroesophageal Reflux Disease, What Is The Efficacy Of Surgical Versus Pharmacotherapy In Reducing Symptoms?, Travis Cook

Physician Assistant Scholarly Project Papers

The purpose of this systematic review is to explore the efficacy of pharmacotherapeutics and surgical interventions for the treatment of gastroesophageal reflux disease (GERD). In this systematic review, five electronic databases were used including AccessMedicine, PubMed, Cochrane library, Dynamed, and Clinical Key. Research criteria included work after 2010, peer reviewed, and only randomized control trials, systematic reviews, and meta-analyses were considered. Studies that were excluded included any that were before 2010, poor study design, and those that looked at other conditions or treatments outside of the research question in study. A total of 9 studies were selected for this systematic …

An Overview Of Mrna Vaccine Technology, Rachel N. Bruening

Physician Assistant Scholarly Project Papers

This project will serve to analyze the mechanism, efficacy, and adverse effects of mRNA technology in detail while also comparing it with a previous recombinant Influenza vaccine trial. In this systematic literature review, three library data bases were searched including Pub Med, Clinical Key, and Ebsco Megafile. Search criteria included the key terms: mRNA vaccines, vaccines, and COVID-19. Additional phrases used included: mechanism, history, and efficacy. Each key word was entered as it appears in the databases with additional phrases used to narrow down the research. The search was limited to the last five years to ensure up to date …

Best Second Oral Agent To Metformin To Manage Type 2 Diabetes, Dhana Acharya

Physician Assistant Scholarly Project Papers

Diabetes is a major health concern in the United States with many long-term complications, such as heart disease, stroke, kidney failure, blindness, and amputation. According to the Center for Disease Control, as of 2020, 34.1 million of US adult had diabetes and 88 million were prediabetic. Due to the severe complications, it is important to manage diabetes with lifestyle changes and pharmacotherapies. Many oral agents such as metformin, sodium glucose transporter 2 inhibitors (SGLT2i), and sulfonylureas are used in the management of type II diabetes. Metformin is typically the first line pharmacotherapy. However, when metformin alone is not enough to …

Diagnosing Mild Tbis With Fluid Biomarkers, Elizabeth J. Perkins

Physician Assistant Scholarly Project Papers

Upon head trauma, neurons within the brain can become stretched and injured. Continuous mild traumatic brain injuries (mTBIs) without proper healing can lead to chronic neurological symptoms. This is especially problematic in contact sports and military personnel. The purpose of this literature review is to take an in depth look at fluid biomarkers that could aid in the diagnosis of a concussion at a point of injury. Databases were used including PubMed, Clinical Key, Embase and Access Medicine. The studies chosen were published within the last 7 years, applicable to the topic and absent of pronounced bias. The 19 works …

Multimodal Pain Management To Reduce Opioid Use After Cholecystectomy, Danielle Tretbar

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine effective pain management options for patients undergoing a cholecystectomy procedure while decreasing the use of postoperative narcotics. In this review, the databases searched included PudMed, Clinical Key and Dynamed Plus. A variety of key terms were used when searching. Studies chosen from this search were peer reviewed and included randomized control trials, systematic reviews and met analyses. Excluded studies did not particularly research the drug classes of interest or they dealt solely with different surgical pain interventions during the procedure. The research presented shows the use of gabapentinoids, …

Breast Conserving Therapy Vs Mastectomy In Treatment Of Early Breast Cancer Patients. Does Brca1/Brca2 Status Change Treatment Recommendations?, Kylie Engebretson

Physician Assistant Scholarly Project Papers

In the United States, breast cancer is the second most common cancer, represents 30% of total cancer cases and 14% of deaths in the United States in 2019. BRCA1 and BRCA2 are genetic mutations that increase the likelihood of developing breast cancer by 57% and 49%, respectfully. Several surgical options are available for those with newly diagnosed early-stage breast cancer. The purpose of this systemic literature review is to evaluation the safety and efficacy of breast conserving therapy versus mastectomy for surgical intervention of early-stage breast cancer patients and evaluate if possessing a BRCA positive mutation changes the recommendation for …