Medicine and Health Sciences Commons^™

Cumulative Lifespan Stress, Inflammation, And Racial Disparities In Mortality Between Black And White Adults, Isaiah D Spears, Aaron J Gorelik, Sara A Norton, Michael J Boudreaux, Megan W Wolk, Jayne Siudzinski, Sarah E Paul, Mary A Cox, Cynthia E Rogers, Thomas F Oltmanns, Patrick L Hill, Ryan Bogdan

2020-Current year OA Pubs

IMPORTANCE: In the US, Black individuals experience higher mortality risk than White individuals. Greater stress exposure and its biological sequelae are theorized to drive this heightened risk.

OBJECTIVE: To evaluate whether greater cumulative lifespan stress exposure and elevated inflammation are associated with increased mortality risk among Black compared with White US individuals.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study (St Louis Personality and Aging Network) recruited participants from 2007 to 2011 from the St Louis, Missouri, metropolitan area. Participants were required to have a mailing address to permit longitudinal follow-up and sixth grade reading level to facilitate understanding of …

Prospective Audit And Feedback By Antibiotic Stewardship Teams To Reduce Antibiotic Overuse At Hospital Discharge: A Stepped-Wedge Cluster-Randomized Clinical Trial, Daniel J Livorsi, Michael Joshua Hendrix, Erin Rachmiel, Jahnavi Bongu, Alice Bewley, Kevin Hsueh, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Antibiotics prescribed at hospital discharge are frequently unnecessary or suboptimal. Strategies to improve prescribing are not well defined.

OBJECTIVE: To evaluate whether a discharge-focused prospective audit and feedback process decreases antibiotic overuse at hospital discharge.

DESIGN, SETTING, AND PARTICIPANTS: This stepped-wedge cluster-randomized clinical trial was conducted across participating units at 10 hospitals with antibiotic stewardship (AS) teams and supporting staff from December 5, 2022, to November 17, 2023. After a 24-week baseline period, 1 hospital crossed into the intervention arm every 2 weeks.

INTERVENTION: The intervention consisted of disseminating institutional guidelines for oral antibiotic step-down to frontline prescribers and …

White Matter Hyperintensity Burden And Decline In Driving Performance Among Older Adults, Madhur Parihar, Yasheng Chen, Byron Xu, Semere Bekena, Ramkrishna K Singh, Yiqi Zhu, Jean-Francois Trani, Jin-Moo Lee, David B Carr, Chia-Ling Phuah, Ganesh M Babulal, Driving Real-World In-Vehicle Evaluation System (Drives) Project

2020-Current year OA Pubs

IMPORTANCE: White matter hyperintensity (WMH) burden is associated with cognitive decline, but its association with driving performance among older adults and the associations of modifiable risk factors remain unclear.

OBJECTIVE: To evaluate the association of total and regional WMH burden with longitudinal naturalistic driving performance in cognitively normal older adults and evaluate moderating associations of cognitive decline and antihypertensive therapy.

DESIGN, SETTING, AND PARTICIPANTS: This prospective longitudinal cohort study enrolled community-dwelling older adults (≥65 years) in the Driving Real-World In-Vehicle Evaluation System Project. Baseline 3-T brain magnetic resonance imaging (MRI) scans and data from continuous in-vehicle driving monitoring were collected …

Impaired Complement Regulation Drives Chronic Lung Allograft Dysfunction After Lung Transplantation, Hrishikesh S. Kulkarni, Laneshia K. Tague, Fuyi Liao, Zhiyi Liu, Lorena Garnica, Nishanth R. Shankar, Xiaobo Wu, Dequan Zhou, Yan Tao, Victoria E. Davis, Cory T. Bernardt, Derek E. Byers, Chad A. Witt, Daniel Kreisel, John P. Atkinson, Andrew E. Gelman, Et Al.

2020-Current year OA Pubs

A greater understanding of chronic lung allograft dysfunction (CLAD) pathobiology, the primary cause of death after lung transplantation (LTx), is needed to improve outcomes. The complement system links innate to adaptive immune responses and is activated early after lung transplantation to form C3 convertase, a critical enzyme that cleaves the central complement component C3. We hypothesized that LTx recipients with a genetic predisposition to enhanced complement activation have worse CLAD-free survival mediated through increased adaptive alloimmunity. We interrogated a known functional C3 polymorphism (C3 R102G) that increases complement activation through impaired C3 convertase inactivation in 2 independent LTx recipient cohorts. …

Exploring The Role Of Occupational Therapy In The Delivery Of Trauma-Informed Services To Hospital-Based Clients Ot, Frank Czuba

Journal of Applied Disciplines

Hospitalization can traumatize clients and impact overall health outcomes, leading to increased hospital readmission rates and resulting in a negative impact for both clients and providers. Limited information exists regarding how hospital-based occupational therapists evaluate and address trauma, even though incorporating trauma-informed principles into professional practice can enhance the occupational therapy process. The study explored the comprehension and perceived significance of trauma-informed tenets among occupational therapists delivering services in hospital-based settings. A quantitative research study with an exploratory design was implemented to explore how occupational therapists (OT) understand and utilize trauma-informed practices with their clients in a hospital setting. An …

The Prophylactic Effect Of Aqueous Chamomile Extract On Nitrogen Dioxide Exposed Mice, Mariam Kbaysi, Ruzanna Petrosyan, Jamilah Borjac

BAU Journal - Science and Technology

Nitrogen dioxide (NO₂) a gaseous air pollutant resulting from industrial activities. It has been associated to various diseases related to oxidative stress and inflammation, including cardiovascular and nervous system disorders. Chamomile is mainly recognized for its high content of antioxidant flavonoids and is extensively utilized in herbal medicine for treating several disorders. The aim of this study is to examen the protective effects of chamomile extract against NO₂-induced damage in female mice. Balb/c mice were divided into four groups: control, chamomile extract, NO₂ derivatives, and NO₂ derivatives combined with chamomile extract. Upon completion of the study, Blood was …

Prevalence Of Sexual Harassment Among Nurses And Nursing Students In A Culturally Conservative Country, Hanadi Mohamad Nur Steitiyeh, Fatin Ahmad Safa, Jana Daoud Al Hajj Daoud, Adam Tarek Ikkawi, Sahed Ali Fawaz, Hiba Deek

BAU Journal - Science and Technology

The prevalence of sexual harassment among nurses and nursing students in Lebanon is an unidentified social concern. This study aims to identify this prevalence and assess the related factors. Using a self-administered questionnaire the sociodemographic characteristics, workplace variables, physical appearance, and the Sexual Experience Questionnaire (SEQ) were assessed, the data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25. A total of 380 participated with 71.8% being female and 63.9% aged between 18 and 25. Sexual harassment was experienced by 91 participants (23.9%) and occurred mainly in the patients’ rooms and during procedures. Policies were absent or …

The Efficacy Of Cgrp Antagonists Versus Other Non-Migraine Specific Medications As Prophylactic Treatment For Episodic And Chronic Migraine, Lauryn C. Hutto

The PA Department Journal of Medical Science

Introduction: Migraines are a disabling neurological condition affecting 12-15% of the population. Migraines are characterized by a unilateral throbbing headache lasting between 4 and 72 hours, often accompanied by photophobia, phonophobia, nausea, or vomiting. Until the approval of the first CGRP antagonist, Erenumab, in May 2018, the prophylactic treatment for migraines relied on non-migraine-specific medications, such as antihypertensives and antiepileptics. Studies have been done to determine the efficacy and safety of the new medications, but few have directly compared them to older non-migraine-specific medications used for prevention. The purpose of this paper is to compare the efficacy of CGRP …

The Role Of Conjunctive Hyperbaric Oxygen Therapy In Decreasing Amputations In Those With Diabetic Foot Ulcers: A Clinical Review, Jazmyne D. Smith

The PA Department Journal of Medical Science

Diabetic Foot Ulcers (DFU) are a common complication of Diabetes Mellitus, which is the most common cause of amputations in the US. The purpose of this clinical review is to analyze the impact of Hyperbaric Oxygen Therapy on reducing amputations and improving healing rates in DFUs. PubMed was searched using the key terms “Diabetic Foot Ulcer,” “Amputation,” and “Hyperbaric Oxygen Therapy.” With the addition of filters, Mesh terms, and Boolean operations, 18 results were yielded. The inclusion and exclusion criteria narrowed the search to 6 articles, which were used for this review. The 6 articles included in this study were …

Pharmacologic Therapy Versus Catheter Ablation For Atrial Fibrillation, Jahkarius Hargrove

The PA Department Journal of Medical Science

Introduction- Atrial fibrillation is a common type of cardiac arrythmia that affects many people across the world. Patients with atrial fibrillation are at high risk for complications and poor outcomes. Stroke is the most prominent complication of atrial fibrillation if left untreated. The purpose of this clinical review is to analyze which modality is a better first line treatment, antiarrhythmic drug therapy or catheter ablation for long term management of this arrythmia.

Methods- Pubmed was searched with a specific search strategy using key terms “cardiac”, “Arrythmia”, “Antiarrhythmic agents”, “radiofrequency ablation”, and “surgical operation”. Operators and filters such as …

Comparing Autografts And Bioengineered Skin Equivalents In The Management Of Severe Burns, Madison Hill

The PA Department Journal of Medical Science

INTRODUCTION: Severe burns are associated with high morbidity, mortality, and treatment costs, often requiring surgical intervention to restore the skin barrier and prevent complications like infection and hypothermia. Autologous skin grafting is the current gold standard for burn wound closure but may not be feasible in cases of large TBSA injuries with limited donor sites. Bioengineered skin equivalents, including acellular dermal substitutes and cell-based therapies, offer potential benefits in wound healing and scar quality while reducing donor site morbidity. This review evaluates the effectiveness of autografts compared to bioengineered skin equivalents in severe burn management, with a focus on healing …

Extracorporeal Shockwave Therapy For Plantar Fasciitis Pain Reduction, Nathan J. Lopez

The PA Department Journal of Medical Science

Introduction: Plantar fasciitis (PF), aka plantar heel pain (PHP), is a degenerative and debilitating musculoskeletal condition that is prevalent across various populations. There is some debate concerning the hierarchy of second-line treatment options. The purpose of this article is to compare the efficacy, as it relates to pain reduction, of extracorporeal shockwave therapy (ESWT) and other invasive, non-surgical interventions (injections, dry needling, etc.).

Methods: PubMed was searched using a specific search strategy with key terms "extracorporeal shockwave therapy" and "plantar fasciitis". Operators and filters were then applied to narrow results to 4 relevant and quality articles for review. …

Prevention Of The Recurrence Of Skin Cancer With The Use Of Nicotinamide, Ryan A. Reibling

The PA Department Journal of Medical Science

Introduction: Skin cancer is the most common form of cancer worldwide, caused by the accumulation of UV ray exposure that people are exposed to daily. The treatment options for skin cancer are costly and inconvenient, with a high chance of recurrence in different sun-exposed areas. Nicotinamide, a form of vitamin B3, has shown promising outcomes in reducing the chance of recurrent in high-risk individuals. The purpose of this review is to examine recent literature on the effectiveness of nicotinamide supplementation in lowering the risk of skin cancer recurrence compared to individuals who do not take it.

Methods: A comprehensive PubMed …

Post-Surgical Prognostic Outlook Comparison Of Off-Pump Vs. On-Pump Cabg Procedures, Tanner A. Hendricks

The PA Department Journal of Medical Science

Introduction: Coronary artery disease in the United States had 680,981 deaths in 2023 alone with 400,000 CABG procedures being done. Coronary artery bypass grafting is a procedure in which coronary arteries occluded by fatty plaques are revascularized to restore blood flow to the myocardium. There are two effective options for this procedure, one being the on-pump approach, and the other being off-pump. Both methods carry risks, such as stoke and MI, as well as benefits, but the question of which carries the better outlook on mortality and complications is up for debate. The purpose of this paper is to study …

Safety And Efficacy Of Stroke Prevention With Warfarin Vs. Direct Oral Anticoagulants In Patients With Atrial Fibrillation: A Clinical Review, Kenneth L. Gentry

The PA Department Journal of Medical Science

Introduction: Atrial fibrillation is one of the most common cardiac arrhythmias in adults. This condition greatly increases a patient’s risk for ischemic stroke and is responsible for one-third ischemic strokes. Current international guidelines recommend the use of oral anticoagulants for stroke prevention in patients with atrial fibrillation. The purpose of this review is to analyze the current literature directly comparing the safety and efficacy of direct oral anticoagulants and warfarin at preventing stroke.

Methods: The PubMed database was searched for the following key terms: vitamin k antagonist, direct oral anticoagulants, stroke, and atrial fibrillation. Boolean operators and MeSH terms …

Efficacy Of Metformin Compared To Insulin In The Management Of Gestational Diabetes, Sarah Mchale

The PA Department Journal of Medical Science

Intro: Gestational diabetes (GDM) is a condition in which pregnant women are unable to use insulin effectively, leading to increased levels of glucose in the body. Although insulin has traditionally been a first-line pharmacologic treatment for GDM, metformin is increasingly being explored as an alternative. The purpose of this clinical review is to analyze whether metformin could be a safe and effective oral antihyperglycemic option compared to insulin in the treatment of GDM.

Methods: PubMed was searched with a specific search strategy using the key terms “insulin,” “metformin,” “gestational diabetes,” and “blood glucose.” Operator and filters narrowed results to 19 …

Efficacy Of Zuranolone Use For Postpartum Depression, Diana G. Welliver

The PA Department Journal of Medical Science

Introduction: Postpartum depression is a major form of depression that occurs anytime within the first year after a woman gives birth. It is characterized by low moods, increased feelings of sadness and anxiety, and a decreased interest in one’s baby. It is commonly treated with the use of selective serotonin reuptake inhibitors (SSRIs), which present with negative side effects and have a long duration of onset. The purpose of this study is to evaluate the efficacy of zuranolone, a fast-acting neuroactive steroid and GABA-A receptor modulator, on its ability to reduce symptoms of postpartum depression.

Methods: The PubMed database was …

Deep Brain Stimulation For The Management Of Non-Motor Symptoms Related To Parkinson’S Disease, Kyla A. Wallaszek

The PA Department Journal of Medical Science

Introduction: Deep brain stimulation (DBS) is a modern neurosurgical technique where electrodes are implanted in specific brain areas and deliver electrical impulses in order to help regulate abnormal brain activity. DBS is used for the management of several neurological conditions and was approved by the FDA for the treatment of Parkinson’s disease in 2003. The purpose of this review is to analyze the effectiveness of DBS for the management of the non-motor symptoms related to Parkinson's disease.

Methods: PubMed was searched using the key terms “Parkinson disease,” “deep brain stimulation,” “voice,” “sleep,” “mood,” “cognition,” and “dysphagia.” Operators and filters narrowed …

Labor Induction Versus Expectant Management In Postterm Pregnancy: A Clinical Review, Marisa Putrasahan

The PA Department Journal of Medical Science

Introduction: Postterm pregnancy is associated with increased morbidity and mortality of infant and mother. Current practice varies in the management of late- and postterm pregnancies, with much discussion surrounding the risks and benefits of the intervention options provided to pregnant patients. This study aims to review literature comparing the effectiveness of induction of labor (IOL) with elective management (EM) in reducing adverse perinatal and maternal outcomes for pregnant patients approaching postterm.

Methods: A literature search was performed on PubMed using key terms “late term pregnancy,” “induction of labor,” and “expectant management.” Operators and additional search filters narrowed results …

Outcomes Of Surgical Versus Transcatheter Aortic Valve Replacement: A Clinical Review, Grace Stang

The PA Department Journal of Medical Science

Introduction: Surgical aortic valve replacement (SAVR) has been the predominant

treatment for aortic stenosis (AS) for decades. However, transcatheter aortic valve replacement (TAVR) is becoming increasingly popular. Originally, TAVRs were only performed on patients who were deemed high-risk for surgery and would have died without the valve replacement. The purpose of this paper is to determine if TAVR or SAVR has better health outcomes for all patients no matter their surgical risk.

Methods: A search via PubMed database was done using the key words “aortic stenosis”, “surgical aortic valve replacement”, “transcatheter aortic valve replacement”, and “mortality.” Additional search filters were …

Efficacy And Safety Of Semaglutide In Adults Without Diabetes Who Are Overweight Or Obese, Rebecca Petty

The PA Department Journal of Medical Science

INTRODUCTION:

Obesity is associated with an increased risk of cardiovascular and metabolic disorders and contributes to the leading cause of death in the US — heart disease. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) have recently emerged as a treatment option for obesity. The purpose of this clinical review is to evaluate the efficacy and safety of semaglutide in adults without diabetes who are overweight or obese.

METHODS:

PubMed was searched using a precise search strategy and the key terms “semaglutide,” “weight loss,” and “without diabetes.” Results were filtered and narrowed using specific inclusion and exclusion criteria. Four high-quality studies were …

“Ecmo Anticoagulation: Should We Consider Bivalirudin Over Heparin?”, Confidence Paul

The PA Department Journal of Medical Science

Introduction: Extracorporeal membrane oxygenation (ECMO) requires systemic anticoagulation to prevent thrombotic events within the circuit. The use of unfractionated heparin has been the traditional anticoagulant of choice. Bivalirudin, a direct thrombin inhibitor, offers an alternative that has theoretical and observed benefits. The purpose of this clinical review is to evaluate whether bivalirudin provides superior safety and efficacy compared to UFH in ECMO patients.

Methods: PubMed was searched with a specific search strategy using key terms “Extracorporeal membrane oxygenation” AND “indirect anticoagulants” AND “deep vein thrombosis”. Operators and filters narrowed the results to four relevant, quality articles for review.

Results: In …

Effects Of Angiotensin-Converting Enzyme Inhibitors And Angiotensin Receptor Blockers On Covid-19 Outcomes In Severely Ill Patients, Madison L. Edwards

The PA Department Journal of Medical Science

Introduction: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the virus SARS-CoV-2 and can cause debilitating illness in vulnerable patient populations. The purpose of this clinical review is to analyze the effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the clinical course and severity in COVID-19 adult patients.

Methods: PubMed was searched with a specific search strategy using key terms “adult,” “COVID-19,” and “RAAS inhibiting medications.” Specific operators and filters narrowed the results to a total of five relevant, quality articles for review.

Results: Two articles were randomized controlled trials that directly compared the continuation of …

Comparison Of Vagal Maneuvers And Antiarrhythmics On Adult Patients Presenting With Supraventricular Tachycardias (Svt), James S. Ng

The PA Department Journal of Medical Science

INTRODUCTION: SVT is a well-known and potentially life-threatening arrhythmia, with vagal maneuvers and/or antiarrhythmic drugs often attempted for first-line conversion. The purpose of this clinical review is to analyze the relative effectiveness and success rates of these specific maneuvers and medications.

METHODS: The following PubMed database search was performed:“((vagal maneuver*) OR (valsalva)) AND (pharmacologic) ((medication) OR (medical therapy) OR (adenosine) OR (beta blocker*) OR (calcium channel blocker*) OR (anti-arrhythmic*) OR (anti arrhythmic*) OR (antiarrhythmic)) AND ((SVT) OR (supraventricular tachycardia))”. Filters were then applied and article titles/abstracts reviewed, resulting in a final selection of five articles for review.

RESULTS:. The most …

The Effects Of A Gluten-Free Diet On Patients With Hashimoto’S Thyroiditis, Chandler Blackburn

The PA Department Journal of Medical Science

Introduction: Hashimoto’s thyroiditis is a chronic autoimmune inflammatory condition of the thyroid gland. Hashimoto’s occurs in five percent of the American population and is the most common cause of hypothyroidism in the US. There are various comorbidities associated with Hashimoto’s, which treatment can help mitigate some of those risks. The purpose of this paper is to evaluate if a gluten-free diet, as an adjunct treatment, can lower autoimmune related antibodies while improving thyroid labs levels.

Methods: PubMed was searched for clinical reviews using key terms “Hashimoto’s disease”, “hypothyroidism”, “gluten”, and “anti-TPO antibodies”. Operators and additional filters narrowed down search results …

Monotherapy Versus Combination Levothyroxine And Liothyronine In The Treatment Of Hypothyroidism, Anne F. Thomas

The PA Department Journal of Medical Science

Introduction: Primary hypothyroidism is a common condition where the thyroid gland cannot produce free thyroxine (T4), leading to low serum levels of it. For this reason, it is often treated directly with monotherapy synthetic T4 or as a combined synthetic T4/T3. The purpose of this clinical review is to analyze the effectiveness of T4 monotherapy versus T4/T3 combination therapy in normalizing TSH values and improving symptoms in adults with hypothyroidism.

Methods: A specific search strategy in PubMed was used to conduct the research, incorporating key terms such as “hypothyroidism,” “levothyroxine,” “liothyronine,” and “TSH.” Four quality articles were left for final …

Modern Approaches To Mental Health: App-Based Cbt Versus Traditional Psychotherapy, Samira Shende

The PA Department Journal of Medical Science

Background: Digital mental health tools are becoming widely used as flexible alternatives to in-person therapy. A key question is how effective they are compared to traditional therapy for people with depression and anxiety.

Objective: To compare how effective digital interventions, like app-based CBT or telehealth, are compared to in-person psychotherapy in reducing symptoms of depression and anxiety in adults.

Methods: A structured PubMed search was conducted using specific search terms, limited to English-language randomized controlled trials, systematic reviews, and meta-analyses published between 2020 and 2025. After screening 116 articles, four high-quality studies were selected for review.

Results: Of the four …

Epinephrine In Cardiac Arrest: Is It Enough?, Zachary Gusler

The PA Department Journal of Medical Science

Introduction: Epinephrine has long been the clinical mainstay of pharmacologic treatment for cardiac arrest management. It provides both α- and β-adrenergic receptor activation. However, at higher dosages, it may lead to sympathetic overload, oxidative stress, and cardiac myocyte apoptosis. The purpose of this paper is to evaluate the rates of ROSC (return of spontaneous circulation) with in-hospital cardiac arrest between epinephrine monotherapy and VSE (vasopressin, steroid, and epinephrine).

Methods: A search via PubMed database using the keywords “Cardiac arrest” AND “VSE” AND “Vasopressor monotherapy” with additional specifiers resulted in 30 articles. 26 articles were removed due to study type and …

Efficacy Of Catheter Ablation Compared To Antiarrhythmic Drug Therapy In Atrial Fibrillation, Sarah Mckinney

The PA Department Journal of Medical Science

Introduction: A-fib occurs when the electrical signals in the heart become unorganized and unsynchronized, resulting in an irregularly irregular heart rate. This can increase the risk of blood clots and stroke. The purpose of this paper is to explore two of the most common treatment options, comparing the efficacy of catheter ablation to AAD (antiarrhythmic drug) therapy in adults diagnosed with atrial fibrillation.

Methods: PubMed was searched using the keywords “atrial fibrillation,” “catheter ablation,” and “antiarrhythmic.” Operators and filters yielded a final result of 159 articles; four articles that most closely aligned with the focus of this research were reviewed. …

Hyaluronic Acid Versus Corticosteroids In Osteoarthritis Of The Knee, Victoria B. Short

The PA Department Journal of Medical Science

Introduction: Osteoarthritis is a very common degenerative disease seen in older adults that is typically due to repetitive movements of the joints over time. Without treatment, osteoarthritis can progress and cause individuals to have decreased function and quality of life. The purpose of this review is to evaluate the effectiveness of hyaluronic acid injections compared to corticosteroid injections in treating osteoarthritis of the knee.

Methods: PubMed was searched with a specific search strategy using key terms “knee osteoarthritis”, “hyaluronic acid”, and “corticosteroids”. Operators and filters were applied to narrow 572 results down to 40. 15 articles were reviewed and 4 …