Diseases Commons^™

Is Oral Dexamethasone Safe And Effective For Treating Asthma Exacerbations In Pediatric Patients?, Benhamin J. Kunze

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not a one or two dose regimen of dexamethasone (DEX) is a safe and effective treatment for asthma exacerbations in the pediatric population.

STUDY DESIGN: Review of three English language, primary randomized controlled trials (RCT) published from 2001-2008.

DATA SOURCES: Three RCTs examining the efficacy of DEX either in a single dose or one dose for two days, compared to a traditional five day regimen of prednisone (PRED).

OUTCOMES MEASURED: The studies examined the number of relapses within 10 days of …

Is The Combination Therapy Of Clopidogrel (Plavix) And Aspirin Compared To Antithrombotic Single Therapy Safe And Effective In The Prevention Of Stroke In Adults?, Tsitsi Masviba

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is the combination therapy of clopidogrel (Plavix) and aspirin compared to antithrombotic single therapy is safe and effective in the prevention of stroke in adults?”

STUDY DESIGN: Review of three, English language, double-blinded, randomized controlled trial studies with an intention-­‐to-­‐treat basis published in 2004-2010.

DATA SOURCES: Three randomized controlled trial studying the safety and effectiveness of the combination therapy of clopidogrel (Plavix) and Aspirin compared to antithrombotic single therapy in the prevention of stroke in adults.

OUTCOME (S) MEASURED: Outcomes measured were …

Is Music Therapy Effective In Improving Emotional Health In Pediatric Cancer Patients?, Elizabeth F. Matesa

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidence based medicine review is to determine whether music therapy is effective in improving emotional health in pediatric cancer patients

STUDY DESIGN: Two randomized controlled trials and a prospective cohort study were reviewed and selected based on their relevance to the clinical question and their inclusion of patient oriented outcomes (POEMS).

DATA SOURCES: Each study was obtained by searching PubMed database.

OUTCOMES MEASURED: The outcomes measured included pain scores measured using a NRS pain scoring scale, anxiety scores were measured using the Spielberger State-Trait Anxiety Inventory (STAI)and visual analog score …

Does The Use Of Fascial Manipulative Therapy Help To Improve Overall Asthma Quality Of Life By Descreasing Asthma Symptoms?, Christie Mecouch

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of fascial manipulative therapy helps to improve overall asthma quality of life by decreasing asthma symptoms.

STUDY DESIGN: Review of two randomized controlled trials (RCTs) and one case study, published between 2005-current, all in the English language.

DATA SOURCES: Two randomized controlled trials (RCTs) and one case study, all of which evaluate the effectiveness of fascial manipulative therapy as it pertains to asthma quality of life. All studies were found using PubMed.

OUTCOMES MEASURED: The outcomes measured were an improvement …

Does Sildenafil Improve Physical Function In Patients With Idiopathic Pulmonary Fibrosis?, Tyler R. Mellinger

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not sildenafil improves physical function in patients with idiopathic pulmonary fibrosis.

STUDY DESIGN: Review of 3 primary research studies published in the English language between 2007 and 2010.

DATA SOURCES: Two randomized, double blind, placebo controlled clinical trials, and one open label study analyzing the effect of sildenafil on patients with idiopathic pulmonary fibrosis were found using PubMed.

OUTCOME MEASURED: The primary tool used to assess physical function in patients with idiopathic pulmonary fibrosis, when treated with sildenafil, was a 6-minute walk distance. …

Is Apixaban Effective For The Prevention Of Stroke In Patients With Non-Valvular Atrial Fibrillation?, Amira Moore

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not Apixaban is effective for the prevention of stroke in patients with non-valvular atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published all published in 2011.

DATA SOUCRES: Three double-blind randomized control trials found using the Cochrane Database and PubMed.

OUTCOME(S) MEASURED: Outcomes measured were occurrence of stroke (TIA or CVA), systemic embolism, major bleeding or clinically relevant non-major bleeding, and incidence of death.

RESULTS: Apixaban 2.5mg and 5mg were both superior to Warfarin in the prevention of stroke or …

Does Autologous Conditioned Il-1 Antagonist (Acs) Reduce Pain In Patients With Oa Or Lumbar Radiculopathy?, Jonathan Mitchell

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine whether or not Autologous conditioned IL-1 antagonist (ACS) reduces pain in patients with OA or lumbar radiculopathy.

STUDY DESIGN: Review of 3 randomized, double-blind controlled clinical trials in 2007, 2008, and 2009, all in English.

DATA SOURCES: Two randomized, double-blinded controlled clinical trials comparing the effectiveness of intra-articular injections of an autologous IL-1 receptor antagonist solution versus a control in OA and one randomized, double-blinded controlled clinical trials comparing autologous IL-1 receptor antagonist epidural injection versus 5 and 10 mg triamcinolone in patients with lumbar radiculopathy.

OUTCOMES MEASURED: The outcomes in this study …

Does Vibration Training Increase Stability In Functionally Unstable Ankles?, Nicole Bryan

PCOM Physician Assistant Studies Student Scholarship

OJECTIVE: The objective of this selective EBM review is to determine whether or not vibration training increases stability in functionally unstable ankles.

STUDY DESIGN: Review of three English language randomized control trials (RCTs) published in 2006, 2008 and 2010.

DATA SOURCES: Three non-blind randomized control trials found via PubMed.

OUTCOMES MEASURED: Efficacy was measured with one (experimental) group receiving vibration training and the other (control) group using either non-vibration exercise techniques or no exercise. Increased stability was measured with electromyography (EMG), balance testing or an isokinetic dynamometer.

RESULTS: Vibration training is a useful tool to …

The Affects Of Music Therapy On Management Of Pain And Anxiety During Burn Dressing Changes, Kush S. Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy improves pain management and anxiety during burn dressing changes.

STUDY DESIGN: Review of three English languages primary randomized controlled trial studies published from 1992-2010.

DATA SOURCES: Three randomized controlled trials studying the affects of music therapy during burn dressing changes were found using PubMed, OVID and Cochrane databases.

OUTCOMES MEASURED: Outcomes measured were level of pain and anxiety experienced by the patients. The severities of these symptoms were measured using a numeric scale system. An analyses of anxiety was measured …

Is Acupuncture Effective In The Prophylaxis Of Recurrent Urinary Tract Infections In Adult Women?, Caitlin E. Mumford

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is effective in the prophylaxis of recurrent urinary infections in adult women.

STUDY DESIGN: Systematic review of three English language primary studies, published between 1998 and 2003.

DATA SOURCES: Three randomized, controlled trials published after 1996, comparing acupuncture to placebo in the prophylaxis of urinary tract infections were obtained using EBSCOhost and PubMed.

OUTCOMES MEASURED: All three studies measured incidence or absence of urinary tract infections, as defined by distal urinary symptoms and/or bacteriuria of ≥ 105 cfu/ml.

RESULTS: Three …

Is Minoxidil Efficacious And Safe For The Treatment Of Androgenetic Alopecia (Aga) In Men, And If So, What Is The Optimal Strength And Means Of Delivery?, Anhthu P. Pickart

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not minoxidil is efficacious and safe for the treatment of androgenetic alopecia (AGA) in men, and if so, what is the optimal strength and means of delivery.

STUDY DESIGN: Review of three double-blind randomized controlled trials studying men (18-49 y/o) with androgenetic alopecia published in English from 2007-2009.

DATA SOURCES: Three articles of double-blind randomized controlled trials found via PubMed.

OUTCOMES MEASURED: Outcomes measured included the efficacy and safety of minoxidil as well as the optimal strength and means of delivery of the …

Is 2% Pirenzephine Gel Effective In Slowing The Progression Of Myopia In Children Aged 7-12 Years Old?, Melissa J. Rivera

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not 2% pirenzepine gel is effective in slowing the progression of myopia in children aged 7-12 years old?

STUDY DESIGN: Systemic review of three primary randomized controlled trials, which were published in 2008, 2004, and 2005.

DATA SOURCES: Multicenter, randomized double masked, placebo controlled, randomized controlled trials (RCT) were found using PubMed, COCHRANE, and OVID databases.

OUTCOMES MEASURED: The outcome, slowing of myopia progression, was measured similarly in all three trials. Progression of myopia was measured via changes in refractory status and spherical …

Are Linoleic Acid Supplements Beneficial In Increasing Growth In Pediatric Cystic Fibrosis Patients?, Sarah M. Saporito

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Are linoleic acid supplements beneficial in increasing growth in pediatric cystic fibrosis patients?”

STUDY DESIGN: Review of three English primary studies published between 1995 and 2000.

DATA SOURCES: Two randomized control trial and one controlled clinical trial were used. Studies were found using PubMed and Cochrane Databases.

OUTCOMES MEASURED: Primary outcomes measured include the taste, smell, and appearance of the supplement and the growth of the cystic fibrosis patients.

RESULTS: In Steinkamp G, Demmelmair et al., the treatment group grew in its weight-for-height; whereas, …

Is Polydextrose A Beneficial Supplement For Gastrointestinal Health And Maintenance Of A Healthy Body Weight?, Katharine Reilly

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine if polydextrose is a beneficial supplement for gastrointestinal health and maintenance of a healthy body weight

STUDY DESIGN: Review of three English language primary randomized controlled studies published from 2000-2011.

DATA SOURCES: All studies were double blind randomized control trials and found using one search+ and EBSCO host through the PCOM library webpage.

OUTCOMES MEASURED: The outcomes measured in each study were based on subjective evaluations of ease of defecation, ease of stool passage, and feelings of fullness.

RESULTS: Only one of the three …

Is L-Carnitine Effective In Reducing Mortality After An Acute Myocardial Infarction?, Jeremiah Spearman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not L-carnitine decreases mortality rates post MI.

STUDY DESIGN: Review of three randomized controlled trials published in 1996, 2000, and 2012, all English language.

DATA SOURCES: Three double blind, randomized controlled clinical trials comparing mortality rates in patients post MI who were treated with L-carnitine or a placebo. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: In the Singh et al. study the outcomes were total cardiac events that included death and nonfatal infarctions, cardiac enzymes activity, infarct size, and any …

Is Aztreonam Lysine For Inhalation Effective In The Treatment Of Patients With Cystic Fibrosis And Pseudomonas Aeruginosa Airway Infection?, Christine Shevchenko

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aztreonam lysine for inhalation is effective in the treatment of patients with cystic fibrosis and Pseudomonas aeruginosa airway infection.

STUDY DESIGN: Review of three English language primary randomized controlled trials published in 2008, 2009, and 2011.

DATA SOURCES: Three randomized, double-blind, placebo-controlled studies using Cochrane and Pubmed databases.

OUTCOMES MEASURED: Patient oriented outcomes measured included change in respiratory symptoms measured by the Cystic Fibrosis Questionnaire-Revised and need for additional anti-pseudomonal antibiotics indicative of pulmonary exacerbation.

RESULTS: In both cystic fibrosis (CF) …

Does The Injection Of Botulinum Toxin Improve Symptoms In Patients With Gastroparesis?, Jillian Solomon

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selected EBM review is to determine whether or not the injection of botulinum toxin improves symptoms in patients with gastroparesis.

STUDY DESIGN: Review of two published, double blind randomized controlled trials and one published, open label pilot study were used for this review, which were found on PubMed.

OUTCOMES MEASURED: The outcome was the change in gastroparesis-associated symptoms, which was measured using the Gastroparesis Cardinal Scale Index (GCSI) and Gastroparesis Questionnaire. In the two double blind, randomized controlled trials by Arts et al. and Friendenberg et al., symptoms were quantified using the …

Is Dexamethasone Epidural Injection Effective In Relieving Radicular Pain In An Adult Population?, Christine M. Unger

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not dexamethasone epidural injections are effective in treating radicular pain in an adult population.

STUDY DESIGN: Review of three randomized controlled trials, two of which were published in 2012 and one in 2010, all English language.

DATA SOURCES: Three randomized controlled trials comparing dexamethasone epidural injections to saline injections. All articles were found using PubMed, Medline, and OVID.

OUTCOMES MEASURED: Researchers measured pain associated with radicular pain using the Short McGill Pain Questionnaire, Numeric Pain Scale, and Oswestry Disability Index.

RESULTS: All …

Is Glycolic Acid Safe And Effective In The Treatment Of Mild To Moderate Acne?, Brittany Stokes

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EMB review is to determine whether or not the use of glycolic acid is effective in the treatment of inflammatory and non-inflammatory acne.

STUDY DESIGN: The review of three randomized, double-blind, controlled trials all published in English language between the years of 2008-2010.

DATA SOURCES: Three randomized, double-blind, controlled trails comparing glycolic acid to a visually matched placebo or pharmaceutical therapy in improvement of acne. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: The improvement of inflammatory and non-inflammatory acne and tolerance/ safety of the intervention. Efficacy was …

Does Treatment With Amantadine Increase The Rate Of Improvement Of Cognitive Function In Patients Suffering From Traumatic Brain Injury?, Matthew Voit

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine, “Does treatment with amantadine improve the rate of cognitive function in patients with Traumatic Brain Injury?”

STUDY DESIGN: Review of three English language randomized controlled trials from 1999-2012

DATA SOURCES: Three randomized, placebo-controlled, double blind cross-over trials comparing amantadine to placebo were found using Pub-Med and Cochrane Databases.

OUTCOMES MEASURED: The trials measured the effects of amantadine on command-following, object recognition, functional object use, intelligible verbalization, reliable yes-or-no communication, sustained attention, orientation, attention, memory, executive flexibility, and behavior and used the following assessment tools: Neurobehavioral Rating Scale and DRS (Disability Rating Scale).

RESULTS …

Is The Addition Of A Topical Agent To Narrowband Uvb Treatment More Effective In Treating Male And Female Adults With Psoriasis Than Narrowband Treatment Alone?, Colleen M. Wagner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of a topical agent to narrowband UVB treatment is more effective in treating adults with psoriasis than narrowband UVB treatment alone.

STUDY DESIGN: Review of three English language primary randomized trials that were published between 2003 and 2012.

DATA SOURCES: A randomized left-right comparison, placebo controlled clinical trial, a randomized trial, and a randomized placebo controlled, blinded clinical trial each comparing the addition of a topical agent to narrowband UVB treatment to narrowband UVB treatment alone were found using PubMed and …

Is A Low Glycemic Index Diet An Effective Treatment Regimen For Acne Vulgaris In Adolescents And Young Adults Ages 15-30?, Gina C. Tomkus

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a low glycemic index (Low GI) diet is an effective treatment for acne vulgaris in adolescents and young adults ages 15-30.

STUDY DESIGN: Systematic review of two randomized, double blind, placebo controlled clinical trial and one parallel clinical trial published in peer-reviewed journals.

DATA SOURCES: Two randomized double blind clinical trials and one parallel clinical trial published in 2007, 2012, and 2010 respectively. The sources studying the use of a low glycemic index diet as a therapeutic intervention for acne vulgaris were obtained …

Is The Addition Of Omega-3 Fatty Acids To Other Treatment Methods Effective In Reducing Pain In Adult Patients With Osteoarthritis?, Lisa C. Martin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: Is the addition of Omega-3 fatty acids to other treatment methods effective in reducing pain in adult patients with osteoarthritis?

STUDY DESIGN: Review of three published, double blind, randomized controlled trials were used for this review and were selected based on their relevance to the clinical question.

DATA SOURCE: The most recent randomized control trials examining the relief of osteoarthritic pain with intake of omega-3 fatty acids in addition to traditional medical therapies were found using Medline, PubMed, and OVID databases.

OUTCOME MEASURED: Relief of osteoarthritic pain with the addition of omega-3 fatty acids to …

Is Melatonin An Effective Treatment For Sleep Problems In Autism?, Andrew J. Winkler

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not melatonin is an effective treatment for sleep problems in Autism.

STUDY DESIGN: Review of three English language, randomized controlled blinded trials published within peer-reviewed journals from 2006-2010 evaluating the efficacy of Melatonin as an oral sleep supplement in diagnosed autistic children.

DATA SOURCES: A double blind, randomized, placebo-controlled, crossover trial; a randomized controlled crossover trial; and a randomized controlled trial found using Cochrane, PubMed, and DynaMed.

OUTCOMES MEASURED: Total night’s sleep duration, number of awakenings, and sleep latency time were all measured …

Increased Incidence Of Asthma After Previous Infantile Rsv Bronchiolitis Infection, Ellen Adelia Doebler

Physician Assistant Scholarly Project Posters

• Respiratory Syncytial Virus (RSV) is a very common infection in children less than two years of age.

• Asthma is a common respiratory disease in childhood, which may cause frequent hospitalizations.

• The purpose of this study is to determine if infants previously diagnosed with RSV bronchiolitis have an increased incidence of asthma diagnosis compared to infants not diagnosed with RSV.

• The literature review examines correlation studies of both disease processes and explores incidence of asthma in patients previously diagnosed with Respiratory Syncytial Virus bronchiolitis.

• Individuals previously diagnosed with Respiratory Syncytial Virus bronchiolitis have a higher risk …

Alternative Treatment With Red Yeast Rice To Reduce Hyperlipidemia, Lisa Froemke

Physician Assistant Scholarly Project Posters

• First line treatment of cardiovascular disease is lifestyle modification followed by the pharmacologic intervention of HMG-CoA reductase inhibitors or statins

• Statins are commonly associated with intolerable side effects such as myalgia leading to medication non-compliance

• RYR preparations claim to inhibit cholesterol synthesis without causing myalgia

• RYR preparations have naturally occurring monacolins such as monacolin K which is chemically identical to lovastatin

• RYR is not regulated by the FDA leading to questionable manufacturing practices producing varying ingredient composition

• The purpose of this study is to investigate the role RYR in hyperlipidemia treatment compared to statins …

The Addition Of Tiotropium In Uncontrolled Asthma, Kathryn Gray

Physician Assistant Scholarly Project Posters

• Many patients with asthma have poorly controlled disease despite the use of both an inhaled corticosteroid (ICS) and a long acting beta agonist (LABA).

• The review explored several studies that compared the addition of tiotropium to patients with uncontrolled asthma currently using both a ICA and a LABA to determine if further symptom reduction is obtained along with reduction of exacerbations

• It was found that patients with poorly controlled asthma will benefit from the addition of tiotropium to the current medication regimen of an ICS and a LABA. Tiotropium offers providers an additional disease controlling option in …

Treatment Of Acute Bronchitis In Children With Pelargonium Sidoides, Amber Houge

Physician Assistant Scholarly Project Posters

Bronchitis is one of the most common acute infections affecting pediatric patients. Most cases are caused by viral infections, do not respond to antibiotic therapy, and can take up to 14 days to resolve with supportive therapy. The purpose of this study is to determine if the use of Pelargonium Sidoides (Umcka™, EPs 7630) extract will decrease the duration and severity of symptoms from acute bronchitis in the pediatric population. Pelargonium Sidoides abstract is an extract of an African Geranium that has been used in traditional medicine for centuries. The review of the literature will evaluate multiple randomized controlled trials …

Hypertonic Saline Therapy In Cystic Fibrosis, Idil Mohamed

Physician Assistant Scholarly Project Posters

Cystic fibrosis is an autosomal recessive genetic disorder that severely affects the lungs as well as other organs in the body. The pathophysiology of cystic fibrosis lung disease involves the production of thick and sticky mucus that accumulates leading to obstruction and inflammation of the airways. This disease is characterized by abnormal transport of sodium and chloride across an epithelium by defective genes, resulting in thick mucus secretions.

Nebulized hypertonic saline (3% NaCl) improves mucociliary clearance through rehydration of the airway surface liquid of the lungs. The purpose of this study is to evaluate the effects of nebulized hypertonic saline …

New Age Anticoagulants: A Safer And More Effective Alternative To Warfarin?, Benjamin Johnson

Physician Assistant Scholarly Project Posters

Atrial fibrillation is the most common sustained heart rhythm in the United States with estimated prevalence rates of 8.8/100 (Wolf, Abbott, & Kannel, 1991). The largest risk for patients with atrial fibrillation is that of ischemic stroke from embolization of an atrial clot, thus the long standing treatment for this arrhythmia is aggressive anticoagulation. For decades this has been accomplished with the use of warfarin, however, the increased risk of hemorrhage combined with the inconvenience of weekly blood testing has prompted the development of potentially safer and more effective alternatives. A systematic review of the literature identified studies that examined …