Nervous System Diseases Commons^™

Does Oral Dextromethorphan Provide Pain Relief In Patients With Diabetic Neuropathy?, Brittany L. Lundberg

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not oral dextromethorphan provides pain relief in patients with diabetic neuropathy.

STUDY DESIGN: Review of three peer-reviewed, double blind, randomized control trials published between 1995-2012.

DATA SOURCES: Studies were selected through Cochrane Library Collection and PubMed and chosen based on their relevance to the clinical question as well as their inclusion criteria; including adults over the age of 18; and those who were experiencing daily pain of moderate intensity, for at least half of the day, over a span of 3 months.

OUTCOMES MEASURED …

Does A Mobile-Bearing Vs. Fixed-Bearing Total Knee Replacement Affect Post-Operative Knee Pain At One Year?, Alison P. Mackey

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a mobile-bearing vs. fixed-bearing total knee replacement affects post-operative knee pain at one year.

STUDY DESIGN: Review of three English language primary studies, published between 2008 and 2012.

DATA SOURCES: Three randomized controlled trials published after 2008 comparing post-operative knee pain in mobile vs. fixed-bearing total knee replacements using PubMed and Cochrane databases.

OUTCOMES MEASURED: Knee pain, reported by patients post-operatively using various professional questionnaires, was the primary outcome measured. Subjects reported pain experienced during specific provoking activities on the EuroQol, Western …

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 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 …

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 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 …

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 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 …

Phenotype Of Transgenic Mice Carrying A Very Low Copy Number Of The Mutant Human G93a Superoxide Dismutase-1 Gene Associated With Amyotrophic Lateral Sclerosis, Jeffrey S. Deitch, Guillermo M. Alexander, Andrew Bensinger, Steven Yang, Juliann T. Jiang, Terry D. Heiman-Patterson

PCOM Scholarly Works

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of the motor neuron. While most cases of ALS are sporadic, 10% are familial (FALS) with 20% of FALS caused by a mutation in the gene that codes for the enzyme Cu/Zn superoxide dismutase (SOD1). There is variability in sporadic ALS as well as FALS where even within the same family some siblings with the same mutation do not manifest disease. A transgenic (Tg) mouse model of FALS containing 25 copies of the mutant human SOD1 gene demonstrates motor neuron pathology and progressive weakness similar to ALS patients, leading to death …

The Cell And Molecular Biology Of Neurodegenerative Diseases: An Overview, Heather L. Montie, Thomas M. Durcan

PCOM Scholarly Works

There is no abstract for this article.

Chlamydia Pneumoniae Infection Of Neuronal Cells Induces Changes In Calcium-Associated Gene Expression Consistent With Alzheimer’S Disease, Christopher Andrew Cappellini, Ahmad B. Cader, Keith G. Williams, Juliana Zoga, Susan T. Hingley

Scholarly Posters

Background and Significance: Previous studies have shown that cells infected with Chlamydia pneumoniae (Cpn) exhibit altered gene expression consistent with that observed in Alzheimer’s disease (AD). Furthermore, AD neurodegeneration has been linked to dysregulation of intracellular calcium and calcium-related processes. Therefore, we hypothesize that one mechanism by which pathogenesis evolves in AD is through infection-induced changes in expression of calcium-related genes. Objectives: To determine if infection of neuronal cells with Cpn alters expression of calciumrelated genes associated with neurodegeneration. Methods: SK-N-MC neuronal cells were infected with Cpn (AR39 strain; MOI=1) for 3 to 72 hours, then calcium-related genes were screened …

Analysis Of Autophagy And Inflammasome Regulation In Neuronal Cells And Monocytes Infected With Chlamydia Pneumoniae: Implications For Alzheimer’S Disease, Brian J. Balin, Christine J. Hammond, Juliana Zoga, Ahmad B. Cader, Annette K. Slutter, Jonathan M. Anzman, Ian Kohler, Susan T. Hingley, Denah M. Appelt

Scholarly Posters

Objectives: Our laboratory has been studying the role of infection with the obligate intracellular bacterium Chlamydia pneumoniae in sporadic late-onset Alzheimer disease (LOAD). This infection may be a trigger for the pathology observed in LOAD as a function of initiating changes in gene regulation following entry of the organism into the brain. As such, we are analyzing how this infection can promote changes in autophagy and inflammasome gene regulation as both have been shown to be altered in LOAD. Methods: Human SKNMC neuronal cells and THP1 monocytes were infected in vitro for 24-72 hrs with a laboratory strain of Chlamydia …

Is Modafinil (Provigil®) Effective In Improving Cognitive Function In Adults With Narcolepsy?, Stephanie V. Bui

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not modafinil (Provigil®) is effective in improving cognitive function in adults with narcolepsy.

STUDY DESIGN: Review of all English language primary randomized controlled trials from 1996 to 2010.

DATA SOURCES: Double-blind, randomized controlled trials that compared modafinil (Provigil®) to a visually matched placebo were found using OVID, MEDLINE, and Cochrane Databases.

OUTCOME(S) MEASURED: Each of the three trials assessed the effect of modafinil on cognitive and executive function by Low-Resolution Brain Electromagnetic Tomography (LORETA), and the following assessment tools: Epworth Sleepiness Scale (ESS), Multiple Sleep …

Is Local Infiltration Analgesia (Lia) A Safe And Effective Method For Post-Operative Pain Management After A Unilateral Total Knee Arthroplasty (Tka)?, Brooke A. Bonnette

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not local infiltration analgesia (LIA) is a safe and effective method for post-operative pain management after a unilateral total knee arthroplasty (TKA).
STUDY DESIGN: Review of three English language primary studies published in 2010 and 2011.

DATA SOURCES: Three randomized controlled trials comparing local infiltration analgesia to three separate controls: epidural analgesia, placebo infiltration and femoral nerve block found using PubMed.

OUTCOMES MEASURED: Clinical outcome was measured by total morphine use postoperatively and average knee pain intensity at rest and upon movement postoperatively. Total morphine use …

What Is The Effectiveness Of Onabotulinumtoxina (Botox®) In Reducing The Number Of Chronic Migraines (Cm) In Patients 18-65 Years Old?, Kristin A. Beddingfield

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not onabotulinumtoxinA (Botox®) is effective in reducing the number of chronic migraines (CM) in patients 18-65 years old? Study Design: Review of three published, double blind randomized controlled trials were used for this review, which were found on PubMed; were selected based on their relevance to the clinical question and if they included patient oriented outcomes.

OUTCOMES MEASURED: The outcomes measured were headache/migraine free days measured by >50% responder rate analysis, the Treatment Responder Rate based on Physician Global Assessment, and total adverse events reported by …

Autophagy And Apoptotic Genes Implicated In Alzheimer’S Disease Are Modulated Following Infection Of Neuronal Cells With Chlamydia Pneumoniae, Denah M. Appelt, Ian Kohler, Annette K. Slutter, Juliana Zoga, Susan T. Hingley, Brian J. Balin

Scholarly Posters

Background: The focus of the current studies was to determine the relationship between the molecular mechanisms interconnecting autophagy and apoptosis following Chlamydia pneumoniae infection in neuronal cells. Dysfunctions in apoptosis and autophagy have been implicated in the neurodegeneration associated with Alzheimer’s disease (AD). Autophagy in AD pathogenesis has been shown to play a role in amyloid processing through the endosomal-lysosomal system. Apoptosis may contribute to the neuronal cell loss observed in AD; however, there is limited evidence of the apoptotic process proceeding to terminal completion. Although Aβ1-42 has been shown to induce apoptosis in neurons and may be an early …

Does Whole Body Vibration (Wbv) Therapy Positively Affect The Motor Skills Of Patients Who Have Been Diagnosed With Parkinson’S Disease?, Courtney Forsyth

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether Whole Body Vibration (WBV) therapy positively affects the motor skills of patients who have been diagnosed with Parkinson’s disease.

STUDY DESIGN: Review of 3 English language primary studies. All three were randomized control trials; one was rater blinded and one double blinded with a placebo.

DATA SOURCES: All of the articles were Randomized Control Trials found using the PubMed database.

OUTCOMES MEASURED: Each of the three studies looked at the symptoms of Parkinson’s disease patients before and after Whole Body Vibration Therapy. Each study used the Unified Parkinson’s Disease …

Is 1.25 Mg Oral Fingolimod Effective In Reducing Relapses In Adults With Relapsing Multiple Sclerosis?, Caitlin M. Cook

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not is 1.25 mg oral fingolimod effective in reducing relapses in adults with relapsing multiple sclerosis.

STUDY DESIGN: Review of three English language primary studies published between 2006 and 2010.

DATA SOURCES: Randomized, double-blind, controlled clinical trials comparing daily 1.25 mg oral fingolimod to either identical placebo capsules or weekly intramuscular interferon beta-1a therapy were found using Pubmed and Cochrane Databases.

OUTCOMES MEASURED: Annualized relapse rate was assessed in all studies. Relapses were confirmed by neurologists and assessed using the Expanded Disability Status Scale (EDSS) to evaluate worsening …

Infection Of Neuronal Cells By Chlamydia Pneumoniae And Herpes Simplex Virus Type 1 Alters Expression Of Genes Associated With Alzheimer’S Disease, Morgan M. Devins, Fiora D. Zoga, Brian J. Balin, Denah M. Appelt, Susan T. Hingley

Scholarly Posters

Several studies have suggested an infectious etiology for Alzheimer’s disease (AD). We have been investigating a potential role for both Chlamydia pneumoniae and Herpes simplex virus type 1 (HSV1) in the initiation of sporadic late-onset AD. Our current study focuses on investigation of gene expression using Alzheimer-specific Real-Time PCR microarrays on RNA derived from SKNMC human neuronal cells infected with C. pneumoniae and/or HSV1. There are distinct differences in the patterns of gene regulation by the two pathogens. For example, C. pneumoniae induces expression of genes involved in amyloid production and processing, such as β-amyloid precursor protein (APP), β-site APP-cleaving …

Analysis Of Chlamydia Pneumoniae And Ad-Like Pathology In The Brains Of Balb/C Mice Following Direct Intra-Cranial Infection, Jessica Rachel Barton, Christine J. Hammond, Amy L. Brady, Denah M. Appelt, Brian J. Balin, Christopher Scott Little

Scholarly Posters

Alzheimer’s disease (AD) is an age-related progressive neurodegenerative disorder and the most common form of dementia. The pathology in the central nervous system (CNS) impairs memory and cognition, hindering the capabilities and the quality of life of the individual. This project continues studying the role of infection and Alzheimer’s disease, as previous studies in this laboratory have done, and contributes to the overall understanding of the possible causes of this disease. In this study, BALB/c mice were infected, via direct intracranial injection, with a respiratory isolate (AR-39) of Chlamydia pneumoniae. Their brains were analyzed at 7 and 14 days post-infection, …

Analysis Of Chlamydia Pneumoniae-Infected Monocytes Following Incubation With A Novel Peptide, Acaly18, Implicates The Inflammasome In Clearance Of Infection, Brian J. Balin, James D. Thacker, Charles Lim, Corey M. Caruthers, Susan T. Hingley, Juliana Zoga, Denah M. Appelt

Scholarly Posters

Chlamydia pneumoniae infection may be a trigger for the pathology observed in sporadic lateonset Alzheimer’s disease as a function of initiating neuroinflammation following entry of the organism into the brain. We have hypothesized that one entry mechanism may be by bloodborne infected monocytes trafficking the infection into the brain. This study focuses on infection of monocytes in vitro followed by analysis using immunofluorescence labeling and RT-PCR-microarray techniques. The microarrays utilized consisted of an Alzheimer’s disease pathway array and an innate and adaptive immunity array from SAbiosciences. Analysis by real time PCR for both gene arrays was performed on uninfected and …

Gestational Diabetes Clinic For Indigent Latinos, Sara Wilson Reece

Scholarly Posters

Gestational diabetes mellitus (GDM), “carbohydrate intolerance of variable severity with onset or fist recognition during pregnancy,” results from insulin resistance and relative insulin deficiency usually in second trimester.¹ • Gestational diabetes (GDM) impacts between 4% and 9% of all pregnancies. • Gestational diabetes (GDM) results in increased fetal complications of macrosomia, shoulder dystocia and neonatal hyperglycemia as well as maternal risks of preeclampsia and polyhydramnois. • Women who are Hispanic or Asian decent are at highest risk of developing GDM. • Diagnosis ² • Perform 75-gramoral glucose tolerance test (OGTT) at 24 – 28 weeks of gestation in women not …

Alzheimer's Disease Association With Chlamydia Pneumoniae, Andrew Short

PCOM Biomedical Studies Student Scholarship

Exogenous bacteria, such as Chlamydia pneumoniae, may be a cause of inflammation that contributes to the progression of Alzheimer's disease (AD). Inflammation has been previously established as a contributor to AD progression. Balin et al. first reported C. pneumoniae in the brains of post-mortem late onset AD patients. PCR analysis showed that 17/19 AD patients were positive for the organism in areas of the brain with typical AD-related neuropathology while 18/19 control patients were PCR-negative. Gerard et al. determined, using real-time PCR, that C. pneumoniae-infected cells colocalize with both neuritic senile plaques and neurofibrillary tangles, the defining pathologies of AD. …

Is L-Carnitine An Effective Treatment To Improve The Quality Of Life For Patients With Rett Syndrome?, Bernadette Mason

PCOM Physician Assistant Studies Student Scholarship

Objective: To determine “Is L-carnitine an effective treatment to improve the quality of life for patients with Rett Syndrome?”

Herpes Simplex Virus 1 And Chlamydophila (Chlamydia) Pneumoniae Promote Ab 1-42 Amyloid Processing In Murine Astrocytes Linking An Infectious Process To Alzheimer's Disease, Laura R. Triplett, Adam L. Dore, Kevin S. Kralik, Brian J. Balin, Susan T. Hingley, Denah M. Appelt

Scholarly Posters

Background: Several studies have suggested an infectious etiology for Alzheimer's disease (AD). Previously, our laboratory identified Chlamydia pneumoniae (Cpn) from autopsied sporadic AD brains, as well as developed a BALB/c mouse model that demonstrated infection-induced amyloid plaques similar to those found in AD. Hypothesis: We propose that an additional pathogen such as herpes simplex virus type 1 (HSV1), also may be a contributing factor in toin the pathology seen in AD. HSV1, in addition to Cpn, may be triggering the abnormal cleavage of the beta amyloid precursor protein (bAPP) into Ab1-42 , thereby contributing to amyloid plaque formation. Our current …