Nervous System Diseases Commons^™

Does Routine Use Of Medical Cannabis (Marijuana) Decrease The Intensity Of Chronic Neuropathic Pain In Adults?, Ben Arpin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM was to investigate the question, “Does routine use of medical cannabis (marijuana) decrease the intensity of neuropathic chronic pain in adults?

STUDY DESIGN: systematic review of 3 English language primary studies, published between 2005 and 2009.

DATA SOURCES: Three Randomized Controlled Trials (RTC’s) published on or after 2005 were selected based on their relevance to the proposed question via PubMed. All three RTC’s compared cannabis use vs. placebo for chronic neuropathic pain, with two RTC’s focusing on HIV neuropathic pain and the third focusing on MS.

OUTCOMES MEASURED: The outcomes measured in these …

Is Enbrel (Etanercept) Safe And Effective In Treating Patients With Sciatic Nerve Pain Resulting From Lumbar Disc Herniation Or Spinal Stenosis?, Abigail Lee Ferry

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Enbrel (etanercept) is safe and effective in treating patients with sciatic nerve pain resulting from lumbar disc herniation or spinal stenosis.

STUDY DESIGN: Review of three English language primary randomized controlled trials from 2012- 2013.

DATA SOURCES: One triple-blind, placebo-controlled randomized clinical trial, one double-blind, placebo-controlled randomized clinical trial, and one prospective randomized clinical trial were found using PubMed. These studies compared treatment with etanercept to treatment with saline and steroids (dexamethasone or methylprednisolone).

OUTCOMES MEASURED: Clinical outcomes of leg and back pain were measured using …

Does Temporal Lobe Resection Cure Seizures In Epileptics?, Alyssa Hall

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not temporal lobe resection cures seizures in epileptics.

Study Design: Systematic review of three English language, peer-reviewed randomized controlled trials, published between 2001 and 2012

Data Sources: Two randomized controlled trials comparing temporal lobe resection surgery to antiepileptic drugs in the treatment of epileptic seizures, and one randomized controlled trial comparing 3.5 cm temporal lobe resection to 2.5 cm temporal lobe resection in the treatment of epileptic seizures. Studies were obtained by the author through the PubMed database.

Outcomes Measured: Primary outcome measured by the three studies was …

Is Safinamide Effective As An Add-On Medication In Treating Parkinson's Disease Motor Symptoms?, Erin E. Kilonsky

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not “Is safinamide effective as an add-on medication in treating Parkinson's disease motor symptoms?”

Study Design: Review of three randomized, controlled studies published in peer reviewed journals in English between 2012-2014.

Data Sources: The three randomized, double-blind clinical trials were found via PubMed and EBSCOhost Web. Articles were selected based on relevance, the date of publication, and whether or not they included patient outcomes.

Outcomes Measured: Among other measures, each trial measured improvement in motor symptoms using the Unified Parkinson’s Disease Rating Scale (UPDRS) Part III (motor) scores, …

Does Hyperbaric Oxygen Therapy Relieve Post-Concussion Symptoms And Improve Quality Of Life?, Kevin (Sung Min) Lee

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not hyperbaric oxygen therapy relieves post-concussion symptoms and improve quality of life.

Study Design: Review of three randomized controlled trials published in English in peer review journals.

Data Sources: Three randomized controlled trials which evaluated the therapeutic benefits of hyperbaric oxygen therapy compared to control group that did not receive any treatment. All studies were found in PubMed database.

Outcomes Measured: All three studies analyzed the effect of hyperbaric oxygen therapy on quality of life. Rivermead Postconcussion Symptoms Questionnaire (RPQ) and EQ-VAS questionnaire were used to measure …

Is Acupuncture An Effective Treatment For Women With Chronic Migraine?, Elham Oumer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is effective in treating chronic migraine in women between the ages of 18-65.

STUDY DESIGN: Review of two randomized controlled trials and one prospective controlled trial published in English language between 2009 and 2014.

DATA SOURCES: Two PCTs and one prospective CT published in peer reviewed journals, searched through PubMed, EBSCOhost.

OUTCOMES MEASURED: The outcome measured included improvement in quality of life, reduction in intensity and number of headache days. This were measured using 50% responders analysis, self reporting by participants, short form 36 (SF-36) …

Do Botulinum Toxin Injections Improve The Freezing Of Gait (Fog) Episodes Experienced By Parkinson’S Disease (Pd) Patients?, Caroline R. Poole

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not botulinum toxin injections improve the freezing of gait (FOG) episodes experienced by patients diagnosed with Parkinson’s disease (PD).

STUDY DESIGN: This review is based on three randomized controlled trials published in 2004, 2005, and 2007. All of the studies compared the efficacy as well as safety of using botulin toxin injections to treat FOG episodes experienced by PD patients.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and were found using PubMed searches.

OUTCOMES MEASURED: For all studies, the safety and efficacy …

Is Tetrahydrocannabinol (Thc)/Cannabidiol (Cbd) Oromucosal Spray An Effective Adjuvant Therapy For Multiple Sclerosis Patients Who Suffer From Central Neuropathic Pain?, Evan Taxin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Tetrahydrocannabinol (THC)/Cannabidiol (CBD) oromucosal spray an effective adjuvant therapy for Multiple Sclerosis (MS) patients who suffer from central neuropathic pain (CNP)?”

STUDY DESIGN: Systematic review of three randomized controlled trials published between 2005-2013, all English language.

DATA SOURCES: Three randomized controlled studies were obtained using PubMed and MedLine.

OUTCOMES MEASURED: The outcome of each study was the subject’s incidence and severity of central neuropathic pain compared to their baseline at the beginning of the study. Outcomes were measured using an 11-point pain scale at various …

Does Cooling Therapy Improve Functional Mobility In Heat-Sensitive Adults Diagnosed With Multiple Sclerosis?, Jordan Robinaugh

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cooling therapy improves functional mobility in heat-sensitive adults diagnosed with MS.

STUDY DESIGN: Systematic review of three randomized controlled trials published between 2007 and 2011, all in the English language.

DATA SOURCES: Three randomized controlled trials were found using the PubMed/MEDLINE database.

OUTCOMES MEASURED: Functional mobility as measured by the Multiple Sclerosis Functional Composite (MSFC), postural control, exercise duration, walking speed, and timed up and go examinations.

RESULTS: In one study, MeyerHeim, et al. demonstrated significant improvements with the experimental intervention on the 25-foot walk, 9-hole …

Does Resistance Training Improve Mobility In Patients With Parkinson’S Disease?, F. Joe Yorio

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM is to determine whether or not resistance training is effective in improving mobility for patients with Parkinson’s disease.

Study Design: Review of four English language randomized control trials (RCT) published between 2012-2013.

Data Sources: Articles used were RCTs and published in peer reviewed journals and found using Pubmed, JAMA, and NCBI.

Outcomes Measured: Effectiveness was measured by comparing a sham, or non-resistance based exercise group, to a resistance based group. Improvement in mobility was measured using UPDRS-III scores.

Results: Patients with Parkinson’s have slow and weak movements which should be improved with resistance …

How Safe And Effective Is Tryptophan In Improving Sleep In Healthy Individuals With Mild Sleep Disorders?, Genevieve Asante-Odame

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not tryptophan is effective in improving sleep in healthy individuals with mild sleep disorders.

STUDY DESIGN: Systematic review of three published, randomized controlled trials (double-blind, placebo-controlled) between 2005-2010, all English language.

DATA SOURCES: Three randomized controlled trials published between 2005 and 2010 were found using PubMed/MEDLINE and Cochrane databases.

OUTCOMES MEASURED: Improved sleep quality and duration of sleep, which were measured using sleep diaries and sleep study questionnaires.

RESULTS: The first study, Cubero et al showed that administration of diet containing high levels of tryptophan reflected more …

Is Yoga Effective In Reducing Fibromyalgia-­Related Symptoms In Women With Fibromyalgia?, Molly R. Beckmann

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not yoga is effective in reducing fibromyalgia-related symptoms in women with fibromyalgia.

Study Design: Review of two published double blind, randomized controlled trials published in 2010 and one before-after study published in 2012 were used for this review and selected based on their relevance to the clinical question

Data Source: Studies were found using PubMed, AMED, and CINAHL Plus.

Outcomes Measured: All three studies measured improvement of fibromyalgia symptoms based on a variety of well-validated measures, most notably the Fibromyalgia Impact Questionnaire, the Quality of Life Profile …

Does Cognitive Behavioral Therapy Effectively Decrease The Severity Of Chronic Pain In Patients With Motor Vehicle Accident (Mva) Associated Post Traumatic Stress Disorder (Ptsd)?, Reanna Gibbs

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cognitive behavioral therapy effectively decreases the severity of chronic pain in patients with motor vehicle accident (MVA) associated post traumatic stress disorder (PTSD).

STUDY DESIGN: Systematic review of two randomized, controlled clinical trials published in 2009 and 2012, respectively, and one primary research case study published in 2003.

DATA SOURCES: Three published studies comparing patient reported reduction in pain severity following treatment with cognitive behavioral therapy (CBT) were found using PubMed.

OUTCOMES MEASURED: The extent of pain reduction experienced by the patient after receiving treatment. Recording …

Is Yoga Effective In Reducing Fatigue In Patients With Multiple Sclerosis?, Melissa L. Hessler

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not the use of yoga helps to improve fatigue in patients with Multiple Sclerosis (MS).

Study Design: Review of three randomized controlled trials (RCTs) published between 2004-current, all in the English language.

Data Sources: Three randomized controlled trials (RCTs), all of which evaluate the effectiveness of yoga compared to a control group that was asked not to change their exercise habits as they pertain to fatigue. All studies were found using PubMed and EBSCOhost.

Outcomes Measured: Each of the three articles analyzed the effects of yoga therapy …

Is Acupuncture An Effective Treatment For Acute Migraine?, Meghan C. Knab

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is an effective treatment for acute migraines.

STUDY DESIGN: Review of three English language randomized controlled trials, published between 2003 and 2012.

DATA SOURCES: Three randomized controlled trials published in peer reviewed journals found using PubMed, Medline, and EBSCOhost.

OUTCOMES MEASURED: The outcomes measured included complete absence of migraine pain, measured by Visual Analog Scale scores and a headache diary, and progression to a fully formed migraine, measured by the Validated Pain Scale by Heller.

RESULTS: The studies by Li et al and Wang et …

Does Balneotherapy Effectively Reduce Non-Specific Chronic Low Back Pain In Adults?, Jenna Srebnik

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not balneotherapy effectively reduces non-specific chronic low back pain in adults.

STUDY DESIGN: Review of three single blind, follow up randomized controlled trials (RCT), published in 2012 and 2005.

DATA SOURCES: Three peer reviewed RCTs were found using PubMed and all compared balneotherapy against various control groups.

OUTCOMES MEASURED: Low back pain of patients was assessed using dose of analgesic consumed, visual analog pain scale (VAS) and Oswestry Low Back Pain Disability Questionnaire (OSWDQ). The tools used to assess significance of outcomes measured were Pvalues, change in …

Does Exercise Reduce The Risk Of Falling In Parkinson’S Patients?, Michael J. Tansey

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not exercise reduces the risk of falls in Parkinson’s patients

Study Design: Review of three English language randomized control trials (RCTs) published in 2003, 2007 and 2010.

Data Sources: 3 randomized controlled trials published after 1999 were obtained using Pubmed.

Outcomes Measured: The Allen study used a Parkinson’s disease fall risk scoring. The Ashburn study used patient dairies to record incidence of falls. The Hirsch study used Sensory Orientation testing assessing the trials resulting in falls.

Results: Allen et al and Ashburn et al found no significant …

Is 30 Ml Cerebrolysin A Safe And Effective Drug For Improving Global And Cognitive Function In Patients With Alzheimer's Disease Aged 50 Years And Older With No Significant Comorbidities?, Anthony Champion

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of 30 mL Cerebrolysin is a safe and effective drug for improving global and cognitive function in patients with Alzheimer’s Disease aged 50 years and older with no significant comorbidities.

STUDY DESIGN: Systematic review of three randomized controlled trials published between 2001-2006, all English language.

DATA SOURCES: Three randomized controlled trials comparing the efficacy of cerebrolysin to placebo in the treatment of individuals ages 50 and over with AD related cognitive and global functioning decline. All articles found using PubMed.

OUTCOMES MEASURED …

Does Prophylacitc Medication Reduce Intrauterin Device (Iud) Insertion Pain In Women Of Childbearing Age?, Mariel M. Deshaies

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not prophylactic medication reduces intrauterine device (IUD) insertion pain in women of childbearing age.

STUDY DESIGN: Review of 3 English language trials: a randomized controlled trial, double-blinded randomized control trial, and a double-blinded randomized placebo controlled trial.

DATA SOURCES: A randomized controlled trial, double-blinded randomized control trial, and a double-blinded randomized placebo controlled trial comparing the prophylactic medications: lidocaine and mistoprostol or placebo group. All articles were found using Medline, PubMed, and OVID.

OUTCOMES MEASURED: Reduction of pain with IUD insertion was compared …

Is Massage Therapy An Effective Treatment For Improving Sleep Quality In Women Age 50-80 Diagnosed With Cancer?, Alexander M. Chase

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not massage therapy is an effective treatment in improving sleep quality among women age 50-80 diagnosed with cancer.

STUDY DESIGN: Review of two English language randomized control trials published in 2004 and 2011 and one English language quasiexperimental pretest-posttest comparison study publishEd in 2002.

DATA SOURCES: Data sources were articles published in peer reviewed journals found using PubMed and EBSCOhost.

OUTCOMES MEASURED: Sleep quality was measured using the Verran and Snyder-Halpem Sleep Scale and the Richards-Campbell Sleep Questionnaire.

RESULTS: Soden et al …

Is Riboflavin Effective As Prophylaxis For Reducing The Frequency Of Migraine Headaches In The Pediatric Population?, Megan Haines

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not riboflavin is effective as prophylaxis for reducing the frequency of migraine headaches in the pediatric population.

Study Design: Systematic review of the three English language primary studies, published between 2008-2010.

Data Sources: Two randomized controlled trials and one retrospective study published after 1996 comparing migraine frequency before and after administration of riboflavin were obtained using PubMed and EBSCO databases.

Outcomes Measured: Reduction in migraine frequency, determined by child-parent collaborated headache diary while using prophylactic intervention, was the primary outcome measured. This outcome …

Does Electroanalgesic Therapy Decrease Neuropathic Pain In Diabetic Patients?, Michelle A. Lee

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not use of electroanalgesic therapy decreases neuropathic pain symptoms in diabetic patients

STUDY DESIGN: Review of a 2 randomized control trial published in 2013 and 2011 published in the English language and an observational study published in 2010 in the German language translated into English.

DATA SOURCES: One randomized, double-blind control trial comparing frequency-modulated electromagnetic stimulation vs placebo in reduction of diabetic neuropathic pain, one randomized, control trial comparing microcurrent transcutaneous electric nerve stimulation vs placebo in reduction of painful diabetic neuropathy and a observational …

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 …

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 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 …