Musculoskeletal Diseases Commons^™

Is Treatment With Topical Glyceryl Trinitrate Effective In Reducing Elbow Pain In Patients With Lateral Epicondylitis?, Benjamin Chartier

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not treatment with topical glyceryl trinitrate is effective in reducing elbow pain in patients with lateral epicondylitis.

Study Design: Review of two English language randomized controlled trials and one primary study published 2003, 2009, 2011.

Data Sources: Two double blind randomized controlled and one prospective comparison study comparing the effectiveness of gylceryl trinitrate to placebo in the treatment of pain related to lateral epicondylitis, found using PubMed, EBSCOhost, and CINAHL Plus.

Outcome(s) Measured: The outcome studied was patient self-rated elbow pain at rest, pain with activity, pain …

In The Treatment Of Patients With Knee Joint Osteoarthritis, Are Platelet Rich Plasma Injections More Effective Than Hyaluronic Acid Injections?, Darshit Gandhi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not "In the treatment of patients with knee joint osteoarthritis, are Platelet Rich Plasma injections more effective than Hyaluronic acid injections?"

Study Design: Review of one randomized double-blind trial, one randomized cohort study, and one randomized control trial published in the English language in the year 2012.

Data Sources: All studies were published in peer-reviewed journals found via the use of PubMed.

Outcome(s) Measured: Patients were divided into two groups: those who received platelet rich plasma injections (PRP) and those who received hyaluronic injections (HA). Efficacy of …

Is Ginger Effective In Reducing Knee Pain In Adults With Osteoarthritis?, Joseph Heng

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this evidence based medicine review is to determine whether ginger is effective in reducing knee pain in adults with osteoarthritis.

Study Design: Three double blind, randomized controlled trials 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 Cochrane and PubMed database.

Outcomes Measured: The outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) via Likert scale and Knee Pain rated via Knee injury and knee Osteoarthritis Outcome score (KOOS) questionnaire which is a …

Is Red Yeast Rice Tolerable In Treating Patients With Dyslipidemia Who Have Statin-Associated Myalgia?, Carie Lam

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not patients who have statin-associated myalgia have improved tolerability for red yeast rice (RYR) as an alternative treatment.

Study Design: This review consists of three double blinded randomized controlled trials published in English in 2009, 2010, 2013.

Data Sources: Three randomized, controlled, double blinded clinical trials on the tolerability of red yeast rice were found on PubMed and Ebsco Host. Two trials comparing red yeast rice to placebo and the third trial comparing red yeast rice to pravastatin.

Outcomes Measured: Each of the three articles analyzed whether …

Is Ayurvedic Effective In Reducing Osteoarthritis Pain In Adults?, Reja Khan

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Ayurvedic is effective in reducing osteoarthritis pain in adults.

Study Design: Review of three English language randomized controlled trials published between from 2004-2013.

Data Sources: Two double blind randomized controlled trials and one open label randomized controlled clinical trial were found using PubMed and Cochrane Library databases.

Outcomes Measured: To measure the effectiveness, the following parameters were utilized visual analog scale (VAS) reported by the patient to assess reduction in pain symptoms of osteoarthritis.

Results: Three randomized controlled studies results found that Ayurvedic medicine was beneficial …

The Effect Of Chronic Sleep Deprivation On Tumor Necrosis Factor Alpha And Bone Health In Peri-Menopausal Rats, Megan Robertson, Derek Booth, Erin Wainwright, Cody Arbuckle, Frank Frisch

Student Scholar Symposium Abstracts and Posters

Post-menopausal osteoporosis is a common syndrome in the United States. The cessation of estrogen signaling coupled with the production of pro-inflammatory cytokines from sleep deprivation leads to an even greater risk of post-menopausal osteoporosis by creating an imbalance between osteoblasts and osteoclasts. With estrogen no longer present to regulate the concentration of osteoclasts and pro-inflammatory cytokines increasing production of osteoclasts, bone is degraded at a faster rate than it is formed. One of the most common treatments for osteoporosis is Zolendronate (a nitrogenous bisphosphonate), which decreases the number of osteoclasts in bone. This preliminary study looked at the effects on …

A Proposed Holistic Model Of Assessment For Children With Cleft Palate Within The Icf-Cy Framework, Rabia Foreman, Jamesa Ewing, Olivia Hawley, Mariana De Cassia Macedo, Naiara Rodrigues Carlota Do Nascimento, Brenda Louw, Luciana Maximino

ETSU Faculty Works

The purpose of this project is to describe a proposed model for the assessment of children with cleft palate within the framework of the ICF-CY (WHO, 2007). Suggestions for clinical application and cleft palate curricula are made, and future research needs are identified.

Parental Perspective: Toddlers With Clefts Using Touch Screen Technology, Cortney Vineyard, Alexandra Coup, Chelsey Hazelett, Rachel Janes, Brenda Louw

ETSU Faculty Works

This investigation assessed the parental perspectives of parents of toddlers with cleft lip and palate and their use of touchscreen technology. Findings will highlight parental perspectives on touchscreen technology in early intervention with their toddler.

Which Clinical Guidelines Should Be Implemented For Management Of Osteopenia In Primary Care? A Clin-Iq, Turia Hollingsworth

Journal of Patient-Centered Research and Reviews

Literature review was conducted to determine clinical guidelines for osteopenia management of immunocompetent patients in the primary care setting. It was concluded that pharmacological treatment should be offered to patients with osteopenia if they are considered high risk, which can be determined by utilizing the World Health Organization Fracture Risk Assessment Tool (FRAX^®) to evaluate 10-year risk. Patients with a calculated hip fracture probability of at least 3% or those with probability of 20% or more for all osteoporotic fractures may be offered bisphosphonate therapy.

Malignant Hyperthermia, Eric Weberding

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is an autosomal-dominant disorder that is inherited. The disturbance of calcium homeostasis associated with MH affects skeletal muscle (Schneiderbanger, Johannsen, Roewer, & Schuster, 2014). This hypermetabolic muscular disorder is triggered by exposure to depolarizing muscle relaxants such as succinylcholine or inhaled halogenated volatile anesthetics such as sevoflurane, halothane, desflurane, enflurane, and isoflurane (Stratman, Flynn, & Hatton, 2009). In susceptible individuals, this potentially lethal syndrome may cause hyperthermia, hypercapnia, muscular rigidity, hypoxemia, acidosis, tachycardia, and hyperkalemia (Schneiderbanger et al., 2014).

Sma-Causing Missense Mutations In Survival Motor Neuron (Smn) Display A Wide Range Of Phenotypes When Modeled In Drosophila, Kavita Praveen, Ying Wen, Kelsey M. Gray, John J. Noto, Akash R. Patlolla, Gregory D. Van Duyne, A. Gregory Matera

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Mutations in the human survival motor neuron 1 (SMN) gene are the primary cause of spinal muscular atrophy (SMA), a devastating neuromuscular disorder. SMN protein has a well-characterized role in the biogenesis of small nuclear ribonucleoproteins (snRNPs), core components of the spliceosome. Additional tissue-specific and global functions have been ascribed to SMN; however, their relevance to SMA pathology is poorly understood and controversial. Using Drosophila as a model system, we created an allelic series of twelve Smn missense mutations, originally identified in human SMA patients. We show that animals expressing these SMA-causing mutations display a broad range of …

An Investigation Of The Relationship Between Plantar Weight Distribution And The Condition Of Osteoarthritic Knees During Quiet Standing, Brian Joseph Sutterer

Graduate Theses - Biology & Biomedical Engineering

Osteoarthritis (OA) is a damaging disease that commonly affects the knee and can impact function of the lower limb. This study examined how plantar weight distribution is related to the changes in knee alignment and various types of joint damage in patients with OA. A force mat was used to measure plantar weight distribution on 37 patients with knee OA, and the internal condition of the knee was evaluated during surgery. Analysis showed a relationship between medial plantar weight distribution and an increase in knee alignment angle (0.20, p < 0.001). For the damage models, an indirect relationship was found between medial weight distribution and ACL damage (-0.14, p=0.029). No relationship was found for the other types of OA damage. It is reasonable to believe they do exist, however. This study found a connection between weight distribution and alignment, and previous research has shown one between alignment and OA.

Quantitative Ultrasound: Measurement Considerations For The Assessment Of Muscular Dystrophy And Sarcopenia, Michael O. Harris-Love, Reza Monfaredi, Catheeja Ismail, Marc R. Blackman, Kevin Cleary

Exercise and Nutrition Sciences Faculty Publications

Diagnostic musculoskeletal ultrasound has potential clinical utility in characterizing pathological muscle tissue. Sonography has been long proposed as method of assessing muscle damage due to neuromuscular diseases such as muscular dystrophy, and more recently, changes in body and tissue composition associated with muscle wasting disorders such as sarcopenia. The use of quantitative ultrasound as an adjunct diagnostic procedure has different technical challenges than the traditional use of ultrasound in clinical medicine. Operator-dependent technique and variation are critical considerations when obtaining measures of echointensity (i.e., tissue composition estimates) and tissue dimensions (i.e., muscle thickness) – key elements of the ultrasound assessment …

Safety Of Infusing Rituximab At A More Rapid Rate In Patients With Rheumatoid Arthritis: Results From The Rate-Ra Study, Charles H. Pritchard, Maria W. Greenwald, Joel M. Kremer, Norman B. Gaylis, William Rigby

Dartmouth Scholarship

As recommended in the current prescribing information, rituximab infusions in patients with rheumatoid arthritis (RA) take 4.25hours for the first infusion and 3.25hours for subsequent infusions, which is a burden on patients and the health care system. We therefore evaluated the safety of infusing rituximab at a faster rate for an infusion period of 2hours in patients with RA.

Effects Of An Osteoporosis Educational Intervention: Knowledge And Self-Efficacy Of Prevention In Young Adult Collegiate Females, Valerie A. Bollenbacher

Evidence-Based Practice Project Reports

Osteoporosis is a silent and potentially debilitating chronic illness. In 2012, the CDC reported that 4.5 million women over the age of 50 were diagnosed with osteoporosis in the United States. Within the next 20 years, 41 million women worldwide are projected to have osteoporosis. The annual financial burden of osteoporosis is estimated to be 19 billion dollars. The objective of this evidence-based practice project was to answer the clinical question: In young adult collegiate females, how does an osteoporosis educational intervention compared to current education effect osteoporosis knowledge and self-efficacy of osteoporosis prevention over a one-month time period? The …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

Performance Evaluation Of Material Decomposition Using Rapid Kvp-Switching Dual-Energy Ct For Assessing Bone Mineral Density, John M. Wait

Dissertations and Theses (Open Access)

Osteoporosis is diagnosed by assessing the bone mineral density (BMD) of the trabecular bone, and has previously been characterized with dual-energy x-ray absorptiometry (DXA) or single-energy computed tomography (SECT). Dual-energy computed tomography (DECT) is able to create two three-dimensional sets of images representing the densities of two materials in a given basis pair. DECT is theoretically capable of providing a true density measurement of trabecular bone material with the proper material basis pair.

Using the rapid kVp-switching GE HD750 scanner, the concentrations of various solutes were assessed in two-material syringe-phantoms in different experimental conditions with DECT material density images, SECT …

Therapy Optimization In Multiple Sclerosis: A Prospective Observational Study Of Therapy Compliance And Outcomes., Patricia K Coyle, Bruce A Cohen, Thomas P. Leist, Clyde Markowitz, Merrikay Oleen-Burkey, Marc Schwartz, Mark J Tullman, Howard Zwibel

Department of Neurology Faculty Papers

BACKGROUND: Data sources for MS research are numerous but rarely provide an objective measure of drug therapy compliance coupled with patient-reported health outcomes. The objective of this paper is to describe the methods and baseline characteristics of the Therapy Optimization in MS (TOP MS) study designed to investigate the relationship between disease-modifying therapy compliance and health outcomes.

METHODS: TOP MS was designed as a prospective, observational, nationwide patient-focused study using an internet portal for data entry. The protocol was reviewed and approved by Sterling IRB. The study was registered with ClinicalTrials.gov. It captured structured survey data monthly from MS patients …

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 …

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 …