Physician Assistant Scholarly Project Posters

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  Mood Stabilizers vs Stimulants for the Management of Attention-Deficit/Hyperactivity Disorder and Comorbidity Bipolar Disorder

  Karina Van Slyke

  BD and ADHD share a lot of similar symptoms such as comorbidities, age of onset, chronic, enduring course of illness with interference of vocational, educational, and developmental milestones. There is immense challenge when it comes to differentiating these disorders due to significant overlap and variable courses of psychopathology in children. Providers need to be aware of the medications that are beneficial for each condition separately and which medications can benefit both conditions. Mood stabilizers are commonly used in bipolar disorder while stimulants are a common treatment for ADHD. A literature review was performed using search databases such as PubMed to answer the question of whether mood stabilizers, stimulants, or the combination of the two would have the most positive effect on these two disorders in children. A total of 14 articles fit the criteria for this literature review. The diversity of pharmacological interventions, including mood stabilizers like lithium and divalproex sodium, and atypical antipsychotics such as aripiprazole and risperidone, underscores the complexity of managing this population. The reviewed literature suggests that stimulant medications, such as lisdexamfetamine dimesylate and mixed amphetamine salts, may contribute to an improved quality of life for individuals with comorbid ADHD and BD. This literature review determined that children with BD and comorbid ADHD respond well and show improvement in ADHD symptoms when treated with polypharmacy of a mood stabilizer and a stimulant, with the suggestion that the mood stabilizer be started first before adding the stimulant.

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  Monoclonal Antibodies vs. Symptomatic Treatment of Hospitalized Patients with COVID-19

  Rpbert White

  The SARS-CoV-2 virus, or COVID-19, was the virus responsible for the worldwide pandemic declared in March, 2020. Individuals can experience a wide variety of symptoms ranging from fever, fatigue, cough, and, in more severe cases, hypoxia requiring invasive mechanical ventilation (IMV). Until recently, symptomatic care was the protocol for patients infected with COVID- 19. The use of oxygen for mild hypoxia and antipyretics for fevers was considered the standard of care (SOC). The use of antiviral medications, such as monoclonal antibodies, has been proposed in the treatment of acute COVID-19 infection. The purpose of this literature review is to determine if monoclonal antibodies could be considered as treatment options for high-risk patients hospitalized with COVID-19. A literature review was performed on PubMed using the following MESH terms: COVID-19, monoclonal antibodies, and hospitalization. Articles from 2020 to the present were included in the search. Studies were limited to randomized control trials and clinical trials. Out of 97 total search results, 20 articles were relevant to the search. 10 articles were removed due to the studies being performed as outpatient procedures. Two studies were removed as they were reviews. There are three common goals throughout the studies analyzed in this literature review regarding the use of monoclonal antibodies in patients with COVID- 19. The first goal is to decrease the length of hospital admission, the second is to decrease the severity of symptoms, shown by a decrease in inflammatory markers, that may be lethal to more fragile patients, and the third is to reduce the overall mortality of COVID-19. The literature review showed monoclonal antibodies are beneficial when their mechanism of action causes direct inhibition of the inflammatory pathway.

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  Efficacy of Complimentary Manual Therapies for Labor Pain Management

  Emily Yenter

  Labor and delivery pain is commonly considered to be the most pain a woman will ever experience. Options for pain control during labor include pharmacological and nonpharmacological. The purpose of this systematic literature is to determine if complementary manual therapies such as massage therapy, acupressure, and reflexology are effective nonpharmacologic management tools for labor pain. The electronic databases PubMed and ClinicalKey were searched, and the ten studies chosen for this review were randomized controlled trials published within the past ten years. Current research provides significant data supporting these three complementary modalities as effective nonpharmacologic management tools to control labor pain. Pain was effectively reduced at multiple points throughout the labor process in each of these studies. Future research could be conducted in the US using therapies in combination as well as using therapies to supplement pharmacological pain management. This research could aid in providing patient education on additional pain control methods during the childbirth process.

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  Statin Therapy vs. Plant-Based Diet for Reduction of Plaque Burden in Coronary Artery Disease

  Molly Evelyn Zak

  Coronary artery disease is one of the most common chronic health conditions to affect adults in the United States, with heart disease being the leading cause of death. Contributing factors include high prevalence of processed foods containing saturated fats, low fiber diets and poor overall nutrition, and physical inactivity. These practices increase risk of low-density lipoprotein cholesterol (LDL-C) plaque buildup and calcification within arteries that supply the heart, leading to decreased blood flow and subsequent oxygen supply. Treatment for coronary artery disease has traditionally been dominated by HMG CoA-reductase inhibitors, or statins. These medications are more effective than the alternative therapy medications called fibrates, and more affordable than the injectable cholesterol medication class of PCSK9 inhibitors. To determine other possible treatment options for reducing plaque buildup, a literature review was completed using retrospective and case/control studies that emphasized specific dietary changes and exercise regimens. Many participants have hesitations about statin therapy due to side effects including myalgias and arthralgias. The results of this review confirm that statin therapy remains an effective treatment for stabilization of lowdensity lipoprotein plaques. Additionally, specific, and consistent dietary modifications can contribute to slowed progression of disease. Primary motivation for treatment resistance was also evaluated in this literature review.

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  Manual vs. Mechanical Chest Compressions in Adult Cardiac Arrest

  Brittany Almquist

  The purpose of this project is to compare the use of manual versus mechanical chest compressions during cardiopulmonary resuscitation (CPR) in the treatment of adult cardiac arrest patients. A literature review was performed using the databases CINAHL, Embase, and PubMed. Studies chosen were peer reviewed randomized controlled trials, respective reviews, a cross-over controlled trial, and an experimental trial. Only articles from the last seven years were included in this review. After exclusion criteria were applied, ten articles were relevant and utilized. Four themes were identified in the literature review, including the achievement of ROSC (return of spontaneous circulation), 30-day survival rate, injuries related to chest compressions, and chest compression reproducibility. The evidence shows an increase in ROSC with the use of mechanical chest compressions versus the use of manual chest compressions but no statistically significant difference in 30-day mortality rate between the two methods. It was found that there is an increase in chest compression related injuries with the use of mechanical chest compressions, but the injuries were not life-threatening. Chest compressions with the use of the mechanical devices were shown to be performed at a rate and depth more consistent with the American Heart Association than those performed manually. Further research needs to be performed with larger patient populations to make official best practice standards for chest compressions in adult cardiac arrest patients.

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  Weight Loss for Bariatric Patients: Arterial Embolization versus Gastric Bypass

  Morgan Bernhardt

   The primary aim of this review is to determine the safety and efficacy of left gastric artery embolization (LGAE) in comparison to Roux-en-Y gastric bypass (RYGB) in bariatric patients for the treatment of obesity.  RYGB, an invasive surgical operation, has been proven to result in long-term efficacy of weight loss but can be associated with a higher risk of early and long-term complications to include a gastrojejunal anastomosis leak, surgical site infection, iron deficiency anemia, bowel obstructions, and hernias. RYGB may require reoperation and does have a risk of mortality. Bariatric surgery is now focusing on the appetite-stimulating hormone, ghrelin, which may play a bigger role in reducing weight.  LGAE is a safe, minimally invasive procedure and the evidence has shown promising results in suppression of ghrelin levels leading to significant weight reduction within one year. Adverse events of LGAE include epigastric discomfort, nausea, vomiting, and superficial gastric ulcers. In the studies selected, no deaths were observed following LGAE.  In conclusion, LGAE is a safer option and has proven short-term efficacy in weight loss. However, data is lacking regarding long-term efficacy of LGAE therefore RYGB is still the primary procedural intervention for bariatric patients. Future studies regarding LGAE will need to focus on proper procedural technique to maximize long-term efficacy.  PubMed, Clinical Key, and ClinicalTrials.gov. were utilized to conduct this literature review. All studies selected have a publication date of <10>years.

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  Comparison of Urethral Bulking Injection Therapy and Surgical Midurethral Sling Placement for Treatment of Stress Urinary Incontinence in Women

  Ashley Black

  This literature review aims to assess the comparative efficacy and safety of urethral bulking injection therapy and surgical midurethral sling intervention in the treatment of stress incontinence in women. A comprehensive search of the existing literature was conducted and includes studies from PubMed, an electronic search databases. The findings indicate that both urethral bulking injection therapy and surgical midurethral sling intervention are suitable interventions to be considered for the treatment of stress incontinence in women. Current research available regarding the efficacy of urethral bulking agents versus midurethral slings suggests that the placement of a miduerthral sling has the highest incidence of cure rates and symptom improvement. However, when evaluating the safety of these procedures, the literature suggests that urethral bulking agents offer a superior safety profile when compared with midurethral slings. Future studies with larger sample sizes, universal screening tools, and longer study durations would provide additional, reliable information regarding the long-term efficacy of these interventions and would aide in the decision-making process. The review concludes that both urethral bulking injection therapy and surgical midurethral sling intervention are effective in the treatment of stress incontinence in women, and the choice of treatment should be based on individual patient factors.

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  A Comparison of Pharmacotherapy versus Complementary Medicine in the Treatment of Migraines

  Samantha Braaten

  Migraine headache is a common, universal neurological disorder that can be complicated to treat. Despite the wide availability of treatments used as prophylactic agents against migraines, outcomes have been inconsistent, and a number of patients do not respond to prophylactic medications. Therefore, it is important to investigate new non-pharmacological modalities accompanied with less adverse effects and maximal efficacy. To determine if complementary medicine modalities such as acupuncture, botulinum toxin-A, or cognitive behavioral therapy can be as effective as traditional pharmacotherapy for the treatment of migraines, a literature review was completed using meta-analyses and clinical trial reviews. Despite the fact there are no studies that have specifically evaluated the research question posed, the compilation of many studies provides some cumulative data. Current literature suggests that pharmacotherapy remains the standard treatment for migraine headaches. Complementary medicine should be considered as an alternative or adjunct therapy and can be used in patients who experience undesirable side effects from pharmacotherapy, or rather have contraindications or intolerance of drug classes. Given the prevalence of migraines, applying this research with clinical application could help providers relay the best individualized treatment options for patients when it comes to managing chronic migraines. Current research regarding complementary medicine does show promise; however, more research still needs to be done in order to place complementary medicine as an equivalent treatment to pharmacotherapy.

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  Liraglutide versus Semaglutide: Long Term Weight Loss Management in Obese Individuals

  McKenzie Burke

  Obesity has been a source of complications affecting multiple aspects from a physiological and psychological standpoint which has been steadily growing. There are a multitude of weight loss programs and medications with the idea of sustaining consistent weight loss to include use of the pharmaceuticals discussed within this review. The purpose of this literature review is to compare the efficacy and safety with use of liraglutide versus semaglutide (GLP-1 receptor agonists) in respect to long term weight loss management while in conjunction to lifestyle modifications within the obese population. Thorough research has been done with the aid of health science databases to include PubMed, ClinicalKey, and EBSCO. All of the studies were published between the year 2014 to 2022 and utilized human subjects greater than or equal to 18 years of age with specificity to subjects who were classified as “obese” based on their body mass index (BMI). The studies which were used throughout this review were composed of randomized control studies and systematic reviews. The data presented shows that both pharmaceuticals represented significant weight loss compared to their corresponding placebo, however concrete evidence was discovered that semaglutide was noted to be superior in compared to liraglutide in the form of weight loss management in obese individuals. Furthermore, the current research that is available and studied does not conclusively provide enough evidence nor has been studied properly when considering long term use of these pharmaceuticals.

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  Alternative Treatment Modalities for Plantar Fasciitis

  Chelsey Clark

  Introduction: Plantar Fasciitis is a common condition in adult patients. The purpose of this literature review is to determine if there is any evidence for alternative treatments in the regimen of plantar fasciitis that has not been resolved with the standard treatment. Methods: The review was done using Pubmed, CINAHL and SportDiscus. Research was included on the following alternative treatments of PF: corticosteroid(CS) injections, extracorporeal shockwave(ESWT), dry needling, platelet-rich plasma (PRP), autologous blood injection (ABI), cupping, custom insoles, and ultrasound therapy (US). Twelve research articles are included. Results: The alternative treatments within this literature review had some promising statistically significant results that will require further investigation. This included positive results in ultrasounds, extracorporeal shockwave, PRP and steroid injections, insole use, dry needling, and ABI. Nothing definitive can be drawn from the results of the studies done. Some of the studies did not have blinding which makes results further questionable. Further research in all areas needs to be done to help draw definitive conclusions. Conclusion: Currently there is no one definitive alternative approach to add to a patient’s traditional regimen in treatment of PF. Keep in mind that some treatments are more affordable and less invasive than others. Educate patients on the risks, both financial and physical, associated with the alternative treatment.

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  Efficacy of Transcutaneous Electrical Nerve Stimulation vs. Calcitonin Gene Related Peptide Antagonists in the Application of Migraine Prophylaxis

  Matthew Davis

  Worldwide migraines affect millions of people everyday causing significant impact on their lives. • Often times, patients have failed several first-line therapies for migraine prophylaxis. • The purpose of this systematic literature review is to evaluate the effectiveness and tolerability of TENS devices vs. CGRP antagonists in the application of migraine prophylaxis. • PubMed and ClinicalKey were searched with key terms, 17 sources were selected that were published after 2016. • Sources included meta-analysis, literature review, and randomized control trials. • Data shows that TENS devices as well as CGRP antagonists were effective and safe therapy options for migraine prophylaxis. • More longitudinal research needs to be conducted to further evaluate the efficacy and safety profile of longterm use of these therapy options.

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  Safety and Efficacy of Apixaban vs Rivaroxaban: In Nonvalvular Atrial Fibrillation

  Cody DeWitt

  • Introduction: Nonvalvular atrial fibrillation, the most common cardiac arrhythmia in developed countries, warrants anticoagulation for stroke prevention. Updated guidelines recommend direct oral anticoagulants (DOACs) over historically used warfarin. The purpose of this review is to compare clinical safety and efficacy outcomes between apixaban and rivaroxaban. • Research Questions: In patients with nonvalvular atrial fibrillation on a direct oral anticoagulant, is there a significant difference in safety and efficacy between apixaban and rivaroxaban? Does decreased kidney function change safety and efficacy? Does varying BMI such as low weight or obesity change safety and efficacy? • Methods: A retrospective literature review was conducted utilizing PubMed databases. Articles included in this review were published in the past five years and compared anticoagulants in the treatment of nonvalvular atrial fibrillation. • Discussion: There were mixed results in the articles analyzed in comparing safety and efficacy in patients without kidney disease and of normal BMI. One showed a decreased risk of stroke and four supported significantly lower bleeding risk while taking apixaban compared to rivaroxaban. When comparing the two medications in patients with chronic kidney disease, there was support to show apixaban was safer and more effective in patients that were in stages 3 and 4. With an elevated BMI being in the inclusion criteria there was no significant difference found in safety and efficacy between the two medications, but there was support to show that they were both better than warfarin based on this criteria. There are no head-to-head direct prospective studies, therefore, one cannot truly say one medication is safer or more effective than the other. There can only be inferences made using these retrospective studies, although they do not all show the same evidence or provide overwhelming support for one drug or the other.

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  Evaluating and comparing the safety and efficacy of rimegepant versus lasmiditan in aborting acute migraine headaches in the adult migraineur

  Anthony Douthit

  Migraine headaches are one of the most common causes of primary headaches and one of the leading causes of disability worldwide. While the mechanism of migraines are not entirely understood, they can result in significant disability (DynaMed, 2023). Dihydroergotamine was introduced for migraine treatment in the 1920s and in the 1990s triptans were introduced and have been the mainstay of acute migraine treatment since their introduction (Solomon et al., 2008). In recent years, there have been several developments in the acute treatment and prophylaxis of migraine headaches. CGRP receptor antagonists and 5-HT1F receptor agonists have been researched, developed, and approved by the FDA for acute migraine treatment. The purpose of this literature review was to compare the efficacy and safety of rimegepant, a CGRP receptor antagonist and lasmiditan, a 5HT1F receptor antagonist in the treatment of acute migraine attacks. This comparison was accomplished by a thorough review of scientific articles available through various resources such as PubMed, Clinical Key and CINAHL Complete. The results from 12 clinic trials that were reviewed indicated that rimegepant and lasmiditan are both superior to placebo in aborting an acute migraine in addition to eliminating most bothersome associated symptoms. Rimegepant and lasmiditan were also proved to be safe in the tested populations although each pharmacological intervention does carry its own set of potential side effects. There have been no direct studies comparing both drugs or comparing the drugs to triptans, however several meta-analyses showed triptans to still be superior in aborting acute migraine headaches

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  Ketamine for active-duty military and veterans with PTSD

  Kristopher Flynt

  The purpose of this research and systematic literature review is to compare the drug ketamine’s efficacy at treating post-traumatic stress disorder for veterans and active-duty military compared to approved Food and Drug Administration (FDA) options and combination medication/psychotherapy. In this review, three databases were searched including Pubmed, ClinicalKey, and PsycInfo from October 3 to January 9, 2023. Additionally, the Veterans Affairs (VA)/Department of Defense (DOD) Clinical Practice Guidelines was utilized. A variety of key and mesh terms were utilized when database searching. Chosen works for review included randomized control trials, systematic reviews, meta-analysis, and retro-perspective studies. Sources that were excluded included those published prior to the year 2010, multiple co-morbidities, non-veteran, and non-military. In total, 18 resources were selected. Most of the research presented shows evidence for the use of serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) as the gold standard of treatment for PTSD.

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  Associations Between Screen Use and Depression in Youth

  David Franta

  the youth population have remained largely unclear  Depression is common in children and adolescents  Screen use is readily available and frequently used by children and adolescents  This literature review was conducted to evaluate current literature regarding depression in the youth population, to include differences between sexes, across ages, and amongst different types of screen use  Results demonstrate that an association between screen use and depression in the youth population does exist, particularly cross sectionally  A causative or reciprocal relationship may be present, however, if it is present, it is quite minor  Girls tend to use more screens than boys  Keywords: screen time, screen use, depression, children, adolescent, adolescents, social media, mental disorders, mental health, depressive disorder, youth, screen media, digital media.

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  Home-Based Cardiac Rehab vs. Center-Based Cardiac Rehab in Rural Areas

  Timothy Fresonke

  Cardiac rehabilitation in rural areas can present unique challenges. The main challenge is the locations patients must travel to receive such care. Some patients are expected to travel more then an hour away, on multiple occasions during the week, to undergo their therapy. A literature review was done to see if there was a safe and effective alternative to the traditional center-based cardiac rehabilitation. The electronic search databases PubMed, Embase and CINAHL Complete were utilized to search for articles that addressed the four main topics of the paper. Dalal et al. (2019) found that home-based cardiac rehabilitation was as safe and effective as the traditional approach and was a more affordable model. Antoniou et al. (2022) stated that “home-based cardiac rehabilitation interventions using wearable sensors can be as effective as center-based cardiac rehabilitation.” Banner et al. (2015) stated that the patients who underwent home-based cardiac rehabilitation “demonstrated statistically significant improvement in exercise capacity, along with total cholesterol, LDL and saturated fat intake,” to that of the traditional approach. Overall, home-based cardiac rehabilitation could be a safe an effective alternative to the center-based approach and is something that should be researched further.

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  Food Intolerance in Patients with Depression

  Victoria Gingrey

  Medication is commonly prescribed for the treatment of depression, but some patients have difficulty finding a medication that is both effective and tolerable while others prefer to avoid medications all together. It has been suggested that dietary modification may reduce the depressive symptoms. As lifestyle changes may be difficult to maintain long term, determining specific foods to avoid for individual patients may improve adherence. A meta-analysis of 10 articles was performed. Articles were found using the electronic search databases PubMed and PsychInfo. Many studies found correlations between biomarkers and the prediction, diagnosis, or treatment of depression, though no study suggested specific guidelines for these purposes. Connections between food intolerance and depression were observed, but not enough data was found to evaluate whether the avoidance of food intolerances reduces depression symptoms when compared to anti-depressant medications.

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  Cognitive Behavior Therapy versus Internet Cognitive Behavior Therapy In Adults with Anxiety or Depression

  Heather Greenwood

  According to the American Psychiatric Association, the prevalence of anxiety and depression in adults in their lifetime are nearly 30% and 16.6% respectively. The combination of pharmacotherapy and psychotherapy interventions (including talk therapy or cognitive behavior therapy (CBT)) are considered best practice, but in recent years there has been an increase in the popularity of applications and web-based services categorized as “internet cognitive behavior therapy”, or ICBT. The question proposed is, are these services as good for patient outcomes as traditional in-person CBT? A literature review was performed using electronic medical database PubMed with key word searches for cognitive behavior therapy and internet delivered cognitive behavior therapy for both anxiety and depression in adults. All searches were limited to the years between 2015 and 2022, with preference to 2018 to 2022 and filters were set to include “Clinical Trial” and “Randomized Control Trial” only. Many articles were eliminated to only include adult populations and the use of true “internet cognitive behavior therapy”, not telemedicine use. Data reviewed shows evidence that participants who used ICBT had statistically significant (p < 0.05) improvement in anxiety or depressive symptoms similar to that of traditional CBT and both CBT and ICBT show substantial improvement from control groups. Overall, more studies are needed utilizing a focus of anxiety or depression alone in adults, for longer periods of time utilized or followed, and as more applications or ICBT options become available. The data thus far is evident, though, that ICBT provides a promising option for patients in which in-person CBT is not an option or is not desired.

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  A Comparison of Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies and Standard Migraine Prophylaxis in Those with Episodic Migraines

  Alexie Harms

  Migraines are debilitating and a frequent reason for primary care visits. Migraines interfere with an individual’s work, school, and daily life. Standard of care treatment options for migraine prophylaxis include Propranolol, Amitriptyline, and Topiramate which were all developed for other medical conditions. These conventional medications can lead to unwanted side effects decreasing treatment adherence. Calcitonin Gene-Related Peptide monoclonal antibodies (CGRP mAbs) have been under study for the treatment and prevention of migraines. The purpose of this research project is to explore the effectiveness and tolerability of CGRP mAbs in reducing the number of migraine days in comparison to conventional migraine prophylactic use for individuals who suffer from episodic migraines.

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  The Effectiveness of the Gut-Brain-Axis versus SSRI for Treatment and Management of Depression

  Jenni Hetletved

  Major Depressive Disorder (MDD) is a crippling condition that affects millions of people worldwide. Serotonin reuptake inhibitors (SSRIs) are the staple treatment adjunct to psychotherapy. Recently, the connection between gut health, specifically the gut brain axis, has been researched to look at the connection between gut microbiota and its effect on depressive symptoms. This meta-analysis evaluates the connection between gut microbiota and depression as well as the effectiveness of SSRI therapy on depression. Results show a significant change in gut microbiota with short term change to a Mediterranean diet (MD) compared to a Western diet (WD). This change in gut microbiota has also shown improvement in depressive symptoms. This analysis also found a link to degradation of serotonin receptors in the hippocampus from certain gut bacteria found in a WD. SSRI therapy showed improvement of symptoms within 4 weeks according to some studies while other studies disagreed showing minimal improvement in depressive symptoms short term, with little increase in effectiveness long term.

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  Proning vs. Respiratory Pharmacotherapeutics in Hospitalized COVID-19 Patients

  Sasha Hopfauf

  The purpose of this research and literature review is to compare the use of prone positioning and respiratory pharmacotherapeutics within hospitalized COVID-19 patients and the outcomes associated with each. A literature review was performed using the databases PubMed, Clinical Key, DynaMed, and CINAHL. A variety of key terms were used when searching. Studies chosen were retrospective reviews, a cross sectional study, an interventional study, and a pilot study. Articles within the last three years were utilized after exclusion criteria was applied. A total of thirteen articles were included within this project. The research shows that pulmonary vasodilators such as inhaled Nitric Oxide (iNO), Epoprostenol (iEpo), and Iloprost did improve oxygenation within COVID-19 patients. Nitric oxide was seen to have the greatest impacts but is not a first line choice due to cost and potential adverse effects. The research also showed that the addition of prone positioning to pulmonary vasodilators increased oxygenation and subsequently increased the PF ratios of the patients. Nitric oxide with prone positioning was seen to have the largest increase in PF ratios throughout the studies. Prone positioning was associated with an adverse effect of pressure ulcers, with most being on the head and face. The most common adverse effect with the use of iEpo was noted to be bleeding which was not life threatening. iNO was noted to have bleeding as well as methemoglobinemia as the most common adverse effects. Overall, further research needs to be performed with larger patient populations and more control over various factors that could influence the patient’s prognosis

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  Gabapentin for Alcohol Use Disorder

  Monica Hurst

  The purpose of this literature review is to determine whether gabapentin is an effective treatment option for alcohol use disorder (AUD). Utilizing data sourced primarily from published clinical trials, gabapentin’s effect on heavy drinking, abstinence, withdrawal symptoms and alcohol cravings will be explored. This review will also compare gabapentin’s efficacy against currently approved AUD treatment options, along with what dosages are most efficacious while contributing the fewest adverse effects. The data presented in this literature review undeniably demonstrates a positive effect of gabapentin on alcohol use disorder; specifically the data shows that gabapentin at multiple dosages helps to decrease heavy drinking days (HDD), total drinking days, and alcohol cravings. Further research should be performed to evaluate whether gabapentin is more efficacious used as a monotherapy vs an additive therapy, what long term effects gabapentin has on AUD, and to define the most effective dosage and treatment duration.

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  Fertility Treatment in PCOS: Metformin vs. Myoinositol

  Kaylina Kelley

  Metformin is commonly used to decrease insulin resistance and increase fertility in women with PCOS. However, it is known to cause many side effects. Myoinositol is a B-vitamin that is thought to also decrease insulin resistance and increase fertility with few side effects. The purpose of this literature review is to determine whether myoinositol is a comparable substitute for metformin in patients with PCOS suffering with infertility. This was done by evaluating pregnancy rates, insulin resistance, and side effects of metformin and myoinositol. A literature review found that both medications had similar pregnancy rates. Neither medication affected insulin resistance. However, myoinositol had fewer side effects and appeared to reduce the occurrence ovarian hyperstimulation syndrome (OHSS).

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  Active Toxoplasmosis Infection: Efficacy and Safety of Treatment Options

  Daniele Krouse

  This literature review intends to investigate the safety and efficacy of two different drug treatment regimens, pyrimethamine versus trimethoprim-sulfamethoxazole, for active toxoplasmosis infections. Affecting nearly 11% of the United States population and up to 80% of the populations of tropical countries, Toxoplasmosis infection is the second leading cause of death from food borne illness. Current classic management of active infection with pyrimethamine is correlated with numerous undesirable side effects, high cost and need for complex use of adjunctive medications. It is necessary to identify alternative treatment options with fewer side effects, less complex regimens, lower cost, and easier access for patients with active infection. A literature review was performed using electronic search databases including PubMed, CINAHL Complete, Clinical Key, and Embase. Key search terms and MESH terms included toxoplasmosis, toxoplasmosis therapy, toxoplasmosis drugs, toxoplasmosis AND pyrimethamine, toxoplasmosis AND pyrimethamine sulfadiazine, toxoplasmosis AND trimethoprim-sulfamethoxazole. Exclusion criteria consisted of articles not available in English or free of cost, involved use of animals, completed in vitro, involved congenital toxoplasmosis, involved pregnant participants or studied latent toxoplasmosis. Following application of inclusion/exclusion criteria a total of six articles were reviewed. Collectively these studies indicate trimethoprim-sulfamethoxazole can be an effective and safe treatment option for active Toxoplasmosis infection in some patient cases; however, it is not clear if trimethoprim-sulfamethoxazole is more effective than the current gold standard treatment of pyrimethamine during the active stage of disease in all patient cases. Overall, further research is recommended.

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  Long Term Control of T2DM and Weight Through Roux-en-Y Gastric Bypass Surgery Versus Weight Loss Medication

  Alexandra Laber

  • Type II diabetes mellitus (T2DM) affects hundreds of millions of individuals in the United States and prevalence is increasing. • As a lifelong disease, interventions must be studied long-term. • This project aims to compare long term efficacity of Roux-en-Y gastric bypass surgery and several antidiabetic medications that result in weight loss in type II diabetics who have failed to achieve goals through first line treatment of diet, exercise, and metformin. • A literature review was completed using the electronic search database PubMed with a variety of MeSH terms and keywords. • Research showed strong evidence that surgery was superior to medications in reducing HbA1C and weight. • Research also showed that the antidiabetic medications discussed decreased HbA1C and weight superiorly to placebos and other classes of antidiabetic medications. • Continued research that directly compares these medications over a longer interval of time is needed.