Physician Assistant Scholarly Project Posters

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  Comparison of Cryopreservation of Ovarian Tissue Versus Cryopreservation of Oocytes in Fertility Preservation

  Madison Nitschke

  This literature review aims to compare ovarian tissue cryopreservation (OTC) and oocyte cryopreservation (OC) as methods for fertility preservation. Electronic health science databases including PubMed, Clinical Key, ScienceDirect, and UpToDate were utilized. Seven articles met the inclusion criteria and were analyzed for this comprehensive review. This review indicates that both oocyte and ovarian tissue cryopreservation can effectively preserve fertility, however, ovarian tissue cryopreservation is deemed most effective for prepubertal girls at high risk of iatrogenic primary ovarian insufficiency (POI), or women who are unable to postpone gonadotoxic treatment. Ovarian tissue cryopreservation offers advantages that oocyte cryopreservation does not, such as multiple spontaneous pregnancies and resumption of ovarian function. Ovarian tissue cryopreservation also does not carry the risks associated with ovarian stimulation and delaying gonadotoxic treatment, unlike oocyte cryopreservation. Despite successful birth rates and low surgical risks associated with ovarian tissue cryopreservation, studies reveal a low utilization rate, with women often considering stored ovarian tissue as a “backup plan”. There is a need for further additional research on ovarian tissue cryopreservation, especially in the younger age groups, as there was limited participation in follow-up studies. Overall, the studies analyzed in this literature review support ovarian tissue cryopreservation as an effective method of fertility preservation but emphasize the importance of further investigation and follow-up studies.

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  Patient Outcomes With Tele-Emergency Medicine Services in Rural Areas

  Andrea Rieder

  The purpose of this literature review was to examine patient outcomes with the use of tele-emergency medicine. Teleemergency medicine serves as a tool to expand the healthcare team in rural facilities by connecting them with specialized providers, typically via video conference call, for assistance in surge or lowstaff situations, or for guidance in more complicated cases that rural providers might typically transfer to a larger hospital. A benefit of adopting a tele-emergency medicine service is that it can shorten time to care and reduce the need for transfers, thereby reducing associated costs. The question arises as to whether patient outcomes are improved as well, or if the limitations of telemedicine lead to lower quality of care. For this review , databases such as PubMed and Embase were used to compile current research on the topic. The results of this study suggest that the quality of patient care does seem to improve with the use of tele-emergency medicine. This is demonstrated by measures such as a decrease in medical errors and positive reviews from medical staff. Discharge status appeared to be affected by using teleemergency medicine, resulting in increased admissions, decreased discharges, and decreased transfers.

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  Probiotic Therapy for the Treatment and Prevention of Bacterial Vaginosis

  Chelsea Scheil

  Bacterial vaginosis (BV) is a common presenting complaint in healthcare, and patients often experience recurrences at a frustrating rate. The mainstay of current treatment is antibiotic therapy, either via oral or vaginal route. When recurrences occur, stronger antibiotics are often employed. This current method of treatment does not address an underlying component that impacts infection recurrence and rate of recurrence- the patient’s baseline vaginal microbiome and the healthy bacteria that support it. To investigate the use of probiotics in bacterial vaginosis treatment, a comprehensive literature review was completed using databases PubMed and Embase. The results of this literature review confirm that probiotic therapy is safe for the treatment of BV. There are a variety of different probiotic bacterial strains and concentrations utilized for either monotherapy to treat BV or in conjunction with antibiotic therapy. Of the bacterial strains analyzed, those that were most studied were L. crispatus and L.rhamnosus via both oral and vaginal use. Both oral route and vaginal route of probiotic treatment were shown to be effective. Vaginal route showed a faster impact on microbiome, but also a faster rate of recurrence than oral probiotic use. Probiotic therapy alone or in conjunction with antibiotics was found to be more effective than placebo or the use of only antibiotics to treat BV. Further research is still needed regarding identifying all possible bacterial strains that are beneficial in treating/preventing BV, differing combinations of strains for increasing efficacy, along with identifying the necessary concentrations of these strains.

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  SSRI/SNRI Medication vs. Cognitive Behavioral Therapy in the Treatment and Management of Postpartum Anxiety

  Kelsey Sederquest

  The purpose of this literature review is to determine the effects of cognitive behavioral therapy (CBT) and Selective Serotonin Reuptake Inhibitors/Selective Norepinephrine Reuptake Inhibitors (SSRI/SNRI) in women suffering from postpartum anxiety. Efficacy of non-pharmacological, pharmacological, and combination therapy compared within this review. Lastly, prophylactic treatment of anxiety was examined in women who were pregnant or who were newly postpartum without diagnosis of anxiety. In this review the database PubMed was utilized to conduct research that included many different keywords. The articles included were limited to within the last 30 years, and research was narrowed by limiting patient population to postpartum women and eliminating articles that did not evaluate CBT or SSRI/SNRI medication as a form of treatment for anxiety during the postpartum period. The data presented shows evidence that CBT and SSRI/SNRI pharmacological treatment are effective in the treatment of postpartum anxiety, which indication that CBT is more effective in the short term, while pharmacological treatment may be more beneficial for patients needing long term treatment. Analysis of literature did not show any evidence suggesting statistically more significant reduction or remission of symptoms when combining non-pharmacological and pharmacological treatments. Further research should be conducted to explore potential benefits of prophylactic treatment in the antepartum period for postpartum anxiety.

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  Exercise and Preventing Dementia in Older Adults

  Valerie Snelling

  Dementia is a devastating diagnosis for millions of individuals and the prevalence is projected to increase significantly in the next 30 years. According to the Centers for Disease Control and Prevention (2019), there are over five million individuals aged 65 and over living in the United States with dementia. That number is estimated to increase to 14 million by 2060. The impact of the increasing prevalence of dementia is significant. Because dementia is a complex disease caused by over 50 underlying health conditions, finding effective treatments for the disease is difficult. This makes prevention of dementia extremely important. The purpose of this literature review is to analyze if exercise prevents dementia in older adults. Studies were included if they analyzed physical activity with the onset of dementia or changes in various cognitive abilities. This literature available to date indicates that exercise is an effective measure to prevent dementia in older adults.

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  Exercise Effect on Gestational Weight Gain and Diabetes in Women of Elevated BMI

  Lauren Staton

  The purpose of this literature review is to determine the effect of exercise on gestational weight gain and diagnosis of gestational diabetes. Maternal obesity is a risk factor that may increase the likelihood of adverse outcomes during pregnancy such as excessive weight gain, gestational diabetes, macrosomia, and cesarean delivery. As obesity has become a more prevalent diagnosis, the healthcare field is beginning to see its effects on an abundance of patient profiles, including pregnant women. In the primary care setting, providers are the source of information for patients as to what healthy weight gain during pregnancy looks like. By implementing recommendations for exercise throughout gestation, excessive weight gain and its associated adverse outcomes may decrease in frequency. This literature review examines the efficacy of prescribed exercise programs on the abovementioned outcomes. Research databases including PubMed and ClinicalKey were used to find studies looking at the effect of exercise on weight gain and diabetes diagnosis during pregnancy. Inclusion and exclusion criteria, later discussed in the methods section, were used to further narrow down papers. Results of this study showed that exercise was able to decrease occurrence of excessive weight gain and gestational diabetes diagnosis in women with pre-pregnancy BMIs in the overweight and obese categories. Further research may need to be done that evaluates the role of physical activity in addition to nutrition, as both are key components to gaining healthy weight during pregnancy.

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  Effects of Probiotic Supplementation on PCOS Outcomes

  Allison Stoeffler

  Polycystic ovarian syndrome (PCOS) is a multifactorial metabolic, endocrinologic, and gynecologic condition affecting up to 5 million women in the United States. It is a disease characterized by oligo- or anovulation, hyperandrogenism, and/or polycystic ovaries. Phenotypic presentation can include irregular menstrual cycles, obesity, hirsutism, insulin resistance, or difficulty conceiving. If untreated, PCOS can result in a sequelae of chronic disease burden. Current standard of care consists of metformin for blood sugar control, oral contraceptives for menstrual regularity, and spironolactone for androgen imbalance, but newer research is identifying gut dysbiosis as a possible contributing etiology to disease development and symptomology. This literature review aims to investigate the effectiveness of probiotic supplement regimens in improving the gut microbiome and subsequent outcomes for patients with PCOS, specifically inflammatory, anthropometric, androgen, and blood sugar markers. A comprehensive literature review was performed using PubMed and Clinical Key databases. A variety of keywords and similar articles were used to identify studies that were further screened for inclusion and exclusion criteria. Studies were excluded if they were systematic reviews, published over 10 years ago, utilized non-human subjects, had poor study design, or looked at conditions outside of PCOS. There were 16 articles that met final criteria and were included in this review. Results showed significant improvement in androgen and inflammatory markers but were inconsistent in anthropometric and blood sugar findings. Further studies with longer duration and increased generalizability are needed to more adequately compare probiotics to standard of care in the treatment of PCOS.

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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

  Robert 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.