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Mental Health Resources & Healthcare Professional Students
Matthew A. Knealing
The reasoning for this review of literature is to determine if implementing mental health resources in graduate healthcare programs decreases the rate of depression and suicidal ideations. In this review of literature, five databases were searched. They included: PubMed, PsycInfo, CINAHL Complete, Clinical Key, and the Cochrane Library from September 15 to January 3, 2020. Due to the topic being dynamic and receiving more acknowledgment in recent years, articles reviewed were restricted to the last six years within the United States. Works chosen were peer reviewed, which included meta analysis, cross sectional, systemic reviews, longitudinal and, survey method studies. Sources that were excluded included opinion based editorials without primary research. This review concluded with 16 articles reviewed. The research in this review shows the prevalence of depression and suicidal ideations amongst graduate healthcare professional students. With the topic being brought into light, much of this research shows that cognitive based therapy can decrease the previously mentioned stressors of graduate healthcare school. Other articles reviewed show methods for effective screening of depression and suicidal ideations along with the implementation of peer reflective groups, pass/fail grading, and the effects of sleep and exercise in this population. Implementation of mental health resources has begun to show promise versus previous methods of as needed services through campus student services. The research indicates that decreasing depression, as well as suicidal ideations, are multifactorial with CBT being effective, but more research, as well as implementation, is needed to determine which screening method along with what resources prove best.
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Antibiotic Efficacy in Lower Back Pain
Alexander m. Lee
Chronic lower back pain affects approximately eight percent of the American population, yet no treatment has been agreed upon universally. Studies suggest that between 20-30 percent of lower back pain cases are caused by a low-virulence bacterial infection of an intervertebral disc. • This scholarly project investigated: In patients with chronic lower back pain and Modic changes after disc herniation, what is the effect of antibiotic therapy on reducing pain symptoms compared to placebo. • The literature review used the following electronic databases: ClinicalKey, Cochrane Library, Embase, and PubMed. Keywords and mesh terms refined searches to the most recent and relevant literature. The articles were then analyzed and refined, revealing ten for critical review. The studies are peer-reviewed and include a double-blind randomized control trial, pilot study, systemic literature reviews, literature reviews, monocentric study, and cohort study. • Most of the research presented shows evidence that Cutibacterium acnes presence in intervertebral discs is not from contamination, but rather is an infectious process that occurs after disc herniation. Additional studies are required, but current research suggests that antibiotic therapy may be efficacious in reducing pain symptoms in those with chronic lower pain and Modic changes after disc herniation.
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The Safety and Efficacy of Antidepressant Use In The Adolescent Population
Jason Marcello
This literature review was conducted to determine the safety and efficacy of antidepressants in the adolescent population based on the currently available research. Specifically, are antidepressants safe and efficacious in treating depression in adolescents and is their use associated with increased risk of suicide. Data was collected by searching medical databases including: Clinical Key, CINAHL Complete, PsycINFO, PubMed, DynaMed Plus, and Cochrane Review. The review of the literature included systematic reviews, metaanalysis, cross-sectional, longitudinal, randomized control trials, and survey methods. All literature works selected were published within the past ten years. Upon analysis, the literature showed a significant increase in the rate of depression and suicide amongst adolescents. However, other studies demonstrated mixed results regarding the risk of suicide in adolescents who were prescribed antidepressants. Based on the literature reviewed, there is not a clear correlation between increased suicide and antidepressant use in adolescents. In fact, some studies show a significant decrease in suicide amongst subjects who were taking an antidepressant. The research indicates that antidepressants and cognitive behavioral therapy (CBT) are both efficacious and relatively safe when used by themselves. When used alone, antidepressants are slightly more efficacious than CBT alone. The literature also indicates that the combinations of CBT and antidepressants are the most efficacious in treating depression in the adolescent population.
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An Analysis of the Incidence and Severity of Drug-Drug Interactions Between Prescribed Pharmaceuticals and Cannabinoids
Jennifer McRae
Identify the incidence and severity of drug-drug interactions between commonly prescribed medications and cannabinoids • Medications that are substrates for CYP2C19, CYP2C9 and CYP1A2 are at the greatest risk of interaction with concomitant use of phytocannabinoids or synthetic cannabinoids • Caution is recommended with medications metabolized via UGT or CES1, however information is currently limited and further research is necessary • Lack of universal standards for laboratory testing of cannabinoid products call into question the legitimacy of reported results in currently reported research as the contents of many cannabinoid products are inaccurately labeled
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The Safety, Accuracy, and Cost-Effectiveness of Confirmatory Penicillin Allergy Testing in the Outpatient Setting as a Means of Reducing Patient Morbidity and Mortality
Mitchell Mimbach
The purpose of this review is to investigate the prevalence of documented penicillin (PCN) allergies in health care and any negative outcomes associated with being labeled as such. Additional topics researched included the safety and accuracy of PCN allergy testing, the cost-effectiveness of PCN allergy testing versus using non-PCN related antibiotics, and barriers to confirmatory PCN allergy testing implementation. A complete review of the aforementioned topics included meta-analysis’, systematic reviews, cohorts, clinical trials, and cross-sectional studies from the last five years. Databases utilized for this research included PubMed, Cochrane Review, Embase, Dynamed Plus, and ClinicalKey. Sources that were excluded from this review included opinion-based editorials and those that failed to include their own research. A total of 18 scholarly sources were utilized for this review. The research revealed a significant portion of the population is incorrectly labeled as having a PCN allergy when properly tested. It also showed that having a PCN allergy is associated with increased morbidity and mortality. Research related to PCN allergy testing indicated high levels of safety and accuracy. Also, PCN allergy testing costs were found to be significantly lower than those associated with using alternative antibiotics. Lastly, a majority of the barriers related to performing PCN allergy testing were largely due to a lack of education on behalf of medical providers and incorrect perceptions from both patients and medical providers alike. These findings together indicate that confirmatory PCN allergy testing in the outpatient setting is safe, accurate, and cost-effective in decreasing the morbidity and mortality associated with having an incorrect PCN allergy label. However, further research is needed to adequately address the barriers and incorrect perceptions both providers and patients possess related to PCN allergy testing.
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Catheter Ablation of the Accessory Pathway in the Asymptomatic Patient with Wolff-Parkinson-White
Erin B. Mondry
The purpose of this research and literature review was to analyze the safety and efficacy associated with invasive catheter ablation of the accessory pathway, in comparison to risk of sudden cardiac death and malignant arrythmias in non-ablated, asymptomatic individuals with Wolff-Parkinson-White (WPW). In this review, five databases were searched including CINAHL, Clinical Key, PubMed, Cochrane Library, and Dynamed Plus. Both keyword and mesh terms were used to define a set of the literature discussing Wolff-Parkinson-White, ventricular preexcitation, radiofrequency catheter ablation, and sudden cardiac death. Works chosen for review were published from 2009 to 2019, and included surveys, case control studies, and cohort studies. Much of the research suggests that electrophysiologists do not currently have an adequate evidence-based recommendation for the management of the asymptomatic patient with WPW. The methodology and safety of the ablation procedures may have evolved over time, making it difficult with the current data available to conclude the safety and efficacy of modern radiofrequency catheter ablation. Research also appears to be lacking longitudinal studies analyzing the outcomes of the non-ablated individuals. Future research is necessary to develop a guideline to direct decision to ablate the asymptomatic patient according to predetermined criteria and patient factors.
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MAT Effectiveness for Oxycodone vs Heroin in Opioid Use Disorders
Casey Myklebust
Opioid use disorder is a major epidemic in the United States. • Rural areas suffer the most with limited resources available for treatments options. • A limited number of providers participate in MAT programs due to a negative stigma. • Project Echo was developed to spread awareness and information about MAT to educate providers and healthcare facilities about the needs of opioid use disorder patients that are not being met. • Buprenorphine, naltrexone, and methadone are the FDA approved medications to assist in MAT. • Medication assisted treatment is a long-term commitment to successfully maintain sobriety. • Medication alone is not a reliable means of achieving nor maintaining sobriety. • Cognitive behavioral therapy has proven to be a key factor in battling opioid use disorder (OUD).
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HPV Vaccine in Adolescents: How to Increase Uptake
Natasha Richsesin
The human papillomavirus (HPV) is a sexually transmitted virus that affects both males and females of all ages. An HPV vaccine was created to help protect against harmful infections caused by the virus.
• This literature review focuses on the relationship between the HPV vaccine and its low uptake from untoward events, misinformation surrounding the vaccine, and different education methods. PubMed, Clinical Key, and Cochrane electronic databases are used for the literature review. A comprehensive literature review was conducted, and articles utilized were based on the age of the population being 11 to 29 years old, the HPV vaccine’s involvement in the article, and the article being published less than 12 years ago.
• The results concerning untoward events related to the HPV vaccine are low and misinformation is common in the news and social media. The research showed the most effective techniques for educating a parent were direct provider-parent communication and informational videos.
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CYP2D6 Polymorphisms and their Effect on Opiate Metabolism
Blair Runde
The purpose of this research and systematic literature review is to determine if pharmacogenetic testing for the CYP2D6 enzyme responsible for the metabolism of several opiates leads to differences in serum levels, side effects, and treatment outcomes for patients with acute or chronic pain. Much of the presented research indicates an association between CYP2D6 phenotypes and differential treatment outcomes. Poor CYP2D6 metabolizers are shown to be at increased risk of analgesic failure contrasted with ultra-rapid metabolizers demonstrating better analgesic control; however, they had a higher risk of side effects and toxicity. Conflicting data is also demonstrated as well as a lack of conclusions that can be drawn for more intermediate metabolizers. It is known the gene that codes for CYP2D6 is one of many that can affect opiate metabolism. More research is needed that encompasses all of these genes in order to make the findings more applicable to clinical practice.
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Methamphetamine: Potential Risk Factor for Neurodegenerative Conditions
Katelyn Sarlette
Methamphetamine use is a relevant problems in many communities. While it has many adverse health effects, it may also contribute to the development of the neurodegenerative conditions such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), and Parkinson’s disease (PD).
• A literature review was conducted using PubMed, EMBASE, Clinical Key, and DynaMed. Literature found included high quality systematic reviews, randomized controlled trials, and meta-analysis.
• Literature supports that METH use has several major neurotoxic effects resulting in physical and cognitive deficits. There is minimal available evidence evaluating METH use as a risk factor for ALS although, they do share a common pathway for neurotoxicity. METH use does not appear to be a risk factor for developing MS but can be a mimicker. METH is a risk factor for developing PD.
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Analysis of Tech-Based and Telemental Health Approaches within the Adolescent and Young Adult Populations of Rural America
Audrey K. Smeenk
The incidences of depression and anxiety among adolescent and young adult populations are intensifying, and resources remain limited for the management of these diseases within rural America.
• Evaluation on different interventions was completed to assess ease of access, efficacy, and patient adherence with the hope to decrease incidence of disease and increase availability of resources to rural areas.
• Based on the current completed research, there is a predominance of evidence that has shown moderate statistical data and promising outcomes from tech-based mobile applications and telemental health. Statistical evidence supports that technological based interventions are a potential treatment option that could assist in the management of mental health symptoms within the adolescent and young adult populations of rural America.
• Due to small study sample sizes and the lack of follow up, further longitudinal research is still needed in order to determine adherence and long-term outcomes compared to other methods used in mental health treatments and in-person assessments.
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Low-Dose Naltrexone for Treatment in Crohn’s Disease and Fibromyalgia
Hannah R. Tkach
The United States has experienced a dramatic increase in opioid abuse and overdoses, leading to a national epidemic. Contributing to this epidemic is the use of opioid therapy for complex chronic inflammatory and neuropathic conditions that remain difficult to treat. Many traditional treatments are ineffective or have intolerable side effects, forcing providers to utilize opioid therapy as a last resort. Recently, there is increased interest in the use of partial opioid antagonist naltrexone to treat Crohn’s disease and fibromyalgia. Previous research suggests the potential for naltrexone to provide analgesic effects when administered in low doses via its unique interaction with opioid receptors located throughout the body. A literature review was performed using a comprehensive electronic search of scientific databases, applying search criteria that included the mesh term naltrexone and keywords Crohn’s disease and fibromyalgia. Preliminary research on the use of low-dose naltrexone (LDN) in fibromyalgia demonstrates mixed results. Some studies show potential for LDN to improve pain symptoms and quality of life in fibromyalgia patients, while others exhibit statistically insignificant results. Current research on LDN use in Crohn’s disease demonstrates that it can improve pain, mucosal healing, and quality of life without adverse effects. The high safety profile, minimal side effects, and effectiveness of LDN seen in preliminary studies support the need for larger, randomized controlled trials to investigate LDN’s efficacy in the treatment of Crohn’s disease and fibromyalgia.
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Resting Heart Rate and its Effect on All-Cause Morbidity and Mortality
Peter V. Tronset
According to the American College of Cardiology (ACA 2019), approximately every 40 seconds an individual has a myocardial infarction (MI).
▪ While the ACA reports a decrease in death rate from cardiovascular disease by 18.6% (2006-2016) and a decrease in death rate from coronary artery disease by 31.8% (2006 – 2016); Heart disease remains the leading cause of death, affecting approximately 5.7 million American adults.
▪ A literature review was conducted through systematic reviews, metaanalyses, randomized controlled trials (RCTs), and peer-reviewed medical journals, The Journal of the American Medical Association (JAMA), and The Journal of the American College of Cardiology (ACC), to evaluate the effects of variation in resting heart rate and its effect on cardiovascular morbidity and mortality.
▪ Literature shows a reduction in resting heart rate to 80 beats per minute or lower has a significant reduction in deposition of plaque within the cardiovascular system, reducing the risk of complications such as coronary artery disease, myocardial infarction, stroke, and death. Additionally, no benefit is found in reduction of resting heart rate below 60 beats per minute, through any method or than natural occurrence
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Early Intervention: Addressing Opioid Use Disorder with Emergency Department Initiated Buprenorphine Therapy
Dustin Voss
An evaluation of opioid use disorder (OUD) as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria.
• The use of buprenorphine in the process of induction, its efficacy for the management of OUD, and barriers to its initiation.
• Outcomes of the initiation of office-based buprenorphine treatment are compared to emergency departmentinitiated buprenorphine treatment for the management of OUD.
• Results revealed that buprenorphine is effective in treating OUD when appropriate induction and maintenance doses are implemented. However, there continue to be barriers in prescribing that have limited access to the medication.
• Office-based buprenorphine treatment of OUD shows decreased engagement in treatment in the first 30 days. • Emergency department-initiated buprenorphine treatment reveals increased participation in treatment within the first 30 and 60 days, a decrease in opioid use, and a decrease in adverse opioid-related events.
• The treatment outcome data reveals that at the 6- and 12- month time frames, retention in buprenorphine therapy is essentially the same when comparing both treatment modalities.
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Hyperbaric Oxygen Therapy for the Treatment of Traumatic Brain Injuries
Jordan A. Wiedmann
This research and systematic literature review evaluates the safety and efficacy of Hyperbaric oxygen therapy (HBOT) to improve treatment outcomes in traumatic brain injuries (TBIs). This review included the search of PubMed, Cochrane Review, Clinical Key, and DynaMed. The search included randomized control trials, systematic reviews, and meta-analyses published in the last 20 years.
• Several studies show evidence to support the use of HBOT in TBIs, however the majority of research suggests overall insufficient evidence on the topic. Several studies also address the concern for safety and side effects, as individuals are exposed to increased pressures for long lengths of time.
• Ultimately, more research and studies are needed in order to claim safety and efficacy in the use of HBOT in TBI treatment.
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Treatment Option Decision Making For Low-Grade Prostate Cancer
Janene Witherite
Prostate cancer (PCa) is the second most common cancer, among men, in the United States.
Low-grade PCa is defined by; lack of metastasis outside the prostate (M0), no lymph node involvement (N0), tumor staging up to T2a, a PSA of less than 10 ng/ml, a Gleason score of less than 6, and no more than two of the 10-12 tissue samples (each composed of less than 50% cancer cells) of the 10-12 samples taken.
Four treatment options exist for low-grade PCa patients: active surveillance (AS), external beam radiotherapy (EBRT), brachytherapy, and radical prostatectomy (RP), all of which cause physical and psychological side effects.
The purpose of this scholarly project is to determine if there is a statistical significance regarding treatment modality chosen and the psychological distress (PD) experienced and to determine if early education and close follow up would aid in management of PD.
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Aspirin Use Following Preeclampsia to Prevent Future Adverse Cardiovascular Outcomes
Kristi Bohlig
• Introduction: Preeclampsia during pregnancy warrants therapy with low dose aspirin. The purpose of this review is to investigate if these women are at increased future risk for cardiovascular morbidity and mortality, and if aspirin therapy prevents future cardiovascular events.
• Research Questions: Do women who had preeclampsia during pregnancy have increased future cardiovascular morbidity and mortality? • Does continued aspirin use in postpartum women, who had preeclampsia during pregnancy, decrease future cardiovascular morbidity and mortality?
• Research Methods: Literature review was conducted utilizing CINAHL, Dynamed plus and PubMed databases.
• Discussion: Many studies have found that preeclampsia does increase risk of cardiovascular morbidity and mortality, but this difference is not statistically significant until later decades in life. There is also new evidence that the risks of bleeding from prophylactic aspirin therapy outweigh the benefit of decreasing cardiovascular and ischemic events. Based on this information, it is prudent to further research and study this group and stratify their risk as well as researching if there is a better modality upon which to provide prophylaxis with lower risk than benefit.
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Aspirin Use Following Preeclampsia to Prevent Future Adverse Cardiovascular Outcomes
Kristi Bohlig
• Introduction: Preeclampsia during pregnancy warrants therapy with low dose aspirin. The purpose of this review is to investigate if these women are at increased future risk for cardiovascular morbidity and mortality, and if aspirin therapy prevents future cardiovascular events.
• Research Questions: Do women who had preeclampsia during pregnancy have increased future cardiovascular morbidity and mortality? • Does continued aspirin use in postpartum women, who had preeclampsia during pregnancy; decrease future cardiovascular morbidity and mortality?
• Research Methods: Literature review was conducted utilizing CINAHL, Dynamed plus and PubMed databases.
• Discussion: Many studies have found that preeclampsia does increase risk of cardiovascular morbidity and mortality, but this difference is not statistically significant until later decades in life. There is also new evidence that the risks of bleeding from prophylactic aspirin therapy outweigh the benefit of decreasing cardiovascular and ischemic events. Based on this information, it is prudent to further research and study this group and stratify their risk as well as researching if there is a better modality upon which to provide prophylaxis with lower risk than benefit.
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A Comparison of Pharmacologic Interventions in Pregnant Women with Opioid Use Disorder
catherine K. Bopp
The purpose of this research and systematic literature review is to determine which pharmacotherapeutic agent, methadone or buprenorphine, leads to better outcomes in cases of pregnant mothers with opioid use disorder (OUD).
Outcomes considered are maternal compliance, neonatal abstinence syndrome severity, and neonatal length of hospital stay. In the review, PubMed, Clinical Key, Cochrane Database of Systematic Reviews, and DynaMed Plus were searched. Key terms searched were “methadone, buprenorphine, pregnancy”, “opioids, pregnancy”, “neonatal abstinence syndrome” and “medication assisted treatment, pregnancy”. Several studies were excluded, as their study population was not specified to have diagnosed OUD in pregnancy. The drawbacks to many of the studies is the inconsistencies in study conditions, and very small sample sizes. Much of the research presented shows evidence for the use of buprenorphine in the treatment of OUD in pregnancy. Buprenorphine seems to be a better medication assisted treatment (MAT) for the neonate in terms of reduced neonatal abstinence syndrome (NAS) and reduced length of hospital stay postpartum, while methadone still performs better for adherence for the mother. More research still needs to be done in order to demonstrate buprenorphine’s superior efficacy compared to methadone use in pregnant patients with OUD
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A Comparison of Pharmacologic Interventions in Pregnant Women with Opioid Use Disorder
Catherine M. Bopp
The purpose of this research and systematic literature review is to determine which pharmacotherapeutic agent, methadone or buprenorphine, leads to better outcomes in cases of pregnant mothers with opioid use disorder (OUD). Outcomes considered are maternal compliance, neonatal abstinence syndrome severity, and neonatal length of hospital stay. In the review, PubMed, Clinical Key, Cochrane Database of Systematic Reviews, and DynaMed Plus were searched. Key terms searched were “methadone, buprenorphine, pregnancy”, “opioids, pregnancy”, “neonatal abstinence syndrome” and “medication assisted treatment, pregnancy”. Several studies were excluded, as their study population was not specified to have diagnosed OUD in pregnancy. The drawbacks to many of the studies is the inconsistencies in study conditions, and very small sample sizes. Much of the research presented shows evidence for the use of buprenorphine in the treatment of OUD in pregnancy. Buprenorphine seems to be a better medication assisted treatment (MAT) for the neonate in terms of reduced neonatal abstinence syndrome (NAS) and reduced length of hospital stay postpartum, while methadone still performs better for adherence for the mother. More research still needs to be done in order to demonstrate buprenorphine’s superior efficacy compared to methadone use in pregnant patients with OUD.
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Treatment Options for Post Treatment Lyme Disease Syndrome
Barbara Bowman
With the high incidence of Lyme disease in the endemic areas of North America, it is important to appropriately diagnosis and treat this condition to prevent post treatment Lyme disease syndrome (PTLDS). Background information regarding Lyme disease is given. The purpose of this research is to discuss the treatment options available for those patients that fit the case definition of PTLDS. A literature review was conducted using several different electronic databases finding peer reviewed research articles pertaining to the treatment options available for PTLDS. Extended antibiotic use is shown to be not beneficial in most cases. Alternative treatment options listed on the internet are shown to be not evidence based. Therefore, symptomatic treatment options seem to be the best positive outcome-based option available for providers to use. These options are discussed in detail throughout this research. Though much more research is needed regarding the topic, this will give providers the information currently available that they will need to know when treating patients with PTLDS. Hopefully this will provide the patients with PTLDS the best outcome possible for improving their quality of life post Lyme disease.
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Fertility Options for Women with Endometriosis: In Vitro Fertilization versus Surgical Excision or Ablation
Jenny Brown
Endometriosis negatively affects the fertility of many women of reproductive age worldwide. Some women with endometriosis are able to conceive without reproduction assistance, while others require medical intervention. In vitro fertilization and surgical management are available and widely used in the treatment of endometriosis associated infertility. In vitro fertilization has been found to be effective in women with stages I-IV endometriosis, with varying degrees of success at each stage. These varying results may be due to oocyte quality and availability as well as endometriosis location. Surgical excision and/or surgical ablation of endometriosis/endometriomas may also improve chance of successful pregnancy but has been found to decrease ovarian reserve and therefore decrease future fertility as a result of ovarian damage and decreased ovarian reserve. This project will discuss surgical treatment of endometriosis and in vitro fertilization in patients with endometriosis and the result of each on achieving and maintaining pregnancy.
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Obesity: Modern Medicine vs. Lifestyle
Jenny Christianson
• Obesity is a rising epidemic, and is one of the most common, costly and preventable health problems the world is experiencing today (Center for Disease Control and Prevention, [CDC], 2017).
• From this, it is important to establish an effective treatment plan that can be implemented across the nation for maximum patient benefit.
• Lifestyle changes such as diet and exercise are important to any health care plan and are equally necessary to reduce health risks. However, in certain patients, lifestyle changes are not enough due to the maladaptive biologic process in their brain. Thus, additional treatment options need to be available to these patients.
• Both medical therapies, pharmacological and surgical, were found to be beneficial in augmenting lifestyle changes in multiple studies. Therefore, it was concluded that pharmacologic and surgical therapies are valid options in resistant obesity in addition to lifestyle changes such as diet and exercise.
• This study was a systematic literature review which evaluated studies from CINAHL, Clinical Key, Cochrane Library, and PubMed to formulate a conclusion. Research focused on two pharmacotherapy options, phentermine and orlistat, in addition to two surgical options, gastric bypass and sleeve gastrectomy, for added weight loss treatment when compared to lifestyle alone.
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Expedited Partner Therapy For Gonorrheal and Chlamydial Infections
Nicholas Coburn-Pierce
Sexually transmitted infections (STI) such as Neisseria Gonorrhoeae and Chlamydia Trachomatis pose a challenge to the healthcare system worldwide. Treating sexual partners is as crucial to controlling the spread of these infections as treating index patients. However, because of problems associated with stigma, reaching affected populations, and ensuring follow up, unique solutions are require to ensure partners receive treatment. One solution is Expedited Partner Therapy (EPT). EPT refers to treating patients, and providing necessary medication for both patient and partner. Current recommendations are for oral doses one gram of azithromycin and 400 milligrams of cefixime. This literature review looked at thirteen studies, and aimed to determine whether EPT is still superior to standard partner notification at reducing further infection, and reinfection in adult Gonorrhea and Chlamydia (GC) patients in the US. Research indicates that EPT remains a viable, cost effective measure at controlling the spread of GC infections. EPT appears to be the best available option despite use of second line treatments in resistance prone infections. Additionally, there is a need for future, large scale, US based randomized controlled trials to unequivocally show the continued effectiveness of EPT.
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Expedited Partner Therapy for Gonorrheal and Chlamydial Infections
Nicholas Coburn-Pierce
Sexually transmitted infections (STI) such as Neisseria Gonorrhoeae and Chlamydia Trachomatis pose a challenge to the healthcare system worldwide. Treating sexual partners is as crucial to controlling the spread of these infections as treating index patients. However, because of problems associated with stigma, reaching affected populations, and ensuring follow-up, unique solutions are require to ensure partners receive treatment. One solution is Expedited Partner Therapy (EPT). EPT refers to treating patients, and providing necessary medication for both patient and partner. Current recommendations are for oral doses one gram of azithromycin and 400 milligrams of cefixime. This literature review looked at thirteen studies, and aimed to determine whether EPT is still superior to standard partner notification at reducing further infection, and reinfection in adult Gonorrhea and Chlamydia (GC) patients in the US. Research indicates that EPT remains a viable, cost- effective measure at controlling the spread of GC infections. EPT appears to be the best available option despite use of second-line treatments in resistance-prone infections. Additionally, there is a need for future, large- scale, US-based randomized controlled trials to unequivocally show the continued effectiveness of EPT.
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