PA Graduate Student Conference Papers

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    Epidermolysis Bullosa: An overview of current and future potential treatment options
    (Wichita State University, 2022-04-29) Howard, Mackenzie; Tanner, Bradley; Trood, Ashley; Hanneman, Ronda
    Epidermolysis Bullosa (EB) is a rare inherited condition of which the most common clinical finding is blistering and erosions of the skin following minor trauma. While this is the most well-known manifestation of EB, there are many other complications, including: gastrointestinal malabsorption, various genitourinary fusions of skin, glomerulonephritis, contractures and fusions of joints, dental abnormalities, corneal scarring, respiratory tract scarring, skin cancer, and cutaneous infections, which can sometimes lead to sepsis and eventually death. EB consists of four main classifications, and 34 distinct subtypes. The four classifications are Epidermolysis Bullosa Simplex (EBS), Junctional Epidermolysis Bullosa (JEB), Dystrophic Epidermolysis Bullosa (DEB), and Kindler Epidermolysis Bullosa (KEB). These classes are distinguished by the layer of skin in which the formation of blisters occurs: EBS is formed in the intraepidermal layer, JEB is formed in the lamina lucida of the basement membrane, DEB is formed below the basement membrane, and Kindler's EB can involve multiple or all these layers. Treatment for EB until recently has largely been supportive care, focusing on symptom management and proper nutritional support. Treatments that are appearing now include gene therapy, stem cell therapy, and placental-based therapies. Gene therapy involves the actual splicing of affected genes that are responsible for adhesions of skin layers associated with certain types of EB. Stem cell and placental-based therapies focus more on regenerating skin for the EB patient, although studies are ongoing. Research continues for treatments to combat this rare genetic disease.
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    New onset of Type 1 diabetes mellitus in children and adolescents after COVID-19 infection: A clinical review
    (Wichita State University, 2022-04-29) Kandul, Ekaterina; Bell, Katelyn; Davis, Elizabeth; Ridder, Lori
    Diabetes mellitus (DM) and COVID-19 have reciprocal relationships. While diabetic patients have worse prognosis after contracting SARS-CoV-2 virus, the virus itself can cause new-onset diabetes in susceptible individuals. This clinical review describes multiple case reports, research, and epidemiological data demonstrating a link between COVID-19 and new-onset type 1 DM in children and adolescents. There are five proposed mechanisms that explain how COVID-19 can lead to new-onset DM. Pathway 1 induces generic autoimmunity that results in pancreatic betacell destruction. Pathway 2 involves the mis-regulation of the ACE2 and angiotensin II levels, which results in vasoconstriction and decreased blood supply to the pancreas resulting in destruction of the beta-cells and new-onset DM type 1. Pathway 3 explains the effect of cytokines on increased gluconeogenesis and beta-cells destruction. Pathway 4 suggests the correlation between stress and hyperglycemic hormone release, which may lead to metabolic imbalance. Pathway 5 explains how the medications involved in COVID-19 treatment may cause increased blood glucose concentrations triggering new-onset DM in predisposed individuals. The data analyzed in this research suggest an increased risk for new-onset type 1 diabetes in children and adolescents after contracting SARS-CoV-2 virus. It is highly recommended to prevent COVID-19 infection in this population by following CDC guidelines. This clinical review attempts to provide information to medical providers and general public regarding the possible COVID-19 sequelae of diabetes mellitus and DKA as well as importance of long-term monitoring of the patients after either symptomatic or asymptomatic COVID-19 infection.
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    Mental health of PA students
    (Wichita State University, 2022-04-29) Gutierrez, Carina; Brown, Natalie; Glidewell, Hannah; Wallace, Michelle
    INTRODUCTION: Evidence has shown that the prevalence of some mental health disorders is higher among students enrolled in medical school. There is a concern that this may be true for physician assistant (PA) students as well, but less data exists. High levels of stress leading to burnout among students is associated with an increased risk of depression, anxiety, and overall poor quality of life. PURPOSE: This research aims to evaluate the prevalence of depression and anxiety in PA students. METHODS: A cross sectional (survey) was distributed to PA students using an anonymous Qualtrics link. The survey link was sent to the program director for all accredited PA programs in the US so that it could be distributed to their students, and additional participants were recruited through social media and local advertisement. Within the survey, the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Assessment (GAD-7) screening tools were utilized to evaluate for the symptoms of generalized anxiety and depressive disorders. RESULTS: Of the study participants, 15.8% identified as male, 83.2% identified as female and 0.6% identified as non-binary. There were 789 students who completed the PHQ-9 and of those 63% (n=497) had scores that indicate mild to severe levels of depression. There were 782 students who completed the GAD-7 and of those 67% (n=520) had scores that indicate mild to severe levels of anxiety. Additionally, 24.2% (195/804) of students report being diagnosed with a mental health disorder since starting their PA program. The influence of COVID-19 was also assessed in our survey, and 70.7% of participants affirmed the pandemic has impacted their mental health. CONCLUSION: The prevalence of anxiety and depression among the PA student population is higher than the general population. Given the rate of depression and anxiety and the number of new diagnoses during the program, more research is needed to better understand what factors may be contributing to this decline in mental health. Further research could allow for implementation of targeted solutions to promote the mental well-being of PA students.
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    An overview of electric scooter trends: A literature review
    (Wichita State University, 2022-04-29) Bohlender, Eva; Callins, Mallory; Radecki, Sarah; Rogers, Corey
    This paper presents a literature review of the known function, uses, benefits, costs, and injury trends that have been reported with the emergence of electric scooters (e-scooters) in the United States. With the rise in e-scooter use and the more widespread availability of these devices they have shown themselves to be a convenient alternative to the traditional means of transportation. However, they also are associated with many costs, such as jeopardizing pedestrian safety and causing personal harm to users. Additionally, there is evidence that these scooters may not be used as originally designed and this is also a personal and public safety issue. Injury trends in particular are a significant portion of the cost associated with the use of these devices. This paper outlines many trends associated with e-scooter injuries; some that are explored are demographic, gender, age, substance use, as well as injury types, locations, and outcomes.
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    Review of evaluation and treatment of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS)
    (Wichita State University, 2022-04-29) Ardery, Savannah; Morgan, Lanette; Schreiber, Claire; Synek, Jacob; Wallace, Michelle
    Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS) is a rare condition that is diagnosed in children who abruptly develop behavioral, verbal, motor, and/or neurologic changes that have a history of infection with group A beta hemolytic streptococcus. This gram-positive bacteria is the culprit responsible for several illnesses including pharyngitis, tonsillitis, scarlet fever, and erysipelas. Children with PANDAS appear extremely ill upon clinical presentation, with extreme compulsions such as licking shoes or barking. Patients also commonly experience behavioral regression, episodes of extreme anxiety or aggression, and motor and phonic tics such as whooping or wringing their hands. Some may even have auditory or visual hallucinations, which can appear identical to psychotic symptoms seen in schizophrenia, bipolar disorder, and lupus cerebritis. Due to the overlap of PANDAS symptoms with OCD, Tourette's syndrome, ADHD, depression, and psychotic disorders, PANDAS is a diagnosis of exclusion that can only be made once these other conditions are ruled out. Initial treatment for PANDAS involves a round of antistreptococcal antibiotics, assuming the patient has an active strep infection. Long term management involves cognitive behavioral therapy and selective serotonin reuptake inhibitors, with benzodiazepines used as needed during acute symptomatic episodes. For patients with severe refractory symptoms or immune dysfunction, plasmapheresis and/or IVIG can be trialed under the guidance of a specialist. It is estimated that nearly 150,000 cases of PANDAS go undiagnosed every year. Our project aims to increase awareness of PANDAS among clinicians and equip them to appropriately diagnose and treat it.
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