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Cannabinoid receptors in the human brain as a pathway as a pathway for the treatment of anxiety, Post-Traumatic stress disorder, and depression
Title
Cannabinoid receptors in the human brain as a pathway as a pathway for the treatment of anxiety, Post-Traumatic stress disorder, and depression.
Creator
Lopez-Whitney, Maria, Marieb College of Health & Human Services
Abstract / Description
Introduction: The endocannabinoid system is widely distributed throughout the brain, with high concentration in areas of mood regulation and emotional processing. This indicates a possible pathway for the treatment of mood disorders, in particular, depression, PTSD, and anxiety.2 This literature review aims to examine and pinpoint possible targets within the endocannabinoid system as a pathway for the treatment of depression, PTSD, and anxiety. Methods: This literature review presents an...
Show moreIntroduction: The endocannabinoid system is widely distributed throughout the brain, with high concentration in areas of mood regulation and emotional processing. This indicates a possible pathway for the treatment of mood disorders, in particular, depression, PTSD, and anxiety.2 This literature review aims to examine and pinpoint possible targets within the endocannabinoid system as a pathway for the treatment of depression, PTSD, and anxiety. Methods: This literature review presents an overview of studies where specific portions of the endocannabinoid system have been tested on either animals or humans as a target in the treatment of PTSD, anxiety, and depression. Discussion: The CB1 receptor has a role in the regulation of depression and anxiety, and the CB1 receptor agonists HU210, rimonabant, and AM251 are promising treatments for depression and anxiety. However, the endocannabinoid degradative pathway FAAH, AEA, and 2-AG are questionable targets in anxiety since certain doses could cause an increase in anxiety.1,4,5 Endocannabinoid system agonist show a promising treatment pathway for PTSD that encompasses the reduction of most symptoms related to the disorder, but only nabilone has been studied. Conclusion: Most studies indicate that using CB1 receptor agonists and the degradative pathway, there is significant reduction in depression and anxiety. However, most of the studies are animal based, which is why there needs to be a transition to human studies in order to develop therapeutic agents. In addition, the role of AEA in anxiety needs to be further researched as a possible pathway with animal studies. Also, while the endocannabinoid agonists show a promising comprehensive treatment for PTSD, more studies must be done to support the role of the endocannabinoid system in the treatment of PTSD.
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Date Issued
2019-12-16
Identifier
fgcu_ETD_0314
Format
Document (PDF)
Evaluating Trust and Its Timeline in Medical Practitioners
Title
Evaluating Trust and Its Timeline in Medical Practitioners.
Creator
Ciccone, Alexandra, Marieb College of Health & Human Services
Abstract / Description
Medicare and Medicaid created the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to capture hospital care information from the patient’s perspective. Patient satisfaction scores are tied to hospital reimbursement. HCAHPS doesn’t evaluate if patients trust their provider. We asked this question along with when and why patient-provider trust was established. 152 (95.6%) of the 159 patients interviewed trusted their medical provider, only seven (4.4%) did not....
Show moreMedicare and Medicaid created the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to capture hospital care information from the patient’s perspective. Patient satisfaction scores are tied to hospital reimbursement. HCAHPS doesn’t evaluate if patients trust their provider. We asked this question along with when and why patient-provider trust was established. 152 (95.6%) of the 159 patients interviewed trusted their medical provider, only seven (4.4%) did not. It is of utmost importance for providers to make a good impression during their initial patient encounter, as 85.5% of patients said trust was developed at their first interaction. A combination of communication skills and time spent ranked highest on patient’s reasoning for why patient-provider trust was or was not developed. This study highlights the need for all medical practitioners to enhance their ability to communicate effectively in order to better influence a patient’s satisfaction and positive perception of their care.
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Date Issued
2019-12-13
Identifier
fgcu_ETD_0317
Format
Document (PDF)
PSYCHOTROPICS EFFECTIVE AT CONTROLLING PSYCHOSIS AND HALLUCINATIONS WITHOUT SIGNIFICANT EXTRAPYRAMIDAL SYMPTOMS IN TREATING LEWY BODY DEMENTIA
Title
PSYCHOTROPICS EFFECTIVE AT CONTROLLING PSYCHOSIS AND HALLUCINATIONS WITHOUT SIGNIFICANT EXTRAPYRAMIDAL SYMPTOMS IN TREATING LEWY BODY DEMENTIA.
Creator
Khaliq, Noshaba, Marieb College of Health & Human Services
Abstract / Description
INTRODUCTION: Lewy body dementia (DLB) is a serious illness, affecting millions worldwide and currently the second most common etiology of the dementia spectrum. Patients, specifically the elderly, are devastated by the symptoms from this illness, chief of which are the disturbing visual hallucinations. Although medication exists to treat this disorder, the psychotropics generally prescribed have far-reaching implications for negative side effects and adverse events. This paper discusses the...
Show moreINTRODUCTION: Lewy body dementia (DLB) is a serious illness, affecting millions worldwide and currently the second most common etiology of the dementia spectrum. Patients, specifically the elderly, are devastated by the symptoms from this illness, chief of which are the disturbing visual hallucinations. Although medication exists to treat this disorder, the psychotropics generally prescribed have far-reaching implications for negative side effects and adverse events. This paper discusses the three medications quetiapine, rivastigmine, and donepezil and examines their risks-benefits profile in treating DLB. METHODS: Chiefly the PubMed database was consulted to gather relevant articles. One open-source database (OMICS) was used to cull several articles. All told, several dozen articles were reviewed, of which 13 were chosen for this review. RESULTS: The three medications reviewed, donepezil, rivastigmine, and quetiapine all have their place in DLB treatment; however, all have widely varying side effects, which are patient-specific. Of the three reviewed, donepezil proved to be the best tolerated at low dosages, and most effective at relieving visual hallucinations without EPS. CONCLUSION: Clinicians must be thoroughly conversant with as many psychotropics as possible, especially when treating DLB patients. Moreover, they must carefully weigh potential benefits against negative side effects. If they cannot make a strong case for use, then the best option is to forgo pharmacologic intervention.
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Date Issued
2019-12-18
Identifier
fgcu_ETD_0315
Format
Document (PDF)
REEVALUATING HEMODYNAMIC RESUSCITATION TO NORMALIZE LACTATE LEVELS IN SEPTIC SHOCK PATIENTS WITH HYPERLACTATEMIA
Title
REEVALUATING HEMODYNAMIC RESUSCITATION TO NORMALIZE LACTATE LEVELS IN SEPTIC SHOCK PATIENTS WITH HYPERLACTATEMIA.
Creator
Trujillo, Ruby, Marieb College of Health & Human Services
Abstract / Description
INTRODUCTION: Although serum lactate levels have served as an important biomarker of illness severity in sepsis patients, lactate should not be the only criterion to guide treatment to enhance survival. Traditionally, clinicians have been instructed by such organizations as the Surviving Sepsis Campaign and its guidelines regarding lactate concentrations and tissue hypoperfusion. As this literature review will show, a combination of lactate with other biomarkers can serve as a more reliable...
Show moreINTRODUCTION: Although serum lactate levels have served as an important biomarker of illness severity in sepsis patients, lactate should not be the only criterion to guide treatment to enhance survival. Traditionally, clinicians have been instructed by such organizations as the Surviving Sepsis Campaign and its guidelines regarding lactate concentrations and tissue hypoperfusion. As this literature review will show, a combination of lactate with other biomarkers can serve as a more reliable predictor of sepsis mortality and thus guide appropriate interventions. METHODS: A search was conducted using the PubMed database. After formulating several research questions related to the topic, relevant keywords were generated. These produced sufficiently many articles related to sepsis resuscitation, lactate levels, and hemodynamic resuscitation. RESULTS: Hyperlactatemia is not the main criterion by which clinicians should be guided when treating patients with sepsis or in septic shock. Rather, lactate levels and lactate clearance should be used along with other assessments to determine appropriate interventions. Oxygen perfusion might do harm if a patient is not suffering from tissue hypoxia; thus, resuscitation must be based on microcirculatory dynamics and not macro hemodynamics. CONCLUSION: Decreased lactate clearance should not be the only criterion of early goal-directed therapy in severly ill sepsis patients. Hemodynamic resuscitation should be implemented based on actual oxygen demand, and measures using lactate with other biomarkers have been shown more reliable in predicting mortality than hyperlactatemia alone.
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Date Issued
2019-12-16
Identifier
fgcu_ETD_0320
Format
Document (PDF)
SECONDARY BENEFITS OF ANTIHYPERTENSIVE MEDICATIONS IN THE TREATMENT OF CANCER
Title
SECONDARY BENEFITS OF ANTIHYPERTENSIVE MEDICATIONS IN THE TREATMENT OF CANCER.
Creator
Szczygiel, Stacy, Marieb College of Health & Human Services
Abstract / Description
Introduction: Traditional cancer treatments remain woefully inadequate to address and manage the increasingly complex manifestations of the disease and its insidious sequelae. While chemotherapy and surgical procedures might still be mainstays of cancer treatment, novel therapies based on existing medications should be explored if these show promise to improve cancer progression. The class of drugs that inhibit the renin-angiotensin-aldosterone-system have shown promise to stem the...
Show moreIntroduction: Traditional cancer treatments remain woefully inadequate to address and manage the increasingly complex manifestations of the disease and its insidious sequelae. While chemotherapy and surgical procedures might still be mainstays of cancer treatment, novel therapies based on existing medications should be explored if these show promise to improve cancer progression. The class of drugs that inhibit the renin-angiotensin-aldosterone-system have shown promise to stem the proliferation of malignant cells and their resulting neoplasms. Methods: Using the PubMed database, a keyword search, using terms related to the topic, produced several articles that presented studies related to the potential secondary benefits of antihypertensive drugs on cancer cell proliferation. Results: Five articles presented compelling evidence that the different types of hypertension medications could confer protection against multiplying cancer cells. Only one article mentioned the possible cancer promoting effects of such medications, but this was only in the context of treating hypertensive geriatric patients and their other age-related disorders. Conclusion: Antihypertensive drugs, particularly those that inhibit the angiotensin converting enzymes, have shown promise to shunt normal cancer metabolic pathways and shut down key processes necessary for malignant cell proliferation. Based on this research, these drugs present promise for adjuvant cancer treatment and disease management.
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Date Issued
2019-12-16
Identifier
fgcu_ETD_0319
Format
Document (PDF)
THE USE OF ANTIBIOTICS FOR NON-OPERATIVE MANAGEMENT OF UNCOMPLICATED APPENDICITIS
Title
THE USE OF ANTIBIOTICS FOR NON-OPERATIVE MANAGEMENT OF UNCOMPLICATED APPENDICITIS.
Creator
Davis, Cody, Marieb College of Health & Human Services
Abstract / Description
Introduction: Appendicitis is a commonly diagnosed source of abdominal pain treated with an appendectomy. Alternative treatments to surgery are not widely used and accepted. Treatment with antibiotics alone has been suggested as an alternative treatment to surgery for patients with uncomplicated appendicitis. Methods: A literature search was conducted using Pub Med and the keywords “appendicitis antibiotics.” A PICO search was also conducted on the trip database with keywords “(appendicitis)...
Show moreIntroduction: Appendicitis is a commonly diagnosed source of abdominal pain treated with an appendectomy. Alternative treatments to surgery are not widely used and accepted. Treatment with antibiotics alone has been suggested as an alternative treatment to surgery for patients with uncomplicated appendicitis. Methods: A literature search was conducted using Pub Med and the keywords “appendicitis antibiotics.” A PICO search was also conducted on the trip database with keywords “(appendicitis)(antibiotic)(surgery or appendectomy).” Discussion: A small randomized control trial performed in the United States showed that 2 out of 15 patients had recurrent appendicitis after being treated only with antibiotics in a combination of inpatient and outpatient therapy. A much larger trial found that 70 out of 257 patients in the antibiotic only treatment group ended up needing an appendectomy after one year follow up, however patients treated only with antibiotics took less sick time from work. This study was extended and after 5 years 30 additional patients required surgery for recurrent appendicitis. Patient preferences were evaluated in two different studies and the results varied depending on the type of education given before the questionnaire. Conclusion: More research is needed to determine how antibiotics should factor into the treatment algorithm for appendicitis in the United States.
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Date Issued
2019-12-12
Identifier
fgcu_ETD_0316
Format
Document (PDF)