| Authors: | Kayla Leiber OMS-II, Dr. Wayne Parker Pharm.D. |
| Background: | Low-dose naltrexone, or LDN, has been suggested as a novel treatment option for several conditions and is of increasing interest due to its potential ability to address certain medical conditions that lack effective treatments or frequently rely on the use of opioids as treatment. This article will systematically quantify the existing research that examines low-dose naltrexone’s efficacy against painful and other relevant medical conditions. |
| Methods: | A scoping review was conducted using the PRISMA-ScR guidelines. Resources utilized for the review included PubMed and Embase. Articles included were required to be original research, published in English, conducted on human subjects, published in the last 15 years, had full text available, and included treatment with naltrexone in an off-label capacity (i.e. not for the treatment of alcohol or opioid use disorder). Zotero, a reference management software, was used to review all search results with this criterion. |
| Results: |
Search results yielded 2,399 articles. 995 did not meet inclusion criteria, 1166 were excluded after screening by title, and 142 were excluded after screening by abstract. 68 articles were ultimately included after a full text review. |
| Conclusions: |
The articles selected presented clinical examples of LDN efficacy for a variety of medical conditions. This review indicates LDN could be a safe and cost-effective treatment option for several of these conditions. These articles also helped to illuminate the current gaps in research, pointing to the need for larger clinical trials and proper dosing studies. |
| Authors: | Grace Herrick, OMS II Kelly Frasier, DO Erin Lowe, DO |
| Abstract: |
Integrating artificial intelligence (AI) into Mohs micrographic surgery (MMS) represents a transformative advancement in dermatological surgery, with the potential to significantly enhance surgical precision, efficiency, and patient outcomes. This review provides a comprehensive summary of AI’s current and emerging roles in MMS, focusing on its application in tumor margin identification, surgical precision, and tissue preservation. Further, it explores AI’s role in predicting tumor complexity and postoperative outcomes, emphasizing how these predictive models can be incorporated into personalized care plans and long-term patient monitoring. Practical steps for implementing AI in clinical practice are provided, focusing on the necessary infrastructure, training, and potential barriers to adoption, while considering the financial implications and potential return on investment for providers. Additionally, this review analyzes the ethical and legal considerations surrounding AI use in MMS, discussing data privacy, security, and the legal implications of AI-assisted procedures. The integration of AI in MMS holds immense promise, but its successful adoption will require careful consideration of clinical, ethical, and financial factors to ensure that this technology ultimately benefits both patients and healthcare providers. |
| Authors: | Alexander Mazzorana, BS, OMS-II |
| Abstract: |
Butyric acid, a short-chain fatty acid (SCFA) produced by gut microbiota, plays a pivotal role in maintaining intestinal barrier integrity and regulating immune responses. This literature review analyzes the role of butyric acid and butyric-acid-producing bacteria in the development of allergies in children. Studies have shown that reduced levels of butyric acid in the gut are associated with increased inflammation and altered immune tolerance, contributing to allergic diseases. This review explores the mechanisms through which butyric acid influences immune modulation, including the suppression of pro-inflammatory cytokines and enhancement of regulatory T cell function. Furthermore, it examines the composition of butyric-acid-producing bacteria in the gut and their impact on early-life immune programming and allergy risk. By synthesizing current evidence, this review aims to elucidate the potential of targeting butyric acid pathways for allergy prevention and treatment strategies in pediatric populations. |
| Authors: | Alexander Mazzorana, BS, OMS-II |
| Abstract: |
Obstructive sleep apnea (OSA) is increasingly recognized as a significant risk factor for vascular dementia (VaD), which severely impairs cognitive function and quality of life. This literature review examines the relationship between OSA and VaD, focusing on mechanisms, gender and age differences, and preventative measures like uvulopalatopharyngoplasty (UPPP) and continuous positive airway pressure (CPAP) therapy.
Population-based studies show a strong correlation between OSA and increased VaD risk, particularly in middle-aged adults and women. Mechanisms such as intermittent hypoxia contribute to neuronal damage and inflammation, while cardiovascular dysfunction, including hypertension, exacerbates cognitive decline. Notably, women may be more vulnerable to the cognitive effects of OSA, especially during menopause when estrogen's protective benefits decrease.
The review also highlights CPAP therapy as the gold standard for OSA management, with evidence suggesting that adherence can improve sleep quality and partially reverse cognitive impairments. Additionally, UPPP is explored as a preventive measure against cognitive decline in OSA patients, with preliminary findings indicating a potential protective effect against dementia, though more longitudinal research is needed to confirm these results.
The link between OSA and VaD emphasizes the intersection of sleep health, cardiovascular function, and cognitive integrity. Early identification and management of OSA are crucial for reducing dementia risk, underscoring the need for interdisciplinary approaches that address both sleep disorders and vascular health. Continued research is essential to clarify the causal mechanisms and explore comprehensive treatment strategies for at-risk populations. |
| Authors: |
Thomas Carter OMS-II, Ryan McClenahan OMS-II, Charles Murrah OMS-II, Tarana Sidhu OMS-II, Corrado Verratti OMS-II
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Background/ Overview: |
Diabetes is increasingly prevalent in the United States, prompting an exploration of its multifaceted causes. This paper investigates various social and environmental factors contributing to the rising incidence of diabetes, aiming to identify the most significant contributor through a synthesis of existing literature. |
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Methods/ Findings: |
The research drew upon meta-analyses and reviews focused on diabetes and social determinants of health. The paper utilized the PubMed and Google Scholar databases and compiled multiple papers and analyses. Selected articles involved adult populations and emphasized social determinants such as income, education, housing, and race. To support the findings, an analysis of demographic data maps was used to visualize correlations between income levels and diabetes prevalence across regions. |
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Results/ Discussions: |
The analysis revealed that income is a crucial determinant of diabetes prevalence. Many associated risk factors, such as access to healthcare and nutritional options, are closely linked to income levels. Data mapping confirmed that areas with lower average incomes generally exhibit higher diabetes rates. While education and housing were significant, they often reflected income disparities, suggesting that improving income could positively impact other modifiable factors. |
| Conclusions: |
This research indicates that income is the most significant factor influencing diabetes prevalence in the United States. Limitations include a focus on the U.S. population and adults. This necessitates further global epidemiological studies and analysis centered on adolescent diabetes. Future research should consist of longitudinal studies to assess income changes on diabetes incidence within communities and finding effective public health strategies to reduce diabetes prevalence through socio-economic interventions |
| Authors: | Danielle Wright OMS-II, Jorge Almira OMS-II, Nasrul Bhuiyan OMS-II, Haley Bracy OMS-II, Kelly Patterson OMS-II, Ludimila Trabanino OMS-II, Timothy Lee Tran OMS-II, John Wahidy OMS-II |
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Background/ Overview: |
Studies have shown an increasing trend in worsening air quality due to climate change with links with asthma rates. A narrative review was done to explore link between climate change and the rate of asthma prevalence in individuals of lower socioeconomic status. |
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Methods/ Findings: |
A systematic search was performed using PubMed with key words such as “asthma”, “socioeconomic status” and “climate change” to narrow search. This study focused on male and females between 5-65 age range and excluded articles with population outside the US. The papers selected focused on populations in different socioeconomic groups. Then a narrative was synthesized utilizing the key findings. |
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Results/ Discussion: |
Studies have shown that asthma is impacted by air quality and pollen. Pollen content increase was linked to climate change in similar areas with a high population living below poverty line. The results indicate that poorer children have higher incidence of asthma exacerbation when compared to their richer counterpart. |
| Conclusion: | This study has shown a strong link between asthma incidence in lower SES populations and increasing climate change. It is also shown that air quality impacted by pollution and industrialization affect these populations at a higher rate in urban areas. Some limitations with this study are that it highlights correlations between factors but cannot establish a causal link due to multiple factors being intertwined with asthma outcomes. Overall, further research is needed in this field to ensure equity for populations at risk. |
| Authors: | Om Jhaveri, OMS-II, Trang Le, OMS-II, Konstantinos Dimitroulas, OMS-II, Lysine Varghese, OMS-II, Lea Oliveros, OMS-II, Trevor Storey, OMS-II |
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Background/ Overview: |
The growing legalization of cannabis within the U.S.A has led to increased usage along with potential adverse effects on already rising rates of psychiatric illness. This study aims to demonstrate the correlation between cannabis use and rising rates of mental illness amongst different populations. |
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Methods/ Findings: |
Sources utilized include data analysis from the Substance Abuse and Mental Health Services Administration, retrospective studies, and meta-analyses involving different demographics. Each study analyzed the heightened correlations found between cannabis use and psychiatric disorders, including generalized anxiety and schizophrenia. |
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Results/ Discussion: |
The prevalence of mental illness related ED visits involving marijuana was significantly higher than non-marijuana related ED visits (Wang et al., 2017). A study examining an outpatient mental health clinic found that children with distinct psychological risk factors are more likely to use cannabis at a higher frequency (Hawke et al., 2020). Resultantly, a connection between marijuana use in the youth population and an increased risk of psychosis is apparent. A similar correlation is seen across other age groups. Data suggests that long-term cannabis use adversely affects mental health, specifically individuals predisposed to mental illness. |
| Conclusion: |
This research revealed a correlation between cannabis consumption and psychosis affecting all age groups, reinforcing existing literature. Although it was previously thought that cannabis solely increased symptoms of anxiety, it can elicit a wide range of psychiatric symptoms. Future studies are needed to better understand the impact of cannabis on young developing brains. |
| Authors: | Darby Keith, BS, OMS-II, Christina Kennedy, PhD |
| Abstract: |
Endophthalmitis is a severe intraocular infection that can occur following intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents, which are standard treatments for neovascular age-related macular degeneration (nAMD). This literature review explores the incidence, risk factors, and prevention strategies associated with endophthalmitis following the administration of bevacizumab, ranibizumab, and aflibercept. Despite the low overall incidence of endophthalmitis, variations exist between different anti-VEGF agents, with compounded bevacizumab showing higher infection rates compared to aflibercept and ranibizumab. Procedural factors, such as drug preparation methods, particularly the use of prefilled syringes and sterile compounding techniques, play a critical role in minimizing the risk of infection. Additionally, the review highlights the importance of infection control measures, such as the use of povidone-iodine and careful handling during injection. Coagulase-negative staphylococci and viridans streptococci are identified as the most common causative pathogens, with streptococcal infections leading to worse visual outcomes. This review underscores the need for rigorous procedural sterility and appropriate use of anti-VEGF agents to prevent endophthalmitis, emphasizing that clinical decisions should balance efficacy, cost, and safety considerations. Future research should focus on optimizing preparation methods and exploring a alternative antiseptics to further reduce the risk of endophthalmitis. |
| Authors: | Kavya Avancha OMS-II, Manu Ponnala OMS-II, Caitlin Roycraft OMS-II, Regla Silveira Rojas OMS-II, Jake Sosa OMS-II, Tyler Speirs OMS-II, Nastaeen Tajin OMS-II |
| Abstract: |
This paper investigates the relationship between sleep deprivation and the rising prevalence of hypertension (HTN) in the adult population of the United States, using a critical evaluation of peer-reviewed articles from the PubMed database. Meta-analyses that examined an adult population from either a medical database or survey dataset were selected for use because they would better represent the overall prevalence at the national level, and in a more medically stable population. Findings indicate that various sleep behaviors and related habits all have impacts on blood pressure secondary to their effects on sleep duration and quality. Potential limitations include using datasets containing self-reported survey information, which can be inaccurate and lead to misrepresentation of the variables being considered. The next step in further researching this topic would be to investigate the clinical efficacy of therapies targeted at sleep hygiene in patients with established hypertension, to assess their use as primary or secondary therapeutic modalities in place of, or as an adjunct to pharmacologic treatment. |