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Efficacy of Catheter Ablation Compared to Antiarrhythmic Drug Therapy in Atrial Fibrillation
Full text linkIntroduction: A-fib occurs when the electrical signals in the heart become unorganized and unsynchronized, resulting in an irregularly irregular heart rate. This can increase the risk of blood clots and stroke. The purpose of this paper is to explore two of the most common treatment options, comparing the efficacy of catheter ablation to AAD (antiarrhythmic drug) therapy in adults diagnosed with atrial fibrillation.
Methods: PubMed was searched using the keywords “atrial fibrillation,” “catheter ablation,” and “antiarrhythmic.” Operators and filters yielded a final result of 159 articles; four articles that most closely aligned with the focus of this research were reviewed.
Results: Studies included systematic reviews and meta-analyses of randomized controlled trials (RCTs), along with the CABANA trial, which further assessed the efficacy of catheter ablation compared to AAD therapy in different age groups.
Discussion: Reviewed articles holistically concluded that catheter ablation is more effective at preventing recurrence of A-fib than AADs alone. Additional benefits to cardiac ablation were found to varying degrees across all four articles, including a reduction in symptomatic atrial arrhythmias, stroke, hospitalizations, cardiac arrest, and bleeding. Additional research is needed to uncover patient barriers in receiving catheter ablations and how the advancement of medicine can improve the efficacy of AAD therapy
In Patients with Submassive Pulmonary Embolism, does Catheter Direct Thrombolysis Reduce Mortality Compared to Anticoagulation
Full text linkIntroduction: PE is a life-threatening condition leading to obstructed blood flow and compromised gas exchange. Prompt recognition and treatment are crucial to improving outcomes and reducing mortality, particularly in patients with submassive PE. This paper evaluates the effectiveness of catheter-directed thrombolysis (CDT) in enhancing treatment protocols for PE compared to standard anticoagulation.
Methods: A literature review was conducted using the PubMed database, focusing on articles related to pulmonary embolism, anticoagulation, and catheter thrombolysis from 2019 to 2024. The search, refined by MeSH terms and Boolean operators, yielded 192 results, narrowed down to 16 relevant randomized control trials, meta-analyses, and systematic reviews. Studies were selected based on specific criteria, such as using PRISMA guidelines, the Newcastle-Ottawa scale, and Cochrane bias risk assessment.
Results: Ultimately four articles were reviewed three of which were meta-analyses that used PRISMA, Cochrane methodology, and the Newcastle-Ottawa scale, and one ongoing randomized control trial. These studies showed that CDT may decrease in-hospital mortality associated with submassive PE.
Discussion: The studies included in the paper consistently found that CDT was associated with a lower risk of death than systemic thrombolysis in patients with submassive PE. While CDT may show a significant reduction in in-hospital and short-term mortality compared to anticoagulation alone, the studies also highlighted gaps in evidence, particularly in establishing CDT as a first-line treatment. Ongoing trials are expected to provide more conclusive data on the long-term efficacy and safety of CDT
The Impact of Proton Pump Inhibitors on Cardiovascular and Bleeding Outcomes in Coronary Heart Disease Patients Undergoing Percutaneous Coronary Intervention
Full text linkIntroduction: Coronary heart disease (CHD) is a leading cause of mortality worldwide, with percutaneous coronary intervention (PCI) as the primary therapeutic approach. This review evaluates the effect of proton pump inhibitors (PPIs) on gastrointestinal (GI) bleeding risks and cardiovascular outcomes in patients with CHD who are undergoing PCI.
Methods: A systematic search using the PubMed database was conducted. Included in the search terms were: “dual antiplatelet therapy,” “proton pump inhibitors,” “percutaneous coronary intervention,” and “clopidogrel.” The search was narrowed down to include only systematic reviews, meta-analyses, and randomized control trials (RCTs) that were published in English within the last 10 years. Based on the quality and relevance of the studies, three were selected for final review.
Results: The chosen studies displayed slightly elevated major adverse cardiovascular events (MACE) that were associated with PPI use, while consistently illustrating a substantial decrease in GI bleeding (OR 0.56). Notably, the study on DAPT duration found significantly reduced bleeding risks (OR 0.61) without increased ischemic risks with the use of very short-term DAPT regimens.
Discussion: The evidence suggests PPI use provides a substantial benefit in reducing GI bleeding, despite its associated moderate increase in cardiovascular risks, which further warrants consideration of use in CHD patients who are undergoing PCI. Further research is necessary to improve both gastrointestinal and cardiovascular outcomes in this population
Alteplase vs. Tenecteplase: Comparing Health Outcomes Following Thrombolytic Administration in Acute Ischemic Stroke
Full text linkIntroduction: Acute ischemic stroke (AIS) results in death of brain tissue necessitating prompt intervention to restore blood flow and minimize neurological damage. Tissue plasminogen activator (tPA), specifically alteplase, has long been the standard treatment for AIS. However, recent research explores the potential advantages of tenecteplase, an alternative thrombolytic agent.
Methods: PubMed was searched, utilizing free text, randomized control trials, systematic reviews, and meta-analyses from 2019-2024. The literature search yielded four relevant results to include in this review comparing tenecteplase and alteplase, focusing on efficacy, safety, and overall clinical outcomes.
Results: All four articles reviewed were systematic reviews and meta-analyses focusing on efficacy and safety outcomes. The results suggest that tenecteplase may offer superior early neurological improvement and recanalization rates compared to alteplase, although both treatments show comparable long-term recovery and safety profiles.
Discussion: Tenecteplase demonstrates a more favorable outcome in terms of recanalization and early neurological benefits, without higher risk of poor neurological recovery, intracranial hemorrhage, symptomatic intracranial hemorrhage, or parenchymal hematoma. These findings underscore the potential for tenecteplase to become a viable alternative to alteplase. Further research is needed to determine dosing strategies of tenecteplase for optimized patient outcomes
Computed Tomography Pulmonary Angiography versus Ventilation-Perfusion Scanning for PE during Pregnancy
Full text linkIntroduction: Pregnant women who are diagnosed with a pulmonary embolism (PE) face a high rate of mortality due to its significant compilations. Timely and accurate diagnosis of PE is essential for appropriate management. Diagnostic imaging modalities, such as computed tomography pulmonary angiography (CTPA) and ventilation-perfusion (V/Q) scan, are required to confirm the PE. This study aims to determine the most optimal early diagnostic imaging for PE in pregnancy.
Methods: This study searched the PubMed database for research comparing diagnostic imaging modalities used in PE for pregnant women from 2018 to 2024. Keywords searched included “pulmonary embolism,” “pregnancy,” “computed tomography pulmonary angiography,” and “ventilation-perfusion scan.” Final results were filtered by comparing V/Q to CTPA scans among RCTs, systematic reviews, and meta-analyses. Studies included were found via applied filters and reference lists of searched items.
Results: In total, 480 patient data points, including pregnant patients, were analyzed across three studies. One study found that the prevalence of imaging was higher for CTPA scans and lower for non-diagnostic results compared to perfusion scans, with linear regression showing significantly more non-diagnostic outcomes for perfusion scans. Researchers in the subsequent study concluded that CTPA was also identified as the most common imaging modality across all pregnancy trimesters, peaking in the third trimester, with an increasing diagnosis rate for PE from the first trimester to postpartum. The final study indicated that helical CTPA had the highest lung dose, while V/Q scans had the highest overall lung radiation exposure. Notably, fetal radiation doses were lower with CTPA than V/Q scans, particularly in early pregnancy, and the risk of childhood cancer from fetal exposure was greater for V/Q scans.
Discussion:CTPA was the most common initial and superior diagnostic imaging modality for confirming PE in pregnant women across all trimesters over V/Q scans. Due to limited data on maternofetal outcomes with ionizing radiation exposure, further assessments on alternate imaging modalities and clinically proven diagnostic algorithms should be conducted
Session IIA: Social Issues Presentation 1 - Portraying Appalachia: Comparing Two Shows
Full text linkUsing the movie Deliverance, I analyze how the two shows, Beverly Hillbillies and Heartstrings portray Appalachia and how the scholarship reacts to the shows
2025, Jan 29 - Faculty Meeting Materials
No full textGardner-Webb University Faculty Meeting Materials from 2025, Jan 29. Meeting Materials include: Agenda, Minutes, Committee Reports, and Provost\u27s Report
A Study of Math 1 Students at Two Eastern High Schools in North Carolina, Employing an Explanatory Design
Full text linkThis study examined the instructional experiences of Math 1 students in the Green Valley (pseudonym) County School District during the 2022-2023 academic year. Using an explanatory sequential mixed methods approach grounded in constructivism (Bruner, 1960; Vygotsky, 1978), behaviorism (Skinner, 1938), universal design for learning (CAST, 2021; Meyer et al., 2014), multiple intelligences (Gardner, 1983), and Piaget\u27s (1954) stages of development, this study explored how students\u27 lived instructional experiences impact academic outcomes. Data, analyzed descriptively and thematically in Qualtrics, revealed a widespread dissatisfaction among students regarding engagement, instructional pace, preparation, and classroom disruptions. Qualitative insights particularly underscore issues with a passive, teacher-centered learning environment and a lack of preparedness for assessments. Students expressed feeling unprepared and unsupported, noting discomfort in asking questions and suggesting a need for more interactive and personalized teaching. The findings indicated that current instructional methods and classroom dynamics do not fully address students\u27 academic and emotional needs in Math 1. Consequently, the study emphasized the need for student-centered, engaging teaching strategies; additional support systems; and a nurturing environment to boost student confidence and participation. The findings will guide instructional improvements in future Math 1 courses at both High School A and High School B, with an action plan and recommendations proposed to the district to address identified gaps