Medicine and Health Sciences Commons^™

What Gives, Samantha Stephen

Akesis

It may never be enough and that's okay.

Balancing Sacrifice, Akesis Anonymous Author

Akesis

We have sacrificed a lot to get into medical school, pushing away quick satisfaction for the hope of a bigger reward in the future. Our faculty members keep telling us that medical school is a marathon, not a race. For this reason, we must be careful about how much we sacrifice to become physicians. Life is a balance, and finding that balance is the key to happiness as a medical professional.

A Brave New World Comes From Strong Roots, Nihit N. Mehta

Akesis

I feel like a monument,

a witnesss to Father Time.

Welcoming Clinical Medicine,

with certain excitement and shine.

A brave new world now awaits behind life's doors,

my roots are strong,

as I come from UNE's shores.

Pressed, Samantha Stephen

Akesis

Pushing myself to reconnect with what makes me feel grounded during my medical pursuits.

Reminding myself what it feels like to think abstractly.

Sunbathers, Jessica Rehrig

Akesis

in series with previous submission

Meditation, Jessica Rehrig

Akesis

in series with first submission

Surfers, Jessica Rehrig

Akesis

this goes in series with my first submission

this photo is "surfers"

Our Love For The Ocean Has Rooted Us Here, Jessica Rehrig

Akesis

Harun Yahya once said,

"I always wonder why birds choose to stay in the same place when they can fly anywhere on the earth, then I ask myself the same question."

This quote echoes a deeper meaning that is intertwined with the human experience, the human connection - to people, to culture, to memory. Often in life we move for school, travel for work, explore different countries for adventure, but we always come back "home". We are all rooted in somewhere or someone, and those connections and relationships shape us into who we are today and give life meaning.

The …

The Opposite Of Rhetoric, Jack C. Lewis

Akesis

There are a handful of moments from my past that continue to motivate me to pursue this medical education. This one in particular, telling a family that there is nothing more we can do for their deceased loved one, left me wanting to say much more than is professionally acceptable. And when I ask “why am I subjecting myself to this grueling education?,” I can find strength in these moments of not knowing whether or not there is more that I could’ve done to help an individual or family through a difficult moment.

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

Hypertonic Saline Versus Mannitol To Improve Brain Relaxation In Craniotomy: A Case Study, Morgan Cornell

Nurse Anesthesia Student Capstones

In neurosurgical procedures, including craniotomy for tumor, neurosurgeons often require a reduction of brain swelling to optimally perform the surgery. The reduction of brain swelling is termed brain relaxation. The anesthesia professional can accomplish brain relaxation using multiple techniques. One such technique is the infusion of certain intravenous fluids to change the osmotic pressure within the cranial vault thereby reducing brain edema (Jaffe, 2014). Highly osmolar fluids such as mannitol and hypertonic saline can be infused to decrease brain edema. Currently, mannitol remains the gold standard for medical treatment of intracranial pressure in neurosurgical procedures (Marko, 2012). This review seeks …

The Impact Of Intraoperative Goal-Directed Fluid Therapy, Marc Yacovone

Nurse Anesthesia Student Capstones

Anesthetists provide intra-operative fluid therapy by utilizing a variety of different methods. Deciding on the appropriate method is multifaceted, and the choice of method is a determinate of safe and effective outcomes. Camach-Navarro et al. (2015) determined that postoperative complications are linked to either giving too much or too little fluid. Unfortunately, the deleterious effects of improper fluid therapy are often overlooked.

Minor surgical procedures which result in little to no blood loss, often lead to positive outcomes using the fixed volume calculation approach to fluid therapy. However, when major surgical procedures are performed on sick patients a fluid management …

The Role Of Platelet Rich Plasma In Pain Management And Decrease In Opioid Use, Sara Cunha

Nurse Anesthesia Student Capstones

Platelet-rich plasma, also known as PRP, has become increasingly popular for the treatment of orthopedic injuries and symptomatic pain that results from such injuries. By promoting a localized inflammatory response, PRP injections increase blood flow to the injured area and expedite the healing process, thereby leading to pain relief. PRP has the potential to be a key player in the future of pain management. However, current evidence of the impact of PRP on pain relief is controversial. This paper aims to review the most current randomized controlled trials evaluating the efficacy of PRP in pain relief in a variety of …

Neurotoxic Effects Of Anesthesia On The Developing Brain, Nicole Hachey

Nurse Anesthesia Student Capstones

Each year, thousands of neonates receive anesthesia and/or sedation for various surgical procedures. With advancements in neonatal care and surgical techniques, the number of infants receiving anesthesia globally will continue to increase. A relatively large and growing body of literature suggests that exposure to general anesthetics can be detrimental to the developing brain. Based upon various animal studies, it is thought that exposure of the immature brain to anesthetic agents may result in apoptosis, neurodegeneration and ultimately long-term cognitive deficiencies (Walters & Paule, 2016). This information presents a dilemma for practitioners when caring for a neonate requiring a surgical procedure, …

Thoracic Epidural Versus Continuous Intercostal Catheter For Patients Undergoing Video Assisted Thoracoscopic Surgery (Vats), Brittany Guilmet

Nurse Anesthesia Student Capstones

Advances in technology have pushed many practitioners towards the implementation of minimally invasive surgery. Many different specialties have rapidly adopted this new approach and patient outcomes have improved as a result of this transition. One specialty, thoracic surgery, has evolved with this change through the development of video assisted thoracoscopic surgery (VATS). Despite improved patient outcomes, thoracic surgery remains one of the most painful procedures that a patient can endure. Although there are many different analgesic modalities available, the gold standard for post-operative analgesia in this patient population remains unknown. The aim of this literature review is to compare the …

Regional Anesthesia And Breast Cancer Recurrence, Michael Dunnington

Nurse Anesthesia Student Capstones

Breast cancer is the most common type of cancer in women in the United States, and surgical resection is the definitive treatment. However, cancer recurrence and metastasis remains a concern for the lifetime of the patients affected. Therefore, much interest has been focused on how anesthetic technique may impact the rates of cancer recurrence and metastasis following breast cancer surgery. In this review, the potential for regional analgesia to reduce the recurrence rate of breast cancer post-operatively is discussed. Supporting evidence from multiple studies is presented, along with a discussion of potential areas of future research that is needed. At …

Dexmedetomidine In The Prevention Of Emergence Delirium In Children, Lauren Anderson

Nurse Anesthesia Student Capstones

This review examines the use of intravenous dexmedetomidine in the role of decreasing or preventing emergence delirium in pediatric patients undergoing ambulatory surgery. The included randomized controlled trials evaluated the administration of dexmedetomidine, whether as a bolus, infusion, or in combination, and its effectiveness in preventing or reducing emergence delirium. The analysis scales for emergence delirium varied between studies, and it was noted that multiple scale components overlapped with pain scale components used in the trials. It has also been noted that differentiating between pain and emergence delirium can be challenging for clinicians (Somaini, Engelhardt, Fumagalli & Ingelmo, 2016). To …

After The Dark Comes The Light, Jenifer Van Deusen

Akesis

No abstract provided.

Progress, William Ciurylo

Akesis

Finally, the weekend. Finally, free of the constraints of mandatory lectures and clinical experiences. Finally, freedom to work how and when I want to work; learn how and when I want to learn. The lack of structure is refreshing. I will be so productive. Finally. But first – I will sleep in. Might as well, I am free to do so after all. I am my own person for once. Just because I sleep in does not mean that I won’t master the material. I work better in the afternoons and evenings anyway. I deserve this after a week of …

The Knock Of Progress, Nihit N. Mehta

Akesis

This work is created as an amateur attempt, to push forward the philosophy of caring touch in modern medicine.

Clinical Performance And The Student Registered Nurse Anesthetist, Alyson Cronan

Nurse Anesthesia Student Capstones

The clinical component of graduate nurse anesthesia programs continues to be the key factor in evaluating and ensuring student success. Clinical experience has a direct correlation on student development in areas of self-awareness, psychomotor proficiency, critical thinking and professionalism. To effectively create a positive and motivating learning environment for the student registered nurse anesthetist (SRNA), the literature recommends instructors theoretically adapt to the individual learning style of the student, and incorporate various teaching techniques and modalities clinically. The overall goal of the clinical rotation is to establish an atmosphere where an individual can modify learning and skills. Positive, respectful and …

A Systematic Analysis On Opioid-Free General Anesthesia Versus Opioid-Based General Anesthesia For Bariatric Surgery, Ina Basha

Nurse Anesthesia Student Capstones

One-third of the American adult population is considered overweight, a figure that is still on the rise. Obesity negatively impacts every organ system in the human body. When minimally invasive strategies such as life style changes fail, bariatric surgery procedures have become the other option. The purpose of this systemic analysis is to look at the outcomes of post-operative pain, post-operative nausea and vomiting (PONV), and the length of stay required in the postanesthesia care unit (PACU) in obese adults undergoing bariatric surgery using opioid-free general anesthesia compared to opioid-based general anesthesia. The studies included in this systematic analysis conclude …

Prophylactic Phenylephrine Infusion Versus Bolus Regimens During Spinal Anesthesia For Cesarean Section, Safira Iddriss

Nurse Anesthesia Student Capstones

Hypotension is a well-recognized phenomenon associated with any spinal anesthesia. It is most particularly evident in the parturients as a higher block is required for cesarean section (C-section) (Nagelhout, 2014). These populations are also more prone to the effect of sympathectomy because of decreased sensitivity to endogenous vasoconstrictors in addition to increased synthesis of endothelium vasodilators (Miller, 2009). Sympathectomy results in hypotension and other adverse effects such as nausea and vomiting. Many studies over the decades have examined the best management option for the hypotension. This review seeks to determine the best management regimen for the use of the vasopressor …

The Effects Of Pain On Informed Consent, Bryan Aja

Nurse Anesthesia Student Capstones

It is common for providers to withhold pain medication as opposed to treating pain prior to obtaining informed consent due to the concern of invalid informed consent. Pain’s influence on cognition can significantly impact the cognitive domains required to obtain valid informed consent. Determining if a patient has the capacity or competence to participate in the informed consent process has medical, ethical, and legal implications. The medical use of competence and capacity is not equivalent to the legal use of the same terminology. Legal implications concerning consent include signing consent while in duress or pain, signing under the influence of …

Utilizing Tranexamic Acid To Reduce Blood Transfusion In Hip Fractures, Katherine Balzano-Cowan, Morgan Guerrette

Nurse Anesthesia Student Capstones

Minimizing perioperative blood loss during orthopedic surgery has proven challenging for providers. Perioperative utilization of antifibrinolytic pharmacologic interventions, such as tranexamic acid (TXA), has been demonstrated as a safe and effective technique for decreasing blood loss and allogenic blood transfusion rates. Currently, the Food and Drug Administration (FDA) approved on-label indications of TXA are for use in short-term treatment of hemophilia patients undergoing dental extractions and in management of patients experiencing menorrhagia (Mayeux, Alwon, Collins, & Hewer, 2016). Despite the current limited scope of FDA approval for TXA, use in elective surgery with otherwise clotting-uncompromised patients is not a new …

2017 University Of New England College Of Osteopathic Medicine Fellowship Recipients, University Of New England College Of Osteopathic Medicine

Peter Morgane Research Fellowships

2017 recipients of the University of New England College of Osteopathic Medicine's Peter Morgane Research Fellowship.

Thank You, I'M Sorry, Paige Kube

Akesis

We go into medicine to help others, cure disease, end suffering. We want to be caretakers, but to do so, there has to be disease. Does that make us thankful for the processes that cause this pain and suffering because it gives us purpose, it allows us to fulfill our role as caretakers? Who would we be without it? How can we help, be of use, if nothing is wrong, if no one needs us?

Are we subconsciously endorsing disease? Are we thankful for it? We say we’re thankful when we end it, cure it, thwart it. But, to be …

A Letter From An Editor, Nihit N. Mehta

Akesis

A Letter from an editor.

Gratitude To Our Family And Friends, Nihit N. Mehta

Akesis

We in the College of Osteopathic Medicine welcome each one of our classes with a White Coat Ceremony. It has been my honor to take part in this event for the last two years, the first time receiving my white coat and the second time as a companion. This event in it’s entirety is as much a celebration of an individual student as it is of their friends and family members. We never truly appreciate the sacrifices our families make, a debt of their love that can never be repaid!

Our missed dates,

Promises wiped from life’s slates,

My dear …

Untitled, Samantha Stephen

Akesis

I am grateful for the forest; for all the adventures I had there, the chance to connect with my friends, and better understand myself.

Made with ink, paper, and adhesive note paper.