Medicine and Health Sciences Commons^™

Being There: Engaging In Conversations About A Child’S Future When They Are Facing Serious Illness, Christine Bennett Md

Journal of Maine Medical Center

No abstract provided.

Increasing Naloxone Co-Prescribing Among At-Risk Individuals: Evaluation Of A Quality Improvement Project In A Large Health System, Sarah Hemphill Ba, Kristen Silvia Md, Marc D. Kimball Md

Journal of Maine Medical Center

Background: Naloxone availability and early administration is key in preventing death following opioid overdose. The CDC advises that naloxone should be made available to all at-risk individuals. In 2017, providers at Maine Medical Center noted that only 6% of at-risk patients had naloxone prescriptions

Methods: Included in this study were all patients of MaineHealth, a health system comprising 9 hospitals and 30 primary care practices, serving approximately 1.1 million patients. Between 2017 and 2020, we implemented several system-wide quality improvement interventions to increase rates of naloxone co-prescribing among at-risk individuals. Risk factors included prescribed opioids ≥50 morphine milligram equivalents, concurrent …

Urticarial Rash In A Patient With Alpha-Gal Syndrome Caused By Subcutaneous Heparin At Prophylactic Dosing: A Case Report, Russell G. Behmer, Randolph S. Thomas, Hani T. Jarawan

Journal of Maine Medical Center

Introduction: We report a patient with a history of red meat allergy, or alpha-gal syndrome, who had an urticarial rash after exposure to unfractionated heparin at a dose typically used for prophylaxis of deep venous thrombosis. Although anaphylactic reactions have been reported with systemic intravenous heparin, we believe this case is the first report of an immunoglobulin E–mediated reaction to subcutaneous heparin at prophylactic dosing.

Clinical Findings: An 85-year-old male had a 3-year history of red meat allergy and was intolerant of pork and beef. He developed an immunoglobulin E–mediated allergic reaction to subcutaneous heparin at a dose of 5000 …

Association Between Primary Care Provider Status And Preventive Health Care Among People Who Inject Drugs, E Katherine Nenninger, Katherine Sharp, Bianca Bustamente, Kim Murray, Kinna Thakarar

Journal of Maine Medical Center

Introduction: People who inject drugs (PWID) are at increased risk for preventable, communicable infections, such as hepatitis B. Preventive care, such as hepatitis B vaccination, is often delivered through primary care providers (PCPs). However, PWID may not have access to PCPs and, therefore, may receive preventive care through other sites. We aimed to characterize PCP and preventive care use among PWID in Maine.

Methods: This is a cross-sectional study of PWID hospitalized with infections associated with injection drug use in Maine from January 2019 to May 2020. Descriptive analyses were used to identify characteristics of participants, rates of screening, and …

Cardiotoxicity From Immune Checkpoint Inhibitors: Myocarditis, Laura Onderko, Elizabeth Bennett, Sanjeev Francis

Journal of Maine Medical Center

Importance: Immune checkpoint inhibitors (ICIs) are a class of immunotherapies that have significant clinical efficacy in treating many cancer types, but they are also associated with systemic effects, including myocarditis.

Objective: This review describes potential mechanisms underlying ICI-associated myocarditis; data on epidemiology, including possible risk factors; diagnostic criteria for ICI-associated myocarditis; and recommendations for managing ICI-associated myocarditis.

Review: This paper is a narrative literature review that summarizes existing literature to increase awareness of ICI-associated cardiotoxicities, including myocarditis.

Findings: Reported cardiovascular adverse events include myocarditis, cardiomyopathy, arrhythmias, pericarditis, vasculitis, atherosclerotic cardiovascular events, Takotsubo syndrome, and venous thromboembolism. Myocarditis is associated with …

A Descriptive Analysis Of Patient Demographics At A Sports Medicine Clinic During The Covid-19 Pandemic, William S. Douglas, Williams Dexter, Amy Haskins Phd, Christina Holt

Journal of Maine Medical Center

No abstract provided.

Telemedicine Consultation To Assess Neonatal Encephalopathy In Rural Community Hospitals And Tertiary Care Centers, Rachel Coffey, Misty Melendi, Anya K. Cutler, Alexa K. Craig

Journal of Maine Medical Center

Introduction: Teleconsultation is used in tertiary care hospitals to evaluate neonatal encephalopathy. Neonates born in community hospitals, however, often experience delayed evaluation due to transport to the tertiary care center. We studied teleconsultations in community hospitals to decrease this disparity.

Methods: Prospective observational study in 9 community hospitals and 1 neonatal intensive care unit. Inclusion criteria: gestational age greater than or equal to 35 weeks and one of the following: umbilical cord pH less than or equal to 7.2, 5-minute Apgar less than 7, prolonged respiratory support, perinatal event, or abnormal neurological exam. We performed synchronized, unscheduled telemedicine consults with …

Senior Academic Ranks In Us Anesthesiology Programs: Differences Between Women And Men And Examination Of Independent Factors For Success, Brenda Lee, Farhad Zahedi, Ina Zaimi, Roman Schumann

Journal of Maine Medical Center

Introduction: Gender equality among faculty is a challenge in academic medicine, including anesthesiology. We investigated the likelihood that several factors were associated with academic success in the United States (US), defined as having achieved a senior academic rank (SAR) in a US anesthesiology training program.

Methods: We collected data available on the Internet on 131 anesthesiology programs, including faculty academic rank, gender, number of faculty, graduate status from an American medical school, fellowship training status, number of residents, number of program fellowships, and geographic location. SAR was defined as either associate professor or professor. Data were analyzed with logistic regression. …