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Articles 31 - 60 of 220
Full-Text Articles in Medicine and Health Sciences
A Case Of Congenital Coronary Sinus Ostial Atresia With Persistent Left Superior Vena Cava, Laura Onderko, Thomas A. Miller, Sean Novak, Jeffrey Rosenblatt
A Case Of Congenital Coronary Sinus Ostial Atresia With Persistent Left Superior Vena Cava, Laura Onderko, Thomas A. Miller, Sean Novak, Jeffrey Rosenblatt
Journal of Maine Medical Center
Introduction: The coronary sinus is responsible for venous drainage of the heart. Congenital anomalies of the coronary sinus are rare and typically associated with other anomalies, such as atrial septal defects or other congenital heart malformations.
Clinical Findings: We present a case of incidentally found atresia of the coronary sinus ostium with associated persistent left superior vena cava. This case involved a 52-year-old patient who initially presented with a supraventricular tachycardia and elevated troponin.
Clinical Course: The patient underwent cardiac workup with a coronary computed tomographic angiography scan. This scan showed no obstructive coronary artery disease, but did show congenital …
Using Hierarchy Of Needs To Build Care Team Engagement, Cathy Palleschi, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Suneela Nayak, Natalia Johnson, Rebecca Brookes
Using Hierarchy Of Needs To Build Care Team Engagement, Cathy Palleschi, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Suneela Nayak, Natalia Johnson, Rebecca Brookes
Operational Transformation
Cardiology Intensive Care & Cardiovascular Interventional Care teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of caregiver physical and mental health wellbeing, as well as engagement in order to continue to provide outstanding care to patients. Leadership devised innovative ways to improve team engagement and ensure that care team members' needs are met.
How Help Provided The Pathway To Become Age-Friendly, Chesley Ferris, Anna Pleet, Emily Carter
How Help Provided The Pathway To Become Age-Friendly, Chesley Ferris, Anna Pleet, Emily Carter
Maine Medical Center
In assessing how the 4Ms framework applies to the Hospital Elder Life Program, we were able to target specific ways to deliver more Age-Friendly care to those enrolled in the program.
Being There: Engaging In Conversations About A Child’S Future When They Are Facing Serious Illness, Christine Bennett Md
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
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
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
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 …
Finding The Right Scope: Dermoscopy For Primary Care, Peggy Cyr, Elizabeth Seiverling
Finding The Right Scope: Dermoscopy For Primary Care, Peggy Cyr, Elizabeth Seiverling
Maine Medical Center
Background
• Primary care physicians (PCPs) frequently address skin concerns and perform clinical skin examinations1
• For PCPs, the use of dermoscopy has been shown to increase the sensitivity for skin cancer diagnosis compared to unassisted examinations2,3
• Prior to this study, no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy
Objectives
• To develop an expert opinion consensus statement on 2 proficiency standards for PCPs using dermoscopy
Impact Of Dermoscopy Training For Pcps On Nnb To Detect Melanoma, Madeline Prentiss, Kathryn Stevens, Henry Stoddard, Peggy Cyr, Laura Houk, Hadjh Ahrns, Elizabeth Seiverling
Impact Of Dermoscopy Training For Pcps On Nnb To Detect Melanoma, Madeline Prentiss, Kathryn Stevens, Henry Stoddard, Peggy Cyr, Laura Houk, Hadjh Ahrns, Elizabeth Seiverling
Maine Medical Center
The goal of this project was to analyze the impact of dermoscopy training on the number of melanocytic nevi needed to biopsy (NNB) to detect a melanoma in the primary care setting .
Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Hadjh Ahrns, Abby Markham, Elizabeth V Seiverling
Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Hadjh Ahrns, Abby Markham, Elizabeth V Seiverling
Maine Medical Center
Here we present an analysis of pediatric dermatology eConsults with emphasis on dermoscopy utilization and the impact on eConsult on infantile hemangiomas (IH) management.
Impact Of Social Media On Safe Sleep, Robin Wolschdorf, Jennifer Hayman, Logan Murray
Impact Of Social Media On Safe Sleep, Robin Wolschdorf, Jennifer Hayman, Logan Murray
Costas T. Lambrew Research Retreat 2022
About 3,500 babies under one year of age die from sleep related complications annually in the United States1. Pediatricians and other health care professionals have a responsibility to counsel families on safe sleep practices to prevent these complications. The American Academy of Pediatrics recommends discussing safe sleep before discharge from the hospital and every newborn visit in the outpatient setting2. This can be done with using the message of the “ABC’s” of safe sleep: Alone on their
Back in a
Crib or bassinette
Pre-Operative Anxiety Related To Major Urogynecologicsurgery, Nadi Nina Kaonga, Mary C Brandes, Caroline Foust-Wright
Pre-Operative Anxiety Related To Major Urogynecologicsurgery, Nadi Nina Kaonga, Mary C Brandes, Caroline Foust-Wright
Costas T. Lambrew Research Retreat 2022
Introduction •Higher levels of pre-operative anxiety are associated with adverse outcomes1-3(e.g., delayed recovery, higher post-op pain levels) •Most evidence arose from cardiothoracic and orthopedic literature (on emergent surgeries) and there is opportunity to further understand perioperative anxiety and elective/quality of life surgeries [within gynecology]4
Takotsubo’Scardiomyopathy: Clinical Characteristics And Outcomes In The Rural State Of Maine, Laura Onderko, Bhavini Prajapati, Wendy Craig, Roisin Morgan
Takotsubo’Scardiomyopathy: Clinical Characteristics And Outcomes In The Rural State Of Maine, Laura Onderko, Bhavini Prajapati, Wendy Craig, Roisin Morgan
Costas T. Lambrew Research Retreat 2022
Pre-existing psychiatric diagnosis linked to developing Takotsubo’sCardiomyopathy. Patients from rural areas less likely to be on psychiatric medications and had higher Takotsubo’srecurrence rate.
Assessment Of Obstetric Outcomes Graphs And Figures For New Mainers, Amy Haskins, Brendan Prast, Tina Holt
Assessment Of Obstetric Outcomes Graphs And Figures For New Mainers, Amy Haskins, Brendan Prast, Tina Holt
Costas T. Lambrew Research Retreat 2022
Introduction
• 4% of Maine’s population in 2018 was recent immigrants
• Maine Medical Center provides obstetrical care for more newly arrived, non- English speaking patients
• Increased risk for health disparities due to: language barriers, low socioeconomic status and stressors from a history of trauma.
Maine Medical Center Experience With Left Ventricular Device Explantation, Laura Onderko, Lauren Vickerson, Andrew Schwartzman
Maine Medical Center Experience With Left Ventricular Device Explantation, Laura Onderko, Lauren Vickerson, Andrew Schwartzman
Costas T. Lambrew Research Retreat 2022
Introduction •Left ventricular assist device (LVAD) is an implantable heart pump that helps support the heart in patients with end stage heart failure with reduced ejection fraction •LVAD therapy is now approved for use as a bridge to transplantation (BTT) and as a destination therapy (DT) in patients who are not candidates for heart transplantation. •The existing literature suggests that close to 10% of patients implanted with LVAD could be explanted for recovery, but the actual rate of explant is significantly lower •Need to examine the clinical course of explanted patients to provide better guidance for the decision to explant …
Perioperative And Postoperative Outcomes Of Morbidly Obese Patients Undergoing Primary Elective Total Hip Arthroplasty With A Muscle Sparing Approach, Brian J. Mcgrory, George Babikian, Adam Rana
Perioperative And Postoperative Outcomes Of Morbidly Obese Patients Undergoing Primary Elective Total Hip Arthroplasty With A Muscle Sparing Approach, Brian J. Mcgrory, George Babikian, Adam Rana
Costas T. Lambrew Research Retreat 2022
Obesity is associated with an increased risk of complications after total hip arthroplasty (THA), including infection and dislocation. •Due to the higher risk of osteoarthritis in obese individuals, understanding factors that can reduce the risk of complications is important. •This study examined the outcomes of morbidly obese (BMI ≥ 40) compared to healthy weight patients(BMI between 18.5-24.9 kg/m2)who underwent a THA with the ABLEapproach. •The ABLE approach: •This approach uses the interval between the anterior aspect of the gluteus mediusand the posterior aspect of the tensor fascia lata. •ABLE is minimally invasive, muscle sparing, and is associated with less painful …
Implementing Trauma-Informed Developmental Care In Nicu/Ccn: Findings From A Pre-Intervention Care Team Survey, Megan Flynn
Implementing Trauma-Informed Developmental Care In Nicu/Ccn: Findings From A Pre-Intervention Care Team Survey, Megan Flynn
Costas T. Lambrew Research Retreat 2022
Priorities Identified by Care Team in NICU/CCN Provide Path to Improving Patient Care
Improving Car-Bed Discharge Process And Follow Up, Haley Pelletier, Gina Trachimowicz
Improving Car-Bed Discharge Process And Follow Up, Haley Pelletier, Gina Trachimowicz
Costas T. Lambrew Research Retreat 2022
The car seat challenge test is most commonly performed on premature infants prior to discharge home from the hospital. Infants who fail the car seat test twice at MMC are discharged home in a carbed. The process of discharging an infant home in a car-bed and the subsequent re-testing prior to transitioning safely to a rear-facing car seat is neither widely understood or standardized among Maine Health providers.
Bilateral Total Hip Arthroplasty: Outcomes Of Staged Vs. Simultaneous Tha Performed Using The Anterior Based Muscle Sparing Approach, Brian J. Mcgrory, George Babikian, Adam Rana
Bilateral Total Hip Arthroplasty: Outcomes Of Staged Vs. Simultaneous Tha Performed Using The Anterior Based Muscle Sparing Approach, Brian J. Mcgrory, George Babikian, Adam Rana
Costas T. Lambrew Research Retreat 2022
•Total Hip Arthroplasty (THA) procedures are becoming increasingly common globally. •There is current debate surrounding the efficacy of simultaneous versus staged bilateral total hip arthroplasty, mainly with regards to patient outcomes and complications. •This study examines the perioperative and postoperative outcomes of simultaneous and staged bilateral THA procedures using the Anterior Based Muscle Sparing (ABMS) approach, also known as the ABLE Advanced Anterior Approach.
Us-Guided Regional Anesthesia (Ugra) In The Ed- A Qi Project, Joshua Rehberg
Us-Guided Regional Anesthesia (Ugra) In The Ed- A Qi Project, Joshua Rehberg
Costas T. Lambrew Research Retreat 2022
Introduction-
Between 01/2021-09/2021 there were 95 people diagnosed with hip fractures in the emergency department. •56% (n= 53) got a fascia iliacacompartment block. •9% of notes had a comment on reevaluation of effectiveness or re-evaluation post-block, only ~50% had a neurovascular exam commenting on both motor function and pulses, and 7% of all blocks (n= 4) had no procedure note. •Goal: The purpose of was to improve the quality of care given to patients receiving US-guided regional anesthesia, provide a way to track the number of ultrasound-guided regional blocks performed in the emergency department, and improve resident education and documentation
Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Laura Houk, Elizabeth Seiverling
Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Laura Houk, Elizabeth Seiverling
Costas T. Lambrew Research Retreat 2022
There are no pediatric dermatologists in Maine. Greater distance from a dermatologist is associated with delays in care and nonadherence to treatment. Timely care is especially crucial for patients with infantile hemangiomas (IH) due to a narrow “window of opportunity” for optimal treatment. A store and forward electronic consultation eConsult ) platform was implemented within our electronic medical record (Epic) to triage referrals from primary care providers ( PCPs). Here we present an analysis of the program outcomes in respect to pediatric eConsults with emphasis on treatment for IH.
The Shifting Role And Expectations Of Physical Therapy In The Pediatric Cystic Fibrosis Clinic During A Global Pandemic, Ana Cairns, Colby Wyatt, C Chaloner, J Takatsuki-Jordan, A Williams
The Shifting Role And Expectations Of Physical Therapy In The Pediatric Cystic Fibrosis Clinic During A Global Pandemic, Ana Cairns, Colby Wyatt, C Chaloner, J Takatsuki-Jordan, A Williams
Costas T. Lambrew Research Retreat 2022
In January 2020, a CFF supported quality improvement study to optimize physical therapy (PT) services in our pediatric CF clinic was underway. •An initial survey had been completed in 2019 to assess family satisfaction with the current provision of PT services. •In March 2020 the COVID-19 pandemic caused a major shift in clinical care in the midst of our project. •Care was changed to telehealth and “hybrid” clinic visits, thereby altering the context of our study, necessitating a change in the focus.
Demographic Factors Contributing To Nas Treatment, Meg Curran, Emma Freeman
Demographic Factors Contributing To Nas Treatment, Meg Curran, Emma Freeman
Costas T. Lambrew Research Retreat 2022
Infants that were formula fed, had unpartnered parents, birthing parents who used illicit substances, and multiple medication exposures were more likely to be treated for NAS
Cross-Sectional Survey Regarding Marijuana Use In Pregnancy, Kathleen S. Carlson
Cross-Sectional Survey Regarding Marijuana Use In Pregnancy, Kathleen S. Carlson
Costas T. Lambrew Research Retreat 2022
Introduction • There is a paucity of data regarding extent and patterns of marijuana use in pregnancy. • Nausea, sleep problems, anxiety are commonly reported reasons for use (Kaarid, 2021) • Marijuana use in pregnancy is associated with increased risk for neonates of preterm delivery, NICU admission, small for gestational age, and lower 1min APGAR scores (Marchand, 2022) • Knowledge of reasons and patterns of marijuana use is important to properly counsel patients, identify patients at risk for use during pregnancy and to offer alternative therapies that are safer during pregnancy.
Social Determinants Of Care In The Mmc Cardiology Fellow’S Clinic, Bhavini Prajapati, Laura Onderko, Darcy Chandler, Sanjeev Francis
Social Determinants Of Care In The Mmc Cardiology Fellow’S Clinic, Bhavini Prajapati, Laura Onderko, Darcy Chandler, Sanjeev Francis
Costas T. Lambrew Research Retreat 2022
Introduction • Social determinants of health are upstream risk factors for cardiovascular disease. • Patients seen in the Cardiology Fellow’s Clinic at MMC are a diverse group that are burdened by many socioeconomic issues. • Addressing these disparities has the potential to prevent the development of other comorbidities known to increase the risk of a cardiovascular event. • The aim of this project was to identify the prevalence of these factors in the cardiology fellow’s clinic
Sleep Patterns & Sleep Problems Vary By Age In Children With Autism, Charles F Reynolds, Matthew Siegel, Briana Taylor
Sleep Patterns & Sleep Problems Vary By Age In Children With Autism, Charles F Reynolds, Matthew Siegel, Briana Taylor
Costas T. Lambrew Research Retreat 2022
Adolescence is a time of increased vulnerability for youth with autism spectrum disorder (ASD).1 • In non-ASD youth, sleep and circadian rhythms demonstrate marked changes during adolescence that delay the biological propensity for sleep.2 • In combination with early school start times, these agerelated changes in sleep and circadian rhythms result in insufficient sleep duration, circadian misalignment, daytime sleepiness, and numerous behavioral and psychiatric problems.3 • Age-related changes in sleep and circadian rhythms, and their relevance for behavioral and psychiatric health have not been examined in youth with ASD.
“Cystectomy…What Bugs You?” Creation Of An Institutional Antibiogram, Erin Santos
“Cystectomy…What Bugs You?” Creation Of An Institutional Antibiogram, Erin Santos
Costas T. Lambrew Research Retreat 2022
BACKGROUND: Radical cystectomy is associated with high rates of post operative morbidity and mortality to improve readmission rates following radical cystectomy, a post cystectomy discharge pathway was created. We set out to create an institution specific antibiogram to identify and target most common causative organisms to specifically decrease genitourinary infection related complications.
Comparing Orthopedic Randomized Control Trials Published In High-Impact Medical And Orthopedic Journals, Andrew Lachance, Emily Dissler
Comparing Orthopedic Randomized Control Trials Published In High-Impact Medical And Orthopedic Journals, Andrew Lachance, Emily Dissler
Costas T. Lambrew Research Retreat 2022
PURPOSE To compare study characteristics, methodologic quality and outcome direction among operative randomized orthopedic trials published in high-impact medical and orthopedic journals and to identify study attributes associated with greater exposure and impact
Prostate Cancer Screening Behaviors Among U.S. Immigrants: A Cross-Sectional Analysis Using The Nhis Database, Joshua Linscott, Mathew Hayn, Jesse Sammon, Stephen Ryan
Prostate Cancer Screening Behaviors Among U.S. Immigrants: A Cross-Sectional Analysis Using The Nhis Database, Joshua Linscott, Mathew Hayn, Jesse Sammon, Stephen Ryan
Costas T. Lambrew Research Retreat 2022
Background • The health of immigrants is affected by barriers that challenge all underserved groups, but immigrant-specific factors such as language proficiency and access to physician services are unique and modifiable obstacles that can impede access to quality healthcare. • Immigrants are less likely than the U.S.-born populations to receive screening for breast, cervical, and colorectal cancers. • Patients with limited English proficiency (LEP) are more likely to be diagnosed with advanced stage cancer. • LEP patients with male genitourinary (GU) cancers are 2.58x more likely to be diagnosed at an advanced stage. • Research suggests physicians often do not …
Cardiotoxicity From Immune Checkpoint Inhibitors: Myocarditis, Laura Onderko, Elizabeth Bennett, Sanjeev Francis
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 …