Medicine and Health Sciences Commons^™

The Effects Of Untreated Reflux On The Incidence Of Feeding Difficulties In Neonates, Anne Grossbauer, Anya Costeloe, Prasad J. Thottam

Posters

• Gastroesophageal reflux (GERD) is the involuntary regurgitation of gastric contents into the esophagus and commonly occurs in infants.
• It is associated with various consequences related to feeding difficulty, such as feeding resistance, oral aversion, dysphagia, laryngomalacia, and failure to thrive.2
• There is a paucity in the literature regarding the incidence rate of feeding difficulties in latepreterm and full-term neonates in the neonatal intensive care unit (NICU).
• Many NICUs employ the use of anti-reflux medications, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2As), to treat GERD.3
• The use of these medications is debated and variable due to perceived …

Clinical Differences In Isolated Post-Capillary Pulmonary Hypertension And Combined Pre- And Postcapillary Pulmonary Hypertension, Emily Schneider, Bhavinkumar D. Dalal

Posters

PULMONARY HYPERTENSION (PH) = RESTING MEAN PULMONARY ARTERY PRESSURE (MPAP) > 20 MMHG.

The World Health Organization recognizes five groups of pulmonary hypertensions:

• • Estimated that > 50% of patients with left heart disease are also affected by pulmonary hypertension.1
• 1 in 4 Americans will develop heart failure in their lifetime.
• Gold standard for diagnosis of PH is a right heart catheterization (RHC).3
• Global burden of PH remains unknown as this illness is poorly surveilled and cases remain underestimated.4,5

Barriers To Mental Health Treatment Among Medical Students: Preclinical Vs. Clinical Years, Urvashi Singh, Agnes Wrobel

Posters

Our study aims to:

• Investigate medical students’ attitudes towards seeking assistance from mental health professionals.
• Compare the importance of various barriers that deter help-seeking in preclinical vs. clinical years of medical education.

Pulmonary Embolism In Pregnancy And Early Postpartum – Identifying Significant Variables To Improve Risk Stratification, Nida Haider, Bhavinkumar Dalal

Posters

• Pulmonary embolism (PE) resulting from deep vein thrombosis (DVT) is one of the leading causes of maternal deaths in developed countries1
• The causative Virchow triad (venous stasis, endothelial injury, and hypercoagulable state) is enhanced in pregnancy making pregnancy an independent risk factor1
• Due to significant overlap between normal physiological changes in pregnancy and clinical symptoms of PE, the threshold for CTPA, confirmatory imaging for PE with potentially harmful effects due to ionizing radiation, is low with increasing incidence of false positives2

Understanding Infectious Disease Consultation Role For Septic Patients In The Medical Intensive Care Unit, Marisa Stratelak, Cloe Nazeer, Bhavinkumar Dalal

Posters

• Sepsis is a medical emergency requiring immediate recognition and prompt treatment.
• 1 in every 3 hospitalized patients who die have sepsis1.
• The mortality rate for patients with severe sepsis in the intensive care unit (ICU) is 32.2%2.
• Early intervention with fluid resuscitation and intravenous antibiotics can reduce mortality rates by 7-9%3.
• Infectious disease (ID) consultation on antimicrobial therapy in the ICU is associated with reduced ICU mortality and ICU length of stay (LOS)4.
• Gaps in literature exist regarding frequency of ID consultation for septic patients in the ICU, including comparing outcomes of patients with and without ID consultation.
• It is …

Water-Soluble Contrast Challenge In The Management Of Pediatric Adhesive Small Bowel Obstruction: A Systematic Review, Max Fliegner, Daniel Finn, Spencer Wilhelm, Nathan Novotny, Anthony Stallion

Posters

Background: Adhesive small bowel obstruction (ASBO) is a serious complication of intra-abdominal surgery1 Water-soluble contrast (WSC) challenges have been used for medical management in the adult population2,3

Knowledge Gap: The therapeutic value of water-soluble contrast challenge in the pediatric population with ASBO is under-studied3,4

Research Question: Does administration of water-soluble contrast challenge reduce the need for surgery in pediatric patients with adhesive small bowel obstruction?

Patient Population Representation In Medical Education Textbooks: Gender Imbalance Of Diagnostic Images, Yasin Sahin, Abdul-Majid Khan, Nicolas Baker, Joshua Daniel, Jacob Keeley

Posters

Gender inequality: a longstanding issue that has been gaining overdue attention. Even within esteemed institutions such as medical schools, gender biases persist. Society trusts that those who attend medical school are given the knowledge needed to provide care and support during their most vulnerable moments as patients. While the education may be there, the “patients” may not be represented accurately. Future healthcare professionals must provide care for all patients, a diverse group encompassing all genders, ages, ethnicities, and backgrounds.

In 2019, the United States Census Bureau reported that the population was about 49% male and 51% female.¹ Therefore, medical students …

Quantitative And Comparative Analysis Of Dream Content In Parkinson’S Disease Patients Pre- And Postdeep Brain Stimulation, Sarvar Oreizi-Esfahani, Michael Staud

Posters

Parkinson’s Disease (PD) is a neurodegenerative disorder stemming from the loss of dopaminergic neurons in the substantia nigra, resulting in impaired neuronal activation which primarily affects the body’s motor function1. Common symptoms include tremor, rigidity, akinesia and loss of balance.

PD also exerts significant effects on sleep patterns. The Default Mode Network (DMN), a series of hubs in the brain with increased metabolic rate during rest, are implicated in the process of dreaming2. Differential activation of these regions may alter the content and quality of one’s dreams2. PD has been shown to impact the function of the DMN and as …

Use Of Early Enteral Nutrition In Mechanically Ventilated Covid-19 Patients, Vivian Chang, Ramin Homayouni, Virginia Uhley

Posters

Malnutrition in critically ill patients has been associated with a greater length of hospital stay, incidence of complications, and risk of death. Up to 37% of critically ill patients in the intensive care unit (ICU) are either moderately or severely malnourished1. Optimizing enteral nutrition delivery is key to maximizing the benefits of nutrition support for critically ill patients. At the onset of the COVID-19 pandemic in March 2020, the role of nutrition support for COVID-19 patients was poorly understood. In May 2020, the American Society of Parenteral and Enteral Nutrition (ASPEN) approved nutrition guidelines for COVID-19 patients that state that …

You’Re Testing My Patients: Clinicians’ Preferences For Structured Reporting And Measurement Data, Davit Melik, Adela Pouzar, Allan Brazier, Sayf Al-Katib

Posters

Radiological reports are a crucial part of patient care and management. Radiologists play a major role in patient care by interpreting imaging studies and making recommendations to referring physicians. 1,2,3 Although some physicians may prefer to initially interpret the imaging studies by themselves, radiologists’ reports have been shown to be significantly more accurate and detailed, which ultimately results in better patient care. 1,4,5,3 Thus it is important for radiology reports to be timely and as accurate as possible to improve overall patient care. The clarity of communication between radiologists and referring physicians in these reports remains an important factor in …

Incidence Of Symptomatic Upper Extremity Deep Vein Thrombosis In Respect To Subcutaneous Port Venous Access Site In Adults: A Retrospective Review, Catherine Bark, Alexsandra Biel, Corinne G. Bowditch, Paul Bove, Jimmi Mangla

Posters

Subcutaneous ports are an essential component of care in patients who require long-term central venous access and are commonly indicated for patients that require chemotherapy, infusions, intravenous (IV) antibiotics or frequent blood draws.1,2 The catheter of the subcutaneous port is commonly inserted through the subclavian vein and internal jugular vein via percutaneous insertion, or the external jugular vein and cephalic vein via surgical cutdown of the vein.

One of the most common port-related complications is venous thromboembolic (VTE) events with rates of symptomatic VTE as high as 13.6%.4,6–11 Patients with symptomatic upper extremity deep vein thrombosis (DVT) can present with …

Breast Irradiation Is Well Tolerated In Carriers Of A Pathogenic Atm Variant, Leah R. Rotenbakh, Andrew H. Zureick, Dana Zakalik, Thomas J. Quinn, Vincent P. Grzywacz, Peter Y. Chen, Joshua T. Dilworth

Posters

• The ataxia telangiectasia mutant (ATM) gene is implicated in DNA damage repair.
• A pathogenic germline variant of the ATM gene is present in approximately 1% of the population.
• ATM gene variant increases radiation sensitivity and elevates the life-time risk of developing breast cancer by two- to four-fold.
• Potential for increased radiosensitivity poses concern for the utilization of radiation therapy (RT) for oncologic treatment in patients with the ATM gene variant.
• Current data regarding RT tolerance are limited and conflicting in this patient population.
• Current guidelines for hereditary breast cancer management issued jointly by the American Society for Radiation Oncology, American …

A Novel Targeted-Sequencing Panel To Detect Lrp5 Gene Variants In Orphan Pediatric Retinal Diseases, Daeun Jeong, Kenneth P. Mitton, Kimberly A. Drenser

Posters

Orphan pediatric retinal diseases which encompass Familial exudative vitreoretinopathy (FEVR), Norrie Disease, and Retinoschisis are associated with mutations in genes involved in the Wnt signaling network, including FZD4, LRP5, TSPAN12, and NDP. See figure-1. FEVR is a retinal disease that lacks normal vascularization and angiogenesis to the peripheral retina. LRP5 variants account for 10-25% of cases of autosomal dominant FEVR. However, not all cases have been linked to these existing variants. Next generation sequencing was used to sequence 76 subjects for novel variants to expand the spectrum of LRP5 variants and better understand the mechanism of pathogenicity.

Association Between Primary Care And Emergency Department Utilization, Donna Kayal, Jacob Keeley, Ramin Homayouni

Posters

Emergency departments have been designed to provide rapid and accessible care for emergent and acute needs for a broad scope of illnesses and injuries.1-2 However, the emergency department (ED) has been facing an overwhelming increase in demand, leading to an increase in wait time and significant overcrowding, which decreases the effectiveness of the ED.1-4 A common explanation that has been noted over the years is utilization of ED services for non-emergent care, which professionals have often labeled as “inappropriate use.”2,5 Such encounters take away time from ED physicians and health care workers, compromising the care for true emergencies and leading …

Efficacy Of An Integrated Computer Assisted Learning (Cal) Module In Student Understanding Of Cardiovascular Embryology, Nicolaas Schimmel, Forrest Bohler, Varna Taranikanti

Posters

• Embryology is one of the most difficult topics for students to master1

Students’ perceptions of embryology are generally more negative:

• Not clinically important1

• More negative attitude than towards gross anatomy1

• Unhappy with current teaching methods and not confident learning it2

An integrated CAL module will allow a more linear model for learning congenital heart diseases, which may help improve students’ understanding of cardiovascular embryology.

• Compared to traditional, more segmental model where students learn embryology separately from clinical presentation, ECG interpretation, etc.
• CAL modules have proven effective for other organ systems3.

• We hypothesized that students would demonstrate …

Demographics And Pain: An Observational Study Of Men Attending An Urban Health Event, Steven A. Kessler, Michael D. Lutz

Posters

• Chronic pain has been estimated to be present in 11.4 to 24 percent of the population.
• Of the 369 measured diseases, the World Health Organization’s Global Burden of Disease Study has 3 conditions associated with chronic pain in the top.
• The economic burden associated with chronic pain is high, with one study suggesting higher annual costs than heart disease, cancer, and diabetes.
• Studies have shown that race and socioeconomic status are factors associated with higher prevalence of chronic pain.

• Higher in minority populations, and those of lower socioeconomic status.
• One study showed that after correcting for income, employment and adverse …

Nocturia In Men And Associated Comorbidities; A Southeast Michigan Study, Daniel Fortney, Alexander Geisenhoff, Bernadette Zwaans, Michael Lutz

Posters

• Nocturia, defined as waking up during the night to void, is a prevalent condition affecting a considerable proportion of the population.
• Many studies have demonstrated that nocturia is associated with poor quality of life and numerous adverse health outcomes 1,2,3,4.
• Patients with nocturia are estimated to have 60% greater hospitalization rates and 19% higher rates of outpatient visits, equating to an annual economic cost of $3,491 per patient 5.
• Although pre-existing studies have not consistently aligned on the association between nocturia and specific comorbidities, the overall agreement on the negative health outcomes and economic strain caused by untreated nocturia remains …

Dental Manifestations And Management Of A Pediatric Patient With Hypophosphatasia: Case Report And Literature Review, Dev Patel, Robin Onikul, Amy Burleson, Brenda S Bohaty, Jenna Sparks, Neena Patel

Posters

Hypophosphatasia is a rare autosomal recessive disorder affecting the ALPL gene, which is involved in mineralization of bones and teeth. Given the importance of mineralization on proper tooth development, patients with hypophosphatasia present with numerous dental manifestations and require careful, coordinated care to maintain function and esthetics. This case report details a 9-year-old patient presenting to Children’s Mercy Kansas City Dental Clinic with complex medical history including hypophosphatasia, hypophosphatemic rickets, and developmental delay. The case report will include the patient’s clinical and radiographic presentation and will detail the patient’s treatment history. The presentation will also review the relevant scientific literature …

Evaluating The Integration Of Traditional And Western Medicine In Rural Ghana: The Role Of Healers And The Government, Teresa Nicole Lemon

Poster Presentations

A question of pressing importance for the healthcare system in Ghana is the integration between biomedicine, which is unreachable for many rural citizens, and traditional medicine, which fills in the gaps in access for rural and non-rural citizens seeking care and is utilized by 70% of the population. The WHO promotes integrated health systems and created strategies to assist governments in their efforts.

The Ghanaian government did create policies to aid in integration, but their attempt to integrate was unsuccessful. This, along with other factors, has led some scholars to consider the government’s efforts as “tokenistic”; however, they do not …

Risky Business: Creating A Process To Review Accuracy Of American Society Of Anesthesia (Asa) Classification And To Improve Overall Quality Risk Adjustment Of Surgical Patients, Jane Kinney, Sonja Orff, Robyn Begin, Nicholas Flavin, Eira Hyrkas, Christopher Adams, Ian Neilson

Costas T. Lambrew Research Retreat 2024

Through interdisciplinary education and the creation of an audit process, we have observed a 30.6% reduction in the number of ASA assignment misclassifications.

Reproducibility Of Maine Ongoing Outreach Simulation Education (Moose) Program In Level I Rural Delivery Hospitals, Allison Zanno, Jeffrey Holmes, Micheline Chipman, Anya K. Cutler, Leah M. Seften, Mary Ottolini, Alexa Craig, Leah Mallory, Misty Melendi

Costas T. Lambrew Research Retreat 2024

Introduction

• Simulation provides an opportunity to practice neonatal resuscitation program (NRP®) guidelines with high acuity, low occurrence events

• Rural hospitals with low birth volumes have infrequent opportunities to maintain skills needed to adequately perform neonatal resuscitation

• With limited clinical opportunities, it is essential to provide ongoing training and education that allow teams to practice these skills

• Training environment includes a facilitated debrief allowing for feedback on performance and areas of improvement

Improving Adherence To The American Academy Of Pediatrics (Aap) Clinical Practice Guideline (Cpg) For The Evaluation And Management Of Well Appearing Febrile Infants At Maine Medical Center: A Quality Improvement Initiative, Gabriela Deoliveira Md, Meredith Jackson Md, Laura J. Faherty Md, Mph, Mshp, Sarah M. Gabrielson Mph, Bsn, Anya K. Cutler Ms

Costas T. Lambrew Research Retreat 2024

Educational interventions aid in adherence to MaineHealth febrile infant guidelines with a positive shift seen in the evaluation of infants 29-60 days of age.

Statewide Needs Assessment Of Neonatal Readiness At Delivery Hospitals In Maine, Allison Zanno, Jay Kerecman, Ann Boomer, Leah M. Seften, Anya K. Cutler, Alexa Craig, Misty Melendi

Costas T. Lambrew Research Retreat 2024

Background

• Neonatal mortality is higher in hospitals with low birth rates

• More than two-thirds of hospitals deliver less than one neonate per day in Maine

• Identification of neonatal preparedness is lacking and will assist in prioritization of education and outreach initiatives to delivery hospitals

• Our objective was to engage stakeholders to understand current neonatal readiness at delivery hospitals across the state and identify barriers to and helpful resources for improving neonatal care delivery

Effect Of Telemedicine Consults On Time To Initiation Of Therapeutic Hypothermia In A Rural State, Alexa Craig, Leah M. Seften, Anya K. Cutler

Costas T. Lambrew Research Retreat 2024

Background

• To receive therapeutic hypothermia (TH), neonates must be transferred within the first 6 hours of life to a center that offers TH treatment

• In rural states, timely identification of neonatal encephalopathy (NE) is challenging due to the large geographic distances

Variations Exist In Hospital And Patient-Reported Outcomes Following Total Hip Arthroplasty According To Biological Sex, Catherine Call, Andrew Lachance, Thomas Zink, Henry Stoddard, Callahan Sturgeon, George Babikian, Adam Rana, Brian J. Mcgrory

Costas T. Lambrew Research Retreat 2024

Introduction

• The effect of biological sex on the outcomes of THA remains unclear.

• Average combined data may mask sex-related variation and obscure clinically relevant differences in outcomes.

Increasing Equitable Access To Pediatric Specialty Care In Maine Through Implementation Of Econsults, David Ireland, Rachel Rockers, Sarah M. Gabrielson, Anya K. Cutler, Laura J. Faherty, Genevieve Whiting

Costas T. Lambrew Research Retreat 2024

Introduction

•Barriers to accessing pediatric specialty care exist for many and are not experienced equally by all.

•eConsults are an asynchronous provider-provider referral modality to obtain low-barrier specialist input in place of some face-to-face (F2F) visits.

•We evaluated sociodemographic factors associated with referral to and receipt of specialist input before and after eConsult implementation at MaineHealth to examine equity implications.

A Continuous Objective Shivering Monitor During Targeted Temperature Management After Cardiac Arrest, Richard R. Riker, Erica Schlichting, David Seder, Mary Weatherbee, David J Gagnon, Teresa May

Costas T. Lambrew Research Retreat 2024

Background:

• Shivering during targeted temperature management (TTM) after cardiac arrest is stressful and linked to cerebral metabolic crisis.

• Few publications report shivering incidence, timing, or severity during TTM, and shivering treatment recommendations conflict.

• To evaluate multimodal shivering assessments, we studied patients during TTM managed with surface cooling, moderate analgosedation, surface counterwarming, and intermittent neuromuscular blockade (NMB) and evaluated surface electromyographic (EMG) power in decibels using the Medtronic bispectral index (BIS) monitor.

Improving And Standardizing Pediatric Asthma Care Across Mainehealth Using The Validated Hospital Asthma Severity Scoring (Hass) Tool, Sean Patterson, Leah Marie Seften, Anya Cutler, Alexa Craig, Anne Coates, Noah Diminick

Costas T. Lambrew Research Retreat 2024

Objective: To assess if an inter-professional educational intervention can improve the accuracy and inter-rater reliability of the HASS.

Unlocking How To Escape Standard Education Platforms: A Prospective Controlled Trial Comparing Traditional Teaching Methods To The Use Of Escape Rooms For Nursing Education, Michael Defrancisco, Amanda Bennett, Victoria English, Meaghan Anderson

Costas T. Lambrew Research Retreat 2024

Introduction: During the pandemic, nurse educators identified gaps in engagement, attendance, and participation among nursing staff in professional development and continuing education. Nurses reported a gap in confidence in practice regarding nurse sensitive indicators: Catheter Associated Urinary Tract Infection (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), falls, and Hospital Acquired Pressure Injuries (HAPI).

Healthcare Enabled By Artificial Intelligence In Real-Time, Felistas Mazhude, Robert S. Kramer, Qingchu Jin, Paul Terwilliger, Alan Hicks, Tyler Kelting, Douglas Sawyer, Jaime Rabb

Costas T. Lambrew Research Retreat 2024

INTRODUCTION: The HEART (Healthcare Enabled by Artificial Intelligence in Real-Time) Project pioneers developing real-time machine learning (ML) predictive analytics to address the need to improve outcomes during recovery from open heart surgery. Our broad objective is to enhance patient outcomes by developing, validating and deploying predictive algorithms into the hands of clinical teams as an early warning and guidance system, allowing care teams an opportunity to be proactive.