Medicine and Health Sciences Commons^™

An Incidental Finding Of Inferior Vena Cava Thrombosis In A Patient Presenting With Gastroenteritis, Berk Celik, Ovidiu Niculescu

Conference Presentation Abstracts

Introduction Inferior vena cava (IVC) thrombosis is an under-recognized entity that is associated with significant morbidity and mortality. IVC thrombosis is prevalent (60% to 80%) among patients with congenital IVC anomalies. These anomalies occur in 0.5%–1% of the general population. Thrombosis of the IVC in the absence of congenital abnormalities is rare and is usually a result of a predisposing hypercoagulable state or IVC filter. Here, we present a case of an incidental finding of IVC thrombosis in a patient presenting with gastroenteritis. Case description A 57-year-old female with a past medical history of obstructive sleep apnea, and non-alcoholic steatohepatitis …

Recurrent Malignant Retroperitoneal Solitary Fibrous Tumour Leading To Obstructive Uropathy And Sepsis, A Case Report, Wesam Almasri, Imran Bitar, Aagamjit Singh, Yusra Zakria, Dilip Khanal

Conference Presentation Abstracts

Introduction Solitary Fibrous Tumours (SFT) are rare mesenchymal tumours. Although initially described pleural in origin, they can arise from virtually any site. SFTs of retroperitoneal origin are especially rare, with limited literature on their management. Here we present a unique case of an aggressive recurrent retroperitoneal SFT causing mass effect leading to obstructive uropathy. Brief case description A 47-year-old Hispanic man without past medical history presented to a neighboring hospital with months-long abdominal pain and urinary retention. CT showed a 14x12x12 cm pelvic mass that could not be separated from the prostate, together with right hydroureteronephrosis. He was discharged with …

Severe Digital Necrosis In The Context Of Raynaud's Phenomenon, Antiphospholipid Antibody Syndrome, And Vasculitis: A Diagnostic Dilemma, Silvana Iskandar, Karan Chhabra, Omar Jameel, Tucker Billups

Conference Presentation Abstracts

Abstract: A 73-year-old male with polyarticular gout, hypertension, and rheumatoid arthritis presented with non-healing necrotic wounds on the distal aspect of his upper extremity digits, most severely affecting the left index finger with eschar. His symptoms had been present for the past six weeks. He also had a history of Raynaud’s phenomenon, which preceded these symptoms. Examination revealed necrotic wounds on the nail beds of seven fingers bilaterally, with significant left index finger necrosis. Despite the severity of his condition, he remained hemodynamically stable throughout hospitalization. Laboratory studies showed positive cardiolipin IgM and beta-2 glycoprotein antibodies on two separate occasions, …

The Silent Progression Of Otomastoiditis: A Case Report On Skull Base Osteomyelitis And Cerebral Venous Thrombosis, Tabssum Chauhan, Ammara Aftab, Ahamed Abdulbagi, Wafa Ahmed, Rajiv John

Conference Presentation Abstracts

Introduction Otomastoiditis, a common ear infection, can progress to severe complications such as skull base osteomyelitis (SBO) and cerebral venous thrombosis (CVT), though these are rare. The incidence of CVT in the context of otomastoiditis is approximately 3 to 4 cases per million adults, but it remains life-threatening. Pre antibiotics, CVT secondary to otomastoiditis showed a near100% mortality rate. Today, early recognition and multidisciplinary management make these complications preventable. This case raises the importance of in-time diagnosis and management in averting severe outcomes such as neurological deficits and death. Case Report A 78-year-old female with uncontrolled insulin-dependent diabetes (HbA1c 10.3%) …

Streptococcus Pneumoniae Cervical Abscess In A Pcv-Immunized Female With Waldenstrom's Macroglobulinema: Exploring The Role Of Opsosonization Failure And Functional Hyposplenesim Beyond The Spectrum Of Malignant B-Cell Disorders, Tanya Amal, Paul Johnson, Ayesha Sharif, Usman Bin Hameed

Conference Presentation Abstracts

A 64-year-old female with recently diagnosed Waldenström's macroglobulinemia presented with pain and swelling in the neck. Three weeks prior, she had accidentally punctured her neck with her fingernail, leading to initial swelling. She visited the ER, but workup showed no acute infection. A contrast-enhanced CT scan revealed enlarged bilateral cervical lymph nodes. Over the next two weeks, the swelling became increasingly painful. On presentation, she had sharp, localized pain (10/10 intensity), tachycardia, and a 3x3 cm swelling on the right side of her neck, with redness, warmth, and tenderness. Laboratory results showed lymphocytic leukocytosis (WBC 31.5, lymphocyte 24.8%, neutrophil 6.1%). …

A Rare Case Of Horner Syndrome Secondary To Perineural Catheter Placement After Orif Of The Right Humeral Shaft, Joseph Dakki, Natalie Dakki, Sant Yadav, Justine Nasr

Conference Presentation Abstracts

Introduction: Horner Syndrome (HS) is a clinical syndrome characterized by the triad of unilateral ptosis, miosis, and anhidrosis. HS is caused by an interruption of the oculosympathetic nerve pathway, a three-neuron pathway. Common causes of Horner Syndrome include carotid dissection, stroke, trauma, tumors, cluster headaches, inflammation, and medical and surgical procedures. However, many cases of HS are also idiopathic. The standard workup of Horner Syndrome includes MRI of the brain, cervical spine, and upper thoracic spine and CT angiography of the circle of willis, aortic arch, and intracranial arteries. This case report will analyze an instance of Horner Syndrome that …

Assessing The State Of Nutrition Education In Michigan Medical Schools, Sarah Bdeir, James Meza, Kareem Tayeb

Conference Presentation Abstracts

Despite the National Academy of Science recommending a minimum of 25 hours of nutrition education, U.S. medical schools dedicate an average of only 19 hours, and 75% lack mandatory clinical nutrition classes¹. Alarmingly, only 14% of current healthcare providers feel confident discussing nutrition with patients, despite its critical role in disease prevention and management². To address this gap, we surveyed medical students at five of seven Michigan medical schools about their schools' approaches to culinary medicine, self-perceived competence, and recommendations for improving nutrition education curricula. The survey was given to key representatives at each medical school, who distributed the survey …

The Diagnostic Dilemma Of Multisystemic Vasculitides - A Case Report Of Granulomatosis With Polyangiitis, Muhammed Hussain, Tabssum Chauhan, Hafsa Hassan, Marian Jamil, Cecilia Big, Rajiv John

Conference Presentation Abstracts

Granulomatosis with Polyangiitis (GPA) is a small vessel vasculitis disorder that classically involves the upper and lower respiratory tract as well as the kidneys. However, its presentation is not limited to these organ systems as it can present with ocular, dermatological or cardiac involvement, thus creating a broad differential when evaluating patients. This case illustrates the diagnostic challenges with infectious and inflammatory etiologies in a patient with systemic symptoms, concerning imaging and travel to a TB-endemic region. A 57-year-old female with a pertinent history of recurrent sinusitis, left otitis media, and prior sinus surgeries was evaluated for suspicion of possible …

Septic Arthritis Caused By A Rare Yeast, Lodderomyces Elongisporus, Osman Muslehuddin, Daphne Pete, Husam Muslehuddin, Hafeezuddin Ahmed

Conference Presentation Abstracts

Introduction: We present a rare case of septic arthritis caused by Lodderomyces elongisporus, a yeast rarely implicated in human infections. This case highlights the diagnostic challenges and management strategies for fungal septic arthritis in an immunocompromised patient. Case Presentation: A 63-year-old African American woman with a complex medical history, including chronic heart failure (CHF), hypertension, end-stage renal disease (ESRD) on hemodialysis, severe protein-energy malnutrition on total parenteral nutrition, duodenal switch with malabsorption, deep vein thrombosis (DVT) on warfarin, and previous sepsis episodes, presented with worsening dyspnea. She was admitted in August 2024 for acute-on-chronic CHF exacerbation. During her admission, she …

Enhancing Hospital Throughput With The Power Of Reminders: Implementing A Discharge Before Noon Strategy At An Urban Teaching Hospital, Jessie Ventura

Doctoral Projects

The doctoral project deploys a "Discharge Before Noon" strategy at an urban teaching hospital to resolve discharge delays and improve patient throughput efficiency. Hospitals experiencing overcrowding must prioritize timely patient discharges to enhance clinical results and operational performance. The project adopted the PARIHS framework to steer implementation through its emphasis on evidence-based practices, contextual factors, and facilitation strategies. The research gathered discharge data and team coordination results before and after the intervention period. The findings revealed elevated discharge numbers before noon and substantial progress in interdisciplinary team collaboration. The initiative indicated an optimizing trend for discharge procedures, even though statistical …

Characterization Of Contributors To Pleural Fluid Viscosity, Yujai Lin, Megan Rushmeyer, Christopher G. Roy, Shannon Donovan, Rachel Cutting, Matthew Buttarazzi, Charlotte Crist, Ted Sears, J B. Zuckerman

Costas T. Lambrew Research Retreat 2025

Background: Pleural effusion is a common consequence of pulmonary disease and may result from a spectrum of conditions. This pilot study seeks to describe relationships between pleural fluid viscosity and fluid analytes commonly measured in clinical laboratories.

Pharmacist-Led Statin Initiation In Adults With Diabetes At An Adult Internal Medicine Clinic, Kevin Le, Michael Takach, Linh Gagnon, Dylan Atchley

Costas T. Lambrew Research Retreat 2025

Purpose: Implement and evaluate a pharmacist-led program addressing the current underutilization of statins among these high-risk patients with diabetes

Physical Activity Programming To Improve Qol In Pediatric Ibd Patients, George Russell, Anya K. Cutler, Anna Furr, Julia Fritz, Kevin Sztam, Birgitta Polson, Rebecca Edwards, Noah Hoffman

Costas T. Lambrew Research Retreat 2025

Discussion: This work contributes to limited literature supporting the positive impact of PA in a target population and provides novel guidelines to implement an accessible PA program proven to be effective and well-liked by patients & families. Findings support incorporation of PA into the holistic care of pediatric patients with IBD.

Mental Health Conditions Among Patients With A Disorder Of The Gut-Brain Interaction, Ambia Ahmed, Nicole Smith, Anya Cutler, Mariaelena Terzis, Laura J. Faherty, Julia Fritz

Costas T. Lambrew Research Retreat 2025

Two thirds of pediatric patients with disorders of the gut-brain interaction have mental health comorbidity.

Clinician Comfort, Attitudes, And Practices With Provision Of Harm Reduction Supplies To Patients Who Use Drugs, Amanda Cahn, Melissa Calica, Erin Mooz, Malia Haddock, Wendy Craig, Tania Strout, Kinna Thakarar

Costas T. Lambrew Research Retreat 2025

Over 100,000 individuals in the United States died from drug overdose in 2022, over 80,000 of which involved opioids. Overdose deaths from psychostimulants (cocaine, methamphetamine) have also been on the rise.

There has also been an increase in substance-related emergency department visits and hospitalizations. People who use drugs (PWUD) often have longer hospital stays, higher self-discharge, and readmission rates.

Laying The Groundwork: Implementing The 2021 Aap Well Appearing Febrile Infant Clinical Practice Guideline Across A Rural Health System, E Freeman, L Mallory, Lm Seften, T Palnitkar, A Cutler, J Gregory, M Jackson

Costas T. Lambrew Research Retreat 2025

The American Academy of Pediatrics (AAP) published their first-ever Clinical Practice Guideline (CPG) on the management of well-appearing febrile infants aged 8-60 days in 2021. A system specific CPG and order set for the management of well-appearing febrile infants has been published across MaineHealth (MH) to align with the AAP.

Factors Influencing No Show Rates In Adult Urology Patients, Bruce T. Ndebanje, Ethan Griffin, Evelyn James, Lily C. Wang

Costas T. Lambrew Research Retreat 2025

Our study highlights a strong association between insurance status and no-show rates. Patients with Medicaid or no insurance were significantly more likely to miss appointments (OR 3.25 and 5.99).

Test-Retest Agreement And Reliability Of Psychosis And Mental Health Screens For Maine Adolescents And Young Adults In Primary Care, Erika Mayer, Eb Bernier, Merelise Ametti, Julia Plumb, Adriana Lovric, Yaerin Wallenberger, Kristen Woodberry

Costas T. Lambrew Research Retreat 2025

Psychotic spectrum disorders are among the most severe mental health conditions. Although early intervention can lead to significantly improved outcomes, minimizing delays in the identification of psychotic spectrum symptoms (PSS) remains challenging.

Implementation And Evaluation Of A Resident Pediatric Complex Care Education Series, Calivin Schaffer, Danielle Doctor, Amy Buczkowski, Bonnie Lynne Boomsma, Logan Murray

Costas T. Lambrew Research Retreat 2025

Children with medical complexity have significant chronic health problems that affect multiple organ systems and result in functional limitations, high health care need or utilization, and often dependence on medical technology. Addressing their needs requires optimizing care within the medical home and medical neighborhood.

Evaluation Of Engagement And Collaboration Among Hospitals In The Maine Rural Maternity & Obstetrics Management Strategies (Rmoms) Network, Molly Volt, Lori Travis, Caroline Zimmerman, Erica Swan, Katherine Crothers, Anna Gilbert, Kate Allerding

Costas T. Lambrew Research Retreat 2025

Introduction

• Maine RMOMS Network: Grant awarded to Maine in 2022, 16 rural birthing hospitals & 5 state partners

• Network Goal: Improve access to maternity and obstetrics care for rural communities

• A qualitative Network Health Evaluation was conducted to diagnose strengths and areas of growth regarding engagement and collaboration

Community Health Workers: Putting "Community" In The Mainehealth Vision, Tim Cowan, Barbara Ginley, Leeanna Lavoie, Jennifer Maillet, Jemma Penberthy, Lori Travis

Costas T. Lambrew Research Retreat 2025

Community Health Workers (CHW) play an increasingly key role across the MaineHealth system. The integration of CHWs and growth of the workforce enhances care and improve patient engagement and outcomes. Utilizing data from FY24, modelling from the MH CHW Work Group as well as patient feedback, this poster illustrates the impact CHWs are having on the lives of patients, the care teams they support and the communities in which they live, work and play.

Rigid Sternal Fixation Alone Does Not Result In A Reduction In Postoperative Opiod Administration Following Cardiac Surgery, Jane Branch, Chinedu Okoli, Kyla Wigant, Jaime Rabb, Robert S. Kramer, Anne Hicks, Ansar Hassan

Costas T. Lambrew Research Retreat 2025

Background: Persistent postoperative pain, infection, and sternal dehiscence are devastating complications after cardiac surgery that affect patient quality of life and increase healthcare system burden. Chronic sternal pain lasting more than 1 year affects 25 to 33% of cardiac surgery patients, and wound complications such as infection and sternal nonunion represent significant peri-operative risk factors1,2. Wire cerclage (WC) is the most widely accepted sternal closure technique among cardiac surgeons because of its perceived lower rates of sternal dehiscence, wound infection, and cost.

A Quality Improvement Project To Reduce Variation In Pediatric Asthma Care Using The Hospital Asthma Severity Scoring (Hass) Tool, Sean Patterson, Leah-Marie Seften, Rachel Williams, Noah Diminick, Anne Coates, Laura Amar-Dolan

Costas T. Lambrew Research Retreat 2025

The aim of this project was to increase HASS score use to greater than 50%within one year and determine the impact of our interventions on the quality of asthma care and patient outcomes.

An Opt Out Tobacco Cessation Referral Process For A Cancer Care Network, Amy Litterini, David Spaulding, Tia Robbins, Brett Cropp, Lauren Couture

Costas T. Lambrew Research Retreat 2025

Opt out tobacco cessation referrals should be standard of care.

Pediatric Asthma Subspecialty Referral Practices In Rural Maine, Paras Patnaik, John Dipalazzo, James Bohnhoff

Costas T. Lambrew Research Retreat 2025

Over 7.2 million children in the United States have asthma.

• >300,000 asthma-related ED visits & hospitalizations yearly
• Both PCP’s and pediatric asthma subspecialists (allergist/immunologists and pediatric pulmonologists) provide long-term asthma care

Overcoming Specialty Care Connection Barriers: The Econsult Effect, Genevieve Whiting, Noah Hoffman, Anya K. Cutler, Leah M. Seften, Laura J. Faherty

Costas T. Lambrew Research Retreat 2025

Pediatric patients are 2.6x more likely to attend a new specialist visit after Specialist affirms referral need via eConsult.

Pilot Study Of Serial Telemedicine Assessments To Safely Exclude Neonates From Therapeutic Hypothermia Treatment, Alexa Craig, Anya K. Cutler

Costas T. Lambrew Research Retreat 2025

Two neonatal encephalopathy exams performed by telemedicine, with scores of less than 4, correctly excluded neonates from treatment with therapeutic hypothermia.

Physical Activity Programming To Improve Qol In Pediatric Ibd Patients, Anna Briley, George Russell, Anya K. Cutler, Anna Furr, Julia Fritz, Kevin Sztam, Birgitta Polson, Rebecca Edwards, Noah Hoffman

Costas T. Lambrew Research Retreat 2025

Discussion: This work contributes to limited literature supporting the positive impact of PA in a target population and provides novel guidelines to implement an accessible PA program proven to be effective and well-liked by patients & families. Findings support incorporation of PA into the holistic care of pediatric patients with IBD.

A Rare Presentation Of Necrotizing Fasciits: A Diagnostic Challenge Triggered By Isolated Persistent Atrial Fibrillation With Rapid Ventricular Response (Afib With Rvr), Rosalyn Bloch, Amira Al-Nabolsi, Jessica Kopicha, David Lang

Conference Presentation Abstracts

According to the most recent review on necrotizing fasciitis (NF), NF often presents with nonspecific findings such as pain, erythema, and swelling. Clinical features include pain out of proportion to physical examination, failure to respond to broadspectrum antibiotics, and the presence of cutaneous bullae on the skin. We report a rare case in which the diagnosis of NF was unexpected due to its atypical presentation and was ultimately prompted by further underlying exploration in the setting of diabetic ketoacidosis (DKA) and persistent Afib with RVR. Case Summary: A 61-year-old male with a history of type 2 diabetes mellitus presented with …

Lower Extremity Edema In A 27-Year-Old Female With Systemic Lupus Erythematosus Glomerulonephritis: Is It Renal-Related Or Does It Warrant Further Workup?, Christine Buchanan, Rosalyn Bloch

Conference Presentation Abstracts

Lupus myocarditis (LM) is a potentially fatal manifestation of systemic lupus erythematosus (SLE) occurring in 5-10% of SLE patientspatients with SLE (1). Lupus nephritis (LN) is a form of glomerulonephritis that constitutes one of the most severe organ manifestations of SLE (2). We present a unique case of a 27-year-old female with acute lower extremity edema secondary to LM with concomitant LN . This case report highlights LM as a rare manifestation of SLE and the importance of a thorough workup of acute bilateral lower extremity swelling in SLE patientspatients with SLE and glomerulonephritis. A 27-year-old female with a past …