Medical Specialties Commons^™

Increasing Colorectal Cancer Screening Adherence: A Scoping Review, Megan E. Billingsley Bsn, Rn, Tiameria T. Ford Bsn, Rn, Mikayla E. Vican Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Rates have steadily increased in recent years due to high rates of obesity, smoking, and sedentary lifestyles. Screening for the disease can lead to early detection and reduced morbidity/mortality, yet screening rates remain low. Existing literature is extensive in discussing methods to increase CRCS adherence; therefore, a scoping review allows for increased understanding of barriers to CRCS and how to address those barriers to increase screening compliance.

Methods A literature search was completed from September 2020 to October 2021. Multiple databases were used, including …

Markers Of Kidney Function, Genetic Variation Related To Cognitive Function, And Cognitive Performance In The Uk Biobank, Erin L Richard, Linda K Mcevoy, Ian J Deary, Gail Davies, Steven Y Cao, Eyal Oren, John E Alcaraz, Andrea Z Lacroix, Jan Bressler, Rany M Salem

Faculty, Staff and Student Publications

BACKGROUND: Chronic kidney disease has been linked to worse cognition. However, this association may be dependent on the marker of kidney function used, and studies assessing modification by genetics are lacking. This study examined associations between multiple measures of kidney function and assessed effect modification by a polygenic score for general cognitive function.

METHODS: In this cross-sectional study of up to 341,208 European ancestry participants from the UK Biobank study, we examined associations between albuminuria and estimated glomerular filtration rate based on creatinine (eGFRcre) or cystatin C (eGFRcys) with cognitive performance on tests of verbal-numeric reasoning, reaction time and visual …

Met Inhibition Sensitizes Rhabdomyosarcoma Cells To Notch Signaling Suppression, Clara Perrone, Silvia Pomella, Matteo Cassandri, Michele Pezzella, Giuseppe Maria Milano, Marta Colletti, Cristina Cossetti, Giulia Pericoli, Angela Di Giannatale, Emmanuel De Billy, Maria Vinci, Stefania Petrini, Francesco Marampon, Concetta Quintarelli, Riccardo Taulli, Josep Roma, Soledad Gallego, Simona Camero, Paolo Mariottini, Manuela Cervelli, Roberta Maestro, Lucio Miele, Biagio De Angelis, Franco Locatelli, Rossella Rota

School of Medicine Faculty Publications

Rhabdomyosarcoma (RMS) is a pediatric myogenic soft tissue sarcoma. The Fusion-Positive (FP) subtype expresses the chimeric protein PAX3-FOXO1 (P3F) while the Fusion-Negative (FN) is devoid of any gene translocation. FP-RMS and metastatic FN-RMS are often unresponsive to conventional therapy. Therefore, novel therapeutic approaches are needed to halt tumor progression. NOTCH signaling has oncogenic functions in RMS and its pharmacologic inhibition through γ-secretase inhibitors blocks tumor growth in vitro and in vivo. Here, we show that NOTCH signaling blockade resulted in the up-regulation and phosphorylation of the MET oncogene in both RH30 (FP-RMS) and RD (FN-RMS) cell lines. Pharmacologic inhibition of …

Provider Perspective On Being Recorded During Emergency Medicine Discharge Conversations., Nickolas Meier, Andrew Little, Teresita Morales-Yurik, Brandon Arehart

Ambulatory and Primary Care Articles

OBJECTIVE:  Despite the possible benefits of provider-recorded visit summaries for patient use, the utilization of such recordings has yet to be adopted as standard care in most specialities. The objective of this study was to investigate the perspectives of emergency department (ED) providers regarding the utilization of audio or video recordings during ED patient encounters, particularly during discharge conversations.

METHODS:  This study utilized an eight-question survey pooling the opinions of various emergency medicine nurses, advanced practitioners, residents, and physicians within a local Ohio hospital system. Providers from multiple healthcare centers were studied. Study data were collected using an anonymous online …

Covid-19 Newsletter (Vol. 116), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Analyzing The Effect Of Interview Time And Day On Emergency Medicine Residency Interview Scores, Alanna O'Connell, Sean Greco, Tingting Zhan, Tracy Brader, Megan Crossman, Robin Naples, Anthony Sielicki, Megan Stobart Gallagher, Peter Tomaselli, Dimitrios Papanagnou

Department of Medicine Faculty Papers

Background: When it comes to scheduling interviews, medical students may wonder if they need a strategy to increase their likelihood of matching. Previous studies examined the temporal effects of the residency interview on overall match rate; however, there are additional factors that affect the match process, including board examination scores and letters of recommendation. Only few studies have examined the effect interview time of day has on match success. The current study examines the impact date and time of interview during the interview season have on candidates' respective interview scores.

Methods: Interview data over a three-year period (i.e., three interview …

Anti‐Cd20 Therapeutic Options In Immune‐Mediated Thrombotic Thrombocytopenic Purpura, Robert W. Maitta

Faculty Scholarship

Immunosuppression with rituximab in immune-mediated thrombotic thrombocytopenic purpura helps decrease production of autoantibody mediating ADAMTS13 clearance from circulation. Failure to respond to rituximab in a satisfactory way or made difficult by adverse events to the medication does not represent a reason to stop considering anti-CD20 therapies to control antibody production. Therefore, both of atumumab and obinutuzumab with specificity to CD20, represent potentially valuable therapeutic tools in patients who are not candidates for rituximab. Commentary on: Doyle et al. The use of obinutuzumab and ofatumumab in the treatment of immune thrombotic thrombocytopenic purpura. Br J Haematol. 2022;198:391-396.1.

Future Of Biomedical, Agricultural, And Biological Systems Research Using Domesticated Animals, Thomas E Spencer, Kevin D Wells, Kiho Lee, Bhanu P Telugu, Peter J Hansen, Frank F Bartol, Leann Blomberg, Lawrence B Schook, Harry Dawson, Joan K Lunney, John P Driver, Teresa A Davis, Sharon M Donovan, Ryan N Dilger, Linda J Saif, Adam Moeser, Jodi L Mcgill, George Smith, James J Ireland

Children’s Nutrition Research Center Staff Publications

Increased knowledge of reproduction and health of domesticated animals is integral to sustain and improve global competitiveness of U.S. animal agriculture, understand and resolve complex animal and human diseases, and advance fundamental research in sciences that are critical to understanding mechanisms of action and identifying future targets for interventions. Historically, federal and state budgets have dwindled and funding for the United States Department of Agriculture (USDA) National Institute of Food and Agriculture (NIFA) competitive grants programs remained relatively stagnant from 1985 through 2010. This shortage in critical financial support for basic and applied research, coupled with the underappreciated knowledge of …

Cyclophosphamide Induces Durable Molecular And Clinical Responses In Patients With Relapsed T-Lgl Leukemia., Zachary Braunstein, Eric Mclaughlin, Anjali Mishra, Jonathan E Brammer

Department of Medical Oncology Faculty Papers

No abstract provided.

Effect Of Lipid-Lowering Medications In Patients With Coronary Artery Bypass Grafting Surgery Outcomes, Chunxia Shi, Zugui Zhang, Jordan E Goldhammer, David Li, Bob Kiaii, Victor Rudriguez, Douglas Boyd, David Lubarsky, Richard Applegate, Hong Liu

Department of Anesthesiology Faculty Papers

Background: Increased life expectancy and improved medical technology allow increasing numbers of elderly patients to undergo cardiac surgery. Elderly patients may be at greater risk of postoperative morbidity and mortality. Complications can lead to worsened quality of life, shortened life expectancy and higher healthcare costs. Reducing perioperative complications, especially severe adverse events, is key to improving outcomes in patients undergoing cardiac surgery. The objective of this study is to determine whether perioperative lipid-lowering medication use is associated with a reduced risk of complications and mortality after coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).

Methods: After IRB approval, we …

Antiviral Activity Of Olanexidine-Containing Hand Rub Against Human Noroviruses, Khalil Ettayebi, Wilhelm Salmen, Kaoru Imai, Akifumi Hagi, Frederick H Neill, Robert L Atmar, B V Venkataram Prasad, Mary K Estes

Faculty, Staff and Students Publications

Human norovirus (HuNoV) is the leading cause of epidemic and sporadic acute gastroenteritis worldwide. HuNoV transmission occurs predominantly by direct person-to-person contact, and its health burden is associated with poor hand hygiene and a lack of effective antiseptics and disinfectants. Specific therapies and methods to prevent and control HuNoV spread previously were difficult to evaluate because of the lack of a cell culture system to propagate infectious virus. This barrier has been overcome with the successful cultivation of HuNoV in nontransformed human intestinal enteroids (HIEs). Here, we report using the HIE cultivation system to evaluate the virucidal efficacy of an …

Pain Management In Postoperative Pediatric Craniotomy Patients: A Scoping Review, Jessica M. Hiltenbrand Bsn, Rn, Sydney A. Scarbrough Bsn, Rn, Kaitlyn E. Shirley Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose/Background The pediatric craniotomy procedure is a complex and painful procedure that requires adequate pain management and frequent neurological assessments. Generally, evidence for pediatric pain management is severely lacking in research, and evidence for pediatric craniotomy patients is lacking even further. This scoping review aims to collect, condense, and review the current data in order to fuel future studies to establish more data, protocols, and evidence-based recommendations for analgesia in the pediatric craniotomy patient population.

Methods The studies selected were peer-reviewed, published in a medical or nursing journal, included study ages 0-21 years, or provided evidence on pediatric analgesia. Sources …

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

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

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.

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 …

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

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

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.

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 …

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

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.

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.

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.

Indispensable Role Of Immunophenotyping In Diagnosing Leukemic Phase Of Blastic Plasmacytoid Dendritic Cell Neoplasm Without Cutaneous Manifestation, Hareem Alam, Nabiha Saeed, Anila Rashid

Department of Pathology and Laboratory Medicine

Blastic plasmacytoid dendritic cell neoplasm usually presents as skin lesions. Diagnostic error occurs when it primarily presents in leukemic phase without skin involvement. Triad of CD4, CD56 and CD123 immunophenotype expression is essential to avoid misdiagnosis of this rare hematological malignancy. Here we describe a patient who presented in overt leukemic phase of BPDCN highlighting diagnostic challenges encountered that resulted in delayed diagnosis and poor outcome

Covid-19 Infection During Pregnancy Induces Differential Gene Expression In Human Cord Blood Cells From Term Neonates, Suhita Gayen Nee' Betal, Pedro Urday, Huda B. Al-Kouatly, Kolawole Solarin, Joanna Chan, Sankar Addya, Rupsa Boelig, Zubair H. Aghai

Department of Pediatrics Faculty Papers

Background: The COVID-19 pandemic continues worldwide with fluctuating case numbers in the United States. This pandemic has affected every segment of the population with more recent hospitalizations in the pediatric population. Vertical transmission of COVID-19 is uncommon, but reports show that there are thrombotic, vascular, and inflammatory changes in the placenta to which neonates are prenatally exposed. Individuals exposed in utero to influenza during the 1918 pandemic had increased risk for heart disease, kidney disease, diabetes, stomach disease and hypertension. Early exposure of COVID-19 during fetal life may lead to altered gene expression with potential long-term consequences.

Objective: To determine …

Nr4a Family Genes: A Review Of Comprehensive Prognostic And Gene Expression Profile Analysis In Breast Cancer, Hassan Yousefi, Jordyn Fong, Suresh K. Alahari

School of Medicine Faculty Publications

This report analyzes nuclear receptor (NR) subfamily 4A’s potential role in treating those diagnosed with breast cancer. Here we reviewed the current literature on NR4 family members. We also examined the relative gene expression of the NR4A receptor subfamily in the basal, HER2 (human epidermal growth factor receptor 2) positive, luminal A, and luminal B subtypes using data from tumor samples in The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). These data showed a positive link between NR4A1-NR4A3 expression and increased overall survival and relapse-free survival in breast cancer patients. In addition, we observed …

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

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

The Impact Of The Covid-19 Pandemic On Care Delivery And Quality Of Life In Lung Cancer Surgery, Dede K. Teteh, Jovani Barajas, Betty Ferrell, Ziaoke Zhou, Loretta Erhunmwunsee, Dan J. Raz, Jae Y. Kim, Virginia Sun

Health Sciences and Kinesiology Faculty Articles

Background

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic and associated restrictions have altered the delivery of surgical care. The purpose of this study was to explore the impact of COVID-19 on care delivery and quality of life (QOL) from the perspectives of lung cancer surgery patients, family caregivers (FCGs), and thoracic surgery teams.

Methods

Patients/FCGs enrolled in a randomized trial of a self-management intervention for lung cancer surgery preparation/recovery were invited to participate in this qualitative study. Patients/FCGs data were collected separately 1-month postdischarge. Interviews were also conducted with thoracic surgery team members. Content analysis approaches were …