Medical Specialties Commons^™

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 …

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.

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.

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

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 …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

A Rare Case Of Esophageal Perforation: Esophageal Perforation Following Cervical Spine Hardware Removal, Amira Al-Nabolsi, Jessica Kopchia, Cameron Hubbard, Hussein Hamade, Mouhamed Shatila

Conference Presentation Abstracts

An esophageal perforation is an uncommonly encountered life-threatening emergency that can lead to leakage of gastric contents into surrounding esophageal tissue. It is most commonly due to iatrogenic injury, typically involving endoscopy, intubation, or esophageal surgery. We describe an unusual case of esophageal perforation secondary to the removal of infected cervical spine hardware. A 73-year-old male with cervical spine central stenosis with history of an anterior cervical spinal fusion of C5-C7 over 40 years ago presented to the emergency department at the request of his pulmonologist. A CT scan of the neck was obtained in the outpatient setting, as the …

Case Report - Complex Management Of Tricuspid And Pulmonic Valve Endocarditis In An Intravenous Drug User: A Case Report And Review Of Challenges And Outcomes, Luxhman Gunaseelan, Michael Kattula, Sam Alsabti, Ahmad El-Gammal, Khurram Arshad, James Richard Spears

Conference Presentation Abstracts

Background: Right-sided infective endocarditis (RSIE), commonly associated with intravenous drug use (IVDU), primarily affects the tricuspid valve (TV). With sustained bacteremia, the pulmonic valve may also become involved. Staphylococcus aureus remains the leading cause of tricuspid valve infective endocarditis (TVIE), diagnosed using Duke’s criteria, which integrate clinical findings, blood culture results, and echocardiographic evidence. The management of TVIE poses unique challenges, particularly in patients with IVDU, who often face barriers to surgical intervention despite severe complications like tricuspid regurgitation (TR), which normally carries a poor prognosis if left untreated. Case Presentation: We describe the case of a 39-year-old female with …

Development Of Parapneumonic Effusion In A Patient Using Kratom, Emma Glover, Morgan Kiryakoza, Nader Mina

Conference Presentation Abstracts

Introduction: “Kratom” refers to both Mitragyna speciosa, a tree native to Southeast Asia, and to its products, derived from the tree’s leaves, which are marked as an herbal supplement. Kratom is an herbal supplement with both opioid and stimulant-like effects. While there are no approved uses for kratom by the U.S. Food and Drug Administration, it is frequently used by individuals to manage withdrawal symptoms and cravings (especially related to opioid use), pain, fatigue, and mental health disorders. Furthermore, because kratom is unregulated, it can contain contaminants, including heavy metals and harmful bacteria. This case details the development of parapneumonic …

Silent To Stressed: Evaluation Of An Incidentaloma With Elevated Normetanephrine Levels, Julia Meireles, Berk Celik, Ajaz Banka

Conference Presentation Abstracts

Introduction/Background: The prevalence of adrenal incidentalomas varies between 1.4-7.3% rising with age due to an increase in imaging studies performed for other reasons. Additional workup is typically done to evaluate for presence of functional masses that over secrete hormones. Elevated catecholamines in the context of an adrenal mass should trigger clinical suspicion for pheochromocytoma, an adrenal medulla tumor. However, for isolated elevations in normetanephrines a broader differential should include paraganglioma as well as stress, certain foods, and medication side effects requiring a thorough history and clinical evaluation. We present a case of an adrenal mass with elevated normetanephrine levels in …

Hiding In The Midgut: A Case Of Small Bowel Diverticular Bleeding In An Elderly Female, Aagamjit Singh, Nishant Aggarwal, Faid Odish

Conference Presentation Abstracts

Introduction Diverticulosis in the colon is a common cause of lower gastrointestinal (GI) bleeding. Non-Meckel diverticula in the small bowel have been reported in the literature; however, they rarely cause significant bleeding. We present a case of an 88-year-old woman with a bleeding jejunal diverticulum that was diagnosed and treated with a push enteroscopy. Case Description An 88-year-old African-American female with a past medical history of colonic diverticulosis and atrial fibrillation on rivaroxaban presented with a 4-day history of melena. She reported having soft, black stools 2–3 times a day, associated with persistent epigastric discomfort and nausea. Her last dose …

Marathon Miles And Melena: Unmasking Acute Gastrointestinal Bleeding In An Endurance Athlete, Usman Bin Hameed, Mujtaba Moazzam, Nathanial Bartosek, Fady Banno, Naveen Reddy

Conference Presentation Abstracts

Gastrointestinal bleeding (GIB) is a recognized complication of endurance sports, particularly long-distance running. While most cases are mild and self-limited, studies indicate that up to 12% of ultramarathon participants experience occult bleeding. Severe or life-threatening GIB, such as ischemic colitis requiring surgery, has been reported but remains rare. Despite its potential significance, exercise-induced GIB remains poorly understood, with limited organized data on its prevalence and mechanisms. A 38-year-old male presented with a three-day history of melena following a recent marathon. Symptoms began with loose stools, progressing to tarry stools, accompanied by fatigue, exertional dyspnea, dizziness, and mild generalized abdominal discomfort. …

Real-World Clinical Burden Of Patients Presenting With Vaginitis Symptoms In The United States, Justin Chen, Jenny Tse, Liucheng Shi, Mindy M. Cheng, Rebecca Lillis, Aimee M. Near

School of Medicine Faculty Publications

Background: While vaginitis is a leading cause of primary care visits among women with a gynecologic-related diagnosis, there are limited contemporary data on the healthcare burden. This study describes the real-world healthcare resource utilization (HCRU) of patients presenting with vaginitis symptoms in the United States (US) at symptom presentation and over long-term follow-up. Methods: This retrospective study utilized IQVIA's Longitudinal Prescription (LRx) and Medical Claims (Dx) databases to capture patients presenting with vaginitis symptoms from January 1, 2018 to September 30, 2022. The date of the first diagnosis code for vaginitis or related symptoms was considered the first clinical presentation …

A Rare Case Of Lenalidomide Associated B Cell Lymphoblastic Leukemia, Yagnapriya Ammakola, Nitya Batra, Ashbita Pokharel, Ishmael Jaiyesimi

Conference Presentation Abstracts

Introduction Autologous stem cell transplantation followed by maintenance with Lenalidomide has improved the overall survival and progression free survival in patients with Multiple Myeloma. However, maintenance therapy with Lenalidomide can increase the risk of several hematological adverse events including secondary B cell lymphoblastic leukemia. We present a case of 61 year old female who was previously treated for multiple myeloma and on maintenance Lenalidomide developed B lymphoblastic leukemia/lymphoma. Case presentation A 61 year old female initially presented with left sided hip pain and lower back pain in 2018.Chest X ray revealed mass like opacity in the left upper lobe and …