scholarly journals Costas T. Lambrew Research Retreat at Maine Medical Center - Abstracts from 2020

2020 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Medical Center ◽  
Maine Medical

Abstract 17309: Validation of a Novel Prediction Tool for Circulatory Etiology Death After Cardiac Arrest

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Karen Bascom ◽  
John Dziodzio ◽  
Samip Vasaiwala ◽  
Michael Mooney ◽  
Nainesh Patel ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medical Center ◽  
Cost Effective ◽  
Circulatory Support ◽  
Prediction Tool ◽  
Data Set ◽  
Derivation Cohort ◽  
Maine Medical ◽  
St Elevation ◽  
Simple Bedside

Introduction: Post-resuscitation cardiac arrest (CA) triage to urgent angiography, percutaneous intervention, and mechanical circulatory support is hampered by inconclusive risk stratification, especially among patients without ST elevation myocardial infarction (STEMI). We analyzed registry data to develop a prediction tool to determine the risk of circulatory-etiology (CV) death in patients without STEMI, and validated it in a separate cohort. Methods: Using the International Cardiac Arrest Registry (INTCAR)-Cardiology data set and stepwise linear regression with an inclusion rule of P≤0.1, we determined demographic and clinical factors independently associated with CV death, and created a weighted prediction model for patients presenting after CA without STEMI. The model was then validated in a separate, larger cohort from INTCAR. This project was approved by the Maine Medical Center IRB. Results: Of 468 patients in the derivation cohort, 90 met criteria for the endpoint. In the multivariable model, age greater than 65 (OR=2.4, p=0.0001), preexisting coronary disease (OR=1.9, P=0.0065), diabetes (OR=1.8, P=0.01), in-hospital arrest (OR=1.5, P=0.1), time from collapse to return of circulation (TTROSC) greater than 25 minutes (OR=1.7, p=0.02), shock at presentation (OR=3.9, P<0.0001), and EF<30% on first echo (OR=1.6, P=0.05) were independently associated with CV death. Using weighted predictors (age>65 =1, prior CAD =1, diabetes =1, in-hospital arrest =1, TTROSC>25 =1, admission LVEF<30% =1, shock =2,), an additive score of 0-2 predicted CV death in 8.5% and ≥3 in 34% in the derivation cohort. In the validation cohort, which comprised 1197 patients, of whom 263 met criteria for CV death, a score of 0-2 was associated with 13.1% and ≥3 with 35.1% CV death, respectively. Conclusions: A simple bedside prediction tool can predict high (34-35.1%) vs. low (8.5-13.1%) risk of circulatory-etiology death in cardiac arrest survivors without STEMI. This model could be used to risk-stratify cardiac arrest survivors, and aid in the triage of patients to appropriate and cost-effective post-resuscitation treatments.

The General Surgery Residency at Maine Medical Center

2010 ◽  
Vol 76 (11) ◽  
pp. 1185-1188
Author(s):  
Ajita S. Prabhu ◽  
Jonathan F. Dreifus ◽  
James F. Whiting
Keyword(s):  
General Surgery ◽  
Medical Center ◽  
Surgical Residency ◽  
Community Program ◽  
General Surgery Residency ◽  
Maine Medical ◽  
Operative Experience ◽  
University Affiliation

The surgical residency at Maine Medical Center is the only surgical residency in Maine. Established in 1947, it presently graduates four categorical residents/year. The residency is a classic example of a “hybrid” residency, retaining the benefits of a community program in terms of large operative experience in a wide variety of procedures, while at the same time allowing for academic exposure through a university affiliation.

Results of High Dose Chemotherapy and Autologous Stem Cell Transplantation in Patients with Acute Myeloid Leukemia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5438-5438
Author(s):  
Kenneth A. Ault ◽  
Delvyn Caedren Case ◽  
Marjorie A. Boyd ◽  
Thomas J. Ervin ◽  
Frederick Aronson ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Myeloid Leukemia ◽  
Medical Center ◽  
Myelogenous Leukemia ◽  
High Dose ◽  
Transplant Program ◽  
Maine Medical ◽  
Acute Myelogenous ◽  
Acute Myeloid

Abstract 43 patients with acute myeloid leukemia have undergone transplantation at our institution over the past 14 years. Patient selection criteria included age less than 70 years, creatinine less than 2mg/ml, no active infection, cardiac ejection fraction >40%, DLCO > 50% of predicted and no other co-morbid conditions that would jeopardize survival. 39 patients were in first remission, 4 were in second or higher remission. 3 patients had favorable cytogenetics, 40 had intermediate or unfavorable cytogenetics. After achieving remission for at least 30 days, patients were consolidated with Etoposide and AraC, followed by G-CSF. Hematopoietic stem cells were collected when the WBC rebounded to at least 10,000/μl. The target dose of CD34 positive cells was 5×106/kg. The minimum dose given was 2.3 × 106/kg). High dose therapy consisted of Busulfan 1mg/kg and Etoposide 60mg/kg. The average age at transplantation was 42 years (range 20 to 61). Days of neutropenia (AGC<500/μl) ranged from 2 to 10 (average 5.2). The median length of follow up is 4.0 years. Kaplan-Meier progression-free survival is 38% at 5 years and 35% at 10 years. Currently 26 patients are alive, and 23 are free from progression. Overall survival is 60%. Maine Medical Center Autologous HPC Transplant Program Acute Myelogenous Leukemia Maine Medical Center Autologous HPC Transplant Program Acute Myelogenous Leukemia

Decreasing Headache Pain Secondary to a Subarachnoid Hemorrhage with the use of Osteopathic Manipulative Medicine

2021 ◽  
Vol 31 (4) ◽  
pp. 34-38
Author(s):  
Precious L Barnes ◽  
Hillary Haas ◽  
Bryan Beck
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Adverse Events ◽  
Chart Review ◽  
Medical Center ◽  
Score Following ◽  
The Third ◽  
Pain Scores ◽  
Maine Medical ◽  
Osteopathic Treatment ◽  
Headache Pain

Abstract Background: Controlling a headache (HA) secondary to a subarachnoid hemorrhage (SAH) can be challenging for most physicians. At Maine Medical Center in Portland, Maine, the neurointensivist and staff noticed a trend in decreasing HA pain caused by a SAH in patients treated with osteopathic cranial manipulative medicine and osteopathic manipulative medicine (OMM), more so than those treated solely with the traditional opioid approach. It was requested that a chart review of these patients be evaluated for an objective analysis of this observation. Hypothesis: A decrease in HA caused by SAH will be observed in the group treated with OMM in comparison to those treated with opioids alone. Methods and Materials: A retrospective, IRB approved, and exempted study reviewed 21 subjects with a SAH that were treated with OMM. This population was analyzed for a decrease in pain score following osteopathic treatment as well as for adverse events 6-month post treatment. Results: Pain scores were consistently reduced when comparing pre-and-post OMM treatment. After the first treatment, pain scores decreased by an average of 4 points, after the second treatment scores decreased by an average of 3 points and after the third treatment pain scores decreased by an average of 2.5 points. The number of adverse events recorded were found to be less than the national averages. Conclusion: The use of OMM as an adjunct with traditional treatments for a SAH can lead to a decrease in HA pain caused by a SAH. Minimal adverse events were observed.

Vasopressin-Induced Hyponatremia in Patients With Aneurysmal Subarachnoid Hemorrhage: A Case Series and Literature Review

2021 ◽  
pp. 089719002110534
Author(s):  
Hilamber Subba ◽  
Richard R. Riker ◽  
Susan Dunn ◽  
David J. Gagnon
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Scale Score ◽  
Serum Sodium ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Medical Center ◽  
Case Series ◽  
Fixed Dose ◽  
Endovascular Coiling ◽  
Convenience Sample ◽  
Maine Medical

Objective Vasopressin may be administered to treat vasospasm following aneurysmal subarachnoid hemorrhage (aSAH). The objectives of this study were to describe five cases of suspected vasopressin-induced hyponatremia after aSAH and to review the literature. Design Single-center, observational case series of intensive care unit (ICU) patients Settings Ten-bed neurological ICU at Maine Medical Center in Portland, Maine Patients Convenience sample of patients with aSAH treated with a vasopressin for symptomatic, radiologically confirmed vasospasm Results A total of five patients were included in the case series with a median age of 57 (51, 65) years and all were women. The median Glasgow coma scale score was 15 (11, 15) on admission, and the Hunt and Hess scale score was 3, (3, 4). All patients were treated with endovascular coiling of their aneurysm. Vasopressin was administered to treat symptomatic, radiographically confirmed vasospasm on median post-bleed day (PBD) 10 (10, 15) at a fixed-dose of .03 units/min. Serum sodium at baseline was 140 (140, 144) mEq/L and decreased to 129 (126, 129) mEq/L within 26 (17, 83) hours of vasopressin initiation for a median change of −16 (−10, −16) mEq/L. Serum sodium returned to baseline within 18 (14, 22) hours of stopping the infusion. Conclusions Vasopressin use in vasospasm after aSAH may be associated with clinically significant hyponatremia within 24 hours of starting the infusion. Hyponatremia appears to resolve within 24 hours of stopping the infusion. Additional study in a larger sample size is needed to determine if a causal relationship exist.

Development of a Safe and Pragmatic Awake Craniotomy Program at Maine Medical Center

2011 ◽  
Vol 23 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Anand I. Rughani ◽  
Theodor Rintel ◽  
Rajiv Desai ◽  
Deborah A. Cushing ◽  
Jeffrey E. Florman
Keyword(s):  
Medical Center ◽  
Awake Craniotomy ◽  
Maine Medical

scholarly journals Candida Infective Endocarditis During the Infectious Diseases and Substance Use Disorder Syndemic: A Six-Year Case Series

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
N P Sankar ◽  
K Thakarar ◽  
Kristina E Rokas
Keyword(s):  
Substance Use ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Infectious Diseases ◽  
Substance Use Disorder ◽  
Medical Center ◽  
Case Series ◽  
Patient Characteristics ◽  
Treatment Regimens ◽  
Maine Medical

Abstract Treatment for Candida infective endocarditis (IE) has not been extensively studied in the setting of rising injection drug use. There were 12 cases of Candida IE at the Maine Medical Center between 2013 and 2018. The patient characteristics, treatment regimens, and outcomes were retrospectively analyzed.

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