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A Review of Trends and Contributing Factors in Tick-borne Disease Surveillance in Maine, 2001–2024
Get PDFImportance: Tick-borne diseases have a major health impact in Maine. There are 5 endemic diseases: anaplasmosis, babesiosis, hard tick relapsing fever, Lyme disease, and Powassan virus disease. Cases of these 5 diseases have increased dramatically over the past 15 years.
Objective: The objective of this review is to summarize tick-borne disease data in Maine. This summary includes showing trends and identifying factors that may be contributing to the trends.
Review: There is a long history of publications about tick-borne diseases in Maine, with articles first appearing in the 1980s. We analyzed tick-borne disease surveillance data collected by Maine Center for Disease Control and Prevention from 2001 to 2024.
Findings: Anaplasmosis, babesiosis, hard tick relapsing fever, Lyme disease, and Powassan virus disease are all being diagnosed more often in Maine. Increasing case counts led to historical highs for most of these conditions in 2024. Coastal counties are most affected. Providers report most cases during the summer months, but they identify cases year-round. Many factors can influence the trends, including climate, diagnostic capabilities, education, and surveillance approaches.
Conclusions: Providers should be aware of tick-borne diseases, consider them in differential diagnoses, and educate patients on how to protect themselves. Without effective measures to combat ticks or immunize humans, community members should be aware of the risks and take precautions to prevent tick bites
Test-Retest Agreement and Reliability of Psychosis and Mental Health Screens for Maine Adolescents and Young Adults in Primary Care
Get PDFPsychotic 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.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2025/1010/thumbnail.jp
Pediatric Asthma Subspecialty Referral Practices in Rural Maine
Get PDFOver 7.2 million children in the United States have asthma. \u3e300,000 asthma-related ED visits & hospitalizations yearly Both PCP’s and pediatric asthma subspecialists (allergist/immunologists and pediatric pulmonologists) provide long-term asthma carehttps://knowledgeconnection.mainehealth.org/lambrew-retreat-2025/1012/thumbnail.jp
Stopping Cavities in Their Tracks: SDF Application in Primary Care
No full textCME available for 1 year after presentation
CME Text Code: 97021
In order to claim CME credit, please complete an evaluation in CloudCME for each presentation.https://knowledgeconnection.mainehealth.org/pediatrics_gr/1076/thumbnail.jp
Safety and efficacy of pegtibatinase enzyme replacement therapy in adults with classical homocystinuria in the COMPOSE® phase 1/2 randomized trial
No full textPURPOSE: As classical homocystinuria (HCU) standard-of-care treatment often cannot achieve adequate metabolic control, the phase 1/2 COMPOSE® trial (NCT03406611) evaluated pegtibatinase enzyme replacement therapy. METHODS: Participants with HCU aged 12-65 years with elevated total plasma homocysteine (tHcy) receiving standard-of-care treatment were randomized 3:1 into six increasing dose cohorts (each n≈4) of subcutaneous pegtibatinase (≤2.5 mg/kg twice weekly [BIW]) or placebo. Primary end points included adverse event incidence and immunogenicity. Secondary end points included tHcy change from baseline to post-treatment (geometric mean of weeks 6-12). RESULTS: Overall, 24 participants were enrolled. Pegtibatinase was generally well tolerated at all doses with no anaphylaxis or severe immune reactions; 15 participants (62.5%) experienced ≥1 treatment-related treatment-emergent adverse event (most commonly injection-site reactions; one serious [acute urticaria]). At the two highest doses, substantial tHcy reductions were observed post-treatment (relative reduction: 57% for 1.5 mg/kg BIW; 67% for 2.5 mg/kg BIW) and all participants maintained tHcy \u3c 100 μM. One participant receiving 2.5 mg/kg BIW achieved tHcy \u3c 15 μM (normal) and methionine \u3c 14 μM (below normal), enabling increased dietary intact protein intake. Changes in other metabolites aligned with tHcy. CONCLUSION: Pegtibatinase was generally well tolerated and substantially reduced tHcy levels, demonstrating potential as a treatment for HCU
A Healthcare Ethics Curriculum for MaineHealth Clinical Ethics Committees
Get PDFHealthcare professionals who sit on ethics committees have widely varying experience and understanding of hospital ethics consultation resources. A curriculum for ethics committee members should provide a range of depth, breadth and flexibility to meet the needs of all ethics committee members.https://knowledgeconnection.mainehealth.org/mite/1003/thumbnail.jp
Intermediate Care Registered Nurse Curriculum and Learning Objective Development Using a Modified Delphi Method
Get PDFAdolescent Substance Use: Current Challenges, Treatment Options and the Role of Primary Care
No full textCME available for 1 year after presentation
CME Text Code: 97005
In order to claim CME credit, please complete an evaluation in CloudCME for each presentation.https://knowledgeconnection.mainehealth.org/pediatrics_gr/1063/thumbnail.jp
Guidance in Tracheostomy Care for Speech-Language Pathologists: The Green Light Tool
No full textPURPOSE: The purpose of this study was to investigate whether the implementation of the Green Light Tool for the evaluation and treatment of tracheostomy patients hospitalized at Maine Medical Center affects the time to initiating oral nutrition, use of speaking valves, and/or time to decannulation for temporary tracheostomies. METHOD: This pre-/post-intervention study uses retrospective chart review to collect data pre-intervention (e.g., Time 1) and at two time points post-intervention: 6 and 12 months after the Green Light Tool was implemented (e.g., Times 2 and 3, respectively). RESULTS: Data from 200 participants were included (Time 1: n = 100, Time 2: n = 50, Time 3: n = 50). Participants from each time period were similar along sex, age, and diagnosis. Participants in Time 1 had a statistically significant shorter length of stay compared to participants in Time 2 (adjusted [adj] p = .005) and Time 3 (adj p = .010). Following implementation of the Green Light Tool, speech-language pathologists (SLPs) received assessment consults sooner after a temporary tracheostomy was placed (adj p \u3c .001), and patients with tracheostomies were evaluated by SLPs earlier in their hospitalization (adj p = .006). There was no significant difference on patient-centered outcomes, such as time to speaking valve use, capping trials, decannulation, oral trials, diet initiation, modified barium swallow, or placement of a percutaneous endoscopic gastrostomy tube. CONCLUSIONS: Use of the Green Light Tool improved the timeliness and consistency with which SLPs evaluated patients and the self-reported comfort SLPs felt when assessing patients with tracheostomies. Possible reasons for a lack of effect on patient-centered outcomes, including the interference of COVID-19, are discussed
Predictive Value of Geriatric Nutritional Risk Index and Risk Analysis Index for Post-operative Outcomes in Spine Surgery Patients: A Comprehensive Analysis.
No full textStudy DesignRetrospective cohort study.ObjectivesFrailty and nutritional status are predictors of adverse spine surgery outcomes. This study evaluated the predictive utility of a combined Risk Analysis Index (RAI) and Geriatric Nutritional Risk Index (GNRI) model, and introduced a compound score integrating RAI, GNRI, American Society of Anesthesiologists (ASA) classification, and Preoperative Acute Severe Condition (PACS). To develop the CGARP score, we performed multivariable logistic regression with 30-day mortality as the dependent variable and GNRI, RAI, ASA, and PACS as independent variables.MethodsUsing the National Surgical Quality Improvement Program (NSQIP) database (2015-2020), we assessed predictive performance for mortality, morbidity, and length of stay in spine surgery patients. Demographics, comorbidities, and surgical risk factors were analyzed across RAI quartiles. Model performance was measured using area under receiver operating characteristic curve (AUROC).ResultsAmong 360 133 patients, increasing frailty and malnutrition were independently associated with worse postoperative outcomes. The RAI-GNRI model showed outcome-specific discrimination, C-statistics 0.619 (reoperation) to 0.882 (mortality). The CGARP compound model outperformed individual predictors across all outcomes, with AUROCs of 0.882 (mortality), 0.762 (non-home discharge), 0.686 (extended length of stay), 0.694 (any complication), and 0.641 (readmission). Internal bootstrapping confirmed model stability. Random Forest was the most predictive machine-learning algorithm (AUC = 0.9553). Threshold analysis using Youden\u27s J statistic identified 4 risk categories, correlating with stepwise increases in mortality, complications, and non-home discharge.DiscussionFrailty and nutritional risk are independently predictive of adverse spine surgery outcomes. The CGARP model demonstrated superior predictive performance and provides clinically actionable risk stratification