6289 research outputs found
Sort by
April 24th, 2024: The Science of Inspiring Learning and Change
No full textZoom Passcode: @z63ok7Nhttps://knowledgeconnection.mainehealth.org/medicine_gr/1024/thumbnail.jp
February 15th, 2024: Preventative Medicine in Older Adults
No full textZoom Passcode: UqW5*m+Hhttps://knowledgeconnection.mainehealth.org/medicine_gr/1018/thumbnail.jp
Post-operative pain control in patients on buprenorphine or methadone for opioid use disorder.
No full textOBJECTIVE: This study aimed to determine whether there is a difference in pain scores and opioid consumption after elective surgery in patients maintained on methadone or buprenorphine for opioid use disorder (OUD). Additionally, we investigated the impact of continuing or discontinuing methadone or buprenorphine on post-operative pain outcomes.
DESIGN: A single-center retrospective cohort study.
SETTING: Tertiary care medical center.
PATIENTS AND PARTICIPANTS: Adults aged 18 years or older with OUD maintained on buprenorphine or methadone who underwent elective surgery between January 1, 2017, and January 1, 2021.
INTERVENTIONS: Patients were identified through electronic medical records, and demographic and clinical data were collected.
MAIN OUTCOME MEASURES: The primary outcome was opioid consumption at 24 hours post-operatively, measured in milligram morphine equivalents. The secondary outcome was opioid consumption and pain scores up to 72 hours post-operatively, assessed using a numeric rating scale.
RESULTS: This study included 366 patients (64 percent on buprenorphine and 36 percent on methadone). Opioid utilization significantly increased when buprenorphine was not administered post-operatively. Both groups exhibited comparable total opioid consumption during the post-operative period. In the buprenorphine cohort, pain scores differed significantly based on the receipt of medications for OUD post-operatively.
CONCLUSIONS: This study reinforces existing evidence supporting the continuation of medications for opioid use disorder, specifically buprenorphine and methadone, during the perioperative period. Dissemination of guideline recommendations is essential to ensure optimal post-operative pain management for this patient population
Racial Disparities in Sports Cardiology: A Review.
No full textIMPORTANCE: Racial disparities in cardiovascular health, including sudden cardiac death (SCD), exist among both the general and athlete populations. Among competitive athletes, disparities in health outcomes potentially influenced by social determinants of health (SDOH) and structural racism remain inadequately understood. This narrative review centers on race in sports cardiology, addressing racial disparities in SCD risk, false-positive cardiac screening rates among athletes, and the prevalence of left ventricular hypertrophy, and encourages a reexamination of race-based practices in sports cardiology, such as the interpretation of screening 12-lead electrocardiogram findings.
OBSERVATIONS: Drawing from an array of sources, including epidemiological data and broader medical literature, this narrative review discusses racial disparities in sports cardiology and calls for a paradigm shift in approach that encompasses 3 key principles: race-conscious awareness, clinical inclusivity, and research-driven refinement of clinical practice. These proposed principles call for a shift away from race-based assumptions towards individualized, health-focused care in sports cardiology. This shift would include fostering awareness of sociopolitical constructs, diversifying the medical team workforce, and conducting diverse, evidence-based research to better understand disparities and address inequities in sports cardiology care.
CONCLUSIONS AND RELEVANCE: In sports cardiology, inadequate consideration of the impact of structural racism and SDOH on racial disparities in health outcomes among athletes has resulted in potential biases in current normative standards and in the clinical approach to the cardiovascular care of athletes. An evidence-based approach to successfully address disparities requires pivoting from outdated race-based practices to a race-conscious framework to better understand and improve health care outcomes for diverse athletic populations
The Comparison Between Chlorhexidine and Povidone-Iodine Antiseptics in the Operating Room to Prevent Surgical Site Infections
Get PDFBackground: Surgical site infections (SSI\u27s) are one of the most common and costly complications from surgery. Chlorhexidine gluconate (CHG) and Povidione-Iodine (PVI) are the most common antiseptics used in surgery. The efficacy and uses of these surgical preps have been studied to determine the most effective in preventing surgical site infections.https://knowledgeconnection.mainehealth.org/nurseresidency/1016/thumbnail.jp
Improving and Standardizing Pediatric Asthma Care Across MaineHealth Using the Validated Hospital Asthma Severity Scoring (HASS) Tool
Get PDFObjective: To assess if an inter-professional educational intervention can improve the accuracy and inter-rater reliability of the HASS.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2024/1011/thumbnail.jp
Neuroendocrinology of bone
No full textThe past decade has witnessed significant advances in our understanding of skeletal homeostasis and the mechanisms that mediate the loss of bone in primary and secondary osteoporosis. Recent breakthroughs have primarily emerged from identifying disease-causing mutations and phenocopying human bone disease in rodents. Notably, using genetically-modified rodent models, disrupting the reciprocal relationship with tropic pituitary hormone and effector hormones, we have learned that pituitary hormones have independent roles in skeletal physiology, beyond their effects exerted through target endocrine glands. The rise of follicle-stimulating hormone (FSH) in the late perimenopause may account, at least in part, for the rapid bone loss when estrogen is normal, while low thyroid-stimulating hormone (TSH) levels may contribute to the bone loss in thyrotoxicosis. Admittedly speculative, suppressed levels of adrenocorticotropic hormone (ACTH) may directly exacerbate bone loss in the setting of glucocorticoid-induced osteoporosis. Furthermore, beyond their established roles in reproduction and lactation, oxytocin and prolactin may affect intergenerational calcium transfer and therefore fetal skeletal mineralization, whereas elevated vasopressin levels in chronic hyponatremic states may increase the risk of bone loss.. Here, we discuss the interaction of each pituitary hormone in relation to its role in bone physiology and pathophysiology
Reproducibility of Maine Ongoing Outreach Simulation Education (MOOSE) Program in Level I Rural Delivery Hospitals
Get PDFIntroduction
• Simulation provides an opportunity to practice neonatal resuscitation program (NRP®) guidelines with high acuity, low occurrence events
• Rural hospitals with low birth volumes have infrequent opportunities to maintain skills needed to adequately perform neonatal resuscitation
• With limited clinical opportunities, it is essential to provide ongoing training and education that allow teams to practice these skills
• Training environment includes a facilitated debrief allowing for feedback on performance and areas of improvementhttps://knowledgeconnection.mainehealth.org/lambrew-retreat-2024/1015/thumbnail.jp
