Introduction: A patient with no prior diagnosis of diabetes presented with diabetic ketoacidosis (DKA) and severe insulin resistance after being treated with enfortumab vedotin (EV). EV-associated DKA is uncommon— described in only a few case reports—and has unknown pathophysiology. This case characterizes the unique features of DKA in this patient and an unusual amount of insulin resistance not typically seen in patients with diabetes. Clinical Findings: A 71-year-old male presented with fatigue, xerostomia, and increased thirst. He had a history of obesity, hypertension, and invasive, high-grade papillary urothelial carcinoma. His laboratory results were consistent with DKA. Clinical Course: The patient was admitted to the hospital and treated using a standardized protocol to correct the hyperosmolality, hypovolemia, metabolic acidosis, and hyperglycemia associated with DKA. After the DKA resolved, the patient needed substantial daily doses of insulin, up to 1000 units per day, for multiple days before being transitioned to an oral antihyperglycemic regimen. His workup included negative results for autoantibodies associated with type 1 diabetes and an elevated C-peptide level, suggesting preserved endogenous production of insulin with severe insulin resistance. Conclusions: EV has a clear role in treating urothelial carcinoma, showing improved survival in certain clinical contexts. Hyperglycemia is a common (14% of patients) side effect, with DKA being a rare and potentially fatal consequence. Patients with known risk factors, such as obesity or elevated hemoglobin A1c, should be closely monitored for hyperglycemia and DKA during EV treatment.
{"title":"New Onset, Refractory Hyperglycemia with Diabetic Ketoacidosis After Enfortumab Vedotin Treatment: A Case Report","authors":"Ross Heinrich, M. Caldwell","doi":"10.46804/2641-2225.1159","DOIUrl":"https://doi.org/10.46804/2641-2225.1159","url":null,"abstract":"Introduction: A patient with no prior diagnosis of diabetes presented with diabetic ketoacidosis (DKA) and severe insulin resistance after being treated with enfortumab vedotin (EV). EV-associated DKA is uncommon— described in only a few case reports—and has unknown pathophysiology. This case characterizes the unique features of DKA in this patient and an unusual amount of insulin resistance not typically seen in patients with diabetes. Clinical Findings: A 71-year-old male presented with fatigue, xerostomia, and increased thirst. He had a history of obesity, hypertension, and invasive, high-grade papillary urothelial carcinoma. His laboratory results were consistent with DKA. Clinical Course: The patient was admitted to the hospital and treated using a standardized protocol to correct the hyperosmolality, hypovolemia, metabolic acidosis, and hyperglycemia associated with DKA. After the DKA resolved, the patient needed substantial daily doses of insulin, up to 1000 units per day, for multiple days before being transitioned to an oral antihyperglycemic regimen. His workup included negative results for autoantibodies associated with type 1 diabetes and an elevated C-peptide level, suggesting preserved endogenous production of insulin with severe insulin resistance. Conclusions: EV has a clear role in treating urothelial carcinoma, showing improved survival in certain clinical contexts. Hyperglycemia is a common (14% of patients) side effect, with DKA being a rare and potentially fatal consequence. Patients with known risk factors, such as obesity or elevated hemoglobin A1c, should be closely monitored for hyperglycemia and DKA during EV treatment.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41795872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joseph Benert, Amy E. Haskins, C. Holt, Krystian Bigosinski
Introduction: Patients with concussion may benefit from care provided by professionals from multiple disciplines based on the constellation of symptoms being reported. This study analyzed referral patterns from primary care and sports medicine clinicians for pediatric patients with sports-related concussion in one health care system. Methods: A retrospective chart review identified referrals placed to physical therapy, occupational therapy, speech pathology, optometry, psychology, neuropsychology, audiology, neurology, ophthalmology, otolaryngology, psychiatry, and sports medicine for pediatric patients with sports-related concussion. These patients were evaluated at MaineHealth family medicine, internal medicine/pediatrics, pediatrics, and sports medicine clinics in southern Maine between February 2019 and June 2022. Results: We identified 375 patients with concussions. These patients were most often evaluated by pediatrics (199; 53.1%) and sports medicine (160; 42.7%), with fewer evaluated by family medicine (28; 7.5%), internal medicine/pediatrics (8 patients; 2.1%), or internal medicine (6; 1.6%). The most common referrals were to physical therapy (40; 10.7%), sports medicine (21; 5.6%), psychology (11; 2.9%), and neurology (9; 2.4%). Sports medicine placed a significantly higher number of referrals ( P < .0001) than non-sports medicine disciplines. Discussion: Compared to prior research, fewer referrals were placed in this cohort of patients with concussion. Possible explanations include a larger population of uncomplicated concussions, the more rural setting in which this study occurred, or a lack of awareness of resources for further concussion care. Conclusions:
{"title":"Referral Patterns for Pediatric Sports-Related Concussion in One New England Health Care System","authors":"Joseph Benert, Amy E. Haskins, C. Holt, Krystian Bigosinski","doi":"10.46804/2641-2225.1154","DOIUrl":"https://doi.org/10.46804/2641-2225.1154","url":null,"abstract":"Introduction: Patients with concussion may benefit from care provided by professionals from multiple disciplines based on the constellation of symptoms being reported. This study analyzed referral patterns from primary care and sports medicine clinicians for pediatric patients with sports-related concussion in one health care system. Methods: A retrospective chart review identified referrals placed to physical therapy, occupational therapy, speech pathology, optometry, psychology, neuropsychology, audiology, neurology, ophthalmology, otolaryngology, psychiatry, and sports medicine for pediatric patients with sports-related concussion. These patients were evaluated at MaineHealth family medicine, internal medicine/pediatrics, pediatrics, and sports medicine clinics in southern Maine between February 2019 and June 2022. Results: We identified 375 patients with concussions. These patients were most often evaluated by pediatrics (199; 53.1%) and sports medicine (160; 42.7%), with fewer evaluated by family medicine (28; 7.5%), internal medicine/pediatrics (8 patients; 2.1%), or internal medicine (6; 1.6%). The most common referrals were to physical therapy (40; 10.7%), sports medicine (21; 5.6%), psychology (11; 2.9%), and neurology (9; 2.4%). Sports medicine placed a significantly higher number of referrals ( P < .0001) than non-sports medicine disciplines. Discussion: Compared to prior research, fewer referrals were placed in this cohort of patients with concussion. Possible explanations include a larger population of uncomplicated concussions, the more rural setting in which this study occurred, or a lack of awareness of resources for further concussion care. Conclusions:","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":"412 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41283060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Brown, Rachel Kupferman, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Bette Gray, V. Hayes, Leah A. Mallory
Introduction: Gender and sexual minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients report poor health care experiences, partly because health care providers are not trained to meet their needs. Simulation can help learners practice competencies related to diversity, equity, and inclusion, but there are psychological safety considerations when recruiting standardized patients (SPs). Our objective was to incorporate the expertise of members of the LGBTQ+ community in our SP pool as we developed related curriculum. Methods: All SPs were invited to participate in a focus group if they identified as LGBTQ+ and wanted to contribute. Content experts developed a focus group guide and facilitated the meeting. Additional members of the research team took de-identified notes. After notes were reviewed for agreement, a thematic analysis was performed. An anonymous survey was sent to SP participants after the focus group meeting. Results: Six SPs verbally participated in a 90-minute focus group, and 4 completed an anonymous follow-up survey. SPs acknowledged psychological safety risks but universally supported the developing curriculum. Most were willing to assume personal risk for the greater good. They emphasized the importance of lived experience to authentic portrayal, but they were open to eventual broader casting with coaching and proposed SP peer support and learner preparation as possible protective measures. Discussion: SPs appreciated the recognition of content expertise and opportunity to influence curricular design. They shared concerns about LGBTQ+ SP self-portrayal in simulation and offered creative suggestions to promote psychological safety. Conclusion: SPs with lived experience can share nuanced feedback and be a resource to co-create curriculum related to diversity, equity, and inclusion.
{"title":"Optimizing Psychological Safety: Using a Focus Group to Acquire Perspectives from Standardized Patients Who Identify as LGBTQ+","authors":"B. Brown, Rachel Kupferman, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Bette Gray, V. Hayes, Leah A. Mallory","doi":"10.46804/2641-2225.1158","DOIUrl":"https://doi.org/10.46804/2641-2225.1158","url":null,"abstract":"Introduction: Gender and sexual minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients report poor health care experiences, partly because health care providers are not trained to meet their needs. Simulation can help learners practice competencies related to diversity, equity, and inclusion, but there are psychological safety considerations when recruiting standardized patients (SPs). Our objective was to incorporate the expertise of members of the LGBTQ+ community in our SP pool as we developed related curriculum. Methods: All SPs were invited to participate in a focus group if they identified as LGBTQ+ and wanted to contribute. Content experts developed a focus group guide and facilitated the meeting. Additional members of the research team took de-identified notes. After notes were reviewed for agreement, a thematic analysis was performed. An anonymous survey was sent to SP participants after the focus group meeting. Results: Six SPs verbally participated in a 90-minute focus group, and 4 completed an anonymous follow-up survey. SPs acknowledged psychological safety risks but universally supported the developing curriculum. Most were willing to assume personal risk for the greater good. They emphasized the importance of lived experience to authentic portrayal, but they were open to eventual broader casting with coaching and proposed SP peer support and learner preparation as possible protective measures. Discussion: SPs appreciated the recognition of content expertise and opportunity to influence curricular design. They shared concerns about LGBTQ+ SP self-portrayal in simulation and offered creative suggestions to promote psychological safety. Conclusion: SPs with lived experience can share nuanced feedback and be a resource to co-create curriculum related to diversity, equity, and inclusion.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45629995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Kupferman, Bette Gray, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, V. Hayes, Leah B. Mallory, B. Brown
Sexual and gender minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients experience health care inequities. Simulation using standardized patients (SPs) is an effective tool for communication-based training. To promote equitable practice, we created an experiential learning opportunity for residents to practice inclusive communication and improve their comfort in caring for LGBTQ+ patients while maintaining the psychological safety of SPs. Methods: Our interdisciplinary team explored relevant simulation curricula, conducted a focus group with LGBTQ+ SPs, created a didactic presentation, and designed and implemented a simulated case. Family medicine residents participated in the training and completed pre-and post-training surveys rating their confidence in sexual health communication and working with sexual and gender minority patients. We compared Likert scale ratings in pre-and post-training surveys using a Wilcoxon signed-rank test. SPs completed post-simulation surveys rating their psychological safety. Results: Residents completed pre-training (n = 13) and post-training (n = 12) surveys. Confidence improved in every category, reaching significance for confidence in obtaining a sexual health history from LGBTQ+ patients. Four SPs completed post-simulation surveys. All SPs reported that the event had educational value and was a positive experience.
{"title":"Improving Inclusive Communication: Pilot Results from a Simulation-Based Learning Opportunity to Practice Taking a Sexual Health History","authors":"Rachel Kupferman, Bette Gray, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, V. Hayes, Leah B. Mallory, B. Brown","doi":"10.46804/2641-2225.1157","DOIUrl":"https://doi.org/10.46804/2641-2225.1157","url":null,"abstract":"Sexual and gender minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients experience health care inequities. Simulation using standardized patients (SPs) is an effective tool for communication-based training. To promote equitable practice, we created an experiential learning opportunity for residents to practice inclusive communication and improve their comfort in caring for LGBTQ+ patients while maintaining the psychological safety of SPs. Methods: Our interdisciplinary team explored relevant simulation curricula, conducted a focus group with LGBTQ+ SPs, created a didactic presentation, and designed and implemented a simulated case. Family medicine residents participated in the training and completed pre-and post-training surveys rating their confidence in sexual health communication and working with sexual and gender minority patients. We compared Likert scale ratings in pre-and post-training surveys using a Wilcoxon signed-rank test. SPs completed post-simulation surveys rating their psychological safety. Results: Residents completed pre-training (n = 13) and post-training (n = 12) surveys. Confidence improved in every category, reaching significance for confidence in obtaining a sexual health history from LGBTQ+ patients. Four SPs completed post-simulation surveys. All SPs reported that the event had educational value and was a positive experience.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46093140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Integration of viral hepatitis/HIV care and substance use disorder (SUD) treatment has been shown to improve patient outcomes, but data are lacking in rural states like Maine. Our study objective was to assess the baseline characteristics and outcomes of patients with SUD who receive combined substance use and viral hepatitis/HIV treatment at a recently established “Bridge Program” in our rural state. Methods: We conducted a retrospective chart review of patients enrolled in the Bridge Program between January 2020 and November 2021. We then performed a descriptive analysis of demographics, health characteristics, preventive services, and treatment outcomes. Results: A total of 14 patients were enrolled in the Bridge Program, of which 13/14 (93%) had hepatitis C, and 3/14 (21%) had HIV. When indicated, 100% of participants received appropriate medication for addiction treatment (buprenorphine/naloxone or naltrexone), naloxone kits, and hepatitis A and B vaccinations. Among patients with hepatitis C, 12/13 (92%) started antiviral treatment, of which 10/12 (83%) either achieved treatment cure or are receiving ongoing treatment. Discussion: Integrated care models can successfully treat SUD and HIV/viral hepatitis as co-occurring medical conditions. These models must consider approaches to reduce the number of visits and travel time required for optimal treatment, and enhance recovery by consistently prescribing evidence-based medication for SUD. Conclusions: Our study shows how an integrated clinic model in a rural state can provide comprehensive care, including SUD treatment, naloxone prescribing, vaccinations, and, importantly, high rates of successful hepatitis C/HIV treatment.
{"title":"Under One Roof – An Integrated Clinic for Substance Use Disorder and Viral Hepatitis/HIV Treatment","authors":"Sarah Hipkens, E. Caron, W. Craig, K. Thakarar","doi":"10.46804/2641-2225.1140","DOIUrl":"https://doi.org/10.46804/2641-2225.1140","url":null,"abstract":"Introduction: Integration of viral hepatitis/HIV care and substance use disorder (SUD) treatment has been shown to improve patient outcomes, but data are lacking in rural states like Maine. Our study objective was to assess the baseline characteristics and outcomes of patients with SUD who receive combined substance use and viral hepatitis/HIV treatment at a recently established “Bridge Program” in our rural state. Methods: We conducted a retrospective chart review of patients enrolled in the Bridge Program between January 2020 and November 2021. We then performed a descriptive analysis of demographics, health characteristics, preventive services, and treatment outcomes. Results: A total of 14 patients were enrolled in the Bridge Program, of which 13/14 (93%) had hepatitis C, and 3/14 (21%) had HIV. When indicated, 100% of participants received appropriate medication for addiction treatment (buprenorphine/naloxone or naltrexone), naloxone kits, and hepatitis A and B vaccinations. Among patients with hepatitis C, 12/13 (92%) started antiviral treatment, of which 10/12 (83%) either achieved treatment cure or are receiving ongoing treatment. Discussion: Integrated care models can successfully treat SUD and HIV/viral hepatitis as co-occurring medical conditions. These models must consider approaches to reduce the number of visits and travel time required for optimal treatment, and enhance recovery by consistently prescribing evidence-based medication for SUD. Conclusions: Our study shows how an integrated clinic model in a rural state can provide comprehensive care, including SUD treatment, naloxone prescribing, vaccinations, and, importantly, high rates of successful hepatitis C/HIV treatment.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44881102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma Cronk, Adriana Isacke, Amy E. Haskins, C. Holt, Krystian Bigosinski
Recommended Citation Cronk, Emma; Isacke, Adriana; Haskins, Amy; Holt, Christina; and Bigosinski, Krystian (2023) "How Are Our Athletes Doing? A Cross-Sectional Analysis of Student-Athlete Mental Health in Fall 2022 at a Maine Division III University," Journal of Maine Medical Center: Vol. 5 : Iss. 2 , Article 7. Available at: https://knowledgeconnection.mainehealth.org/jmmc/vol5/iss2/7 https://doi.org/10.46804/ 2641-2225.1155
{"title":"How Are Our Athletes Doing? A Cross-Sectional Analysis of Student-Athlete Mental Health in Fall 2022 at a Maine Division III University","authors":"Emma Cronk, Adriana Isacke, Amy E. Haskins, C. Holt, Krystian Bigosinski","doi":"10.46804/2641-2225.1155","DOIUrl":"https://doi.org/10.46804/2641-2225.1155","url":null,"abstract":"Recommended Citation Cronk, Emma; Isacke, Adriana; Haskins, Amy; Holt, Christina; and Bigosinski, Krystian (2023) \"How Are Our Athletes Doing? A Cross-Sectional Analysis of Student-Athlete Mental Health in Fall 2022 at a Maine Division III University,\" Journal of Maine Medical Center: Vol. 5 : Iss. 2 , Article 7. Available at: https://knowledgeconnection.mainehealth.org/jmmc/vol5/iss2/7 https://doi.org/10.46804/ 2641-2225.1155","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47505821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Artificial Intelligence (AI): Promise or peril for the publishing world?","authors":"R. Bing-You","doi":"10.46804/2641-2225.1166","DOIUrl":"https://doi.org/10.46804/2641-2225.1166","url":null,"abstract":"","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49553452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving PubMed for the Novice at the Expense of the Expert: Surveying Librarians 3 Years Post-New PubMed","authors":"Tim Kenny, Heather Kemp","doi":"10.46804/2641-2225.1163","DOIUrl":"https://doi.org/10.46804/2641-2225.1163","url":null,"abstract":"","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44582761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Agmas, W. Craig, Kathleen M. Fairfield, B. F. King, Elizabeth Eisenhardt, K. Thakarar
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{"title":"A Cascade of Care of Patients with Hepatitis C Infection in a Rural State","authors":"W. Agmas, W. Craig, Kathleen M. Fairfield, B. F. King, Elizabeth Eisenhardt, K. Thakarar","doi":"10.46804/2641-2225.1137","DOIUrl":"https://doi.org/10.46804/2641-2225.1137","url":null,"abstract":"The","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44222368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura L. Onderko, T. Miller, Sean H Novak, J. Rosenblatt
{"title":"A Case of Congenital Coronary Sinus Ostial Atresia with Persistent Left Superior Vena Cava","authors":"Laura L. Onderko, T. Miller, Sean H Novak, J. Rosenblatt","doi":"10.46804/2641-2225.1136","DOIUrl":"https://doi.org/10.46804/2641-2225.1136","url":null,"abstract":"","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47235041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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