MAT for Opioid Use Disorder in Maine

Opioid Use Disorder (OUD) is a major problem in the state of Maine with one person dying from overdose every day. Medication Assisted Treatment (MAT) using Suboxone has been shown to be helpful in the treatment of OUD, but there is currently a great need for providers to prescribe Suboxone in this region. We looked at barriers that providers saw for obtaining a waiver to prescribe Suboxone and created a handout to educate providers on MAT and the process for getting the waiver.https://scholarworks.uvm.edu/fmclerk/1309/thumbnail.jp

Assessing the Awareness of Lead Hazards in the Greater Burlington Area

Introduction. Lead is a heavy metal found in and around homes built before 1978, comprising more than 80% of the housing stock in Chittenden County, Vermont. Lead exposure during infancy and childhood can have deleterious effects on development. Our study assessed baseline community understanding of potential household lead hazards in Chittenden County, Vermont. Methods.. 123 paper, 10-question surveys were randomly administered to Chittenden County, VT residents to assess recognition of lead toxicology symptoms and awareness of lead safety programs. Scores were treated as continuous variables, demographically grouped, and analyzed using non-parametric statistical analysis (Mann-Whitney & Kruskal-Wallis). Individual questions were treated as dichotomous variables, demographically grouped and analyzed using chi-squared testing. Results.. 48% of survey participants understood the interaction between ADHD and lead or knew the importance of window maintenance. 54.5% were aware of the Burlington Lead Program\u27s assistance program. Participants earning less than $60,000 and those with less than a graduate degree scored statistically lower (p Conclusion.. Lesser-known lead poisoning symptoms and home interventions that decrease lead exposure should be emphasized to the community. High-risk groups requiring targeted education include those who rent, have lower income and education levels. Primary care providers could serve a larger role in educating patients. Additional efforts should be made to publicize services offered by the Burlington Lead Program.https://scholarworks.uvm.edu/comphp_gallery/1241/thumbnail.jp

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Activated cholinergic signaling provides a target in squamous cell lung carcinoma.

The binding of exogenous nicotine to nicotinic acetylcholine (ACh) receptors (nAChR) and the binding of endogenous ACh to both nAChR and muscarinic ACh receptors (mAChR) stimulate growth of both small cell and non-small cell lung carcinomas. Understanding how cholinergic signaling is up-regulated in lung cancer may suggest new therapeutic approaches. Analysis of 28 squamous cell lung carcinomas (SCC) showed increased levels of alpha5 and beta3 nAChR mRNA and increased levels of ACh associated with increased levels of choline acetyltransferase mRNA and decreased cholinesterase mRNAs. Lynx1, an allosteric inhibitor of nAChR activity, was also decreased in SCC. Thus, cholinergic signaling is broadly increased in SCC caused by increased levels of receptors, increased levels of ligands, and decreased levels of receptor inhibitors. Partially explaining the cholinergic up-regulation seen in SCC, incubation of the H520 SCC cell line with nicotine increased levels of ACh secretion, increased expression of nAChR, and, as measured by electrophysiologic recording, increased activity of the expressed nAChR. Consistent with these effects, nicotine stimulated proliferation of H520 cells. One approach to blocking proliferative effects of nicotine and ACh on growth of lung cancers may be through M3 mAChR antagonists, which can limit the activation of mitogen-activated protein kinase that is caused by both nicotinic and muscarinic signaling. This was tested with the M3-selective muscarinic antagonist darifenacin. Darifenacin blocked nicotine-stimulated H520 growth in vitro and also blocked H520 growth in nude mice in vivo. Thus, cholinergic signaling is broadly up-regulated in SCC and blocking cholinergic signaling can limit basal and nicotine-stimulated growth of SCC