Page 23 - Delaware Medical Journal - January/February 2020
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ABSTRACTS
Methods: 23 subjects receiving
IV sedation were given prospective questionnaires, including chronic
pain and Beck’s Depression Inventory Wilmington Hospital OMFS clinics. Their age averaged 36 years, with 57% male and 43% female subjects.
Results: Subjects who received IV Ketamine reported lower post-operative pain scores and used fewer opioids than those who did not. Additionally, this subject group reported lower depression scores postoperatively.
Conclusions: Ketamine has value
to patients beyond just its anesthetic properties. Chronic pain and mood appear to be positively altered by the
use of Ketamine in outpatient surgical procedures. Ketamine use should be unless contraindicated, in patients with chronic pain and depression. Especially in the era of the opioid epidemic, health care providers should seek any possible advantage for positive treatment effects of their chosen medications. Further studies with larger sample sizes must continue
secondary effects, perhaps justifying its use as a sole therapy for chronic pain and depression.
Accepted/Prior Presentations: Conference: 7th Annual American College of Oral and Maxillofacial Surgeons Resident Meeting Conference Date:
CONTRIBUTORS
■ CHRISTOPHER PAOLINO, DMD joined ChristianaCare in 2016, after matriculating from Tufts University School of Dental Medicine. He is currently a Senior Resident with the Oral and Maxillofacial Surgery Residency program.
■ DAN MEARA, MD, DMD, MS, FACS joined ChristianaCare in 2010, after completing a
craniomaxillofacial surgery fellowship at West Virginia University/Charleston Area Medical Center. He is currently the Chairman of the Oral and Maxillofacial Surgery Residency program at ChristianaCare.
■ QUEEN RALPH is a recent graduate of Delaware State University with a bachelor’s degree in Biological Sciences. She is enrolled at Rutgers University (Newark), pursuing a master’s in Biomedical Sciences in preparation for dental school.
The Influence of State-Funded Cancer Care Treatment Program on Clinical Outcomes in Breast Cancer Patients
Breast Surgical Oncology
Jennifer Sims-Mourtada, PhD; Diana Dickson-Witmer, MD, FACS; Nicholas Petrelli, MD, FACS
Jennifer Sims-Mourtada, PhD; Diana Dickson-Witmer, MD, FACS; Nicholas Petrelli, MD, FACS
Background: Although there has been national improvement in overall survival for breast cancer patients, those without insurance have poorer outcomes. The Delaware Cancer Treatment Program (DCTP) provides free cancer care for qualified patients without insurance.
Objective(s): Our study compared
the outcomes of patients whose cancer care was funded by the Delaware Cancer Treatment Program to patients covered by Medicaid, Medicare, private insurance, and uninsured patients.
Methods: Patient demographics and breast cancer-specific survival of patients treated at the Helen F. Graham Cancer Center from 2007-2017 were compared according to payer status. Tukey’s multiple comparisons test, Chi squared and one-way Anova were used to determine the differences in age,
ethnicity, and stage of presentation based on insurance status. Kaplan- Meyer and Log-rank analysis were used to determine differences in recurrence- free and breast cancer-specific survival among groups [p >0.05] using Prism 6.
Results: Of the 7,179 breast cancer patients treated at ChristianaCare funding from the DCTP. Recurrence- free survival and overall survival
were significantly lower for DCTP versus private and Medicaid, p<0.0001. There was no significant difference in survival or recurrence-free survival between uninsured and DCTP cases. Patients with DCTP funding were diagnosed at a significantly later stage than all other types of payers (p= 0.047). Twenty-six percent of patients with DCTP were diagnosed at Stage IV. There is a significant difference
in race between Medicare and private insurance. There is a significant difference in race between DCTP, Medicare, and private insurance; p<0.0004 and p<0.0001 respectively.
Conclusions: There is no significant difference in race between uninsured, Medicaid, or DCTP. There is a significant difference in race between DCTP, Medicare, and private patients. Disease-free and overall survival in DCTP patients was worse than for those with private insurance, Medicaid, or Medicare. These results indicate
that although breast patients qualify for treatment coverage, there may be
a failure to provide state-funded early screening programs that may help with earlier diagnosis.
Accepted/Prior Presentations: Conference: The American Society of Breast Surgeons 20th Annual Meeting, Dallas, Texas
Conference Date: April 30-May 5, 2019
Del Med J | January/February 2020 | Vol. 92 | No. 1
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