Neonatal abstinence syndrome (NAS) is a syndrome of withdrawal symptoms in newborn infants that have a history of prenatal exposure to certain substances. Affected infants may have gastrointestinal (GI) issues, such as gassiness and diarrhea. Although infants with known exposures may be monitored in the first few days of life, it is unclear how long these symptoms persist. This poster will examine GI issues in the first six months of life across four groups of infants: those with prenatal opioid exposure, those with prenatal substance exposure that does not include opioids, those with polysubstance exposure, and those without substance exposure in a pediatric clinic in northeast TN. A retrospective chart review of 600 charts of infants born from 2017—2020 was conducted with IRB approval in a pediatric clinic in rural middle Appalachia. Of these, 300 charts were selected based on known prenatal substance exposure, and the other 300 charts were randomly selected. A REDCap extraction manual was created, research assistants were trained, and % agreement was determined. Data was collected about type of prenatal substance exposure, growth, and medical conditions in the first three years of life. Infants were divided into groups by type of prenatal substance exposure for analysis. The opioid-only group included exposure to buprenorphine, methadone, or other opiates. The other (non-opioid) exposure group included exposure to marijuana, cocaine, benzodiazepines, methamphetamines, and prescription ADHD medications. The polysubstance exposure group included exposure to both opiate and non-opiate substances. The control group had no prenatal substance exposure. Analyses were performed using SAS version 9.4. Descriptive statistics showed the demographics of the sample were representative of the population in rural middle Appalachia, with a predominantly Caucasian sample of 121 females and 123 males, mostly receiving TennCare. Chi-square results showed there was only a statistically significant difference between the prenatal substance exposure groups at 2 months, X2 (3, N = 176) = 8.03, p = 0.045, but not at hospital discharge, within the first few days of life, at 1 month, 4 months, or 6 months. Infants in the opioid-only exposure group were most likely to have GI issues. These findings suggest that GI issues are more likely to occur in infants with certain prenatal substance exposures. This poster also shows a longitudinal perspective of these issues, indicating that the symptoms may persist in the first few months of life. Thus, caregivers of infants at risk for NAS may benefit with information about the long-term effects. Because the retrospective chart review is still in progress, this poster only analyzes a preliminary number of charts. Future research should also take into consideration other factors that may be associated with GI issues in this population, such as nutrition.

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Purpose: The purpose of this study was to evaluate the effectiveness of triaging patients with motion-provoked dizziness into a benign paroxysmal positional vertigo (BPPV) clinic. Method: A retrospective chart review was performed of veterans who were tested and treated for BPPV in a triaged BPPV clinic and veterans who were tested and treated for BPPV in a traditional vestibular clinic. Results: The BPPV triage clinic had a hit rate of 39%. On average, the triaged BPPV clinic reduced patient wait times by 23 days relative to the wait times for the traditional vestibular clinic while also reducing patient costs. Conclusion: Triaging patients with BPPV is one method to improve access to evaluation and treatment and a mechanism for the effective use of clinic time and resources.