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6. Bidirectionality of smoking and depression in adolescents: a systematic review

Author

Farooqui, Mudassir, Shoaib, Samra, Afaq, Humera, Quadri, Syed, Zaina, Fatima, Baig, Aqsa, Liaquat, Ayesha, Sarwar, Zoona, Zafar, Atif, and Younus, Sana

Subjects
depressive disorder, Smoking, depression, adolescents, mental health
Abstract

Introduction Recently, evidence has been accumulating that both smoking and mental health disorders are continuously increasing among adolescents. This systematic review elucidates the research into evidence of the direction of the association and risk factors influencing the relationship between smoking and depression. We also highlight recent studies on the effects of electronic cigarettes and developments on the association between depression and smoking. Methods A literature search was conducted on databases including PubMed, Ovid Medline, EMBASE, and PsycINFO and in relevant neurology and psychiatry journals. Terms used for electronic searches included smoking, tobacco, cigarettes; depression; adolescent, youth; direction. Relevant information was then utilized to synthesize findings on the association between smoking and depression among adolescent population. Results The initial database searches yielded 2,738 related articles. After screening and cross-referencing, duplicate articles, articles published in languages other than English, and studies on animals, social and lifestyle factors, mood disorders, and substance use were excluded. Of these, a total of 122 publications only focusing on smoking and depression in the adolescent population were selected for synthesis in this qualitative systemic review. These include 110 original research articles, eight meta-analyses and reviews, and four reports and websites. Conclusion The relationship between smoking and depression in the literature does not reflect the cause-effect relationship. The lack of evidence on the direction of the association may reflect futile study designs, confounding factors and/or use of indirect measures of depression and quantification of smoking. Future prospective randomized studies should target elucidation of the causal association.

Published
2023

9. Simultaneous Detection of Multiple Tumor-targeted Gold Nanoparticles in HER2-Positive Breast Tumors Using Optoacoustic Imaging

Author

Samykutty, Abhilash, primary, Thomas, Karl N., additional, McNally, Molly, additional, Hagood, Jordan, additional, Chiba, Akiko, additional, Thomas, Alexandra, additional, McWilliams, Libby, additional, Behkam, Bahareh, additional, Zhan, Ying, additional, Council-Troche, McAlister, additional, Claros-Sorto, Juan C., additional, Henson, Christina, additional, Garwe, Tabitha, additional, Sarwar, Zoona, additional, Grizzle, William E., additional, and McNally, Lacey R., additional

Published
2023
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14. Negative FAST Exam Predicts Successful Non-operative Management in Pediatric Solid Organ Injury: A Prospective ATOMAC+ Study

Author

McGaha, Paul, II, Motghare, Prasenjeet, Sarwar, Zoona, Garcia, Nilda M, Lawson, Karla A, Bhatia, Amina, Langlais, Crystal S, Linnaus, Maria E., Todd Maxson, R., Eubanks, James W, III, Alder, Adam C., Tuggle, David, Ponsky, Todd A., Leys, Charles W, Ostlie, Daniel J, St. Peter, Shawn D., Notrica, David M., and Letton, Robert W

Published
2018
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15. Negative Focused Abdominal Sonography for Trauma examination predicts successful nonoperative management in pediatric solid organ injury: A prospective Arizona-Texas-Oklahoma-Memphis-Arkansas + Consortium study

Author

McGaha, Paul, II, Motghare, Prasenjeet, Sarwar, Zoona, Garcia, Nilda M., Lawson, Karla A., Bhatia, Amina, Langlais, Crystal S., Linnaus, Maria E., Maxson, R. Todd, Eubanks, James W., III, Alder, Adam C., Tuggle, David, Ponsky, Todd A., Leys, Charles W., Ostlie, Daniel J., St. Peter, Shawn D., Notrica, David M., and Letton, Robert W.

Published
2019
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16. The Effect of Body Mass Index on the Creation of an End-Colostomy in Rectal Cancer Patients

Author

Grimes, Arthur D., Stewart, Kenneth E., Morris, Katherine T., Dunn, Gary D., Booth, Kristina K., Carter, Steven N., Garwe, Tabitha, Sarwar, Zoona, and Fischer, Laura E.

Abstract

With the increasing prevalence of obesity, there has been a parallel increase in the incidence of rectal cancer. The association of body mass index (BMI) and end-colostomy creation versus primary anastomosis in patients undergoing proctectomy for rectal cancer has not been described. This is a retrospective study of patients with rectal cancer from 2012 to 2018 using data from the National Surgical Quality Improvement Project. 16,446 (92.1%) underwent primary anastomosis and 1,418 (7.9%) underwent creation of an end-colostomy. Patients with a BMI of 25-29.9 (overweight) comprised the most frequent group to have a proctectomy (reference group), but the least likely to have an end-colostomy. Patients with severe obesity (BMI 50+) had an adjusted odds ratio for end-colostomy of 2.7 (95% CI 1.5-4.7) compared to the reference group. Patients who have severe obesity should be counseled regarding the likelihood of an end-colostomy and may benefit from medical weight management or weight-loss surgery.

Published
2023
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20. Attempting to Bridge the Gap: Comparison of Clinical Characteristics, Ultrasound, and Final Surgical Pathology of Emergency Department vs Outpatient Clinic Patients Undergoing Cholecystectomy

Author

Martin, Whitney T, primary, Snyder, Katherine B, additional, Stewart, Kenneth, additional, Sarwar, Zoona, additional, Starr, William, additional, Grady, Anna, additional, Ball, Jonathan, additional, Raines, Alexander R, additional, and Cross, Alisa M, additional

Published
2022
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24. Association of Cardiovascular Disease Risk Factors with Exclusive Smokeless Tobacco Use among US Males: Cross-Sectional Analysis of NHANES Data 2003-2018.

Author

Mushtaq, Nasir, Sarwar, Zoona, Kouplen, Kate, Ahmed, Rizwan, and Beebe, Laura A.

Subjects
*SMOKELESS tobacco, *CARDIOVASCULAR diseases risk factors, *TOBACCO use, *CROSS-sectional method, *HEALTH & Nutrition Examination Survey
Abstract

Purpose: To evaluate cardiovascular disease (CVD) risk factors among smokeless tobacco (ST) users. Exclusive ST users were compared to exclusive cigarette smokers and non-tobacco users. Design: Cross-sectional study Sample: Data were used from 16,336 adult males who participated in one of the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018. Measures: Biochemically verified tobacco use, CVD risk factors (hypertension, cholesterol levels, BMI categories), physical activity, cotinine concentration, and sociodemographic variables. Analysis: Weighted analysis of the aggregate data was performed. ST users were compared with cigarette smokers and nontobacco users for their association with CVD risk factors. Associations were examined using univariate and multiple logistic regression with odds ratios (OR) and 95% confidence intervals (CI) reported. Results: Prevalence of exclusive ST use was 4.4% whereas, exclusive smoking was 22.2%. Among ST users, 36.2% were hypertensive, 24.5% had high cholesterol levels, and most of them were overweight (31.1%) or obese (52.6%). ST users were more likely to have hypertension compared to smokers (aOR = 1.48, 95%CI: 1.12, 1.95) and nontobacco users (aOR = 1.41, 95%CI: 1.09, 1.83) adjusted for other covariates. ST users were twice more likely to be obese than nontobacco users (aOR = 2.18, 95%CI: 1.52, 3.11). ST users had significantly higher cotinine concentration than smokers. Conclusion: Study findings indicate substantial association of ST use among males with hypertension and obesity which are independent risk factors of CVD. [ABSTRACT FROM AUTHOR]

Published
2023
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26. Traumatic Pediatric Fatalities: Are They Preventable?

Author

Lewis, Samara L., primary, Liebe, Heather, additional, Jeffery, Christopher, additional, Sebastian, Rohan, additional, Stewart, Kenneth E., additional, Sarwar, Zoona, additional, Gamino, Laura, additional, and Johnson, Jeremy J., additional

Published
2022
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38. Risk Factors Associated With Readmission After Pancreatectomy: A Single-Institution Retrospective Cohort Study

Author

Bonds, Morgan, Garwe, Tabitha, Rozich, Noah, Oluborode, Babawale, Sarwar, Zoona, Postier, Russell G, and Morris, Katherine T

Abstract

Background Pancreatectomy has a significant rate of procedure-specific morbidity which can result in readmission. Readmission has been proposed as a measure of quality. The goal of this study is to determine what factors are associated with readmission after pancreatectomy and whether readmission can be prevented.Methods A retrospective review of a single institution’s pancreatectomies between January 2011 and April 2015 was performed. Demographic, perioperative, and outpatient data were collected from the medical record. Primary outcome was 90-day readmission. Univariate and multivariable analyses were performed to determine which factors were associated with increased risk for readmission.Results A total of 257 patients met inclusion criteria; the 90-day readmission rate was 32.7%. The median time to readmission was 13 days. Readmitted patients were more likely to have a postoperative pancreatic fistula (POPF) on univariate analysis. Surgical site infections were more common in readmitted patients (18% vs 6.4%, P= .0138). Upon multivariable adjustment, only POPF (P= .0005) remained significant. A positive dose-response relationship was noted between POPF grade and the odds of readmission with odds ratios (ORs) ranging from 1.6 (95% Confidence Interval (CI): .6-4.1) for grade A to 16.7 (95% CI: 1.8-156.8) for grade C, albeit with limited precision.Conclusions Readmission after pancreatectomy is a common occurrence despite the many advancements in perioperative care. Our data suggest that POPF is a risk factor for readmission after pancreatectomy. Presently, this factor is not clearly preventable. This suggests that readmission may not be the best measure of quality to utilize in the evaluation of pancreatic surgery.

Published
2022
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39. Association of Interfacility Helicopter versus Ground Ambulance Transport and in-Hospital Mortality among Trauma Patients.

Author

Stewart, Kenneth, Garwe, Tabitha, Oluborode, Babawale, Sarwar, Zoona, and Albrecht, Roxie M.

Subjects
AIRPLANE ambulances, ACQUISITION of data methodology, CONFIDENCE intervals, TRAUMA centers, PATIENTS, TERTIARY care, RETROSPECTIVE studies, HOSPITAL mortality, HOSPITAL admission & discharge, EMERGENCY medical services, MEDICAL records, DESCRIPTIVE statistics, PROPORTIONAL hazards models
Abstract

Relatively few studies have compared outcomes between helicopter transport (HT) and ground transport (GT) for the inter-facility transfer of trauma patients to tertiary trauma centers (TTC). Mixed results have been reported from these studies ranging from a slight increase in odds of survival for the severely injured to no evident benefit for HT patients. We hypothesized there was no adjusted difference in mortality between patients transported interfacility by HT or GT taking into account distance from TTC. Data from an inclusive statewide trauma registry was used to conduct a retrospective cohort study of adult (18+ years old) trauma patients who initially presented to a non-tertiary trauma center (NTC) before subsequent transfer by HT or GT to a TTC. Records from the NTC and TTC were linked (N = 9880). We used propensity adjusted, multivariable Cox proportional hazards models to assess the association of HT on mortality at 72-hour and within the first 2 weeks of arrival at a TTC; these multivariable analyses were stratified by distance (miles) between NTC and TTC: 21-90, and greater than 90. Mean distance between NTC and TTC was greater for HT patients, 96.7 miles versus 69.9 miles for GT. A higher proportion of patients among the HT group had an ISS of 16 or higher (24.6% vs 10.9%), an initial SBP < 90 mmHg (7.3% vs 2.8%), and GCS < 10 (12.5% vs 3.7%) than the GT group. HT was associated with significantly decreased 72-hour mortality (HR 0.65, 95%CI 0.48-0.90) for patients transferred from a NTC <90 miles from the TTC. No association was seen for patients transferred more than 90 miles to the TTC. No significant association of HT and 2-week mortality was seen at any distance from the TTC. Only for patients transferred from an NTC <90 miles from the receiving TTC was HT associated with a significantly decreased hazard of mortality in the first 72 hours. Many HT patients, especially from the most distant NTCs, had minor injuries and normal vital signs at both the NTC and TTC suggesting the decision to use HT for these patients was resource-driven rather than clinical. [ABSTRACT FROM AUTHOR]

Published
2021
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43. Effect of Post-splenectomy Booster Vaccine Program on Vaccination Compliance in Trauma Patients

Author

Gonzalez, Robert A., Robbins, Justin M., Garwe, Tabitha, Stewart, Kenneth E., Sarwar, Zoona, Cross, Alisa M., Celii, Amanda M., and Albrecht, Roxie M.

Abstract

Objective In 2012, the Centers for Disease Control and Prevention (CDC) Advisory Council on Immunization Practice recommended an additional post-splenectomy booster vaccine at 8 weeks following the initial vaccine. The objective of this study was to evaluate our vaccination compliance rate and what sociodemographic factors were associated with noncompliance following this recommendation.Materials and Methods A retrospective review of a performance improvement database of trauma patients eligible for post-splenectomy vaccination (PSV) at a level I trauma center was carried out between 2009 and 2018. Overall and institutional compliance with PSV was compared before and after the addition of booster vaccine recommendation. Factors associated with booster noncompliance were also identified.Results A total of 257 patients were identified. PSV compliance rate in the pre-booster was 98.4%, while overall and institutional post-booster compliance rate were significantly lower at 66.9% (P≤ .001) and 50.0% (P≤ .001), respectively. Compared to booster institutional compliers, institutional noncompliers lived farther from the trauma center (48 vs. 86 miles, P= .02), and though not statistically significant, these patients were generally older (34.9 vs. 40.5, P= .05).Discussion PSV booster compliance is low even with the current educational materials and recommendations. Additional approaches to improve compliance rates need to be implemented, such as sending letters to the patient and their primary care providers (PCPs), collaborating with rehab/long-term acute care centers, communicating with city and county health departments and city pharmacies, or mirroring other countries and creating a national database for asplenic patients to provide complete information.

Published
2021
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44. Learning Curve of a Laparoscopic Pancreaticoduodenectomy Program at a Second Institution

Author

Martin, W. Taylor, Bonds, Morgan, Fischer, Laura, Morris, Katherine T., Sarwar, Zoona, Stewart, Kenneth, Garwe, Tabitha, Paniccia, Alessandro, Schulick, Richard D., Jain, Ajay, and Edil, Barish H.

Abstract

Background Historically, pancreaticoduodenectomy (PD) has been performed via a laparotomy, but increasingly, laparoscopic and robotic platforms are being employed for PD. Laparoscopic PD has a steep surgeon specific learning curve and programmatic elements that must be optimized. These factors may limit a surgeon who is proficient at laparoscopic PD to develop a program at another institution. We hypothesize that the learning curve for a surgeon transferring a program to a second institution is shorter than the initial laparoscopic PD learning curve for the same surgeon.Methods A retrospective review of patients who underwent laparoscopic PD for any indication at the first institution (FI) from 2012 to 2017 and the second institution (SI) from 2018 to 2021 was conducted. Standard statistical analysis was performed. The learning curve was identified using one-sided CUSUM analysis of operative times.Result We identified 110 participants, 90 from the FI and 20 from the SI. More patients at the FI were diagnosed with periampullary adenocarcinoma on final pathology compared to the SI (65.6% vs 40.0%, P= .0132). FI operative times stabilized after the 25th laparoscopic PD and SI operative times stabilized after the 5th operation. No statistically significant difference was identified in postoperative complications.Conclusions The learning curve and average operative time of an SI laparoscopic PD program was shorter than the initial learning curve for a single surgeon with comparable outcomes. This suggests that complex minimally invasive surgical programs can be safely transferred to another high-volume institution without significant loss of progress.

Published
2024
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45. Negative FAST Exam Predicts Successful Non-operative Management in Pediatric Solid Organ Injury: A Prospective ATOMAC+ Study.

Author

McGaha II, Paul, Motghare, Prasenjeet, Sarwar, Zoona, Garcia, Nilda M., Lawson, Karla A., Bhatia, Amina, Langlais, Crystal S., Linnaus, Maria E., Maxson, R. Todd, Eubanks III, James W., Alder, Adam C., Tuggle, David, Ponsky, Todd A., Leys, Charles W., Ostlie, Daniel J., St. Peter, Shawn D., Notrica, David M., Letton, Robert W., McGaha, Paul 2nd, and Todd Maxson, R

Published
2019
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48. Computed Tomography with Intravenous Contrast Is Not Associated with Development of Acute Kidney Injury in Severely Injured Pediatric Patients.

Author

Paul K M 2nd, Johnson J, Garwe T, Sarwar Z, Motghare P, Daly W, and Letton R

Subjects
Administration, Intravenous, Child, Child, Preschool, Contrast Media administration & dosage, Female, Humans, Incidence, Injury Severity Score, Male, Retrospective Studies, Trauma Centers, Acute Kidney Injury epidemiology, Contrast Media adverse effects, Tomography, X-Ray Computed adverse effects, Wounds and Injuries diagnostic imaging
Abstract

Data for the incidence of acute kidney injury (AKI) related to intravenous contrast administration in the pediatric trauma population are limited. Obtaining a creatinine value before elective CT scans is a relatively accepted standard of care. We sought to determine whether there was any significant difference in the incidence of AKI between severely injured patients who received IV contrast and those who did not. We reviewed data from the trauma registry at our Level I pediatric trauma center. We limited the patients to severely injured pediatric traumas (<15 years old) directly transported from the scene of injury with a creatinine level measured on arrival. Two hundred and eleven patients were included in the study. AKI was defined by the criteria of the AKI Network. We then compared incidence of AKI in those who received a CT scan with IV contrast with those who did not receive IV contrast. The two groups were comparable in age, gender, Glasgow Coma Scale, Injury Severity Score, mean creatinine on arrival, and mean creatinine post-CT scan/arrival. There was no significant difference in AKI between the two. In a subgroup analysis of patients presenting in shock, there was no significant difference in AKI. Our study suggests that IV contrast is not associated with the development of AKI in severely injured pediatric trauma patients. Although obtaining a creatinine value before exposure is ideal, a CT scan with IV contrast in severely injured children should not be delayed to obtain a creatinine value.

Published
2019

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