Medical Specialties Commons^™

International Pooled Patient-Level Meta-Analysis Of Ketamine Infusion For Depression: In Search Of Clinical Moderators, Rebecca B Price, Nicholas Kissel, Andrew Baumeister, Rebecca Rohac, Mary L Woody, Elizabeth D Ballard, Carlos A Zarate, William Deakin, Chadi G Abdallah, Adriana Feder, Dennis S Charney, Michael F Grunebaum, J John Mann, Sanjay J Mathew, Bronagh Gallagher, Declan M Mcloughlin, James W Murrough, Suresh Muthukumaraswamy, Rebecca Mcmillan, Rachael Sumner, George Papakostas, Maurizio Fava, Rebecca Hock, Jennifer L Phillips, Pierre Blier, Paulo Shiroma, Peter Šóš, Tung-Ping Su, Mu-Hong Chen, Mikael Tiger, Johan Lundberg, Samuel T Wilkinson, Meredith L Wallace

Children’s Nutrition Research Center Staff Publications

Depression is disabling and highly prevalent. Intravenous (IV) ketamine displays rapid-onset antidepressant properties, but little is known regarding which patients are most likely to benefit, limiting personalized prescriptions. We identified randomized controlled trials of IV ketamine that recruited individuals with a relevant psychiatric diagnosis (e.g., unipolar or bipolar depression; post-traumatic stress disorder), included one or more control arms, did not provide any other study-administered treatment in conjunction with ketamine (although clinically prescribed concurrent treatments were allowable), and assessed outcome using either the Montgomery-Åsberg Depression Rating Scale or the Hamilton Rating Scale for Depression (HRSD-17). Individual patient-level data for at least …

Pediatric Lung Transplantation For Covid-19: Unique Clinical And Psychosocial Barriers, Anupam Kumar, Gloria W Li, Justin M Segraves, Aladdein Mattar, Maheshwari Ramineni, Gabriel Loor, Puneet S Garcha

Faculty, Staff and Students Publications

BACKGROUND: SARS-CoV-2 infection in the age group of 0-17 years contributes to approximately 22% of all laboratory-confirmed SARS-CoV-2 infections. Fortunately, this age group has a lower death rate (0.5 per 100 000) that accounts for only 4% of the total deaths due to COVID-19. Despite the low mortality rate in the pediatric population, children of minority groups represented 78% of the deaths highlighting the existing disparities in access to health care.

METHODS: With the emergence of the more contagious COVID-19 variants and the relatively slow pace of vaccination among the pediatric population, it is possible to see more cases of …

Psychiatric Comorbidities And Their Treatment Predict Buprenorphine Continuation Among Postpartum People With Opioid Use Disorder, Hannah Shadowen, Stephanie Violante, Andrea Gataric, Alison N Goulding, Caitlin E Martin

Faculty, Staff and Students Publications

BACKGROUND: Opioid use disorder (OUD) is a growing crisis among pregnant and postpartum people. Psychiatric comorbidities are common, yet how they impact OUD treatment outcomes is not well characterized. The aim of this study was to assess the association of psychiatric comorbidities and receipt of psychiatric treatment with buprenorphine continuation through one year postpartum among a sample of people with OUD.

METHODS: A subsample was identified from a larger retrospective cohort of patients receiving buprenorphine for OUD at the time of delivery from an academic medical center between 2017 and 2020. Medical record abstractions were conducted during pregnancy through one …

Psychiatric Medications: Does Education Affect Medication Prescriptions?, Surina M. Narine, Mary D. Ramos, Sarah Chu

Symposium of Student Scholars

Background: There is a lack of research on racial challenges among underrepresented adolescents regarding prescription drug use for mental illnesses. Purpose: This study addressed the following question: In adolescent minorities, how does education about racial disparity and culture affect the stigma and number of prescriptions written for psychiatric medications? This evidence-based practice project aimed to identify if racial awareness directly impacts the amount of psychiatric medication prescribed for adolescent minorities. Methods: Literature reviews analyzed qualitative and quantitative data to provide correlating information on racial disparities and psychotropic medications. This study examined the following possible factors for decreased prescribed drugs within …

Avpcancerfree: Impact Of A Digital Behavior Change Intervention On Parental Hpv Vaccine –Related Perceptions And Behaviors, Ross Shegog, Lara S Savas, C Mary Healy, Erica L Frost, Sharon P Coan, Efrat K Gabay, Sharice M Preston, Stanley W Spinner, Mathew Wilbur, Elisabeth Becker, Travis Teague, Sally W Vernon

Faculty, Staff and Student Publications

Parent hesitancy contributes to reduced HPV vaccination rates. The HPVcancerfree app (HPVCF) was designed to assist parents in making evidence-based decisions regarding HPV vaccination. This study examined if parents of vaccine-eligible youth (11-12 yrs.) who use HPVCF in addition to usual care demonstrate significantly more positive intentions and attitudes toward HPV vaccination and greater HPV vaccination rates compared to those not using HPVCF. Clinics (n = 51) within a large urban pediatric network were randomly assigned to treatment (HPVCF + usual care) or comparison (usual care only) conditions in a RCT conducted between September 2017 and February 2019. Parents completed …

Validation Of Prediction Rules For Computed Tomography Use In Children With Blunt Abdominal Or Blunt Head Trauma: Protocol For A Prospective Multicenter Observational Cohort Study, Irma T Ugalde, Pradip P Chaudhari, Mohamed Badawy, Paul Ishimine, Kevan A Mccarten-Gibbs, Kenneth Yen, Nisa S Atigapramoj, Allyson Sage, Donovan Nielsen, P David Adelson, Jeffrey Upperman, Daniel Tancredi, Nathan Kuppermann, James F Holmes

Faculty, Staff and Student Publications

BACKGROUND: Traumatic brain injuries (TBIs) and intra-abdominal injuries (IAIs) are 2 leading causes of traumatic death and disability in children. To avoid missed or delayed diagnoses leading to increased morbidity, computed tomography (CT) is used liberally. However, the overuse of CT leads to inefficient care and radiation-induced malignancies. Therefore, to maximize precision and minimize the overuse of CT, the Pediatric Emergency Care Applied Research Network (PECARN) previously derived clinical prediction rules for identifying children at high risk and very low risk for IAIs undergoing acute intervention and clinically important TBIs after blunt trauma in large cohorts of children who are …

Qualitative Analysis Of A Twitter-Disseminated Survey Reveals New Patient Perspectives On The Impact Of Urinary Tract Infection, Marissa Valentine-King, Lindsey Laytner, Casey Hines-Munson, Kiara Olmeda, Barbara Trautner, Sheryl Justice, Christina Ching, Larissa Grigoryan

Faculty, Staff and Students Publications

Few studies have harnessed social media to explore patients’ experiences with urinary tract infection (UTI); therefore, we captured UTI experiences and future research suggestions through a Twitter-disseminated survey. The survey posed three qualitative questions inquiring about the impact of UTIs, greatest UTI management hurdle, and research suggestions. We also asked participants to rate how seriously others perceive UTIs and the importance of UTIs in their life (scale: 1–100 (highest)). The study period spanned from January to June 2021. Coding was performed in duplicate, followed by thematic analysis. Of 466 participants from 22 countries, 128 considered their UTIs recurrent (n …

Genome-Transcriptome-Functional Connectivity-Cognition Link Differentiates Schizophrenia From Bipolar Disorder, Jiayu Chen, Zening Fu, Juan R Bustillo, Nora I Perrone-Bizzozero, Dongdong Lin, Jose Canive, Godfrey D Pearlson, Julia M Stephen, Andrew R Mayer, Steven G Potkin, Theo G M Van Erp, Peter Kochunov, L Elliot Hong, Bhim M Adhikari, Ole A Andreassen, Ingrid Agartz, Lars T Westlye, Jing Sui, Yuhui Du, Fabio Macciardi, Faith M Hanlon, Rex E Jung, Jessica A Turner, Jingyu Liu, Vince D Calhoun

Faculty, Staff and Student Publications

BACKGROUND AND HYPOTHESIS: Schizophrenia (SZ) and bipolar disorder (BD) share genetic risk factors, yet patients display differential levels of cognitive impairment. We hypothesized a genome-transcriptome-functional connectivity (frontoparietal)-cognition pathway linked to SZ-versus-BD differences, and conducted a multiscale study to delineate this pathway.

STUDY DESIGNS: Large genome-wide studies provided single nucleotide polymorphisms (SNPs) conferring more risk for SZ than BD, and we identified their regulated genes, namely SZ-biased SNPs and genes. We then (a) computed the polygenic risk score for SZ (PRSSZ) of SZ-biased SNPs and examined its associations with imaging-based frontoparietal functional connectivity (FC) and cognitive performances; (b) examined the spatial …

Cerebral Blood Flow And Cardiovascular Risk Effects On Resting Brain Regional Homogeneity, Bhim M Adhikari, L Elliot Hong, Zhiwei Zhao, Danny J J Wang, Paul M Thompson, Neda Jahanshad, Alyssa H Zhu, Stefan Holiga, Jessica A Turner, Theo G M Van Erp, Vince D Calhoun, Kathryn S Hatch, Heather Bruce, Stephanie M Hare, Joshua Chiappelli, Eric L Goldwaser, Mark D Kvarta, Yizhou Ma, Xiaoming Du, Thomas E Nichols, Alan R Shuldiner, Braxton D Mitchell, Juergen Dukart, Shuo Chen, Peter Kochunov

Faculty, Staff and Student Publications

Regional homogeneity (ReHo) is a measure of local functional brain connectivity that has been reported to be altered in a wide range of neuropsychiatric disorders. Computed from brain resting-state functional MRI time series, ReHo is also sensitive to fluctuations in cerebral blood flow (CBF) that in turn may be influenced by cerebrovascular health. We accessed cerebrovascular health with Framingham cardiovascular risk score (FCVRS). We hypothesize that ReHo signal may be influenced by regional CBF; and that these associations can be summarized as FCVRS→CBF→ReHo. We used three independent samples to test this hypothesis. A test-retest sample of N = 30 healthy …

Resilience And Prenatal Mental Health In Pakistan: A Qualitative Inquiry, Shireen Shehzad, David Arthur, An-Sofie Van Parys, Nicole Letourneau, Gail Wagnild, Shahirose Sadrudin Premji, Nargis Asad, Olivier Degomme

School of Nursing & Midwifery

Background: Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.
Methods: The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A …

Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi

Community Health Sciences

Objectives: A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.
Design: An exploratory qualitative study.
Setting: Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.
Participants: In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.
Results: …

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Creatively Capturing Structure And Energy: Zero Balancing's Essential Elements (Article & Video), Lisa Bardarson

Journal of Transformative Touch

Through the creative use of coloring, I am devising a way to document Zero Balancing’s two foundational elements, structure and energy and the changes that occur following a ZB session. I believe this experiential activity will be a creative fulcrum, helping the client connect more effectively with the deepest part of themselves thereby experiencing greater ease and freedom from their issues. As the activity of coloring is a “right brain”/ creative endeavor, I believe it can serve to enhance a client’s expanded state of consciousness, one of the hallmarks of a Zero Balancing session, as well as improve their overall …

A Comprehensive Review On Nutraceuticals: Therapy Support And Formulation Challenges, Vivek Puri, Manju Nagpal, Inderbir Singh, Manjinder Singh, Gitika Arora Dhingra, Kampanart Huanbutta, Divya Dheer, Ameya Sharma, Tanikan Sangnim

Faculty, Staff and Student Publications

Nutraceuticals are the nourishing components (hybrid of nutrition and pharmaceuticals) that are biologically active and possess capability for maintaining optimal health and benefits. These products play a significant role in human health care and its endurance, most importantly for the future therapeutic development. Nutraceuticals have received recognition due to their nutritional benefits along with therapeutic effects and safety profile. Nutraceuticals are globally growing in the field of services such as health care promotion, disease reduction, etc. Various drug nutraceutical interactions have also been elaborated with various examples in this review. Several patents on nutraceuticals in agricultural applications and in various …

Living With Brain Cancer: From Researcher To Patient, Stephen P. Chelko, Daniel L. Fay Ph.D.

Patient Experience Journal

As an academic researcher, my work-life revolves around testing the efficaciousness of pharmaceutical drugs on the prevention of cardiac dysfunction, arrhythmias, and sudden cardiac death in animal models of heart disease. I never thought I would go from someone studying a life-threatening disease to a patient living with one in twenty-four hours. Yet, that transformation occurred October 8, 2019. I was just appointed to Assistant Professor at Johns Hopkins University School of Medicine (JHUSOM), yet after sitting for my professional headshot I had a grand mal seizure. I cannot recall this event, but I bit the tip of my tongue …

An Evaluation Of Peer-Rated Surgical Skill And Its Relationship With Detrusor Muscle Sampling In Transurethral Resection Of Bladder Tumor, Minh N Pham, Oliver S Ko, Reiping Huang, Amanda X Vo, Kyle P Tsai, Jeremy D Lai, Matthew T Hudnall, Joshua A Halpern, Joshua J Meeks, Jonas Benson, Ricardo Soares, Ronald Kim, Karl Y Bilimoria, Jonah J Stulberg, Gregory B Auffenberg

Faculty, Staff and Student Publications

OBJECTIVE: To assess the reliability of peer-review of TURBT videos as a means to evaluate surgeon skill and its relationship to detrusor sampling.

METHODS: Urologists from an academic health system submitted TURBT videos in 2019. Ten blinded peers evaluated each surgeon's performance using a 10-item scoring instrument to quantify surgeon skill. Normalized composite skill scores for each surgeon were calculated using peer ratings. For surgeons submitting videos, we retrospectively reviewed all TURBT pathology results (2018-2019) to assess surgeon-specific detrusor sampling. A hierarchical logistic regression model was fit to evaluate the association between skill and detrusor sampling, adjusting for patient and …

Prevalent Multimorbidity Combinations Among Middle-Aged And Older Adults Seen In Community Health Centers, Ana R Quiñones, Steele H Valenzuela, Nathalie Huguet, Maria Ukhanova, Miguel Marino, Jennifer A Lucas, Jean O'Malley, Teresa D Schmidt, Robert Voss, Katherine Peak, Nathaniel T Warren, John Heintzman

Faculty, Staff and Student Publications

BACKGROUND: Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs).

OBJECTIVE: To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period.

DESIGN: A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic …

Factors Associated With Loss Of Motivation And Hesitation To Work Amongst Frontline Health Care Providers During The Covid-19 Pandemic: A Cross-Sectional Survey From A Developing Country, Mehreen Malik, Syeda Tayyaba Rehan, Farheen Malik, Jawad Ahmed, Chaudhary Abdul Fatir, Hassan Ul Hussain, Asiyah Aman, Muhammad Junaid Tahir

Department of Anaesthesia

Background: The COVID-19 took over the world in 2020 and a lockdown has been imposed seeing its fast spread. Frontline health care workers (HCWs) were reported frequently with a lack of motivation, hesitancy and unwillingness to perform their duties during this pandemic. This cross-sectional survey aims to evaluate the factors associated with lack of motivation and increased hesitancy among the frontline HCWs to perform their duties during COVID-19 pandemic.
Materials and methods: A total of 239 HCWs were included in this web-based cross-sectional study, who have worked during the COVID-19 pandemic. The anonymous online questionnaire was sent to all faculty, …

Rare Genetic Variants Explain Missing Heritability In Smoking, Seon-Kyeong Jang, Luke Evans, Allison Fialkowski, Donna K Arnett, Allison E Ashley-Koch, Kathleen C Barnes, Diane M Becker, Joshua C Bis, John Blangero, Eugene R Bleecker, Meher Preethi Boorgula, Donald W Bowden, Jennifer A Brody, Brian E Cade, Brenda W Campbell Jenkins, April P Carson, Sameer Chavan, L Adrienne Cupples, Brian Custer, Scott M Damrauer, Sean P David, Mariza De Andrade, Carla L Dinardo, Tasha E Fingerlin, Myriam Fornage, Barry I Freedman, Melanie E Garrett, Sina A Gharib, David C Glahn, Jeffrey Haessler, Susan R Heckbert, John E Hokanson, Lifang Hou, Shih-Jen Hwang, Matthew C Hyman, Renae Judy, Anne E Justice, Robert C Kaplan, Sharon L R Kardia, Shannon Kelly, Wonji Kim, Charles Kooperberg, Daniel Levy, Donald M Lloyd-Jones, Ruth J F Loos, Ani W Manichaikul, Mark T Gladwin, Lisa Warsinger Martin, Mehdi Nouraie, Olle Melander, Deborah A Meyers, Courtney G Montgomery, Kari E North, Elizabeth C Oelsner, Nicholette D Palmer, Marinelle Payton, Anna L Peljto, Patricia A Peyser, Michael Preuss, Bruce M Psaty, Dandi Qiao, Daniel J Rader, Nicholas Rafaels, Susan Redline, Robert M Reed, Alexander P Reiner, Stephen S Rich, Jerome I Rotter, David A Schwartz, Aladdin H Shadyab, Edwin K Silverman, Nicholas L Smith, J Gustav Smith, Albert V Smith, Jennifer A Smith, Weihong Tang, Kent D Taylor, Marilyn J Telen, Ramachandran S Vasan, Victor R Gordeuk, Zhe Wang, Kerri L Wiggins, Lisa R Yanek, Ivana V Yang, Kendra A Young, Kristin L Young, Yingze Zhang, Dajiang J Liu, Matthew C Keller, Scott Vrieze

Faculty, Staff and Student Publications

Common genetic variants explain less variation in complex phenotypes than inferred from family-based studies, and there is a debate on the source of this 'missing heritability'. We investigated the contribution of rare genetic variants to tobacco use with whole-genome sequences from up to 26,257 unrelated individuals of European ancestries and 11,743 individuals of African ancestries. Across four smoking traits, single-nucleotide-polymorphism-based heritability ([Formula: see text]) was estimated from 0.13 to 0.28 (s.e., 0.10-0.13) in European ancestries, with 35-74% of it attributable to rare variants with minor allele frequencies between 0.01% and 1%. These heritability estimates are 1.5-4 times higher than past …

Brain-Wide Versus Genome-Wide Vulnerability Biomarkers For Severe Mental Illnesses, Peter Kochunov, Yizhou Ma, Kathryn S Hatch, Si Gao, Neda Jahanshad, Paul M Thompson, Bhim M Adhikari, Heather Bruce, Andrew Van Der Vaart, Eric L Goldwaser, Aris Sotiras, Mark D Kvarta, Tianzhou Ma, Shuo Chen, Thomas E Nichols, L Elliot Hong

Faculty, Staff and Student Publications

Severe mental illnesses (SMI), including major depressive (MDD), bipolar (BD), and schizophrenia spectrum (SSD) disorders have multifactorial risk factors and capturing their complex etiopathophysiology in an individual remains challenging. Regional vulnerability index (RVI) was used to measure individual's brain‐wide similarity to the expected SMI patterns derived from meta‐analytical studies. It is analogous to polygenic risk scores (PRS) that measure individual's similarity to genome‐wide patterns in SMI. We hypothesized that RVI is an intermediary phenotype between genome and symptoms and is sensitive to both genetic and environmental risks for SMI. UK Biobank sample of N = 17,053/19,265 M/F (age = 64.8 …

Brain Structure In Acutely Underweight And Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis By The Enigma Eating Disorders Working Group, Esther Walton, Fabio Bernardoni, Victoria-Luise Batury, Klaas Bahnsen, Sara Larivière, Giovanni Abbate-Daga, Susana Andres-Perpiña, Lasse Bang, Amanda Bischoff-Grethe, Samantha J Brooks, Iain C Campbell, Giammarco Cascino, Josefina Castro-Fornieles, Enrico Collantoni, Federico D'Agata, Brigitte Dahmen, Unna N Danner, Angela Favaro, Jamie D Feusner, Guido K W Frank, Hans-Christoph Friederich, John L Graner, Beate Herpertz-Dahlmann, Andreas Hess, Stefanie Horndasch, Allan S Kaplan, Lisa-Katrin Kaufmann, Walter H Kaye, Sahib S Khalsa, Kevin S Labar, Luca Lavagnino, Luisa Lazaro, Renzo Manara, Amy E Miles, Gabriella F Milos, Alessio Maria Monteleone, Palmiero Monteleone, Benson Mwangi, Owen O'Daly, Jose Pariente, Julie Roesch, Ulrike H Schmidt, Jochen Seitz, Megan E Shott, Joe J Simon, Paul A M Smeets, Christian K Tamnes, Elena Tenconi, Sophia I Thomopoulos, Annemarie A Van Elburg, Aristotle N Voineskos, Georg G Von Polier, Christina E Wierenga, Nancy L Zucker, Neda Jahanshad, Joseph A King, Paul M Thompson, Laura A Berner, Stefan Ehrlich

Faculty, Staff and Student Publications

Background: The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and dependencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data.

Methods: We analyzed T1-weighted structural magnetic resonance imaging scans assessed with standardized methods from 685 female patients with AN …

Same Day Discharge Following Elective, Minimally Invasive, Colorectal Surgery : A Review Of Enhanced Recovery Protocols And Early Outcomes By The Sages Colorectal Surgical Committee With Recommendations Regarding Patient Selection, Remote Monitoring, And Successful Implementation, Elisabeth C Mclemore, Lawrence Lee, Traci L Hedrick, Laila Rashidi, Erik P Askenasy, Daniel Popowich, Patricia Sylla

Faculty, Staff and Student Publications

BACKGROUND: As enhanced recovery programs (ERPs) have continued to evolve, the length of hospitalization (LOS) following elective minimally invasive colorectal surgery has continued to decline. Further refinements in multimodal perioperative pain management strategies have resulted in reduced opioid consumption. The interest in ambulatory colectomy has dramatically accelerated during the COVID-19 pandemic. Severe restrictions in hospital capacity and fear of COVID transmission forced surgical teams to rethink strategies to further reduce length of inpatient stay.

METHODS: Members of the SAGES Colorectal Surgery Committee began reviewing the emergence of SDD protocols and early publications for SDD in 2019. The authors met at …

Is Antibiotic Prophylaxis Necessary After Endoscopic Ultrasound-Guided Fine-Needle Aspiration Of Pancreatic Cysts?, Seifeldin Hakim, Mihajlo Gjeorgjievski, Zubair Khan, Michael E Cannon, Kevin Yu, Prithvi Patil, Roy Tomas Davee, Sushovan Guha, Ricardo Badillo, Laith Jamil, Nirav Thosani, Srinivas Ramireddy

Faculty, Staff and Student Publications

BACKGROUND/AIMS: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics.

METHODS: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and …

Outcomes Of Gynecologic Cancer Surgery During The Covid-19 Pandemic: An International, Multicenter, Prospective Covidsurg-Gynecologic Oncology Cancer Study, Christina Fotopoulou, Tabassum Khan, Juraj Bracinik, James Glasbey, Nadeem Abu-Rustum, Luis Chiva, Anna Fagotti, Keiichi Fujiwara, Rahel Ghebre, Murat Gutelkin, Thomas O Konney, Joseph Ng, Rene Pareja, Rajkumar Kottayasamy Seenivasagam, Jalid Sehouli, Shylasree T S Surappa, Aneel Bhangu, Elaine Leung, Sudha Sundar

Faculty, Staff and Student Publications

BACKGROUND: The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during the COVID-19 pandemic, which are currently unclear.

OBJECTIVE: This study aimed to evaluate the changes in care and short-term outcomes of surgical patients with gynecologic cancers during the COVID-19 pandemic. We hypothesized that the COVID-19 pandemic had led to a delay in surgical cancer care, especially in patients who required more extensive …

The Association Of Human Leukocyte Antigen Genotyping Among Sudanese Patients With Rheumatoid Arthritis: Reference To Ethnicity, Deborah R Young, Benjamin D Hong, Kristina H Lewis, Silvia R Paz, Bhumi B Bhakta, Mayra Macias, Cecelia L Crawford, Adam Drewnowski, Ming Ji, Darren D Moore, Ernest Shen, Sameer B Murali, Karen J Coleman

Faculty, Staff and Student Publications

OBJECTIVE: This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors.

METHODS: Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. One-year percentage total weight loss (%TWL) was determined from electronic medical records. Covariates included demographics, Charlson Comorbidity Index, geocoded variables to assess neighborhood quality, and physical activity. The authors assessed the association between %TWL at 1 year and PSQI …

Does Attention-Deficit/Hyperactivity Disorder Increase The Risk Of Minor Blunt Head Trauma In Children?, Murat Pakyurek, Mohamed Badawy, Irma T Ugalde, Paul Ishimine, Pradip P Chaudhari, Kevan Mccarten-Gibbs, Ozra Nobari, Nathan Kuppermann, James F Holmes

Faculty, Staff and Student Publications

PROBLEM: It is unclear if attention-deficit hyperactivity disorder (ADHD) increases the risk of head trauma in children.

METHODS: We conducted a multicenter prospective observational study of children with minor blunt head trauma. Guardians were queried, and medical records were reviewed as to whether the patient had previously been diagnosed with ADHD. Enrolled patients were categorized based on their mechanism of injury, with a comparison of those with motor vehicle collision (MVC) versus non-MVC mechanisms.

FINDINGS: A total of 3410 (84%) enrolled children had ADHD status available, and 274 (8.0%; 95% confidence interval, CI: 7.1, 9.0%) had been diagnosed with ADHD. …

Comparison Of Pulmonary Function Changes Between Patients Receiving Neoadjuvant Chemotherapy And Chemoradiotherapy Prior To Minimally Invasive Esophagectomy: A Randomized And Controlled Trial, Xiaosang Chen, Mingjun Du, Han Tang, Hao Wang, Yong Fang, Miao Lin, Jun Yin, Lijie Tan, Yaxing Shen

Faculty, Staff and Student Publications

PURPOSE: Adequate pulmonary function is important for patients undergoing surgical resection of esophageal cancer, especially those that received neoadjuvant therapy. However, it is unknown if pre-operative radiation affects pulmonary function differently compared to chemotherapy. The purpose of this study was to compare changes in pulmonary function between patients undergoing minimally invasive esophagectomy (MIE) who received neoadjuvant chemotherapy or chemoradiotherapy.

METHODS: Between March 2017 and March 2018, esophageal cancer patients requiring neoadjuvant therapy were prospectively enrolled and randomly assigned to receive chemotherapy (CT) or chemoradiotherapy (CRT) before MIE. All patients received pulmonary function testing before and after the neoadjuvant therapy. Changes …

“Racing-Stripe” Modification Of Radial Forearm Free Flap: Technique And Experience (704 Consecutive Cases), Emmanuel G Melissinos, Erik S Marques

Faculty, Staff and Student Publications

The radial forearm fasciocutaneous free flap (RFFF) has proven to be a versatile and reliable tool for the reconstructive microsurgeon when addressing soft-tissue defects. A significant drawback of the traditional RFFF is related to donor site morbidity and wound healing complications, especially when coverage of sizable defects is planned. The authors describe the "racing-stripe" modification of the RFFF (RS-RFFF) that involves harvesting a large segment of the deep forearm fascia with a narrow strip of skin overlying the radial vessels, thus allowing primary closure of the donor site.

METHODS: Retrospective chart review was conducted of a single surgeon's (E.G.M.) experience …

Structural Brain Alterations Associated With Suicidal Thoughts And Behaviors In Young People: Results From 21 International Studies From The Enigma Suicidal Thoughts And Behaviours Consortium, Laura S Van Velzen, Maria R Dauvermann, Lejla Colic, Luca M Villa, Hannah S Savage, Yara J Toenders, Alyssa H Zhu, Joanna K Bright, Adrián I Campos, Lauren E Salminen, Sonia Ambrogi, Rosa Ayesa-Arriola, Nerisa Banaj, Zeynep Başgöze, Jochen Bauer, Karina Blair, Robert James Blair, Katharina Brosch, Yuqi Cheng, Romain Colle, Colm G Connolly, Emmanuelle Corruble, Baptiste Couvy-Duchesne, Benedicto Crespo-Facorro, Kathryn R Cullen, Udo Dannlowski, Christopher G Davey, Katharina Dohm, Janice M Fullerton, Ali Saffet Gonul, Ian H Gotlib, Dominik Grotegerd, Tim Hahn, Ben J Harrison, Mengxin He, Ian B Hickie, Tiffany C Ho, Frank Iorfino, Andreas Jansen, Fabrice Jollant, Tilo Kircher, Bonnie Klimes-Dougan, Melissa Klug, Elisabeth J Leehr, Elizabeth T C Lippard, Katie A Mclaughlin, Susanne Meinert, Adam Bryant Miller, Philip B Mitchell, Benson Mwangi, Igor Nenadić, Amar Ojha, Bronwyn J Overs, Julia-Katharina Pfarr, Fabrizio Piras, Kai G Ringwald, Gloria Roberts, Georg Romer, Marsal Sanches, Margaret A Sheridan, Jair C Soares, Gianfranco Spalletta, Frederike Stein, Giana I Teresi, Diana Tordesillas-Gutiérrez, Aslihan Uyar-Demir, Nic J A Van Der Wee, Steven J Van Der Werff, Robert R J M Vermeiren, Alexandra Winter, Mon-Ju Wu, Tony T Yang, Paul M Thompson, Miguel E Rentería, Neda Jahanshad, Hilary P Blumberg, Anne-Laura Van Harmelen, Enigma Suicidal Thoughts And Behaviours Consortium, Lianne Schmaal

Faculty, Staff and Student Publications

Identifying brain alterations associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and improving early intervention and prevention. The ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium analyzed neuroimaging data harmonized across sites to examine brain morphology associated with STBs in youth. We performed analyses in three separate stages, in samples ranging from most to least homogeneous in terms of suicide assessment instrument and mental disorder. First, in a sample of 577 young people with mood disorders, in which STBs were assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Second, in a sample …

Isotretinoin, Vitamin A Supplements, And Unintended Pregnancies In Post Roe V Wade America, Praneet S Paidisetty, Leonard K Wang, Dina H Zamil, Shangyi Fu, Zeena Y Nawas

Faculty, Staff and Students Publications

Isotretinoin is a potent vitamin A derivative that is used to treat acne. However, despite its utility in dermatologic care, it is also highly teratogenic and can cause severe life-threatening fetal abnormalities in the first trimester of pregnancy. As a result, existing regulations are stringent in order to prevent accidental pregnancies in women taking isotretinoin. In the unlikely case of an unintended pregnancy, while taking isotretinoin, a woman could terminate her pregnancy with an abortion. However, with the recent overturning of Roe v. Wade, we explore the consequences of this landmark United States Supreme Court ruling with special attention …