Steven Mongin - Academia.edu (original) (raw)

Papers by Steven Mongin

Limited data are available in the literature on carcinogen uptake by children exposed to environm... more Limited data are available in the literature on carcinogen uptake by children exposed to environmental tobacco smoke (ETS). In this study, we quantified metabolites of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1(3-pyridyl)-1-butanone (NNK) in the urine of elementary school-aged children participating in the School Health Initiative: Environment, Learning, Disease study, a schoolbased investigation of the environmental health of children. The metabolites of NNK are 4-(methylnitrosamino)-1-(3pyridyl)-1-butanol (NNAL) and its glucuronide (NNALGluc). We also measured cotinine and its glucuronide (total cotinine). Urine samples were collected from 204 children. Seventy (34.3%) of these had total cotinine >5 ng/ml. NNAL or NNAL-Gluc was detected in 52 of 54 samples with total cotinine >5 ng/ml and in 10 of 20 samples with total cotinine <5 ng/ml. Levels of NNAL plus NNAL-Gluc and total cotinine were significantly higher when exposure to ETS was reported than when...

La Revue du praticien, 2002

Transplantation Reports, 2020

Introduction: Kidney transplantation (KT) demands that patients navigate a complex healthcare sys... more Introduction: Kidney transplantation (KT) demands that patients navigate a complex healthcare system and adhere to lifelong therapy and surveillance. Cultural and linguistic discordance between patients and providers has been identified as a barrier to successful KT. We studied KT outcomes and disparities among a native Somali population living in Minnesota. Methods: Between 1995 and 2015, 2,385 patients underwent KT at our institution; 22 were self-designated Somali nationals. Patient and graft survival and time to first rejection were analyzed. Utilization of interpreter services was evaluated. Results: Patient survival for the Somali cohort at 1 year was 100% and 95.5% at 5 years; compared to 97.2% at 1 year and 89.1% at 5 years for the Caucasian cohort (p = 0.40). Graft survival for the Somali cohort at 1 year was 100% and 95.5% at 5 years; for the Caucasian cohort 94.8% and 81.6% (p = 0.35). Rejection-free survival in the Somali cohort was 100% at 1 and 5 years, for the Caucasian cohort 86.2% and 82.1 (p = 0.41). Among 22 adult Somali KT recipients, 15 (68%) patients frequently utilized interpreter services in their KT-related clinical encounters. Conclusion: Immigrant Somali KT recipients, appear to have comparable KT outcomes compared to a contemporaneous Caucasian cohort. 100,011, 129,018, and 183,039 respectively. It is estimated that 59,058 (32%) of the US population are concentrated in the Minneapolis-Saint

American Journal of Gastroenterology, 2013

Clinical Transplantation, 2019

Kidney transplantation (KT) is the optimal therapy for endstage renal disease (ESRD) patients. 1 ... more Kidney transplantation (KT) is the optimal therapy for endstage renal disease (ESRD) patients. 1 Kidney transplantation requires the delivery of highly complex, sophisticated, and well-coordinated care involving a large multidisciplinary team of physicians, nurses, pharmacists, care coordinators, social workers, and most importantly, the patient and their support network. Numerous studies have addressed the role that physician cultural and linguistic competency and patient medical competency influence a successful outcome following transplantation. 2,3 This interplay on outcomes transcends medical specialty, ethnicity, cultural background, spoken language, or even gender. 2,4,5

The American Journal of Surgery, 2019

RESULTS: Eighty-eight patients had an average follow-up duration of 6.7 (AE2.9) years. Thirty (34... more RESULTS: Eighty-eight patients had an average follow-up duration of 6.7 (AE2.9) years. Thirty (34%) patients were naïve to

Journal of the American College of Surgeons, 2019

BACKGROUND: A total pancreatectomy and intraportal islet cell autotransplant (TPIAT) is increasin... more BACKGROUND: A total pancreatectomy and intraportal islet cell autotransplant (TPIAT) is increasingly being offered to patients with chronic pancreatitis (CP). The benefits include removal of the root cause of pain and amelioration of diabetes. However, the long-term durability of this operation remains unclear. STUDY DESIGN: Of the 742 patients who have undergone a TPIAT at our center, 215 who did so between 1998 and 2008 now have at least 10 years of follow-up time and were eligible for this single-center observational study. Our outcomes measures included abdominal pain relief, narcotic use, islet graft function (subdivided into 3 groups: insulin independence; partial graft function, defined by C-peptide level > 0.6 mg/dL; and no function, defined by C-peptide level < 0.6 mg/dL), and health-related quality of life. RESULTS: The 10-year actuarial survival rate was 72%. A BMI > 30 kg/m 2 (p = 0.04) predicted 10-year mortality. The rates of pain relief were 82% at 10 years and 90% at 15 years. Narcotic use declined with time: the rates were 50% at 5 years and 37% at 10 years. At 10 years, the rate of insulin independence was 20%; the rate of partial graft function, 32%. Transplantation of islet equivalents/kg > 4,000 was the strongest predictor of islet graft function at 10 years. Pediatric patients were more likely to have islet function than adults (p = 0.01). Health-related quality of life continued to improve at 10 years, even in patients on narcotics.

Journal of the American College of Surgeons, 2018

Living liver donation is one of the most selfless and humane acts a person can perform. Few singl... more Living liver donation is one of the most selfless and humane acts a person can perform. Few single-center reports have been published specifically evaluating complications and quality of life post-donation. We conducted a retrospective analysis of outcomes of 176 living liver donors at our center to determine the incidence, type, and Clavien grade of complications, as well as long-term quality of life. Of 176 living donors, 154 underwent right hepatectomy, 4 underwent left hepatectomy lobectomy, and 18 underwent left lateral segmentectomy. Mean follow-up time was 4.8 years. Complications were more frequent among right-lobe donors than left-lateral segmentectomy and left-lobe donors (p = 0.003). Of note, 82% of complications were Clavien grade 1 or 2. Of the 154 right-lobe donors, 3 had Clavien grade 3a complications, 9 had grade 3b complications (4 had bile leaks, 3 had intra-abdominal bleeding, and 2 had pleural effusions). No donor had complications that were Clavien grade 4 or hi...

American journal of industrial medicine, 2018

We conducted external comparisons for the prevalence of asthma, hypertension, diabetes, and cance... more We conducted external comparisons for the prevalence of asthma, hypertension, diabetes, and cancer among World Trade Center (WTC) general responders using the National Health Interview Survey (NHIS) as the reference, along with internal comparisons for the incidence of asthma. Standardized Morbidity Ratios (SMRs) were calculated for the prevalence of the health conditions, and risk ratios (RRs) for asthma incidence. Relative to the NHIS, asthma prevalence was in excess in responders over the study years (age-adjusted SMRs = 1.3-2.8). Hypertension prevalence began to exceed expected from 2006 while diabetes was lower than expected. An upward trend towards excess cancer prevalence was observed. Internal comparisons showed elevated asthma incidence among protective service and utility workers compared to construction workers; while those who arrived at the WTC site in the morning of 9/11 had a lower asthma risk than those who arrived in the afternoon. The use of NHIS data as a referenc...

American Journal of Epidemiology, 2017

The unexpected nature of disasters leaves little time or resources for organized health surveilla... more The unexpected nature of disasters leaves little time or resources for organized health surveillance of the affected population, and even less for those who are unaffected. An ideal epidemiologic study would monitor both groups equally well, but would typically be decided against as infeasible or costly. Exposure and health outcome data at the level of the individual can be difficult to obtain. Despite these challenges, the health effects of a disaster can be approximated. Approaches include 1) the use of publicly available exposure data in geographic detail, 2) health outcomes data-collected before, during, and after the event, and 3) statistical modeling designed to compare the observed frequency of health outcomes with the counterfactual frequency hidden by the disaster itself. We applied these strategies to Hurricane Sandy, which struck the northeastern United States in October 2012. Hospital admissions data from the state of New York with information on primary payer as well as patient demographic characteristics were analyzed. To illustrate the method, we present multivariate logistic regression results for the first 2 months after the hurricane. Inferential implications of admissions data on nearly the entire target population in the wake of a disaster are discussed.

Children/youths, as well as adults, are at risk of injury on agricultural operations where occupa... more Children/youths, as well as adults, are at risk of injury on agricultural operations where occupational and residential environments overlap. This study was conducted to determine the short- and long-term physical, psychosocial, and economic consequences of injuries occurring among children/youths living in households with agricultural operations in Minnesota, Wisconsin, North Dakota, South Dakota, and Nebraska Midwestern states characteristic of major types of agricultural production in the United States (US). From a random selection of 32,000 agricultural operations, generated from the states' operations by the US Department of Agriculture, 1,474 of 3,443 eligible households with children participated. Baseline and follow-up data on physical and mental health, agricultural and other injury disability, and economic status, were collected by trained interviewers using computerized assisted telephone interview (CATI) data collection instruments; two six-month injury data collecti...

Background/Purpose: Violence is a major occupational problem; yet, the population of educators ha... more Background/Purpose: Violence is a major occupational problem; yet, the population of educators has been neglected. The objective was to identify their potential risks for physical assault (PA) and nonphysical violence (NPV), based on hours exposed. Methods: From a random sample of 26,000 licensed kindergarten through grade 12 Minnesota educators, 6,469 eligible educators were included. Data were collected, using specially designed mailed questionnaires (12-month recall). Calculated PA and NPV rates, per 100,000 working hours, used generalized linear models with Poisson distribution. Directed acyclic graphs identified confounders for multivariable analyses, adjusted for non-response and unknown eligibility. Results/Outcomes: NPV rates were higher than PA rates (26.37 and 5.31). Subcategory NPV rates were: threat (34.82); sexual harassment (7.58); verbal abuse (55.48); bullying (19.62). Multivariate analyses for respective PA and NPV models revealed increased rate ratios (95% CIs) for...

Introduction Recent events heightened awareness of school violence affecting educators. Previousl... more Introduction Recent events heightened awareness of school violence affecting educators. Previously, the focus had been on students, not teachers. Methods Data were analyzed from a population-based study of 26,000 randomly selected Minnesota educators. 6469 were eligible and contacted in study Phase 1 to determine violent events. In Phase 2 (case-control study), cases (n=299 reporting physical assault in previous year) and controls n=(867, no events) provided exposure information for the month prior to assault, and randomly selected months, respectively. Directed acyclic graphs were used to select confounders for multiple regression analyses. Results Response for each study phase was 84%. Cases and controls, respectively, reported being trained about the following ten topics by their current employer/school: resolving conflicts (55%, 54%); using appropriate restraining techniques (55%, 27%); reporting work-related physical assault (54%, 50%); preventing bullying (53%, 58%); reporting...

Work, 2012

A case-control study design was used to investigate risks of work-related physical assault (PA) a... more A case-control study design was used to investigate risks of work-related physical assault (PA) associated with a history of violent victimization among educators. A total of 6,469 state-licensed educators (Kindergarten - Grade 12) worked in the previous 12~months and were eligible to participate. Exposure data were collected from cases (reporting a PA event in previous 12 months, n=290) for the month before PA, and from controls (no work-related PA in previous 12 months; n=867) for a randomly selected working month. Odds ratios and 95% confidence intervals identified increased risks for educators with any prior history of work-related (17.3, 11.4-26.3) or non-work-related PA (2.0, 1.2-3.5). In addition, PA risk in the previous twelve months increased with the number of previous victimizations, and risk also increased for educators with histories of non-physical violence (work- and non work-related). The results present a compelling case for targeted interventions and further research.