deSouza, Ian
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Biography
B.S. Biological Sciences with high honors 1995, Cornell University; M.D. 1999, New York University School of Medicine; Internship and Residency 2003, Bellevue Hospital Center/New York University School of Medicine
38 results
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Publication Open Access The "NUTS" statistic: Applying an EBM disease model to defensive medicine.(2021-09-15) Allen, Robert; Cai, Angela G; Tepler, Peter; deSouza, Ian SPhysicians believe that malpractice concerns result in unnecessary testing, and many emergency physicians state that avoiding malpractice is a contributing factor to ordering medically unnecessary tests. Unfortunately, defensive medicine does not come without possible harm to patients who may be subject to non-beneficial, downstream testing, procedures, and hospitalizations. We submit a novel statistic, "NUTS" or "Number of Unnecessary Tests to avoid one Suit. " We calculated a NUTS of 4737 for troponin testing in ED patients with suspected myocardial infarction, meaning a clinician will need to order 4737 medically unnecessary troponin tests to avoid one missed myocardial infarction lawsuit. The NUTS framework offers us an evidence-based lens to examine defensive medicine less superstitiously and more based on currently available data.Publication Open Access Publication Open Access The soymilk diet: A previously unknown etiology of acute pancreatitis.(2021-01-27) deSouza, Ian S; Lipsitt, AlexanderWe present a case of daily, large ingestions of soymilk that likely led to acute pancreatitis. Soybean contains trypsin inhibitor that when ingested will reduce the activity of trypsin in the intestine. A decrease in intestinal proteolytic activity removes the negative feedback on the pancreatic acinar cells, leading to an inappropriate increase in intrapancreatic trypsin secretion. When trypsin activation exceeds the capacity of pancreatic secretory trypsin inhibitor, the subsequent cascade of events can lead to acute pancreatitis.Publication Open Access Pharmacologic Cardioversion of Recent-Onset Atrial Fibrillation and Flutter in the Emergency Department: A Systematic Review and Network Meta-analysis.(2020-03-12) deSouza, Ian S; Tadrous, Mina; Sexton, Theresa; Benabbas, Roshanak; Carmelli, Guy; Sinert, RichardWe conduct a systematic review and Bayesian network meta-analysis to indirectly compare and rank antidysrhythmic drugs for pharmacologic cardioversion of recent-onset atrial fibrillation and atrial flutter in the emergency department (ED).Publication Open Access Serial Sonographic Assessment of Pulmonary Edema in Patients With Hypertensive Acute Heart Failure.(2017-07-31) Martindale, Jennifer L; Secko, Michael; Kilpatrick, John F; deSouza, Ian S; Paladino, Lorenzo; Aherne, Andrew; Mehta, Ninfa; Conigiliaro, Alyssa; Sinert, RichardObjective measures of clinical improvement in patients with acute heart failure (AHF) are lacking. The aim of this study was to determine whether repeated lung sonography could semiquantitatively capture changes in pulmonary edema (B-lines) in patients with hypertensive AHF early in the course of treatment.Publication Open Access Ecstasy (MDMA) deaths in New York City: a case series and review of the literature.Gill, James R; Hayes, Jonathan A; deSouza, Ian S; Marker, Elizabeth; Stajic, MarinaMDMA ("ecstasy") has gained renewed popularity as a drug of abuse. To access the epidemiology and causes of death of MDMA-positive fatalities, all deaths investigated by the OCME that tested positive for MDMA (22 deaths) between January 1997 and June 2000 were reviewed. There were three deaths in each 1997 and 1998, eleven in 1999, and five in the first part of 2000. Of these 22 deaths, 13 were due to acute drug intoxications, 7 due to mechanical injury (blunt trauma, gunshot wounds), and 2 due to a combination of natural disease and acute drug intoxication. Evidence of recent opiate and/or cocaine use was found in 7 of the acute intoxication deaths and in none of the traumatic or combination natural/intoxication deaths. The race of all decedents was White between the ages of 17-41 years, and 18 of 22 were men.Publication Open Access Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis.(2016-02-13) Martindale, Jennifer L; Wakai, Abel; Collins, Sean P; Levy, Phillip D; Diercks, Deborah; Hiestand, Brian C; Fermann, Gregory J; deSouza, Ian; Sinert, RichardAcute heart failure (AHF) is one of the most common diagnoses assigned to emergency department (ED) patients who are hospitalized. Despite its high prevalence in the emergency setting, the diagnosis of AHF in ED patients with undifferentiated dyspnea can be challenging.Publication Open Access Publication Open Access Ankle-brachial index for diagnosis of arterial injury in penetrating extremity trauma.(2021-03-05) Benabbas, Roshanak; deSouza, Ian SPublication Open Access Re: Amiodarone for sustained stable ventricular tachycardia in the prehospital setting.(2018-09-03) deSouza, Ian S