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 Influence of Serial ECG on the Test Characteristics of the Sgarbossa Criteria in Ventricular Paced Rhythms.Tan, Calvin J; deSouza, Ian SPublication Open Access An unusual case of burning hands.(2021-05-13) Chu, Kathy; deSouza, Ian SBurning Hands Syndrome is an unusual variant of central cord syndrome. There have been few published reports, and none in the emergency medicine literature. We present a case of Burning Hands Syndrome in which there were no computed tomography (CT) findings of cervical spine injury and only subtle magnetic resonance (MR) abnormalities. We discuss the importance of early diagnosis, as the optimal management of these patients ultimately depends upon prompt recognition of the underlying cervical trauma and a spinal cord at risk for further injury.Publication Open Access Is Experienced Physician Gestalt With an Electrocardiogram Sufficient to Accurately Exclude Acute Myocardial Infarction in a Patient With Suspected Acute Coronary Syndrome?(2019-10-25) deSouza, Ian S; Sinert, RichardPublication Open Access Fortuitous Identification of Fluctuating AV Block: A Case Report.(2019-05-06) deSouza, Ian S; Dilip, MonishaVagally mediated atrioventricular block (AVB) may occur as a result of increased parasympathetic tone. This particular AVB is infrequently described in the literature, but its prevalence may be underestimated, as it may occur without recognition.Publication Open Access β-Blockers versus calcium channel blockers for acute rate control of atrial fibrillation with rapid ventricular response: a systematic review.Martindale, Jennifer L; deSouza, Ian S; Silverberg, Mark; Freedman, Joseph; Sinert, RichardThis is a systematic review of the literature to compare the efficacy of calcium channel blockers to β-blockers for acute rate control of atrial fibrillation with rapid ventricular response in the emergency department setting. PubMed, EMBASE, and the Cochrane Registry were searched. Relative risk (95% confidence interval) was calculated between drugs and methodological quality of included studies was evaluated. Of the 1003 studies yielded by our initial search, two met inclusion criteria and provided sufficient data. These were randomized double-blinded studies (n=92) comparing intravenous diltiazem with intravenous metoprolol. The combined relative risk of acute rate control by diltiazem versus metoprolol was 1.8 (95% confidence interval 1.2-2.6). On the basis of the paucity of available evidence, diltiazem may be more effective than metoprolol in achieving rapid rate control, but high-quality randomized studies are needed.Publication Open Access Corrigendum to "Rapid tranquilization of the agitated patient in the emergency department: A systematic review and network meta-analysis" [American Journal of Emergency Medicine 51 (2022) 363-373].(2021-11-29) deSouza, Ian S; Thode, Henry C; Shrestha, Pragati; Allen, Robert; Koos, Jessica; Singer, Adam JPublication Open Access Accuracy of Physical Examination, Ankle-Brachial Index, and Ultrasonography in the Diagnosis of Arterial Injury in Patients With Penetrating Extremity Trauma: A Systematic Review and Meta-analysis.deSouza, Ian S; Benabbas, Roshanak; McKee, Sean; Zangbar, Bardiya; Jain, Ashika; Paladino, Lorenzo; Boudourakis, Leon; Sinert, RichardPenetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Timely, accurate diagnosis is essential for potential intervention in order to prevent significant morbidity.Publication Open Access Point-of-care Ultrasonography of a Rare Cause of Hemoperitoneum.(2018-09-05) Kelson, Kyle R; Riscinti, Matthew; Secko, Michael; deSouza, Ian SA young woman presented to the emergency department with lethargy, hemodynamic instability, and diffuse abdominal tenderness. On point-of-care ultrasound (PoCUS), she was found to have intraperitoneal free fluid and a large pelvic mass, which were discovered intraoperatively to be hemoperitoneum due to ruptured vessels of a uterine leiomyoma. Although rare, a life-threatening, ruptured leiomyoma may be treated surgically if recognized in an expedient fashion. A PoCUS can aid the emergency clinician in prompt diagnosis.Publication Open Access Rapid tranquilization of the agitated patient in the emergency department: A systematic review and network meta-analysis.(2021-11-14) deSouza, Ian S; Thode, Henry C; Shrestha, Pragati; Allen, Robert; Koos, Jessica; Singer, Adam JSafe and effective tranquilization of the acutely agitated patient is challenging, and head-to-head comparisons of medications are limited. We aimed to identify the most optimal agent(s) for rapid tranquilization of the severely agitated patient in the emergency department (ED).Publication Open Access Ventricular tachycardia as a consequence of triggered activity.(2020-11-07) Riggins, John; Douglas, Taylor; deSouza, Ian SOne of the less frequent underlying mechanisms of ventricular tachycardia (VT) is triggered activity. Triggered activity refers to an extrasystole due to a premature depolarization that occurs when the amplitude of an early or delayed afterdepolarization brings the cardiac membrane to its threshold potential. Hydrochlorothiazide and hydroxyzine can prolong repolarization and QT interval and are associated with early afterdepolarizations. Cyclic AMP-mediated, delayed afterdepolarizations can occur as a result of catecholaminergic surge. Delayed afterdepolarization is classically associated with outflow tract (OT) tachycardia, a type of VT that is uniquely defined by its termination with adenosine. We present a case of triggered OT tachycardia for which intravenous amiodarone through its antiadrenergic effect may have been effective. Infusions of magnesium and a cardioselective, β-receptor antagonist that does not prolong repolarization may have been more appropriate given the concurrent, acquired prolonged QT syndrome. After initial stabilization, considering the underlying VT mechanism may prompt the clinician to select the most appropriate, further treatment.