The American surgeon
-
The American surgeon · Dec 2020
Meta AnalysisMeta-Analysis on the Effect of Pasireotide for Prevention of Postoperative Pancreatic Fistula.
A randomized controlled trial of routine administration of pasireotide demonstrated decreased incidence of clinically significant postoperative pancreatic fistula (POPF). Recent studies have not replicated these results. A meta-analysis was performed to evaluate its efficacy in this setting. ⋯ Routine administration of pasireotide did not decrease POPF rates for all pancreatectomies, but was associated with lower rates for PD, and decreased readmission rates. Further prospective, randomized studies are warranted.
-
The American surgeon · Dec 2020
Disproportionate Impact of COVID-19 Pandemic on Racial and Ethnic Minorities.
Health disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities. ⋯ COVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention.
-
The American surgeon · Dec 2020
Observational StudyIntensive Care Unit Bed Utilization and Head Injury Burden in a Resource-Poor Setting.
In high-income countries (HICs), the intensive care unit (ICU) bed density is approximately 20-32 beds/100 000 population compared with countries in sub-Saharan Africa, like Malawi, with an ICU bed density of 0.1 beds/100 000 population. We hypothesize that the ICU bed utilization in Malawi will be high. ⋯ Despite the high burden of critical illness, the bed occupancy rates, turn over days, and turnover interval reveal significant underutilization of the available ICU beds. ICU bed underutilization may be attributable to the absence of an admission and discharge protocols. A lack of brain death policy further impedes appropriate ICU utilization.
-
The American surgeon · Dec 2020
Timing of Prophylactic Inferior Vena Cava Filter Placement and Trauma Outcomes : Does Early Placement Matter?
Prophylactic inferior vena cava filters (IVCFs) are often placed in trauma patients who cannot receive prophylactic anticoagulation. IVCFs are utilized in an effort to reduce the risk of acute pulmonary embolism (PE) and mortality. This study aims to investigate whether time-to-filter placement is associated with differences in trauma outcomes. ⋯ Currently, there are no investigations in the trauma literature looking at the impact of time-to-filter on complications related to venous thromboembolism and potential survival benefit. Results of this investigation showed that IVCF placement within the first 48 hours was significantly associated with shorter ICU- and hospital- LOS.