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Article ; Online: Review of the EAST Practice Management Guideline: Evaluation and Management of Traumatic Diaphragmatic Injuries.

Diaz, Jose J

2019 Volume 154, Issue 7, Page(s) 666–667

MeSH term(s)	Diaphragm/injuries ; Disease Management ; Humans ; Laparoscopy/methods ; Practice Guidelines as Topic ; Thoracic Injuries/surgery ; Wounds, Penetrating/surgery
Language	English
Publishing date	2019-05-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2019.1156
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Article ; Online: Dementia and the Critically Ill Older Adult.

Ghneim, Mira / Diaz, Jose J

Critical care clinics

2020 Volume 37, Issue 1, Page(s) 191–203

Abstract: Dementia is a terminal illness that leads to progressive cognitive and functional decline. As the elderly population grows, the incidence of dementia in hospitalized older adults increases and is associated with poor short-term and long-term outcomes. ... ...

Abstract	Dementia is a terminal illness that leads to progressive cognitive and functional decline. As the elderly population grows, the incidence of dementia in hospitalized older adults increases and is associated with poor short-term and long-term outcomes. Delirium is associated with an accelerated cognitive decline in hospitalized patients with dementia. The first step in the management of dementia is accurate and early diagnosis. Evidence-based management guidelines in the setting of critical illness and dementia are lacking. The cornerstone of management is defining goals of care early in the course of hospitalization and using palliative care and hospice when deemed appropriate.
MeSH term(s)	Aged ; Critical Illness ; Delirium/diagnosis ; Delirium/epidemiology ; Delirium/etiology ; Dementia/diagnosis ; Dementia/epidemiology ; Dementia/therapy ; Hospitalization ; Humans ; Palliative Care
Language	English
Publishing date	2020-10-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1006423-0
ISSN	1557-8232 ; 0749-0704
ISSN (online)	1557-8232
ISSN	0749-0704
DOI	10.1016/j.ccc.2020.08.010
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Article ; Online: Surgical Stabilization of Rib Fractures in Severe Injury Is Not Associated With Worse Outcomes.

Harfouche, Melike N / Nigam, Rohan / Efron, David T / Diaz, Jose J

The Journal of surgical research

2022 Volume 284, Page(s) 106–113

Abstract: Introduction: This study aimed to determine whether surgical stabilization of rib fractures (SSRF) is associated with worse outcomes in individuals with multicompartmental injuries.: Materials and methods: A retrospective review of a prospective ... ...

Abstract	Introduction: This study aimed to determine whether surgical stabilization of rib fractures (SSRF) is associated with worse outcomes in individuals with multicompartmental injuries. Materials and methods: A retrospective review of a prospective trauma registry was performed for adult blunt trauma patients (aged ≥ 18 y) with Injury Severity Score ≥ 15 and radiographic evidence of rib fractures (2015-2020). Individuals without concomitant head, abdomen/pelvis, or lower extremity Abbreviated Injury Scale scores ≥ 3 were excluded. Propensity match on demographic and clinical variables was performed comparing patients treated nonoperatively (NO) to those undergoing SSRF. A chart review was performed for additional data. Primary outcome was hospital length of stay (LOS). Secondary outcomes were in-hospital mortality, intensive care unit LOS, and duration of mechanical ventilation. Results: One thousand nine hundred ninety three patients fit the inclusion criteria (NO = 1,951, SSRF = 42). After matching, there were 98 in the NO group and 42 in the SSRF group. Mean age was 51 y, 61.4% were male, and 71.4% were of White race. Median time to fixation was 5 d. The SSRF group had more severe chest trauma as evidenced by a higher RibScore (3.2 versus 1.7, P < 0.001) and had a longer LOS (18 versus 9 d, P < 0.001), intensive care unit LOS (13 versus 3 d, P = 0.007), and duration of mechanical ventilation (8 versus 2 d, P = 0.013) on univariate analysis. Multivariable regression analysis demonstrated no association between SSRF and these short-term outcomes. Conclusions: Despite delayed average time to intervention, SSRF in a trauma-patient population with multicompartmental injuries and competing management priorities is not associated with worse short-term outcomes.
MeSH term(s)	Adult ; Humans ; Male ; Middle Aged ; Female ; Rib Fractures/complications ; Rib Fractures/surgery ; Treatment Outcome ; Length of Stay ; Retrospective Studies ; Fracture Fixation, Internal/adverse effects
Language	English
Publishing date	2022-12-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.11.053
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Article ; Online: Minimally invasive chest wall stabilization: a novel surgical approach to video-assisted rib plating (VARP).

Diaz, Jose J / Azar, Faris K

Trauma surgery & acute care open

2019 Volume 4, Issue 1, Page(s) e000366

Abstract: The current morbidity of rib plating is due to the size of the incision required to perform an open procedure. We describe a minimally invasive laparoscopic approach to rib plating. A cadaver model was used to develop the surgical technique by performing ...

Abstract	The current morbidity of rib plating is due to the size of the incision required to perform an open procedure. We describe a minimally invasive laparoscopic approach to rib plating. A cadaver model was used to develop the surgical technique by performing both left and right posterior-lateral rib plating. A small incision was made over the auscultatory triangle. The potential working space is developed under the posterior shoulder girdle and the scapula. A table-based retractor was used to elevate the scapula and the muscles. Two separate ports were placed: one camera port and one working port. In three cadaver models, 12 rib fractures were plated and the surgical technique is described. This novel technique will likely allow for faster recovery and was especially useful in the subscapular space.
Keywords	covid19
Language	English
Publishing date	2019-12-18
Publishing country	England
Document type	Journal Article
ISSN	2397-5776
ISSN (online)	2397-5776
DOI	10.1136/tsaco-2019-000366
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Article ; Online: "Mission Zero" Grant Brings Air Force Trauma Surgery to Tampa General Hospital and University of South Florida.

Hodgson, John A / Chandy, Joby / Moran, Michele / Herron, Thomas J / Diaz, Jose J

Military medicine

2023

Language	English
Publishing date	2023-11-07
Publishing country	England
Document type	Journal Article
ZDB-ID	391061-1
ISSN	1930-613X ; 0026-4075
ISSN (online)	1930-613X
ISSN	0026-4075
DOI	10.1093/milmed/usad420
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Article ; Online: Greater cost without greater benefit: The need to refine transfer criteria for patients with severe acute pancreatitis.

Harfouche, Melike N / Ghneim, Mira / Nezami, Nariman / Vesselinov, Roumen / Diaz, Jose J

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

2023 Volume 23, Issue 7, Page(s) 784–788

Abstract: Background: Appropriate and timely care is essential in the management of severe acute pancreatitis (SAP). We hypothesized that transferred patients with SAP undergoing procedural intervention would have higher mortality compared to those managed ... ...

Abstract	Background: Appropriate and timely care is essential in the management of severe acute pancreatitis (SAP). We hypothesized that transferred patients with SAP undergoing procedural intervention would have higher mortality compared to those managed directly at academic centers. Methods: This was a retrospective analysis of Maryland's statewide claims database from 2009 to 2022 of adult patients admitted with a primary diagnosis of SAP (acute pancreatitis with organ failure). Patients were divided into three groups: those admitted directly from the emergency room to academic facilities (AD), non-academic facilities (NA), or transferred to academic facilities (TR). Procedural intervention included endoscopic, percutaneous image-guided, or surgical. The primary outcome was in-hospital mortality. Secondary outcomes were admission costs, length of stay (LOS), and intensive care unit (ICU) admission. Results: There were 7,648 (48.9%) in the NA group, 6,682 (42.7%) in the AD group and 1,316 (8.4%) in the TR group. On regression analysis, odds of death were 0.57x lower in the NA group and 0.67x lower in the AD group compared to transfers (<0.001). Procedural intervention was not associated with increased mortality. Transferred patients had longer median LOS (11 vs NA = 5, AD = 6, p < 0.001), increased median cost of admission ($41k vs NA = $12k, AD = $17k, p < 0.001) and greater ICU admission (45.6% vs NA = 20.6%, AD = 23.9%, p < 0.001). Conclusion: Transferred patients have greater burden of illness and cost of care without evidence of improved outcomes in the management of SAP regardless of procedural intervention. Transfer criteria for patients with SAP must be further refined to reduce unnecessary transfers.
MeSH term(s)	Adult ; Humans ; Acute Disease ; Intensive Care Units ; Length of Stay ; Pancreatitis/surgery ; Pancreatitis/complications ; Retrospective Studies ; Cost-Benefit Analysis ; Insurance Claim Review/economics
Language	English
Publishing date	2023-08-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2056680-3
ISSN	1424-3911 ; 1424-3903
ISSN (online)	1424-3911
ISSN	1424-3903
DOI	10.1016/j.pan.2023.08.010
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Article ; Online: Transition to Permitless Open Carry and Association with Firearm-Related Suicide.

Grimsley, Emily A / Torikashvili, Johnathan V / Janjua, Haroon M / Read, Meagan D / Kuo, Paul C / Diaz, Jose J

Journal of the American College of Surgeons

2024 Volume 238, Issue 4, Page(s) 681–688

Abstract: Background: Firearm-related death rates continue to rise in the US. As some states enact more permissive firearm laws, we sought to assess the relationship between a change to permitless open carry (PLOC) and subsequent firearm-related death rates, a ... ...

Abstract	Background: Firearm-related death rates continue to rise in the US. As some states enact more permissive firearm laws, we sought to assess the relationship between a change to permitless open carry (PLOC) and subsequent firearm-related death rates, a currently understudied topic. Study design: Using state-level data from 2013 to 2021, we performed a linear panel analysis using a state fixed-effects model. We examined total firearm-related death, suicide, and homicide rates separately. If a significant association between OC law and death rate was found, we then performed a difference-in-difference (DID) analysis to assess for a causal relationship between changing to PLOC and increased death rate. For significant DID results, we performed confirmatory DID separating firearm and nonfirearm death rates. Results: Nineteen states maintained a no OC or permit-required law, whereas 5 changed to permitless and 26 had a PLOC before 2013. The fixed-effects model indicated more permissive OC law that was associated with increased total firearm-related deaths and suicides. In DID, changing law to PLOC had a significant average treatment effect on the treated of 1.57 (95% CI 1.05 to 2.09) for total suicide rate but no significant average treatment effect for the total firearm-related death rate. Confirmatory DID results found a significant average treatment effect on the treated of 1.18 (95% CI 0.90 to 1.46) for firearm suicide rate. Conclusions: OC law is associated with total firearm-related death and suicide rates. Based on our DID results, changing to PLOC is indeed strongly associated with increased suicides by firearm.
MeSH term(s)	Humans ; United States/epidemiology ; Suicide ; Firearms ; Homicide ; Wounds, Gunshot
Language	English
Publishing date	2024-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1097/XCS.0000000000000959
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Article ; Online: Cirrhosis Increases the Rate of Failure of Nonoperative Management in Blunt Liver Injuries.

Grimsley, Emily A / Lippincott, Michelle / Read, Meagan D / Lorch, Steven / Farach, Sandra M / Kuo, Paul C / Diaz, Jose J

The American surgeon

2024 , Page(s) 31348241241631

Abstract: Pre-existing cirrhosis is associated with increased mortality in blunt liver injury. Despite widespread use of nonoperative management (NOM) for blunt liver injury, there is a relative paucity of data regarding how pre-existing cirrhosis impacts the ... ...

Abstract	Pre-existing cirrhosis is associated with increased mortality in blunt liver injury. Despite widespread use of nonoperative management (NOM) for blunt liver injury, there is a relative paucity of data regarding how pre-existing cirrhosis impacts the success of NOM. Herein, we perform a retrospective cohort study using ACS TQIP 2017-2020 data to assess the relationship between cirrhosis and failure of NOM for adult patients with blunt liver injury. 37,176 patients were included (342 cirrhosis and 36,834 without cirrhosis). After propensity-score matching, patients with pre-existing cirrhosis had higher rates of failure of NOM (32.2 vs 14.1%,
Language	English
Publishing date	2024-03-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348241241631
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Article ; Online: Open reduction internal fixation of rib fractures: a biomechanical comparison between the RibLoc U Plus

Oppizzi, Giovanni / Xu, Dali / Patel, Tirth / Diaz, Jose J / Zhang, Li-Qun

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2022 Volume 49, Issue 1, Page(s) 383–391

Abstract: Objectives: In this study, we assessed the bending strength of two surgical repairs of rib fracture using RibLoc: Methods: After a rib fracture was created in seven pairs of cadaveric rib specimens, one side was repaired with the anterior plate and ... ...

Abstract	Objectives: In this study, we assessed the bending strength of two surgical repairs of rib fracture using RibLoc Methods: After a rib fracture was created in seven pairs of cadaveric rib specimens, one side was repaired with the anterior plate and the other side repaired with the RibLoc U Plus Results: The ribs repaired with the RibLoc U Plus Conclusion: The biomechanical study showed that the RibLoc U Plus
MeSH term(s)	Humans ; Rib Fractures/surgery ; Biomechanical Phenomena ; Ribs/surgery ; Open Fracture Reduction ; Bone Plates ; Fracture Fixation, Internal
Language	English
Publishing date	2022-08-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-022-02075-x
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Article ; Online: Not All Fluid Collections Are Created Equal: Clinical Course and Outcomes of Pancreatic Pseudocysts and Acute Peripancreatic Fluid Collections Requiring Intervention.

Kim, Kevin T / Clark, Jaclyn / Ghneim, Mira / Feliciano, David V / Diaz, Jose J / Harfouche, Melike

The American surgeon

2022 Volume 89, Issue 5, Page(s) 1774–1780

Abstract: Background: Knowledge on pancreatic pseudocyst (PP) management has mostly involved large database analysis, which limits understanding of a complex and heterogeneous disease. We aimed to review the clinical course and outcomes of PP and acute ... ...

Abstract	Background: Knowledge on pancreatic pseudocyst (PP) management has mostly involved large database analysis, which limits understanding of a complex and heterogeneous disease. We aimed to review the clinical course and outcomes of PP and acute peripancreatic fluid collections (APFC) that require intervention at 1 high-volume center. Methods: Retrospective review of patients with APFC and PP undergoing drainage (2011-2018) was performed. Patients were divided into groups based on initial intervention: surgical (SR), percutaneous (PC), or endoscopic (EN) drainage. Primary outcome was mortality by initial intervention type. Secondary outcomes included subsequent interventions required, length of stay (LOS), readmission rates, and discharge disposition. Results: Of 88 patients, 40 (46.1%) underwent SR, 40 (44.9%) PC, and 8 (9.0%) EN. No patients in EN group had APACHE II scores>20. Pancreatic necrosis was higher in SR (80.5%) and PC (62.5%) groups ( Conclusion: Patients undergoing surgical or percutaneous drainage of APFC and PP have a greater burden of illness and more local complications requiring intervention compared to endoscopic drainage. The heterogeneity in presentation of peripancreatic fluid collections in acute pancreatitis must be considered when evaluating the benefits of each intervention.
MeSH term(s)	Humans ; Pancreatic Pseudocyst/surgery ; Pancreatic Pseudocyst/complications ; Pancreatitis/surgery ; Pancreatitis/complications ; Acute Disease ; Drainage/adverse effects ; Disease Progression ; Treatment Outcome
Language	English
Publishing date	2022-02-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348221078955
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