J E Hollander

..We compared the predictive properties of P-selectin to creatine kinase, MB fraction (CK-MB) for detecting acute myocardial infarction (AMI), acute coronary syndromes (ACS) and serious cardiac events upon emergency department (ED) arrival...

..We review the general principles of wound care and expand on the use of tissue adhesives for laceration repair...

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..We hypothesized that the use of "real-time" neural networks would decrease the admission rate for ED chest pain patients...

..Prior studies have shown that this system captures >85% of eligible patients. Methods to obtain closer to 100% enrollment are desired...

..We tested the hypothesis that monitoring admitted low-risk patients with chest pain for dysrhythmia is low yield (<1% detection of life-threatening dysrhythmias requiring treatment)...

..To determine the interrater reliability of potential predictor variables that may be used to construct a clinical decision rule for emergency computed tomography of the head in blunt head injury victims...

..Similar programs can be developed in a variety of outpatient and inpatient settings allowing the performance of high-quality clinical research in a time-efficient and cost-effective manner...

..Studies of programmatic interventions for victims of violence in the home may require the use of informed consent. The use of informed consent may result in ascertainment bias, with victims of violence being less likely to participate...

..To evaluate the 3-month cosmetic outcome following laceration repair with a new tissue adhesive, 2-octylcyanoacrylate, as a function of physician experience with this tissue adhesive...

..02), respectively. Our data demonstrate that the specificity of myoglobin was altered by recent cocaine use. The specificity of CK-MB was affected less and the specificity of cardiac troponin I was not affected by recent cocaine use...

..Patients with lacerations are most concerned about the ultimate cosmetic appearance of their wound. We evaluated methods to assess the long-term cosmetic appearance by telephone survey...

..To describe the evaluation and outcomes of elder patients with suspected acute coronary syndromes (ACS) presenting to the emergency department (ED)...

..The optimal test depends upon the relative importance of the sensitivity or specificity for clinical decision-making in an individual patient...

..1% to 0.2%). CONCLUSIONS: A modified clinical decision rule described a group of patients with a 0.14% risk of ACS that was free from 30-day adverse CV events...

..Although intensity of medical management was similar between groups, it was generally lower than current guidelines recommend, indicating potential for improvement in NSTEMI outcomes, regardless of time of presentation...

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..3 ng/mL) did not identify a subgroup of chest pain patients at <1% risk for death, AMI, or revascularization within 30 days...

..Although trauma activations improve the care of trauma patients, they may be associated with a negative impact on the care of other patients requiring contemporaneous resources...

..Most of our knowledge of laceration management comes from studies in animal models or patients with closure of sterile postoperative surgical incisions. Traumatic laceration management has not been well studied...

..The authors assessed whether different clinical characteristics at emergency department presentation account for this gender bias...

..Their validity in single-race populations has not been tested. The authors sought to compare the performance of a risk stratification tool between a mixed-race U.S. patient population and an Asian patient population...

..To determine the association between emergency practitioner level of training and cosmetic appearance of primarily closed wounds as evaluated at the time of suture removal...

..To compare a new assay for cardiac troponin 1 (cTn-1) with an assay for creatine kinase-MB (CK-MB) for the diagnosis of acute myocardial infarction (AMI)...

..In patients presenting to the emergency department (ED) with an initial diagnostic impression of noncardiac chest pain, we determine the 30-day incidence of adverse cardiac events and characteristics associated with those events...

..There are known race and sex differences in emergent cardiac care. Many feel these differences reflect a bias from the physician. We hypothesized these differences may be the result of patient preferences...

..To determine whether race or gender affected time to initial electrocardiogram (ECG) for patients who presented to an emergency department with chest pain...

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..The objective was to determine the incremental benefit of a shortness-of-breath (SOB) point-of-care biomarker panel on the diagnostic accuracy of emergency department (ED) patients presenting with dyspnea...

..We seek to determine whether cardiac risk factor burden (defined as the number of conventional cardiac risk factors present) is useful for the diagnosis of acute coronary syndromes in the emergency department (ED) setting...

..Numerous studies have documented treatment disparities in patients with acute coronary syndromes based on race and gender. Other causes for treatment disparities may exist...

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..The objective of this study was to develop a reliable scale for the assessment of airway visualization during endotracheal intubation...

..It may be reasonable to expedite outpatient management and limit unnecessary admissions in these cohorts...

..Existing cosmetic scales for wounds are based only on practitioners' evaluations. They have not been validated using the patient's assessment...

..Cosmetic outcome is particularly important to patients with facial lacerations. This information should be useful when designing outcome studies of laceration management...

..We also assessed the residency directors' experience in use of these devices...

..We determined whether a simple emergency department intervention improves the likelihood of primary care provider (PCP) follow-up after ED discharge for an acute asthma exacerbation...

..This report compares a novel attribute-matching method to generate a PTP for acute coronary syndrome (ACS). We compare the new method with a validated logistic regression equation (LRE)...

..7%, depending on ECG classification category. CONCLUSION: The ECG classification system that is being recommended in the standardized guidelines predicts 30-day composite rates of death, acute myocardial infarction, and revascularization...

..We assess hospital readmission and death within 60 days in older adults admitted from the emergency department (ED) and discharged by an inpatient service within 24 hours...

..We describe the methods for data collection and the ED population enrolled in a multicenter registry of patients with chest pain...

..One alternative is to board admitted patients in inpatient hallways. We assess ED patient preferences for boarding location...

..The goal of this study was to assess its ability to predict adverse cardiovascular outcomes in cocaine-associated chest pain...

..The sex of the individual performing screening affects the willingness of adult male and female ED patients to disclose incidents of intimate partner violence (IPV)...

..40 to 0.68 and OR, 0.68; 95% CI = 0.47 to 0.99). CONCLUSIONS: Racial disparities in acute chest pain management extend beyond cardiac catheterization. Poor compliance with recommended treatments for ACS may be an explanation...

..The study aimed to determine whether aspirin therapy was differentially administered according to race, sex, or age in patients with undifferentiated chest pain who presented to an urban academic emergency department...

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..Previous prospective studies, which found approximately a 6% incidence of AMI, have been criticized for selection bias. This study sought to determine the rate of AMI in patients with cocaine-associated chest pain...

..Similarly, more nurses and ancillary staff have become involved in prospective clinical research. Much of this success is attributed to the novel use of resources through the academic associate program...

..We compared a qualitative urine acetaminophen screen to the quantitative serum acetaminophen to test the hypothesis that a negative urine acetaminophen screen would be predictive of a negative serum acetaminophen level...

..We studied the cardiac and hemodynamic profiles in emergency department chest pain patients following recent cocaine use...

..To determine whether out-of-hospital care charts selectively report trauma triage criteria, and the impact of such documentation on triage guideline development...

..Finally, telemetry is not indicated for patients requiring minor blood transfusion, low risk chest pain patients with normal electrocardiography, and stable patients receiving anticoagulation for pulmonary embolism...

..We sought to expand the clinical application of the TIMI risk score by assessing its prognostic accuracy in patients in the emergency department with potential acute coronary syndromes...

..The authors hypothesized that patients with a normal or nonspecific ECG during symptoms have a lower risk for ACS than do those who are asymptomatic...

..There seems to be a need for standardized reporting guidelines because important information is not currently being reported...

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..We hypothesize that they would be at least as accurate because they would not be distracted by clinical requirements...

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..The authors determined the association between T-wave abnormalities on the presenting ECG and cardiovascular outcomes within 30 days of presentation in patients with potential acute coronary syndromes (ACSs)...

..We hypothesized that the presence of an alternative diagnosis in patients with a TIMI risk score less than 2 might identify a cohort of patients safe for ED discharge...

..Specifically, the study estimated both the within- and among-hospital effects of black versus non-black race on LOS for admitted patients...

..The objective was to study the association between factors related to emergency department (ED) crowding and patient satisfaction...

..We hypothesized that emergency physicians would use more resources to evaluate acute abdominal pain in obese patients as compared with that in nonobese patients...

..We studied if emergency department (ED) crowding affects the quality of resident and medical student education on individual patient encounters...

..The authors assessed whether a gender disparity exists in the administration of analgesia for acute abdominal pain...

..Invasive and noninvasive impedance cardiography can be used to diagnose or even predict development of heart failure, but its role in clinical practice still needs to be better defined...

..The long-term outcome of patients discharged from the ED with negative coronary CTA has not been well studied...

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..To determine emergency department patients' behaviors during informed consent for an intimate partner violence survey...

..We assessed the relationship between emergency department (ED) crowding and delays in care in patients presenting with abdominal pain who receive abdominal computed tomography (CT)...

..The answer is to find measures of system throughput and/or work flow that are associated with improved patient care outcomes...

..For patients presenting to the emergency department with ACS, the benefits and risks of initiating clopidogrel or GP IIb/IIIa inhibitor therapy need to be considered on an individual basis...

..Also, patients with the lowest risk as defined by a TIMI score of zero had a 1.7% incidence of adverse events. Therefore, the TIMI risk score should not be used in isolation to determine disposition of ED chest pain patients...

..We assessed whether adding revascularization to a strictly defined composite end point of death, acute myocardial infarction (AMI), and unstable angina (UA) impacts the likelihood of patients attaining the composite end point...

..Universal screening for interpersonal violence is recommended despite a lack of confirmed efficacy. We hypothesized that the detection of violence via universal screening would result in high intervention rates for victims...

..This suggests that patients with chest pain who are admitted to non-intensive-care telemetry (or observation unit) beds might not need stress testing before hospital release...

..Emergency department (ED) overcrowding threatens quality of care by delaying the time to diagnosis and treatment of patients with time-sensitive diseases, such as acute stroke...

..The authors hypothesized that a nonteaching service designed to identify and admit low-risk chest pain patients should reduce those pressures...

..The objective of this study was to determine the effect of increasing head elevation and neck flexion on the quality of laryngeal view during laryngoscopy...

..The objective of this study was to use the same registry to determine whether a network could be trained accurately to identify the larger subset of patients who have cardiac ischemia...

..We perform a videographic analysis of external laryngeal manipulation (ELM) by novice intubators using a direct laryngoscopic imaging system and a validated means of assessing laryngeal view (percentage of glottic opening [POGO] score)...

..Therefore, the investigators' emergency department (ED) incorporated CT coronary angiography into the evaluation of low-risk patients with chest pain...

..This paper describes the attributes of clinical outcomes and illustrates how to develop novel outcomes, using as an example the authors' experience in developing a wound cosmesis outcome measure...

..Although self-reporting of substance use is not reliable, reliance on drug screening alone is also flawed. Optimal identification of drug use in emergency department psychiatric patients requires both history and drug screening...

..As the specialty of emergency medicine (EM) matures, its journals should be publishing research of a quality similar to that which appears in other premier journals...

..Little is known about the effect of psychiatric co-morbid disorders that emerge after minor injury on functional recovery. This study examined the effect of post-injury depression on return to pre-injury levels of function...

..The ILMA should be further studied to determine if it may permit endotracheal intubation by first responders, paramedical personnel, and other medical staff with limited or no laryngoscopy skills...

..We seek to determine the impact of emergency department (ED) crowding on delays in antibiotic administration for patients with community-acquired pneumonia...

..The authors hypothesized that specific ECG findings, other than those previously identified in higher-risk populations, would be predictive of cardiac outcomes and positive cardiac markers...

..A lower cut-point (BNP > or = 54 pg/mL) should be used in severely obese patients to preserve sensitivity. A higher cut-point in lean patients (BNP > or = 170 pg/mL) could be used to increase specificity...

..CONCLUSION: In patients presenting to the ED with heart failure, the disconnect between perceived severity of CHF and severity as determined by BNP levels is most pronounced in African Americans...

..Strategies tailored to early identification and management of these patients would be desirable...

..B-type natriuretic peptide is released from the cardiac ventricles in response to increased wall tension...

..CONCLUSION: Knowledge of these commonly obtained variables should aid clinicians in the interpretation of moderately elevated BNP results in patients presenting with acute dyspnea in the emergency department...

..Echocardiography and B-type natriuretic peptide (BNP) are diagnostic tests for congestive heart failure (CHF), but an emergency diagnosis can be difficult...