Judd Hollander - Academia.edu (original) (raw)

Papers by Judd Hollander

Research paper thumbnail of Images in Emergency Medicine

Annals of Emergency Medicine, 2005

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Research paper thumbnail of The role of the emergency department in the management of acute heart failure: An international perspective on education and research

European heart journal. Acute cardiovascular care, Jan 11, 2015

Emergency departments are a major entry point for the initial management of acute heart failure (... more Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management. Unfortunately, outcomes remain poor, with nearly a third of patients dying or re-hospitalised within 3 months post-discharge. In the absence of robust research evidence, consensus is an important source of guidance for AHF care. Thus, we convened an international group of practising emergency physicians, cardiologi...

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Research paper thumbnail of Serial sampling of copeptin levels improves diagnosis and risk stratification in patients presenting with chest pain: results from the CHOPIN trial

Emergency medicine journal : EMJ, Jan 23, 2015

Copeptin has demonstrated a role in early rule out for acute myocardial infarction (AMI) in combi... more Copeptin has demonstrated a role in early rule out for acute myocardial infarction (AMI) in combination with a negative troponin. However, management of patients with chest pain with a positive copeptin in the setting of a negative troponin is unclear. The multicentre CHOPIN trial enrolled 2071 patients with acute chest pain. Of these, 476 subjects with an initial negative troponin but an elevated copeptin (>14 pmol/L) were included in this study. Copeptin and troponin levels were rechecked at 2 h and the final diagnosis of AMI was made by two independent, blinded cardiologists. Follow-up at 30 days was obtained for major adverse cardiac events (MACEs), including death, AMI and urgent revascularisation. Of the 476 patients analysed, 365 (76.7%) had a persistently elevated copeptin at 2 h and 111 patients (23.3%) had a copeptin that fell below the cut-off of 14 pmol/L. When the second copeptin was elevated there were 18 AMIs (4.9%) compared with 0 (0%) when the second copeptin was...

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Research paper thumbnail of Relationship of B-type natriuretic peptide and anemia in patients with and without heart failure: a substudy from the Breathing Not Properly (BNP) Multinational Study

While anemia is a significant risk factor for poor outcomes in patients with heart failure (HF), ... more While anemia is a significant risk factor for poor outcomes in patients with heart failure (HF), it is not in defined guidelines for HF assessment. B-type natriuretic peptide (BNP) is a marker for diagnosis and management of patients with HF. We determined the incidence of anemia in patients with HF and the relationship between BNP and hemoglobin (Hgb) levels in patients with and without HF. Results from the Breathing Not Properly Multinational Trial consisted of 1,586 patients presenting to the emergency department (ED) with dyspnea. Because renal insufficiency is a confounding variable for BNP, patients with a creatinine of or=2.0 mg/dL were excluded. The remaining data were evaluated from 620 non-HF patients (337 M, 283 F) and 547 HF patients (299 M, 248 F). The New York Heart Association (NYHA) HF classification and ejection fraction by echocardiography were assessed for HF patients. Blood was tested for Hgb, BNP, and creatinine. Using World Health Organization criteria for anem...

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Research paper thumbnail of Early, upstream, and consistent antithrombotic therapy in high risk non-ST-elevation ACS: Should bivalirudin be initiated in the ED prior to coronary angiography?

Annals of Emergency Medicine

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Research paper thumbnail of Relationship between B-type natriuretic peptide and adverse outcome in patients with clinical evidence of sepsis presenting to the emergency department

Academic Emergency Medicine

Myocardial dysfunction is an important aspect of sepsis pathophysiology. B-type natriuretic pepti... more Myocardial dysfunction is an important aspect of sepsis pathophysiology. B-type natriuretic peptide (BNP) is a neurohormone released from the ventricles in response to myocardial stretch and volume overload. The authors hypothesized that an elevated BNP in patients presenting to the emergency department (ED) with suspected sepsis are at increased risk for development of adverse events. This was a prospective, observational, multicenter cohort study in 10 EDs. Patients were eligible if they were older than 18 years, had two or more systemic inflammatory response syndrome (SIRS) criteria, and had suspected infection or a serum lactate level > 2.5 mmol/L. Patients were excluded if they were pregnant, had do-not-attempt-resuscitation status, sustained a cardiac arrest prior to hospital arrival, had known chronic renal insufficiency, or were on dialysis. BNP levels were obtained at arrival. The primary outcome was a composite of severe sepsis, septic shock within 72 hours, or in-hospi...

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Research paper thumbnail of Acute Kidney Injury Develops Rapidly In Emergency Department Patients With Severe Sepsis

B25. MONITORING AND NON-PULMONARY CRITICAL CARE, 2011

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Research paper thumbnail of Midregional Proadrenomedullin Predicts Mortality and Major Adverse Cardiac Events in Patients Presenting With Chest Pain: Results From the CHOPIN Trial

Academic Emergency Medicine, 2015

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Research paper thumbnail of COPEPTIN PROVIDES PROGNOSTIC VALUE IN PATIENTS WITH ACUTE CHEST PAIN

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Research paper thumbnail of Pretest probability assessment derived from attribute matching

BMC medical informatics and decision making, 2005

Pretest probability (PTP) assessment plays a central role in diagnosis. This report compares a no... more Pretest probability (PTP) assessment plays a central role in diagnosis. 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). Eight clinical variables (attributes) were chosen by classification and regression tree analysis of a prospectively collected reference database of 14,796 emergency department (ED) patients evaluated for possible ACS. For attribute matching, a computer program identifies patients within the database who have the exact profile defined by clinician input of the eight attributes. The novel method was compared with the LRE for ability to produce PTP estimation <2% in a validation set of 8,120 patients evaluated for possible ACS and did not have ST segment elevation on ECG. 1,061 patients were excluded prior to validation analysis because of ST-segment elevation (713), missing data (77) or being lost to follow-up (271). In the val...

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Research paper thumbnail of A novel biomarker panel with a Multimarker Index value for the diagnosis of sepsis in the Emergency Department

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Research paper thumbnail of Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group

Journal of cardiac failure, 2015

Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency depart... more Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition dec...

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Research paper thumbnail of Age-Related Differences in Biomarkers of Acute Inflammation During Hospitalization for Sepsis

Shock, 2014

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Research paper thumbnail of Self-reported cocaine use, emergency physician testing and outcomes in suspected acute coronary syndromes: A nested matched case-control study

BMJ Open, 2012

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Research paper thumbnail of Emergency Department Antithrombin III And Plasminogen Activator Inhibitor-1 Initial Plasma Levels Are Associated With Acute Lung Injury In Patients With Severe Sepsis And Septic Shock

B23. CAN ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME CASES BE SUB-CATEGORIZED: EPIDEMIOLOGY AND PROGNOSIS, 2010

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Research paper thumbnail of Improving the 510(k) FDA process for cardiac troponin assays: in search of common ground

Clinical chemistry, 2014

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Research paper thumbnail of Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure

New England Journal of Medicine, 2002

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Research paper thumbnail of A comparison of bedside B-type natriuretic peptide versus echocardiographic determination of ejection fraction in the diagnosis of heart failure

Journal of the American College of Cardiology, 2003

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Research paper thumbnail of Impact of Atrial Fibrillation on the Diagnostic Performance of B-Type Natriuretic Peptide Concentration in Dyspneic Patients

Journal of the American College of Cardiology, 2005

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Research paper thumbnail of Primary results of the BNP multinational study: B-type natriuretic peptide in the emergency diagnosis of heart failure

Journal of the American College of Cardiology, 2002

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Research paper thumbnail of Images in Emergency Medicine

Annals of Emergency Medicine, 2005

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Research paper thumbnail of The role of the emergency department in the management of acute heart failure: An international perspective on education and research

European heart journal. Acute cardiovascular care, Jan 11, 2015

Emergency departments are a major entry point for the initial management of acute heart failure (... more Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management. Unfortunately, outcomes remain poor, with nearly a third of patients dying or re-hospitalised within 3 months post-discharge. In the absence of robust research evidence, consensus is an important source of guidance for AHF care. Thus, we convened an international group of practising emergency physicians, cardiologi...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Serial sampling of copeptin levels improves diagnosis and risk stratification in patients presenting with chest pain: results from the CHOPIN trial

Emergency medicine journal : EMJ, Jan 23, 2015

Copeptin has demonstrated a role in early rule out for acute myocardial infarction (AMI) in combi... more Copeptin has demonstrated a role in early rule out for acute myocardial infarction (AMI) in combination with a negative troponin. However, management of patients with chest pain with a positive copeptin in the setting of a negative troponin is unclear. The multicentre CHOPIN trial enrolled 2071 patients with acute chest pain. Of these, 476 subjects with an initial negative troponin but an elevated copeptin (>14 pmol/L) were included in this study. Copeptin and troponin levels were rechecked at 2 h and the final diagnosis of AMI was made by two independent, blinded cardiologists. Follow-up at 30 days was obtained for major adverse cardiac events (MACEs), including death, AMI and urgent revascularisation. Of the 476 patients analysed, 365 (76.7%) had a persistently elevated copeptin at 2 h and 111 patients (23.3%) had a copeptin that fell below the cut-off of 14 pmol/L. When the second copeptin was elevated there were 18 AMIs (4.9%) compared with 0 (0%) when the second copeptin was...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Relationship of B-type natriuretic peptide and anemia in patients with and without heart failure: a substudy from the Breathing Not Properly (BNP) Multinational Study

While anemia is a significant risk factor for poor outcomes in patients with heart failure (HF), ... more While anemia is a significant risk factor for poor outcomes in patients with heart failure (HF), it is not in defined guidelines for HF assessment. B-type natriuretic peptide (BNP) is a marker for diagnosis and management of patients with HF. We determined the incidence of anemia in patients with HF and the relationship between BNP and hemoglobin (Hgb) levels in patients with and without HF. Results from the Breathing Not Properly Multinational Trial consisted of 1,586 patients presenting to the emergency department (ED) with dyspnea. Because renal insufficiency is a confounding variable for BNP, patients with a creatinine of or=2.0 mg/dL were excluded. The remaining data were evaluated from 620 non-HF patients (337 M, 283 F) and 547 HF patients (299 M, 248 F). The New York Heart Association (NYHA) HF classification and ejection fraction by echocardiography were assessed for HF patients. Blood was tested for Hgb, BNP, and creatinine. Using World Health Organization criteria for anem...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Early, upstream, and consistent antithrombotic therapy in high risk non-ST-elevation ACS: Should bivalirudin be initiated in the ED prior to coronary angiography?

Annals of Emergency Medicine

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Relationship between B-type natriuretic peptide and adverse outcome in patients with clinical evidence of sepsis presenting to the emergency department

Academic Emergency Medicine

Myocardial dysfunction is an important aspect of sepsis pathophysiology. B-type natriuretic pepti... more Myocardial dysfunction is an important aspect of sepsis pathophysiology. B-type natriuretic peptide (BNP) is a neurohormone released from the ventricles in response to myocardial stretch and volume overload. The authors hypothesized that an elevated BNP in patients presenting to the emergency department (ED) with suspected sepsis are at increased risk for development of adverse events. This was a prospective, observational, multicenter cohort study in 10 EDs. Patients were eligible if they were older than 18 years, had two or more systemic inflammatory response syndrome (SIRS) criteria, and had suspected infection or a serum lactate level > 2.5 mmol/L. Patients were excluded if they were pregnant, had do-not-attempt-resuscitation status, sustained a cardiac arrest prior to hospital arrival, had known chronic renal insufficiency, or were on dialysis. BNP levels were obtained at arrival. The primary outcome was a composite of severe sepsis, septic shock within 72 hours, or in-hospi...

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Research paper thumbnail of Acute Kidney Injury Develops Rapidly In Emergency Department Patients With Severe Sepsis

B25. MONITORING AND NON-PULMONARY CRITICAL CARE, 2011

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Midregional Proadrenomedullin Predicts Mortality and Major Adverse Cardiac Events in Patients Presenting With Chest Pain: Results From the CHOPIN Trial

Academic Emergency Medicine, 2015

Bookmarks Related papers MentionsView impact

Research paper thumbnail of COPEPTIN PROVIDES PROGNOSTIC VALUE IN PATIENTS WITH ACUTE CHEST PAIN

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Pretest probability assessment derived from attribute matching

BMC medical informatics and decision making, 2005

Pretest probability (PTP) assessment plays a central role in diagnosis. This report compares a no... more Pretest probability (PTP) assessment plays a central role in diagnosis. 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). Eight clinical variables (attributes) were chosen by classification and regression tree analysis of a prospectively collected reference database of 14,796 emergency department (ED) patients evaluated for possible ACS. For attribute matching, a computer program identifies patients within the database who have the exact profile defined by clinician input of the eight attributes. The novel method was compared with the LRE for ability to produce PTP estimation <2% in a validation set of 8,120 patients evaluated for possible ACS and did not have ST segment elevation on ECG. 1,061 patients were excluded prior to validation analysis because of ST-segment elevation (713), missing data (77) or being lost to follow-up (271). In the val...

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Research paper thumbnail of A novel biomarker panel with a Multimarker Index value for the diagnosis of sepsis in the Emergency Department

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group

Journal of cardiac failure, 2015

Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency depart... more Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition dec...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Age-Related Differences in Biomarkers of Acute Inflammation During Hospitalization for Sepsis

Shock, 2014

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Self-reported cocaine use, emergency physician testing and outcomes in suspected acute coronary syndromes: A nested matched case-control study

BMJ Open, 2012

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Emergency Department Antithrombin III And Plasminogen Activator Inhibitor-1 Initial Plasma Levels Are Associated With Acute Lung Injury In Patients With Severe Sepsis And Septic Shock

B23. CAN ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME CASES BE SUB-CATEGORIZED: EPIDEMIOLOGY AND PROGNOSIS, 2010

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Improving the 510(k) FDA process for cardiac troponin assays: in search of common ground

Clinical chemistry, 2014

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure

New England Journal of Medicine, 2002

Bookmarks Related papers MentionsView impact

Research paper thumbnail of A comparison of bedside B-type natriuretic peptide versus echocardiographic determination of ejection fraction in the diagnosis of heart failure

Journal of the American College of Cardiology, 2003

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Impact of Atrial Fibrillation on the Diagnostic Performance of B-Type Natriuretic Peptide Concentration in Dyspneic Patients

Journal of the American College of Cardiology, 2005

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Primary results of the BNP multinational study: B-type natriuretic peptide in the emergency diagnosis of heart failure

Journal of the American College of Cardiology, 2002

Bookmarks Related papers MentionsView impact