John C. Stein

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CONTEXT The potential effects of increasing numbers of uninsured and underinsured persons on US emergency departments (EDs) is a concern for the health care safety net. OBJECTIVE To describe the changes in ED visits that occurred from 1997 through 2007 in the adult and pediatric US populations by sociodemographic group, designation of safety-net ED, and(More)
PURPOSE To evaluate the performance of a rapid, bedside whole blood C-reactive protein test as a diagnostic test for pneumonia in adults. METHODS We enrolled consecutive adults who presented with acute cough (duration < or =3 weeks). A fingerstick blood specimen for C-reactive protein level was obtained. Patients also provided information about(More)
BACKGROUND Rapid activation of the cardiac catheterization laboratory for primary percutaneous coronary intervention (PCI) improves outcomes for ST-segment elevation myocardial infarction (STEMI), but selected emphasis on minimizing time to reperfusion may lead to a greater frequency of false-positive activations. METHODS We analyzed consecutive patients(More)
BACKGROUND Increased trimethoprim/sulfamethoxazole (TMP/SMX) resistance has led to changes in empiric treatment of female urinary tract infections (UTI) in the emergency department (ED), particularly increased use of fluoroquinolones (Acad Emerg Med.2009;16(6):500-507). Whether prescribing changes have affected susceptibility in uropathogens is unclear.(More)
BACKGROUND Constipation in pediatric patients is a common diagnosis in the emergency department (ED) and may occasionally arise from a significant underlying illness. OBJECTIVE To discuss a rare cause of constipation that led to a strangulated small bowel and cardiac arrest. CASE REPORT A 7-year-old boy presented in pulseless electrical activity. The(More)
BACKGROUND Individual signs and symptoms are of limited value for the diagnosis of influenza. OBJECTIVE To develop a decision tree for the diagnosis of influenza based on a classification and regression tree (CART) analysis. METHODS Data from two previous similar cohort studies were assembled into a single dataset. The data were randomly divided into a(More)
BACKGROUND Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was to measure FGF-23 levels in critically ill patients with(More)
PURPOSE Many behavioral studies have found impaired perception of dynamic visual stimuli in dyslexia and several neuroimaging studies have found reduced activation of the human motion area MT+ in dyslexia. These results are often interpreted as a magnocellular (MC) deficit in dyslexia. It has also been claimed that colored filters can help dyslexics to(More)
STUDY OBJECTIVE We seek to compare ultrasonographically guided peripheral intravenous access to a non-ultrasonographically guided method in a randomized trial of emergency department patients with difficult intravenous access. METHODS A prospective cohort of patients with difficult intravenous access was established. Patients were randomized to 2 groups:(More)
STUDY OBJECTIVE The purpose of this study is to compare ultrasonographic visualization of the jugular and common femoral veins by using a novel technique (humming) and 2 conventional techniques (Valsalva's maneuver and Trendelenburg's position). The Valsalva's maneuver and Trendelenburg's position are common methods for producing venous distention, aiding(More)