Robert L. Sherwin

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Studies of acute myocardial infarction, trauma, and stroke have been translated into improved outcomes by earlier diagnosis and application of therapy at the most proximal stage of hospital presentation. Most therapies for these diseases are instituted prior to admission to an ICU; this approach to the sepsis patient has been lacking. In response, a trial(More)
INTRODUCTION To characterize cardiac complications in acute ischemic stroke (AIS) patients admitted from an urban emergency department (ED). METHODS Retrospective cross-sectional study evaluating AIS patients admitted from the ED within 24 hours of symptom onset who also had an echocardiogram performed within 72 hours of admission. RESULTS Two hundred(More)
INTRODUCTION Near-infrared spectroscopy (NIRS) noninvasively measures peripheral tissue oxygen saturation (StO₂). NIRS may be utilized along with a vascular occlusion test, in which limb blood flow is temporarily occluded and released, to quantify a tissue bed's rate of oxygen exchange during ischemia and recovery. The objective of this study was to test(More)
BACKGROUND Streptococcus pneumoniae causes a substantial proportion of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) in the United States. Limited data are available regarding the pneumococcal serotypes causing CAP and HCAP. METHODS Adults aged ≥ 50 years presenting to participating US hospitals with radiographically(More)
NOTICE Neither the United States government nor any agency thereof, nor any of their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned(More)
BACKGROUND The purpose of this study was to determine whether the provision of corticosteroids improves time to shock reversal and outcomes in patients with post-cardiac arrest shock. METHODS We conducted a randomized, double-blind trial of post-cardiac arrest patients in shock, defined as vasopressor support for a minimum of 1 hour. Patients were(More)
Scientific evidence has established several links between metabolic and neurocognitive dysfunction, and epidemiologic evidence has revealed an increased risk of Alzheimer's disease and vascular dementia in patients with diabetes. In July 2015, the National Institute of Diabetes, Digestive, and Kidney Diseases gathered experts from multiple clinical and(More)
INTRODUCTION Noninvasive hemodynamic (HD) assessments in the emergency department (ED) might assist in the diagnosis, therapeutic plan development and risk stratification of acutely ill patients. This multinational observational study was designed to initiate noninvasive HD measurements prior to any ED patient therapeutic interventions and broadly evaluate(More)
Do steroids administered in the emergency room improve mortality or shock reversal in patients with septic shock? D. Executive Summary: Answer: Overall Benefit: Yes. Although the literature is heterogeneous, underlying themes remain in distinct favor of steroid administration in patients with refractory septic shock. (Level of Recommendation: B1) 28-Day(More)
Critically ill emergency department (ED) patients that require admission to the intensive care unit (ICU) often utilize significant personnel, time, and equipment when compared to patients who do not require ICU level care. In many EDs, critical resources can quickly be depleted. This has the potential to adversely affect the care provided to these(More)
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