Simon A Mahler

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BACKGROUND The HEART Pathway is a decision aid designed to identify emergency department patients with acute chest pain for early discharge. No randomized trials have compared the HEART Pathway with usual care. METHODS AND RESULTS Adult emergency department patients with symptoms related to acute coronary syndrome without ST-elevation on ECG (n=282) were(More)
BACKGROUND Extracellular nucleotides mediate many cellular functions and are released in response to mechanical stress in vitro. It is unknown whether adenosine triphosphate (ATP) is released in vivo during mechanical ventilation (MV). We hypothesized that stress from high-pressure MV would increase airway ATP, contributing to MV-associated lung edema. (More)
CONTEXT Teaching 12-lead electrocardiogram (ECG) interpretation to students and residents is a challenge for medical educators. To date, few studies have compared the effectiveness of different techniques used for ECG teaching. OBJECTIVES This study aimed to determine if common teaching techniques, such as those involving workshops, lectures and(More)
Using airborne multispectral digital camera imagery, we compared a number of feature combination techniques in image classification to distinguish vineyard from non-vineyard land-cover types in northern California. Image processing techniques were applied to raw images to generate feature images including grey level co-occurrence based texture measures, low(More)
OBJECTIVE The objective of the study was to determine if balanced electrolyte solution (BES) prevents hyperchloremic metabolic acidosis in patients with diabetic ketoacidosis (DKA). METHODS This is a prospective, randomized, double-blind study. A convenience sample of DKA patients aged 18 to 65 years with serum bicarbonate less than or equal to 15 and(More)
Initial base-line electrocardiograms are used to assess the efficacy of treatment for ventricular arrhythmias. This approach assumes that in the absence of treatment the frequency of arrhythmia would remain constant. To test the validity of this assumption, we studied 26 clinically stable patients with symptomatic but not life-threatening ventricular(More)
OBJECTIVE The objective of the study was to determine if the short-axis approach and long-axis approach to ultrasound-guided peripheral intravenous access (USGPIV) differ in success rate, catheter insertion time, and number of needle sticks. METHODS A convenience sample of emergency department patients aged 18 to 65 years with difficult IV access (2 or(More)
BACKGROUND Patients with low-risk chest pain have high utilization of stress testing and cardiac imaging, but low rates of acute coronary syndrome (ACS). The objective of this study was to determine whether the HEART score could safely reduce objective cardiac testing in patients with low-risk chest pain. METHODS A cohort of chest pain patients was(More)
BACKGROUND The utility of ultrasound-guided peripheral intravenous access (USGPIV) has been well described. However, few studies have investigated USGPIV techniques. OBJECTIVES To describe a modified Seldinger technique for USGPIV. METHODS Emergency Department patients with difficult i.v. access (three or more failed landmark attempts) were(More)
OBJECTIVE To examine the isolated and combined effects of positive end-expiratory pressure (PEEP) and partial liquid ventilation (PLV) on the development of ventilator-induced lung injury in an ovine model. DESIGN Prospective controlled animal study. SETTING University-based cardiovascular animal physiology laboratory. SUBJECTS Thirty-eight(More)