Lincoln Hospital

About: Lincoln Hospital is a healthcare organization based out in New York, New York, United States. It is known for research contribution in the topics: Population & Emergency department. The organization has 1033 authors who have published 929 publications receiving 14486 citations. The organization is also known as: Lincoln Medical and Mental Health Center & Lincoln Hospital.

HIV Infection and Acute Stroke: A Case Report and a Review of the Literature

Abstract: Background. In the United States, ischemic stroke in HIV-infected patients has increased by 60%. However, unexpected cardiovascular events in relatively young patients have been observed. Clinical Vignette. A 31-year-old male who presented with a 5-hour history of sudden onset slurred speech and left hemiplegia. He has medical history of HIV infection for 2 years taking ARTs. On exam, a significant left hemiparesis was noticed. Brain MRI showed right anterior corona radiata and basal ganglia acute infarction. Discussion. Several mechanisms have been proposed for the relationship between HIV infection and cardiovascular risk. (i) HIV-associated dyslipidemia: HIV-infected patients tend to develop decrease in HDL-c and LDL-c levels. ART was associated with an increase in LDL-c but little change in HDL-c. (ii) Endothelial dysfunction: certain antiretroviral agents may independently contribute to endothelial damage. (iii) Hypertension: systolic blood pressure is higher in those using ART for greater than five years. (iv) Insulin resistance and diabetes have been noticed with ART. (v) Chronic inflammation. (vi) Hypercoagulability: decrease in proteins C and S was associated with HIV infection. Conclusion. Poorly controlled HIV infection and/or the introduction of ATR might be risk factors for cardiovascular events. More studies needed to address this medical dilemma.

Liquid Silicone-Induced Extensive and Debilitating Granulomatosis Responding to Hydroxychloroquine.

Abstract: In the last two decades, there has been a significant rise in body-image improvement among the American consumers. Cosmetic injectable procedures have increased by 40.6% in the past 5 years. There has also been an increase in nonmedical, illegal, and self-appointed personnel, offering cheaper hazardous procedures. Silicone has been in use since 1965. In 1991, FDA issued guidelines prohibiting the marketing of injectable liquid silicone. However, it is biologically inert, is associated with inflammatory response, and leads to serious complications like granulomatosis, migration, acute pneumonitis, pulmonary embolism, and even death. Here, we present a case of silicone-induced granulomatosis with extensive migration which ended in bilateral mastectomy, multiple anterior chest debulking procedures, and finally peg tube placement due to compression of the esophageal lumen by granulomas. The patient was eventually started on immunomodulatory treatment, hydroxychloroquine with good response.

An unusual cause of dyspnea.

Abstract: Dyspnea is an alarming symptom for both the patient and the emergency physician. There are many causes of dyspnea, some of which are life-threatening, especially in the elderly patient. In addition to the usual cardiac and pulmonary causes such as congestive heart failure, asthma exacerbation, COPD, pneumonia, and pulmonary embolism, there are less common causes of dyspnea, which if not diagnosed and managed expeditiously may have dire consequences for both the patient and physician. We present a case of an elderly patient with a life-threatening unusual cause of acute shortness of breath, a diaphragmatic hernia with sepsis.

Acquired Brachial Arteriovenous Fistula in an Ex-Premature Infant

Abstract: Jatrogenic vascular injuries sustained during venipuncture, catheterization, or central venous canulation do occur and may result in arteriovenous fistula (AVF) formation. The incidence of traumatic brachial artery fistula is reported to be 6% in civilians.' The incidence of acquired AVF in children secondary to venipuncture (excluding those from intervention-related procedures) is not exactly known but

The success of laser laparoscopy in the treatment of endometriosis: a two-step analysis.

Abstract: Background and objectives The most advantageous treatment for nonextensive endometriosis has long been the subject of debate. In recent years, the ability to detect atypical presentations has allowed the gynecological surgeon to treat this disease more readily. The treatment in the past has only been concerned with the singular treatment being applied at the time, not on the effects that previous treatments have had. The purpose of the current study was to see whether previous unsuccessful treatment modalities affected subsequent laser laparoscopy treatment of endometriosis. Methods Patients who were previously treated for their endometriosis (minimal and mild) underwent treatment of their disease by laser laparoscopy and the results were analyzed by chi2 (chi-square) analysis. Results Those patients previously treated with laser laparoscopy and laparotomy demonstrated poorer results than those previously treated with expectant, medical, or cautery. The sum of the original treatments plus the second treatment of laser laparoscopy was equal in all groups. Conclusions If endometriosis is diagnosed at the time of laparoscopy and is easily amenable to treatment, it behooves the physician to treat it at the time of surgery.