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.

The use of non- invasive ventilation in asthma exacerbation - a two year retrospective analysis of outcomes.

Abstract: Background: The use of Non-Invasive Ventilation (NIV) in acute asthma exacerbation remains controversial. Comparative data on patient characteristics that benefit from NIV in asthma exacerbation to those patients that fail NIV remains limited. Our study compares some of these patient characteristics and examines if NIV is safe and effective in carefully selected patients. Methods: Following institutional review board approval, we extracted from the electronic medical record and conducted a retrospective chart-based review of those patients who received NIV in the emergency room for a diagnosis of asthma exacerbation from January 2017 to December 2018. Results and Conclusion: The rate of failure of NIV overall was low, at 9.17%, with younger patients more likely to fail NIV (P = 0.03) and need invasive mechanical ventilation. Surprisingly, baseline asthma severity did not impact NIV failure rate, and neither did body mass index, smoking history, and a host of clinical characteristics. Understandably, the length of stay was significantly longer in the group of patients that failed NIV. There were no adverse events, such as an increased rate of barotrauma events in either group. In conclusion, this study contributes to the growing body of evidence that NIV is a safe and effective adjunct to routine care in the management of patients with asthma exacerbation.

A neonate with asymmetric arm movements.

Abstract: Abnormal arm posture or movements in a neonate may cause significant concern in a pediatric emergency department. This can be secondary to osteomyelitis, which may rarely present with asymmetric arm movements in the neonatal period. The diagnosis of osteomyelitis is difficult to establish in a neonate because systemic signs may not be present at this age. We report an infant with upper limb weakness and asymmetric movements 3 weeks after delivery.

Prolonged survival in metastatic colorectal cancer following chemotherapy

Abstract: Key Clinical Message The cost of treating metastatic colorectal cancer has increased significantly after the introduction of targeted antivascular therapies. We report the unusual case of a patient with colorectal cancer with several large liver metastases at diagnosis, who was cured after removal of the primary tumor and treatment with 5-FU/LV only.

A Novice Guide to Applications of Simulation in the Pediatric Emergency Department

Abstract: Healthcare systems and health professions education have gone through radical changes in the past decades. These changes have made it imperative to explore innovative and alternative ways of teaching and training. Simulation-based education has emerged as an effective teaching strategy for both learners and practicing health professionals. Simulation is an educational technique that recreates real-life experiences. Learning occurs through participation in these simulation experiences followed by a period of guided debriefing and reflection. Pediatric emergency medicine, by its very nature, can benefit greatly from a well-designed and thoughtfully implemented simulation program. This review outlines situations where simulation may be used for maximum effectiveness in a pediatric emergency department and provides an overview of the basics of debriefing. A thorough description of each identified use of simulation is beyond the scope of this article.

Sarcoidosis Causing Mid-Esophageal Traction Diverticulum

Abstract: A 78-year-old man presented to the outpatient clinic with progressive dysphagia with solid food for a few years. He had the feeling that food got stuck in his chest when swallowing. He denied any fevers, unintentional weight loss, hemoptysis, sore throat, odynophagia, shortness of breath, or wheezing. On examination he was hemodynamically stable. Chest exam revealed lower left lung crackles. He reported a medical history of bronchial asthma, allergic rhinitis, pulmonary hypertension, and sarcoidosis. Sarcoidosis was diagnosed in 2007 when he presented with a face lesion proved to be lupus pernio by skin biopsy (Figure 1). Computed tomography scan of the chest in 2012 after an asthma attack was concerning for bilateral pulmonary stellate opacities, pleural-based opacities, and mediastinal and hilar lymphadenopathy. Infrared-guided biopsy obtained at that time showed histological findings of sarcoidosis (Figure 2). Esophagram showed an esophageal diverticulum in mid-esophagus measuring 1.5 cm in diameter (Figure 3). Absence of esophageal motility abnormality and presence of lung andmediastinal lymph node fibrosis noted with radiological and histological means indicated a diagnosis of traction mid-esophageal diverticulum. Despite the presence of symptoms, the patient was a poor surgical candidate.