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.

An Analysis of UCNS Certified Headache Center Patient Intake Forms.

Abstract: OBJECTIVE Compare the similarities and differences among headache intake forms from headache centers with United Council of Neurologic Subspecialties (UCNS) accredited headache medicine fellowships in the United States. Patient intake forms establish a first communication with patients. There have been no studies evaluating them at headache centers. Analysis of these forms can provide insight into their content and potential for improvement. METHODS This observational study involved collection and analysis of intake forms from 25 UCNS fellowship accredited headache centers from July 2014 to October 2014. Forms were compared and contrasted in terms of data fields included, response format, and use of validated assessment tools. RESULTS Forms shared many common elements, yet were highly variable in content, style, scales, and methods of analysis. Twenty percent (5/20) of centers did not have a formal intake form. Forms ranged from 1 to 28 pages. Seventy percent (12/17) utilized a check box format, 23% (4/17) utilized an open ended/fill in the blank format, and 6% (1/17) utilized a circle the response(s) format. Family history was inquired about in 82% (14/17) of forms and past medical history (PMH) in 58% (10/17) of forms. Gender questions were asked 82% (14/17) of the time for women, 29% (5/17) for men. Eighty-eight percent (15/17) of forms had questions concerning any type of previous medication tried. DISCUSSION Patient intake forms are useful for clinical purposes, but vary markedly between UCNS headache centers. Ultimately, a universal intake form could be generated, providing a research-based alternative to the form currently used at each center. Use of a standardized intake form by UCNS centers would streamline data collection, a good first step in the eventual generation of a headache registry.

Hydrocephalus in a hydropic fetus with Turner syndrome: a rare association.

Abstract: We report a rare case of antenatally diagnosed Turner syndrome associated with hydrocephalus. In addition, the fetus had cystic hygroma, hydrops fetalis and hypoplastic left heart syndrome. Pregnancy was terminated because of the poor outcome of the above-mentioned anomalies. A possible mechanism for the development of hydrocephalus is discussed.

An Unusual Cause of Abdominal Pain and Fever in a Diabetic Patient

Abstract: Diagnosis: Emphysematous gastritis. This patient with uncontrolled diabetes and acute-on-chronic osteomyelitis developed fever and abdominal pain with leukocytosis during his hospitalization for limb amputation. Radiographic imaging revealed gas accumulation in the posterior stomach wall and within the portal vein (Figure 1) that was highly suggestive of emphysematous gastritis. Empiric treatment was started with imipenem, and the patient underwent emergent explorative laparotomy, which showed extensive tissue necrosis and edema of the greater curvature of the stomach. A partial gastrectomy was performed, and Gram stains prepared from necrotic tissue sections revealed gram-positive rods with enclosed endospores most consistent with Clostridium species (Figure 2). Further speciation was obtained by immunohistochemistry and identified Clostridium septicum as the underlyingmicroorganism (Figure 3). Antimicrobial therapy was tailored accordingly and continued with ampicillin and clindamycin for a total course of 14 days. The patient responded well and was discharged 18 days after his surgery. Emphysematous gastritis is a rare entity of gas gangrene characterized by necrotizing infection of the stomach wall with gas-producing microorganisms. Mortality rates up to 60% have been reported in multiple reviews [1, 2]. Common isolates are Streptococcus species, Enterobacteriaceae, Pseudomonas aeruginosa, and Clostridium perfringens [1, 3]. In our patient, C. septicum (Figure 2) invaded the stomach wall and caused gas gangrene. To our knowledge, C. septicum has not been isolated in any case of emphysematous gastritis in humans so far. Although difficult to grow in blood or tissue cultures, we identified the organism by using immunohistochemistry on paraffin sections of surgical specimens (Figure 3). Intramural microbial infections of the stomach do not occur commonly given the bactericidal environment, the presence of a protective mucosal barrier, and the rich blood supply this organ receives. In patients with emphysematous gastritis, these protective mechanisms are altered in the setting of preexisting conditions. Prior abdominal surgeries, alcoholism, diabetes, high-dose steroid therapy, and a prior ingestion of corrosive substances have all been described in patients with emphysematous gastritis and are recognized as predisposing factors [1, 4, 5]. Our patient had uncontrolled diabetes as his primary risk factor. There are no standardized recommendations for management of emphysematous gastritis available in the literature, and both operative and conservative approaches have been reported with good outcomes [3, 6]. It is crucial for clinicians to consider this diagnosis in a patient with abdominal pain and a history of diabetes, alcohol abuse, prior abdominal surgeries, or corrosive injuries of the stomach mucosa to enable early recognition and intervention. Figure 1. Axial contrast-enhanced computed tomographic image through the upper abdomen demonstrates gas within the nondependent portion of the stomach (arrows). Also note the portal venous gas (asterisk). Figure 2. Tissue section obtained from the greater curvature of the stomach. Gram-positive rods (arrows) with endospores (arrowheads) are seen in the necrotizing tissue (Periodic acid-Schiff counterstain).

Extensive cutaneous sarcoidosis. Ga-67 imaging.

Abstract: A 32-year-old woman with biopsy proven sarcoidosis was referred for Ga-67 imaging. In addition to systemic manifestations of sarcoidosis, the patient also had multiple skin nodules. Ga-67 imaging showed bilateral, symmetric increased uptake in the parotid glands. Increased tracer uptake was also noted in both supraclavicular, right paratracheal, and bilateral hilar regions consistent with lymphadenopathy. In addition, multiple foci of increased uptake were noted diffusely throughout all four extremities involving the subcutaneous tissues. Punch biopsy of one of the skin nodules demonstrated non-caseating granulomatous dermatitis and panniculitis consistent with sarcoidosis.

Paroxysmal neuropathic pain in an adolescent female with syringomyelia: a review of literature.

Abstract: Paroxysmal neuropathic pain is an uncommon complaint among pediatric patients visiting the emergency department It is a rare presentation in children with syringomyelia Patients with syringomyelia may present with a variety of pain symptoms It is the site and extension of the syrinx, which determines the character of pain We report an adolescent with Chiari malformation type 1 with syringomyelia who presented with neuropathic pain, dysesthesia, and absent triceps (C7) reflex The pertinent literature is reviewed