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.

Subgrouping with psychiatric inpatients in group psychotherapy: linking dependency and counterdependency.

Abstract: A model of inpatient group psychotherapy that focuses on two frequently observed patient subgroups reflecting contrasting attitudes toward authority is presented. The counterdependent subgroup overly values autonomy, opposes unit restrictions, and rejects treatment. The dependent subgroup tends to accept the unit's treatment and structure but is overly passive. In this model these attitudes are addressed in order to help patients adapt to the unit and to facilitate discharge. The author describes a three-stage group designed to help patients achieve these goals.

Community-associated methicillin-resistant staphylococcal infection in an inner city hospital pediatric inpatient population.

Abstract: Background: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious problem in the community setting, primarily as a cause of skin and soft tissue infections. Methods: A retrospective study based on the review of pediatric inpatients admitted to Lincoln Medical and Mental Health Center from March 2006 to February 2007 was performed. Results: Eighteen (55%) of the thirty-three patients identified were infected with community associated (CA) MRSA. All patients had skin and soft tissue infections. Seventeen (94%) of eighteen CA-MRSA isolates were susceptible to trimethoprim-sulfamethoxazole and tetracycline, respectively, and eleven (61%) were susceptible to levofloxacin. Conclusions: Skin and soft tissue infections are the most common clinical manifestation of CA-MRSA in our population. The 55% prevalence of MRSA in our patients suggests reconsidering empirical antimicrobial choices. Surgical intervention is important in the management of these infections, and clindamycin resistance among CA-MRSA isolates should be monitored locally to determine if empiric therapy is appropriate.

Paraneoplastic Arthritis in a Patient With Gastric Cancer: A Case Report.

Abstract: Paraneoplastic syndromes occur in the presence of a tumor and are known to cause a myriad of systemic manifestations by mechanisms other than direct metastasis. Although considered to be rare, tumors can cause paraneoplastic rheumatological manifestations such as paraneoplastic arthritis. Differentiating between paraneoplastic arthritis and primary rheumatoid arthritis (RA) presents a diagnostic challenge to physicians. Here we describe a case of an 83-year-old male with complaints of painful joint swelling of his hands, elbows, and feet. Subsequent tests ultimately led to the diagnosis of gastric cancer with associated paraneoplastic arthritis. We highlight the physical, laboratory, and imaging findings associated with the diagnosis of paraneoplastic arthritis with emphasis on the differences between this diagnosis and that of RA. Despite the uncommon nature of paraneoplastic arthritis, it remains of paramount importance to be aware of its association with malignancies, aiding in possible earlier diagnosis.

Initiation of Somatostatin analogues for neuroendocrine tumor patients: a cost-effectiveness analysis.

Abstract: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are heterogeneous neoplasms. Although some have a relatively benign and indolent natural history, others can be aggressive and ultimately fatal. Somatostatin analogues (SSAs) improve both quality of life and survival for these patients once they develop metastatic disease. However, these drugs are costly and their cost-effectiveness is not known. A decision-analytic model was developed and analyzed to compare two treatment strategies for patients with Stage IV GEP-NETs. The first strategy had all patients start SSA immediately while the second strategy waited, reserving SSA initiation until the patient showed signs of progression. Sensitivity analysis was performed to explore model parameter uncertainty. Our model of patients age 60 with metastatic GEP-NETs suggests empiric initiation of SSA led to an increase 0.62 unadjusted life-years and incremental increase in quality-adjusted life years (QALYs) of 0.44. The incremental costs were $388,966 per QALY and not cost-effective at a willingness-to-pay threshold of $100,000. Death was attributed to GEP-NETs for 94.1% of patients in the SSA arm vs. 94.9% of patients in the DELAY SSA arm. Sensitivity analysis found that the model was most sensitive to costs of SSAs. Using probabilistic sensitivity analysis, the SSA strategy was only cost-effective 1.4% of the time at a WTP threshold of $100,000 per QALY. Our modeling study finds it is not cost-effective to initiate SSAs at time of presentation for patients with metastatic GEP-NETs. Further clinical studies are needed to identify the optimal timing to initiate these drugs.