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.

Newborn screening for human immunodeficiency virus infection in the Bronx, NY, and evolving public health policy.

Abstract: New advances in the diagnosis and treatment of HIV infection continue to propel changes in public understanding of HIV infection and the administration of public health law. Over the past decade, New York State has moved from a policy of blind newborn screening for seroprevalence data to mandatory HIV testing as part of the statewide Newborn Screening (NBS) Program. A new statewide program of expedited HIV testing (48-hr turnaround results) of pregnant women and newborns (whose HIV status is unknown at the time of delivery) began in the summer of 1999. To better understand the impact this program might have on the patients who receive health care at Lincoln Medical and Mental Health Center (Lincoln Hospital), we evaluated our experience with the current NBS program prior to inauguration of the new expedited testing program. We evaluated the NBS program from February 1, 1997, to January 31, 1999, including total number of HIV-exposed/infected infants born, mother's HIV status (if known) at the time of delivery, amount of time between blood sampling and return of the test results to the Hospital, and medical follow-up of infants with positive newborn screening test results. This was a retrospective study of the NBS registry and the medical records of patients who receive primary health care from the Pediatric Immunology Service of the Department of Pediatrics at Lincoln Hospital. One hundred and four newborns were identified with positive-HIV antibody (HIV-Ab-positive), and 13 (12.5%) were confirmed to be HIV-infected by positive polymerase chain reaction (PCR) test of viral DNA. Sixty-five (62.5%) of the newborns with positive NBS screening test results were born to mothers who were known to be HIV-infected prior to delivery; 39 (37.5%) were unanticipated. Four (30%) of the 13 HIV-infected babies were born to mothers who were known to be HIV-infected prior to delivery, and 9 (70%) were born to mothers whose HIV status was unknown at the time of delivery. Eighty percent (80%) of HIV-Ab-positive infants continued to receive follow-up care at Lincoln Hospital. Relocation to other health-care facilities occurred as a result of parental choice or due to foster care placement. No babies were "lost" from the NBS program. The average time between sampling and receipt of results for all blood tests was 16 days (range 10 to 141). Nearly 40% of newborns who acquired HIV infection from their mothers were unanticipated because the mother's HIV status was unknown at the time of delivery. These unanticipated HIV-infected infants represent missed opportunities for prevention of maternal-to-child transmission of HIV infection and early therapeutic intervention for HIV-infected infants. The new expedited HIV-testing program for New York State will facilitate early diagnosis, prevention and treatment of the HIV-exposed/infected infant for whom maternal HIV status is unknown at the time of delivery.

Clinical Application of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention for Stable Coronary Artery Disease.

Abstract: Revascularization in stable ischemic heart disease (SIHD) is indicated in patients on optimal medical therapy with angina and/or demonstrable ischemia and a significant stenosis in one or more epicardial coronary arteries. Angiography alone, however, cannot accurately determine the hemodynamic significance of coronary lesions, particularly those of intermediate stenosis severity. A lesion may appear significant on coronary angiogram but may not have functional significance. Percutaneous coronary intervention (PCI) of functionally insignificant coronary artery lesions may have serious consequences; therefore, judicious decision-making in the cardiac catheterization laboratory is indicated. For this reason, it is becoming increasingly important to show that a stenosis is capable to induce myocardial ischemia prior to intervention. Fractional flow reserve (FFR) has emerged as a useful tool for this purpose. In this review, we will briefly discuss the principle of FFR, current evidence and rationale supporting its use, and comparison with other modalities.

Unusual presentation of focal nodular hyperplasia.

Abstract: We report an unusual case of focal nodular hyperplasia presenting as a large tumor-like mass extending to the gastric pylorus. This showed increased activity on hepatobiliary imaging. Focal nodular hyperplasia usually develops in women of childbearing age (1). Although It may manifest clinically with vague abdominal pain and fullness, it typically Is identified Incidentally (1). The etiology of FNH remains unknown. However, regression has been documented after the discontinuation of oral contraceptives. Pathologically, the lesion consists of a nodular mass, frequently containing a central stellate scar with radiating fibrous septations (2). Histologic examination reveals an abnormal arrangement of hepatocytes, Kupffer cells, and bile ducts (2). Nuclear imaging reveals uptake of Tc-99m SC in 70% of cases because of the presence of Kupffer cells (3). Although rarely reported, two cases of hepatoblastoma showing uptake of Tc-99m SC have been noted in children (4). However, no known cases of hepatoblastoma have been reported to demonstrate both Tc-99m SC and HIDA uptake. These findings also assist in excluding hepatic adenomas from further clinical consideration (5,6). Sonographic evaluation reveals a nonspecific appearance, ranging from hypoecholc to hyperechloc (7). The size of individual lesions ranges from I cm to 20 cm, with multiple lesions being reported in 13% of cases (7). CT evaluation typically demonstrates a homogeneous mass of slightly decreased density, which becomes iso-to-hyperdense with intravenous contrast administration (7). A central fibrous scar Is infrequently demonstrated on CT or ultrasound (3). This case emphasizes the potential of FNH to appear as a large tumor with extra-hepatic extension. It also supports the role of nuclear imaging when evaluating the etiology of a mass identified on CT or ultrasound.