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.

Insulin-like growth factor binding protein-1 predicts preterm premature rupture of membranes in twin pregnancies

Abstract: Mechanisms leading to preterm premature rupture of membranes (PPROM) remain incompletely defined. Based on the elevated occurrence of PPROM in twin gestations and recent studies of the involvement of insulin-like growth factor binding protein-1 (IGFBP-1) in the inhibition of collagen production we hypothesized that serum IGFBP-1 levels might be predictive of susceptibility to PPROM in women with twins. In this prospective study peripheral blood was obtained from 58 women with twin gestations prior to 20 weeks gestation and sera analyzed by ELISA for concentrations of IGFBP-1. Demographic and clinical outcome data were subsequently obtained and associations between IGFBP-1 and PPROM were analyzed by the Mann–Whitney test and receiver operator curve (ROC) analysis. Eight of our subjects developed PPROM. They did not differ from the other women in demographics, medical history or current pregnancy outcome parameters. However, median IGFBP-1 levels were higher in women who subsequently developed PPROM (59.3 ng/ml) than in the other women (46.6 ng/ml) (p = 0.042). Using a cutoff value of 53.9 ng/ml the circulating IGFBP-1 level predicted development of PPROM with a sensitivity of 74%, specificity of 75%, a negative predictive value of 97% and a positive predictive value of 20%. Pending validation in larger studies the findings suggest that determination of serum IGFBP-1 levels in women with twin pregnancies may predict the later development of PPROM.

Management of musculoskeletal complications in endstage renal disease: an update

Abstract: People treated with prolonged hemodialysis now survive longer and increasingly develop musculoskeletal complications. Significant advances have been made in the management of musculoskeletal manifestations in patients undergoing hemodialysis for endstage renal disease. Noncalcium-based phosphate binders are preferred for the management of hyperphosphatemia. Vitamin D therapy is based on intact parathyroid hormone levels. Newer Vitamin D sterols and calcimimetic agents seem to control secondary hyperparathyroidism without increasing the calcium–phosphorous product. Use of biocompatible dialyzers for hemodialysis may delay articular manifestations of beta-2 microglobulin amyloidosis. Beta-2 microglobulin adsorption columns when used along with hemodialysis may lead to lower beta-2 microglobulin levels and improvement in articular manifestations of beta-2 microglobulin amyloidosis. In this review, we focus on the latest advancements in the management of secondary hyperparathyroidism and beta-2 microglobulin amyloidosis.

Clinical experience with rifampin-isoniazid-streptomycin-ethambutol (rise)-resistant tuberculosis

Abstract: We review demographic and clinical features of 55 patients with rifampin-isoniazid-streptomycin-ethambutol (RISE)-resistant tuberculosis in our hospital from April 1, 1991, to July 31, 1993. Fifty-one of the 55 patients (median age, 36 years) were seropositive for human immunodeficiency virus (HIV), and 49 had AIDS. Among the HIV-infected patients, the median CD4 cell count was 31/mm3. Forty-two patients died during the study period. Exogenous reinfection or superinfection with RISE-resistant tuberculosis occurred in 12 of 55 patients with a prior history of tuberculosis infection or disease. Fourteen of 55 received appropriate therapy, eight of whom became culture negative after a median of 68 days. Twelve of the 14 appropriately treated patients survived at least 6 months. When appropriately managed, even severely immunosuppressed individuals with HIV infection may have their RISE-resistant tuberculosis successfully controlled or eradicated. This infection however, remains highly lethal in the majority of patients with AIDS. Patients remain infectious for prolonged periods, even after appropriate therapy has been initiated.