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.

A child with abdominal pain and hyperglycemia: is it diabetic ketoacidosis?

Abstract: Hyperglycemia, abdominal pain, and vomiting are the most common manifestations of diabetic ketoacidosis in pediatric patients. The absence of ketonemia in these patients should prompt a consideration of acute pancreatitis. We report a case of an 11-year-old girl with acute necrotizing pancreatitis, who was initially diagnosed as having new onset diabetes with nonketotic hyperglycemia.

Graduate medical education downsizing: perceived effects of participating in the HCFA demonstration project in New York State.

Abstract: . Objective: Financial support for graduate medical education (GME) is shrinking nationally as Medicare cuts GME funds. Thirty-nine hospitals in New York State (NYS) voluntarily participated in a Health Care Financing Administration demonstration project (HCFADP)—the goal of which was to reduce total residency training positions by 4-5%/year over a five-year period, while increasing primary care positions. The objective of this study was to determine the effect of downsizing on emergency department (ED) staffing and emergency medicine (EM) residency training. Methods: Structured interviews and surveys of NYS program directors (PDs) were conducted in October—December 1999. Simple frequencies are reported. Results: One hundred percent of 17 PDs completed the interviews and seven of 12 participants in the HCFADP returned surveys. Twelve of 17 programs participated in HCFADP and two programs downsized outside HCFADP. Seven of 12 participants lost EM positions. Six of 12 programs were forced to exclude outside residents from rotating in their ED, leading to a need for one participating program and one non-participating program to find alternative sites for trauma. Five of 12 institutions provided resident staffing data, reporting a reduction in ED resident coverage in year 1 of the project of 9-40%. Programs compensated by increasing the number of shifts worked (4/12), increasing shift length (1/12), decreasing pediatric ED shifts (1/12), decreasing elective or research time (2/12), and decreasing off-service rotations (4/12). Six departments hired physician assistants or nurse practitioners, two hired faculty, and two hired resident moonlighters. Six of 12 programs withdrew from HCFADP and returned to previous resident numbers. Eight of 12 PDs thought that they had decreased time for clinical teaching. Conclusions: A 4-5% reduction in residency positions was associated with a marked reduction in ED resident staffing and EM residency curriculum changes.

Community-acquired methicillin-resistant Staphylococcus aureus nasal abscesses in a lower socioeconomic urban population.

Abstract: Background To determine the prevalence of community-acquired methicillin-resistant S. aureus (CA-MRSA) and methicillin-sensitive S. aureus (MSSA) nasal abscesses in a lower socioeconomic status urban population over a 5-year period. Methods A retrospective chart review of 29 consecutive patients with nasal abscess cultures performed in the otolaryngology clinic from 2007 to 2012. Results Twenty-nine cases of nasal abscesses were identified. All cultures grew S. aureus; 34.5% were MSSA and 65.5% were CA-MRSA. Comparing CA-MRSA and MSSA, there was no statistically significant increase in prevalence of CA-MRSA over 5 years; and there was no statistical difference comparing gender, year, or age. There was a high rate of erythromycin resistance (15/19) and a low rate of sulfamethoxazole/trimethoprim (2/19) and clindamycin (1/19) resistance in the CA-MRSA cases. Conclusion In this population, the proportion of CA-MRSA nasal abscesses is nearly twice that of MSSA nasal abscesses. The overall prevalence of CA-MRSA appears to be stable over the past 5 years. This may represent a stabilization of CA-MRSA colonization in this community. An awareness of the high proportion of CA-MRSA will allow for the appropriate selection of antibiotic therapy.

Bioterrorism: a clinical reality.

Abstract: The intentional delivery of Bacillus anthracis spores through mailed letters or packages established the clinical reality of bioterrorism in the United States in autumn 2001. An understanding of the epidemiology, clinical manifestations, and management of the more credible biologic agents is critical to limiting morbidity and mortality from a bioterrorism attack.1-5 Children may be particularly vulnerable to a bioterrorist attack for several reasons.6 They have a more rapid respiratory rate, a lower breathing zone, increased skin permeability, higher ratio of skin surface area to mass, and less fl uid reserve than adults. Accurate and rapid diagnosis may be more diffi cult in children because of their inability to describe symptoms. Their caretakers may become ill or require quarantine during a bioterrorist event. Preventive and therapeutic agents recommended for adults exposed or potentially exposed to agents of bioterrorism have not been studied in infants and children.7