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.

Disseminated Mycobacterial Infection as a Sequelae of Bladder Biopsy

Abstract: Disseminated Mycobacterium infections have been commonly documented in the immunocompromised and patients who undergo treatment for non-muscle invasive bladder cancer with the Bacillus Calmette-Guerin vaccine; however, it was unique to our patient's case that she had no record of receiving vaccination in her native country, was immunocompetent, and had exposure to bovine livestock before immigrating to the United States. A 57-year-old woman with no significant medical history presented with complaints of abdominal pains and yellowing of her skin. Laboratory workup was consistent with cholestatic hepatitis. One month prior to presentation, she underwent biopsy and culture of an unspecified bladder mass, which turned out to be positive for Mycobacterium bovis. All antituberculosis medications were discontinued, without improvement of her symptoms and hepatic function tests. Subsequent liver biopsy showed the presence of granulomas with acid-fast bacilli; hence, disseminated infection was highly suspected. Multiple sputum cultures and quantiferon tests were negative, and other diagnostic tests were unremarkable. Initiation of appropriate antibiotics resulted in marked symptomatic improvement and gradual normalization of hepatic function parameters. Disseminated mycobacterial infection may present differently in patients; however, it is important to note that the source of primary infection may vary. Prompt diagnosis and treatment of these pathogens may lead to improved outcomes.

Data analysis and interpretation of results in DATAS trial.

Abstract: Regarding the DATAS randomized study by Almendral et al. , 1 we would like to comment on methodological issues that may limit the validity of the results of this trial. The investigators have created clinically significant adverse events (CSAEs) scoring system2 based on assigning arbitrary weights to actual events that may artificially change the value of the analysed events, …

Mallet Finger Injuries

Abstract: Mallet finger is the term usually applied to extensor avulsion fractures. However, this entity may also be caused by distal extensor tendon ruptures. Either one results in an inability to extend the DIP joint. Mallet finger injuries are named for the resulting flexion deformity of the fingertip, which resembles a mallet or hammer. Mallet finger injuries are caused by the disruption of the extensor mechanism of the phalanx at the level of the distal interphalangeal joint, usually due to a forced flexion at the distal interphalangeal joint. This injury results in the inability to extend the distal phalanx. A mallet fracture occurs when the extensor tendon also causes avulsion of the distal phalanx. There are three subtypes of mallet fractures based on the age of the patient and the percent of the articular surface of the distal phalanx involved. The treatment remains controversial. In general, it is guided by the amount of articular surface involved in the fracture.

Characterization of phenotype and immunoglobulin genes of autoreactive b cells in sjogren's syndrome

Abstract: Background Characteristic changes in the distribution of peripheral B cell subsets and differences in use of immunoglobulin-variable region genes are features of Sjogren9s Syndrome (SS). Studies on Hepatitis C virus infected (HCV+) mixed Cryoglobulinemia (MC) patients have revealed B cell clonal expansion expressing stereotypical Rheumatoid Factor (RF) encoded by the immunoglobulin genes VH1-69 and Vk 3-20. G6 antibody specific for VH1-69 can identify the RF- expressing B cells in HCV+MC patients.Since some SS patients have been known to develop lymphomas bearing VH1-69 encoded antibodies, we hypothesized that SS patients might have clonal expansions of VH1-69-bearing B cells. Objectives Identify B lymphocyte characteristics in patients with Sjogren9s syndrome Methods We obtained blood samples from 13 patients diagnosed with SS at a teaching hospital rheumatology clinic, serving a large inner city population. Further processing of the blood samples from these patients was done at Rockefeller University and the Peripheral Blood Mononuclear Cells (PBMCs) were cryopreserved. Fluorescent- labeled Ro/SS-A (52,60kDA) and La-SS-B antigens were obtained. The purpose was to label B cells that make SS-A antibody so they could be seen by flow cytometry. Results Preliminary flow cytometric analysis of B cells in 8 of the blood samples showed a B cell phenotype different from that seen in HCV-associated MC. The memory B cells were high in CD-21, unlike those seen in HCV-associated MC. Few VH1-69 + B cells were seen in 4/8 patients analyzed. The other blood samples showed very few cells binding SS-A. Conclusions Unraveling the association between autoimmunity and lympoproliferation in SS patients will have clinical value, and B cell gene expression data may be able to predict susceptibility to lymphoma in these individuals. The abnormally expanded B cells should be studied at the transcriptional, proteomic and functional levels. The lack of direct comparison between the B cell repertoire in the blood and that in the parotids and/or minor salivary glands has prevented drawing of firm conclusions. The long term goal would be to clone, sequence and characterize autoantibodies produced in SS. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.5796