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.

Measuring Intubation in the Emergency Department: Is It Time to Include End-tidal Carbon Dioxide to Determine the Onset of Apnea?

Abstract: Dr. Driver and colleagues (1) conducted a well-designed study to determine the effect of the administration of a neuromuscular-blocking agent before the administration of a sedative agent for rapid sequence intubation/induction (RSI) in the emergency department (ED) setting. This study suggests there is a reduction in the time to intubation by approximately 6 seconds by administering a neuromuscular blocking-agent first, which defies conventional teaching that a sedative agent should be administered first. This article is protected by copyright. All rights reserved.

Exceptional Presentation of Heart Thrombi Secondary to Myocardial Infarction Due to COVID-19 Pandemic.

Abstract: Left ventricular thrombi (LVT) is an uncommon complication that can occur after a myocardial infarction thanks to the discovery of revascularization therapies. Before it, an LVT was described in up to 60% of patients with myocardial infarction. The authors present a case of a 46-year-old female who presented to the emergency department with one week of dyspnea, who had symptoms of chest pain for a week, however, did not show up in the hospital due to the ongoing COVID-19 pandemic. In-patient new-onset heart failure workup during that time was minimized due to the state of emergency COVID-19 pandemic. The patient lost to follow up appointment and then presented again to the hospital with Echocardiogram at that time showing mid to distal septal and apical hypokinesis, EF 30%-35% and a highly mobile circumferential echogenic mass of 2.4x2.4 cm noted in the left ventricle (LV) with differentials of LV thrombus vs cardiac tumor. Hospital complicated by LV thrombus embolization with bilateral lower extremities (LEs) arterial thrombi and limb ischemia. Left cardiac cath with a result of severe triple vessel disease requires either coronary artery bypass grafting (CABG) or complex percutaneous coronary intervention (PCI). A tentative plan was to pursue CABG, however, lower extremities must be healed prior to cardiothoracic surgery.

Herpes Simplex Encephalitis

Abstract: Herpetic infections have been well documented even in ancient Greek literature Herpes viruses are large double-stranded DNA viruses There are eight different types of herpes viruses affecting humans (human herpes virus (HHV))Herpes simplex encephalitis is an acute or subacute illness associated with focal or global cerebral dysfunction caused by herpes simplex viruses belonging to either type 1(HSV-1) or type 2(HSV-2) The vast majority of herpes simplex encephalitis is caused by HSV-1, with HSV-2 constituting only less than 10% Almost all of the herpes encephalitis beyond the neonatal period is caused by herpes simplex type 1(HSV-1), which is identified as the most common cause for fatal encephalitis, occurring in a sporadic and non-seasonal pattern across the globe Herpes encephalitis in neonates could be either due to HSV-1 or HSV-2 though the latter is more common HSV-2 can also cause encephalitis in immunocompromised patientsHerpes simplex 1 encephalitis (HSV-1) in adults is associated with significant morbidity and death despite treatment with antiviral therapy Herpes simplex encephalitis is again a devastating disease in infants and children irrespective of treatment Neonatal encephalitis caused by HSV-2 involves the brain more globally, and it results in more neurologic sequelae

Different pathogenic mechanisms of early-onset preeclampsia, late-onset preeclampsia, and hemolysis, elevated liver enzymes, low platelet syndrome.

Abstract: To the Editor, We read with interest the article titled “First trimester complete blood cell (CBC) indices in early and late-onset preeclampsia” by Örgül et al.(1) published in the Turkish Journal of Obstetrics and Gynecology in June 2019. We share the same enthusiasm in the use of a cheap and simple CBC count as an early predictor of poor obstetric outcomes. CBC is the first laboratory investigation performed in every pregnant woman and its value is not limited to diagnosing current medical conditions, it can also be used as a predictor of future events. In their article, Örgül et al.(1) show that white blood cell (WBCs) and neutrophil counts are significantly elevated in the first trimester of pregnancies with early and late-onset preeclampsia, compared with controls. They also give an excellent clinical tool in finding a specific cut-off value, using receiver operating characteristic curve analysis; specifically, 9.55x103/uL for WBCs and 6.45x103/uL for neutrophils. Unfortunately, in their statistical analysis, when comparing the three groups, they did not perform a post-hoc analysis to compare one group with each other. In our recent studies, we analyzed CBC indices in pregnancy affected by hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome vs. controls(2,3). We found no differences in the first trimester in terms of neutrophil count, and we did not analyze the total WBC count.(2) We obtained informed consent from the patients included in our study. We think that the difference between our study and the study of Örgül et al.(1) is due to the different pathogenesis of HELLP syndrome and preeclampsia. We think that preeclampsia is caused by an early placentation defect, whereas HELLP syndrome is determined by a maternal immunologic “storm” of circulating inflammatory molecules triggered in the third trimester. Örgül et al.(1) mentioned that early-onset preeclampsia was caused by early placentation defects, and late-onset preeclampsia was more related to maternal characteristics: in this regards, as mentioned earlier, a post-hoc analysis would have been very useful. Ethics Informed Consent: We obtained informed consent from the patients included in our study. Peer-review: Externally peer-reviewed Financial Disclosure: The author declared that this study received no financial support.