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.

Results from the Trial Using Motivational Interviewing, Positive Affect, and Self-Affirmation in African Americans with Hypertension (TRIUMPH)

Abstract: Objective: Our objective was to determine the the effectiveness in combining positive affect and self-affirmation strategies with motivational interviewing in improving blood pressure control among hypertensive African Americans compared with AA hypertensives in an education-only control group. Design: Randomized trial. Setting: Ambulatory practices in the South Bronx and Harlem, New York City. Participants: African American adults with uncontrolled hypertension. Interventions: Participants were randomized to a positive affect and self-affirmation intervention or an education control group. The positive affect and self-affirmation intervention involved having participants think about things that made them happy and that reminded them of their core values on a daily basis. These strategies were reinforced every two months through motivational interviewing. The control arm received a workbook of strategies on blood pressure control. All participants were called every two months for one year. Main outcomes: Blood pressure control rate. Results: A total of 238 participants were randomized. The average age was 56 + 11, approximately 70% were female, 80% were not married, and up to 70% completed high school. There was no difference in control rates between the intervention and the control group. However, at one year, female participants were more likely to be controlled. Participants with high depressive symptoms or high perceived stress at baseline were less likely to be controlled. Conclusions: While this study did not demonstrate an intervention effect, it does provide important insight into the psychosocial factors that may underlie blood pressure control in African Americans. Implications for future behavioral intervention trials are discussed. Ethn Dis. 2016;26(1):51-60; doi:10.18865/ed.26.1.51

Geriatric (G60) trauma patients with severe rib fractures: Is muscle sparing minimally invasive thoracotomy rib fixation safe and does it improve post-operative pulmonary function?

Abstract: Background Patient outcomes after muscle sparing minimally invasive thoracotomy rib fixation (MSMIT-ORF) in geriatric G60 trauma patients remain poorly studied. This study determined the effect of MSMIT-ORF on pulmonary function (PFT). Non-operatively managed (NOM) patients were also described. Methods Medical records of G60 patients with severe rib fractures with PFTs measured before and after MSMIT-ORF were examined. Patient outcomes (MSMIT-ORF vs NOM) were adjusted in a multivariate logistic regression model. Results 64 patients underwent MSMIT-ORF, 135 were NOM patients. MSMIT-ORF treated patients showed improvements in PFTs on postoperative day 5, p = 0.001. After adjustment analysis, MSMIT-ORF was associated with increased hospital length of stay (OR 44.9; 95% CI, 9.8–205, p Conclusions MSMIT-ORF is safe and improves pulmonary function in G60 trauma patients diagnosed with severe rib fractures. Future randomized control studies are needed for confirmation.

Nasal cannula end-tidal CO2 correlates with serum lactate levels and odds of operative intervention in penetrating trauma patients: a prospective cohort study.

Abstract: Background: Penetrating trauma patients in shock often require urgent operative intervention. Studies have demonstrated that variables obtained in the emergency department, such as lactate levels, can help the physician determine the presence of hemorrhagic shock, leading to more rapid intervention and improve prognosis in trauma patients. The purpose of the study is to determine if end-tidal (ET) CO2 correlates with serum lactate levels, a measure of tissue hypoxia and subsequently shock, in penetrating trauma patients. Secondarily, we sought to determine whether ET CO2 could be used to determine the patient's odds of requiring operative intervention. Methods: A prospective observational cohort study was undertaken at an urban Level 1 trauma center. Baseline ET CO2 from nasal cannula and serum lactate level were recorded in all patients in whom the trauma team was activated. Outcomes defined were whether operative intervention was needed. Pearson correlation (R), correlation coefficient (r(2)), and odds ratio were calculated. Results: One hundred five patients were enrolled. Pearson correlations and coefficients calculated for serum lactate level to ET CO2 were R = -0.86 (r(2) = 0.74, p < 0.0001). Of patients requiring operative intervention, 81.97% had abnormally low ET CO2 and 54.1% had abnormally high serum lactate levels. Odds ratios of patients needing an emergent operation with abnormally low ET CO2 was 20.4 (95% confidence interval, 7.47-55.96) and with abnormally high serum lactate levels was 4 (95% confidence interval, 1.68-5.93). Conclusion: ET CO2 has a strong inverse correlation to serum lactate levels. Abnormally low ET CO2 values were associated with greater increased odds compared with serum lactate levels of penetrating trauma patients requiring operative intervention. Level of evidence: Prognostic/diagnostic study, level I.