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Institution

Lincoln Hospital

HealthcareNew York, New York, United States
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.


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Journal ArticleDOI
TL;DR: Cognitive deficits in otherwise asymptomatic subjects exposed to high altitude are caused by subclinical cerebral edema, and data show a trend toward decreased cognitive deficits in subjects pretreated with dexamethasone.

12 citations

Journal ArticleDOI
TL;DR: As operative trauma continues to decrease the ATOM course shows benefit for all residents regardless of the depth of their clinical trauma exposure in surgical residency, including residents with different levels of trauma exposure.
Abstract: The Advanced Trauma Operative Management (ATOM) course is a simulation course adopted by the American College of Surgeons to teach operative management of primarily penetrating, traumatic injuries. Although it is clear that overall operative trauma exposure is decreasing, the educational benefit of ATOM for residents with different amounts of trauma exposure remains unclear. Our aim was to determine whether residents from trauma centers experienced less benefit from the ATOM course when compared with residents from nontrauma centers. We compared two groups of residents who take ATOM through our institutional course, those from trauma centers and those from nontrauma centers. ATOM pre- and postcourse evaluations of knowledge and self-efficacy were collected from October 2007 to June 2013. Overall residents from three institutions, two trauma centers (100 residents) and one nontrauma center (34 residents), were included in the study. All resident groups had statistically significant improvement in knowledge and self-efficacy after taking the ATOM course (P < 0.0001). There was no statistically significant difference in improvement relative to each of the groups in the ATOM categories of knowledge and self-efficacy. Our data show that residents with different levels of trauma exposure had similar pre- and postcourse scores as well as improvement in the ATOM evaluations. As operative trauma continues to decrease the ATOM course shows benefit for all residents regardless of the depth of their clinical trauma exposure in surgical residency.

12 citations

Journal ArticleDOI
TL;DR: Urinalysis is not an accurate predictor of UTI, and local patterns of antibiotic resistance between E. coli and non–E.
Abstract: OBJECTIVES The objective of this study was (1) to determine the reliability of urinalysis (UA) for predicting urinary tract infection (UTI) in febrile children, (2) to determine whether UA findings can predict Escherichia coli versus non-E. coli urinary tract infection, and (3) to determine if empiric antibiotics should be selected based on E. coli versus non-E. coli infection predictions. METHODS This was a retrospective chart review of children from 2 months to 2 years of age who presented to the emergency department with fever (rectal temperature >100.4°F) and had a positive urine culture. This study was conducted between January 2004 and December 2007. Negative UA was defined as urine white blood cell count less than 5 per high-power field, negative leukocyte esterase, and negative nitrites. Urine cultures were classified into E. coli and non-E. coli groups. These groups were compared for sex, race, and UA findings. Multivariate forward logistic regression, using the Wald test, was performed to calculate the likelihood ratio (LR) of each variable (eg, sex, race, UA parameters) in predicting UTI. In addition, antibiotic sensitivities between both groups were compared. RESULTS Of 749 medical records reviewed, 608 were included; negative UA(-) was present in 183 cases, and positive UA(+) was observed in 425 cases. Furthermore, 424 cases were caused by E. coli, and 184 were due to non-E. coli organisms. Among 425 UA(+) cases, E. coli was identified in 349 (82.1%), whereas non-E. coli organisms were present in 76 (17.9%); in contrast, in 183 UA(-) cases, 108 (59%) were due to non-E. coli organisms versus 75 (41%), which were caused by E. coli. Urinalysis results were shown to be associated with organism group (P < 0.001). Positive leukocytes esterase had an LR of 2.5 (95% confidence interval [CI], 1.5-4.2), positive nitrites had an LR of 2.8 (95% CI, 1.4-5.5), and urine white blood cell count had an LR of 1.8 (95% CI, 1.3-2.4) in predicting E. coli versus non-E. coli infections. Antibiotic sensitivity compared between UA groups demonstrated equivalent superiority of cefazolin (94.7% sensitive in UA(+) vs 84.0% in UA(-) group; P < 0.0001), cefuroxime (98.2% vs 91.7%; P < 0.001), and nitrofurantoin (96.1% vs 82.2%; P < 0.0001) in the UA(+) group. In contrast, the UA(-) group showed significant sensitivity to trimethoprim-sulfamethoxazole (82.2% vs 71.3% in UA(+); P = 0.008). CONCLUSIONS Urinalysis is not an accurate predictor of UTI. A positive urine culture in the presence of negative UA most likely grew non-E. coli organisms, whereas most UA(+) results were associated with E. coli. This study also highlighted local patterns of antibiotic resistance between E. coli and non-E. coli groups. Negative UA results in the presence of strong suspicion of a UTI suggest a non-E. coli organism, which may be best treated with trimethoprim-sulfamethoxazole. Conversely, UA(+) results suggest E. coli, which calls for treatment with cefazolin or cefuroxime.

12 citations

Journal ArticleDOI
TL;DR: A detailed description of the theoretical framework and study design of TRIUMPH is provided and a critical reflection of the lessons learned in the process of implementing a health behavior intervention in a community-based setting is concluded.

12 citations

Journal ArticleDOI
TL;DR: It is suggested that guaiac testing is not accurate enough to rule out the presence of occult rectal injury in patients with penetrating trauma and must not influence the decision to further evaluate patients with high-risk injuries.
Abstract: Rectal examination with guaiac testing is a standard part of the emergency department evaluation of acutely traumatized patients. Its major role is in the recognition of occult bowel injury. We questioned its efficacy in detecting occult rectal injury in patients with penetrating trauma. We reviewed the charts of 19 patients with suspected rectal injury. Ten injuries were to the abdomen, nine to the buttock, and three to the thigh. Guaiac testing was 69% (11/16) sensitive and 33% (1/3) specific. Rigid sigmoidoscopy was 100% (12/12) sensitive and 67% (2/3) specific. Sensitivity was 100% (8/8) when the two were combined. Our findings suggest that guaiac testing is not accurate enough to rule out the presence of occult rectal injury. The result of guaiac testing must not influence the decision to further evaluate patients with high-risk injuries.

12 citations


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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20231
20224
202178
202086
201984
201839