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.

Promoting an obesity education program among minority patients in a single urban pediatric Emergency Department (ED)

Abstract: Background The purpose of this study was to assess the feasibility of the Emergency Department (ED) as a place for obesity education and to evaluate its impact on patient’s lifestyle modification.

Alteration of serum pituitary hormone levels in postmenopausal women with stroke.

Abstract: The aim of this study was to determine if circulating levels of pituitary hormones are altered by stroke and, if so, whether these alterations offer insight into specific neurochemical pathways in the region of the central nervous system injury. Twenty-eight consecutive postmenopausal women undergoing computed tomographic imaging of the brain for evaluation of clinical evidence of stroke underwent blood sampling for determination of serum levels of luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, triiodothyronine, prolactin, estradiol, and sex hormone--binding globulin. In stroke involving the caudate, serum levels of luteinizing hormone and follicle-stimulating hormone were reduced to 16% and 24% of concentrations found in those with stroke outside of the basal ganglia (p < 0.03 and p < 0.01, respectively). Levels of estradiol, sex hormone-binding globulin, thyroid-stimulating hormone, and prolactin were similar in all stroke groups. Nonspecific biochemical effects of stress that might influence hormone concentrations were assessed by measurement of serum triiodothyronine, the level of which is a sensitive biochemical correlate of disease severity. These levels were not different between stroke groups. Stroke involving the caudate nucleus may interrupt neurotransmitter pathways involved in control of secretion of gonadotropins. Peripheral levels of these hormones may serve as a marker for central neurochemical disturbances associated with stroke in specific brain regions.

Partial Hydatidiform Mole With False-Negative Urine Human Chorionic Gonadatropin Test in the Emergency Department

Abstract: Background Hydatidiform mole (molar pregnancy) is a benign tumor of placental trophoblastic cells, which release human chorionic gonadotropin (hCG). Several case reports have described complete hydatidiform moles with false-negative urine qualitative hCG tests. These negative pregnancy tests have been attributed to the hook effect. We report an unusual presentation of a partial mole and review an alternative explanation for the negative hCG test. As partial moles are usually not associated with a large proliferation of trophoblastic cells, levels of hCG are commonly Objective In a pregnant patient, vaginal bleeding and abdominal pain are common presentations. Molar pregnancy is an uncommon cause of abdominal pain and vaginal bleeding that should be considered. Case Report A 47-year-old female presented to the emergency department with abdominal pain and vaginal bleeding. Urine qualitative hCG was negative and serum quantitative hCG was 1,094,950 mIU/mL. Pelvic ultrasonography showed a uterine cavity containing a soft-tissue mass with multiple cystic lesions and the hydatidiform mole was extracted with suction curettage. Tissue pathology confirmed partial hydatidiform mole. Conclusions In addition to the hook effect, we present another possible explanation for the false-negative test; namely the inability of some assays to detect hCG-degradation products, which may be higher in clinical samples from patients with hydatidiform mole. This case underscores the importance of knowing the limitations of the commonly used hCG assays.

Fracture of the penis: an atypical presentation

Abstract: Fracture of the penis is an uncommon injury presenting to the emergency department (ED). Personal embarrassment and social scenarios associated with this condition may result in underreporting. Patients often delay seeking medical attention, and even when they do, as in our case report, they may withhold the condition for a significant time. ED physicians need to be aware of the social inhibitions and the need for early diagnosis and prompt treatment. A delay in treatment increases the risk of complications such as ischemia, necrosis and penile deformity. Fracture of the penis is caused by rupture of the tunica albuginea of one or both corpora cavernosa by a blunt trauma to the erect penis. Diagnosis is usually clinical as evident by the characteristic history and clinical presentation. Diagnostic modalities aid in the management of the fracture and associated injuries if present. But promptness in the recognition and initiation of treatment can significantly reduce the chances of post-injury complications. We present a case of penile fracture in a young male who presented to the ED with abdominal pain, but careful history and physical examination revealed penile fracture. A delay in diagnosis could have led to complications. Our case report is an attempt to emphasize the need to suspect injury to the penis in a young adult who might present to the emergency department with an entirely different complaint and also to treat any penile trauma as an emergency. This report provides evidence of an uncommon and underreported clinical entity. A review of the pertinent literature is included.

Is there a relationship between wound infections and laceration closure times

Abstract: Lacerations account for a large number of ED visits. Is there a “golden period” beyond which lacerations should not be repaired primarily? What type of relationship exists between time of repair and wound infection rates? Is it linear or exponential? Currently, the influence of laceration age on the risk of infection in simple lacerations repaired is not clearly defined. We conducted this study to determine the influence of time of primary wound closure on the infection rate. This is a prospective observational study of patients who presented to the Emergency Department (ED) with a laceration requiring closure from April 2009 to November 2010. The wound closure time was defined as the time interval from when the patient reported laceration occurred until the time of the start of the wound repair procedure. Univariate analysis was performed to determine the factors predictive of infection. A non-parametric Wilcoxon rank-sum test was performed to compare the median differences of time of laceration repair. Chi-square (Fisher's exact) tests were performed to test for infection differences with regard to gender, race, location of laceration, mechanism of injury, co-morbidities, type of anesthesia and type of suture material used. Over the study period, 297 participants met the inclusion criteria and were followed. Of the included participants, 224 (75.4%) were male and 73 (24.6%) were female. Ten patients (3.4%) developed a wound infection. Of these infections, five occurred on hands, four on extremities (not hands) and one on the face. One of these patients was African American, seven were Hispanic and two were Caucasian (p = 0.0005). Median wound closure time in the infection group was 867 min and in the non-infection group 330 min (p = 0.03). Without controlling various confounding factors, the median wound closure time for the lacerations in the wound infection group was statistically significantly longer than in the non-infection group.