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.

Pancreatic injury: accidental or nonaccidental.

Abstract: The diagnosis of abuse in a child with occult abdominal injuries is difficult. Not many patients with nonaccidental trauma present with a clear history of the injury. The absence of a reliable history in patients with nonaccidental trauma makes determination of an exact mechanism difficult. In most cases, patients present to the emergency department with inaccurate or misleading histories; some give no history of trauma, which may delay recognition of serious abdominal injuries. In addition, the child may have other injuries, such as neurologic or musculoskeletal, which divert attention from occult abdominal injuries. Pancreatic and duodenal injuries are considered specific for abuse. We report a child with pancreatic injury without an appropriate history of trauma, determined to be caused by nonaccidental trauma.

Acute Genital Edema during Peritoneal Dialysis: A Review for Surgeons.

Abstract: Acute genital edema (AGE) is an infrequent but disruptive complication in patients on continuous ambulatory peritoneal dialysis. It is a common manifestation of dialysate leakage caused by inguinal, umbilical, femoral, or incisional hernias; peritoneal tears; leaks around the dialysis catheter; trauma; fluid overload; and malignancy. The evaluation of AGE begins with a history and physical exam. However, the physical exam in these patients is often indeterminate. Several diagnostic measures exist to evaluate and guide management of AGE occurring during continuous ambulatory peritoneal dialysis but little agreement exists on an optimum method. We have conducted a review of the literature on the evaluation and management of AGE and present a summary of the data. CT peritoneography and peritoneal scintigraphy have been used extensively to evaluate AGE although no comparative studies exist. MRI peritoneography has also been described. CT peritoneography offers more anatomical detail but may not be as sensitive as peritoneal scintigraphy in detecting a peritoneal fluid leak as the cause for AGE. CT is also more costly and subjects the patient to more radiation. MRI is a noncontrast study without radiation risk, but has not been studied to the same degree. If testing is equivocal or bilateral hernias are suspected, diagnostic laparoscopy is helpful and can be combined with hernia repair. Whether the etiology is a leak or tear, low-volume peritoneal dialysis (PD) or cessation of PD for two to four weeks will allow closure. However, hernias almost always require operative repair with mesh usually without disrupting PD.

Confirming the Diagnosis of Cannabinoid Hyperemesis

Abstract: To the Editor: I was delighted to read the interesting case report by Chang and Windish1 of 2 patients with cannabinoid hyperemesis and compulsive bathing. However, I was surprised by the authors' claim that these cases were the first reported in the United States. I found 3 other case reports that had already been published in the United States by simply searching PubMed and Google.2-4 Although still rarely reported, cannabinoid hyperemesis may be much more common than currently recognized. Because this syndrome has been recognized only recently and its validity has been questioned,5 it is of paramount importance to clearly define and fully report all new cases. The diagnosis is suggested by the characteristic triad of habitual cannabis use, cyclic vomiting, and compulsive bathing, but confirmation relies heavily on patient follow-up. Previous case reports and case series have shown that, almost universally, patients improve in the months after marijuana cessation, thus confirming the diagnosis. Unfortunately, adequate patient follow-up was lacking for the 2 cases by Chang and Windish, and the diagnosis remains uncertain. I hope that the authors can convey their patients' outcome and that a future issue of Mayo Clinic Proceedings might provide the necessary follow-up to confirm the suspected diagnosis.