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.

Safe Haven Laws: lack of awareness, misinformation, and shortfalls in resident education.

Abstract: Infanticide is defined as the killing of a child in the first 12 months of life, while neonaticide refers to the killing of a child in the first 24 hours of life [1,2]. The tragedy of abandoned or murdered newborns continues to be a reality in our society [3-7]. The Centers for Disease Control report that a person is 10 times more likely to die of homicide on the day they are born than at any other time during their life [8,9]. About 150 to 300 cases of neonaticide occur per year in the United States with an incidence to be 2.1 per 100000 live births per year [3,4]. The stories behind these abandoned newborns are varied but typically involve an unplanned, unwanted, and concealed pregnancy [1,5,6,10-12]. The mother is generally the perpetrator, though paternal neonaticide had been reported [13-15]. The most common Fig. 2. Measurements of the alpha and beta angles and the base of the triangle do not coincide with those established for the Brugada pattern.

Marchiafava-Bignami disease in a trauma patient

Abstract: Marchiafava-Bignami disease (MBD) is a rare pathological condition affecting the corpus callosum (CC), characterized by progressive demyelination and necrosis. While usually found in patients with chronic alcoholism, it has rarely been characterized in non-alcoholics. We describe a trauma patient with an unknown mechanism of injury, who was found to have MBD after remaining comatose for a prolonged period of time. Magnetic resonance imaging (MRI) demonstrated restricted diffusion involving the genu, body, and splenium of the CC. The patient eventually awoke but was non-communicative and uncomprehending prior to discharge to a nursing facility. We reviewed the literature and report here the first case of MBD encountered in a trauma patient. In conclusion, MBD is an extremely rare condition in non-alcoholic patients, and the use of MRI is crucial for its identification.

Megacolon: constipation or volvulus?

Abstract: Pediatric abdominal complaints are common presentations in emergency departments, and emergency physicians are challenged every day with a vast array of gastrointestinal disorders. Differentiating the child with a benign abdominal process from the child with a more serious condition can be difficult. We report a case of massive dilatation of the colon due to fecal impaction. Means for distinguishing constipation from alternative diagnoses are discussed.

Rituximab and lupus interstitial lung disease: friend or foe?

Abstract: Dear Editor, A 29-year old Mexican male with systemic lupus erythematosus (SLE) and secondary Sjogren’s syndrome presented to the emergency room of UMDNJ University Hospital, Newark, NJ, US, with dyspnea, productive cough, fever, chills, tachycardia and bilateral pleuritic chest pain of 2 weeks’ duration. Physical examination revealed crackles on lung auscultation. The patient was admitted for presumed communityacquired pneumonia and treated with intravenous levofloxacin. Initial pulmonary function tests (PFTs) revealed a restrictive defect with impaired gas exchange. Laboratory investigations revealed lupus flare with increased titers of anti-nuclear antibodies (ANA), anti-Ro and anti-La antibodies, anti-double stranded-DNA (anti-dsDNA) antibodies, along with low complement levels, elevated C-reactive protein levels and erythrocyte sedimentation rate. Electrocardiography (ECG) showed sinus tachycardia. Echocardiogram showed normal contractility and absence of thrombi. Chest imaging revealed patchy infiltrates and high-resolution computed tomography (HRCT) scan of the chest showed right pleural effusion, groundglass opacity and basal atelectasis, consistent with the diagnosis of lupus pneumonitis. The patient received high-dose intravenous steroids and was discharged from the hospital on oral prednisone 60 mg/daily, and hydroxychloroquine 400 mg/ daily. Five days post-discharge, the patient’s oxygen saturation was normal but his complaints of dyspnea continued. Subsequently, mycophenolate mofetil (MMF) 2 g/daily was added to his treatment regimen. However, the patient continued to complain of reduced exercise tolerance associated with a progressive decline in respiratory function on spirometry. The patient was reluctant to undergo cyclophosphamide treatment and rituximab was infused at a dose of 1000 mg at weeks 0 and 2. The patient improved both in terms of subjective symptoms of dyspnea and exercise tolerance, and in terms of spirometric parameters: increase of forced expiratory volume in 1 sec (FEV1) by 25% (49% to 74%), forced vital capacity (FVC) by 15% (2.21 L or 51% to 3.1 L or 66%), and diffusion capacity of carbon monoxide (DLCO) by 17% (42% to 59%). Respiratory complications of SLE may involve every element of the respiratory tract and are relatively common as the initial manifestation of this disease occurring in 60–80% of patients during the course of the disease. The pathology involves genetic, endocrine, environmental, pharmacological and immunological factors with a cytotoxic reaction of auto antibodies against complement, a circulating immune complex reaction and a hyperactivity of B lymphocytes. Acute lupus pneumonitis (ALP) is an uncommon complication of SLE, reported to occur in 0–14% of patients, in 50% of whom it may be the presenting manifestation. The natural history and etiology of ALP remain inadequately defined and the treatment options are limited and lack the support of randomized controlled trials. Although high-dose steroids and cyclophosphamide are the most commonly used therapies, their efficacy is questionable in some cases and the toxicity and sterility risk associated with cyclophosphamide is often not acceptable to patients. In SLE specifically, B-cell depletion has been shown to be an effective treatment. Disease control and sustained remission in patients with active, multi-organ SLE has been demonstrated. The pathogenesis of ALP is unclear and therefore the exact mechanism by which B-cell depletion improves this condition is also uncertain. Rituximab is a chimeric monoclonal antibody targeting the CD20 antigen on mature B-cells, and thereby causing B-cell depletion, which has been successfully employed for a variety of autoimmune conditions with an acceptable safety profile. Moreover, it has been reported in one study to be effective toward systemic sclerosis-induced interstitial lung disease (ILD); however, limited data exists for its use in SLEinduced ILD. On the contrary, there have been isolated case reports with rituximab-induced ILD in SLE patients. Based on current observations, we speculate that B-cell depletion may be more beneficial in International Journal of Rheumatic Diseases 2011; 14: e3–e4