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.

Latex-induced anaphylactic reaction in a child with spina bifida.

Abstract: Allergy to natural rubber latex presents a unique challenge in the emergency department. Latex allergy in children is most commonly identified in patients who have undergone multiple operations for neural tube defects or genitourinary anomalies. We report a life-threatening anaphylactic reaction to latex in a patient with spina bifida even with latex-free precautions.

Focused Training for Humanitarian Responders in Regional Anesthesia Techniques for a Planned Randomized Controlled Trial in a Disaster Setting.

Abstract: BACKGROUND Lower extremity trauma during earthquakes accounts for the largest burden of geophysical disaster-related injuries. Insufficient pain management is common in disaster settings, and regional anesthesia (RA) has the potential to reduce pain in injured patients beyond current standards. To date, no prospective research has evaluated the use of RA in a disaster setting. This cross-sectional study assesses knowledge translation and skill acquisition outcomes for lower extremity RA performed with and without ultrasound guidance among a cohort of Medecins Sans Frontieres (MSF) volunteers who will function as proceduralists in a planned randomized controlled trial evaluating the efficacy of RA for pain management in an earthquake setting. METHODS Generalist humanitarian healthcare responders, including both physicians and nurses, were trained in ultrasound guided femoral nerve block (USGFNB) and landmark guided fascia iliaca compartment block (LGFICB) techniques using didactic sessions and interactive simulations during a one-day focused course. Outcome measures evaluated interval knowledge attainment and technical proficiency in performing the RA procedures. Knowledge attainment was assessed via pre- and post-test evaluations and procedural proficiency was evaluated through monitored simulations, with performance of critical actions graded by two independent observers. RESULTS Twelve humanitarian response providers were enrolled and completed the trainings and assessments. Knowledge scores significantly increased from a mean pre-test score of 79% to post-test score of 88% (p<0.001). In practical evaluation of the LGFICB, participants correctly performed a median of 15.0 (Interquartile Range (IQR) 14.0-16.0) out of 16 critical actions. For the USGFNB, the median score was also 15.0 (IQR 14.0-16.0) out of 16 critical actions. Inter-rater reliability for completion of critical actions was excellent, with inter-rater agreement of 83.3% and 91.7% for the LGFICB and USGFNB evaluations, respectively. DISCUSSION Prior to conducting a trial of RA in a disaster setting, providers need to gain understanding and skills necessary to perform the interventions. This evaluation demonstrated attainment of high knowledge and technical skill scores in both physicians and nurses after a brief training in regional anesthesia techniques. This study demonstrates the feasibility of rapidly training generalist humanitarian responders to provide both LGFICB and USGFNB during humanitarian emergencies.

Hard Palate Melanoma: A Population-based Analysis of Epidemiology and Survival Outcomes.

Abstract: BACKGROUND/AIM Hard palate melanoma is an extremely rare and aggressive tumor arising from the mucosal epithelium of the oral cavity. The aim of this study was to analyze epidemiology, loco-regional treatment patterns and survival outcomes of this disease. MATERIALS AND METHODS The National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database was searched for all cases of hard palate melanoma diagnosed between 1973 and 2012. The Kaplan-Meier method was used to calculate overall survival rate, log-rank test to compare survivals of different subgroups, and Cox hazard regression analysis to determine independent predictors of overall survival. RESULTS Overall, 83 patients were identified, 49 female and 34 males. The distribution among ages was: 13.3% <50 years, 38.6% between 50 and 69 years, 48.2% ≥70. Surgery alone was applied in 48.2% of patients, radiation therapy alone in 6%, and combination of surgery and radiation therapy in 33.7%. Overall 5-year survival was 26.3%. Survival with adjuvant radiation therapy was not longer than with surgery alone. CONCLUSION Hard palate melanoma is a rare malignancy mostly affecting the elderly, with low overall survival. The main treatment is surgical resection, while adjuvant radiotherapy does not improve survival. The establishment of an international registry is warranted to better define treatment options.