scholarly journals The Burden of Neurocysticercosis at a Single New York Hospital

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Amy Spallone ◽  
Luboslav Woroch ◽  
Keith Sweeney ◽  
Roberta Seidman ◽  
Luis A. Marcos
Keyword(s):  
United States ◽  
New York ◽  
Medical Center ◽  
Long Island ◽  
Taenia Solium ◽  
The United States ◽  
University Hospital ◽  
Predominantly Hispanic ◽  
Icd 10 ◽  
Risk Patients

Neurocysticercosis (NCC), a disease caused by the larval pork tapeworm Taenia solium, has emerged as an important infection in the United States. In this study, we describe the spectrum of NCC infection in eastern Long Island, where there is a growing population of immigrants from endemic countries. A retrospective study was designed to identify patients diagnosed with NCC using ICD-9 and ICD-10 codes in the electronic medical records at Stony Brook University Hospital between 2005 and 2016. We identified 52 patients (56% male, median age: 35 years) diagnosed with NCC in the only tertiary medical center in Suffolk County. Twenty-five cases were reported in the last three years of the study. Forty-eight (94%) patients self-identified as Hispanic or Latino in the electronic medical record. Twenty-two (44%) and 28 (56%) patients had parenchymal and extraparenchymal lesions, respectively. Nineteen (41.3%) patients presented with seizures to the emergency department. Six patients (11.7%) had hydrocephalus, and five of them required frequent hospitalizations and neurosurgical interventions, including permanent ventriculoperitoneal shunts or temporary external ventricular drains. No deaths were reported. The minimum accumulated estimated cost of NCC hospitalizations during the study period for all patients was approximately 1.4 million United States dollars (USD). In conclusion, NCC predominantly affects young, Hispanic immigrants in Eastern Long Island, particularly in zip codes correlating to predominantly Hispanic communities. The number of cases diagnosed increased at an alarming rate during the study period. Our study suggests a growing need for screening high-risk patients and connecting patients to care in hopes of providing early intervention and treatment to avoid potentially detrimental neurological sequelae.

scholarly journals 667. An Emerging Tick-Borne Disease in Long Island, New York: Relapsing Fever Caused by Borrelia miyamotoi

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S241-S241
Author(s):  
Luis Marcos ◽  
Kalie Smith ◽  
Fredric Weinbaum ◽  
Eric Spitzer
Keyword(s):  
New York ◽  
Medical Center ◽  
Long Island ◽  
Suffolk County ◽  
University Hospital ◽  
Borrelia Miyamotoi ◽  
Relapsing Fever ◽  
Igg Antibody ◽  
Tick Borne Disease ◽  
East End

Abstract Background Suffolk County (Long Island, New York) reports annually the highest absolute number of tick-borne diseases in New York. A new Borrelia species, Borrelia miyamotoi which causes a relapsing fever, has been reported in New York recently. The aim of this study was to identify the number of cases of B. miyamotoi diagnosed in Suffolk county. Methods A retrospective chart review was performed in Stony Brook (SB) Medicine hospitals, SB University Hospital (the only tertiary medical center in Suffolk County) and Southampton Hospital (a major hospital in the east end of Suffolk County). Laboratory records were queried for a positive B. miyamotoi PCR test from blood or a positive IgG antibody with a B. miyamotoi-specific EIA that utilizes a recombinant GlpQ antigen (both tests performed in a commercial laboratory). Results Twenty-eight cases were positive for serology (IgG EIA; n = 19) or PCR (n = 9). None of the IgG-positive cases had a positive PCR result indicating that individuals were likely exposed to B. miyamotoi in the past. Of the nine PCR-positive cases (median age:67 years), eight were men, three were diagnosed in the outpatient clinic (33.3%) and six were diagnosed through the emergency department and required hospitalization (66.6%). Thrombocytopenia and transaminitis were common findings. Two-thirds of these nine cases were diagnosed in the period of 2016–2017 and one-third in the period, 2013–2015 (P = 0.17). Conclusion An increasing number of cases of B. miyamotoi were observed in Suffolk County during 2013–2017 and two-thirds required hospitalization. The real burden of this tick borne disease in Suffolk County and the rest of the state is unknown. Disclosures All authors: No reported disclosures.

scholarly journals Utility of a Telephone Triage Hotline in Response to the COVID-19 Pandemic: Longitudinal Observational Study (Preprint)

2021 ◽  
Author(s):  
Benjamin A Y Cher ◽  
Eric A Wilson ◽  
Alexa M Pinsky ◽  
Ryan F Townshend ◽  
Ann V Wolski ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Patient Portal ◽  
Telephone Triage ◽  
Telephone Hotline ◽  
Risk Patients ◽  
Triage Algorithm

BACKGROUND During the initial months of the COVID-19 pandemic, rapidly rising disease prevalence in the United States created a demand for patient-facing information exchanges that addressed questions and concerns about the disease. One approach to managing increased patient volumes during a pandemic involves the implementation of telephone-based triage systems. During a pandemic, telephone triage hotlines can be employed in innovative ways to conserve medical resources and offer useful population-level data about disease symptomatology and risk factor profiles. OBJECTIVE The aim of this study is to describe and evaluate the COVID-19 telephone triage hotline used by a large academic medical center in the midwestern United States. METHODS Michigan Medicine established a telephone hotline to triage inbound patient calls related to COVID-19. For calls received between March 24, 2020, and May 5, 2020, we described total call volume, data reported by callers including COVID-19 risk factors and symptomatology, and distribution of callers to triage algorithm endpoints. We also described symptomatology reported by callers who were directed to the institutional patient portal (online medical visit questionnaire). RESULTS A total of 3929 calls (average 91 calls per day) were received by the call center during the study period. The maximum total number of daily calls peaked at 211 on March 24, 2020. Call volumes were the highest from 6 AM to 11 AM and during evening hours. Callers were most often directed to the online patient portal (1654/3929, 42%), nursing hotlines (1338/3929, 34%), or employee health services (709/3929, 18%). Cough (126/370 of callers, 34%), shortness of breath (101/370, 27%), upper respiratory infection (28/111, 25%), and fever (89/370, 24%) were the most commonly reported symptoms. Immunocompromised state (23/370, 6%) and age >65 years (18/370, 5%) were the most commonly reported risk factors. CONCLUSIONS The triage algorithm successfully diverted low-risk patients to suitable algorithm endpoints, while directing high-risk patients onward for immediate assessment. Data collected from hotline calls also enhanced knowledge of symptoms and risk factors that typified community members, demonstrating that pandemic hotlines can aid in the clinical characterization of novel diseases.

scholarly journals COVID-19-Associated Critical Illness—Report of the First 300 Patients Admitted to Intensive Care Units at a New York City Medical Center

2020 ◽  
Vol 35 (10) ◽  
pp. 963-970 ◽  
Author(s):  
Sudham Chand ◽  
Sumit Kapoor ◽  
Deborah Orsi ◽  
Melissa J. Fazzari ◽  
Tristan G. Tanner ◽  
...  
Keyword(s):  
United States ◽  
New York ◽  
Mechanical Ventilation ◽  
New York City ◽  
Intensive Care ◽  
Critical Illness ◽  
Mortality Rate ◽  
York City ◽  
Medical Center ◽  
The United States

Background: The first confirmed case of novel coronavirus (2019-nCoV) infection in the United States was reported from the state of Washington in January, 2020. By March, 2020, New York City had become the epicenter of the outbreak in the United States. Methods: We tracked all patients with confirmed coronavirus-19 (COVID-19) infection admitted to intensive care units (ICU) at Montefiore Medical Center (Bronx, NY). Data were obtained through manual review of electronic medical records. Patients had at least 30 days of follow-up. Results: Our first 300 ICU patients were admitted March 10 through April 11, 2020. The majority (60.7%) of patients were men. Acute respiratory distress syndrome (ARDS) was documented in 91.7% of patients; 91.3% required mechanical ventilation. Prone positioning was employed in 58% of patients and neuromuscular blockade in 47.8% of mechanically-ventilated patients. Neither intervention was associated with decreased mortality. Vasopressors were required in 77.7% of patients. Acute kidney injury (AKI) was present on admission in 40.7% of patients, and developed subsequently in 36.0%; 50.9% of patients with AKI received renal replacement therapy (RRT). Overall 30-day mortality rate was 52.3%, and 55.8% among patients receiving mechanical ventilation. In univariate analysis, higher mortality rate was associated with increasing age, male sex, hypertension, obesity, smoking, number of comorbidities, AKI on presentation, and need for vasopressor support. A representative multivariable model for 30-day mortality is also presented, containing patient age, gender, body mass index, and AKI at admission. As of May 11, 2020, 2 patients (0.7%) remained hospitalized. Conclusions: Mortality in critical illness associated with COVID-19 is high. The majority of patients develop ARDS requiring mechanical ventilation, vasopressor-dependent shock, and AKI. The variation in mortality rates reported to date likely reflects differences in the severity of illness of the evaluated populations.

Tuberculous Otitis Media: Report of 2 Cases on Long Island, N.Y., and a Review of all Cases Reported in the United States from 1990 through 2003

2005 ◽  
Vol 84 (8) ◽  
pp. 488-497 ◽  
Author(s):  
Lisa M. Chirch ◽  
Khalid Ahmad ◽  
Warren Spinner ◽  
Victor E. Jimenez ◽  
Susan V. Donelan ◽  
...  
Keyword(s):  
United States ◽  
New York ◽  
Otitis Media ◽  
Frozen Section ◽  
The United States ◽  
The Other ◽  
University Hospital ◽  
Media Report ◽  
Tuberculous Otitis Media ◽  
High Degree

We report 2 cases of tuberculous otitis media that were diagnosed at Stony Brook University Hospital in New York since 1999. Both patients were women, aged 30 and 31 years. One patient had grown up in Russia, the other was a native-born American who had never left the East Coast region of the United States. Both patients had been symptomatic for many months; one complained of chronic otorrhea, and the other reported otorrhea, hearing loss, and discomfort. Neither patient responded to medical management, and both ultimately underwent surgery. One was diagnosed after surgical pathology revealed acid-fast bacilli on frozen-section analysis. In the other, pathology revealed chronic inflammation and granulomata, but stains were negative and her diagnosis was delayed for almost 2 years. We also review 9 other cases of tuberculous otitis media in the United States that have been reported in the literature since 1990. Our review suggests that the number of cases is rising in areas where tuberculosis is most common—that is, in major U.S. cities. Although 3 of these 9 cases occurred as reactivation disease in immigrants, most might have occurred as a result of local transmission. Clinicians should maintain a high degree of suspicion for tuberculosis in patients with chronic otitis symptoms, particularly those who are at higher risk of exposure to tuberculosis.

scholarly journals SOME PSYCHODIDÆ FROM LONG ISLAND, N. Y

1894 ◽  
Vol 26 (12) ◽  
pp. 329-333 ◽  
Author(s):  
Nathan Banks
Keyword(s):  
United States ◽  
New York ◽  
Long Island ◽  
The United States ◽  
Sea Cliff

Thomas Say described one species of Psychoda from the United States; Walker descrbied another from Hudson's Bay; and Dr. Williston, in Entom. News, 1893, described a third species from New York. I have noticed in the vicinity of Sea Cliff, N. Y., seven species, only one of which I have identified as previously described. Most of the forms I have collected are probably common elsewhere in the Eastern States and in Canada.

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