Journal of Community Hospital Internal Medicine Perspectives最新文献

Game Changer or More of the Same? A Comparative Meta-analysis of Rezafungin and Caspofungin in Treating Candidemia and Invasive Candidiasis. 改变游戏规则还是一成不变？雷沙芬净和卡泊芬净治疗念珠菌血症和侵袭性念珠菌病的比较荟萃分析。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1391

Zouina Sarfraz, Zeeshan Nasir, Faheem Javad, Aden Khan, Bushra Shah, Musfira Khalid, Azza Sarfraz, Muzna Sarfraz, Amna Minhas, Suchal A Gondal

{"title":"Game Changer or More of the Same? A Comparative Meta-analysis of Rezafungin and Caspofungin in Treating Candidemia and Invasive Candidiasis.","authors":"Zouina Sarfraz, Zeeshan Nasir, Faheem Javad, Aden Khan, Bushra Shah, Musfira Khalid, Azza Sarfraz, Muzna Sarfraz, Amna Minhas, Suchal A Gondal","doi":"10.55729/2000-9666.1391","DOIUrl":"https://doi.org/10.55729/2000-9666.1391","url":null,"abstract":"This meta-analysis assesses the recent Food and Drug Administration (FDA)-approved antifungal, rezafungin, for treating candidemia and invasive candidiasis-both are significant health concerns with limited treatment options. Two randomized controlled trials comparing rezafungin to caspofungin were meta-analyzed, revealing no significant differences in global cure rates and 30-day all-cause mortality. While rezafungin's unique attributes, like a novel mechanism and once-weekly dosing, may enhance patient adherence, concerns arise about its clinical relevance given the substantial investment. The study emphasizes the need for ongoing research, post-marketing surveillance, and real-world data to determine rezafungin's true value in managing these life-threatening fungal infections. Despite FDA approval, further investigation is warranted for a comprehensive understanding of rezafungin's efficacy and safety.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 5","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postpartum Acquired Hemophilia A. 产后获得性血友病 A。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1382

Khawaja O Omar, William Sebastian, Suzanne Kemper

{"title":"Postpartum Acquired Hemophilia A.","authors":"Khawaja O Omar, William Sebastian, Suzanne Kemper","doi":"10.55729/2000-9666.1382","DOIUrl":"https://doi.org/10.55729/2000-9666.1382","url":null,"abstract":"Acquired hemophilia A (AHA) is a bleeding disorder that occurs from aberrant production of autoantibodies that target factor VIII. The underlying cause of AHA is unclear but can present postpartum. Very few cases have reported instances of AHA coexisting with other hematological disorders, such as sickle cell trait (SCT). Although rare and no direct correlation between the two, critical situations involving intractable bleeding can intensify the severity of these disorders. A 31-year-old pregnant female with a medical history significant for SCT presented to the hospital for a C-section. Shortly after the procedure she experienced intractable bleeding from multiple sites. Initial lab work yielded an isolated increase in activated partial thromboplastin time (aPTT). Further investigation showed abnormal mixing studies, reduced factor VIII activity and the presence of factor VIII antibodies. The patient was diagnosed with postpartum AHA (PAH) and treated with activated Factor VII and prednisone. PAH is an uncommon bleeding disorder that commonly occurs one to four months postpartum and presents as excessive bleeding elevated aPTT, abnormal mixing studies, and reduced factor VIII levels with abnormally high inhibitor levels. Despite an unknown identifiable etiology, treatment hinges upon establishing hemostasis and eradicating the aberrant generated factor VIII inhibitors. The association of AHA and other hematological disorders is not yet elucidated.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 5","pages":"85-88"},"PeriodicalIF":0.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blast and Bursts: Unveiling Splenic Rupture in Blastic Plasmacytoid Dendritic Cell Neoplasia. 爆炸与爆发：揭开浆细胞性树突状细胞肿瘤的脾破裂之谜

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1389

Abdulahi Hassan, Matthew Simpson, Rahim Jiwani, Abigail Arrigo, Palgun Nisarga, Olukemi A Esan, Anna Koget

引用次数: 0

Characterization of Markers in Blood Tests of Patients With Pleural Effusion and Their Correlation to Different Etiologies. 胸腔积液患者血液检测中标记物的特征及其与不同病因的相关性。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1395

Raymond Farah, Keren Sidar-Orlin, Adi Sharabi-Nov

{"title":"Characterization of Markers in Blood Tests of Patients With Pleural Effusion and Their Correlation to Different Etiologies.","authors":"Raymond Farah, Keren Sidar-Orlin, Adi Sharabi-Nov","doi":"10.55729/2000-9666.1395","DOIUrl":"https://doi.org/10.55729/2000-9666.1395","url":null,"abstract":"Background: To investigate the etiology of pleural effusion, a variety of examinations are performed, including invasive ones: Thoracentesis is an invasive procedure to remove fluid or air from the pleural cavity for diagnostic or therapeutic purposes. Until now, there are no blood markers that can help us diagnose the type of pleural effusion without the need for pleural puncture or drainage.Aims: The aim of this study was to investigate the relationship and the utility of the new inflammatory markers taken from complete blood count (CBC) to differentiate between the various types of pleural effusion before the invasive procedure decision.Material and methods: This is an observational retrospective study. Data was collected from medical records of patients aged 18-90 admitted in Ziv Medical Center, Safed, Israel that were diagnosed with pleural effusion from 2013 to 2019. Of those patients, of whom inflammatory markers from blood counts and thoracentesis results were obtained, the outcomes were compared with the diagnosis type of pleural effusion.Results: This study involved 391 patients, 256 suffered from exudate type effusion, their median age was 72 years, while 135 suffered from transudate effusion, their median age was 80 years. Those with exudate effusion had higher levels of CRP, platelets, neutrophils, and lymphocytes in blood, whereas those with transudate effusion had higher levels of MPV and RDW in blood. Other blood markers such as NLR and PLR were not statistically significant, but were also higher in the blood of patients with exudate effusion.Conclusion: An evaluation of simple and inexpensive measurements of blood count such as platelets, neutrophils, lymphocytes, MPV, RDW may provide insight into the etiology of pleural effusion.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 5","pages":"30-34"},"PeriodicalIF":0.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Computer-aided Detection Technology in Adenoma Detection Rate Among Experienced Endoscopists in the Community Setting. 计算机辅助检测技术对社区经验丰富的内镜医师腺瘤检出率的影响

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1396

Mohammed Ahsan, Zackary Anderson, Medjine Jarbath, Maged Bakr, Raymond W Phillips

{"title":"The Impact of Computer-aided Detection Technology in Adenoma Detection Rate Among Experienced Endoscopists in the Community Setting.","authors":"Mohammed Ahsan, Zackary Anderson, Medjine Jarbath, Maged Bakr, Raymond W Phillips","doi":"10.55729/2000-9666.1396","DOIUrl":"https://doi.org/10.55729/2000-9666.1396","url":null,"abstract":"Adenoma detection rate (ADR) is a key quality metric in screening colonoscopies. An adenoma detection rate of greater than 30% reduces the incidence of colorectal carcinoma (CRC). Furthermore, studies have demonstrated an inverse relationship between ADR and the incidence of CRC. Computer aided detection (CAD) can improve ADR, but these studies have largely been in major medical centers. In this retrospective single center observational study, screening colonoscopies in average-risk patients were compared among 5 experienced endoscopists in the year before and the year after implementation of the CAD (GI Genius). Training for GI Genius was completed in December 2021 and the technology was implemented the beginning of January 2022. We evaluated the adenoma detection rate (ADR) for 1838 screening colonoscopies in 2021 (before CAD incorporation) and 2629 screening colonoscopies in 2022 (after CAD incorporation) to assess efficacy of AI-assisted colonoscopy. Our study demonstrates that the incorporation of CAD technology in a group of experienced endoscopists in a community setting significantly improved ADR. The ADR of the entire group increased significantly (p < 0.05) following the implementation of CAD technology. The improvement in ADR was attributed to an increased detection of small (<6 mm) polyps. The clinical significance of improved detection of small polyps is uncertain, and further investigation should be done on the economical benefit of incorporating an AI model in the community setting.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 5","pages":"42-48"},"PeriodicalIF":0.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Myroides odoratus Induced Cellulitis and Bacteremia in an Elderly Male. 臭蕈诱发一名老年男性的蜂窝织炎和菌血症

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1386

Edward Lovering, Ananta Paudel, Christopher J Haas

引用次数: 0

Abnormal TSH Level as a Predictor of Severe Outcomes Among Patients Hospitalized With COVID-19. TSH 水平异常是 COVID-19 住院患者严重后果的预测因素。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1400

Pinak A Shah, Kartika Shetty, Faraz Rahman, Andrey Manov, Mayesha Sharaf

{"title":"Abnormal TSH Level as a Predictor of Severe Outcomes Among Patients Hospitalized With COVID-19.","authors":"Pinak A Shah, Kartika Shetty, Faraz Rahman, Andrey Manov, Mayesha Sharaf","doi":"10.55729/2000-9666.1400","DOIUrl":"https://doi.org/10.55729/2000-9666.1400","url":null,"abstract":"Objective: To assess the association between thyroid dysfunction and mortality among patients hospitalized with COVID-19. Design: This is a retrospective multi-center study, which examined all patients admitted with Covid-19 diagnoses, and thyroid function results in absence of known thyroid disease.Results: 10,933 hospitalized COVID-19 positive patients were included in the study. These patients were without prior diagnosis or treatment of thyroid disease. Outcomes assessed were mortality, ICU admission, Ventilator use, length of stay, readmission and complications during hospital stay. Patients with low TSH and Low free T4 had odds of mortality of 10.07(95% CI [7.44-13.6]) compared to patients with Normal TSH and any free T4 levels. Patients with Low TSH and High free T4 also had odds of mortality of 1.38 (95% CI [1.19-1.59]) compared to patients with Normal TSH and Any free T4 level. Patients with Low TSH and Normal free T4 levels also had an Odds of mortality of 1.46 (95% CI [1.31-1.62]) compared to patients with Normal TSH and any free T4 level. Patients with Low TSH also had higher odds of ICU admission and Ventilator use when compared to patients with normal TSH.Conclusions: This study shows that patients with low TSH, regardless of free T4 level, indicates poor prognosis for hospitalized patients with SARS-CoV-2 infection and offers further insights into possible prognostic value of TSH levels for severe COVID-19 outcomes.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 5","pages":"35-41"},"PeriodicalIF":0.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Admitted With Epistaxis, Discharged on Immunosuppressants! - An Unusual Presentation of Mixed Connective Tissue Disease. 因鼻衄入院，服用免疫抑制剂后出院！- 混合性结缔组织病的不寻常表现。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1383

Anne C Laird, Basem Al Achras

引用次数: 0

Case Report: A Typical Lyme Disease With Uncommon Neurologic Presentation. 病例报告：典型莱姆病与不常见的神经系统表现。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1388

Guo Cheng, Neeraj Parkash, Amrita Daniel, Surendra Marur

引用次数: 0

Relationship Between Lower Esophageal Sphincter Muscles Thickness and Their Response to Pneumatic Dilation in Patients With Achalasia. 食道下段括约肌厚度与食道下段括约肌对气压扩张反应的关系

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI: 10.55729/2000-9666.1381

Foroogh A Avanaki, Mahdi Saravi, Nader Roshan, Razman A Bahri, Parnian Shobeiri, Faeze Salahshour, Hanieh Radkhah

{"title":"Relationship Between Lower Esophageal Sphincter Muscles Thickness and Their Response to Pneumatic Dilation in Patients With Achalasia.","authors":"Foroogh A Avanaki, Mahdi Saravi, Nader Roshan, Razman A Bahri, Parnian Shobeiri, Faeze Salahshour, Hanieh Radkhah","doi":"10.55729/2000-9666.1381","DOIUrl":"https://doi.org/10.55729/2000-9666.1381","url":null,"abstract":"Background: Prognostic factors play a major role in managing achalasia patients treated with pneumatic dilatation (PD) and understanding the pathophysiology of the disease. In this regard, the muscular thickness of the lower esophageal sphincter (LES) has drawn attention in recently published studies.Methods: Patients with newly diagnosed achalasia were included consecutively in this study, and Endoscopic Ultrasound (EUS) was used to determine the thickness of longitudinal and circular muscles of LES. To determine the recurrence of symptoms, patients were followed up for one year using the Eckardt questionnaire. The relationship between pre-treatment LES muscle thickness and symptom recurrence was investigated.Results: Seventeen of nineteen treated patients were enrolled in this study and the data of sixteen patients was analyzed. Although not statistically significant, those with thinner LES had recurrent symptoms ( p-value = 0.08). Patients with a thicker LES (5.1 mm vs. 4.6 mm) initially responded better to pneumatic dilatation ( p-value = 0.03). After initial therapy, severe pain (daily pain) was strongly associated with symptom recurrence.Conclusions: Severe retrosternal chest pain and a thin LES appear to be surrogate markers for advanced disease and poor outcomes. Pre-treatment integrated relaxation pressure (IRP) seems to be a promising predictor of PD prognosis. Due to the study's heterogeneous population, the findings cannot be generalized to all achalasia patients, and larger-scale studies are necessary to confirm these findings.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 5","pages":"21-29"},"PeriodicalIF":0.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0