Journal of Community Hospital Internal Medicine Perspectives最新文献

{"title":"Role of Artificial Intelligence-assisted Decision Support Tool for Common Rhythm Disturbances: A ChatGPT Proof-of-concept Study.","authors":"Jahanzeb Malik, Muhammad W Afzal, Salaar S Khan, Muhammad R Umer, Bushra Fakhar, Amin Mehmoodi","doi":"10.55729/2000-9666.1402","DOIUrl":"10.55729/2000-9666.1402","url":null,"abstract":"<p><strong>Background: </strong>The objective of this article was to explore the use of ChatGPT as a clinical support tool for common arrhythmias.</p><p><strong>Methods: </strong>This study assessed the feasibility of using ChatGPT as an AI decision-support tool for common rhythm disturbances. The study was conducted using retrospective data collected from electronic medical records (EMRs) of patients with documented rhythm disturbances. The model's performance was evaluated using sensitivity, specificity, positive predictive value, and negative predictive value.</p><p><strong>Results: </strong>A total of 20,000 patients with rhythm disturbances were included in the study. The ChatGPT model demonstrated high diagnostic accuracy in identifying and diagnosing common rhythm disturbances, with a sensitivity of 93%, specificity of 89%, positive predictive value of 91%, and negative predictive value of 92%. The ROC curve analysis showed an area under the curve (AUC) of 0.743, indicating the excellent diagnostic performance of the ChatGPT model.</p><p><strong>Conclusion: </strong>The model's diagnostic performance was comparable to clinical experts, indicating its potential to enhance clinical decision-making and improve patient outcomes.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"5-9"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006448","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}

{"title":"Cough-hypersensitivity Syndrome-A New Paradigm in the Evaluation of Chronic Refractory Cough and Its Novel Therapeutic Horizons-A Review.","authors":"Dawlat Khan, Hammad Chaudhry, Phool Iqbal, Dawood Shehzad, Muhammad Yasir, Wahab Khan, Aiman Zia, Mamoon Ahmed","doi":"10.55729/2000-9666.1417","DOIUrl":"10.55729/2000-9666.1417","url":null,"abstract":"<p><p>Chronic cough is defined as a persistent cough, lasting beyond 8 weeks, poses a global health challenge, impacting a substantial portion of the world's population. In the United States, it stands as a prominent cause for numerous visits to primary care and pulmonology clinics, imposing a significant healthcare burden and utilizing valuable resources. While chronic cough can be indicative of serious underlying lung conditions, once serious pulmonary diseases are excluded, the leading culprits are often identified as gastroesophageal reflux, upper airway cough syndrome, and eosinophilic airway inflammation. Cough Hypersensitivity Syndrome (CHS) serves as a paradigm for understanding chronic refractory cough. CHS is chronic cough triggered by low-level tussigneic stimuli once more common etiologies have been effectively addressed. This review delves into the definition, pathophysiology, current therapeutic options, and novel treatments for Cough Hypersensitivity Syndrome (CHS).</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"75-81"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006399","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}

{"title":"Hidradenitis Suppurativa and Peripheral Ulcerative Keratitis.","authors":"Indira Acharya, Mohamed I Jalloh, Caroline D Trevisan, Christopher J Haas","doi":"10.55729/2000-9666.1408","DOIUrl":"10.55729/2000-9666.1408","url":null,"abstract":"<p><p>The co-occurrence of inflammatory eye disease and hidradenitis suppurativa (HS) is uncommon; ocular involvement typically manifests as anterior uveitis. In this report, we present a unique case of peripheral ulcerative keratitis (PUK) where both infectious and rheumatological workup was negative, leading us to consider the possibility of an association between this condition and severe HS. As far as we are aware, there have only been six documented cases of PUK associated with HS.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"89-93"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006418","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}

{"title":"A Rare Case of Anti-Caspr2 Autoimmune Encephalitis Associated with a Testicular Mixed Germ Cell Tumor.","authors":"Rakahn Haddadin, Danny Aboujamra, Kush Kapadia, Samuel Yoon, Zade Zahlan, Lindsay Buczek, Hatim Gemil","doi":"10.55729/2000-9666.1414","DOIUrl":"10.55729/2000-9666.1414","url":null,"abstract":"<p><p>Paraneoplastic limbic encephalitis (PLE) is a poorly understood condition, thought to be caused by the cross-reacting of tumor antibodies with neurons in the brain, resulting in neuropsychiatric sequelae, such as personality and behavioral changes, psychosis, memory loss, and seizures. Anti-contactin-associated protein-like 2 (CASPR2) antibodies can cause PLE in patients with particular tumors, which in most cases can be identified as thymoma, lung cancer, or endometrial cancer. Some case reports show rare instances with other tumors, such as throat or sigmoid carcinoma. We present the first reported case of CASPR2-antibody encephalitis secondary to a testicular mixed germ cell tumor.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"104-107"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006269","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}

{"title":"New Era - Same Perspective.","authors":"Surendra Marur, Gillian Junker","doi":"10.55729/2000-9666.1405","DOIUrl":"https://doi.org/10.55729/2000-9666.1405","url":null,"abstract":"<p><p>Brief history of JCHIMP, future direction and acknowledgement of our 2023 reviewers and sources of our authors.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006365","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}

{"title":"The Diagnostic and Therapeutic Dilemma of Multiple Left Ventricular Masses.","authors":"Yasmin H Youssef, Mohamad S Alabdaljabar, Meltiady Issa","doi":"10.55729/2000-9666.1410","DOIUrl":"10.55729/2000-9666.1410","url":null,"abstract":"<p><p>Intracardiac masses are rare and potentially life-threatening entities with diverse clinical presentations. The prompt identification of cardiac masses is critical. However, even with the advancement we have in imaging modalities, diagnosing cardiac masses remains a formidable challenge. Herein, we present the case of a 62-year-old female who presented with a three-week history of dyspnea and chest pain. Further workup revealed elevated troponins, thrombocytosis, and ST-segment elevation in the anterolateral leads. Chest CT revealed a concerning lung mass, along with vertebral lesions and a large pleural effusion. The patient underwent treatment for suspected myocardial infarction. Additional imaging identified five intracardiac masses in the left ventricle suspicious for either malignancy or thrombi. High-intensity heparin drip was started, yet the patient developed neurological symptoms. Neuroimaging showed new cerebral infarcts. Based on the patient and her family's wishes, the patient transitioned to comfort care and passed away from gastrointestinal bleeding. In our case, the patient's presentation raised questions about whether her intracardiac masses were malignant or thrombotic. The decision to initiate and maintain anticoagulation therapy constitutes a debate, emphasizing the need for an individualized approach and shared decision-making with the patient and the multidisciplinary team.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"108-110"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006450","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}

{"title":"Monkeypox Vaccine Hesitancy Among Healthcare Workers in Pakistan.","authors":"Zahira Ali, Asmara Malik, Jahanzeb Malik, Tooba Fida, Uzma Ishaq, Amna Ashraf, Saqlain Ahmed, Ali Karim, Allah Warayo, Waheed Akhtar","doi":"10.55729/2000-9666.1401","DOIUrl":"10.55729/2000-9666.1401","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate healthcare workers (HCWs) acceptance of the HMPXV vaccine in Pakistan and identify influencing factors.</p><p><strong>Methods: </strong>A cross-sectional survey of 4257 HCWs assessed vaccine acceptance across demographics, ethnicity, marital status, specialty, medical conditions, and education. Logistic regression identified predictors of acceptance.</p><p><strong>Results: </strong>The overall HMPXV vaccine acceptance among HCWs was 73.1%. The gender distribution shows that a majority of participants are female (56.60%) while males constitute 43.40% of the sample. Interestingly, vaccine acceptance is higher among females (68.43%) compared to males (31.57%). Ethnicity in the sample reveals that Punjabi participants are the most common at 45.25%, followed by Pashtun (26.06%), Sindhi (14.41%), Balochi (12.72%), and Other (1.46%). Age categories are compared to the 18-30 age group. The odds of vaccine acceptance are lower for individuals aged 31-40 (OR 0.48, 95% CI 0.19-1.25) and for those over 60 (OR 0.80, 95% CI 0.41-0.97). Conversely, the odds are higher for those aged 41-50 (OR 1.93, 95% CI 0.27-3.01) and 51-60 (OR 0.54, 95% CI 0.19-1.67). Gender comparison reveals that females have higher odds of vaccine acceptance (OR 0.26, 95% CI 0.21-1.24) than males. Among ethnicities, Sindhi participants (OR 1.21, 95% CI 0.23-1.88) have slightly higher odds of vaccine acceptance than Punjabi participants. Marital status doesn't significantly influence vaccine acceptance, but married individuals have slightly higher odds (OR 1.75, 95% CI 0.87-5.06). In terms of specialty, Surgery/Allied professionals have lower odds of vaccine acceptance (OR 0.48, 95% CI 0.13-1.70) compared to Medicine/Allied professionals.</p><p><strong>Conclusion: </strong>Strategies addressing demographic disparities and countering misinformation are crucial for enhancing HMPXV vaccine uptake among HCWs. Targeted interventions are necessary for effective vaccination coverage in healthcare settings.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"50-57"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006348","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}

{"title":"An Atypical Case of Herpes Simplex 1 Meningitis.","authors":"Nadim Ojaimi, Sofia Zhang, Marcos Wolff, Christopher J Haas","doi":"10.55729/2000-9666.1413","DOIUrl":"10.55729/2000-9666.1413","url":null,"abstract":"<p><p>Herpes simplex virus (HSV) is well known to cause Central Nervous System (CNS) infections, ranging from more common HSV-2 viral meningitis to the more rare and severe HSV-1 encephalitis. Here we present an atypical case of aseptic meningitis due to HSV-1. Intriguingly, despite the potential severity of HSV-1 infections, the patient had an uncomplicated course with only mild symptoms that resolved with conservative management alone. This case report aims to provide a frame of reference for the non-specific presentation of a patient with uncommon HSV-1 meningitis.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"101-103"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006383","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}

{"title":"Beneath the Surface: Diagnosing Gastric Linitis Plastica.","authors":"Anurag Marasini, Thilini Delungahawatta, Bryan Szeto, Robert Jones, Christopher J Haas","doi":"10.55729/2000-9666.1415","DOIUrl":"10.55729/2000-9666.1415","url":null,"abstract":"<p><p>Gastric Linitis plastica is characterized by extensive infiltration of gastric wall by poorly differentiated tumor cells, creating a \"leather-bottle stomach\" appearance. We describe a case involving a 71-year-old male presenting with globus sensation, early satiety and weight loss. Recent EGD had revealed chronic gastritis with polypoid mucosa at the GE junction, and subsequent FDG-PET indicated asymmetric FDG localization. On admission, repeat EGD with deep biopsies confirmed invasive poorly differentiated gastric adenocarcinoma with signet ring features. Despite palliative radiation, the patient died within a month, highlighting the disease's aggressiveness and importance of advanced diagnostic techniques in suspected cases of Linitis plastica.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"124-127"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006390","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}

{"title":"Isolated Alkaline Phosphatase Elevation in Severe Osteoporosis Treatment: Implications of Teriparatide.","authors":"Nazmul Hasan, Emilie Chow, Daniel Yang, Priyanka Iyer, Andrew Reikes","doi":"10.55729/2000-9666.1407","DOIUrl":"10.55729/2000-9666.1407","url":null,"abstract":"<p><p>In severe osteoporosis, anabolic agents such as teriparatide (Forteo) are more commonly used. As a PTH analog, teripararide has a limited side effect profile with potential for mild hypercalcemia and dyspepsia. In this report we highlight another less common side effect, asymptomatic elevation in alkaline phosphatase.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"97-100"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006424","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}