Journal of Community Hospital Internal Medicine Perspectives最新文献

{"title":"Shadows in the Light: Moonshine's White Lightning and Vision Loss.","authors":"Nadim Ojaimi, Aida Metri, Carl Tanba, Carlos E Baleeiro","doi":"10.55729/2000-9666.1598","DOIUrl":"https://doi.org/10.55729/2000-9666.1598","url":null,"abstract":"<p><p>Methanol poisoning remains an important cause of severe metabolic and neurologic toxicity, most commonly resulting from ingestion of illicit or improperly distilled alcoholic beverages such as Moonshine. We report a case of acute methanol toxicity following Moonshine ingestion, presenting with central nervous system manifestations and visual symptoms. The patient experienced rapid clinical and visual improvement after timely treatment with fomepizole and emergent hemodialysis. In addition to standard therapy, corticosteroids were administered as an adjunctive treatment for visual involvement. This case highlights the importance of early recognition and prompt extracorporeal clearance in methanol poisoning and explores the potential role of corticosteroids as an adjunct in patients presenting with visual symptoms.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 3","pages":"38-41"},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793521","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 Hidden Crisis: A Rare Case of Thyrotoxicosis in a Young Female, Mimicking Neuromuscular Disease.","authors":"Ali H Awan, Fnu Sameeha, Seerat Riaz, Hafiz M H Butt, Sajeela Riaz, Hilana S Omar, Shafia Naeem, Abida Perveen, Jahanzeb Malik","doi":"10.55729/2000-9666.1588","DOIUrl":"https://doi.org/10.55729/2000-9666.1588","url":null,"abstract":"<p><p>Thyrotoxic periodic paralysis (TPP) is a rare but life-threatening cause of acute flaccid paralysis associated with hypokalemia. Although more common in males and individuals of Asian descent, it may present atypically in young females and be easily misdiagnosed. We report a case of a 30-year-old female who presented with acute quadriparesis. Extensive neuromuscular evaluation initially pointed toward Guillain-Barré syndrome (GBS), but subsequent investigations revealed profound hypokalemia. Further workup confirmed thyrotoxicosis as the underlying cause. Prompt potassium replacement and initiation of antithyroid therapy led to complete clinical recovery. This case highlights the importance of considering both endocrine disorders and electrolyte disturbances, such as hypokalemia, in the differential diagnosis of acute paralysis.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 3","pages":"13-18"},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793481","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":"Lungs and Beyond: Seizures as Presenting Symptom in a Patient With <i>Mycobacterium chimaera</i> Infection.","authors":"Samar Mehyar, Tripti Adhikari, Shweta Kambali, Harneet K Ghumman, Avneet K Ghumman, Parul Sud, Mehrshad F Sabet, Elizabeth Mikhail, Sohrab Singh","doi":"10.55729/2000-9666.1597","DOIUrl":"https://doi.org/10.55729/2000-9666.1597","url":null,"abstract":"<p><p><i>Mycobacterium chimaera</i> is a slow-growing, non-tuberculous mycobacterium (NTM) that belongs to the <i>Mycobacterium avium</i> complex (MAC). It first emerged as a pathogen after being associated with infections in patients who underwent cardiothoracic surgery when patients were getting exposed to heater cooler units, especially those requiring extracorporeal membrane oxygenation (ECMO) or prosthetic valve placement. We report an atypical presentation of <i>M. chimaera</i> infection in a patient with COPD, but no prior history of cardiac surgery or immunosuppression.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 3","pages":"34-37"},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793072","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":"Innocent Until Proven Guilty: Native Valve <i>Staphylococcus lugdunensis</i> Infective Endocarditis Complicated by Embolic Stroke in a Peritoneal Dialysis Patient: A Case Report.","authors":"Hasan Obeidat, Sandeep Kshetri, Mohamad Mansour, Rabin Shrestha","doi":"10.55729/2000-9666.1599","DOIUrl":"https://doi.org/10.55729/2000-9666.1599","url":null,"abstract":"<p><p><i>Staphylococcus lugdunensis</i> is a coagulase-negative staphylococcus (CoNS) with unique virulence traits that mimic <i>Staphylococcus aureus</i>, despite traditionally being grouped among less pathogenic skin flora. Unlike other CoNS, <i>S. lugdunensis</i> can infect native valves and cause aggressive infective endocarditis (IE). We present a rare and instructive case of <i>S. lugdunensis</i> native mitral valve endocarditis complicated by cerebral embolic infarctions and requiring surgical valve replacement in a patient on chronic peritoneal dialysis. This case underscores the diagnostic challenge of CoNS bacteremia, highlights the embolic potential of <i>S. lugdunensis</i>, and represents one of the few documented cases of stroke complicating <i>S. lugdunensis</i> IE in a dialysis-dependent patient without prosthetic devices.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 3","pages":"42-46"},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793776","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":"Job Decisions to Leave a Hospitalist Group Among Millennial Hospitalists Born in or After 1982: A Survey Based Study.","authors":"Maria Carolina Musri, Flora Kisuule, Sean Tackett, Amteshwar Singh","doi":"10.55729/2000-9666.1600","DOIUrl":"https://doi.org/10.55729/2000-9666.1600","url":null,"abstract":"<p><p>High turnover among millennial hospitalists, who constitute a large proportion of early-career physicians, remains a concern. Using purposeful sampling, we surveyed 136 millennial hospitalists to understand what factors influence their decisions to leave a hospital medicine group. Family reasons (81%) and geographical location (80%) were the factors most commonly identified as important influences on decisions to leave. While these factors may be non-modifiable to a large extent, these findings underscore the importance of identifying such needs at the time of recruitment. Institutional reputation was ranked the least frequently influencing factor, when millennial hospitalists contemplate leaving a hospital medicine group. Understanding the values of this group of hospitalists needs careful attention to reduce attrition and improve retention in hospital medicine groups.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 3","pages":"1-4"},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793809","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":"Non-alcoholic Wernicke Encephalopathy With Atypical Cortical Involvement on MRI: A Case Report.","authors":"Tomoki Hongo, Takahiro Goshima, Ryosuke Yokoi, Hiroko Watase, Mitsunaga Iwata","doi":"10.55729/2000-9666.1602","DOIUrl":"https://doi.org/10.55729/2000-9666.1602","url":null,"abstract":"<p><p>While Wernicke encephalopathy (WE) is well-recognized as a condition most frequently associated with chronic excessive alcohol consumption, non-alcoholic WE (NAWE) remain underrecognized despite their clinical importance. An 85-year-old nursing home resident was brought to the Emergency Department (ED) with impaired consciousness. She had been taking furosemide 40 mg and spironolactone 25 mg daily for chronic heart failure for five months prior to presentation. One month before admission, she began receiving parenteral nutrition without thiamine due to poor oral intake accompanied by vomiting. On arrival, her Glasgow Coma Scale score was 3, exhibiting flaccid quadriplegia and absent deep tendon and oculocephalic reflexes. Brain MRI demonstrated hyperintensities in the peri-central sulcus cortex as well as typical WE-related regions, including the periaqueductal gray and bilateral medial thalami, on diffusion-weighted imaging (DWI) and T2-weighted imaging. Intravenous high-dose thiamine therapy was initiated based on a clinical diagnosis of WE, subsequently confirmed by a thiamine level below the detection limit (<5 ng>/mL). Although follow-up MRI showed radiological improvement after seven days, neurological recovery remained minimal despite 35 days of treatment. Nonspecific clinical manifestation of NAWE makes early diagnosis difficult, often resulting in progression to more advanced stages with cortical lesions. To prevent irreversible and potentially fatal neurological sequelae, it is crucial to be aware of NAWE in its early stages, particularly in patients with known risk factors, such as malnutrition (poor nutritional intake), parenteral nutrition without thiamine, gastric bypass surgery, malabsorption, dialysis, diuretic use, infections/sepsis, and hyperthyroidism.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 3","pages":"47-49"},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793174","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":"Identifying and Comparing Communication Challenges Between Nurses and Resident Physicians.","authors":"Anh Nguyen, Ho-Man Yeung","doi":"10.55729/2000-9666.1596","DOIUrl":"https://doi.org/10.55729/2000-9666.1596","url":null,"abstract":"<p><strong>Background: </strong>Effective healthcare delivery involves coordinated communication between healthcare team members.</p><p><strong>Objective: </strong>This study compares challenges in communication between nurses and residents.</p><p><strong>Methods: </strong>This is a single-centered survey study in which 58 Nurses and 54 Internal Medicine residents at Temple University Hospital anonymously completed a 14-item questionnaire between August 2023 and March, 2024.</p><p><strong>Results: </strong>Approximately 42% (54/128) residents participated. When assessing overall satisfaction, residents expressed lower satisfaction compared to nurses (57% vs 86%; p < 0.001). Additionally, residents find nursing documentation less helpful than nurses do vice versa (5% vs 74%; p < 0.0001). Residents more often than nurses ask the other for clarifications (85% vs 65%; p < 0.05). Interesting, 67% of nurses reported care delays due to inadequate coordination while 100% of residents reported delays (p < 0.0001). Residents reported greater difficulties in reaching the correct nurse than nurses in reaching the correct resident (91% vs 53%; p < 0.0001) and they also encountered both higher frustration and confusion in communication (93% vs 63%; p < 0.001 and 74% vs 52%; p < 0.05, respectively). Residents are also more likely to perceive nurses as not understanding the plan of the day (81% vs 63%; p < 0.05). On the other hand, both felt respected and heard (p = 0.10; p = 0.49) and satisfied with overall coordination and responsiveness (p = 0.32; p = 0.34). The study highlights notable challenges between nurses and residents, such as documentation and coordination. Free responses provided insight into barriers preventing effective communications and are categorized into \"Responsiveness\", \"System-based\", \"Directedness\", and \"Respect\".</p><p><strong>Conclusion: </strong>Future research should focus on addressing these differences to foster better teamwork and understanding.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 3","pages":"5-12"},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793791","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":"Don't Mistake it for RA: A Case of Antithyroid Arthritis Syndrome After Methimazole Initiation.","authors":"Michael K Viggiano, Auda Baker, Diana Palanker, Ayrton Bangolo, Anna Belyayeva, Iyad Baker","doi":"10.55729/2000-9666.1579","DOIUrl":"10.55729/2000-9666.1579","url":null,"abstract":"<p><p>Antithyroid arthritis syndrome (AAS) is a rare reaction to thionamides (e.g., methimazole) that can cause sudden, severe joint pain. It often gets mistaken for rheumatoid arthritis or lupus but typically improves within four weeks when the medication is stopped. A 51-year-old man with Graves' disease developed a rash and disabling joint pain in multiple areas within weeks of starting methimazole. Labs showed elevated liver enzymes and CRP, but no autoimmune markers. Symptoms improved quickly after a short steroid taper and stopping the drug. This case shows how AAS can mimic autoimmune disease and why it is important to recognize early to avoid unnecessary treatment.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"65-67"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793784","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":"Artificial Intelligence in Medicine: A Definition of Terms.","authors":"Teray Johnson, Melvin Blanchard","doi":"10.55729/2000-9666.1562","DOIUrl":"10.55729/2000-9666.1562","url":null,"abstract":"<p><p>As artificial intelligence (AI) tools gain traction in clinical, operational, and administrative settings, healthcare professionals must develop a foundational understanding of key AI concepts to engage with these technologies responsibly and effectively. This perspective outlines essential AI terminology-such as machine learning, generative and agentic AI, large language models, artificial neural networks, and prompt engineering-paired with concrete clinical examples to illustrate their relevance in modern medical practice. By clarifying these terms and exploring their applications, this paper aims to equip healthcare leaders with the vocabulary and context necessary to evaluate, implement, and oversee AI systems within their organizations. Such literacy is critical to ensuring that AI technologies are used ethically, transparently, and in service of improving patient outcomes.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"1-6"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793730","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":"Impact of Atrial Fibrillation on Hospital Outcomes in NSTEMI Patients: A Retrospective Cohort Study.","authors":"Swatam Jain, Pinak A Shah, Kartika Shetty","doi":"10.55729/2000-9666.1587","DOIUrl":"10.55729/2000-9666.1587","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common sustained arrhythmia and frequently occurs in patients with acute coronary syndromes (ACS). Non-ST elevation myocardial infarction (NSTEMI) accounts for nearly 70% of ACS hospitalizations and poses significant morbidity and healthcare burden. Despite its prevalence, the impact of AF on inhospital outcomes in NSTEMI remains underrecognized, and current risk models often exclude AF.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using de-identified patient-level data from HCA Healthcare, capturing 31,649 NSTEMI admissions across 180 U.S. hospitals (2021-2022). Patients were stratified based on coronary artery bypass grafting (CABG) status. Multivariable logistic and linear regression models evaluated associations between AF and in-hospital mortality, 30-day readmission, and length of stay (LOS).</p><p><strong>Results: </strong>AF was independently associated with worse in-hospital outcomes in both CABG and non-CABG groups. Among CABG patients, AF was linked to increased odds of in-hospital mortality (OR 2.02), 30-day readmission (OR 1.15), and prolonged LOS (OR 1.21). In non-CABG patients, AF was similarly associated with higher odds of mortality (OR 1.89), readmission (OR 1.23), and LOS (OR 1.31) (all p < 0.05). Female sex, heart failure, CKD, and COPD were also linked to adverse outcomes.</p><p><strong>Conclusion: </strong>In this large, multicenter cohort, AF was significantly associated with increased in-hospital mortality, readmission, and LOS among NSTEMI patients, irrespective of CABG status. These findings highlight AF as a key clinical factor warranting consideration in NSTEMI management. Future studies should explore mechanisms underlying these associations and identify strategies for risk mitigation in this high-risk population.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"22-29"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793803","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}