Journal of Community Hospital Internal Medicine Perspectives最新文献_第6页

Diagnosis and Characterization of Thyroid Dysfunction in Patients Evaluated in Primary Care in a Rural Zone of Honduras. 在洪都拉斯农村地区的初级保健评估患者甲状腺功能障碍的诊断和特征。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1580

Javier S Asfura, Travis W Harris, Amanda Reeck, María F Chévez

{"title":"Diagnosis and Characterization of Thyroid Dysfunction in Patients Evaluated in Primary Care in a Rural Zone of Honduras.","authors":"Javier S Asfura, Travis W Harris, Amanda Reeck, María F Chévez","doi":"10.55729/2000-9666.1580","DOIUrl":"10.55729/2000-9666.1580","url":null,"abstract":"Background: Thyroid disorders are prevalent and frequently underdiagnosed in primary care, particularly in resource-limited rural areas. Their nonspecific symptoms complicate early recognition and treatment. This study aimed to determine the prevalence of thyroid dysfunction and describe the clinical reasoning, diagnostic strategies, and laboratory findings among adults evaluated with TSH testing in rural Honduras.Methods: A retrospective, descriptive, cross-sectional study was conducted at Hospital Loma de Luz in Balfate, Honduras. Adult patients aged ≥18 years who underwent diagnostic TSH testing between January 1, 2022, and January 31, 2023, were included. Patients with prior thyroid diagnoses or current pregnancy were excluded. Data on demographics, symptoms, comorbidities, and labs were collected from electronic records and analyzed using SPSS v26.Results: Of 310 patients initially screened for suspected thyroid dysfunction, 185 met inclusion criteria. Thyroid dysfunction was present in 16.8 % of patients: 11.3 % had hypothyroidism and 5.4 % had hyperthyroidism. The majority of cases were women (83.9 %) aged 18-59. Common symptoms included fatigue (61.3 %), palpitations (48.4 %), and neck enlargement (25.8 %). Comorbidities included hypertension (32.3 %), diabetes (22.6 %), autoimmune diseases (12.9 %), and depression (9.7 %). Only 3.2 % had complete thyroid panels (TSH, T4L, and T3T).Conclusion: Thyroid dysfunction was found in nearly one in six adults evaluated with TSH in rural primary care. Female sex, vague symptoms, and autoimmune disease were frequently associated. Reflex T4L testing could improve diagnostic efficiency and facilitate earlier treatment.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"14-21"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793795","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 Social Determinants of Health on Chronic Diseases: A Narrative Review. 健康的社会决定因素对慢性疾病的影响：叙述回顾。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1583

Farooq Hyder, Hina Pervaiz, Abdullah Ashraf, Abida Perveen

{"title":"The Impact of Social Determinants of Health on Chronic Diseases: A Narrative Review.","authors":"Farooq Hyder, Hina Pervaiz, Abdullah Ashraf, Abida Perveen","doi":"10.55729/2000-9666.1583","DOIUrl":"10.55729/2000-9666.1583","url":null,"abstract":"Chronic diseases such as cardiovascular disease, diabetes, chronic respiratory disorders, and certain cancers are leading causes of morbidity and mortality worldwide. While biological and behavioral factors contribute to their development, growing evidence indicates that social determinants of health (SDOH) play a fundamental role in influencing chronic disease outcomes. SDOH include socioeconomic status, education, employment, housing conditions, neighborhood environment, access to nutritious food, and availability of healthcare services. These factors not only shape individual health behaviors but also determine access to preventive care, disease management resources, and overall quality of life. Individuals and communities facing socioeconomic disadvantage are disproportionately affected by chronic diseases due to cumulative exposure to risk-enhancing environments, chronic stress, limited health literacy, and systemic barriers within healthcare systems. This narrative review explores the multidimensional impact of SDOH on the prevalence, progression, and management of chronic diseases. It highlights the interconnected nature of social and environmental influences and examines how disparities in education, employment, housing, and racial or geographic equity contribute to poor health outcomes. The review also identifies key gaps in the existing literature, including the need for more intersectional and context-specific research, particularly in underserved and marginalized populations. Lastly, it proposes future directions that include policy integration, community engagement, and cross-sector collaboration as essential strategies for addressing the root causes of chronic disease and promoting health equity. Understanding and addressing SDOH is crucial for creating effective, sustainable, and inclusive approaches to chronic disease prevention and management.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"30-37"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793782","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

Congenital Absence of the Inferior Vena Cava Presenting as Extensive Deep Vein Thrombosis in a Young Male: A Case Report and Review. 年轻男性先天性下腔静脉缺失表现为广泛深静脉血栓：1例报告与回顾。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1581

Aman Ullah, Faseeh Haider, Sara Sartaj, Muhammad Arham, Muhammad U Imtiaz, Fatima B Athar, Nabeel Rajeh

{"title":"Congenital Absence of the Inferior Vena Cava Presenting as Extensive Deep Vein Thrombosis in a Young Male: A Case Report and Review.","authors":"Aman Ullah, Faseeh Haider, Sara Sartaj, Muhammad Arham, Muhammad U Imtiaz, Fatima B Athar, Nabeel Rajeh","doi":"10.55729/2000-9666.1581","DOIUrl":"10.55729/2000-9666.1581","url":null,"abstract":"Inferior vena cava (IVC) agenesis is a rare congenital anomaly associated with deep vein thrombosis (DVT), particularly in young adults without identifiable risk factors. We report the case of a 27-year-old male presenting with right lower extremity swelling and hip pain. Imaging revealed extensive thrombosis from the popliteal vein to the right common iliac vein. Diagnostic venography confirmed congenital absence of the IVC, with venous drainage via collateral lumbar pathways. The patient underwent catheter-directed thrombolysis and endovascular thrombectomy. Given the extensive thrombus burden and risk of pulmonary embolism, lifelong anticoagulation with a direct oral anticoagulant was initiated. This case highlights that in young patients with extensive iliofemoral DVT and no identifiable risk factors, congenital IVC agenesis should be suspected. Timely venographic confirmation is crucial, as management requires both endovascular intervention and lifelong anticoagulation due to impaired venous return.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"90-95"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793815","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

ALK-negative Anaplastic Large Cell Lymphoma Presenting as Back Pain. alk阴性间变性大细胞淋巴瘤表现为背部疼痛。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1589

Khalid Javed, Mariah M Bilalaga, Sareema Adnan, Ramya Vasireddy, David Blackwood, Christopher Haas

{"title":"ALK-negative Anaplastic Large Cell Lymphoma Presenting as Back Pain.","authors":"Khalid Javed, Mariah M Bilalaga, Sareema Adnan, Ramya Vasireddy, David Blackwood, Christopher Haas","doi":"10.55729/2000-9666.1589","DOIUrl":"10.55729/2000-9666.1589","url":null,"abstract":"Anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL) is a distinct subtype of mature T-cell non-Hodgkin lymphoma characterized by large, strongly positive CD30 lymphoid cells that lack expression and rearrangement of the ALK gene. Here, we present a unique case of ALK-negative ALCL in a 34-year-old male patient who presented with acute on chronic back pain. Initial emergent MRI spine demonstrated lytic changes of L3 and L4 with probable psoas fluid collection, with high suspicion for Pott's disease. However, subsequent work-up including a CT-guided bone biopsy revealed ALK-negative ALCL. Patient underwent radiation to his lumbar spine and psoas muscle, with good radiographic response in those areas, however, further imaging with PET/CT showed widespread metastatic disease. Considering the burden of his disease, the patient received chemotherapy with BV-CHP, and achieved good response to therapy notable on his repeat PET/CT after his third cycle. Unfortunately, due to insurance coverage, patient transitioned his care to a different facility and no further information could be obtained. This case highlights an infrequent and unique presentation of ALK-negative ALCL, where progressive lumbar back pain in a young individual without B symptoms or lymphadenopathy warranted additional diagnostic workup for malignancy without anchoring to common diagnoses.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"80-85"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793658","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

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1590

Shahem Abbarh, Bisher Sawaf, Radhika Vij, Kiyoko Oshima, Keiichi Kinowaki, Abhinav Sankineni

{"title":"IgG4-related Sclerosing Cholangitis Masquerading as Cholangiocarcinoma: A Diagnostic Challenge.","authors":"Shahem Abbarh, Bisher Sawaf, Radhika Vij, Kiyoko Oshima, Keiichi Kinowaki, Abhinav Sankineni","doi":"10.55729/2000-9666.1590","DOIUrl":"10.55729/2000-9666.1590","url":null,"abstract":"Background: IgG4-related sclerosing cholangitis (IgG4-SC) is a rare immune-mediated disorder affecting the biliary tree and leading to biliary strictures that may resemble cholangiocarcinoma (CCA).Case presentation: An elderly man presented with a one-week history of jaundice, pale stool, and dark urine. This was associated with unintentional weight loss over the past year. Laboratory findings were notable for cholestasis and significantly elevated CA19-9. Imaging demonstrated multiple diffuse biliary strictures of malignant appearance. Cytology showed atypical glandular cells. The patient was misdiagnosed with CCA and was assessed for a possible surgical intervention or chemoradiotherapy. However, the patient was eventually diagnosed with IgG4-SC after a high serum IgG4 level and liver biopsy. The patient responded well to steroids.Conclusion: This case underscores the diagnostic dilemma posed by IgG4-SC, particularly in elderly patients with cholestatic jaundice and elevated CA 19-9, which can be misleading for malignancy.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"45-49"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793810","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

Make Your Deposit: A Case of IgA-dominant Infection-associated Glomerulonephritis. 存款：一例iga显性感染相关性肾小球肾炎。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1575

Inaas Shirazi, Jonathan Ma, Shemrine Mark, Olena Bolotova, Papiya Begum, Yihe Yang, Zubin Tharayil, Ravi Gupta

{"title":"Make Your Deposit: A Case of IgA-dominant Infection-associated Glomerulonephritis.","authors":"Inaas Shirazi, Jonathan Ma, Shemrine Mark, Olena Bolotova, Papiya Begum, Yihe Yang, Zubin Tharayil, Ravi Gupta","doi":"10.55729/2000-9666.1575","DOIUrl":"10.55729/2000-9666.1575","url":null,"abstract":"Glomerular injury secondary to infection is a well-documented phenomenon. While the incidence of classic acute post-streptococcal glomerulonephritis (APIGN) has declined in developed countries over the past few decades, IgA-dominant infection-associated glomerulonephritis (IgA PIGN) is emerging as a distinct renal pathology. Characterized by predominant deposition of IgA antibodies within the glomeruli following infection, IgA-dominant PIGN differs from classic PIGN, which typically involves IgG and C3 deposits. This condition is often associated with staphylococcal infections and carries a poor prognosis. It commonly affects older adults and presents with reduced glomerular filtration rate and heavy proteinuria. Due to its rarity and overlapping clinical features with other glomerular diseases, IgA PIGN can be challenging to diagnose, often progressing to end-stage renal disease (ESRD) in approximately 80 % of cases. Prompt diagnosis and management, often requiring renal biopsy, are crucial for improving outcomes. Here, we present a case of IgA-dominant postinfectious glomerulonephritis.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"61-64"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793831","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

Empowering Residents in Community-based Internal Medicine Programs: A Structured Framework Integrating Simulation Labs, AI, and Gamification. 授权居民在社区内科项目：一个结构化的框架集成模拟实验室，人工智能和游戏化。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-01-19 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1570

Nirmay Sonar, Zaynah Sadiq, Bernie Sergent

{"title":"Empowering Residents in Community-based Internal Medicine Programs: A Structured Framework Integrating Simulation Labs, AI, and Gamification.","authors":"Nirmay Sonar, Zaynah Sadiq, Bernie Sergent","doi":"10.55729/2000-9666.1570","DOIUrl":"10.55729/2000-9666.1570","url":null,"abstract":"Community-based internal medicine residencies train nearly half of all U.S. IM residents and are essential for staffing underserved areas. These programs often face educational gaps due to limited resources, faculty development, and procedural training opportunities. We designed a 12-month quality initiative for 27 residents at a small community hospital blending new high-fidelity simulation drills (e.g. in-situ rapid-response and procedural labs), restructured didactics (gamified quizzes, NEJM Resident 360™, HumanDx cases), enhanced orientation (\"intern survival guide\"), research education, wellness retreats, community outreach and AI-driven, individualized case feedback. New interventions were implemented alongside existing activities, with targeted outcomes including clinical competency, board readiness, communication skills, and well-being. Over one year, the mean In-Training Examination (ITE) scores rose from 56.7 % to 59.9 % (p = 0.025) and percentile rank by 11.8 points, CAHPS patient communication scores improved from the 66th to 97th percentile (p < 0.05), and resident satisfaction (ACGME survey) increased from 70 % to 84 %. 78 % of residents found simulation \"very useful,\" while 74 % felt supported by wellness initiatives. Gamified learning was highly relevant to 44 %. Sustained impact needs continued leadership and formal GME integration. Investing in resident education directly improves patient care, creating a continuous cycle of clinical excellence.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 1","pages":"3-9"},"PeriodicalIF":0.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433226","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

Disguised and Dangerous: A Case of Cervicofacial Actinomycosis Presenting With Hemoptysis. 伪装和危险：1例颈面放线菌病表现为咯血。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-01-19 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1569

Tharun Shyam, Shamanth M Reddy, Saumya Nanda, Yan N Tun, Rohan Pinto, Navjot Somal, Ravi K Patti

引用次数: 0

A Strategy for Surge Management: Senior Residents on the Admitting Frontlines. 激增管理策略：老年住院医师在入院的第一线。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-01-19 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1565

Hamza Saifuddin, Oliver Yockey, Rachelle Pichot, Gwendolyn Brainard, Samantha Labay, Michael S Wang

{"title":"A Strategy for Surge Management: Senior Residents on the Admitting Frontlines.","authors":"Hamza Saifuddin, Oliver Yockey, Rachelle Pichot, Gwendolyn Brainard, Samantha Labay, Michael S Wang","doi":"10.55729/2000-9666.1565","DOIUrl":"10.55729/2000-9666.1565","url":null,"abstract":"Hospitals adapt to surges in a variety of ways, including expediting admitting and discharge procedures, hiring temporary staff and locums to meet increased demand, and temporarily expanding or creating facilities. To mitigate negative effects associated with surges, a small community-based hospital's Internal Medicine (IM) residency program and hospitalist program collaborated by shifting senior residents into admitting physician roles with indirect supervision to meet increased surge needs. This shift allowed an admitting attending physician to shift to a newly created rounding service and, on average, the number of rounding services was increased from seven to nine. Over a fifteen-month period (five quarters), there was a substantial increase in patient census and rounding physicians, paired with minimal differences in individual physician loads, suggesting that this approach helped alleviate strain on the hospital system. Additionally, this approach was well-received by residents, with residents reporting that the workload during the surge was appropriate, that the balance between service and education was appropriate, and that the surge experience was beneficial for their education and ability to practice independently. In summary, this innovative surge management technique has the potential to help mitigate the risk of burnout among hospitalists, while prioritizing resident wellness and education. Importantly, this novel approach may be reproducible in other community hospitals and scalable in larger institutions with residency programs.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 1","pages":"10-15"},"PeriodicalIF":0.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433194","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 Shocking Case of a Bleeding Heart. 一颗令人震惊的流血的心。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-01-19 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1568

Muhammad I Khan, Samra Israr, Muhammad H Khan, Nadim Jaafar, Rahul Sharma, Shilpi Ahmed

{"title":"The Shocking Case of a Bleeding Heart.","authors":"Muhammad I Khan, Samra Israr, Muhammad H Khan, Nadim Jaafar, Rahul Sharma, Shilpi Ahmed","doi":"10.55729/2000-9666.1568","DOIUrl":"10.55729/2000-9666.1568","url":null,"abstract":"Hemopericardium is a rare but life-threatening complication of anticoagulation therapy. Although bleeding complications are well documented with direct oral anticoagulants (DOACs), apixaban-induced hemopericardium is exceedingly rare. We report a case of a 56-year-old female with multiple comorbidities, including end-stage renal disease (ESRD) on hemodialysis, paroxysmal atrial fibrillation, cerebral vascular accident with residual right-sided weakness, and coronary artery disease, who presented with progressive dyspnea over two months. Imaging revealed a massive pericardial effusion without tamponade Physiology. Despite initial conservative measures, the patient developed hemodynamic instability following fluid removal during dialysis, necessitating urgent pericardiocentesis, which drained 1560 mL of hemorrhagic fluid. Pericardial fluid analysis was negative for malignancy or infection, and apixaban was identified as the likely culprit. DOAC-associated hemopericardium is an underrecognized but serious complication, particularly in patients with renal impairment and concurrent use of p-glycoprotein or CYP3A4 inhibitors, such as amiodarone. Given the increased risk of supratherapeutic drug accumulation in ESRD, clinicians must exercise caution when administering DOACs. This case highlights the importance of recognizing spontaneous hemopericardium as a potential adverse effect of apixaban, especially in high-risk populations. Early echocardiographic evaluation and swift intervention are crucial for preventing catastrophic outcomes.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 1","pages":"60-63"},"PeriodicalIF":0.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432488","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