Journal of Community Hospital Internal Medicine Perspectives最新文献

{"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}

{"title":"Type B Aortic Dissection Secondary to Non-typhoidal Salmonella Aortitis: A Case Report and Literature Review.","authors":"Laxman Wagle, Dhiraj R Regmi, Alexander Reyes, Rashmita Regmi","doi":"10.55729/2000-9666.1419","DOIUrl":"10.55729/2000-9666.1419","url":null,"abstract":"<p><p>Infectious aortitis is an uncommon but potentially fatal condition that can lead to aortic dissection or rupture. We describe a case of a 69-year-old female who developed a Stanford type B aortic dissection, presumptively caused by Salmonella, which was successfully managed with thoracic endovascular aneurysm repair (TEVAR) and long-term antibiotics. A literature review of 17 reported cases from 2000 to 2024 of aortic dissection secondary to infectious aortitis was conducted. The most frequently implicated causative organisms were Salmonella and Staphylococcus species. Presenting symptoms were non-specific, such as fever, chest or abdominal pain, and constitutional symptoms. Predisposing factors included hypertension, malignancy, diabetes, atherosclerosis, and hyperlipidemia. The proposed pathogenesis involves bacterial seeding of the aortic wall, leading to enzymatic degradation and structural weakening. Management requires prompt surgical intervention (open or endovascular) based on Stanford dissection type, combined with long-term antibiotic therapy. Early diagnosis is crucial, as infectious aortitis can rapidly progress to life-threatening sequelae like rupture or dissection. Clinicians must maintain a high index of suspicion in at-risk patients presenting with suggestive symptoms or imaging findings.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"66-74"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006451","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":"Clinical Variables Associated With Impaired Consciousness in Hospitalized COVID-19 Patients.","authors":"Sandra Gomez-Paz, Eric Lam, Joshua Fogel, Sofia Rubinstein","doi":"10.55729/2000-9666.1422","DOIUrl":"10.55729/2000-9666.1422","url":null,"abstract":"<p><strong>Background: </strong>Impaired consciousness is associated with complications and mortality in COVID-19 patients. We study factors associated with impaired consciousness as measured by the Glasgow Coma Scale (GCS) in COVID-19 patients.</p><p><strong>Methods: </strong>This is a retrospective study of 604 patients with COVID-19 in the metropolitan New York City area. We study the association of demographics, comorbidity, disease severity, treatment management, and laboratory measurements with both GCS nadir during hospitalization and GCS at discharge.</p><p><strong>Results: </strong>Age was significantly associated with severe GCS nadir during hospitalization and at hospital discharge. Body mass index comorbidity was significantly associated with severe GCS at hospital discharge. Sedation treatment was significantly associated with both moderate and severe GCS nadir during hospitalization. Glucose nadir was significantly associated with severe GCS nadir during hospitalization. Sodium level at admission was associated with decreased relative risk while BUN peak level during hospitalization was associated with increased relative risk for severe GCS on discharge.</p><p><strong>Conclusion: </strong>We found that factors from demographics, comorbidity, treatment management, and laboratory measurements were associated with GCS while disease severity was not significantly associated with GCS. These findings can guide clinicians for treatment approaches for the early identification of impaired consciousness and its degrees of severity in COVID-19 patients.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"43-49"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006397","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":"Evaluating the Cavitary Lung Lesions on CT Scan of COVID-19 Patients: A Retrospective Study.","authors":"Golnaz Moradi, Safa S Etehadi, Seyed H Mousavi, Rayeheh Mohammadi","doi":"10.55729/2000-9666.1411","DOIUrl":"10.55729/2000-9666.1411","url":null,"abstract":"<p><strong>Background: </strong>It has been shown that cavitary lesions on CT scans of patients with COVID-19 may be related to their clinical symptoms and mortality rate.</p><p><strong>Materials and methods: </strong>The study population included patients diagnosed with COVID-19 based on RT-PCR results from throat samples or typical clinical and chest CT scan findings who were hospitalized at Sina Hospital in Tehran in 2020 and underwent chest CT scans. Chest CT scans were examined for the severity of pulmonary opacities and the presence, number, size, wall thickness, and distribution of cavitary lung lesions.</p><p><strong>Results: </strong>Oxygen saturation was lower in patients with cavitary lesions in the initial state and after treatment than those without cavitation, and a statistically significant relationship was observed (p < 0.05). In terms of gender, a significant correlation was observed, and the prevalence of cavitary lesions was higher in men (p < 0.05). Also, the in-hospital mortality rate was higher in patients with cavitary lesions (p < 0.05).</p><p><strong>Conclusion: </strong>Based on our results, the presence of cavitary lung lesions in COVID-19 patients is related to the mortality rate, severity of pulmonary involvement, and patients' gender.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 6","pages":"23-29"},"PeriodicalIF":0.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006413","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":"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":"<p><p>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.</p>","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}

{"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":"<p><p>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.</p>","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}

{"title":"Blast and Bursts: Unveiling Splenic Rupture in Blastic Plasmacytoid Dendritic Cell Neoplasia.","authors":"Abdulahi Hassan, Matthew Simpson, Rahim Jiwani, Abigail Arrigo, Palgun Nisarga, Olukemi A Esan, Anna Koget","doi":"10.55729/2000-9666.1389","DOIUrl":"https://doi.org/10.55729/2000-9666.1389","url":null,"abstract":"<p><p>Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) is a rare hematologic cancer, accounting for less than 1% of acute leukemias in the U.S. Diagnosis involves detecting markers like CD123, CD4, CD56, TCL1, and TCF4. Treatment typically involved acute leukemia therapies, but Tagraxofusp, a targeted therapy, was recently approved. Despite advancements, prognosis remains grim, with a median survival of around 1 year. Atraumatic splenic rupture (ASR) is a rare complication of this condition, with only five cases reported from 1994 to 2018. Here we present a case of BPDCN complicated by ASR. This case emphasizes the challenges of diagnosing and treating BPDCN, noting its rarity and absence of standard therapy. Tagraxofusp has shown promising results but presents safety concerns like capillary leak syndrome, particularly in elderly patients with comorbidities.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"14 5","pages":"96-100"},"PeriodicalIF":0.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466596","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}