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Sump Syndrome: The Forgotten Cause Of Painless Jaundice In The Elderly, Mark Ayoub, Amna Anees

Journal of Community Hospital Internal Medicine Perspectives

Painless jaundice is a common presentation of abdominal malignancy seen in elderly patients. While malignancy may be a common cause of obstructive jaundice in that population group, anchor bias should always be avoided. We present a case of an elderly woman who presented with painless jaundice and weight loss. She had a very remote history of cholecystitis. She was found to have Sump syndrome due to a stricture at the Choledochoduodenostomy (CDD) site. She underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent placement which shortly led to resolution of her jaundice. Biopsy from the stricture site came back negative for malignancy.

Successful Rapid Benzodiazepine Detoxification In An Acute Care Hospital: A Case Report, Taku Harada, Kazuki Tatebayashi, Mori Nakai

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Benzodiazepine (BZD) dependence and withdrawal are significant public health concerns, affecting 15–30% of regular users within 4-6 weeks of administration. Rapid BZD tapering protocols in acute care settings can mitigate withdrawal symptoms and facilitate rehabilitation, yet are challenging due to variability in patient responses. Case Presentation: We report a case of a 67-year-old male with a history of high-dose BZD use for panic disorder and depression and recent mild ischemic stroke, presenting with worsening left lower limb paralysis. The patient's complex medication regimen included multiple BZDs and other psychotropic drugs. Given the risks associated with high-dose BZD use, particularly …

Superior Mesenteric Artery Stenosis With Dissection Secondary To Fibromuscular Dysplasia : A Case Report, Jayasree Ravilla, Ping He, Steven Brant, Doantrang Du

Journal of Community Hospital Internal Medicine Perspectives

Superior Mesenteric Artery stenosis increases with advancing age and is usually associated with atherosclerosis or thrombosis. Mesenteric ischemia occurs when the blood flow to the visceral organs is inadequate to meet their metabolic needs. While it can be asymptomatic, the patient can experience chronic or acute mesenteric ischemia symptoms. Although not frequently encountered, SMA stenosis can be rarely caused by fibromuscular dysplasia (FMD). Here we report a case of a 66-year-old female with SMA stenosis and subsequent mesenteric ischemia secondary to FMD. The main objective of this case report is to raise awareness about the occurrence of mesenteric ischemia from …

Thromboembolic Event In Isolated Non-Compaction Cardiomyopathy With Multiple Sclerosis, Comfort Olayioye, Indira Acharya, Christopher J Haas

Journal of Community Hospital Internal Medicine Perspectives

Non-compaction cardiomyopathy (NCCM) is a complex, exceedingly rare form of cardiomyopathy. Transient ischemic attack/ stroke in NCCM may be cardioembolic or atherosclerotic in origin. While the connection between NCCM and neuromuscular conditions has been documented before, its association with neurological conditions, such as multiple sclerosis has not been established. Here, we present a case of a 45-year-old female with multiple sclerosis (MS) who presented in the context of a transient ischemic attack (TIA) and was found to have non-compaction cardiomyopathy complicated by thromboembolism. To our knowledge, this is the third reported case of NCCM with MS.

A Rare Case Of Anca-Negative Rapidly Progressive Glomerulonephritis, Jerry Kenmoe, Elizabeth Mikhail, Fahimeh Talaei, Arvind Kunadi

Journal of Community Hospital Internal Medicine Perspectives

ANCA-negative rapidly progressive glomerulonephritis (RPGN) is a rare condition caused by glomerular injury in the absence of detectable antineutrophil cytoplasmic antibodies (ANCAs). While comprehensive epidemiologic data is limited, ANCAnegative RPGN is known to comprise 5-20% of all glomerulonephritis cases. We report the case of a 43-year-old male who presented to the hospital after a snowmobile accident with symptoms of general malaise along with the emergence of a new-onset rash and tea-colored urine. Further workup with CT-guided kidney biopsy confirmed the diagnosis of RPGN by revealing histopathological findings of crescentic glomerulonephritis and significant glomerular inflammation. Treatment was promptly initiated with prednisone …

Harbinger Of Lyme Carditis: From Atrioventricular Block To Atrial Fibrillation, Maryam Barkhordarian, Mark Grijalva, Avani Kolla, Aaron Stein, Dmitry Nemirovsky

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Lyme disease is a tick-borne illness that is most commonly caused by Borrelia burgdorferi and transmitted by the Ixodes tick. Common manifestations are fevers, headache, arthralgia, erythema migrans, and, if left untreated, can progress to neuropathy and carditis. Lyme carditis most commonly presents with high degree atrioventricular block, however, may present with other arrhythmias.

Case presentation: We present a case of a 70 year old male with past medical history of hypertension and polycythemia vera who presented to the hospital with lightheadedness and bradycardia following 2 weeks of fever. His electrocardiogram showed atrial fibrillation with regularized conduction at 40 …

A Recurring Theme: A Rare Case Of Pembrolizumab-Induced Acute Interstitial Nephritis, Jonathan London, Sabrina Bulancea, Inaas Shirazi, Victoria Oriuwa, Olena Bolotova, Zubin Tharayil

Journal of Community Hospital Internal Medicine Perspectives

Pembrolizumab is utilized in the treatment of multiple different malignancies, including non-small cell lung cancer, head and neck squamous cell carcinoma, melanoma, renal cell carcinoma, endometrial cancer, and more. Pembrolizumab is an immune checkpoint inhibitor that inhibits the programmed cell death-1 (PD-1) signaling pathway. Despite its benefits in treating multiple cancers, there are many reported adverse effects of Pembrolizumab affecting various organ systems; rarely it can cause acute interstitial nephritis (AIN). We present the case of a 79-year-old male with metastatic retroperitoneal squamous cell carcinoma who was found to have recurrent acute interstitial nephritis after pembrolizumab therapy.

Temporomandibular Joint Disorder And Anterior Scleritis As Initial Presentations Of Undiagnosed Rheumatoid Arthritis, Nazmul Hasan, Daniel Yang

Journal of Community Hospital Internal Medicine Perspectives

Rheumatoid arthritis is an autoimmune inflammatory process that involves multiple organ systems. While symmetric joint swelling of the extremities are the most widely recognized symptoms, the disease can present in a myriad of different ways, of which scleritis and temporomandibular involvement are less recognized manifestations. While scleritis and temporomandibular disorder (TMD) may at times present in isolation, it is critical to consider their strong association with autoimmune disease as it allows for early diagnosis of inflammatory conditions and allow for the formulation of tailored treatment plans to halt their progression.

Transient Telangiectatic Purpura: A Rare Post-Operative Phenomenon, Zackary Anderson, Michael Schoeller, Rebecca Witherell

Journal of Community Hospital Internal Medicine Perspectives

Axillary lymph node dissection (ALND) is a surgical procedure for malignant disease with well known complications, that is less well known is its association with a painless dermatomal rash formally known as transient telangiectatic purpura. This is a case report describing a case of transient telangiectatic purpura, describing its natural history and inferring on its pathophysiology.

Menetrier Disease – A Rare Presentation Of Gastrointestinal Bleeding, Jayasree Ravilla, Ping He, Mahmoud Ali, Anish Patel

Journal of Community Hospital Internal Medicine Perspectives

Gastric polyps are extensions of the mucosa or submucosal space that are usually asymptomatic. One of the rare manifestations of gastric polyps is Menetrier's disease. Menetrier's disease (MD), also known as giant hypertrophic gastritis, is a progressive disease whose pathogenesis is not fully understood. Though a rare diagnosis, it needs to be well studied due to its association with the neoplasia. Here, we present a case of Menitriere's disease associated with gastrointestinal bleeding and describe its clinical course and outcome.

Iga Nephropathy Secondary To Covid-19 Infection - A Case Report, Sanjivani Shrestha, Sumanth Kumar Bandaru, Man Kit Michael Siu, Silvia Malvica, Joselito Cabacar

Journal of Community Hospital Internal Medicine Perspectives

We present a case of a 73-year-old African American lady with COVID-19 infection who developed Acute Kidney Injury (AKI) and significant proteinuria. Renal biopsy showed IgA nephropathy. Patient was eventually diagnosed with IgA nephropathy secondary to COVID Infection. This unique case highlights the complexity of renal involvement in COVID-19. Notably, the onset of IgA nephropathy in the patient occurred several weeks after her COVID-19 diagnosis, deviating from the typical synpharyngitic presentation with respiratory symptoms. This article contributes to the growing body of evidence regarding renal complications associated with COVID-19 and highlights the need for vigilance in assessing and managing renal …

Spontaneous Coronary Artery Dissection: A Case Series And Review Of The Literature, Shaikh B. Iqbal, Yakubu Bene-Alhasan, Shiavax J. Rao

Journal of Community Hospital Internal Medicine Perspectives

Although previously considered rare, spontaneous coronary artery dissection (SCAD) is increasingly recognized as an important cause of myocardial infarction in young women. We present three unique cases of SCAD: A 46-year-old woman with a history of trigeminal neuralgia and anxiety presenting elevated troponin-I and chest pain. A 36- year-old woman with recent miscarriage presenting with diffuse T wave inversions and elevated troponin-I. A 58-year-old man with a recent COVID-19 infection presenting with diffuse ST elevations. SCAD is associated with many risk factors. Conservative management is preferred due to spontaneous healing of vessels compared to PCI driven management of atherosclerotic acute …

Cardiovascular Interventions In Patients With Active And Advanced Malignancy: An Updated Review, Fahad Waqar, Ayesha Sultan, Romeet Raja Bathija, Amin Mehmoodi, Jahanzeb Malik

Journal of Community Hospital Internal Medicine Perspectives

In the context of active, advanced malignancies, the recommendation for invasive cardiac interventions is grounded primarily in evidence from trials focused on specific cardiovascular conditions. However, the inclusion of individuals with advanced malignancies in these trials has historically been limited, and the intricate interplay between cancer and cardiovascular disease poses unique challenges for treatment decisions. In this comprehensive review, we delve into the complex landscape of invasive cardiac interventions and their applicability in patients with active, advanced cancer. Our analysis encompasses a range of cardiovascular scenarios, including STsegment elevation myocardial infarction, non–ST-segment elevation acute coronary syndromes, multivessel coronary disease, severe …

Frailty Indices And Their Importance In Elderly Patients: A Perspective Review, Rachna Valvani, Nismat Javed, Timothy Vittorio, Moiud Mohyeldin

Journal of Community Hospital Internal Medicine Perspectives

The aging demographic landscape of the United States highlights a concomitant rise in chronic conditions and infectious diseases. Older adults face a heightened susceptibility to infections, particularly pneumonia and urinary tract infections, and comorbidities such as cancer, cardiovascular disease, and dementia. Frailty, defined by a set of phenotypic criteria, emerges as a crucial predictor of adverse outcomes in infections, affecting hospitalization and post-care interventions. In the context of cancer, various frailty indices demonstrate their utility in predicting complications, mortality, and long-term outcomes. Cardiovascular diseases, including acute coronary syndrome and myocardial infarctions, exhibit varied associations with frailty, influencing both short-term and …

Radioactive Iodine Treatment Of Graves' Disease: Predictors Of Time Interval Greater Than 90 Days For Treatment Success, Luis E. Joya, Joshua Fogel, Kaushik Mandal, David S. Rosenthal

Journal of Community Hospital Internal Medicine Perspectives

Objective: Radioactive iodine (RAI) is often used for treating Graves’ disease. We study predictors for a time interval greater than 90 days between RAI treatment and success.

Methods: This was a retrospective study of 106 patients with Graves’ disease seen at a public hospital in suburban New York City. Predictor variables were from demographics, prior treatment history, iodine 131 RAI treatment, and thyroid function prior to RAI treatment.

Results: There were 62.3% that had a time interval greater than 90 days between RAI treatment and success. Only the thyroid function prior to RAI treatment variable of free thyroxine (FT4) had …

Pengembangan Bahan Ajar E-Learning Berbasis Edmodo Pada Materi Litosfer Kelas X Sma, Dedi Sasmito Utomo, Sumarmi Sumarmi, Singgih Susilo

Jurnal Pendidikan Geografi: Kajian, Teori, dan Praktek dalam Bidang Pendidikan dan Ilmu Geografi

The objective of this research and development is to produce: (1) E learning materials based on the material Edmodo lithosphere grade X, (2) virtual classroom Edmodo, and (3) Edmodo guide books for teachers and students. Data were collected by using a validation sheet and questionnaire. Qualitative data are derived from expert validation of material, language, and learning design, while quantitative data derived from student questionnaires. Results of the research are: (1) E learning instructional materials contained in the web categorized of well, (2) the virtual classroom Edmodo contained at the http://edmodo.com/dedisasmito, and (3) guide book Edmodo entitled "learning Edmodo with …

Review Of Disabling Leadership: A Practical Theology For The Broken Body Of Christ, Elyse Penton

Liberty Theological Review

This is a review of Andrew T. Draper, Jody Michele, and Andrea Mae's book, Disabling Leadership: A Practical Theology for the Broken Body of Christ. This review includes a summary of the contents and engages in a critique of the overall book. This review discusses a practical theology of disability inclusive church leaders and how they can make their congregations into an accessible community.

Echoes Of Eden In Proverbs: Towards A Biblical Theological Ethic, Armen Oganessian

Liberty Theological Review

Abstract:

This study argues for a biblical-theological approach to the ethics of Proverbs. It proposes that the ethical foundation for Proverbs lies in the principles established in Genesis 1-4 The argument unfolds as follows: Tracing the Abrahamic and Davidic covenants, one sees Solomon, the author of Proverbs, as a partial fulfillment of the promised seed in Genesis 3:15. Furthermore, other biblical writers depict Solomon as an Adamic king ruling in an Eden-like context. Consequently, understanding Proverbs' position within redemptive history encourages readers to interpret it through an Edenic framework. In other words, a biblical-theological approach compels readers to interpret Proverbs …

Running Economy Changes Alter Predicted Running Speed And Performance In Collegiate Runners, Oluchi Ibe, Robert Musci, Jenevieve L. Roper

International Journal of Exercise Science

International Journal of Exercise Science 17(1): 965-974, 2024. The goal of the study was to determine the effect of altering running strategy on predicted running performance in distance runners through application of a novel prediction model. Fifteen male (n = 10; Age: 22.2 ± 4.9 years; Height: 177.7 ± 7.4 cm; Mass: 68.6 ± 6.7 kg) and female (n = 5; Age: 21.8 ± 4.1 years; Height: 167.4 ± 7.8 cm; Mass: 59.3 ± 8.1 kg) long distance runners were recruited to participate in the study. Participants’ oxygen consumption (VO₂) and carbon dioxide (VCO₂) …

Finding Aid For The Violet Valley Bookstore Collection (Mum00798)

Archives & Special Collections: Finding Aids (alphabetical)

Nestled between BTC Grocery and the Warren Building on Water Valley’s Main Street, the Violet Valley Bookstore makes feminist, queer, and multicultural books available to the Water Valley community, the state of Mississippi, and the South. Established in 2017 by Dr. Jamie Harker, Violet Valley is Mississippi's only queer, feminist, transinclusive bookstore. It carries used books covering an array of topics, along with a of new books featuring feminist and LGBTQ authors, and is a registered 501(c)3 nonprofit.

Rage Against The Machine: Copyright Infringement In Ai-Generated Music, Joseph Will

Journal of Intellectual Property Law

AI-generated music has garnered significant attention, with many raising concerns about the new technology’s potential impact on both the music industry and human creativity. Others, including some musicians, have expressed excitement about AI and its potential for furthering creativity. Much focus has been placed on “deepfakes” of famous musicians, but there is also the issue of the use of copyrighted songs as training inputs for AI music generators. Some have argued that this machine learning process constitutes widespread copyright infringement, though it is not clear how courts will address this novel phenomenon. This Note examines AI-generated music through the lens …

Guilty Pleasures: The Copyright And Labor Of Reality Television, Emily Tracy

Journal of Intellectual Property Law

The Writers Guild of America’s 2023 strike forced audiences to reckon with Hollywood’s labor issues and the powerhouse unions that seek to solve them. Television networks responded with “strike-proof” fall schedules that highlighted a gap in the entertainment industry’s union membership: reality television. This Note examines and questions that gap, focusing on the labor of reality story producers and the important role it plays in creating a copyrightable product. Although copyright doctrine offers story producers little to no protection against exploitation, copyright case law implicitly recognizes story producers as, essentially, writers. This Note uses that case law to argue that …

Commerciality & Originality: Andy Warhol’S Impact On Analyzing Fair Use On Social Media, Bob Anderson

Journal of Intellectual Property Law

This Note creates a three-bucket commerciality approach for noncommercial content, advertisements, and monetized content to answer how copyright’s fair use protects social media content. To demonstrate its application, the bucket approach is applied to current discussions surrounding social media including video thumbnails, memes, reaction and commentary videos, music in videos, and news reporting. While there is no definitive answer to fair use, this Note attempts to provide clearer guidance using Andy Warhol Foundation for the Visual Arts, Inc. v. Goldsmith’s lessons.

With the amount of social media content growing exponentially, copying of original content has become rampant. Though many …

Eliminating Ghostwriters: How A Federal Right Of Publicity Can Save The Music Industry From Generative Artificial Intelligence, Ikram Ali Mohammed

Journal of Intellectual Property Law

Copyright law is currently incapable of resolving challenges introduced by the use of generative artificial intelligence, or generative AI, in the music industry. This technology is being adopted by both copyright holders and licensees, as well as independent artists and third-party applications. In 2023, online producer Ghostwriter created a song (Heart on My Sleeve) directly influenced by copyrighted materials from global artists Drake and The Weeknd using AI technology. The composition garnered millions of listeners across social media and streaming platforms. However, neither the original artists nor their music group (i.e., Universal Music Group) provided Ghostwriter a license …

Full Issue: Volume 5, Issue 2, Editorial Board

Swarthmore Undergraduate History Journal

The second issue in the fifth volume of the Swarthmore Undergraduate History Journal.

À Propos Decolonization: The “Affaire D’Amour” Between The Renault Factory Strikes Of 1947 And French Malagasy Discrimination, Grace E. Wurzer

Swarthmore Undergraduate History Journal

In 1947, The Monnet Plan was introduced in France to reinvigorate the economy, which was still feeble after World War II. Its high demands of factory workers soon led to strikes, which quickly gained the support of the French Communist Party. Concurrently, the French government was rapidly decolonizing Madagascar. Newly independent Africans found themselves financially strained in the wake of decolonization and were enticed to immigrate to France in the hopes of attaining economic freedom and citizenship in exchange for labor. These laborers, who were employed by the stricken factories, also garnered the support of the PCF, much to the …

From “Defilement” To “Modernity”: How Japan's Encounter With The West Brought Beef To The Table, Ying Yi Tan

Swarthmore Undergraduate History Journal

The long Tokugawa – Meiji transition (1850s – 1880s) is arguably one of the most profound socio-economic transitions that Japan underwent in its history. This paper uses beef consumption in Japan as a lens to further investigate the players involved in this transition. Historically more eschewed than other types of meat and tightly associated with the notion of the “other,” beef became an embodiment of progress and modernity during the Meiji Period. Through tracing the historical shift in the Japanese perception of beef, this paper argues that the evolution of beef consumption corresponds to the radically shifting attitudes of the …

The Potomac Ploy: George Washington’S Secret Scheme That Shaped The Nation’S Capital, Benjamin A. Savel

Swarthmore Undergraduate History Journal

For over 200 years, historians have glossed over blemishes on George Washington’s reputation, transforming the president into an almost mythological figure of the United States’ national identity. This paper brings into focus one of the more overlooked narratives about the president, revealing that his choice of Washington DC and the Potomac River as the location for the national capital was driven by financial self-interest and not by a prescient vision of future national unity.

Overwhelming evidence demonstrates that Washington knew the Potomac River could not serve as a national waterway; he was well aware of impassible rapids, sudden drops that …

The "Burden Of Blame": Coalition-Building In The Transgender Movement From The 1970s Through The 1990s, Julia F. Grafstein

Swarthmore Undergraduate History Journal

Coalition-building within the transgender movement has received scant attention from scholars in transgender history. The vulnerable period after the Stonewall Riots in 1969 was one of extreme growth in the transgender movement, as trans people came together to challenge injustices they experienced, such as employment discrimination, cross-dressing laws, police brutality, and equal access to medical care. This essay documents not only the extent of these injustices, but also the ways in which trans people united to educate and support one another in the face of injustice. Trans activists also sought to educate cisgender people and reform the prejudices of people …

Land, Labor, And The Railroad In Industrial Appalachia: How The Baltimore And Ohio Railroad Engineered Space, 1843-1872, Lillian R. K. M. Austin

Swarthmore Undergraduate History Journal

During the nineteenth century, the Baltimore and Ohio railroad reshaped the social, political, and physical environment of the mid-Atlantic around the needs of the industrial economy. The creation of industrial space, and the proliferation of communities to populate it, is seen retrospectively as an inevitable consequence of technological innovation, but engaging with contemporary corporate records reveals that this space, like the railroad, was engineered. In order to design a supply chain that would make industrialization economical, the railroad and coal industries engaged in political and social engineering to design the new locales of industrialism, exemplified in the Allegheny Mountains by …