Digital Commons Network^™

Up-Regulation Of Interferon-A/Apobec3g Signal Pathway Potently Inactivates Hiv-1 Infectivity In Resting Cd4-T Cells, Keyang Chen, Jialing Huang, Chune Zhang, Sophia Huang, Giuseppe Nunnari, Feng-Xiang Wang, Xiangrong Tong, Ling Gao, Kristi Nikisher, Hui Zhang

Department of Medicine Faculty Papers

Poster Presentation.

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Jefferson Journal of Psychiatry

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Editorial Board

Jefferson Journal of Psychiatry

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Mourning, Salman Akhtar M.D.

Jefferson Journal of Psychiatry

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Neuroleptic Malignant Syndrome, With Attention To Its Occurrence With Atypical Antipsychotic Medication: A Review, Sarah Guzofski M.D. (Pgy2), Ruben Peralta M.D.

Jefferson Journal of Psychiatry

The neuroleptic malignant syndrome (NMS) is an idiopathic, life-threatening reaction to antipsychotic medication. NMS was traditionally attributed to potent dopamine antagonism of typical antipsychotics, but cases of NMS have now been reported for each of the newer antipsychotics. When NMS is caused by a newer, atypical antipsychotic the presentation differs somewhat; fever, rigidity, and, possibly, death may be less frequent. Diagnostic features, predisposing factors, and treatment are discussed, as is the important matter of reinstituting antipsychotic treatment.

A Kind Of Poem For My Friend And Me, Hilary O'Neill M.D. (Pgy4)

Jefferson Journal of Psychiatry

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First-Known Hypnopompic Hallucination Occurring In-Hospital: Case Report, Paul Ballas D.O. (Pgy2)

Jefferson Journal of Psychiatry

Despite the high prevalence of hypnopompic hallucinations in the community, to our knowledge there are no reports that have been published in the English literature of these phenomenon observed by staff in the hospital setting. Psychiatric or neurological evaluation often ensues if a patient reports hallucinations in other circumstances, but when they are reported in connection with sleep, further evaluation is rarely performed because such events are common in the general populace. Our report emphasizes the distinction between hypnopompic and hypnagogic hallucination as an ongoing feature of life that someone is aware of, which we believe to be the case …

No More Cuts: The Curious Fate Of Self-Mutilation In Its Development, Zhabiz Kazeminezhad M.D. (Pgy4), Salman Akhtar M.D.

Jefferson Journal of Psychiatry

In this article, we present descriptions of four young women with relatively severe personality disorders. All four were in psychodynamic psychotherapy and all had the symptom of self-cutting. During their treatment, it became evident that their self-cutting had undergone a transformation and a new symptom had appeared in its place. In three, self-cutting was substituted by behaviors that we might call "cutting equivalents" and, in the fourth, by an enhanced self-reflective attitude and by journal-writing. We suggest that symptom-replacement for self-cutting may be common in its developmental course or in its course as it becomes influenced by psychotherapy, and that …

Psychiatric Diagnoses In Patients With Williams Syndrome And Their Families, Janet C. Kennedy M.D. (Pgy1), David L. Kaye M.D., Laurie S. Sadler M.D.

Jefferson Journal of Psychiatry

Williams Syndrome (WS) is a genetic disorder associated with mental retardation (MR) and a distinct behavioral phenotype including a friendly and outgoing personality. This population, like others with MR, has been reported to have an increased rate of symptoms of mental illness; however, few studies have used DSM-IV criteria to quantify specific psychiatric diagnoses in WS and the prevalence of psychiatric illness in relatives of individuals with WS and the possible relationship between family and patient diagnoses is currently unknown.

Methods: Twenty-one families participated; the patients’ average age was 16 years. DSM-IV diagnoses were applied by using the Anxiety …

Psychogenic Stuttering Following A Gastric Bypass Operation: Case Report, Deborah B. Raphael M.D. (Pgy2), Frank B. Schoenfeld M.D.

Jefferson Journal of Psychiatry

We evaluated a 44-year-old female with bipolar affective disorder who presented with a 4-month history of severe stuttering and vague neurologic complaints. She had lost 200 pounds after gastric bypass surgery two years before. A childhood sexual-abuse victim, she admits that she "hid" in her weight for most of her life. Neurological evaluation of this patient was negative, and speech-pathology evaluation revealed highly atypical stuttering. Gastric bypass patients with a history of psychiatric disorders and childhood sexual abuse may be particularly vulnerable to somatoform disorders.

What Investigations Are Ordered In Patients With First-Episode Psychosis?, Allan Shefrin M.D. (Pgy2), Derek Puddester M.D., Stephanie Greenham Ph.D., Lise Bisnaire Ph.D., Hazen Gandy M.D.

Jefferson Journal of Psychiatry

Psychiatrists are often left with the dilemma of which investigations to order in adolescents presenting with a first episode of psychosis. Blood work, urine studies, and neuroimaging studies were tracked in 13 adolescents admitted with a diagnosis of first-episode psychosis over a 13-month period to the Children’s Hospital of Eastern Ontario. Variation was found in the amount of investigation ordered: 85% of patients received a drug screen; 54% a CT scan; 8% an MRI; 92% a CBC with differential; 92% electrolytes. Abnormalities of CT scans were detected in 2 patients (29%); in neither case did the result lead to a …

Nms, And Why We Should Call It (Malignant) Catatonia, Robert Arnold Johnson M.D. (Pgy4)

Jefferson Journal of Psychiatry

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The Diagnosis Of Adrenal Insufficiency In The Critically Ill Patient: Does It Really Matter?, Paul E. Marik

Division of Pulmonary and Critical Care Medicine Faculty Papers

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The Sub-Axial Cervical Spine Injury Classification System (Slic): A Novel Approach To Recognize The Importance Of Morphology, Neurology And Integrity Of The Disco-Ligamentous Complex, Alexander R. Vaccaro, R. John Hulbert, Charles Fisher, Marcel Dvorak, Alpesh A. Patel, Ronald A. Lehman Jr., Paul Anderson, James Harrop, F. C. Oner, Paul Arnold, Michael Fehlings, Rune Hedlund, Ignacio Madrazo, Glenn Rechtine, Bizhan Aarabi, Mike Shainline, Spine Trauma Study Group

Department of Orthopaedic Surgery Faculty Papers

Abstract Background Context Despite technological advances in spine surgery, classification of sub-axial cervical spine injuries remains largely descriptive, lacking standardization and any relationship to prognosis or clinical decision making. Purpose The primary purpose of this paper is to define a classification system for sub-axial cervical spine trauma that conveys information about injury pattern and severity as well as treatment considerations and prognosis. The proposed system is designed to be both comprehensive and easy to use. The secondary objective is to evaluate the classification system in the basic principles of classification construction, namely reliability and validity. Study Design/Setting Derivation of the …

Gnrh Agonist And Antagonist: Options For Endometriosis Pain Treatment , Frances R. Batzer

Department of Obstetrics and Gynecology Faculty Papers

Basic science research into the mechanism of the development of endometriosis, its persistence and resulting pain has begun to improve our understanding of how various therapeutic options work. While none of the available treatments resolves the underlying disease process, there are a growing number of alternatives. One of the more recent classes of medical options includes the GnRH agonist and antagonists. While at present this class of medical options is the most expensive and involved in implementation, they prove invaluable in terms of offering an aggressive, successful alternative for many patients. Furthermore, they may act directly on endometrial lesions in …

Patient Education In Glaucoma: What Do Patients Know About Glaucoma?, Vital Paulino Costa, George L Spaeth, Maura Smith, Cordelia Uddoh, José Paulo Cabral Vasconcellos, Newton Kara-José

Wills Eye Hospital Papers

PURPOSE: To evaluate the knowledge glaucoma patients have about their disease and its treatment.

METHODS: One hundred and eighty-three patients were interviewed at the Glaucoma Service of Wills Eye Hospital (Philadelphia, USA, Group 1) and 100 at the Glaucoma Service of University of Campinas (Campinas, Brazil, Group 2). An informal, relaxed atmosphere was created by the interviewer before asking a list of 18 open-ended questions.

RESULTS: In Group 1, 44% of the 183 patients did not have an acceptable idea about what glaucoma is, 30% did not know the purpose of the medications they were taking, 47% were not aware …

Bibliography Of Secondary Sources On The History Of Dermatology Iii. Books, Monographs, And Chapters In English Supplemented Through 2005., Lawrence Charles Parish, John Thorne Crissey, Jennifer L Parish, Daniel H Parish

Department of Dermatology and Cutaneous Biology Faculty Papers

Providing supplements to the history of dermatology bibliographic record has been a continuous project for the past four decades. When the endeavor was initiated, the original authors decided that only contributions in English and those directly related to dermatology, excluding sexually transmitted diseases as such, would be indexed.

There is the perennial question of whether such a manually created bibiliographic project has a need. The obvious answer remains yes. While Index Medicus has expanded the number of journals that are indexed, the number of dermatology publications currently included by Index Medicus is just over fifty. Granted, most of the papers …

Dermatology Is A Specialty; Dermatology Is Not A Subspecialty., Lawrence Parish, Larry E Millikan

Department of Dermatology and Cutaneous Biology Faculty Papers

Specialization began in American medicine about the time of the War Between the States. Several factors spurred the direction of practitioners away from being the so-called “complete physicians. Most important were the advances in instrumentation made by the 1860’s, which allowed ophthalmology and otolaryngology to develop into distinct divisions of allopathic medicine; sometimes, they even joined together, viz eye, ear, nose, and throat specialist. Dermatology, too, became one of the early specialties for a myriad of reasons ranging from the obvious – visual inspection - to the mundane, viz. default – syphilis was too ugly and complicated for every physician …

The Role Of Allograft Inflammatory Factor 1 In Systemic Sclerosis, Francesco Del Galdo, Carol M. Artlett, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

ABSTRACT

Purpose: To review studies which support the hypothesis that allograft inflammatory factor-1 (AIF-1), a protein initially identified in chronically rejected cardiac allografts, may be involved in the pathogenesis of the progressive fibroproliferative vasculopathy which is a hallmark of systemic sclerosis (SSc).

Recent findings: Recent findings demonstrated elevated AIF-1 expression both in SSc affected tissues and peripheral blood mononuclear cells. A detailed immunohistopathologic study examined the tissue and cellular localization of the protein in affected SSc tissues and demonstrated its expression in the endothelium of dermal and pulmonary vessels, in the pulmonary parenchyma, and in relevant inflammatory cells including T …

Liver Transplant Recipient With Calcineurin-Inhibitor Induced Pain Syndrome: A Case Report, Nethra S. Ankam, Md, Stanley R. Jacobs, Md

Department of Rehabilitation Medicine Faculty Papers

Setting: University Hospital

Patient: 65-year-old female status-post liver transplant secondary to cirrhosis.

Case Description: Prior to the rehabilitation consult on post-operative day 42, she had an episode of acute rejection requiring rapid escalation of cyclosporine dosage, later changed to high dose tacrolimus for immunosuppression, resulting in high blood levels of both calcineurin inhibitors. She then complained of paroxysms of 10/10 pain over her entire body not relieved by opioids despite escalation in medication by the acute pain service. She was not participating in a rehabilitation program because of pain. Examination revealed an anxious woman for whom any tactile stimulation …

Rehabilitation Of A Patient With Diabetic Myonecrosis: A Case Report, Nethra S. Ankam, Md, Vishal Kancherla, Do, Stanley R. Jacobs, Md

Department of Rehabilitation Medicine Faculty Papers

Setting: Inpatient rehabilitation unit at a university hospital

Patient: 37-year-old male with diabetic myonecrosis.

Case Description: The patient had a long-standing history of uncontrolled diabetes mellitus with multiple comorbidities, including end-stage renal disease on dialysis and diabetic myonecrosis of the left biceps femoris diagnosed by biopsy and magnetic resonance imaging (MRI.) On this admission, he presented with right leg pain and swelling, found to be a reoccurrence of diabetic myonecrosis in the vastus lateralis, medialis, and intermedius, diagnosed by MRI only. Prior to admission, he lived alone in a wheelchair inaccessible duplex and required minimal assistance with housekeeping.

Assessment/Results: …

Carah's Bookshelf

CenterPieces

Occupational Therapy and Dementia Care: The Home Environmental Skills-Building Program for Individuals and Families

by Laura N. Gitlin, PhD and Mary Corcoran, PhD, OTR/L with contributors, published by AOTA Press, the American Occupational Therapy Association, Inc.

ISBN: 1569002037

Based on over 15 years of research, the book presents the Home Environmental Skill-building Program (ESP), an evidence-based intervention to support families and persons with dementia and enhance quality of life. The book provides the theoretical and empirical evidence for the program and describes its protocols in depth.

Physical Function in Older Adults: A Comprehensive Guide to Its Meaning and Measurement

by …

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CenterPieces

For easy printing, the full newsletter is available as a single PDF.

We Are Seeking Participants For The Following Studies

CenterPieces

Title: Experience of Suffering in Old Age

Funding Source: National Institute on Aging

Principal Investigator: Helen K. Black, PhD

Target population: Philadelphia area residents over the age of 80 years old.

This 4-year study examines the experience of suffering and its relation to health, gender, and ethnicity among community dwelling elders aged 80+ using the open-ended interview schedule as its primary tool. This project explores through qualitative research the under-studied construct of suffering in later life and how suffering affects mental, physical and spiritual health.

Participants are interviewed in their homes on three occasions and are paid for their interviews. …

New Award: Carah And Germantown's Center In The Park Awarded $2.2 Million To Study Mental Health Of Older African-American Adults

CenterPieces

Why do older African-Americans tend to report less depression than Whites although they have poorer health and higher rates of chronic illness?

Research from the past 15 years consistently shows health disparities between Whites and minorities in the United States. African-Americans, in particular, are at higher risk than Caucasians for serious health conditions such as stroke, diabetes, cancer, cardiovascular disease and mild cognitive impairment. These chronic conditions typically contribute to depression in elders as a whole. However, the rates of depression for African-Americans are unclear with many studies reporting lower depression than in Whites and others reporting the reverse.

This …

Project Able Featured By Reuters Health Service

CenterPieces

CARAH's randomized trial, Project ABLE (Advancing Better Living for Elders), funded by the National Institute on Aging, and published in the May, 2006 issue of the Journal of the American Geriatric Society, was recently featured by Reuters Health service, the world's leading provider of medical and healthcare news.

This study tested a six-month intervention in which people received four 90-minute visits with an occupational therapist, as well as one 20-minute telephone contact, and one 90-minute physical therapy visit and home modifications provided by the Philadelphia Corporation for Aging. Of 319 men and women 70 years of age and older, half …

Geriatric Education Update

CenterPieces

Despite extensive government cutbacks in funding for aging research and elimination of federal support for geriatric and gerontological training, Jefferson has launched exciting new programs in this area. The year-old Division of Geriatric Medicine, housed within the Dept. of Family and Community Medicine, is under the directorship of Dr. Christine Arenson. In collaboration with CARAH, the Dept. of Occupational Therapy and the Dept. of Nursing, the Division has received funding for a Geriatric Education Center. In addition to Drs. Arenson and Gitlin, participants in this initiative include Dr. Cecelia Borden (Dept. of Nursing), Stephen Kern (Dept. of Occupational Therapy), Nancy …

2005 Dementia Conference Attracts Record Turn Out

CenterPieces

The 6th annual Dementia Management Conference - "New Directions in Providing Care to Patients and their Families" - was held on February 4, 2005 in the Bluemle Auditorium. This successful conference was co-sponsored by the Center for Applied Research on Aging and Health, Thomas Jefferson University Hospital and the Farber Institute for Neurosciences. In attendance were over 115 health care professionals, including physicians, nurses, occupational and physical therapists, social workers, researchers, and family members.

Attendees had the opportunity to learn from and ask questions of a panel of nationally recognized experts in the field of Alzheimer’s disease and related dementias. …

Message From Dean Erdman, James B. Erdman

CenterPieces

Congratulations to the Center and its Director, Dr. Laura Gitlin, on the inaugural issue of CARAH’s newsletter. In our discussions of the development of CARAH, one of the principal goals of the Center is its educational mission as is clear from the other information contained in this publication. Committed as the Center’s research professionals are to improving the health and quality of life of our seniors, it is not enough to conduct research that has the potential to provide significant help and support for patients and their caregivers. Those findings must also be disseminated, must be translated into action, must …

Graduating "Seniors" Of Center In The Park's Harvest Health Program

CenterPieces

"I have been to many health classes but none like this. This class was great and well organized."

"When I wake up I start exercising in bed. The Harvest Health classes have motivated me. I am now exercising 6 days a week."

"I use a motorized wheelchair, and I walk only a few steps. Thanks to the support from my classmates and the instructors, I achieved my action plan and am now walking in the corridor at Center in the Park. The program has motivated me to achieve my goals."

These are the accolades that Project Director Delores Palmer hears …