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Using Psychoanalytically Oriented Psychotherapy With The Elderly, Mark D. Miller, Md
Using Psychoanalytically Oriented Psychotherapy With The Elderly, Mark D. Miller, Md
Jefferson Journal of Psychiatry
Psychotherapy with the elderly, like geriatric medicine, has become a subject of renewed interest. This paper will review some pertinent aspects of the subject and hopefully dispel some myths. A case will be presented where psychoanalytically oriented psychotherapy was employed. In this case, forced termination was necessary after one year due to the therapist graduating from residency.
Download Entire Pdf: The Medicine Forum, Vol 5, Winter 2003
Download Entire Pdf: The Medicine Forum, Vol 5, Winter 2003
The Medicine Forum
Download entire PDF: The Medine Forum, (The Journal of Thomas Jefferson University Hospital, Department of Internal Medicine), Vol 5, Winter 2003.
Clinical Quiz
The Medicine Forum
5 question clinical quiz. Answers after case presentation: A Man with Dyspnea and Diffuse Abdominal Pain by Dominick Galluzzo MD.
Effects Of Walnut Consumption As Part Of Heart Healthy Diet On Atherogenic Lipoprotein Subclasses, Kimberly L. Dulaney, Md, John M. Morgan, Md, David M. Capuzzi, Md
Effects Of Walnut Consumption As Part Of Heart Healthy Diet On Atherogenic Lipoprotein Subclasses, Kimberly L. Dulaney, Md, John M. Morgan, Md, David M. Capuzzi, Md
The Medicine Forum
Nutritional therapy is fundamental in the treatment of
cardiovascular disease. Studies that utilized a low-fat diet
supplemented with 64 grams/day of walnuts have shown
a significant reduction in serum levels of total and LDL
cholesterol, and triglycerides. This study was designed to
see if lipoprotein subclasses varied in patients eating a
low-fat walnut supplemented diet.
A Man With Shortness Of Breath And An Abnormal Ecg: A Short Case, David Defeo, Md
A Man With Shortness Of Breath And An Abnormal Ecg: A Short Case, David Defeo, Md
The Medicine Forum
An 80 year-old Chinese male with a history of tobacco
use and asthma presented to the ER complaining of
shortness of breath that was unresponsive to
bronchodilator use. The patient’s ECG on admission was
sinus rhythm at 95 beats per minute with minimal ST
elevations in V2-V4. Laboratory results were significant
for a troponin of 7.7. The patient was started on anticoagulation
with heparin. A transthoracic echocardiogram
revealed an ejection fraction of 25%. The patient
underwent coronary catheterization, which revealed
luminal irregularities of his coronary arteries. Figures 1
and 2 show the end diastolic and end systolic left
ventriculograms from …
An Unresponsive Woman Found Down, Murliya Gowda, Md
An Unresponsive Woman Found Down, Murliya Gowda, Md
The Medicine Forum
A middle-aged unidentified female presented by fire
rescue to the emergency department after being found
unconscious in the snow. Her identity, familiar contacts,
and medical history were not known, but the patient was
presumed to be homeless.
A Woman With Headache And Chest Pain, Theresa Pondok, Md
A Woman With Headache And Chest Pain, Theresa Pondok, Md
The Medicine Forum
A 34 y/o woman, with a past medical history significant
for asthma, newly diagnosed hypertension, and migraines,
presented to the emergency department with complaints
of sudden onset chest pain. She was an active young
woman, who up until the day of admission, had been able
to run several miles without chest pain or shortness of
breath. Symptoms began the morning of admission, when
the patient reported that she developed a migraine
heachache, with typical right-sided temporal pain. After
administering an injection of Sumatriptan, her headache
resolved. Soon thereafter, she noted 5/10 substernal chest
pressure occurring suddenly at rest, without radiation …
A Man With Shortness Of Breath And Bloating, Matthew E. Levy,Md
A Man With Shortness Of Breath And Bloating, Matthew E. Levy,Md
The Medicine Forum
The patient is a 61-year-old male with a past medical
history of hypertension and insulin-dependent diabetes
mellitus presented to the ED with new onset shortness
of breath. He reported a three week progression of
dyspnea after one flight of stairs, from a normal baseline.
The patient also noticed 2 pillow orthopnea and
increased urinary frequency and urgency. He denied
fevers, chills, chest pain, palpitations or productive
cough. Symptoms began when he ran out of his oral
medications three weeks prior to admission (furosemide,
enalapril, digoxin, metoprolol, spironolactone, aspirin).
Family history was positive for alcoholic cirrhosis. Social
history was positive for …
Training Residents In Acls/Code Response Using A Computerized Medical Simulator: Improving Resident Comfort And Preparedness, Elisabeth Dial, Md, Henry Schairer, Md, Steven Silver, Md, Jennifer Claves, Md, David Gardiner, Md, John Caruso Md, Salvatore Mangione, Md, Gregory C. Kane, Md
Training Residents In Acls/Code Response Using A Computerized Medical Simulator: Improving Resident Comfort And Preparedness, Elisabeth Dial, Md, Henry Schairer, Md, Steven Silver, Md, Jennifer Claves, Md, David Gardiner, Md, John Caruso Md, Salvatore Mangione, Md, Gregory C. Kane, Md
The Medicine Forum
Internal Medicine residents are responsible for leading the
code response team at most teaching hospitals, yet many
graduating interns (PGY1s) may feel unprepared to run
codes. Currently, the only formal training for house staff
is the two-day American Heart Association’s Advanced
Cardiac Life Support (ACLS) course, generally required at
the beginning of internship, with recertification necessary
every two years. This course does not address leadership
skills or a resident’s self-reported sense of comfort with
leading a code team within a teaching hospital. Prior
investigations have highlighted the deterioration in
knowledge of important ACLS protocols, with knowledge
levels at or near …
A Woman With Extreme Fatigue, Christopher Dimaio Md, Chief Medical Resident
A Woman With Extreme Fatigue, Christopher Dimaio Md, Chief Medical Resident
The Medicine Forum
A 23 year old female presented to her primary care
provider’s office complaining of extreme fatigue over the
past few weeks.
Isolated Abducens Nerve Palsy Secondary To Varicella Zoster In A Patient With Hiv, Ellen B. Lunenfeld, Md, John A. Walker, Md
Isolated Abducens Nerve Palsy Secondary To Varicella Zoster In A Patient With Hiv, Ellen B. Lunenfeld, Md, John A. Walker, Md
The Medicine Forum
17
Varicella Zoster, the recrudescence of the dormant
varicella virus, occurs more often in older patients and
in those who are immunocompromised. Herpes Zoster
ophthalmicus (HZO) is the second most common
manifestation of the disease, second only to thoracic and
lumbar zoster.1 HZO is estimated to account for 10% to
25% of cases.2,3 HZO can lead to a number of ocular
complications, including proptosis, disciform keratitis,
internal ophthalmoplegia, bilateral retinal detachments,
Argyll-Robertson pupil, and progressive outer retinal
neuropathy (PORN).
A Male With Chills And Arthralgias, Lo-Ku Chiang, Md, Ambrish Ojha, Md
A Male With Chills And Arthralgias, Lo-Ku Chiang, Md, Ambrish Ojha, Md
The Medicine Forum
A 53-year old man presented to the ED with complaints
of fevers and chills for 5 days. Two days prior, he started
having generalized arthralgias and a painfully numb left
index finger. Similar symptoms had also begun on his
left great toe (See Figures D and E, Color Plates page
19). The patient denied recent trauma, although he was
unsure if he had sustained an insect bite on the dorsal
aspect of his left hand 8 hours prior to the onset of
symptoms. Three sets of blood cultures obtained prior
to admission were positive for methacillin-sensitive
Staphylococcus aureus. The patient …
Prevention Of Central Venous Catheter-Related Infections, Raghuram Mallya, Md
Prevention Of Central Venous Catheter-Related Infections, Raghuram Mallya, Md
The Medicine Forum
The central venous catheter is a valuable tool in inpatient
medicine. However, with its use comes the risk of local
and systemic infections. Kluger et al estimated that
250,000 cases of central line-associated blood stream
infections occur annually. Mortality rates range from 12-
25% per infection.1 Therefore, it is essential that health
care providers take all necessary precautionary measures
to avoid infection. Guidelines have been published by the
Centers for Disease Control and Prevention to provide
an evidence-based medicine (EBM) approach for
avoiding central venous catheter-related infections.
Recommendations include proper skin cleansing, the use
of maximal sterile barriers, selection of …