Digital Commons Network^™

Brief Remarks On Some Linguistic Features Of "Empathy" And "Sympathy", Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

The use of words by an individual or culture is subject to the very same psychological forces that drive man's other activities . Hence, the history of a word's usage becomes a telling record of the mental processes of its creators and users, both conscious and unconscious. Etymology, as Freud has observed in his dreambook (1900), contributes significantly to our understanding of the deeper layers of the psyche . Let us take the word "rival," for example, and see how we may make use of etymological data. It is derived from the Latin "riva lis," I which originally meant "one …

Countertransference And Inpatient Psychiatry: Theoretical And Clinical Aspects, Edward Kim, Md

Jefferson Journal of Psychiatry

Few aspects of psychiatric training are more troubling to beginning residents than the emerging awareness of their own countertransferences. This is often viewed with a mixture of disgust and embarassment as a sign of incompetence and lack of professionalism. Conflicting views on the origins of, and appropriate responses to countertransference further add to the difficulty and anxiety of psychiatric training. The frustration and sense of helplessness which often accompany these feelings can lead to disillusionment and various degrees of acting out which ultimately compromise patient care and resident education. Ironically, the feeling of being overwhelmed by countertransference can often occur …

Zinc Supplementation As An Adjunct To Antibiotics In The Treatment Of Pneumonia In Children 2 To 59 Months Of Age, Batool A. Haider, Zohra S. Lassi, Amina Ahmed, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Diarrhoeal disorders and acute respiratory infections (ARIs), especially pneumonia, are the most common causes of death in low-income countries. Studies evaluating the impact of zinc supplementation as an adjunct in the management of pneumonia are limited and have shown variable results.
Objectives: To evaluate zinc supplementation, as an adjunct to antibiotics, in the treatment (clinical recovery) of pneumonia in children aged two to 59 months.
Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), which contains the Cochrane Acute Respiratory Infections (ARI) Group's and the Cochrane Infectious Diseases Group's Specialised …

Com Outlook Fall 2011, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Doulas Going Dutch: The Role Of Professional Labor Support In The Netherlands, Monica He

Independent Study Project (ISP) Collection

This study uses a mixed method approach and medicalization theory to explore the new role of professional doulas in the Netherlands through the perspectives of women who have had doula-attended births. Survey data from the Dutch doula association is first analyzed in order to quantify women’s experiences with doula care and characterize their demographic information and birth outcomes. Simulatenously, nine in-depth interviews are conducted with Dutch and non- Dutch mothers who have recently had doula-attended births. The interviews focus on experiences with doula care in the context of the Dutch maternity care system. Quantitative analysis finds women who had doulas …

Mechanisms Of Neuronal Death Induced By Environmental Toxicants In Murine Cortical Culture, Travis Rush

Dissertations (1934 -)

This study was directed at examining the neurotoxic mechanisms of several classes of environmental toxicants implicated in neurodegenerative disease. Primary cortical cultures were exposed to organophosphorus pesticides, heavy metals and the cyanobacterial toxin, beta-N-methylamino-L-alanine (BMAA). Several components relating to neuronal injury were assessed in each study and novel aspects are described.

The main action of organophosphorous insecticides is generally believed to be the inhibition of acetylcholinesterase. However, these compounds are now recognized to inhibit many other enzymes and cause neuronal death through a variety of mechanisms. I found that exposure to chlorpyrifos or diazinon caused concentration-dependent neurotoxicity that could not …

Poor Women With Sexually Transmitted Infections: Providers’ Perspectives On Diagnoses, Genevieve R. Cox

Sociology

This article presents results from a study of health care providers, mainly nurses and nurse practitioners, who routinely diagnose sexually transmitted diseases (STDs) in rural low-income populations in West Virginia (WV). A qualitative analysis of eighteen semi-structured interviews reveals that providers who consistently work with low-income populations believe patients undergo a negative change in self-image in response to a chronic STD diagnosis. Providers express concerns about a number of issues related to low-income, rural women’s access to sexual health care and see the need for more sexuality education, more funding for free and reduced cost clinics, and more available health …

Smart Rehabilitation For The 21st Century: The Tampa Smart Home For Veterans With Traumatic Brain Injury, Jan Jasiewicz, William D. Kearns, Jeffrey Craighead, James L. Fozard, Steven Scott, Jay Mccarthy

Rehabilitation and Mental Health Counseling Faculty Publications

No abstract provided.

Oncolog, Volume 56, Number 10, October 2011, Bryan Tutt, Sunni Hosemann

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Treating Cancer in Pregnant Patients: Pregnancy is usually a joyous, hopeful time; a cancer diagnosis can be devastating. When pregnancy and cancer occur together, they present special challenges for patients and physicians. Fortunately, these challenges often can be overcome by a multidisciplinary approach to treatment
• Compass: Non-Small Cell Lung Cancer: Stage IIIA-Many factors affect treatment sequences
• HOUSE CALL: Understanding Cancer Risk and Risk Factors: Your risk factors might affect your need for cancer screening

Advanced Glycation End Products Accelerate Ischemia/Reperfusion Injury Through Receptor Of Advanced End Product/Nitrative Thioredoxin Inactivation In Cardiac Microvascular Endothelial Cells., Yi Liu, Yanzhuo Ma, Rutao Wang, Chenhai Xia, Rongqing Zhang, Kun Lian, Ronghua Luan, Lu Sun, Lu Yang, Wayne B Lau, Haichang Wang, Ling Tao

Department of Emergency Medicine Faculty Papers

The advanced glycation end products (AGEs) are associated with increased cardiac endothelial injury. However, no causative link has been established between increased AGEs and enhanced endothelial injury after ischemia/reperfusion. More importantly, the molecular mechanisms by which AGEs may increase endothelial injury remain unknown. Adult rat cardiac microvascular endothelial cells (CMECs) were isolated and incubated with AGE-modified bovine serum albumin (BSA) or BSA. After AGE-BSA or BSA preculture, CMECs were subjected to simulated ischemia (SI)/reperfusion (R). AGE-BSA increased SI/R injury as evidenced by enhanced lactate dehydrogenase release and caspase-3 activity. Moreover, AGE-BSA significantly increased SI/R-induced oxidative/nitrative stress in CMECs (as measured …

Reduced Cardioprotective Action Of Adiponectin In High-Fat Diet-Induced Type Ii Diabetic Mice And Its Underlying Mechanisms., Wei Yi, Yang Sun, Erhe Gao, Xufeng Wei, Wayne Bond Lau, Qijun Zheng, Yajing Wang, Yuexing Yuan, Xiaoliang Wang, Ling Tao, Rong Li, Walter Koch, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

Diabetes exacerbates ischemic heart disease morbidity and mortality via incompletely understood mechanisms. Although adiponectin (APN) reduces myocardial ischemia/reperfusion (MI/R) injury in nondiabetic animals, whether APN's cardioprotective actions are altered in diabetes, a pathologic condition with endogenously reduced APN, has never been investigated. High-fat diet (HD)-induced diabetic mice and normal diet (ND) controls were subjected to MI via coronary artery ligation, and given vehicle or APN globular domain (gAPN, 2 μg/g) 10 min before reperfusion. Compared to ND mice (where gAPN exerted pronounced cardioprotection), HD mice manifested greater MI/R injury, and a tripled gAPN dose was requisite to achieve cardioprotective extent …

Infectious Disease As A Security Threat, With Particular Application To The Migration Context, Marielena Faria

Independent Study Project (ISP) Collection

This paper analyzes the threat infectious diseases impose on global security, specifically in the migration context. Infectious diseases can threaten security through a variety of areas, and this paper aims to identify the global spread of infectious diseases through migration, international crises, humanitarian emergencies, HIV/AIDS, and emerging and re-emerging infectious diseases. This paper explores global health, security, and migration in an attempt to determine if combining these three areas can be meaningful. Generally, studies approach only two of the three areas to examine a topic, but this paper will assess and point out when combining all three fields is relevant. …

Audit On Preoperative Midazolam And Level Of Sedation, Sanam Muhammad, Shahla Siddiqui

Department of Anaesthesia

We wished to observe by carrying out a prospective clinical audit, the level of sedation and time interval of all adult elective surgery patients. We enrolled adult ASA I-III patients who came for elective surgery to the Aga Khan University Hospital preoperative surgery suite for 3 months. Hundred patients were enrolled. The majority of patients got 7.5 mg of PO Midazolam. Our median Ramsay sedation score was 2 and the Median drug to door time was 52.35 minutes. 11 patients were reportedly 'drowsy' in the recovery room one hour after surgery was completed. These were mostly the same patients who …

Endovascular Approach As Primary Treatment For Traumatic Carotid Cavernous Fistula: Local Experience From Pakistan, Rana Shoaib Hamid, Tanveer Ul Haq, Muhammad Shahzad Shamim, Syed Faraz Kazim, Basit Salam

Department of Radiology

Objective: To evaluate the technical success, complications and outcome of endovascular management of post traumatic carotid cavernous fistula (CCF) in patients presenting at a tertiary care hospital in Karahci.
Methods: Descriptive case series of 26 patients of post traumatic CCF treated by endovascular techniques was carried out at Radiology and Neurosurgery departments of Aga Khan University hospital between January 2010 to March 2010. Medical records and radiology reports were retrospectively reviewed from November 2000 to December 2009. The diagnosis was primarily clinical and was confirmed in all cases by CT or MRI. Endovascular procedures were performed under general anaesthesia through …

Wound Healing And The Role Of Biomarkers And Biofilms, Mujtaba Khan

All Capstone Projects

An injury to the skin alters the integrity of underlying tissues and microcirculation and thus certainly culminates in a wound. Wound healing is a highly complex, dynamic, interactive and well regulated physiological process involving blood cells, extracellular matrix, parenchyma cells and soluble mediators. It starts with alteration in integrity of tissues and ends with the formation of scar. The process of wound healing is distinguished into Haemostasis, Inflammation, Proliferation and Remodeling. Various cells like platelets, neutrophils, macrophages, lymphocytes, angiocytes, keratinocytes, fibroblasts and factors like platelet derived growth factor, transforming growth factor, platelet derived epidermal growth factors, fibroblasts growth factor, albumin, …

Challenges And Barriers To Improving Care Of The Musculoskeletal Patient Of The Future - A Debate Article And Global Perspective., Hangama C Fayaz, Jesse B Jupiter, Hans Christoph Pape, R Malcolm Smith, Peter V Giannoudis, Christopher G Moran, Christian Krettek, Karl J Prommersberger, Michael J Raschke, Javad Parvizi

Rothman Institute Papers

UNLABELLED: ABSTRACT:

BACKGROUND: With greater technological developments in the care of musculoskeletal patients, we are entering an era of rapid change in our understanding of the pathophysiology of traumatic injury; assessment and treatment of polytrauma and related disorders; and treatment outcomes. In developed countries, it is very likely that we will have algorithms for the approach to many musculoskeletal disorders as we strive for the best approach with which to evaluate treatment success. This debate article is founded on predictions of future health care needs that are solely based on the subjective inputs and opinions of the world's leading orthopedic …

Dysmorphophobia In A Diastrophic Dwarf: A Psychiatry-Dermatology Liaison Approach, Donald J. Kushon, Md

Jefferson Journal of Psychiatry

This is a case study of a 30-year-old male diastrophic dwarf who complained of hypertrichosis on his back and nose of 3 years duration. He had no previous psychiatric history, and although the distortion he described on his back was not apparent to others, there was a minimal amount of dark hair growth on his nose. He had unresolved conflicts concerning his disproportionate arms and legs and had sought surgical correction for many years from many orthopedic surgeons to no avail. After a diagnosis of dysmorphophobia was made by a psychiatric consultant, weekly visits with the dermatologist were arranged for …

Psychotherapy And Mental Retardation: What's The Use?, Jolyn Welsh Wagner, Md

Jefferson Journal of Psychiatry

The lack of adequate treatment opportunities for mentally retarded people with emotional disturbances has been well documented (11,14,9,16,8,2 1,10,19). A high prevalence of psychopathology, estimated at 4- 5 times that of the non-retarded population (8,10) identifies a population extremely vulnerable to emotional problems. Although advocates from many disciplines, including psychiatry, (15) have worked diligently since the early 20th Century to eliminate massive institutionalization, sterilization, and isolation of the retarded from society's defensive arsenal, the mental healthfield, especially psychiatry, has failed to meet current needs with appropriate clinical services.

The Missed Appointment: A Resident's Journal Through Activity To Introspection, Marcia J. Kaplan, Md

Jefferson Journal of Psychiatry

There was one experience during my medical school psychiatry rotation that I could not forget. In a classroom on the cardiology ward, I listened, transfixed like a child at a magic show, as a psychiatrist interviewed a man who was recovering from a heart attack. Initially the man denied any stresses in his life that might have affected his health, but as he went on, a different story unfolded. He spoke of his recent retirement, his wife's dissatisfactions and hostility, his disappointment with his children, his growing sense of failure and futility, and the recurring tightness in his chest that …

The Potential Role Of Psychiatry Residents' Councils, J. Thomas Pichot, Md

Jefferson Journal of Psychiatry

There are numerous books and articles within the scientific literature that deal with issues of training psychiatry residents and the characteristics of that milieu. Those authors that deal primarily with stress usually discuss the sources of the stress and the resultant behavioral changes that are manifested by the trainees. Typically, are relatively small portion of the discussion is devoted to how these problems are, or might be, addressed. This paper, while not itself intended to be an overview of stress in residency; will concentrate on a literature review of some specific aspects of the residency training process, primarily role definition …

Brief Communication: A Resident Elective Abroad, P. Conlon, M.B.

Jefferson Journal of Psychiatry

Elective study abroad during a residency is unusual, although this is not uncommon for medical students and fellows. There may be several reasons for this. Resident training programs are structured to last three or four years in North America and traditionally are under the auspices of specific university departments. This is a relatively short period of training compared to European countries, and consequently there tends to be less flexibility, and therefore less mobility, in training. Residencies also tend to be a combination of education, training and service requirements, and as programs have a specific allocation of positions for each year …

A Psychiatric Perspective On Erectile Dysfunction, Syed Ahmed, Md

Jefferson Journal of Psychiatry

Erectile impotence is a common family health problem, with exact incidence unknown, that adversely affects both men and their female partners. It is classified as "inhibited sexual excitement" in DSM-III and is defined as the inability to attain or maintain a penile erection until completion of the sexual act. It had been stated formerly, without supporting evidence, that 90% of erectile disorders were "psychogenic. " Today, however, only about one-third are so classified (1). In Kinsey's (2) series, the prevalence of impotence was less than 2% until the age of 40 years; it increased to 6-7% at age 55 …

Accepting Dependence, Julia Zawatsky, Md

Jefferson Journal of Psychiatry

There is an increasing emphasis on short term treatment in Psychiatry. Short term treatment may not provide the time necessary to permit the regression and foster the dependence necessary for successful treatment.

Supervising Residents Treating Multiproblem Patients: Transformations Of Therapeutic Narcissism, Susan J. Olson, Md, Valerie A. Westhead, Md, Jean M. Goodwin, Md, Mph

Jefferson Journal of Psychiatry

While much of the literature on psychotherapy supervision focuses on teaching psychotherapeutic techniques, most residents and supervisors realize that there is another agenda: making the often drained and narcissistically injured therapist feel better. The beginning therapist's self-esteem is especially vulnerable to injury because most psychiatric residents have "heavily committed themselves to a field of endeavor for which ... they are relatively untested" (I). Coupled with this, they are often assigned the most difficult and demanding patients, those with narcissistic disorders who are unable to soothe themselves. Both Searles (2) and Balint (3) describe the barrage of counter transferences usually experienced …

A Brief Note On A Psychotherapeutic Technique Described By Glover And Its Application During Psychiatric Residency, Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

Few would dispute the existence of a general tendency to blame psychological ailments on physical problems. For example, we often attribute changes in mood to the somatic effects of the weather, irritability to diet, apathy to physical exhaustion, etc. How many of us can deny at some time having attempted to explain to our spouses that an outburst of temper was really the fault of our indigestion, let us say? Of course, our spouses are rather skeptical. And as psychiatrists we too preserve a skepticism towards the explanations of this kind which our patients so often provide. This is not …

The Usefulness Of Neutrality, Julia Jones Zawatsky, Md

Jefferson Journal of Psychiatry

Recently, the idea of therapeutic neutrality has been attacked. Many observers have suggested that the neutral therapist is inhuman and unempathic. Actually, being a neutral therapist means being especially human and empathic. The neutral therapist's empathic contact with the patient is the most extensive in that it includes not only contact with feelings and thoughts of which the patient is aware, but also contact with all those intolerable thoughts and feelings of which the patient prefers to be unaware. Such awareness in the therapist is possible only when the therapist remains, as Anna Freud (I) recommends, equidistant from the patient's …

Editor's Column, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

As the Jefferson Journal of Psychiatry continues in its early growth phase, having accomplished a successful synthesis to become a national publication, we note its own apparent power of accommodation equal to the strain of fusing and adjusting internal and external changes.

Psychiatric residency in itself demands such accommodation. A group of finishing second year residents were taking stock of the fir st half of this process: They noted the difficulty in reconciling their initial conceptions and intentions with the subsequent realization of the limits to knowledge or intervention; they called this disillusionment. Others spoke of a converse strengthening …

Reciprocal Effects Of Oxidative Stress On Heme Oxygenase Expression And Activity Contributes To Reno-Vascular Abnormalities In Ec-Sod Knockout Mice, Tomoko Kawakami, Nitin Puri, Komal Sodhi, Lars Bellner, Toru Takahashi, Kiyoshi Morita, Rita Rezzani, Tim D. Oury, Nader G. Abraham

Biochemistry and Microbiology

Heme oxygenase (HO) system is one of the key regulators of cellular redox homeostasis which responds to oxidative stress (ROS) via HO-1 induction. However, recent reports have suggested an inhibitory effect of ROS on HO activity. In light of these conflicting reports, this study was designed to evaluate effects of chronic oxidative stress on HO system and its role in contributing towards patho-physiological abnormalities observed in extracellular superoxide dismutase (EC-SOD, SOD3) KO animals. Experiments were performed in WT and EC-SOD^(−/−) mice treated with and without HO inducer, cobalt protoporphyrin (CoPP). EC-SOD^(−/−) mice exhibited oxidative stress, renal histopathological abnormalities, …

Severe Propylthiouracil-Induced Hepatotoxicity In Pregnancy Managed Successfully By Liver Transplantation: A Case Report, Evan Sequeira, Sikolia Wanyonyi, Raj Dodia

Obstetrics and Gynaecology, East Africa

Introduction: Propylthiouracil-induced severe hepatotoxicity is a relatively rare occurrence, with very few cases reported in the literature. The management of this complication in pregnancy can be a challenge because of the effects of the various treatment options on the fetus.

Case presentation: We report a rare case of fulminant hepatic failure in a 36-year-old gravida 2 black woman of African descent that occurred at 17 weeks gestation following propylthiouracil treatment for Graves’ disease. Her liver failure was managed by liver transplantation and thyroidectomy. Her pregnancy was continued to term, though with not so favorable early childhood sequelae.

Conclusion: This case …

Cranioplasty After Decompressive Craniectomy: An Institutional Audit And Analysis Of Factors Related To Complications, Zain A. Sobani, Muhammad Shahzad Shamim, Syed Nabeel Zafar, Mohsin Qadeer, Najiha Bilal, Syed Ghulam Murtaza, Ather Enam, Muhammad Ehsan Bari

Section of Neurosurgery

Background:Although a relatively simple procedure, cranioplasties have been associated with high complication rates. Keeping this in perspective, we aimed to determine the factors associated with immediate and long-term complications of cranioplasties at our institution.
Methods: A retrospective review of Patient records was carried out for Patients having undergone reconstructive cranioplasties at our institution during the last 10 years (2001-2010). All case notes, records, and investigations were reviewed and the data were recorded in a predesigned questionnaire. Complications were recorded along with existing comorbids and measures taken for their prevention and management. Univariate and multivariate logistic regression analysis was performed …