Digital Commons Network^™

Conversion Disorder In A Depressed Patient: The Analysis Of Paralysis, Michael A. Chen Ph.D., David S. Im M.D.

Jefferson Journal of Psychiatry

Patients presenting with neurologic and pseudoneurologic symptoms present both a diagnostic and treatment challenge. This case report describes the ER course of a man who presented with aphonia and paralysis, his medical clearance, transfer to the psychiatric ER and subsequent recovery. The history of conversion disorder and its characteristics are briefly reviewed, and the etiology of this patient's symptoms and a discussion of effective treatment plans are discussed.

On The Technical Error Of The Psychotherapist, Satoshi Tamiya M.D., Tetsuro Takahashi M.D.

Jefferson Journal of Psychiatry

The authors present a psychotherapy case where the therapist's countertransference-based technical error and his way of dealing with it remarkably influenced the course of treatment. The authors emphasize that appropriate training, including supervision and personal psychotherapy or psychoanalysis, is imperative, especially so that the beginning therapist can learn to manage countertranference appropriately. Since technical errors cannot always be avoided, it is important for the therapist to deal with them therapeutically, without feeling ashamed or guilty.

Case Report Of Dramatic Resolution Of Psychotic Symptoms During Cross-Over To Clozapine, Leo Sher M.D., Alan Mendelowitz M.D.

Jefferson Journal of Psychiatry

Clozapine is the first antipsychotic drug with proven superiority over conventional antipsychotics in the management of treatment-resistant patients. We describe a case of tratment-resistant schizoaffective disorder in a young woman who improved rapidly on clozapine. The patient was started on a low dose of clozapine while fluphenazine was decreased. She improved significantly during the first several days of treatment. This improvement took place well before the expected effect of clozapine. Possible explanations for this unusual response include: 1) the placebo effect; 2) fluphenazine dose-response curve; 3) acute clozapine neurochemical mechanisms; 4) inaccurate original diagnosis. Better understanding of the mechanisms of …

Case Report: Failure Of Group Therapy With Elderly Russian-Jewish Immigrants (An Exploratory Analysis), Gennady Berezkin M.D.

Jefferson Journal of Psychiatry

This paper is a description of an unsuccessful attempt to carry out group therapy with elderly Russian-Jewish immigrants.

An attempt was made to conduct group therapy following general principals of traditional psychotherapy with geriatric populations.

In the final analysis, we conclude that culturally based preconceptions toward psychotherapy, culturally based stereotypes of interpersonal relationships and culturally-based transference to the therapist were the primary reasons for the development of negative transference and resistance which culminated in the ultimate failure of group psychotherapy with this group of elderly immigrants.

The Somatization Of Depression In Native Pakistani Women, Rubeena H. Mian M.D., Linda S. Grossman Ph.D.

Jefferson Journal of Psychiatry

Previous studies have pointed out the comorbidity of somatization and depression among non-Western psychiatric patients. We studied the somatization of depression in Pakistani women. Two groups were studies: inpatients with DSM-III-R diagnoses of major depression and a comparison sample of women living in the community without psychiatric diagnoses. Both groups were administered a rating scale for somatization. Results indicated that patients reported significantly more somatic symptoms than nonpatients. These findings support the concept that somatization may be a cultural mode of mental distress among Pakistani women, as has been observed for other non-Western populations.

Folie Á Deux: Two Case Reports, Mohammad Y. Abu-Salha M.D.

Jefferson Journal of Psychiatry

Two cases of “Shared Psychotic Disorder” were diagnosed over a period of less than a year in a children’s psychiatric center. Shared Psychotic Disorder is one of the differential diagnoses that need to be entertained when evaluating a delusional patient. Including the patient’s family and/or significant others in the assessment increases the possibility of diagnosing Shared Psychotic Disorder. An eight-year-old girl was admitted after exhibiting psychotic behavior with paranoid delusions she shared with her mother. Specifically, she reported that “neighbors next door were repeatedly breaking into her house, pinning her down, raping her, and injecting her with I.V. drugs.” An …

Early Detection Of Autism In The Population, John D. Mclennan M.D., Ph.D.

Jefferson Journal of Psychiatry

Frequently there is a delay in the diagnosis of autism in children which may result in a lost opportunity to provide early intervention. Signal detection studies have suggested that single items have good predictability for autism which suggests simple screening procedures may be helpful in the early detection of an autistic disorder. Studies of autism in the very young have found that specific social deficits appear to characterize this group. A three stage procedure is presented as a possible approach to detect autism at an early age in the population thereby allowing for early intervention.

Steroid-Induced Psychosis Presenting As "Alice In Wonderland" Syndrome, Vinobha Gorriah M.D., Frank W. Favazza M.D., Migdalia Fort-Ramirez M.D.

Jefferson Journal of Psychiatry

A 40 year old overweight male with a history of bronchial asthma, hypertension, and “schizophrenia” was admitted for intractable bronchial asthma. He did not have a history of drug or alcohol use.

Upon admission, he was treated with high doses of IV methyl prednisone, oral prednisone, and triamcinolone inhaler. He developed complex visual hallucinations which decreased following tapering of prednisone and discontinuation of the triamcinolone. EEG showed diffuse slowing suggesting a toxic metabolic state.

The Role Of Group Psychotherapy In Psychiatric Residency Training, Shahbaz R. Khan M.D., Katherine A. Cowan M.D., Pedro Ruiz M.D.

Jefferson Journal of Psychiatry

Group psychotherapy has become a well-recognized treatment modality in the mental health field. Educationally, however, group psychotherapy has not reached the priority level it deserves. We described our experiences in using group psychotherapy as a training tool at the University of Texas at Houston. In describing our program, we used case illustrations to better demonstrate the richness of our training experiences. Group psychotherapy should be more extensively used in the training of tomorrow’s mental health professionals.

Ultradian Cycles Of Mood In Normal And Depressed Subjects, Donald P. Hall Jr., M.D., David Benedek M.D., Audrey Chang

Jefferson Journal of Psychiatry

Objective: To study ultradian cycles of mood in four inpatient groups.

Method: We assessed the mood of depressed and nondepressed subjects, on an hourly basis, between 7:00 a.m. and 10:00 p.m. for two consecutive days using a visual analog scale of mood. Hourly mood scores for each group were plotted against time.

Results: We found ultradian cycles with mean lengths of 3-4 hours in all groups. The major depressive episode and adjustment disorder depression groups, however, had ultradian cycles of significantly greater amplitude than ward staff.

Conclusions: Depressed patients demonstrate greater amplitude in ultradian cycles of mood than nondepressed subjects.

Smoking Rates After Cessation Of Alcohol And/Or Cocaine: A Pilot Study, Timothy R. Jennings M.D.

Jefferson Journal of Psychiatry

Objective: To assess the change in smoking rates in alcohol and/or cocaine dependent patients after the cessation of the primary drug of use.

Design: A self-report questionnaire was administered upon admission to a Residential Treatment Facility, in the fourth week, and in the final (sixth) week of the program. The control group was administered a self-report questionnaire at the time of intake as controls and again four and six weeks later.

Setting: Residential Treatment Facility (RTF) a 30 bed inpatient alcohol and drug treatment unit, at Eisenhower Army Medical Center, Fort Gordon, Georgia.

Patients: A Total of 42 patients; 37 …

Are Baby Boomers Who Care For Their Older Parents Planning For Their Own Future Long-Term Care Needs?, Alison Kleppinger, Julie T. Robison

UCHC Articles - Research

A rapidly expanding number of baby boomers provide care to aging parents. This study examines associations between caregiver status and outcomes related to awareness and anticipation of future long-term care (LTC) needs using 2007 Connecticut Long-Term Care Needs Assessment survey data. Baby boomers who were adult child caregivers (n = 353) vs. baby boomers who were not (n = 1242) were more likely to anticipate some future LTC needs and to have considered certain financing strategies. Although baby boomer adult child caregivers more readily anticipate some future LTC needs, they are not taking specific actions. It is important to address …

Purging Of Memories From Conscious Awareness Tracked In The Human Brain, Benjamin Levy, Michael C. Anderson

Psychology

Understanding the neural basis of conscious experience and its regulation are fundamental goals of science. While recent research has made substantial progress in identifying the neural correlates of conscious experiences, it remains unclear how individuals exert control over the contents of awareness. In particular, can a memory that has entered the aware state be purged from consciousness if it is not currently desired? Here we tracked the correlates of consciousness in humans using functional magnetic resonance imaging and demonstrated the involvement of a downregulation mechanism that purges contents from conscious awareness. When individuals tried to prevent the retrieval of a …

Ensembles Of Human Mtl Neurons "Jump Back In Time" In Response To A Repeated Stimulus, M. W. Howard, Indre Viskontas, K. H. Shankar, I. Fried

Psychology

Episodic memory, which depends critically on the integrity of the medial temporal lobe (MTL), has been described as ‘‘mental time travel’’ in which the rememberer ‘‘jumps back in time.’’ The neural mechanism underlying this ability remains elusive. Mathematical and computational models of performance in episodic memory tasks provide a specific hypothesis regarding the computation that supports such a jump back in time. The models suggest that a representation of temporal context, a representation that changes gradually over macroscopic periods of time, is the cue for episodic recall. According to these models, a jump back in time corresponds to a stimulus …

Synapsis: Philadelphia Campus (2012), Philadelphia College Of Osteopathic Medicine

All Yearbooks

This yearbook includes American Medical Association (AMA), American Medical Student Association (AMSA), American Medical Women's Association (AMWA), Association of the American College of Osteopathic Family Physicians (ACOFP), Asian Pacific American Medical Student Association (APAMSA), Robert Berger, DO Pediatrics Society, Christian Medical Dental Association (CMDA), Kappa Sigma Phi, KSPh, (ΚΣΦ) Women's Osteopathic Society, Medical Students for Choice, Military Osteopathic Physicians and Surgeons (AMOPS), Muslim Student Medical Association, National Latino Health Organization (NLHO), Phi Sigma Gamma PSG, (ΦΣΓ) Fraternity, Physicians for Human Rights Club, Physicians for Social Responsibility Club, Sigma Sigma Phi SSPh, (ΣΣΦ) Honorary Osteopathic Service Fraternity, Student American Osteopathic Academy …

Manipulating Fate: Medical Innovations, Ethical Implications, Theatrical Illuminations, Karen H. Rothenberg, Lynn W. Bush

Faculty Scholarship

Transformative innovations in medicine and their ethical complexities create frequent confusion and misinterpretation that color the imagination. Placed in historical context, theatre provides a framework to reflect upon how the ethical, legal, and social implications of emerging technologies evolve over time and how attempts to control fate through medical science have shaped -- and been shaped by -- personal and professional relationships. The drama of these human interactions is powerful and has the potential to generate fear, create hope, transform identity, and inspire empathy -- a vivid source to observe the complex implications of translating research into clinical practice through …

The Role Of Ptip In Breast Cancer, Lina Niu

Theses, Dissertations and Capstones

In the U.S., breast cancer comprises about 30% of all cancer cases (excluding skin cancer) in women. Such a high incidence makes breast cancer a significant health concern, but our understanding of the molecular and cellular mechanisms of this disease is still limited. Growing evidence suggests that the development of human breast cancer may involve epigenetics, which attributes changes in phenotype to mechanisms other than changes in the DNA sequence itself. Histones as the chief proteins of chromatin work on gene expression, and methylation of histone 3 lysine 4 (H3K4) results in transcriptional activation. Lately, Paired box (Pax) trans-activation domain-interacting …

Factors That Motivate Certified Registered Nurse Anesthetists To Practice Independently In The Appalachian Region, Michael Lee Frame Jr.

Theses, Dissertations and Capstones

Introduction: Independent Certified Registered Nurse Anesthetists (CRNAs) provide anesthesia services without the supervision or medical direction of anesthesiologists in healthcare facilities throughout the United States. The present literature is limited concerning the factors that motivate CRNAs to choose employment in rural independent practice.

Research Hypothesis: In a sample of CRNAs who practice independently in one of the 13 states of the Appalachian region there will be no differences between the CRNAs from Appalachian and Non-Appalachian counties in their responses to the motivation factors of achievement, recognition, responsibility, advancement, work itself, salary, working conditions, company and administrative policies, supervision, and …

The Effect Of Education On Healthcare Personnel's Knowledge Of Lymphedema Detection And Prevention, Dolly Wilson

Nursing Theses and Capstone Projects

Secondary lymphedema (SLE) is a serious problem for many of the 2.6 million breast cancer survivors in the United States. It is estimated that 28 - 38% of breast cancer survivors develop lymphedema. The five-year incidence ranges from 43% to 94% (Armer, 2010). The purpose of this study was to evaluate the effectiveness of an education program on healthcare personnel's knowledge of the risk of and preventive measures for upper limb lymphedema in breast cancer patients. A sample of healthcare personnel (N = 32) included both trained healthcare personnel and ancillary staff who are employed in a single oncology center …

2012 Cancer Care Annual Report, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center.

Reintegration Of Child Soldiers In Burundi: A Tracer Study, Mark J.D. Jordans, Ivan H. Komproe, Wietse A. Tol, Aline Ndayisaba, Theodora Nisabwe, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Reasons For Low Pandemic H1n1 2009 Vaccine Acceptance Within A College Sample, Russell D. Ravert, Linda Y. Fu

Pediatrics Faculty Publications

This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% …

Posttraumatic Stress Disorder Prevalence And Risk Of Recurrence In Acute Coronary Syndrome Patients: A Meta-Analytic Review., D. Edmondson, S. Richardson, L. Falzon, K. W. Davidson, M. A. Mills, Y. Neria

Journal Articles

BACKGROUND: Acute coronary syndromes (ACS; myocardial infarction or unstable angina) can induce posttraumatic stress disorder (PTSD), and ACS-induced PTSD may increase patients' risk for subsequent cardiac events and mortality.

OBJECTIVE: To determine the prevalence of PTSD induced by ACS and to quantify the association between ACS-induced PTSD and adverse clinical outcomes using systematic review and meta-analysis.

DATA SOURCES: Articles were identified by searching Ovid MEDLINE, PsycINFO, and Scopus, and through manual search of reference lists.

METHODOLOGY/PRINCIPAL FINDINGS: Observational cohort studies that assessed PTSD with specific reference to an ACS event at least 1 month prior. We extracted estimates of the …

Com Outlook Winter 2012, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Invisible Chronic Illness: Invisible Is Not Imaginary, Rebecca Tadlock-Marlo

Faculty Research & Creative Activity

The need for counselors to be versed in various areas of multicultural counseling is a requirement to the profession (ACA Code of Ethics, 2005). Providing a basis of counselor knowledge in dealing with the various areas of multiculturalism is necessary to revolutionize how we are able to help clients with various life stories. One of the goals within the ACA standards is to help navigate a sense of empowerment for such clients. Counselors must promote holistic wellness in the often challenging social, emotional, cognitive, and spiritual path of comeback. With the rise in invisible chronic physical conditions, the importance of …

Evaluating Psychiatric Patients’ Attitudes Of A Shared Electronic Medical Record, Edward R. Norris Md, Fapa, Fapm, Julia R. Correll Ba, Jamie Bongiovi Lcsw, David Dylewski Ms, Gail Stern Msn, Michael Kaufmann Md

Department of Psychiatry

No abstract provided.

Neurotechnology And Psychiatric Biomarkers, William Bosl

Nursing and Health Professions Faculty Research and Publications

No abstract provided.

A Randomized Placebo-Controlled Trial Of Varenicline For Smoking Cessation Allowing Flexible Quit Dates, Stephen I. Rennard, John Hughes, Paul M. Cinciripini, Eva Kralikova, Tobias Raupach, Carmen Arteaga, Lisa B. St Aubin, Cristina Russ, The Flexible Quit Date Study Group

Journal Articles: Pulmonary & Critical Care Med

INTRODUCTION: Current smoking cessation guidelines recommend setting a quit date prior to starting pharmacotherapy. However, providing flexibility in the date of quitting may be more acceptable to some smokers. The objective of this study was to compare varenicline 1 mg twice daily (b.i.d.) with placebo in subjects using a flexible quit date paradigm after starting medication.

METHODS: In this double-blind, randomized, placebo-controlled international study, smokers of ≥10 cigarettes/day, aged 18-75 years, and who were motivated to quit were randomized (3:1) to receive varenicline 1 mg b.i.d. or placebo for 12 weeks. Subjects were followed up through Week 24. Subjects were …

Feasibility And Compliance With Daily Home Ecg Monitoring Of The Qt Interval In Heart Transplant Recipients, Erik V. Carter, Kathleen T. Hickey, David M. Pickham, Lynn V. Doering, Belinda Chen, Patricia R. E. Harris, Barbara J. Drew

Collected Faculty Scholarship

About 13% of adult heart transplant recipients do not survive to one year and a major cause of death is acute cellular allograft rejection.^1,2 According to the 2009 annual United States data published from the International Society for Heart Lung Transplantation Registry, acute rejection occurs in 25 – 35% of transplant recipients within the first year following transplant surgery.³ In order to detect the early stages of rejection so that more aggressive and early immunosuppressant therapy can be initiated, frequent biopsies of heart tissue are performed (typically, weekly or every other week in the first 3 months and …

Information Fusion And Quantum Logic In Family Medicine, F. Matthew Mihelic

Faculty Publications

A time-tested model for information fusion and analysis is provided by Family Medicine. Family Medicine is a discipline that operates in the realms of botJ1 technical and social sciences to analyze massive amounts of information from mulriple sources in order to make decisions that bring about tJie integration and coordination of interdisciplinary interventions involving scientific, psychological, and social aspects of medical care. This generalist function serves to lower the organizational entropy of complex systems and thereby improve efficiency while reducing ilie risk of catastrophic failure. Simply bringing a group of specialists together in one place does not bring about the …