Digital Commons Network^™

A Major Event Of Self-Mutilation In A Patient With Fetal Alcohol Syndrome, Joel P. Johnson M.D. (Pgy4), Steven Sugden M.D., James A. Bourgeois O.D., M.D.

Jefferson Journal of Psychiatry

We describe a young adult male with fetal alcohol syndrome (FAS) who presented with a non-repetitive, major, genital self-mutilation necessitating urological intervention. On formal psychiatric evaluation, he did not have psychosis or suicidality. Most commonly, self-injury in developmental disability is less severe and more stereotypic; major-class self-mutilation is confined, generally, to psychosis. It is this discrepancy that is the unusual feature of our case.

Autocastration And Autoamputation Of The Penis In A Patient With Delusions Of Sexual Guilt, Craig B. Franke M.D. (Pgy4), James A. Rush M.D. (Pgy3)

Jefferson Journal of Psychiatry

Genital self-mutilation (GSM) is a rare event that is commonly associated with psychotic disorders; we report an occurrence in the context of psychosis and drug use. We also review the etiologies of this phenomenon and how these etiologies differ across gender.

Clozapine, Fluoxetine, And Benztropine- Associated Ileus: Case Report, Pegah Pajouhi M.D. (Pgy1), James A. Bourgeois O.D., M.D.

Jefferson Journal of Psychiatry

Gastrointestinal complications of anticholinergic medications are prevalent, potentially life-threatening, and could be more actively prevented. We present a case report of an ileus that required surgical intervention and developed in the context of clozapine, benztropine, and fluoxetine use. The case exemplifies the potential anticholinergic toxicities of clozapine and benztropine as well as possible pharmacokinetic interactions between fluoxetine, clozapine, and benztropine. We discuss ways to minimize the likelihood of anticholinergic complications with these medications.

How Emotional Processes Affect Physical Health And Well-Being

Topics in Integrative Medicine

An important philosophical principle of integrative medicine is the interrelationship of physical, emotional and spiritual aspects of health. This article describes mind-body influences and interactions, and presents some of the evidence that supports it.

Aoa Symposium. Orthopaedists Partnering With Other Physicians To Provide Musculoskeletal Care., Alan Hilibrand, Kurt P Spindler, Scott D Boden

Rothman Institute Papers

No abstract provided.

How To Prevent Perioperative Myocardial Injury: The Conundrum Continues, Jian-Zhong Sun, David Maguire

Department of Anesthesiology Faculty Papers

BACKGROUND: Perioperative myocardial injury (PMI) remains a major cause of perioperative morbidity and mortality but clinical strategies to prevent PMI are still uncertain.

METHODS AND RESULTS: We comprehensively searched PubMed for major research articles concerning clinical strategies to prevent PMI. The key findings are as follows: (1) the American College of Cardiology/American Heart Association guideline update for perioperative cardiovascular evaluation for noncardiac surgery is very useful to stratify cardiac risk preoperatively; (2) cardiac troponin has emerged as a biomarker to diagnose postoperative PMI and to predict clinical outcomes; (3) coronary revascularization before noncardiac surgery probably would provide cardiac protection in …

Targeted Therapies In The Management Of Metastatic Bladder Cancer., Matteo Fassan, Edouard J. Trabulsi, Leonard G Gomella, Raffaele Baffa

Department of Urology Faculty Papers

The management of metastatic urothelial carcinoma (UC) of the bladder is a common and complex clinical challenge. Despite the fact that UC is one of the most frequent tumors in the population, long term survival for metastatic disease remains low, and chemotherapy is curative for only a small minority of patients. UC is genetically heterogeneous, and it is surrounded by a complex tissue microenvironment. The problems of clinical practice in the field of metastatic bladder cancer have begun to stimulate translational research. Advances in the understanding of the molecular biology of urothelial cancer continue to contribute to the identification of …

Modulation Of Tgf-Beta Signaling By Proinflammatory Cytokines In Articular Chondrocytes., Jorge A. Roman-Blas, David G. Stokes, Sergio A. Jimenez

Department of Medicine Faculty Papers

OBJECTIVE: The normal structure and function of articular cartilage are the result of a precisely balanced interaction between anabolic and catabolic processes. The transforming growth factor-beta (TGF-beta) family of growth factors generally exerts an anabolic or repair response; in contrast, proinflammatory cytokines such as interleukin 1 beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) exert a strong catabolic effect. Recent evidence has shown that IL-1beta, and TNF-alpha, and the TGF-beta signaling pathways share an antagonistic relationship. The aim of this study was to determine whether the modulation of the response of articular chondrocytes to TGF-beta by IL-1beta or TNF-alpha signaling pathways …

Comparison Of Eight Prosthetic Aortic Valves In A Cadaver Model., Benjamin A. Youdelman, Hitoshi Hirose, Harsh Jain, J Yasha Kresh, John W.C. Entwistle, Andrew S. Wechsler

Department of Surgery Faculty Papers

OBJECTIVES: Proper valve selection is critical to ensure appropriate valve replacement for patients, because implantation of a small valve might place the patient at risk for persistent gradients. Labeled valve size is not the same as millimeter measure of prosthetic valve diameters or the annulus into which it will fit. Studies that use the labeled valve size in lieu of actual measured diameter in millimeters to compare different valves might be misleading. Using human cadaver hearts, we sized the aortic annulus with 8 commonly used prosthetic aortic valve sizers and compared the valves using geometric orifice area. This novel method …

Special Article: Physical Activity, Physical Fitness, And Cardiovascular Risk Factors In Childhood, Samuel S. Gidding

Department of Pediatrics Faculty Papers

In adults, physical activity and exercise training are associated with reduced cardiovascular morbidity and mortality, a reduced likelihood of developing adverse cardiovascular risk factors, and improved insulin sensitivity. In childhood, participation in appropriate physical activity may prevent the development of cardiovascular risk factors in the future and complement treatment of existing cardiovascular risk factors, including hypertension, dyslipidemia, and overweight. Exercise in children can also significantly improve insulin sensitivity independent of weight loss. These e fects are mediated in overweight children by increases in lean body mass relative to fat mass and associated improvements in inflammatory mediators, endothelial function, and the …

In Vitro Methods For Generating Highly Purified Ebv Associated Tumor Antigen-Specific T Cells By Using Solid Phase T Cell Selection System For Immunotherapy, Jongming Li, Bijoyesh Mookerjee, John Wagner, Neal Flomenberg

Department of Medical Oncology Faculty Papers

Adoptive cell transfer immunotherapy has been utilized to treat EBV related human malignancies including post-transplant lymphoproliferative diseases, Hodgkin's lymphoma and nasopharyngeal carcinoma. However, there are limited options available for tumor antigen-specific T cell purification. Here we describe a novel solid phase T cell selection system, in which monocytes or EBV transformed B-lymphocytes are immobilized on solid support for antigen-specific T cell purification. We hypothesize and prove that antigen-specific T cells recognize their cognate antigens and bind to them faster than non-antigen specific T cells. Therefore antigen-specific T cells can be concentrated on the surface after removing the non-adherent cells by …

Bactericidal Activity Of Extended 9-Glycyl-Amido-Minocyclines, Chang-Po Chen, Allen R. Zeiger, Dr. Eric Wickstrom

Department of Biochemistry and Molecular Biology Faculty Papers

The need for self-protecting polymer or alloy implants resistant to a broad spectrum of bacterial challenges led us to investigate covalent bonding of minocycline (MIN), a tetracycline derivative, to polystyrene beads and to titanium alloy foils by oligoethylene glycol spacers. 9-Hydrazino-acetyl-amido-MIN, and simpler glycylcycline derivatives, retained minimum inhibitory concentration (MIC) against Staphylococcus aureus comparable to MIN. However, PEG-glycyl-amido-MIN showed very low activity. Hence, we coupled 9-hydrazino-acetyl-amido-MIN to the aldehyde termini of oligoethylene glycol spacers bonded to polystyrene and titanium alloy surfaces to form acid-releasable hydrazone linkages. 9-Hydrazino-acetyl-amido-MIN was released from the monolayers more rapidly at pH 5.0 than at pH …

Renal Cell Carcinoma Metastatic To The Duodenum: Treatment By Classic Pancreaticoduodenectomy And Review Of The Literature, Robert Adamo, Patrick J. Greaney Jr., Agnieszka Witkiewicz, Eugene P. Kennedy, Charles J. Yeo

Department of Surgery Faculty Papers

Renal cell cancer (RCC) most commonly metastasizes to the lungs, bones, liver, renal fossa, and brain, although metastases can occur elsewhere. RCC metastatic to the duodenum is especially rare, with only a small number of cases reported in the literature. Herein, we describe a case of an 86-year-old woman with a history of RCC treated by radical nephrectomy 13 years previously. The patient presented with duodenal obstruction and anemia from a solitary duodenal mass invading into the pancreas and was treated via classic pancreaticoduodenectomy. Preoperative imaging and intra-operative assessment showed no evidence of other disease. Pathology confirmed metastatic RCC without …

Elimination/Challenge Diet

Marcus Institute of Integrative Health of Integrative Medicine Protocols

There are several approaches to identifying food intolerance, and food influences on chronic symptoms and chronic disease. The following instructions describe the approach that we have found to be most helpful for improving patient symptoms and identifying the specific food or foods that may be problematic.

A Dipeptidyl Aminopeptidase-Like Protein Remodels Gating Charge Dynamics In Kv4.2 Channels, Kevin Dougherty, Manuel Covarrubias

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Dipeptidyl aminopeptidase–like proteins (DPLPs) interact with Kv4 channels and thereby induce a profound remodeling of activation and inactivation gating. DPLPs are constitutive components of the neuronal Kv4 channel complex, and recent observations have suggested the critical functional role of the single transmembrane segment of these proteins (Zagha, E., A. Ozaita, S.Y. Chang, M.S. Nadal, U. Lin, M.J. Saganich, T. McCormack, K.O. Akinsanya, S.Y. Qi, and B. Rudy. 2005. J. Biol. Chem. 280:18853–18861). However, the underlying mechanism of action is unknown. We hypothesized that a unique interaction between the Kv4.2 channel and a DPLP found in brain (DPPX-S) may remodel the …

International Education Week 2007

Diversity Programs

Lectures during International Education Week, November 2007.

Micro Rna 145 Targets The Insulin Receptor Substrate-1 And Inhibits The Growth Of Colon Cancer Cells, Bin Shi, Laura Sepp-Lorenzino, Marco Prisco, Peter Linsley, Tiziana Deangelis, Renato Baserga

Department of Cancer Biology Faculty Papers

The insulin receptor substrate-1 (IRS-1), a docking protein for both the type 1 insulin-like growth factor receptor (IGF-IR) and the insulin receptor, is known to send a mitogenic, anti-apoptotic, and anti-differentiation signal. Several micro RNAs (miRs) are suggested by the data base as possible candidates for targeting IRS-1. We show here that one of the miRs predicted by the data base, miR145, whether transfected as a synthetic oligonucleotide or expressed from a plasmid, causes down-regulation of IRS-1 in human colon cancer cells. IRS-1 mRNA is not decreased by miR145, while it is down-regulated by an siRNA targeting IRS-1. Targeting of …

Developing "Human Functioning And Rehabilitation Research" From The Comprehensive Perspective., Gerold Stucki, Jan Dietrich Reinhardt, Gunnar Grimby, John Melvin

Department of Rehabilitation Medicine Faculty Papers

With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research, integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. Here we will summarize approaches to address these challenges with respect to 3 areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programmes and the building of university centres and collaboration networks.

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 3, Iss. 9, November/December 2007

Public Health Link

This issue includes: Jefferson’s MPH Program Active at the American Public Health Association (APHA) Meeting in Washington, D.C., an article written by Dr. Plumb "Homelessness—Care, Prevention and Public Policy", announcing new thesis presenters, Jefferson MPH Program Director, Dr. Simmons, Elected President of the Society for Public Health Education (SOPHE), announcing the New MPH Program Coordinator, and the First MPH Faculty and Community Advisory Board Dinner.

Native American Heritage Month 2007

Diversity Programs

Lecture during Native American Heritage Month, November 2007.

Ferric Gluconate Yields Cost-Savings In Hemodialysis Patients With High Ferritin And Low Tsat: Results From The Drive Studies, Laura T. Pizzi, Thomas J. Bunz, David S. Goldfarb, Daniel W. Coyne, Ajay K. Singh

College of Population Health Lectures, Presentations, Workshops

Purpose: One third of hemodialysis patients have high serum ferritin levels and low transferrin saturation (TSAT). The purpose of this analysis was to determine the cost effectiveness of administering 1g of sodium ferric gluconate complex (SFGC: also referred to as ferric gluconate) to patients with serum ferritin >500ng/mL and TSAT ≤25% based on the Dialysis Patients Response to IV Iron with Elevated Ferritin (DRIVE) study and its 6-week observational extension (DRIVE-II). In these studies, IV iron administration resulted in reduced epoetin requirements.

Methods: Decision analysis was performed using a time horizon of 12 weeks, consistent with the combined duration of …

Robot-Assisted Prostate Brachytherapy, Yan Yu, Tarun Podder, Y D. Zhang, W S. Ng, V Misic, J Sherman, L Fu, D Fuller, D J. Rubens, J D. Strang, R A. Brasacchio, E M. Messing

Department of Radiation Oncology Faculty Papers

Abstract: In contemporary brachytherapy procedures, needle placement at the desired target is challenging due to a variety of reasons. A robot-assisted brachytherapy system can potentially improve needle placement and seed delivery, resulting in enhanced therapeutic delivery. In this paper we present a 16 DOF (degrees-of-freedom) robotic system (9DOF positioning module and 7DOF surgery module) developed and fabricated for prostate brachytherapy. Strategies to reduce needle deflection and target movement were incorporated after extensive experimental validation. Provisions for needle motion and force feedback were included into the system for improving robot control and seed delivery. Preliminary experimental results reveal that the prototype …

The Activity Of Azithromycin Against Leishmania (Viannia) Braziliensis And Leishmania (Leishmania) Amazonensis In The Golden Hamster Model., Angel Sinagra, Concepción Luna, David Abraham, Maria Del Carmen Iannella, Adelina Riarte, Alejandro J. Krolewiecki

Department of Microbiology and Immunology Faculty Papers

New therapeutic alternatives against leishmaniasis remain a priority. The activity of azithromycin against Leishmania (Leishmania) major has been previously demonstrated. Different responses among species of Leishmania make species-specific drug screening necessary. The activity of azithromycin against Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis was evaluated in golden hamsters infected through footpad injections of metacyclic promastigotes, and compared with untreated controls and animals treated with meglumine antimoniate. Footpad thickness, lesion cultures and dissemination sites were analyzed. Treatment of golden hamsters with oral azithromycin at 450mg/kg had no activity against infections with Leishmania (Leishmania) amazonensis. For infections due to Leishmania (Viannia) braziliensis, …

Download The Pdf Of The Entire Issue

Jefferson Surgical Solutions

No abstract provided.

Sirtuins, Nuclear Hormone Receptor Acetylation And Transcriptional Regulation, James R. Whittle, Michael J. Powell, Vladimir M. Popov, L. Andrew Shirley, Chenguang Wang, Richard G. Pestell

Department of Cancer Biology Faculty Papers

Endocrine signaling via nuclear receptors (NRs) is known to play an important role in normal physiology as well as in human tumor progression. Hormones regulate gene expression by altering local chromatin structure and, thereby, accessibility of transcriptional co-regulators to DNA. Recently it has been shown that non-histone proteins involved in hormone signaling, such as nuclear receptors and NR co-activators, are regulated by acetylation, resulting in their altered transcriptional activity. NAD-dependent protein deacetylases, the sirtuins (Sir2-related enzymes), directly modify NRs. Because sirtuins have been shown to regulate tumor cellular growth, aging, metabolic signaling and endocrine hormone signaling, they might play a …

Jss Editorial Board & Credits

Jefferson Surgical Solutions

No abstract provided.

News In Brief

Jefferson Surgical Solutions

No abstract provided.

Those Who Give

Jefferson Surgical Solutions

No abstract provided.

On The Job

Jefferson Surgical Solutions

No abstract provided.

More Veggies, Less Breast Cancer: Unlocking One Secret To Prevention

Jefferson Surgical Solutions

No abstract provided.