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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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Evaluation Of A Telephone-Based Support Group Intervention For Female Caregivers Of Community-Dwelling Individuals With Dementia, Laraine Winter, Laura N. Gitlin

Center for Applied Research on Aging and Health Research Papers

Family caregivers, the "second victims" or hidden patients in dementia care, are at risk for social isolation, stress, depression, and mortality. Telephone-based support (telesupport groups) represents a practical, low-burden, low-cost source of emotional support. The present study evaluated the feasibility and effectiveness of professionally led telephone-based support groups for female family caregivers of community-dwelling dementia patients. Recruited through various community sources, 103 female caregivers were randomized to the telesupport group treatment or a control condition. Effects on caregiver burden, depression, and personal gains were evaluated at 6 months, the main end point. Older caregivers (≥65) in telesupport reported lower depression …

Normal Sleep And Circadian Rhythms: Neurobiologic Mechanisms Underlying Sleep And Wakefulness, Dimitri Markov, Marina Goldman

Department of Psychiatry and Human Behavior Faculty Papers

Sleep is a vital, highly organized process regulated by complex systems of neuronal networks and neurotransmitters. Sleep plays an important role in the regulation of central nervous system and body physiologic functions. Sleep architecture changes with age and is easily susceptible to external and internal disruption. Reduction or disruption of sleep can affect numerous functions varying from thermoregulation to learning and memory during the waking state.

Chemoprevention Of Breast Cancer For Women At Hgh Risk, Kathryn Chan, Gloria J. Morris

Department of Medicine Faculty Papers

Breast cancer remains the second most common cause of cancer death in the United States. Several studies have identified cohorts of women at higher than average risk to develop this disease. These are women who are exposed to high levels of endogenous or exogenous estrogens, those with a family history of breast cancer, and those who harbor benign breast disease or genetic mutations that predispose to breast cancer. In this population group, adapting a chemoprevention strategy to decrease the risk of developing overt disease is a strong consideration. To this end, tamoxifen is the most accepted agent to date. This …

Higher Self-Reported Physical Activity Is Associated With Lower Systolic Blood Pressure: The Dietary Intervention Study In Childhood (Disc) , Samuel S. Gidding, Bruce A. Barton, Joanne A. Dorgan, Sue Y.S. Kimm, Peter O. Kwiterovich, Normal L. Lasser, Alan M. Robson, Victor J. Stevens, Linda Van Horn, Denise G. Simons-Morton

Department of Pediatrics Faculty Papers

Objective: Children participating in a dietary clinical trial were studied to assess physical activity patterns in boys and girls longitudinally from late childhood through puberty; and to determine the association of level of physical activity on systolic blood pressure (SBP), low density lipoprotein (LDL) cholesterol, and body mass index (BMI).

Patients and Methods: In the Dietary Intervention Study in Childhood (DISC), a randomized clinical trial of a reduced saturated fat and cholesterol diet in 8-10 year olds with elevated LDL, a questionnaire that determined time spent in five intensity levels of physical activity was completed at baseline and …

Preface To The Psychiatric Clinics Of North American, 2006, Karl Doghramji

Department of Psychiatry and Human Behavior Faculty Papers

Introducton to the special issue on the sleep-psychiatry interface.

Combined Effects Of Aldehyde Dehydrogenase Variants And Maternal Mitochondrial Genes On Alcohol Consumption, Yedy Israel, Maria E. Quintanilla, Amalia Sapag, Lutske Tampier

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Two lines of rats bred to differ in their voluntary alcohol consumption — the alcohol-abstaining UChA rats and the alcohol-drinking UChB rats — differ in how effectively toxic acetaldehyde is removed during alcohol metabolism. UChB animals carry efficient variants of the aldehyde dehydrogenase 2 (ALDH2) genes and have active mitochondria, resulting in fast removal of acetaldehyde. UChA animals, in contrast, carry less efficient ALDH2 variants and less active mitochondria, which result in transient elevations of acetaldehyde levels after alcohol ingestion. Cross-breeding studies have demonstrated that the presence of active mitochondria inherited from UChB females can fully abolish the reduction of …

Biomolecular Tuning Of Electronic Transport Properties Of Carbon Nanotubes Via Antibody Functionalization, Kasif Teker, Dr. Eric Wickstrom, Balaji Panchapakesan

Department of Biochemistry and Molecular Biology Faculty Papers

Carbon nanotubes (CNTs) are remarkable solidstate nanomaterials due to their unique electrical and mechanical properties. The electronic properties of nanotubes combined with biological molecules such as proteins could make miniature devices for biological sensing applications. In this paper, the noncovalent interaction of single-wall CNTs with antibodies is presented for its potential applications for detecting overexpressed cell surface receptors in breast cancer cells. The degree of binding of antibodies on CNTs was found to be more than 80% for an extended sampling area by confocal microscopy. The key to achieve such high degree of functionalization is due to the separation of …

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

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

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Donor Tricuspid Annuloplasty During Orthotopic Heart Transplantation: Long-Term Results Of A Prospective Controlled Study, Valluvan Jeevanandum, Hyde Russell, Paul Mather, Satoshi Furukawa, Allen Anderson, Jaishankar Raman

Department of Medicine Faculty Papers

Background: Development of tricuspid regurgitation after orthotopic heart transplantation can cause heart failure along with renal and hepatic impairment and portends a poor prognosis. If tricuspid regurgitation causes significant symptoms, tricuspid valve repair or replacement is often required. This study was designed to study the effects of prophylactic tricuspid valve annuloplasty (TVA) during orthotopic heart transplantation on long-term survival, renal function, and amount of tricuspid regurgitation.

Methods: Between April 1997 and March 1998, 60 patients (aged 18 to 70 years; 22 female) randomly received either standard bicaval orthotopic heart transplantation (group STD; n = 30) or bicaval orthotopic …

Multiple Domains In Siz Sumo Ligases Contribute To Substrate Selectivity., Alison Reindle, Irina Belichenko, Gwendolyn R Bylebyl, Xiaole L Chen, Nishant Gandhi, Erica S Johnson

Department of Biochemistry and Molecular Biology Faculty Papers

Saccharomyces cerevisiae contains two Siz/PIAS SUMO E3 ligases, Siz1 and Siz2/Nfi1, and one other known ligase, Mms21. Although ubiquitin ligases are highly substrate-specific, the degree to which SUMO ligases target distinct sets of substrates is unknown. Here we show that although Siz1 and Siz2 each have unique substrates in vivo, sumoylation of many substrates can be stimulated by either protein. Furthermore, in the absence of both Siz proteins, many of the same substrates are still sumoylated at low levels. Some of this residual sumoylation depends on MMS21. Siz1 targets its unique substrates through at least two distinct domains. Sumoylation of …

International Education Week 2006

Diversity Programs

Lectures during International Education Week, November 2006.

Antimicrobial Effects Of Liquid Anesthetic Isoflurane On Candida Albicans, Viachaslau M. Barodka, Edward Acheampong, Garry Powell, Ludmilla Lobach, David A. Logan, Zahida Parveen, Valerie Armstead, Muhammad Mukhtar

Department of Medicine Faculty Papers

Candida albicans is a dimorphic fungus that can grow in yeast morphology or hyphal form depending on the surrounding environment. This ubiquitous fungus is present in skin and mucus membranes as a potential pathogen that under opportunistic conditions causes a series of systemic and superficial infections known as candidiasis, moniliasis or simply candidiasis. There has been a steady increase in the prevalence of candidiasis that is expressed in more virulent forms of infection. Although candidiasis is commonly manifested as mucocutaneous disease, life-threatening systemic invasion by this fungus can occur in every part of the body. The severity of candidal infections …

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 …

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 …

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 2, Iss. 8, November/December 2006

Public Health Link

Vol. 2, Iss. 8 includes a faculty spotlight on Mona Sarfaty, an article on Richard Wender becoming President of the American Cancer Society and Jefferson presenters at the upcoming American Public Health Association meeting.

Epigenetics And The Estrogen Receptor, Jennifer E. Leader, Chenuang Wang, Vladimir M. Popov, Maofu Fu, Richard G. Pestell

Department of Cancer Biology Faculty Papers

The position effect variegation in Drosophila and Schizosaccharomyces pombe, and higher-order chromatin structure regulation in yeast, is orchestrated by modifier genes of the Su(var) group, (e.g., histone deacetylases ([HDACs]), protein phosphatases) and enhancer E(Var) group (e.g., ATP [adenosine 5'-triphosphate]-dependent nucleosome remodeling proteins). Higher-order chromatin structure is regulated in part by covalent modification of the N-terminal histone tails of chromatin, and histone tails in turn serve as platforms for recruitment of signaling modules that include nonhistone proteins such as heterochromatin protein (HP1) and NuRD. Because the enzymes governing chromatin structure through covalent modifications of histones (acetylation, methylation, phosphorylation, ubiquitination) can also …

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 …

Demonstrating The Value Of The Rn In Ambulatory Care, Beth Ann Swan, Regina Conway-Phillips, Karen F. Griffin

College of Nursing Faculty Papers & Presentations

During 2003, an estimated 906 million visits were made to physician offices in the United States (Hing, Cherry, & Woodwell, 2005).

Overall, 42% of visits to outpatient settings were attended by a registered nurse (Middleton & Hing, 2005).

Despite ambulatory care being the fastest growing site for care, it is the least studied.

The purpose of this article is to provide an overview of the role of the RN in ambulatory care and describe the direct and indirect economic value of RNs in ambulatory care settings.

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: …

Preventive Medicine: A "Cure" For The Healthcare Crisis, Janice L. Clarke, Deborah Meiris

College of Population Health Faculty Papers

Introductory Editorial: Few would dispute the premise that prevention, early detection, and early intervention form the first line of defense on the disease management (DM) continuum. That being the case, our national statistics on preventive health should be raising concerns throughout the industry. The US healthcare delivery system continues to fall woefully short of its prevention targets. On the international scene, the United States lags behind countries with less wealth and less technological savvy. Commentaries abound on the problems, but recently I became aware of an organization with an exciting goal and a novel solution for bringing preventive medicine …