Medicine and Health Sciences Commons^™

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 …

The Use Of Maintenance Electroconvulsive Therapy For Relapsing Depression, Ted A. Matzen, Md, Ronald L. Martin, Md, Tim J. Watt, Md, Douglas K. Reilly, Md

Jefferson Journal of Psychiatry

It is generally accepted that electroconvulsive therapy (ECT) is an effective treatment of major depressive episodes in patients with both unipolar and bipolar affective disorders (1). Yet, repeated relapse of depression occurs in some patients, even with vigorous maintenance therapy on antidepressant drugs (2-4). This often necessitates rehospitalization for ECT. In past decades, several authors suggested that periodic outpatient ECT was efficacious as a maintenance therapy (5-7). Recently, maintenance ECT was recommended by Fink (8), and Maletzky (9), but barely mentioned in two reviews (10,11), and discouraged in another (12) . However, a recent nationwide survey has disclosed that such …

The Effect Of Acute And Chronic Ethanol On Dopamine Turnover In The Caudate Nucleus Of The Rat, Rif S. El-Mallakh, Md

Jefferson Journal of Psychiatry

It is generally believed that acute and chronic ethanol (EtOH) administration alters the activity of catecholamines in the brain, however, the specific effects of EtOH on the dopaminergic system are disputed (I). Acute EtOH administration has been variously reported to decrease (2,3), increase (4,5), and cause no change (6 ,7) in dopamine (DA) synthesis and turnover. Likewise, chronic EtOH treatments have been reported to decrease (2,8) and increase (9, 10) DA synthesis and turnover. Many of these apparently conflicting results are explained by the use of different animal models (rat (2, 3,6,7,10), rabbit (6), and mouse (4,5,9)), different methods of …

Bioethical Issues In The Management Of Gender Dysphoria, George R. Brown, Md

Jefferson Journal of Psychiatry

The term "gender dysphoria" ( I) describes a heterogeneous group of individuals who express varying degrees of dissatisfaction with their anatomic gender (hence "gender dysphoria"), and the desire to possess the secondary sexual characteristics of the opposite sex. Only a minority o f these patients can be considered on the extreme end of a spectrum of subjective dissatisfaction with assigned anatomy and societally sanctioned gender role (i.e., "transsexual"). The number of such patients presenting to psychiatric clinics has greatly increased subsequent to the 1966 publication of Harry Benjamin's seminal work, The Transsexual Phenomenon (2), and extensive media coverage of individual …

Presentation And Differential Diagnosis Of Hyponatremia In A Schizophrenic Adult Male, Michael J. Sedlacek, Md

Jefferson Journal of Psychiatry

The diagnosis o f hyponatremia can prove to be a challenging task since initial symptomatology may mimic psychiatric illness. Accurate diagnosis and subsequent treatment is essential as this disorder can progress to seizures, coma and death if not recognized. Neither the true incidence nor the etiology of hyponatremia in the schizophrenic population has been established, but a definite association has been shown to exist. A recent retrospective study involving over 20,000 hospital admissions found a 5.8% incidence of hyponatremia in the schizophrenic population as compared with a 0.36% incidence for all admissions (1). The following case illustrates the features of …

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 …

Editor's Column, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

An exhibition of paintings of the American Old West caught my attention one afternoon, after I had wandered across the street from our affiliate V.A. outpatient clinic to the Pennsylvania Academy of the Fine Arts. A popular theme among these romanticized views of the American frontier was the image of the trapper; alone, silent figure working at the nation's interface with the unknown. Several paintings depicted a custom known as the rendez-vous, a semi-annual occurrence wherein the trappers gathered eastward to river outposts in order to socialize, trade information and hand-made maps, restock supplies, and display for sale the …

Resident Editorial Board

Jefferson Journal of Psychiatry

List of Resident Editorial Board for Volume 6, Number 1, 1998 of Jefferson Journal of Psychiatry.

The Use Of Targeted Charge-Reversal Nanoparticles (Tcrns) To Investigate Nuclear Delivery Of Fluorescent Agents To Cancer Cells: Implications For Novel Prostate And Breast Cancer Therapy, Mario Dance

Theses and Dissertations

Nanotechnology has recently emerged as a strong contributor toward research efforts to develop targeted systems of drug delivery in cancer therapy. Our work investigates the therapeutic potential of Targeted Charge-Reversal Nanoparticles (TCRNs), a novel nanoparticle with in vitro evidence of nuclear drug delivery. Using M12 prostate cancer cells, MDA-MB-231 breast cancer cells, and modified derivatives of these cell lines, we investigated the ability of Folic Acid-tagged TCRNs to deliver Nile Red and Dimethyl Indole Redfluorescent (DiR) fluorescent dyes to the nucleus of cells using confocal microscopy and in vivo biphontonic imaging using Xenogen® Technology. Confocal imaging with the SCP28 derivative …

A Regularization Corrected Score Method For Nonlinear Regression Models With Covariate Error, David M. Zucker, Malka Gorfine, Yi Li, Donna Spiegelman

Harvard University Biostatistics Working Paper Series

No abstract provided.

Waiting For Symptoms: How Long Can I Hang On?, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

What's New In Orthopaedic Trauma, William M. Ricci, Christopher Mcandrew, David Merriman, Michael J. Gardner

Open Access Publications

No abstract provided.

Atypical Clinical And Diagnostic Features In Ménétrier's Disease In A Child, Michael Chung, Jaime Pittenger, Deborah Flomenhoft, Jeffrey Bennett, Eun Young Lee, Harohalli Shashidhar

Internal Medicine Faculty Publications

Ménétrier's disease is one of the rarest protein-losing gastropathies in childhood. It is characterized clinically by non-specific gastrointestinal symptoms and edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. In adults, this disease can be devastating with significant morbidity and mortality. In childhood, it is a self-limiting, transient and benign illness. Its treatment is largely supportive with total parenteral nutrition (TPN) while oral intake is encouraged. Acute onset of vomiting in healthy school age children can be initially explained by acute viral gastroenteritis. However, persistent vomiting associated with hematemesis and severe abdominal pain should warrant further work-up. This case …

Genome Of Mycoplasma Haemofelis, Unraveling Its Strategies For Survival And Persistence, Andrea P. Santos, Ana Ms Guimaraes, Naila C. Do Nascimento, Phillip J. Sanmiguel, Samuel W. Martin, Joanne Messick

Department of Comparative Pathobiology Faculty Publications

Mycoplasma haemofelis is a mycoplasmal pathogen (hemoplasma) that attaches to the host’s erythrocytes. Distributed worldwide, it has a significant impact on the health of cats causing acute disease and, despite treatment, establishing chronic infection. It might also have a role as a zoonotic agent, especially in immunocompromised patients. Whole genome sequencing and analyses of M. haemofelis strain Ohio2 was undertaken as a step toward understanding its survival and persistence. Metabolic pathways are reduced, relying on the host to supply many of the nutrients and metabolites needed for survival. M. haemofelis must import glucose for ATP generation and ribose derivates for …

Glutamatergic Plasticity In Medial Prefrontal Cortex And Ventral Tegmental Area Following Extended-Access Cocaine Self-Administration, Behnam Ghasemzadeh, Preethi Vasudevan, Chad Giles, Anthony Purgianto, Chad Seubert, John R. Mantsch

Biomedical Sciences Faculty Research and Publications

Glutamate signaling in prefrontal cortex and ventral tegmental area plays an important role in the molecular and behavioral plasticity associated with addiction to drugs of abuse. The current study investigated the expression and postsynaptic density redistribution of glutamate receptors and synaptic scaffolding proteins in dorsomedial and ventromedial prefrontal cortex and ventral tegmental area after cocaine self-administration. After 14 days of extended-access (6 h/day) cocaine self-administration, rats were exposed to one of three withdrawal regimen for 10 days. Animals either stayed in home cages (Home), returned to self-administration boxes with the levers withdrawn (Box), or underwent extinction training (Extinction). Extinction training …

Mycoplasma Pneumoniae Periprosthetic Joint Infection Identified By 16s Ribosomal Rna Gene Amplification And Sequencing: A Case Report, Zhuolin Han, Carey-Ann D. Burnham, John Clohisy, Hilary Babcock

Open Access Publications

No abstract provided.

Estimation Of Risk Ratios In Cohort Studies With Common Outcomes: A Simple And Efficient Two-Stage Approach, Eric J. Tchetgen

Harvard University Biostatistics Working Paper Series

No abstract provided.

Reducing Psychosocial And Behavioral Pregnancy Risk Factors: Results Of A Randomized Clinical Trial Among High-Risk Pregnant African American Women, Jill G. Joseph, Ayman El-Mohandes, Michele Kiely, M. Nabil El-Khorazaty, Marie G. Gantz, Allan A. Johnson, Kathy S. Katz, Susan M. Blake, Maryann W. Rossi, Siva Subramanian

Publications and Research

Objectives. We evaluated the efficacy of a primary care intervention targeting pregnant African American women and focusing on psychosocial and behavioral risk factors for poor reproductive outcomes (cigarette smoking, secondhand smoke exposure, depression, and intimate partner violence).

Methods. Pregnant African American women (N=1044) were randomized to an intervention or usual care group. Clinic-based, individually tailored counseling sessions were adapted from evidence-based interventions. Follow-up data were obtained for 850 women. Multiple imputation methodology was used to estimate missing data. Outcome measures were number of risks at baseline, first follow-up, and second follow-up and within-person changes in risk from baseline to the …

Rna Oxidation Adducts 8-Ohg And 8-Oha Change With Aβ42 Levels In Late-Stage Alzheimer's Disease, Adam M. Weidner, Melissa A. Bradley, Tina L. Beckett, Dana M. Niedowicz, Amy L.S. Dowling, Sergey V. Matveev, Harry Levine, Mark A. Lovell, M. Paul Murphy

Sanders-Brown Center on Aging Faculty Publications

While research supports amyloid-β (Aβ) as the etiologic agent of Alzheimer's disease (AD), the mechanism of action remains unclear. Evidence indicates that adducts of RNA caused by oxidation also represent an early phenomenon in AD. It is currently unknown what type of influence these two observations have on each other, if any. We quantified five RNA adducts by gas chromatography/mass spectroscopy across five brain regions from AD cases and age-matched controls. We then used a reductive directed analysis to compare the RNA adducts to common indices of AD neuropathology and various pools of Aβ. Using data from four disease-affected brain …

Highly Variable Recessive Lthal Or Nearly Lethal Mutation Rates During Germ-Line Development Of Male Drosophila Melanogaster, Jian-Jun Gao, Xue-Rong Pan, Jing Hu, Li Ma, Jian-Min Wu, Ye-Lin Shao, Sara A Barton, Ronny C Woodruff, Ya-Ping Zhang, Yun-Xin Fu

Faculty, Staff and Student Publications

Each cell of higher organism adults is derived from a fertilized egg through a series of divisions, during which mutations can occur. Both the rate and timing of mutations can have profound impacts on both the individual and the population, because mutations that occur at early cell divisions will affect more tissues and are more likely to be transferred to the next generation. Using large-scale multigeneration screening experiments for recessive lethal or nearly lethal mutations of Drosophila melanogaster and recently developed statistical analysis, we show for male D. melanogaster that (i) mutation rates (for recessive lethal or nearly lethal) are …

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

In Response: Should Psychotherapy Be Taught To Psychiatric Residents?, Robert Michels, Md

Jefferson Journal of Psychiatry

The debate discussing whether psychotherapy should be taught to psychiatric residents (1) reflects the change, growth, and maturation of the profession. A theme that virtually defined psychiatric practice only a few decades ago is viewed by some as ready for discard while others still see it as essential. Of course, this isn't the first time. Eighty years ago some argued that the intellectual excitement and therapeutic promise of psychoanalysis was more than ample reason to discard the sterile and clinically nihilistic concern with constitutional neuropathic diatheses that marked 19th century psychiatry. Fortunately, wiser heads prevailed.

Book Review: The Soft Voice Of Reason, Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

FREUD AS AN EXPERT WITNESS

K. R. Eissler

Madison, Connecticut, International Universities Press 1986, 449 pages.

Book Review: Towards A Practical Guide To The Therapy Of The Borderline Patient, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

EFFECTIVE PSYCHOTHERAPY WITH BORDERLINE PATIENTS:CASE STUDIES

Robert J. Waldinger, M.D .John G. Gunderson, M.D.

New York, Macmillan 1987, 232 pages

Book Review: Adapting Psychotherapy For An Underserved Population, Lorna Clark-Rubin, Md

Jefferson Journal of Psychiatry

PSYCHOTHERAPY IN THE COMMUNITY:A PSYCHOANALYTICALLY BASED GUIDE TO THE TREATMENT OF THE ADULT

Eric Lager, M.D., Israel Zwerling, M.D.with Joseph Slap, M.D., Samuel Bullock, M.D. Warren Smith, M.D.Warren H. Green, Inc., St. Louis

1983. pp. 190.

The Witness, Paul D. Zislis, Md

Jefferson Journal of Psychiatry

I want to tell you a story. Why? I don't know. Perhaps so that you will understand. Perhaps so that I will understand. It is a story of the present. It is a story that allows a little comprehension of the past. And it is a story that reveals glimpses of the future.

First this preface:

For years I have been drawn as if by a magnet to the subject of the Holocaust. I have read much about it, spoken to some who survived it, seen films on it, visited museums concerned with it. I have seen the faces …

Developmental Stages Of Learning Psychotherapy, Duncan B. Clark, Phd, Md

Jefferson Journal of Psychiatry

The contradictory philosophies of the major schools of psychotherapy present a dizzying array of alternative approaches for the psychiatry resident. The academic efforts that have been made to synthesize differing approaches to psychotherapy have not met with widespread acceptance. Part of the reason why such a synthesis has been slow in coming may be found in the stages of development the practitioner goes through in learning psychotherapy. The concepts of developmental psychology discussed by Chandler (7) in describing the adolescent's confrontation with relativism and "epistemological loneliness" can help us understand some of the cognitive problems faced by the psychiatry resident. …

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 …