Medicine and Health Sciences Commons^™

Canoe Trip, David Mitchell, Md

Jefferson Journal of Psychiatry

"Perfect," he said as he carved his knife into the surgical wound, exposing another layer of fascia. We were standing in the operating theatre: he, the surgical chief resident, and I, a third-year medical student. It was the first of many appendectomies I would scrub in for during my surgical rotation. The patient was a I2-year-old boy who had come to the Grand Valley Hospital emergency room that day. He had a low-grade fever, sweats, and periumbilical pain that had migrated to the right lower quadrant of his abdomen. After quizzing me on various anatomical structures, removing the inflamed appendix, …

Folie Á Deux, Ulhas Mayekar, Md

Jefferson Journal of Psychiatry

Folie a deux, also called dual psychosis, involves the transfer of delusional ideas from a psychotic individual to a nonpsychotic individual within the framework of a close relationship, with the eventual in corporation of the delusional system into the psyche of the previously non psychotic individual.

Diagnosis In The Neuroleptic Malignant Syndrome, James H. Dallman, Md, Cpt, Mc

Jefferson Journal of Psychiatry

Neuroleptic malignant syndrome (NMS) is an uncommon, potentially lethal complication of treatment with antipsychotic medication. First described in American journals by Delay and Deniker in 1968 (1), this syndrome has been reported for many years in the European and Japanese literature.

Decision Trees For Use In Childhood Mental Disorders, Henry A. Doenlen, Md

Jefferson Journal of Psychiatry

The third edition of The Diagnostic and Statistical Manual ofMental Disorders (DSM-III) (1) provides specific diagnostic categories for use in childhood mental disorders, even though these diagnoses are not limited to children. In addition, many of the diagnostic categories used for adults are considered appropriate for use in children. DSM-I II instructs the clinician to diagnose children by first considering the section "Disorders First Evident in Infancy, Childhood, or Adolescence" before considering the disorders described elsewhere. However, this may lead to problems because some major diagnostic categories such as affective disorders and schizophrenia are not included …

The Neuropsychiatric Syndrome Of A Psychomotor Seizure Disorder In Shakespeare's Othello, The Moor Of Venice, Alan J. Cohen, Md

Jefferson Journal of Psychiatry

Many of Shakespeare's characters suffer from the myriad of medical and surgical ailments that afflict mankind. Although many of these diseases serve merely to enhance the subtle shading of character in Shakespearean drama, certain disorders seem to provide a vital focus for the basic theme and plot development of the plays. No group of disorders is more implicated by the behavior and thought patterns of Shakespeare's characters than neuropsychiatric disease. Othello, the Moor of Venice stands out as a striking example of a tragedy

in which the main character suffers grievous consequences from a disease that affects …

Carbamazepine In Treatment Of The Violent Psychotic Patient, Lauren A. Pate, Md

Jefferson Journal of Psychiatry

Violence in the psychiatric setting may be perpetrated by patients with a variety of diagnoses including character disorders, episodic dyscontrol syndromes, and drug or alcohol intoxication. The violent behavior of aggressive psychotic patients is typically the most bizarre, unpredictable, and the least responsive to intervention with neuroleptics or lithium carbonate. Carbamazepine, an established anticonvulsant, has achieved growing prominence as an adjunctive measure in treatment of the violent psychotic. This paper will review the literature and summarize the posited pharmacological mechanisms, reported side effects, and clinical experience with carbamazepine in controlling the symptoms of violence and aggression in psychosis.

The Stress Factor: Exploring The Possibility Of A Psychological Component To Cancer, Bernard M. Edelstein, Md

Jefferson Journal of Psychiatry

As dwellers in the same house, it seems only logical that psyche and soma would be interdependent , that well-being in one would promote health in the other, and that illness in one would soon become manifest in its partner. Yet quantifying this intuitive relationship has long been a difficult task. Establishing a mechanism for disease-heart disease, infectious disease, neoplastic disease which can withstand the scrutiny of experimental rigor, is difficult enough. To introduce a seemingly not quantifiable entity such as psychology in the form of stress or anxiety presents such great complexity that for a long time it seemed …

Using Psychoanalytically Oriented Psychotherapy With The Elderly, Mark D. Miller, Md

Jefferson Journal of Psychiatry

Psychotherapy with the elderly, like geriatric medicine, has become a subject of renewed interest. This paper will review some pertinent aspects of the subject and hopefully dispel some myths. A case will be presented where psychoanalytically oriented psychotherapy was employed. In this case, forced termination was necessary after one year due to the therapist graduating from residency.

Psychoanalysis: Science Or Fiction?, Emanuel E. Garcia

Jefferson Journal of Psychiatry

The completion of this paper comes coincidentally at a time when a book by a scholarly philosopher, Adolf Grunbaum, entitled The Foundations of Psychoanalysis:A Philosophical Critique, has just been published and purports to answer the question of the scientific status of analysis. This temporally follows Jeffrey Masson's work (1) which accuses Freud of abandoning the so-called seduction hypothesis and by so doing laying unsound groundwork for the "science" that consumes Freud's nearly limitless energies . In short, it is a period in which psychoanalysis finds itself condemned, but perhaps in a …

Faculty Advisor's Column, Harvey J. Schwartz, Md

Jefferson Journal of Psychiatry

It is with great pleasure that with this issue of The Jefferson Journal of Psychiatry-A Resident Publication we are expanding into a national journal for psychiatric residents. As part of that effort, we welcome the American Psychiatric Association Committee of Residents as our national editorial board. Our circulation will include all psychiatry residents, residency directors, and department chairmen nationwide . We look forward to continuing our three year tradition of presenting scholarly, thought provoking and creative ideas from psychiatric residents around the country. Our commitment to the two pillars of clinical and …

Editor's Column, Jeffrey R. Sarnoff, Md

Jefferson Journal of Psychiatry

The Jefferson Journal of Psychiatry (JJP) seeks to enhance the scope and quality of post-graduate training in psychiatry, by providing a forum in which residents can publish a wide variety of scientific communications.

Editorial Staff

Jefferson Journal of Psychiatry

List of Editorial Staff for Volume 4, Number 1, Winter 1986 issue of the Jefferson Journal of Psychiatry.

Community Health Centers And The Economy: Assessing Centers' Role In Immediate Job Creation Efforts, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federal investment in community health centers not only creates health care access but, based on previous studies, generates an estimated 8:1 return for medically underserved communities while creating thousands of jobs. Since our earlier 2008 economic impact study, Congress has made two major program investments: $2 billion under the American Reinvestment and Recovery Act (ARRA) of 2009; and $11 billion under the Affordable Care Act (ACA). This analysis measures the economic and jobs-creation benefits of this cumulative investment in health centers, as well as the impact of legislation enacted in April, 2011, which reduced the first year of new …

Aligning Graduate Medical Education With Public Policy, Rob Cunningham

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

Reduction Of Anxiety In College Students With Asperger's Disorder Using Behavioral Relaxation Training, Jaclyn Bechtler

Theses and Dissertations

The purpose of this study was to reduce levels of anxiety in college students with Asperger's Disorder. Two students from Rowan University were taught Behavioral Relaxation Training over a period of four weeks. Measurements of anxiety and relaxation were gathered during biweekly sessions and those results were graphed. Results showed that a) behavioral relaxation training was quickly learned by participants and b) anxiety levels decreased on some measures with the use of behavioral relaxation. Issues facing those with Asperger's Disorder were discussed as well as the wide variety of populations that have demonstrated positive change with behavioral relaxation training.

Sequential Alterations In Catabolic And Anabolic Gene Expression Parallel Pathological Changes During Progression Of Monoiodoacetate-Induced Arthritis, Jin Nam, Priyangi Perera, Jie Liu, Bjoern Rath, James Deschner, Robert Gassner, Timothy A. Butterfield, Sudha Agarwal

Physical Therapy Faculty Publications

Chronic inflammation is one of the major causes of cartilage destruction in osteoarthritis. Here, we systematically analyzed the changes in gene expression associated with the progression of cartilage destruction in monoiodoacetate-induced arthritis (MIA) of the rat knee. Sprague Dawley female rats were given intra-articular injection of monoiodoacetate in the knee. The progression of MIA was monitored macroscopically, microscopically and by micro-computed tomography. Grade 1 damage was observed by day 5 post-monoiodoacetate injection, progressively increasing to Grade 2 by day 9, and to Grade 3-3.5 by day 21. Affymetrix GeneChip was utilized to analyze the transcriptome-wide changes in gene expression, and …

Early Maladaptive Schemas And Negative Life Events In The Prediction Of Depression And Anxiety, Lindsay Anmuth

Theses and Dissertations

This study tested the relationships between Young's (1990, 2003) model of Early Maladaptive Schemas (EMSs), negative life events occurring over the past 4 months, depressive symptoms, and anxious symptoms. We also replicated a design testing the ability of EMSs, negative life events, and their interaction to predict depressive and anxious symptoms and extended the design to include specific categories of negative life events (interpersonal and achievement). Results of this study showed that EMSs are predictive of depressive and anxious symptoms, but that negative life events account for a greater prediction. The EMS model was just as highly associated with and …

Beta-Lysine Discrimination By Lysyl-Trna Synthetase, Marla S. Gilreath, Hervé Roy, Tammy J. Bullwinkle, Assaf Katz, Michael Ibba, William Wiley Navarre

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Elongation factor P is modified with (R)‐β‐lysine by the lysyl‐tRNA synthetase (LysRS) paralog PoxA. PoxA specificity is orthogonal to LysRS, despite their high similarity. To investigate α‐ and β‐lysine recognition by LysRS and PoxA, amino acid replacements were made in the LysRS active site guided by the PoxA structure. A233S LysRS behaved as wild type with α‐lysine, while the G469A and A233S/G469A variants decreased stable α‐lysyl‐adenylate formation. A233S LysRS recognized β‐lysine better than wildtype, suggesting a role for this residue in discriminating α‐ and β‐amino acids. Both enantiomers of β‐lysine were substrates for tRNA aminoacylation by LysRS, which, together with …

Pipkiγ Regulates Focal Adhesion Dynamics And Colon Cancer Cell Invasion, Zhaofei Wu, Xiang Li, Manjula Sunkara, Heather Spearman, Andrew J. Morris, Cai Huang

Markey Cancer Center Faculty Publications

Focal adhesion assembly and disassembly are essential for cell migration and cancer invasion, but the detailed molecular mechanisms regulating these processes remain to be elucidated. Phosphatidylinositol phosphate kinase type Iγ (PIPKIγ) binds talin and is required for focal adhesion formation in EGF-stimulated cells, but its role in regulating focal adhesion dynamics and cancer invasion is poorly understood. We show here that overexpression of PIPKIγ promoted focal adhesion formation, whereas cells expressing either PIPKIγ^K188,200R or PIPKIγ^D316K, two kinase-dead mutants, had much fewer focal adhesions than those expressing WT PIPKIγ in CHO-K1 cells and HCT116 colon cancer cells. Furthermore, …

Medical School Watercooler Newsletter - September 11, 2011, Lindsey Lyle

Watercooler Newsletter

This is the September 11, 2011 edition of the Frederick P. Whiddon College of Medicine's newsletter, Watercooler

Contents Include

• Press-Register Ad To Feature 'Top Docs'
• Dr. Dean Parmelee to Present Two Workshops

• Mark Your Calendars - Gulf Coast Liver Support Group Meeting

• Basic Medical Sciences Graduate Program Student Receives Edwin R. Hughes Award

• Interventional Neurologist to Discuss New Treatments for Stroke

• Free Community Lecture on Weight Loss

Gm-Csf Production Allows The Identification Of Immunoprevalent Antigens Recognized By Human Cd4+ T Cells Following Smallpox Vaccination, Valeria A. Judkowski, Alcinette Bunying, Feng Ge, Jon R. Appel, Kingyee Law, Atima Sharma, Claudia Raja-Gabaglia, Patricia Norori, Radleigh Santos, Marc Giulianotti, Mark K. Slifka, Daniel C. Douek, Barney S. Graham, Clemencia Pinilla

Mathematics Faculty Articles

The threat of bioterrorism with smallpox and the broad use of vaccinia vectors for other vaccines have led to the resurgence in the study of vaccinia immunological memory. The importance of the role of CD4+ T cells in the control of vaccinia infection is well known. However, more CD8+ than CD4+ T cell epitopes recognized by human subjects immunized with vaccinia virus have been reported. This could be, in part, due to the fact that most of the studies that have identified human CD4+ specific protein-derived fragments or peptides have used IFN-γ production to evaluate vaccinia specific T cell responses. …

A Night Team Curriculum For The Inpatient Service, Priti Bhansali, Christine Skurkis, Karin Gray, Aisha Davis, Edwin Zalneraitis

E-Learning Modules

Due to ACGME work duty hour requirements, many residency programs have initiated a Night Team (NT) rotation. There may be limited direct contact with faculty overnight. The provision of an educational experience and ability to evaluate performance on the NT rotation are needed. This curriculum, originally developed at the University of Connecticut Pediatric Residency Program, may be adapted for other programs.

Goals for the rotation were developed with resident input and include:

1. Improving clinical reasoning and communication skills.
2. Increasing faculty feedback.
3. Providing appropriate patient surveillance.
4. Enhancing the teaching role of the senior resident.

Educational activities include:

1. Periodic structured audit of …

Activation Of Matrix Metalloproteinases Following Anti-Aβ Immunotherapy; Implications For Microhemorrhage Occurrence, Donna M. Wilcock, Dave Morgan, Marcia N. Gordon, Tiffany L. Taylor, Lisa A. Ridnour, David A. Wink, Carol A. Colton

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Anti-Aβ immunotherapy is a promising approach to the prevention and treatment of Alzheimer's disease (AD) currently in clinical trials. There is extensive evidence, both in mice and humans that a significant adverse event is the occurrence of microhemorrhages. Also, vasogenic edema was reported in phase 2 of a passive immunization clinical trial. In order to overcome these vascular adverse effects it is critical that we understand the mechanism(s) by which they occur.

METHODS: We have examined the matrix metalloproteinase (MMP) protein degradation system in two previously published anti-Aβ immunotherapy studies. The first was a passive immunization study in which …

Supplier-Induced Demand For Psychiatric Admissions In Northern New England, Bradley V. Watts, Brian Shiner, Gunnar Klauss, William B. Weeks

Dartmouth Scholarship

The development of hospital service areas (HSAs) using small area analysis has been useful in examining variation in medical and surgical care; however, the techniques of small area analysis are underdeveloped in understanding psychiatric admission rates. We sought to develop these techniques in order to understand the relationship between psychiatric bed supply and admission rates in Northern New England. Our primary hypotheses were that there would be substantial variation in psychiatric admission across geographic settings and that bed availability would be positively correlated with admission rates, reflecting a supplier-induced demand phenomenon. Our secondary hypothesis was that the construction of psychiatric …

Coordinated Regulation By Agra, Sara, And Sarr To Control Agr Expression In Staphylococcus Aureus, Dindo Reyes, Diego O. Andrey, Antoinette Monod, William L. Kelley, Gongyi Zhang, Ambrose L. Cheung

Dartmouth Scholarship

The agr locus of Staphylococcus aureus is composed of two divergent transcripts (RNAII and RNAIII) driven by the P2 and P3 promoters. The P2-P3 intergenic region comprises the SarA/SarR binding sites and the four AgrA boxes to which AgrA binds. We reported here the role of AgrA, SarA, and SarR on agr P2 and P3 transcription. Using real-time reverse transcription (RT)-PCR and promoter fusion studies with selected single, double, triple, and complemented mutants, we showed that AgrA is indispensable to agr P2 and P3 transcription, whereas SarA activates and SarR represses P2 transcription. In vitro runoff transcription assays revealed that …

Dha Supplemented In Peptamen Diet Offers No Advantage In Pathways To Amyloidosis: Is It Time To Evaluate Composite Lipid Diet?, Zareen Amtul, Mary Keet, Peter Merrifield, David Westaway, Richard F. Rozmahel

Anatomy and Cell Biology Publications

Numerous reports have documented the beneficial effects of dietary docosahexaenoic acid (DHA) on beta-amyloid production and Alzheimer's disease (AD). However, none of these studies have examined and compared DHA, in combination with other dietary nutrients, for its effects on plaque pathogenesis. Potential interactions of DHA with other dietary nutrients and fatty acids are conventionally ignored. Here we investigated DHA with two dietary regimes; peptamen (pep+DHA) and low fat diet (low fat+DHA). Peptamen base liquid diet is a standard sole-source nutrition for patients with gastrointestinal dysfunction. Here we demonstrate that a robust AD transgenic mouse model shows an increased tendency to …

Senior Transportation Abstracts: A Focus On Options, Helen Kerschner, Nina M. Silverstein

Gerontology Institute Publications

This collection of abstracts represents a publication of importance for understanding the needs, challenges, solutions, and/or every day issues related to senior transportation services. While several of the abstracts include information about senior driver safety, the collection’s primary purpose is to present a holistic approach to transportation options for older adults. Such a collection is timely because, although the practice of providing transportation to older adults is not new, research and preparation of practical informational and technical materials related to older adult transportation service needs and service delivery are quite recent.

On The Nondifferential Misclassification Of A Binary Confounder, Elizabeth L. Ogburn, Tyler J. Vanderweele

COBRA Preprint Series

Abstract Consider a study with binary exposure, outcome, and confounder, where the confounder is nondifferentially misclassified. Epidemiologists have long accepted the unproven but oft-cited result that, if the confounder is binary, odds ratios, risk ratios, and risk differences which control for the mismeasured confounder will lie between the crude and the true measures. In this paper the authors provide an analytic proof of the result in the absence of a qualitative interaction between treatment and confounder, and demonstrate via counterexample that the result need not hold when there is a qualitative interaction between treatment and confounder. They also present an …

Isolated Adult Hypoganglionosis Presenting As Sigmoid Volvulus: A Case Report., Irfan Qadir, Muhammad Musa Salick, Abrar Barakzai, Hasnain Zafar

Department of Surgery Docs

Introduction:Isolated hypoganglionosis is a rare cause of intestinal innervation defects. It is characterized by sparse and small myenteric ganglia, absent or low acetylcholinesterase activity in the lamina propria and hypertrophy of the muscularis mucosae, principally in the region of the colon and rectum. It accounts for 5% of all intestinal neuronal malformations. To the best of our knowledge, only 92 cases of isolated hypoganglionosis were reported from 1978 to 2009. Isolated hypoganglionosis usually manifests as enterocolitis or poor bowel function, and is diagnosed in infancy or childhood. We report the first case of isolated hypoganglionosis presenting with sigmoid volvulus …

Towards A New Paradigm Of Non-Captive Research On Cetacean Cognition, Lori Marino, Toni Frohoff

Experimentation Collection

Contemporary knowledge of impressive neurophysiology and behavior in cetaceans, combined with increasing opportunities for studying free-ranging cetaceans who initiate sociable interaction with humans, are converging to highlight serious ethical considerations and emerging opportunities for a new era of progressive and less-invasive cetacean research. Most research on cetacean cognition has taken place in controlled captive settings, e.g., research labs, marine parks. While these environments afford a certain amount of experimental rigor and logistical control they are fraught with limitations in external validity, impose tremendous stress on the part of the captive animals, and place burdens on populations from which they are …