Medicine and Health Sciences Commons^™

The Serotonin Theory Of Depression, Christopher W. Kerr

Jefferson Journal of Psychiatry

In its simplest form, the serotonin deficiency theory of depression postulates that there is a net reduction in serotonin transmission in depressive illness. The pathophysiological change may result from two different mechanisms. The first involves a decrease in serotonin (5-HT) availability which has the consequential effect of compensatory receptor up-regulation or super sensitivity. The second mechanism implies a primary defect in receptor activity and/or signal transduction. The objective of this review is to analyze the serotonin system in depression as it relates to the above two postulates.

Jefferson Journal Award

Jefferson Journal of Psychiatry

The Jefferson Journal Award has been established to honor the best paper submitted during each calendar year to the Jefferson Journal of Psychiatry: A Resident Publication. An award of one thousand dollars is given to the chosen author, with an additional one thousand dollars to be given to the residency program or fellowship in which the author is enrolled. The winning submission is selected by the Journal's editorial board from manuscripts submitted on any subject related to psychiatric practice or research.

The editorial board of the Journal is proud to announce the recipient of the 1993 Jefferson Journal Award: Scott …

Editor's Column, Mary E. Donovan, Md

Jefferson Journal of Psychiatry

With this edition of the Jefferson Journal of Psychiatry I am pleased to welcome Edward Silberman, M.D. as our new Faculty Advisor. Dr. Silberman is the Residency Program Director at Thomas Jefferson University, and he brings a great deal of enthusiasm about resident research, writing and publishing to the Journal. In addition to enthusiasm, he brings his own experience with writing for psychiatric publication with which to advise us, and we welcome his guidance as the Journal begins its twelfth year of publication.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Staff for Volume 12, Number 1, 1994 for Jefferson Journal of Psychiatry.

The Testing Of A Tennis-Specific Fitness Program, Kara Johnson

Honors Capstones

Capstone submitted as a graduation requirement for BSU Honors Program.

Histone Deacetylase Inhibitor Valproic Acid Suppresses The Growth And Increases The Androgen Responsiveness Of Prostate Cancer Cells., Yu-Wei Chou, Nagendra K. Chaturvedi, Shougiang Ouyang, Fen-Fen Lin, Dharam Kaushik, Jue Wang, Isaac Kim, Ming-Fong Lin

Journal Articles: Biochemistry & Molecular Biology

We identified the molecular target by histone deacetylase (HDAC) inhibitors for exploring their potential prostate cancer (PCa) therapy. Upon HDAC inhibitors-treatment, LNCaP cell growth was suppressed, correlating with increased cellular prostatic acid phosphatase (cPAcP) expression, an authentic protein tyrosine phosphatase. In those cells, ErbB-2 was dephosphorylated, histone H3/H4 acetylation and methylation increased and cyclin proteins decreased. In PAcP shRNA-transfected C-81 cells, valproic acid (VPA) efficacy of growth suppression was diminished. Further, VPA pre-treatment enhanced androgen responsiveness of C-81, C4-2 and MDA PCa2b-AI cells. Thus, cPAcP expression is involved in growth suppression by HDAC inhibitors in PCa cells, and VPA pre-treatments …

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Development Of A Novel Approach To Assess Qualitative And Quantitative Dynamics Associated With The Subcutaneous Or Intramuscular Administration Of Pharmaceuticals And Associated Parenteral Delivery Systems, Eric Edwards

Theses and Dissertations

There has been a significant increase in the number of injectable pharmaceutical products over the last decade that have been incorporated into unique delivery systems such as pen injectors, auto-injectors, or pre-filled syringes. The advancement of these delivery systems and the paradigm shift towards administration of injectables in the out-of-hospital or home setting have introduced variables that can affect the bioavailability of injectable drugs and potential pharmacologic outcomes. An approach that allows for the qualitative and quantitative dispersion assessment of an injectable at the moment of tissue deposition coupled with an assessment of systemic exposure parameters could provide substantial information …

Attempting To Close The Food Gap: An Evaluation Of The 2011 Fair Share Program In Gettysburg, Pa, Lisa M. Martin

Student Publications

Background: Families in Adams County with an income between 160% and 250% of the Federal Poverty Income Guidelines and ineligible for federal food assistance programs were determined to be in the “food gap.” In collaboration with Adams County Farm Fresh Markets and the Center for Public Service at Gettysburg College, the Adams County Food Policy Council developed the Fair Share Program to provide monthly food vouchers and educational sessions to a group of families in the food gap to use at farmers markets in Gettysburg, PA. The goals of the program were to provide families not eligible for federal food …

The Determinants Of A Nurse's Discretionary Decision To Respond To Situations That Place Patients At Risk For Safety Events But Requires A Response That Is Beyond The Scope Of Nursing Practice, Kathy Baker

Theses and Dissertations

A nurse’s contribution to patient safety in regards to early detection of issues in the clinical setting is undisputed (Redman, 2008). If these patient situations require a response that is beyond the scope of nursing practice, in most instances nurses are not sanctioned to intervene without physician consultation (Gaba, 2000). The evidence in the nursing literature does suggest that some nurses exercise professional discretion and are, at times, making the decision to initiate interventions independently (Benner, Hooper-Kyriakidis, & Stannard, 1999; Hutchinson, 1990; Tiffany, Cruise, & Cruise, 1988). The focus of this inquiry was to examine the determinants of a nurse’s …

Psychodynamic Contours Of Post-Traumatic Stress Disorder, Noah D. Freedman, Md

Jefferson Journal of Psychiatry

PSYCHOTHERAPY OF THE COMBAT VETERAN

Harvey J. Schwartz, M.D., Ed.New York, Spectrum Publications, 1984

Distributed by: Integrated Publishers, 195 McGregor St., Manchester , NH 03102, 603-669-5933

Psychodynamics: The State Of The Art, Robert Hall, M.D.

Jefferson Journal of Psychiatry

PSYCHODYNAMIC CONCEPTS IN GENERAL PSYCHIATRY

Harvey J. Schwartz, MD with Efrain Bleiberg, MD and Sidney Weissman, MD editors

American Psychiatric Press, Inc., in press.

Walking In One's Own Shoes, Robert Neil Gerstman, D.O.

Jefferson Journal of Psychiatry

ILLNESS IN THE ANALYST:IMPLICATIONS FOR THE TREATMENT RELATIONSHIP

Harvey J . Schwartz, M.D. and Ann-Louise S. Silver, M.D.,

Editors International Universities Press, New York 1990, 347 pp., $42.50

The Psychoanalytic Approach To Bulimia, Doris Mirowski, M.D.

Jefferson Journal of Psychiatry

BULIMIA: PSYCHOANALYTIC TREATMENT AND THEORY

Harvey J. Schwartz, M.D., Ed.

International Universities Press, Inc., Madison, CT.

1990 (second edition), 549 pages, $65.00.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

What Place Does The Real-Relationship Have In The Process Of Therapeutic Character Change?, Patrice Duquette, Md

Jefferson Journal of Psychiatry

The relationship between therapist and patient is an important tool in the process of helping a patient change. There are various elements that make up the total relationship between patient and therapist, each with its own power to exert for and against change. Transference can be one of the most relentless of these elements in maintaining the status quo for ourpatients. To help our patients make significant gains against this relentless pressure is most of our task in psychotherapy. The real-relationship has been considered in the literature since the early 1940's and is described by Greenson as "the realistic and …

Climbing Through The Milwaukee County Civil Commitment Process, Jon A. Lehrmann, Md

Jefferson Journal of Psychiatry

Civil commitment has become a practically unavoidable process for today's practicing psychiatrist. It creates a complicated triangular relationship involving the legal system, the medical system, and the patient.

This article is a first person narrative of a case which helps describe the Wisconsin civil commitment process as it operates in Milwaukee County. It illustrates the frustrations that a psychiatrist (and in this case a first year psychiatry resident) can experience in such a system. Finally, it addresses these problems associated with civil commitment and discusses possible solutions.

Involuntary Psychiatric Hospitalization And Risk Management: The Ethical Considerations, Richard C. Christensen, Md, Ma

Jefferson Journal of Psychiatry

During an era where physicians go to great lengths to limit personal risk and ensure self-protection from lawsuits, psychiatrists may be inclined to err on the side of involuntarily hospitalizing patients who have been briefly evaluated in the emergency room or clinic setting. However, conscientious treatment decisions, particularly those pertaining to involuntary psychiatric hospitalization, need to address at least two fundamental ethical concerns: the patient's best interests and the clinician's motives. This article discusses the moral components involved in clinical decision making and presents a case example which highlights the ethical implications of involuntary psychiatric hospitalizations.

Carbamazepine-Associated Hyponatremia, Mitchell S. Gandelman, Md, Phd, Sandra Dabora, Md, Phd, Rebecca L. Johnson, Md, Michelle B. Riba, Md

Jefferson Journal of Psychiatry

Four cases of CBZ-induced or exacerbated hyponatremia are described in middle-aged to elderly females. Two cases are remarkable in that the pretreatment sodium levels demonstrate hyponatremia. A return to prior sodium levels was observed upon the discontinuation of carbamazepine therapy. No definitive conclusions can be drawn from these case reports; however, similarities in the cases can be examined as follows: (1) all four women have medical problems, in particular two patients had pre-existing hyponatremia; (2) all four patients were using concurrent medications; (3) all four women presented psychotic. A literature review examines risk factors, pharmacological mechanism, and the time course …

Polymyalgia Rheumatica Presenting As Depression: The Role Of The History And Physical Examination In Psychiatric Assessment, J.H. Ennis, Msw, Md, J.K. Leclair, Md, Frcp (C), L. Wadas, Bsw, Csw, C. Patterson, Md, Frcp (C)

Jefferson Journal of Psychiatry

Surveys have indicated that physical examination is a diagnostic tool that is infrequently used by psychiatrists. This is an unfortunate state of affairs in light of the act that the bio-psycho-social formulation of health-care problems is integral to the treatment of psychiatric disorders. The situation becomes all the more complex when faced with the high comorbidity of physical and psychiatric illness in the elderly presenting with depression. The physical examination, guided by a detailed history, must be considered an integral part of the assessment of depression in the elderly. A case study of polymyalgia rheumatica presenting as depression is utilized …

Firesetting In Children, Donna V. Mehregany, Md

Jefferson Journal of Psychiatry

This article reviews the literature regarding the history, etiology, diagnosis, and treatment of firesetting. A critique of the literature reveals the need to generate a clearer definition of firesetting as well as more stringent criteria for diagnosing firesetting. The standard treatments for firesetting are reviewed. Linkage of childhood firesetting to future adolescent and adult crimes is also examined. Finally, avenues for future research are discussed.

Pharmacologic Advances In The Treatment Of Schizophrenia, Scott A. West, Md

Jefferson Journal of Psychiatry

The treatment of schizophrenia was revolutionized with the introduction of chlorpromaeine in 1952. The effectiveness of chlorpromazine in controlling psychotic symptoms lead to the dopamine Hypothesis of schizophrenia, which revolutionized our conceptualization of this illness. Since that time, numerous typical antipsychotic drugs have been developed for the treatment of schizophrenia. However, the introduction of clozapine in 1990 began a new era in the pharmacologic management of schizophrenia. Clozapine, an atypical antipsychotic drug, is effective in controlling the positive Symptoms of schizophrenia in a large number of otherwise treatment-resistant patients, and also improves the negative symptoms of the illness in marry …

Psychogenic Amnesia: A Case Involving Amobarbital Interview And The News Media, Tracey G. Skale, Md, James Randolph Hillard, Md

Jefferson Journal of Psychiatry

A young man was admitted to an urban general hospital psychiatric unit after being brought from a local shopping mall unable to remember his name or any other personal information. He was alert and oriented and demonstrated no cognitive impairment. He agreed to an amobarbital interview and agreed to letting local news media display his picture in hopes that someone would recognize him. The amobarbital interview yielded information allowing identification of the individual, with the help of the news media. News media coverage also led to the discovery that the individual was wanted for a violent crime in another state …

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

Jefferson Journal of Psychiatry

It has been a pleasure and a privilege to have been the Faculty Advisor for the Jefferson Journal of Psychiatry for the past 10 years. We began this resident written and edited journal in 1983 as a small in-house publication designed to encourage our residents to put their thoughts about patient care into written form. Since then we have grown considerably and now serve as the only national resident journal in medicine. Many people over the years have made this effort possible. I would like to pay special thanks to our generous and supportive sponsors and …

Editor's Column, Mary E. Donovan, Md

Jefferson Journal of Psychiatry

In this edition of The Jefferson Journal of Psychiatry we say good-bye to Harvey J. Schwartz, M.D., who founded it as a resident education project ten years ago and who has been our Faculty Advisor ever since. Under Dr. Schwartz's mentorship the Journal has grown from a departmental vehicle for residents' writings to a national publication in which residents can be proud to have their work presented. Having become a nation-wide resident education project, sponsored in part by the APA, the Journal serves to meet a need for all psychiatry residents: to learn about writing, editing and publishing.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Board for Volume 11, Number 2, 1993 of Jefferson Journal of Psychiatry.

Facilitating The Staff Nurse's Role In Creating A Culture Of Care On An Obstetrical Care Unit, Laura Struve Hanson

Theses and Graduate Projects

The art of caring is foundational to the nursing profession, but too often nurses prioritize care for others above care for themselves. Nurse self-care and peer care are integral in the creation of a unit culture of care. This project introduces a new nursing practice model based on Jean Watson's caring theory and Caritas Processes to guide staff nurses on an obstetrical unit in creating a culture of care for self and peers. The practice model relies on nurse courage, intentional collaboration, and creativity to uniquely integrate the Caritas Processes into professional practice. This progression fosters the emergence of holistic …

Introducing Integrative Medicine At The Bedside To Patients With Post-Traumatic Headache Pain, Melissa E. Allard

Theses and Graduate Projects

The use of integrative medicine is growing, and the nursing profession has a responsibility to meet the changing needs of patients. This paper describes a model of nursing for delivering integrative medicine practices at the bedside to persons suffering with post-traumatic headache pain related to traumatic brain injury (TBI) and is grounded in Katherine Kolcaba's Comfort Theory. A patient is best served when the holistic principles of integrative medicine are facilitated by a nurse who is centered and able to introduce these modalities with positive intention. The goal of the practice model is to provide the foundation for nursing to …

Advancing A Culture Of Safety Through The Creation Of A Unit-Based Safety Team, Lynda K. Carr

Theses and Graduate Projects

Hospitals are challenged to create a strong culture of safety within their organization to eliminate harm to patients. This paper describes a project to advance a culture of safety on a cardiovascular acute care unit at an urban hospital through the creation of a unit-based safety team. Based on the premise that patient safety is a local phenomenon, the rationale for the project is to aim interventions at the unit level where they will have the greatest impact. Four key steps in creating an effective unit-based safety team are highlighted: team member selection, team development, enacting interventions, and evaluating interventions …

Interferon Alpha For Chronic Hepatitis D, Zaigham Abbas, Muhammad Arsalan Khan, Mohammad Salih, Wasim Jafri

Department of Medicine

Background:

Hepatitis D virus is a small defective RNA virus that requires the presence of hepatitis B virus infection to infect a person. Hepatitis D is a difficult-to-treat infection. Several clinical trials have been published on the efficacy of interferon alpha for hepatitis D virus (HDV) infection. However, there are few randomised trials evaluating the effects of interferon alpha, and it is difficult to judge any benefit of this intervention from the individual trials.

Objectives:

To evaluate the beneficial and harmful effects of interferon alpha for Patients with chronic hepatitis D.

Search methods:

We identified relevant for the review randomised …