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Medical School Watercooler Newsletter - January 15, 2012, Lindsey Lyle

Watercooler Newsletter

This is the January 15, 2012 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Making the Right Connection
• Med School Café - Expert Advice for the Community
• Mark Your Calendars - Upcoming Events
• Dramatically Improving Your Health with Bariatric Surgery

National Longitudinal Survey Of Public Health Systems: 2011-2012 Wave, Public Health Practice-Based Research Networks

Health Management and Policy Reports

Since 1998, researchers have followed a nationally representative cohort of U.S. communities to examine the types of public health activities performed within the community, the range of organizations contributing to each activity, and the perceived effectiveness of each activity in addressing community needs. This information, obtained through a validated survey of local public health officials, provides an in-depth view of the structure and function of local public health delivery systems and how these systems evolve over time. Originally conducted with support from the U.S. Centers for Disease Control and Prevention, the National Longitudinal Survey of Public Health Systems (NLSPHS) was …

Orai1 Deficiency Leads To Heart Failure And Skeletal Myopathy In Zebrafish., Mirko Völkers, Nima Dolatabadi, Natalie Gude, Patrick Most, Mark A Sussman, David Hassel

Center for Translational Medicine Faculty Papers

Mutations in the store-operated Ca²⁺ entry pore protein ORAI1 have been reported to cause myopathies in human patients but the mechanism involved is not known. Cardiomyocytes express ORAI1 but its role in heart function is also unknown. Using reverse genetics in zebrafish, we demonstrated that inactivation of the highly conserved zebrafish orthologue of ORAI1 resulted in severe heart failure, reduced ventricular systolic function, bradycardia and skeletal muscle weakness. Electron microscopy of Orai1-deficient myocytes revealed progressive skeletal muscle instability with loss of myofiber integrity and ultrastructural abnormalities of the z-disc in both skeletal and cardiac muscle. Isolated Orai1-deficient cardiomyocytes showed loss …

Human Pulmonary Microvascular Endothelial Cells Support Productive Replication Of Highly Pathogenic Avian Influenza Viruses: Possible Involvement In The Pathogenesis Of Human H5n1 Virus Infection, Hui Zeng, Claudia Pappas, Jessica A. Belser, Katherine V. Houser, Weiming Zhong, Debra A. Wadford, Troy Stevens, Ron Balczon, Jacqueline M. Katz, Terrence M. Tumpey

University Faculty and Staff Publications

Highly pathogenic avian influenza (HPAI) H5N1 viruses continue to cause sporadic human infections with a high fatality rate. Respiratory failure due to acute respiratory distress syndrome (ARDS) is a complication among hospitalized patients. Since progressive pulmonary endothelial damage is the hallmark of ARDS, we investigated host responses following HPAI virus infection of human pulmonary microvascular endothelial cells. Evaluation of these cells for the presence of receptors preferred by influenza virus demonstrated that avian-like (α2-3-linked) receptors were more abundant than human-like (α2-6-linked) receptors. To test the permissiveness of pulmonary endothelial cells to virus infection, we compared the replication of selected seasonal, …

Uterine Dysfunction In Biglycan And Decorin Deficient Mice Leads To Dystocia During Parturition., Zhiping Wu, Abraham W Aron, Elyse E Macksoud, Renato V Iozzo, Chi-Ming Hai, Beatrice E Lechner

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Cesarean birth rates are rising. Uterine dysfunction, the exact mechanism of which is unknown, is a common indication for Cesarean delivery. Biglycan and decorin are two small leucine-rich proteoglycans expressed in the extracellular matrix of reproductive tissues and muscle. Mice deficient in biglycan display a mild muscular dystrophy, and, along with mice deficient in decorin, are models of Ehlers-Danlos Syndrome, a connective tissue anomaly associated with uterine rupture. As a variant of Ehlers-Danlos Syndrome is caused by a genetic mutation resulting in abnormal biglycan and decorin secretion, we hypothesized that biglycan and decorin play a role in uterine function. Thus, …

About The Authors

Jefferson Journal of Psychiatry

No abstract provided.

About The Authors

Jefferson Journal of Psychiatry

No abstract provided.

Case Report Of Dramatic Resolution Of Psychotic Symptoms During Cross-Over To Clozapine, Leo Sher M.D., Alan Mendelowitz M.D.

Jefferson Journal of Psychiatry

Clozapine is the first antipsychotic drug with proven superiority over conventional antipsychotics in the management of treatment-resistant patients. We describe a case of tratment-resistant schizoaffective disorder in a young woman who improved rapidly on clozapine. The patient was started on a low dose of clozapine while fluphenazine was decreased. She improved significantly during the first several days of treatment. This improvement took place well before the expected effect of clozapine. Possible explanations for this unusual response include: 1) the placebo effect; 2) fluphenazine dose-response curve; 3) acute clozapine neurochemical mechanisms; 4) inaccurate original diagnosis. Better understanding of the mechanisms of …

Case Report: Failure Of Group Therapy With Elderly Russian-Jewish Immigrants (An Exploratory Analysis), Gennady Berezkin M.D.

Jefferson Journal of Psychiatry

This paper is a description of an unsuccessful attempt to carry out group therapy with elderly Russian-Jewish immigrants.

An attempt was made to conduct group therapy following general principals of traditional psychotherapy with geriatric populations.

In the final analysis, we conclude that culturally based preconceptions toward psychotherapy, culturally based stereotypes of interpersonal relationships and culturally-based transference to the therapist were the primary reasons for the development of negative transference and resistance which culminated in the ultimate failure of group psychotherapy with this group of elderly immigrants.

Saint Simeon The Stylite: A Psychiatric Examination Of The Life Of A Fifth Century Monk, Iracema Leroi M.D., Joseph B. A. Meagher M.D., M.R.C. (Psych) Frcpc

Jefferson Journal of Psychiatry

Religion is now the focus of more attention in psychiatry. This paper examines the life of the fifth century monk, Simeon the Stylite, from a contemporary psychiatric perspective. Such a retrospective examination presents difficulties with regard to the diagnosis of possible psychotic phenomena. A further examination presents difficulties with regard to the diagnosis of possible psychotic phenomena. A further problem is trying to distinguish between a religious and a psychiatric interpretation of particular experiences.

The authors outline the life of Simeon and some contemporary opinions. They agree with Kroll and deGanck that great caution is needed in the psychiatric interpretation …

The Psychiatry Access Center: A New Opportunity For Innovative Residency Training, M. Bates Redwine M.D., Ryan Finkelbine M.D., William Carson M.D., Susan Hardesty M.D., Linda Lewis M.N., R.N., C.S.

Jefferson Journal of Psychiatry

A recently introduced PGY-1 rotation in an innovative, managed care oriented program offers many training advantages for residents. The rotation offers first-year residents intensive interviewing-skills training, experience with obtaining and documenting the psychiatric history and physical examination, and in the process, offers early exposure to a managed care environment. The Psychiatry Access Center employs non-resident clinicians to perform urgent evaluations and all admissions to the main psychiatric hospital. The service has been tested successfully without requiring resident work, and therefore allows the integration of residents into the system via a new rotation designed to focus exclusively on educational needs.

Implementation Of A Computer-Based Communication System For Psychiatry Residents, Daniel Z. Lieberman M.D.

Jefferson Journal of Psychiatry

In order to encourage different kinds of communication among residents who were located at a number of geographically separate sites, a computerized communication system was implemented. Priority was placed on both richness of features and ease of use. Residents were able to send private email, join public conferences, and access databases of information. The system was initially used by a large number of residents, and usage patterns are described. The introduction to information technology that residents gained from the system led to other computer projects, and an interest in the resources of the Internet.

Call For Papers On Aspects Of Violence And Psychiatric Training, Derek Puddester M.D.

Jefferson Journal of Psychiatry

No abstract provided.

Difficulties Associated With A Clinical Psychiatric Study Of A Transient Population, Stephen Zerby M.D.

Jefferson Journal of Psychiatry

No abstract provided.

Editor's Column, Stephen Zerby M.D.

Jefferson Journal of Psychiatry

No abstract provided.

Ginkgo Extract Egb761 Confers Neuroprotection By Reduction Of Glutamate Release In Ischemic Brain, Alexander Mdzinarishvili, Rachita K. Sumbria, Dorothee Lang, Jochen Klein

Pharmacy Faculty Articles and Research

Purpose - Ginkgo extract EGb761 has shown anti-edema and anti-ischemic effects in various experimental models. In the present study, we demonstrate neuroprotective effects of EGb761 in experimental stroke while monitoring brain metabolism by microdialysis. Methods - We have used oxygen-glucose deprivation in brain slices in vitro and middle cerebral artery occlusion (MCAO) in vivo to induce ischemia in mouse brain. We used microdialysis in mouse striatum to monitor extracellular concentrations of glucose and glutamate. Results - In vitro, EGb761 reduced ischemia-induced cell swelling in hippocampal slices by 60%. In vivo, administration of EGb761 (300 mg/kg) reduced cell degeneration and edema …

Housework Metaphor For Gambling Public Health Action: An Indigenous Perspective, Lorna Dyall, Zoe Hawke, Ruth Herd, Papa Nahi

Aboriginal Policy Research Consortium International (APRCi)

Housework,thosedutiesdoneathomeorinone’scommunitytokeepandcleanand tidy, is used in this paper as a metaphor for Māori involvement in gambling public health action in New Zealand. For over a decade Māori have been developing their own voice, public health actions, gambling services, research and workforce development initiatives to address gambling related harm at a whānau, community, local government, national and now international level. Involvement in gambling public health action has required Māori to utilise our Treaty of Waitangi and now international indigenous peoples’ rights to ensuring legislation and host responsibility requirements are met at all levels in New Zealand society. Housework which is a demanding …

A High Density Snp Array For The Domestic Horse And Extant Perissodactyla: Utility For Association Mapping, Genetic Diversity, And Phylogeny Studies, Molly E. Mccue, Danika L. Bannasch, Jessica L. Petersen, Jessica Gurr, Ernie Bailey, Matthew M. Binns, Ottmar Distl, Gérard Guérin, Telhisa Hasegawa, Emmeline W. Hill, Tosso Leeb, Gabriella Lindgren, M Cecilia T. Penedo, Knut H. Røed, Oliver A. Ryder, June E. Swinburne, Teruaki Tozaki, Stephanie J. Valberg, Mark Vaudin, Kerstin Lindblad-Toh, Claire M. Wade, James R. Mickelson

Veterinary Science Faculty Publications

An equine SNP genotyping array was developed and evaluated on a panel of samples representing 14 domestic horse breeds and 18 evolutionarily related species. More than 54,000 polymorphic SNPs provided an average inter-SNP spacing of ∼43 kb. The mean minor allele frequency across domestic horse breeds was 0.23, and the number of polymorphic SNPs within breeds ranged from 43,287 to 52,085. Genome-wide linkage disequilibrium (LD) in most breeds declined rapidly over the first 50-100 kb and reached background levels within 1-2 Mb. The extent of LD and the level of inbreeding were highest in the Thoroughbred and lowest in the …

Inflammatory Signaling Compromises Cell Responses To Interferon Alpha., W-C Huangfu, J Qian, C Liu, J Liu, A E Lokshin, D P Baker, H Rui, S Y Fuchs

Department of Cancer Biology Faculty Papers

Interferon alpha (IFNα) is widely used for treatment of melanoma and certain other malignancies. This cytokine as well as the related IFNβ exerts potent anti-tumorigenic effects; however, their efficacy in patients is often suboptimal. Here, we report that inflammatory signaling impedes the effects of IFNα/β. Melanoma cells can secrete pro-inflammatory cytokines that inhibit cellular responses to IFNα/β via activating the ligand-independent pathway for the phosphorylation and subsequent ubiquitination and accelerated degradation of the IFNAR1 chain of type I IFN receptor. Catalytic activity of the p38 protein kinase was required for IFNAR1 downregulation and inhibition of IFNα/β signaling induced by proinflammatory …

The Social Production Of Substance Abuse And Hiv/Hcv Risk: An Exploratory Study Of Opioid-Using Immigrants From The Former Soviet Union Living In New York City, Honoria Guarino, Sarah K. Moore, Lisa A. Marsch, Sal Florio

Dartmouth Scholarship

Several former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection. In-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment …

Intrapersonal Deficits & Revictimization: Factors Predicting Risk Recognition, Kari Mastromonica

Theses and Dissertations

The purpose of this exploratory research was to identify whether intrapersonal factors, specifically sexual assertiveness and sexual self-esteem, would predict an individual's ability to detect risk for being sexually revictimized. A previously validated laboratory analogue (Angelone, Mitchell, & Carola, 2009), in which female participants are led to believe that they are engaging in a speed date with a man, was used to measure risk recognition. Additional measures were included to assess sexual victimization history and the intrapersonal factors. Of the total sample, 30.2% (N = 16) had no sexual victimization history, while 69.8% had some form of sexual victimization history. …

Defiant Children: A Clinician's Manual For Assessment And Parent Training By Russell A. Barkley, M.D., Stephen Zerby M.D.

Jefferson Journal of Psychiatry

No abstract provided.

[In Response To "The Neuroleptic Treatment Of Schizophrenia: Dosing Strategies, Depot Preparations And Novel Medications" By Alexander S. Young, M.D. (Volume 13, 18-26)], James Longhurst M.D., Joseph Cassar M.D.

Jefferson Journal of Psychiatry

No abstract provided.

The Relevance Of Transference During Medication Management: A Case Of Erotized Transference, Helen C. Kales M.D., James Abelson M.D., Ph.D., Michelle B. Riba M.D.

Jefferson Journal of Psychiatry

Forces existing in psychiatry may diminish the importance of psychotherapy training as psychiatrists are increasingly given the task of medication management. Psychotherapeutic relationships can be created in medication management settings, however, and the neglect of concepts such as transference could have deleterious consequences. The authors describe the case of a man with a traumatic brain injury referred for medication management who developed an erotized transference toward his female resident-physician. This case illustrates the concept that an understanding of transference is relevant to the setting of medication management

Gabapentin In The Treatment Of Bipolar Disorder, Wendy M. Waits, Donald P. Hall Jr., M.D.

Jefferson Journal of Psychiatry

Gabapentin, a relatively new anti-epileptic drug (AED), is emerging as a therapeutic option for treatment refractory and rapid-cycling bipolar illnesses. Pharmacotherapy for bipolar disorders traditionally involves valproate, carbamazapine, or lithium, drugs which are associated with numerous adverse effects. Conversely, gabapentin has an attractive pharmacokinetics profile and relatively few side effects. There are no large randomized controlled clinical trials to date examining gabapentin’s role in mood stabilization. However, informal reports have cited encouraging results in up to 80% of patients and general tolerance to side effects. These findings make the new drug a possible choice for patients who have failed to …

The Somatization Of Depression In Native Pakistani Women, Rubeena H. Mian M.D., Linda S. Grossman Ph.D.

Jefferson Journal of Psychiatry

Previous studies have pointed out the comorbidity of somatization and depression among non-Western psychiatric patients. We studied the somatization of depression in Pakistani women. Two groups were studies: inpatients with DSM-III-R diagnoses of major depression and a comparison sample of women living in the community without psychiatric diagnoses. Both groups were administered a rating scale for somatization. Results indicated that patients reported significantly more somatic symptoms than nonpatients. These findings support the concept that somatization may be a cultural mode of mental distress among Pakistani women, as has been observed for other non-Western populations.

Folie Á Deux: Two Case Reports, Mohammad Y. Abu-Salha M.D.

Jefferson Journal of Psychiatry

Two cases of “Shared Psychotic Disorder” were diagnosed over a period of less than a year in a children’s psychiatric center. Shared Psychotic Disorder is one of the differential diagnoses that need to be entertained when evaluating a delusional patient. Including the patient’s family and/or significant others in the assessment increases the possibility of diagnosing Shared Psychotic Disorder. An eight-year-old girl was admitted after exhibiting psychotic behavior with paranoid delusions she shared with her mother. Specifically, she reported that “neighbors next door were repeatedly breaking into her house, pinning her down, raping her, and injecting her with I.V. drugs.” An …

Early Detection Of Autism In The Population, John D. Mclennan M.D., Ph.D.

Jefferson Journal of Psychiatry

Frequently there is a delay in the diagnosis of autism in children which may result in a lost opportunity to provide early intervention. Signal detection studies have suggested that single items have good predictability for autism which suggests simple screening procedures may be helpful in the early detection of an autistic disorder. Studies of autism in the very young have found that specific social deficits appear to characterize this group. A three stage procedure is presented as a possible approach to detect autism at an early age in the population thereby allowing for early intervention.

Editor's Column, Tanis Gaitens M.D.

Jefferson Journal of Psychiatry

No abstract provided.

Children And Adolexcents Of Distinction - Culturally Diverse Children And Adolescents: Assessment, Diagnosis, And Treatment By Ian A. Canino, M.D. And Jeanne Spurlock, M.D., Lloyda R. Broomes M.D.

Jefferson Journal of Psychiatry

No abstract provided.