Medical Specialties Commons^™

A Case Of Recurrent Dissociative Episodes In A Patient With Congenital Defects, Mark Miller, Md

Jefferson Journal of Psychiatry

Case Report

Marie, a 30 year old American-born Hispanic female, was first seen in the emergency room with suicidal ideation (the impulse to jump in front of an oncoming car), depression, anxiety, and distress about "always getting attacked so much."

Interpersonal Relationships As Sources Of Medical Student Stress, Beverly Jones, Md

Jefferson Journal of Psychiatry

Introduction

The issue of physician impairment, that is , decreased ability or quality of functioning due to intemperate use of drugs or alcohol, emotional or psychiatric dysfunction, has recently received attention (1,5) . Studies have indicated the risks physicians face of substance abuse problems(6,7), marital discord(8,9), suicide (lO,ll), and psychiatric problems (l2-14). studies have also addressed the difficulties faced by medical students (15-20).

A group of medical students at the University of North Carolina came together to investigate the subject of medical student impairment . A survey was constructed in order to ascertain the sources of stress in medical school. …

Olfaction And Sexuality, Michael Buxbaum, Md

Jefferson Journal of Psychiatry

A patient who describes himself as "sanitary" told me of his concern with odors. Whenever he thinks about establishing a sexual relationship , he develops a fear that his partner may smell offensive, especially around her genital area. He describes signs and symptoms of sympathetic overactivity when he engages in foreplay, and is afraid that he might be impotent if he smells anything offensive. In fact, he has to insert a finger into his partner's vagina during foreplay, to test the nature of the odor. He feels relieved when the smell is neutral or perfumed, and demonstrates enhanced sexual performance. …

Editors' Column

Jefferson Journal of Psychiatry

With this issue, The Jefferson Journal of Psychiatry , a Resident Publication, comes into being.

The purpose of this journal is to provide a forum for the presentation of ideas, data, and discussion. We are trying to give residents a setting in which to communicate in a way more formal than the seminars of residency training, but less forbidding than national journals.

Introduction, Harvey J. Schwartz, Md

Jefferson Journal of Psychiatry

It is with great pride that we introduce our new resident JOURNAL. This unique forum was created to allow our resident s the opportunity to explore the challenges and pleasures to writing and publishing. Putting one's thoughts and experiences on paper demands a clarity of thinking and a willingness to share what is otherwise private.

For the resident this becomes a valuable educational enterprise. For the faculty this is an opportunity to view first hand the work of our trainees . Not limited to reading course descriptions of clinical service schedules, our staff can now get to know t he …

Identification Of Factors Associated With Good Response To Growth Hormone Therapy In Children With Short Stature: Results From The Answer Program®., Peter A Lee, John Germak, Robert Gut, Naum Khutoryansky, Judith Ross

Department of Pediatrics Faculty Papers

UNLABELLED: ABSTRACT:

OBJECTIVE: To identify factors associated with growth in children on growth hormone (GH) therapy using data from the American Norditropin Studies: Web-enabled Research (ANSWER) Program® registry.

METHODS: GH-naïve children with GH deficiency, multiple pituitary hormone deficiency, idiopathic short stature, Turner syndrome, or a history of small for gestational age were eligible (N = 1,002). Using a longitudinal statistical approach, predictive factors were identified in patients with GHD for change from baseline in height standard deviation score (ΔHSDS) following 2 years of treatment.

RESULTS: Gradual increases in ΔHSDS over time were observed for all diagnostic categories. Significant predictive factors …

Oncogene-Induced Nrf2 Transcription Promotes Ros Detoxification And Tumorigenesis., Gina M. Denicola, Florian A. Karreth, Timothy J. Humpton, Aarthi Gopinathan, Cong Wei, Kristopher Frese, Dipti Mangal, Kenneth H. Yu, Charles J. Yeo, Eric S. Calhoun, Francesca Scrimieri, Jordan M. Winter, Ralph H. Hruban, Christine Iacobuzio-Donahue, Scott E. Kern, Ian A Blair, David A. Tuveson

Department of Surgery Faculty Papers

Reactive oxygen species (ROS) are mutagenic and may thereby promote cancer. Normally, ROS levels are tightly controlled by an inducible antioxidant program that responds to cellular stressors and is predominantly regulated by the transcription factor Nrf2 (also known as Nfe2l2) and its repressor protein Keap1 (refs 2-5). In contrast to the acute physiological regulation of Nrf2, in neoplasia there is evidence for increased basal activation of Nrf2. Indeed, somatic mutations that disrupt the Nrf2-Keap1 interaction to stabilize Nrf2 and increase the constitutive transcription of Nrf2 target genes were recently identified, indicating that enhanced ROS detoxification and additional Nrf2 functions may …

Ceacam1 Separates Graft-Versus-Host-Disease From Graft-Versus-Tumor Activity After Experimental Allogeneic Bone Marrow Transplantation., Sydney X Lu, Lucy W Kappel, Anne-Marie Charbonneau-Allard, Renée Atallah, Amanda M Holland, Claire Turbide, Vanessa M Hubbard, Jimmy A Rotolo, Marsinay Smith, David Suh, Christopher King, Uttam K Rao, Nury Yim, Johanne L Bautista, Robert R Jenq, Olaf Penack, Il-Kang Na, Chen Liu, George Murphy, Onder Alpdogan, Richard S Blumberg, Fernando Macian, Kathryn V Holmes, Nicole Beauchemin, Marcel R M Van Den Brink

Department of Medical Oncology Faculty Papers

BACKGROUND: Allogeneic bone marrow transplantation (allo-BMT) is a potentially curative therapy for a variety of hematologic diseases, but benefits, including graft-versus-tumor (GVT) activity are limited by graft-versus-host-disease (GVHD). Carcinoembryonic antigen related cell adhesion molecule 1 (Ceacam1) is a transmembrane glycoprotein found on epithelium, T cells, and many tumors. It regulates a variety of physiologic and pathological processes such as tumor biology, leukocyte activation, and energy homeostasis. Previous studies suggest that Ceacam1 negatively regulates inflammation in inflammatory bowel disease models.

METHODS: We studied Ceacam1 as a regulator of GVHD and GVT after allogeneic bone marrow transplantation (allo-BMT) in mouse models. In …

Recruitment And Retention Of Diverse Populations In Antiretroviral Clinical Trials: Practical Applications From The Gender, Race And Clinical Experience Study., Ron Falcon, Dawn Averitt Bridge, Judith Currier, Kathleen Squires, Debbie Hagins, Deborah Schaible, Robert Ryan, Joseph Mrus

Division of Infectious Diseases and Environmental Medicine Faculty Papers

BACKGROUND: Women, particularly women of color, remain underrepresented in antiretroviral (ARV) clinical trials. To evaluate sex-based differences in darunavir/ritonavir-based therapy, the Gender, Race And Clinical Experience (GRACE) study was designed to enroll and retain a high proportion of women representative of the racial/ethnic demographics of women with HIV/AIDS in the United States. The recruitment and retention strategies used in GRACE are described in this article.

METHODS: Recruitment and retention strategies targeting women included selecting study sites that focused on women, involving community consultants, site-specific enrollment plans, access to other ARV drugs, study branding, site and patient toolkits, targeted public relations, …

Psychological And Cognitive Determinants Of Vision Function In Age-Related Macular Degeneration., Barry W. Rovner, Robin J Casten, Robert W Massof, Benjamin E Leiby, William S Tasman

Department of Neurology Faculty Papers

OBJECTIVE: To investigate the effect of coping strategies, depression, physical health, and cognition on National Eye Institute Visual Function Questionnaire scores obtained at baseline in a sample of older patients with age-related macular degeneration (AMD) enrolled in the Improving Function in AMD Trial, a randomized controlled clinical trial that compares the efficacy of problem-solving therapy with that of supportive therapy to improve vision function in patients with AMD.

METHODS: Baseline evaluation of 241 older outpatients with advanced AMD who were enrolled in a clinical trial testing the efficacy of a behavioral intervention to improve vision function. Vision function was characterized …

Tumor-Derived Interleukin-10 As A Prognostic Factor In Stage Iii Patients Undergoing Adjuvant Treatment With An Autologous Melanoma Cell Vaccine., Amit Mahipal, Mizue Terai, David Berd, Inna Chervoneva, Kashyap Patel, Michael Mastrangelo, Takami Sato

Department of Medical Oncology Faculty Papers

OBJECTIVES: Interleukin-10 (IL-10) downregulates T-cell-mediated immune responses. We studied the association between IL-10 production by freshly isolated melanoma cell suspensions in vitro and overall survival in patients undergoing adjuvant treatment with a vaccine prepared from the same autologous melanoma cells modified with a hapten, dinitrophenyl (DNP).

METHODS: Forty-four patients with cutaneous melanoma (29 stage III and 15 stage IV) were prospectively evaluated. Tumor cells were extracted from metastatic deposits for production of DNP-modified autologous melanoma cell vaccine. Small aliquots of the melanoma cell suspensions were separated prior to vaccine processing and cultured overnight for IL-10 production. Based on a blind …

Department Of Radiology-Annual Executive Summary Report-July 1, 2010 To June 30, 2011, Vijay M. Rao, Md

Department of Radiology Administrative Documents and Reports

90 page Department of Radiology Annual Executive Summary Report, July 1, 2010 to June 30, 2011, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Tables of Contents:

Department of Radiology

Chairman, Vice Chairmen 1

Divisions and Directors 1

Committees and Chairmen 1

Radiology Department Faculty Rank 2

Faculty with Secondary Appointments 3

Clinical Divisions 4

Radiology Residents and Fellows 5

Department Organizational Chart 6

Department Administration Chart 7

State of the Department 8

Appendix I: Publications Journal Articles 22

Books and Book Chapters 30

Abstracts 33

Appendix II: Formal Scientific Presentations 44

Appendix III: Honors, Editorial Activities, Service to Regional …

Bapcap2-1 Does Preoperative Aspirin Improve Outcomes In Cardiac Surgery Patients?, Jian-Zhong Sun, L. Cao, H. Liu, W. Sun, S Silvestry, J. Diehl

Department of Anesthesiology Faculty Papers

Best Abstracts - Runner-up Session 2 presented at Euroanaesthesia 2011 in the Netherlands.

Background and Goal of Study: The effects of preoperative aspirin on major cardiocerebral and renal outcomes and mortality remain uncertain.

Obesity And Other Predictors Of Absenteeism In Philadelphia School Children., Elizabeth B Rappaport, Constantine Daskalakis, Jocelyn Andrel

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Limited data indicate that obese children are absent from school more than their normal-weight peers. We analyzed administrative data from a large urban school district to investigate the association of obesity and student sociodemographic characteristics with absenteeism.

METHODS: We analyzed 291,040 records, representing 165,056 unique students (grades 1-12). Obesity status was classified according to Centers for Disease Control and Prevention age- and sex-specific percentiles for body mass index (BMI) and analyses were based on negative binomial regression.

RESULTS: Overall rates of overweight and obesity were 17% and 20%, respectively, and the estimated absence rate was 17 absences per 180 …

Transfection Of Human Platelets With Short Interfering Rna., Wei Hong, Altaf A Kondkar, Srikanth Nagalla, Wolfgang Bergmeier, Ying Jin, Jay Herman, Paul Bray

Cardeza Foundation for Hematologic Research

Platelets contain mRNAs and are capable of translating mRNA into protein, and it has been previously demonstrated that platelets increase their levels of integrin β3 overtime while in blood bank storage conditions. We are unaware of prior attempts to introduce nucleic acids into platelets. Considering the potential clinical and research utility of manipulating platelet gene expression, we tested whether small interfering RNAs (siRNAs) could be transfected into normal human platelets. Multiple conditions were tested, including lipofectamine versus electroporation, different amounts of siRNA, the effect of different buffers and the presence of plasma during transfection, and the time for optimal siRNA …

Femoroacetabular Impingement: Saving The Joint, Ronald Huang, Javad Parvizi

Department of Orthopaedic Surgery Faculty Papers

Many factors have been linked to the development of osteoarthritis (OA) of the hip, but often, cases are still considered “idiopathic.” Femoroacetabular impingement (FAI) has been suggested as a possible etiologic factor for the otherwise “idiopathic” cases. It is theorized that the subtle morphologic abnormalities seen at the head-neck junction and acetabulum in FAI may lead to labral tears, chondral damage, and subsequent progression of OA. Prevalence of FAI has been suggested to be as high as 14% in the general population. It often presents in young active patients that subject their hip joint to repetitive micro trauma associated with …

Evaluation Of The Use Of Patient-Focused Simulation For Student Assessment In A Surgery Clerkship., Gerald A Isenberg, Katherine W Berg, Judith A Veloski, Dale D Berg, J J. Veloski, Charles Yeo

Department of Surgery Faculty Papers

BACKGROUND: The purpose of this study was to evaluate the use of simulated patients in conjunction with anatomic and tissue task-training models to assess skills.

METHODS: Faculty reviewed the objectives of the clerkship to identify skills to be acquired. Three cases were developed related to rectal examination, suturing, and inserting intravenous lines and nasogastric tubes. Student scores were based on their ability to gather data from simulated patients and perform procedures on simulation models.

RESULTS: A total of 670 students were assessed between 2006 and 2009. Alpha reliability coefficients were .97 for Communication/Interpersonal Skills, .71 for Procedures, and .58 for …

Chemical Cardiomyopathies: The Negative Effects Of Medications And Nonprescribed Drugs On The Heart., Vincent M Figueredo

Division of Cardiology Faculty Papers

The heart is a target of injury for many chemical compounds, both medically prescribed and not medically prescribed. Pathophysiologic mechanisms underlying the development of chemical-induced cardiomyopathies vary depending on the inciting agent, including direct toxic effects, neurohormonal activation, altered calcium homeostasis, and oxidative stress. Numerous chemicals and drugs are implicated in cardiomyopathy. This article discusses examples of medication and nonprescribed drug-induced cardiomyopathies and reviews their pathophysiologic mechanisms.

Endothelial Differentiation Of Adipose-Derived Stem Cells From Elderly Patients With Cardiovascular Disease., Ping Zhang, Neil Moudgill, Eric Hager, Nicolas Tarola, Christopher Dimatteo, Stephen Mcilhenny, Thomas Tulenko, Paul J Dimuzio

Department of Surgery Faculty Papers

Adipose-derived stem cells (ASCs) possess significant therapeutic potential for tissue engineering and regeneration. This study investigates the endothelial differentiation and functional capacity of ASCs isolated from elderly patients. Isolation of ASCs from 53 patients (50-89 years) revealed that advanced age or comorbidity did not negatively impact stem cell harvest; rather, higher numbers were observed in older donors (>70 years) than in younger. ASCs cultured in endothelial growth medium-2 for up to 3 weeks formed cords upon Matrigel and demonstrated acetylated-low-density lipoprotein and lectin uptake. Further stimulation with vascular endothelial growth factor and shear stress upregulated endothelial cell-specific markers (CD31, …

Acute Effects Of A Selective Cannabinoid-2 Receptor Agonist On Neuroinflammation In A Model Of Traumatic Brain Injury., Melanie B Elliott, Ronald F Tuma, Peter S Amenta, Mary F Barbe, Jack I Jallo

Department of Neurosurgery Faculty Papers

Proposed therapeutic strategies for attenuating secondary traumatic brain injury (TBI) include modulation of acute neuroimmune responses. The goal of this study was to examine the acute effects of cannabinoid-2 receptor (CB(2)R) modulation on behavioral deficits, cerebral edema, perivascular substance P, and macrophage/microglial activation in a murine model of TBI. Thirty male C57BL/6 mice underwent sham surgery, or cortical contusion impact injury (CCI). CCI mice received vehicle or the CB(2)R agonist 0-1966 at 1 and 24 h after injury. Performance on the rotarod, forelimb cylinder, and open-field tests were evaluated before and at 48 h after sham or CCI surgery. Cerebral …

Religious Experiences Shrink Part Of The Brain, Andrew Newberg, M.D.

Marcus Institute of Integrative Health Faculty Papers

A study links life-changing religious experiences, like being born again, with atrophy in the hippocampus.

The article, “Religious factors and hippocampal atrophy in late life,” by Amy Owen and colleagues at Duke University represents an important advance in our growing understanding of the relationship between the brain and religion. The study showed greater atrophy in the hippocampus in individuals who identify with specific religious groups as well as those with no religious affiliation. It is a surprising result, given that many prior studies have shown religion to have potentially beneficial effects on brain function, anxiety, and depression.

Effects Of Walnut Consumption As Part Of Heart Healthy Diet On Atherogenic Lipoprotein Subclasses, Kimberly L. Dulaney, Md, John M. Morgan, Md, David M. Capuzzi, Md

The Medicine Forum

Nutritional therapy is fundamental in the treatment of
cardiovascular disease. Studies that utilized a low-fat diet
supplemented with 64 grams/day of walnuts have shown
a significant reduction in serum levels of total and LDL
cholesterol, and triglycerides. This study was designed to
see if lipoprotein subclasses varied in patients eating a
low-fat walnut supplemented diet.

Multiple Courses Of Stereotactic Re-Irradiation In Recurrent Oligodendroglioma: A Case Report., Shannon Fogh, Charles Glass, David W Andrews, Maria Werner-Wasik

Department of Radiation Oncology Faculty Papers

INTRODUCTION: High grade gliomas are an insidious disease associated with an extremely poor prognosis. The role of re-irradiation for recurrent gliomas is unclear but several retrospective studies have indicated mild toxicity and modest outcomes with this regimen. With subsequent progression, it is unclear what options remain and more radiotherapy is rarely offered for fear of surpassing normal central nervous system tissue tolerance and causing significant side effects without significant benefit.

CASE PRESENTATION: In this report, we describe a 37-year-old Caucasian male initially diagnosed with a grade IV oligodendroglioma, who received multiple courses of re-irradiation and experienced a survival of 10 …

Download The Full Pdf Of Jefferson Surgical Solutions Spring 2011, Volume 6, Number 1

Jefferson Surgical Solutions

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News In Brief

Jefferson Surgical Solutions

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Those Who Give: Making A Difference Now And Down The Road: The Howell Professorship In Pancreatic Cancer Research

Jefferson Surgical Solutions

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On The Job: Dr. Goldberg Spends Research Year Targeting Breast Cancer

Jefferson Surgical Solutions

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Beekley’S Combat Experience Informs Research And Protocols At Home And Abroad

Jefferson Surgical Solutions

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Resident Update: Lieutenant Commander Daniel R. Grabo

Jefferson Surgical Solutions

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Creating Second Chances For All Ages: The Live Donor Liver Transplant Program

Jefferson Surgical Solutions

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