Medical Specialties Commons^™

Characterization Of Invasive And Colonizing Isolates Of Streptococcus Agalactiae In East African Adults, Charlotte Huber, Francis Mcodimba, Valentin Pflueger, Claudia Daubenberger, Gunturu Revathi

Pathology, East Africa

Ninety-five colonizing isolates and 74 invasive isolates of Streptococcus agalactiae from Kenyan adults were characterized by using capsular serotyping and multilocus sequence typing. Twenty-two sequence types clustering into five clonal complexes were found. Data support the view that S. agalactiae isolates belonging to a limited number of clonal complexes are invasive in adults worldwide.

Use Of The Term "Elderly", Dale Avers, Marybeth Brown, Kevin Chui, Rita A. Wong, Michelle M. Lusardi

All PTHMS Faculty Publications

Using the term elderly for a person who is robust and independent as well as for a person who is frail and dependent says little about the individual.

Endovascular Approach As Primary Treatment For Traumatic Carotid Cavernous Fistula: Local Experience From Pakistan, Rana Shoaib Hamid, Tanveer Ul Haq, Muhammad Shahzad Shamim, Syed Faraz Kazim, Basit Salam

Department of Radiology

Objective: To evaluate the technical success, complications and outcome of endovascular management of post traumatic carotid cavernous fistula (CCF) in patients presenting at a tertiary care hospital in Karahci.
Methods: Descriptive case series of 26 patients of post traumatic CCF treated by endovascular techniques was carried out at Radiology and Neurosurgery departments of Aga Khan University hospital between January 2010 to March 2010. Medical records and radiology reports were retrospectively reviewed from November 2000 to December 2009. The diagnosis was primarily clinical and was confirmed in all cases by CT or MRI. Endovascular procedures were performed under general anaesthesia through …

My Patient's Brain Mri Has Cerebral Microbleeds--What Does This Finding Mean, Shaista Anwar Siddiqi, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Coronary Ct Radiation Reduction - The Lehigh Valley Health Network Experience, Nitin Verma Md, Ashish N. Kabra Md, Justin D. Roberts Do, James A. Newcomb Md, Howard Rosenberg Md, Julie Gubernick, Robert Kricun Md, Matthew W. Martinez Md

Department of Medicine

No abstract provided.

Male Gender Preference, Female Gender Disadvantage As Risk Factors For Psychological Morbidity In Pakistani Women Of Childbearing Age - A Life Course Perspective, Farah Qadir, Murad M. Khan Dr., Girmay Medhin, Martin Prince

Department of Psychiatry

Background: In Pakistan, preference for boys over girls is deeply culturally embedded. From birth, many women experience gendered disadvantages, less access to scarce resources, poorer health care, higher child mortality, limited education, less employment outside of the home and circumscribed autonomy. The prevalence of psychological morbidity is exceptionally high among women. We hypothesise that, among women of childbearing age, gender disadvantage is an independent risk factor for psychological morbidity. Methods: A cross-sectional catchment area survey of 525 women aged 18 to 35 years living in Islamabad and Rawalpindi. The effect of gender disadvantage was assessed as a latent variable using …

Use Of Dried-Blood-Spot Samples And In-House Assays To Identify Antiretroviral Drug Resistance In Hiv-Infected Children In Resource-Constrained Settings, Carrie Ziemniak, Yohannes Mengistu, Andrea Ruff, Ya-Hui Chen, Leila Khaki, Abubaker Bedri, Birgitte B. Simen, Paul Palumbo

Dartmouth Scholarship

Monitoring HIV drug resistance is an important component of the World Health Organization's global HIV program. HIV drug resistance testing is optimal with commercially available clinically validated test kits using plasma; however, that type of testing may not be feasible or affordable in resource-constrained settings. HIV genotyping from dried blood spots (DBS) with noncommercial (in-house) assays may facilitate the capture of HIV drug resistance outcomes in resource-constrained settings but has had varying rates of success. With in-house assays for HIV reverse transcriptase, we evaluated the yield of genotyping DBS samples collected from HIV-infected children who were enrolled in two clinical …

Strain-Dependent Variation In The Early Transcriptional Response To Cns Injury Using A Cortical Explant System, David J. Graber, Brent T. Harris, William F. Hickey

Dartmouth Scholarship

While it is clear that inbred strains of mice have variations in immunological responsiveness, the influence of genetic background following tissue damage in the central nervous system is not fully understood. A cortical explant system was employed as a model for injury to determine whether the immediate transcriptional response to tissue resection revealed differences among three mouse strains. Immunological mRNAs were measured in cerebral cortex from SJL/J, C57BL/6J, and BALB/cJ mice using real time RT-PCR. Freshly isolated cortical tissue and cortical sections incubated in explant medium were examined. Levels of mRNA, normalized to β-actin, were compared using one way analysis …

Whole-Exome Sequencing Of Dna From Peripheral Blood Mononuclear Cells (Pbmc) And Ebv-Transformed Lymphocytes From The Same Donor., Eric R Londin, Margaret A Keller, Michael R D'Andrea, Kathleen Delgrosso, Adam Ertel, Saul Surrey, Paolo Fortina

Kimmel Cancer Center Faculty Papers

BACKGROUND: The creation of lymphoblastoid cell lines (LCLs) through Epstein-Barr virus (EBV) transformation of B-lymphocytes can result in a valuable biomaterial for cell biology research and a renewable source of DNA. While LCLs have been used extensively in cellular and genetic studies, the process of cell transformation and expansion during culturing may introduce genomic changes that may impact their use and the interpretation of subsequent genetic findings.

RESULTS: We performed whole exome sequencing on a tetrad family using DNA derived from peripheral blood mononuclear cells (PBMCs) and LCLs from each individual. We generated over 4.7 GB of mappable sequence to …

Challenges And Barriers To Improving Care Of The Musculoskeletal Patient Of The Future - A Debate Article And Global Perspective., Hangama C Fayaz, Jesse B Jupiter, Hans Christoph Pape, R Malcolm Smith, Peter V Giannoudis, Christopher G Moran, Christian Krettek, Karl J Prommersberger, Michael J Raschke, Javad Parvizi

Rothman Institute Papers

UNLABELLED: ABSTRACT:

BACKGROUND: With greater technological developments in the care of musculoskeletal patients, we are entering an era of rapid change in our understanding of the pathophysiology of traumatic injury; assessment and treatment of polytrauma and related disorders; and treatment outcomes. In developed countries, it is very likely that we will have algorithms for the approach to many musculoskeletal disorders as we strive for the best approach with which to evaluate treatment success. This debate article is founded on predictions of future health care needs that are solely based on the subjective inputs and opinions of the world's leading orthopedic …

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor for Volume 6, Number 2, 1988 issue of Jefferson Journal of Psychiatry

In The Beginning...Phylogeny In Freud's Overview Of The Transference Neuroses: A Review-Essay, Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

A PHYLOGENETIC FANTASY

I. Grubrich-Simitis, editor

A. Hoffer and P. T. Hoffer, translators

Harvard University Press, Cambridge, Mass.

1987

Book Review: A Portrait Of The Analyst, Michael B. Knable, D.O.

Jefferson Journal of Psychiatry

A MIND OF HER OWN: THE LIFE OF KAREN HORNEY

Susan Quinn

New York , Summit Books

Book Review: Lessons Of War, Ronald J. Koshes, Md

Jefferson Journal of Psychiatry

MILITARY PSYCHIATRY: A COMPARATIVE PERSPECTIVE

Richard A. Gabriel, editor

New York, The Greenwood Press 1986, 170 pages

In Response: The Ideal Psychiatry Residency Training Program, Allan Tasman, Md

Jefferson Journal of Psychiatry

There is little to be added in the way of specifics to James Deming's review of the necessary ingredients for an ideal Residency Training Program (1). He not only reviews the specific issues which must be addressed regarding the "nuts and bolts" of training, but also emphasizes the need for phase specificity of both clinical and didactic experiences and the need to view residency training from a developmental perspective. Rather than comment specifically on the points Deming raises, I would like to address other ingredients in residency training which are to be valued in the ideal program.

The Role Of The Resident On The Psychiatric Inpatient Unit: A Systems Perspective, E. Michael Kahn, Md

Jefferson Journal of Psychiatry

A resident in psychiatry is customarily assigned to inpatient duty for the first year of training. The resident's tasks in this setting are complex, and he' is rarely prepared to perform all of them well (1,2,3). The stress on the resident in this situation is great. Most often, these challenges and their mastery are discussed in terms of intrapsychic conflicts; the traditional remedy is the assignment of a supervisor. Little consideration has be en given to the interpersonal and systems matrices in which these events occur, and the coping techniques and conceptual tools which the resident may use to meet …

Uses Of Carbamazepine For Psychiatric Disorders: A Review, Edward Kim, Md

Jefferson Journal of Psychiatry

Carbamazepine, first synthesized in 1953, was initially marketed in Europe as an anticonvulsant. In 1971 Dalby reported the drug's psychotropic effects, most notably mood stabilization, in patients with temporal lobe epilepsy (TLE) (1). Other psychiatric applications such as the treatment of affectively and behaviorally labile patients are being explored. These studies are yielding data relevant to the treatment and understanding of the neurobiology of mental illness. For this reason, familiarity with carbamazepine is becoming increasingly important to psychiatrists.

Dysmorphophobia In A Diastrophic Dwarf: A Psychiatry-Dermatology Liaison Approach, Donald J. Kushon, Md

Jefferson Journal of Psychiatry

This is a case study of a 30-year-old male diastrophic dwarf who complained of hypertrichosis on his back and nose of 3 years duration. He had no previous psychiatric history, and although the distortion he described on his back was not apparent to others, there was a minimal amount of dark hair growth on his nose. He had unresolved conflicts concerning his disproportionate arms and legs and had sought surgical correction for many years from many orthopedic surgeons to no avail. After a diagnosis of dysmorphophobia was made by a psychiatric consultant, weekly visits with the dermatologist were arranged for …

Transparency And Termination In Group Psychotherapy: A Resident's Perspective, Althea Donovan, Md

Jefferson Journal of Psychiatry

Termination has been seen as a difficult and complex process in group psychotherapy. Although termination of group members has be en explored, little is written on the subject of the therapist's termination; i.e., in the case of a group which continues after the therapist departs. This circumstance must occur frequently, however, especially since 91% of psychiatric programs, (Yalom (1985) citing Pinney) have at least one year of group psychotherapy training. This implies that group therapist termination must occur on a regular basis at some training programs. Even so, there are no specific guidelines or more general exploration of an inexperienced …

Psychotherapy And Mental Retardation: What's The Use?, Jolyn Welsh Wagner, Md

Jefferson Journal of Psychiatry

The lack of adequate treatment opportunities for mentally retarded people with emotional disturbances has been well documented (11,14,9,16,8,2 1,10,19). A high prevalence of psychopathology, estimated at 4- 5 times that of the non-retarded population (8,10) identifies a population extremely vulnerable to emotional problems. Although advocates from many disciplines, including psychiatry, (15) have worked diligently since the early 20th Century to eliminate massive institutionalization, sterilization, and isolation of the retarded from society's defensive arsenal, the mental healthfield, especially psychiatry, has failed to meet current needs with appropriate clinical services.

The Missed Appointment: A Resident's Journal Through Activity To Introspection, Marcia J. Kaplan, Md

Jefferson Journal of Psychiatry

There was one experience during my medical school psychiatry rotation that I could not forget. In a classroom on the cardiology ward, I listened, transfixed like a child at a magic show, as a psychiatrist interviewed a man who was recovering from a heart attack. Initially the man denied any stresses in his life that might have affected his health, but as he went on, a different story unfolded. He spoke of his recent retirement, his wife's dissatisfactions and hostility, his disappointment with his children, his growing sense of failure and futility, and the recurring tightness in his chest that …

The Potential Role Of Psychiatry Residents' Councils, J. Thomas Pichot, Md

Jefferson Journal of Psychiatry

There are numerous books and articles within the scientific literature that deal with issues of training psychiatry residents and the characteristics of that milieu. Those authors that deal primarily with stress usually discuss the sources of the stress and the resultant behavioral changes that are manifested by the trainees. Typically, are relatively small portion of the discussion is devoted to how these problems are, or might be, addressed. This paper, while not itself intended to be an overview of stress in residency; will concentrate on a literature review of some specific aspects of the residency training process, primarily role definition …

The Physical Examination In Psychiatry, Scott Patten, Md

Jefferson Journal of Psychiatry

The physical examination is a neglected aspect of the psychiatric assessment. For example, a survey of ninety-eight practicing psychiatrists, conducted by Patterson (1) in 1978, found that none of them routinely performed physical examinations on their patients. More than one-half of these psychiatrists reported that they no longer felt competent to do so. One situation in which psychiatrists do often perform physicals is while admitting patients to hospital. However, the quality of these examinations is often poor (2 ,3).

An indifferent attitude toward the physical examination has persisted in psychiatry despite numerous publications emphasizing the importance of medical assessment (2-8). …

Some Comments On The Concept Of The Ego-Ideal, Gurmeet Kanwal, Md

Jefferson Journal of Psychiatry

In a review of the literature on the ego-ideal my impression has been that this concept has been placed in the position of a stepchild of the structural model of the mind, falling somewhere between the ego and the super-ego, and yet remaining loosely linked to both. Authors such as Jacobson (1954), Hartmann and Lowenstein (1962), Sandler (1963), and Schafer (196 7), have regarded the ego-ideal as a substructure of the super-ego. Others like Annie Reich (1953, 1954), Lampl de-Groot (1947), Peter Bios (1972), and Chasseguet-Smirgel (1975), have tended to view the two as being separate structures.

The purpose of …

Editor's Column, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

In selecting, or as now in introducing the table of contents of each new issue of the Jefferson Journal, or in response to some occasional question as to the orientation of the Journal, the ghostly concept of eclecticism reappears. In choosing a residency training program in psychiatry, the nascent resident of the 1980's was usually met with a chorus of "eclectic" brochures and training directors, each describing their own version of this ideal. Having comfortably accepted this pleasingly vague and democratic ideal, it was disconcerting to hear my own training director, Dr. Harvey Schwartz, challenge this descriptive term. He …

Resident Editorial Board

Jefferson Journal of Psychiatry

List of Resident Editorial Board for Volume 6, Number 2, 1988 issue of Jefferson Journal of Psychiatry.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor, Volume 6, Number 1, 1987.

A Personal Journey, Shimon Waldfogel, Md

Jefferson Journal of Psychiatry

MAUS A SURVIVOR'S TALE

Art Spiegelman

New York Pantheon Books 1986.

Obsessive-Compulsive Disorder Reconsidered, Christopher J. Mcdougle, Md

Jefferson Journal of Psychiatry

OBSESSIVE-COMPULSIVE DISORDERS: THEORY & MANAGEMENT

Edited by Michael A. Jenike, Lee Baer, William E. Minichiello

Littleton, Mass, PSG Publishing Company, In c.1986. 196 pages, $24.50

In Response: The Usefulness Of Neutrality, Paul A. Dewald, Md

Jefferson Journal of Psychiatry

The term "neutrality" as used in psychoanalysis has multiple meanings, each carrying major emotional significance. In that sense "neutrality" is a term which evokes the metaphor of the "Six Blind Men and the Elephant."

In her paper, "The Usefulness of Neutrality," Julia Jones Zawatsky uses the term to express a variety of issues related to a complex and difficult clinical situation. Neutrality includes the therapist taking an equidistant position from the various forces involved in the compromise formation used to solve psychic conflict. She also uses the term to acknowledge the multiple facets of the therapist's conscious and unconscious …