Medical Specialties Commons^™

Bdnf Val66met Polymorphism And Antipsychotic-Induced Tardive Dyskinesia Occurrence And Severity: A Meta-Analysis, I. Miura, Jianping Zhang, M. Nitta, T. Lencz, John Kane, Anil Malhotra, H. Yabe, Christoph Correll

Journal Articles

Background: Tardive dyskinesia (TD) is a serious long-term consequence of antipsychotic treatment. Since brain-derived neurotrophic factor (BDNF) has potent neurotrophic activity, genetic alterations in the BDNF gene may affect antipsychotic-induced TD. Methods: Searching PubMed and Web of Science until 05/31/13, we conducted a systematic review and a meta-analysis of the effects of BDNF Val66Met polymorphism on antipsychotic-induced TD. Pooled odds ratio was calculated to assess the effects of BDNF Val66Met polymorphism on TD occurrence. Additionally, pooled standardized mean differences (Hedges'g) were calculated to assess the effects on Abnormal Involuntary Movement Scale (AIMS) total score. Results: Out of 699 potentially eligible …

Excess Of Homozygosity In The Major Histocompatibility Complex In Schizophrenia, S. Mukherjee, S. Guha, M. Ikeda, N. Iwata, Anil Malhotra, I. Pe'er, A. Darvasi, T. Lencz

Journal Articles

Genome-wide association studies (GWAS) in schizophrenia have focused on additive allelic effects to identify disease risk loci. In order to examine potential recessive effects, we applied a novel approach to identify regions of excess homozygosity in an ethnically homogenous cohort: 904 schizophrenia cases and 1640 controls drawn from the Ashkenazi Jewish (AJ) population. Genome-wide examination of runs of homozygosity identified an excess in cases localized to the major histocompatibility complex (MHC). To refine this signal, we used the recently developed GERMLINE algorithm to identify chromosomal segments shared identical-by-descent (IBD) and compared homozygosity at such segments in cases and controls. We …

Matrics Cognitive Consensus Battery (Mccb) Performance In Children, Adolescents, And Young Adults, G. C. Nitzburg, P. Derosse, K. E. Burdick, B. D. Peters, C. B. Gopin, Anil Malhotra

Journal Articles

Background: Neurodevelopmental models of schizophrenia suggest that cognitive deficits may be observed during childhood and adolescence, long before the onset of psychotic symptoms. Elucidating the trajectory of normal cognitive development during childhood and adolescence may therefore provide a basis for identifying specific abnormalities related to the development of schizophrenia. The MATRICS Consensus Cognitive Battery (MCCB), which was designed for use in clinical trials targeting cognitive deficits most common in schizophrenia, may provide a mechanism to understand this trajectory. To date, however, there is no performance data for the MCCB in healthy children and adolescents. The present study sought to establish …

Age-Related Differences In White Matter Tract Microstructure Are Associated With Cognitive Performance From Childhood To Adulthood, B. D. Peters, T. Ikuta, P. Derosse, M. John, K. E. Burdick, P. Gruner, D. M. Prendergast, Philip Szeszko, Anil Malhotra

Journal Articles

Background: Age-related differences in white matter tract microstructure have been well established across the life span. In the present cross-sectional study, we examined whether these differences are associated with neurocognitive performance from childhood to late adulthood. Methods: Diffusion tensor imaging was performed in 296 healthy subjects aged 8 to 68 years (mean = 29.6, SD = 14.6). The corpus callosum, two projection tracts, and five association tracts were traced using probabilistic tractography. A neurocognitive test battery was used to assess speed of processing, attention, spatial working memory, verbal functioning, visual learning, and executive functioning. Linear mediation models were used to …

Brain White Matter Development Is Associated With A Human-Specific Haplotype Increasing The Synthesis Of Long Chain Fatty Acids, B. D. Peters, A. N. Voineskos, P. R. Szeszko, T. A. Lett, P. Derosse, S. Guha, K. H. Karlsgodt, M. John, T. Lencz, A. K. Malhotra, +4 Additional Authors

Journal Articles

The genetic and molecular pathways driving human brain white matter (WM) development are only beginning to be discovered. Long chain polyunsaturated fatty acids (LC-PUFAs) have been implicated in myelination in animal models and humans. The biosynthesis of LC-PUFAs is regulated by the fatty acid desaturase (FADS) genes, of which a human-specific haplotype is strongly associated with omega-3 and omega-6 LC-PUFA concentrations in blood. To investigate the relationship between LC-PUFA synthesis and human brain WM development, we examined whether this FADS haplotype is associated with age-related WM differences across the life span in healthy individuals 9-86 years of age (n = …

Delineation Of Hippocampal Subregions Using T1-Weighted Magnetic Resonance Images At 3 Tesla, K. Rhindress, T. Ikuta, R. Wellington, A. K. Malhotra, P. Szeszko

Journal Articles

Although several novel approaches for hippocampal subregion delineation have been developed, they need to be applied prospectively and may be limited by long scan times, the use of high field (>3T) imaging systems, and limited reliability metrics. Moreover, the majority of MR imaging data collected to date has employed a T1-weighted acquisition, creating a critical need for an approach that provides reliable hippocampal subregion segmentation using such a contrast. We present a highly reliable approach for the identification of six subregions comprising the hippocampal formation from MR images including the subiculum, dentate gyrus/cornu Ammonis 4 (DG/CA4), entorhinal cortex, fimbria, …

White Matter Changes Associated With Antipsychotic Treatment In First-Episode Psychosis, P. Szeszko, D. G. Robinson, T. Ikuta, B. D. Peters, J. Gallego, J. Kane, A. K. Malhotra

Journal Articles

Second-generation antipsychotics are utilized extensively in the treatment of psychotic disorders and other psychiatric conditions, but the effects of these medications on human brain white matter are not well understood. We thus investigated the effects of second-generation antipsychotics on white matter integrity using tract-based spatial statistics in patients experiencing a first episode of psychosis with little or no prior antipsychotic exposure, and how potential changes were associated with metabolic side effects. Thirty-five (26 men/9 women) patients experiencing a first episode of psychosis received diffusion tensor imaging (DTI) exams, clinical assessments, and provided fasting blood samples at the onset of antipsychotic …

Prevalence And Correlates Of Antipsychotic Polypharmacy In Children And Adolescents Receiving Antipsychotic Treatment*, N. Toteja, J. Gallego, E. Saito, T. Gerhard, A. Winterstein, M. Olfson, C. U. Correll

Journal Articles

Antipsychotic polypharmacy (APP), which is common in adults with psychotic disorders, is of unproven efficacy and raises safety concerns. Although youth are increasingly prescribed antipsychotics, little is known about APP in this population. We performed a systematic PubMed search (last update 26 January 2013) of studies reporting the prevalence of APP in antipsychotic-treated youth. Summary statistics and statistical tests were calculated at the study level and not weighted by sample size. Fifteen studies (n=58041, range 68-23183) reported on APP in youth [mean age=13.4 +/- 1.7 yr, 67.1 +/- 10.2% male, 77.9 +/- 27.4% treated with second-generation antipsychotics (SGAs)]. Data collected …

Age-Associated Alterations In Corpus Callosum White Matter Integrity In Bipolar Disorder Assessed Using Probabilistic Tractography, N. Toteja, P. Guvenek-Cokol, T. Ikuta, V. Kafantaris, B. D. Peters, K. E. Burdick, M. John, A. K. Malhotra, P. Szeszko

Journal Articles

OBJECTIVES: Atypical age-associated changes in white matter integrity may play a role in the neurobiology of bipolar disorder, but no studies have examined the major white matter tracts using nonlinear statistical modeling across a wide age range in this disorder. The goal of this study was to identify possible deviations in the typical pattern of age-associated changes in white matter integrity in patients with bipolar disorder across the age range of 9-62 years. METHODS: Diffusion tensor imaging was performed in 57 (20 male and 37 female) patients with a diagnosis of bipolar disorder and 57 (20 male and 37 female) …

Genome-Wide Mapping Of Ibd Segments In An Ashkenazi Pd Cohort Identifies Associated Haplotypes, V. Vacic, L. J. Ozelius, L. N. Clark, A. Bar-Shira, M. Gana-Weisz, T. Gurevich, A. Gusev, S. Guha, T. Lencz, A. Orr-Urtreger, +10 Additional Authors

Journal Articles

The recent series of large genome-wide association studies in European and Japanese cohorts established that Parkinson disease (PD) has a substantial genetic component. To further investigate the genetic landscape of PD, we performed a genome-wide scan in the largest to date Ashkenazi Jewish cohort of 1130 Parkinson patients and 2611 pooled controls. Motivated by the reduced disease allele heterogeneity and a high degree of identical-by-descent (IBD) haplotype sharing in this founder population, we conducted a haplotype association study based on mapping of shared IBD segments. We observed significant haplotype association signals at three previously implicated Parkinson loci: LRRK2 (OR = …

In Reference To "The Value Of Resident Presentations At Scientific Meetings", J. A. Eloy, P. F. Svider, A. J. Folbe, M. Setzen, S. Baredes

Journal Articles

No abstract provided.

Expression Of Blimp-1 In Dendritic Cells Modulates The Innate Inflammatory Response In Dextran Sodium Sulfate-Induced Colitis, S. J. Kim, J. Goldstein, K. Dorso, M. Merad, L. Mayer, J. M. Crawford, P. K. Gregersen, B. Diamond

Journal Articles

A single nucleotide polymorphism of PRDM1, the gene encoding Blimp-1, is strongly associated with inflammatory bowel disease. Here, we demonstrate that Blimp-1 in CD103(+) dendritic cells (DCs) critically contributes to the regulation of macrophage homeostasis in the colon. Dextran sodium sulfate (DSS)-exposed Blimp-1(cko) mice with a deletion of Blimp-1 in CD103(+) DCs and CD11c(hi) macrophages exhibited severe inflammatory symptoms, pronounced weight loss, high mortality, robust infiltration of neutrophils in epithelial regions of the colon, an increased expression of proinflammatory cytokines and a significant decrease in CD103(+) DCs in the colon compared with DSS exposed wild-type (WT) mice. Purified colonic macrophages …

Schwannoma Of The Cervical Esophagus, M. Ferrante, A. Khan, C. Fan, F. Z. Jelloul

Journal Articles

Esophageal schwannoma is a rare tumor first described in 1967 by Chaterlin and Fissore. These tumors are most commonly found incidentally or from diagnostic work up of dysphagia or dyspnea. This entity cannot be diagnosed on clinical or radiographic basis alone. Histology demonstrates palisading spindle cells, few if any mitotic figures, and a peripheral cuff of lymphoid cells. Immunohistochemically, tumor cells stain positive for S100, a characteristic marker of Schwann cells. Once diagnosed, surgical enucleation is the typical treatment method employed.

Aggressive Renal Angiomyolipoma Of The Lipomatous Variant With Inferior Vena Cava Thrombus: A Case Report And Review Of The Literature, C. Fox, S. S. Salami, D. M. Moreira, G. S. Landis, D. Chan, O. Yaskiv, M. A. Vira

Journal Articles

Two variants of renal angiomyolipoma (AML)—classic and epithelioid—have been described. Although the epithelioid variant has been reported to demonstrate an aggressive clinical behavior, classic AML is usually benign. Herein, we report a case of a 42-year-old asymptomatic woman with a lipomatous variant of renal AML associated with an inferior vena cava thrombus managed with radical nephrectomy and caval thrombectomy.

Mantle Cell Lymphoma With In Situ Or Mantle Zone Growth Pattern: A Study Of Five Cases And Review Of Literature, P. Hsu, T. Yang, S. Sheikh-Fayyaz, J. Brody, J. Bandovic, S. Roy, J. Laser, J. E. Kolitz, C. Devoe, X. Zhang

Journal Articles

We present two rare cases of in situ mantle cell lymphoma ("in situ MCL") and three cases of MCL with mantle zone growth pattern (MCL-MZGP). The patients include four males and one female, with a median age of 66 years (range, 52 to 86 years). Two present with isolated lymphadenopathy and three with multiple lymphadenopathy. At presentation, the complete blood count (CBC) and serum lactate dehydrogenase (LDH) are normal in all cases. Histologic examination reveals an in situ pattern in two cases and a mantle zone growth pattern in three cases. The staging bone marrow biopsies show minimal involvement by …

Arthroscopic Treatment Of Bucket-Handle Labral Tear And Acetabular Fracture, K. J. Stabile, J. A. Neumann, S. Mannava, E. A. Howse, A. J. Stubbs

Journal Articles

Traumatic hip dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the joint. These types of injury often lead to traumatic arthritis. In some cases an osseo-labral fragment may become incarcerated in the joint that is not readily visualized preoperatively. In place of open surgery, hip arthroscopy permits a technique to remove loose bodies and repair labral tears to restore joint congruity and achieve fracture reduction and fixation.

Inhibition Of Extracellular Hmgb1 Attenuates Hyperoxia-Induced Inflammatory Acute Lung Injury, M. Entezari, M. Javdan, D. J. Antoine, D. M. Morrow, R. A. Sitapara, V. Patel, M. Wang, L. Sharma, H. Wang, L. L. Mantell, +7 Additional Authors

Journal Articles

Prolonged exposure to hyperoxia results in acute lung injury (ALI), accompanied by a significant elevation in the levels of proinflammatory cytokines and leukocyte infiltration in the lungs. However, the mechanisms underlying hyperoxia-induced proinflammatory ALI remain to be elucidated. In this study, we investigated the role of the proinflammatory cytokine high mobility group box protein 1 (HMGB1) in hyperoxic inflammatory lung injury, using an adult mouse model. The exposure of C57BL/6 mice to >/=99% O2 (hyperoxia) significantly increased the accumulation of HMGB1 in the bronchoalveolar lavage fluids (BALF) prior to the onset of severe inflammatory lung injury. In the airways of …

Comment On "Effectiveness Of Naltrexone In The Prevention Of Delayed Respiratory Arrest In Opioid-Naive Methadone-Intoxicated Patients'', B. D. Kessler, R. S. Hoffman

Journal Articles

No abstract provided.

Arthroscopic Hip Labral Repair: The Iberian Suture Technique, A. J. Stubbs, J. S. Andersen, S. Mannava, B. M. Wooster, E. A. Howse, S. B. Winter

Journal Articles

Arthroscopic hip labral repair has beneficial short-term outcomes; however, debate exists regarding ideal surgical labral repair technique. This technical note presents an arthroscopic repair technique that uses intrasubstance labral suture passage to restore the chondrolabral interface. This "Iberian suture technique" allows for an anatomic repair while posing minimal risk of damage to the labral and chondral tissues.

Should Osteopathic Students Applying To Allopathic Emergency Medicine Programs Take The Usmle Exam?, M. Weizberg, D. Kass, A. Hussains, J. Cohen, B. Hahn

Journal Articles

INTRODUCTION: Board scores are an important aspect of an emergency medicine (EM) residency application. Residency directors use these standardized tests to objectively evaluate an applicant's potential and help decide whether to interview a candidate. While allopathic (MD) students take the United States Medical Licensing Examination (USMLE), osteopathic (DO) students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). It is difficult to compare these scores. Previous literature proposed an equation to predict USMLE based on COMLEX. Recent analyses suggested this may no longer be accurate. DO students applying to allopathic programs frequently ask whether they should take USMLE to overcome this …

Bilateral Hydronephrosis And Cystitis Resulting From, V. H. Tran, M. Nelson, J. Nogar, R. M. Bramante

Journal Articles

Ketamine associated urinary dysfunction has become increasingly more common worldwide. Point-of-care ultrasound (POCUS) is an established modality for diagnosing hydronephrosis in the emergency department. We describe a case of a young male ketamine abuser with severe urinary urgency and frequency in which POCUS performed by the emergency physician demonstrated bilateral hydronephrosis and a focally thickened irregular shaped bladder. Emergency physicians should consider using POCUS evaluate for hydronephrosis and bladder changes in ketamine abusers with lower urinary tract symptoms. The mainstay of treatment is discontinuing ketamine abuse.

Helping The Community From The Bottom Up: Distributing Diapers To The Williamsburg Community, Constance A. Hull, Caroline Kelsey

VA Engage Journal

There is a great need for a sustainable supply of clean diapers for low-income residents of Williamsburg since this region is without a diaper bank. Being unable to afford diapers can have a myriad of negative consequences from being unable to send children to child care to increased health risks involved in leaving a baby in a soiled diaper. Our model of a diaper bank differs from most because we mail diapers directly to families, eliminating transportation needs. We hope to partner with community agencies and The College of William & Mary to expand our services and create a more …

Diabetes Prevention Of The Hispanic Population: Health Lifestyle Management Education At Our Lady Of Guadelupe Clinic In Worthington, Minnesota., Laura J. Bade, Amber E. Dionne, Erin A. Manoles, Lisa R. Milbrant

All Electronic Theses and Dissertations

The purpose of this research study was to utilize educational tools on healthy lifestyles in order to promote Diabetes Mellitus Type II (DMII) prevention in the Hispanic population in Worthington, Minnesota. Hispanic adults are 1.7 times more likely to be diagnosed with Diabetes Mellitus (DM) by a physician than non-Hispanics. Since DMII is a preventable disease, education focused on nutrition and activity will help prevent diabetes and its associated comorbidities. An educational seminar was conducted at Our Lady of Guadalupe in Worthington, Minnesota. A pretest/posttest was administered to assess the knowledge gained with the utilization of the educational tool. Despite …

Ethical Dilemmas Posed In The Care Of Obese Patients In The Emergency Department, Arvind Venkat, Gregory Luke Larkin

Journal of Health Ethics

The rising prevalence of obesity represents a health care crisis. As the gateway to the health care system, the emergency department is the clinical setting where the difficulties posed by the care of obese patients are heightened. These difficulties include the increasing burden of obesity-related illnesses, the challenges posed in diagnostic evaluation and treatment and the known barriers to access to care seen in this patient population. The limitations posed by obesity on care in the emergency department, the one guaranteed access point for medical treatment, creates a series of ethical dilemmas for emergency physicians and the facilities in which …

Mitochondrial Dna Copy Numbers In Pyramidal Neurons Are Decreased And Mitochondrial Biogenesis Transcriptome Signaling Is Disrupted In Alzheimer’S Disease Hippocampi, Ann C. Rice, Paula M. Keeney, Norah K. Algarzae, Amy C. Ladd, Ravindar R. Thomas, James P. Bennett

Neurology Publications

Alzheimer's disease (AD) is the major cause of adult-onset dementia and is characterized in its pre-diagnostic stage by reduced cerebral cortical glucose metabolism and in later stages by reduced cortical oxygen uptake, implying reduced mitochondrial respiration. Using quantitative PCR we determined the mitochondrial DNA (mtDNA) gene copy numbers from multiple groups of 15 or 20 pyramidal neurons, GFAP(+) astrocytes and dentate granule neurons isolated using laser capture microdissection, and the relative expression of mitochondrial biogenesis (mitobiogenesis) genes in hippocampi from 10 AD and 9 control (CTL) cases. AD pyramidal but not dentate granule neurons had significantly reduced mtDNA copy numbers …

Letrozole Versus Clomiphene For Infertility In The Polycystic Ovary Syndrome, Richard S. Legro, Robert Bryzki, Michael Diamond, Christos Coutifaris, William D. Schlaff, Peter Casson, Gregory M. Christman, Hao Huang, Qingshang Yan, Ruben Alvero, Daniel J. Haisenleder, Kurt T. Barnhart, G. Wright Bates, Rebecca Usadi, Scott Lucidi, Valerie Baker, J. C. Trussell, Stephen A. Krawetz, Peter Snyder, Dana Ohl, Nanette Santoro, Esther Eisenberg, Heping Zhang

Obstetrics and Gynecology Publications

BACKGROUND

Clomiphene is the current first-line infertility treatment in women with the polycystic ovary syndrome, but aromatase inhibitors, including letrozole, might result in better pregnancy outcomes.

Full Text of Background...

METHODS

In this double-blind, multicenter trial, we randomly assigned 750 women, in a 1:1 ratio, to receive letrozole or clomiphene for up to five treatment cycles, with visits to determine ovulation and pregnancy, followed by tracking of pregnancies. The polycystic ovary syndrome was defined according to modified Rotterdam criteria (anovulation with either hyperandrogenism or polycystic ovaries). Participants were 18 to 40 years of age, had at least one patent fallopian …

Hospitalization Rates In Patients Switched From Oral Anti-Psychotics To Aripiprazole Once-Monthly: Final Efficacy Analysis, John Kane, C. Zhao, B. R. Johnson, R. A. Baker, A. Eramo, R. D. Mcquade, A. R. Duca, R. Sanchez, T. Peters-Strickland

Journal Articles

Abstract Objective: To compare hospitalization rates in patients with schizophrenia treated prospectively with aripiprazole once-monthly 400 mg (AOM 400; an extended-release injectable suspension) vs the same patients' retrospective rates with their prior oral anti-psychotic therapy. Research design and methods: Multi-center, open-label, mirror-image, naturalistic study in a community setting in North America. Patients who required a change in treatment and/or would benefit from long-acting injectable anti-psychotic therapy were treated prospectively for 6 months with AOM 400. Retrospective data on hospitalization rates were obtained. Clinical trial registration: ClinicalTrials.gov: NCT01432444. Main outcome measures: The proportion of patients with >/=1 psychiatric inpatient hospitalization with …

Optimal Treatment Of Alzheimer's Disease Psychosis: Challenges And Solutions, Jeremy Koppel, Blaine Greenwald

Journal Articles

Psychotic symptoms emerging in the context of neurodegeneration as a consequence of Alzheimer's disease was recognized and documented by Alois Alzheimer himself in his description of the first reported case of the disease. Over a quarter of a century ago, in the context of attempting to develop prognostic markers of disease progression, psychosis was identified as an independent predictor of a more-rapid cognitive decline. This finding has been subsequently well replicated, rendering psychotic symptoms an important area of exploration in clinical history taking - above and beyond treatment necessity - as their presence has prognostic significance. Further, there is now …

The Relationship Of Neurocognition And Negative Symptoms To Social And Role Functioning Over Time In Individuals At Clinical High Risk In The First Phase Of The North American Prodrome Longitudinal Study, E. C. Meyer, Ricardo Carrion, Barbara Cornblatt, J. Addington, K. S. Cadenhead, T. D. Cannon, T. H. Mcglashan, D. O. Perkins, M. T. Tsuang, L. J. Seidman, +3 Additional Authors

Journal Articles

OBJECTIVES: Impaired social, role, and neurocognitive functioning are preillness characteristics of people who later develop psychosis. In people with schizophrenia, neurocognition and negative symptoms are associated with functional impairment. We examined the relative contributions of neurocognition and symptoms to social and role functioning over time in clinically high-risk (CHR) individuals and determined if negative symptoms mediated the influence of cognition on functioning. METHODS: Social, role, and neurocognitive functioning and positive, negative, and disorganized symptoms were assessed in 167 individuals at CHR for psychosis in the North American Prodrome Longitudinal Study Phase 1 (NAPLS-1), of whom 96 were reassessed at 12 …

Comparative Effectiveness Of Risperidone Long-Acting Injectable Vs First-Generation Antipsychotic Long-Acting Injectables In Schizophrenia: Results From A Nationwide, Retrospective Inception Cohort Study, J. Nielsen, S. O. Jensen, R. B. Friis, J. B. Valentin, Christoph Correll

Journal Articles

Objective: To compare in a generalizable sample/setting objective outcomes in patients receiving first-generation antipsychotic long-acting injectables (FGA-LAIs) or risperidone-LAI (RIS-LAI). Methods: Nationwide, retrospective inception cohort study of adults with International Classification of Diseases-10 schizophrenia using Danish registers from 1995 to 2009 comparing outcomes between clinician's/patient's choice treatment with FGA-LAIs or RIS-LAI. Primary outcome was time to psychiatric hospitalization using Cox-regression adjusting for relevant covariates. Secondary outcomes included time to all-cause discontinuation and psychiatric hospitalization in patients without LAI possession gap >28 days, and number of bed-days after psychiatric hospitalization. Results: Among 4532 patients followed for 2700 patient-years, 2078 received RIS-LAI …