Medical Specialties Commons^™

The Career Support Network (Csn): Workforce Programming Through A New Lens, Rickie Brawer, Mph, Phd, James D. Plumb Md, Mph, Stephen Kern, Phd, Otr/L, Faota

Department of Family & Community Medicine Faculty Papers

Challenges:

Loss of Earn center as referral source

Multiple IRB submissions

Training/orientation at Philadelphia Prison System for working with pre-release prisoners

Service team organization/scheduling

Coordinating of cohorts at various stages of enrollment

Sepa-Reads: Cardiovascular Health Literacy Coalition, Rickie Brawer, Mph, Phd, James D. Plumb Md, Mph, Rob Simmons Drph,Mph,Ches, Martha Romney Rn,Ms,Jd,Mph, Patricia Yurchick, Rn, Mba, Cphq, Leslie Stearns

Department of Family & Community Medicine Faculty Papers

Poster includes:

Health literacy definition

Factors that contribute to health literacy

Extent of the literacy problem

What do we know from a decade of research?

Readmission rates

Evaluation: long and short term outcomes

And much more.

Boerhaave's Syndrome As A First Presentation Of Eosinophilic Esophagitis, Whitney E. Jackson, Vaibhav Mehendiratta, Juan P. Palazzo, Anthony J. Dimarino, Sidney Cohen

Division of Internal Medicine Faculty Papers & Presentations

Purpose: Prior studies have reported esophageal rupture following endoscopy or bolus impaction in eosinophilic esophagitis. The purpose of this study is to examine the frequency and characteristics of spontaneous rupture (Boerhaave's Syndrome) associated with vomiting S-435 AGA Abstracts in eosinophilic esophagitis.

Methods: A retrospective search of inpatient and outpatient records was conducted for the diagnoses "Boerhaave's", "eosinophilic esophagitis", and "esophageal rupture" from January 2001 to January 2011 within the gastroenterology division at an urban tertiary care hospital. For each subject identified, medical records, endoscopy reports, biopsy reports and radiographic studies were reviewed. A faculty member of the Department of Pathology …

Lymph Node Ratio Is An Important And Independent Prognostic Factor For Patients With Stage Iii Melanoma, Adam C. Berger, Michael Fierro, John C. Kairys, David Berd, Takami Sato, Jocelyn Andrel, Terry Hyslop, Michael J. Mastrangelo

Kimmel Cancer Center Faculty Papers

INTRODUCTION:

The incidence of melanoma is dramatically increasing worldwide. We hypothesized that the ratio of metastatic to examined lymph node ratio (LNR) would be the most important prognostic factor for stage III patients.

METHODS:

We retrospectively reviewed our institutional database of melanoma patients and identified 168 patients who underwent lymph node dissection (LND) for stage III disease between 1993 and 2007. Patients were divided into three groups based on LNR (≤10%, n = 93; 10-≤25%, n = 45; and >25%, n = 30). Univariate and multivariate analysis was performed using Cox proportional hazards model.

RESULTS:

The median survival time of …

Conversion From Enzyme-Inducing Antiepileptic Drugs To Topiramate: Effects On Lipids And C-Reactive Protein., Scott Mintzer, Christopher T Skidmore, Sara J Rankin, Inna Chervoneva, Edward Pequinot, David M Capuzzi, Michael R Sperling

Department of Neurology Faculty Papers

PURPOSE: We previously demonstrated that converting patients from the enzyme-inducers phenytoin or carbamazepine to the non-inducers levetiracetam or lamotrigine reduces serum lipids and C-reactive protein (CRP). We sought to determine if the same changes would occur when patients were switched to topiramate, which has shown some evidence of enzyme induction at high doses. We also examined the effects of drug switch on low-density lipoprotein (LDL) particle concentration.

METHODS: We converted 13 patients from phenytoin or carbamazepine monotherapy to topiramate monotherapy (most at doses of 100-150 mg/day). Fasting lipids, including LDL particle concentration, and CRP were obtained before and ≥6 weeks …

Trends In The Utilization Of Outpatient Advanced Imaging After The Deficit Reduction Act., David C Levin, Vijay M Rao, Laurence Parker

Department of Radiology Faculty Papers

PURPOSE: After the Deficit Reduction Act (DRA) took effect in 2007, there was concern that private office-based imaging facilities would close, that advanced imaging would shift to less convenient hospital-based facilities, and that access to advanced imaging might be restricted. The aim of this study was to see if these developments occurred during the years after the DRA.

METHODS: Using Medicare data, outpatient CT, MRI, and nuclear medicine trends before and after the DRA were studied. Procedure volumes performed in private offices and hospital outpatient departments (HOPDs) were tabulated separately. Volumes were tracked from 2000 to 2006 (before the DRA) …

Determining Efficacy Of Breast Cancer Therapy By Pet Imaging Of Her2 Mrna, Bishnuhari Paudyal, Kaijun Zhang, Changpo Chen, Neil Mehta, Eric Wickstrom, Brian Gray, Jeffrey Mattis, Koon Pak, Mathew L Thakur

Department of Radiology Faculty Papers

No abstract provided.

Optical Imaging For Determination Of Apoptosis Medicated Therapeutic Efficacy, Kaijun Zhang, Bishnuhari Paudyal, Neil Mehta, Brian Gray, Koon Y. Pak, Eric Wickstrom, Mathew L Thakur

Department of Radiology Faculty Papers

No abstract provided.

Acute Hypotensive Transfusion Reaction: A Case Report, Waleed Shah, Elia S. Elia

Department of Anesthesiology Faculty Papers

Introduction:

Acute hypotensive transfusion reactions are characterized by an abrupt and early onset of hypotension. This is often severe and lacks other signs of symptoms associated with more common causes of hypotension or transfusion reactions. Once the transfusion is stopped, the hypotension rapidly resolves, usually without the need for therapy.

Case Report detailed in poster.

Lymph Node Ratio Is An Important And Independent Prognostic Factor For Patients With Stage Iii Melanoma., Adam C. Berger, Michael Fierro, John C Kairys, David Berd, Takami Sato, Jocelyn Andrel, Terry Hyslop, Michael J Mastrangelo

Department of Surgery Faculty Papers

INTRODUCTION: The incidence of melanoma is dramatically increasing worldwide. We hypothesized that the ratio of metastatic to examined lymph node ratio (LNR) would be the most important prognostic factor for stage III patients.

METHODS: We retrospectively reviewed our institutional database of melanoma patients and identified 168 patients who underwent lymph node dissection (LND) for stage III disease between 1993 and 2007. Patients were divided into three groups based on LNR (≤10%, n = 93; 10-≤25%, n = 45; and >25%, n = 30). Univariate and multivariate analysis was performed using Cox proportional hazards model.

RESULTS: The median survival time of …

A Meta-Analysis Of Array-Cgh Studies Implicates Antiviral Immunity Pathways In The Development Of Hepatocellular Carcinoma., Xu Guo, Yanna Ba, Xi Ma, Jiaze An, Yukui Shang, Qichao Huang, Hushan Yang, Zhinan Chen, Jinliang Xing

Kimmel Cancer Center Faculty Papers

BACKGROUND: The development and progression of hepatocellular carcinoma (HCC) is significantly correlated to the accumulation of genomic alterations. Array-based comparative genomic hybridization (array CGH) has been applied to a wide range of tumors including HCCs for the genome-wide high resolution screening of DNA copy number changes. However, the relevant chromosomal variations that play a central role in the development of HCC still are not fully elucidated.

METHODS: In present study, in order to further characterize the copy number alterations (CNAs) important to HCC development, we conducted a meta-analysis of four published independent array-CGH datasets including total 159 samples.

RESULTS: Eighty …

Wnt Signaling Exerts An Antiproliferative Effect On Adult Cardiac Progenitor Cells Through Igfbp3., Angelos Oikonomopoulos, Konstantina-Ioanna Sereti, Frank Conyers, Michael Bauer, Annette Liao, Jian Guan, Dylan Crapps, Jung-Kyu Han, Hanhua Dong, Ahmad F Bayomy, Gabriel C Fine, Karen Westerman, Travis L Biechele, Randall T Moon, Thomas Force, Ronglih Liao

Center for Translational Medicine Faculty Papers

RATIONALE: Recent work in animal models and humans has demonstrated the presence of organ-specific progenitor cells required for the regenerative capacity of the adult heart. In response to tissue injury, progenitor cells differentiate into specialized cells, while their numbers are maintained through mechanisms of self-renewal. The molecular cues that dictate the self-renewal of adult progenitor cells in the heart, however, remain unclear.

OBJECTIVE: We investigate the role of canonical Wnt signaling on adult cardiac side population (CSP) cells under physiological and disease conditions.

METHODS AND RESULTS: CSP cells isolated from C57BL/6J mice were used to study the effects of canonical …

Treatment Of Chronic Mental Illness, Anu A. Matorin, Md

Jefferson Journal of Psychiatry

RESIDENT'S GUIDE TO TREATMENT OF PEOPLE WITH CHRONIC MENTAL ILLNESS

(GAP Report 136; 1993)

Formulated by the Committee on Psychiatry and the Community, Group for the Advancement of Psychiatry American Psychiatric Press, Inc., 1993, 230 pages, $30.00

A Mesmerizing Book, Daniel A. Monti, Md

Jefferson Journal of Psychiatry

HYPNOSIS IN THE RELIEF OF PAIN

Ernest R. Hilgard and Josephine R. Hilgard

Brunner/Maze!, Inc., New York 1994, paperback, $28 .95, 294 pgs.

Prediction Of Treatment Response And Diagnosis In Psychiatry, Eduardo Dunayevich, Md

Jefferson Journal of Psychiatry

The lack of diagnostic gold standards and the multiplicity of vantage points used to conceptualize mental illness renders psychiatric diagnostic and therapeutic approaches susceptible to individual and cultural biases. Developments in therapeutic approaches have often provided vantage points from which to conceptualize psychopathology. The identification of predictors of treatment response may be a useful element for clinicians to select between multiple treatment tools in an expanding therapeutic armamentarium while fostering refinements in current diagnostic systems.

The Forgotten Evaluation: Taking Competence Seriously, Seth E. Tabb, Md, Scott A. West, Md

Jefferson Journal of Psychiatry

The medical literature devotes little attention to the application of competency to the general medical patient. Commonly, the only cases recognized as necessitating a competency evaluation are overtly psychotic patients, patients requiring written informed consent, and those patients who refuse treatments strongly recommended by their physician. Clarifying terminology and redefining competency provides a practical screening method for assessing competency in all patients. When physicians neglect the evaluation of competency, patient autonomy is compromised. Not only are all physicians capable of performing a competency evaluation, they are ethically and professionally required to do so.

Transition To Psychiatric Residency: Unique Stresses; Unique Rewards, Catherine A. Belitsky, Md, Frcp(C), Sidney H. Kennedy, Md, Frcp(C)

Jefferson Journal of Psychiatry

An individual's decision to pursue a psychiatric residency following medical school training is shaped by many factors. Beginning residents are often ill prepared for the relative impact that the shift from medical doctor to psychiatric resident entails. This paper reviews the literature regarding demographic and psychological factors relating to recruitment, dynamic and practical issues confronting the beginning resident, and various coping styles adopted. These factors are considered in the context of an inpatient setting where the majority of residents begin their training. Much of the resident response is seen as adaptive and a number of strategies for coping are suggested.

Patients Who Request A Female Psychotherapist, Timothy C. Smith, Md, Melinda Fudge, Md, Salman Akhtar, Md, Steven Samuel, Phd

Jefferson Journal of Psychiatry

Upon arriving at an outpatient clinic, many patients request to see a female psychotherapist. Yet little has been written on this topic. The aim of this study was to explore the demographic and clinical characteristics of such patients. We compared patients who voiced a preference for a female therapist with controls on the demographic variables of age, sex, race, marital and financial status and the clinical characteristics of diagnosis, history of sexual abuse, sexual preference, overt presence of sexual or social difficulties, history of prior treatment, gender of the previous therapist, and treatment drop out rate. A chi square analysis …

Non-Neuroleptic Pharmacotherapy Of Schizophrenia, Sajiv John, Md, Atul Mahableshwarkar, Md

Jefferson Journal of Psychiatry

Patients with schizophrenia are typically treated with a neuroleptic and some form of psychosocial intervention. In spite of optimum treatment, up to one-third of patients continue to remain severely disabled due to persistent positive or negative symptoms. A variety of drugs have been tried as alternatives or additions to traditional neuroleptics in these patients. This paper is a review of these nonneuroleptic treatment alternatives and an attempt to establish some guidelines for their use.

A Case Study Of Obsessive-Compulsive Disorder: Some Diagnostic Considerations, Jeanette M. Stumbo Zaimes, Md

Jefferson Journal of Psychiatry

Obsessive-Compulsive Disorder (OCD) was considered a rare disorder prior to 1984 when the initial results from the Epidemiologic Catchment Area survey demonstrated a substantial prevalence of the disorder (1). Thus there may be many patients today who entered treatment prior to 1984 with undiagnosed OCD. This paper gives the history of one such patient and reviews the current literature on OCD as it pertains to the diagnostic evidence in this case.

Concepts And Models Of Empathy: Past, Present, And Future, Elizabeth Ann Baxter, Md

Jefferson Journal of Psychiatry

The subject of empathy has been increasing in popularity and importance; correspondingly, the theoretical aspects of empathy are in need of further development. This paper outlines key concepts and processes related to empathy, particularly the mechanisms of identification and regression as they are discussed in the models of empathy articulated by Fleiss, Greenson, and Jordan. Similarities and differences of the models are examined, in addition to each model's description of the roles of identification and regression. Although each model has made significant contributions towards a theoretical perspective of empathy, none of them have distinguished pathological from non-pathological uses of identification. …

Case Report: Sometimes A Cigar Is Just A Cigar, Zafar Y. Ibrahim, Md, Ellen F. Brooks, Md

Jefferson Journal of Psychiatry

This unusual case underscores the need for psychiatrists to consider treatable and curable causes of acute behavior changes even when historical data are not easily available. This case presentation invites physicians of mind (and body) to utilize simple and common-sense approaches while evaluating their patients.

Editor's Column, Mary E. Donovan, Md

Jefferson Journal of Psychiatry

"Sometimes a cigar is just a cigar. " Others had learned, "My son, sometimes a cigar is just a good smoke." Like many of our colleagues, we believed that these were Freud's words during a question and answer session after a lecture he gave at Clark University. The words were comforting in a way, giving us a chance to chalk at least some things up to pure coincidence, thus releasing us from relentless unconscious agendas and hidden sexual interpretations.

Current Concepts-Past Contributions, Cynthia L. Theiss, Md

Jefferson Journal of Psychiatry

WOMEN BEYOND FREUD: NEW CONCEPTS OF FEMININE PSYCHOLOGY

Edited by Milton M. Berger, M.D., with chapters by Marianne Horney Eckardt, Carol Gilligan , Douglas H. Ingram, Helen Singer Kaplan, Harold I. Lief, Jean Baker Miller, Silvia W. Olarte, Susan Quinn, and Mario Rendon

Brunner/Mazel, Inc., New York , 1994, 162 pages, $26.95

Old Age No Barrier To Psychotherapy, Jeanette Oleskowicz, Md

Jefferson Journal of Psychiatry

THE PSYCHOTHERAPY OF THE ELDERLY SELF

Hyman Muslin MD

Brunner /Mazel Inc., New York 1992, Hard cover

$27.50, 220 pages

Life Under Scrutiny, Andres Martin, Md

Jefferson Journal of Psychiatry

ON KISSING, TICKLING, AND BEING BORED: PSYCHOANALYTIC ESSAYS ON THE UNEXAMINED LIFE

Adam Phillips

Harvard University Press Cambridge, Massachusettes

1993, Hardcover, 138 pages, $ 19.95

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

Sexual Side Effects Of Psychiatric Medications In Women: A Clinical Review, Laura L. Post, Md, Faacs

Jefferson Journal of Psychiatry

Sexual side effects of psychiatric medications have been estimated to occur in 60% of male clients (1) and 30% of female clients (2). Despite a body of literature relating individual medications to specific sexual side effects, few studies have satisfactorily addressed the psychotropic-induced sexual dysfunctions in women. The spectrum of known sexual sided effects resulting from psychopharmacologic interventionswill be reviewed. Guidelines for appropriately addressing the possibility of sexual side effects within a therapeutic relationship for maximizing reporting of sexual side effects, and for possible treatment approaches to sexual side effects will be described.

Positron Emission Tomography In Psychiatry: New Sights, New Insights, Shitij Kapur, Md, Sylvain Houle, Md, Phd, Frcp (C), Gregory M. Brown, Md, Phd, Frcp (C)

Jefferson Journal of Psychiatry

Positron Emission Tomography (PET) is a new tool with which to explore the neurobiological basis of psychiatric illness. PET permits in-vivo measurement of regional cerebral blood flow, regional glucose metabolism, as well as information about neurochemicals and their receptors. Since regional cerebral bloodflow and glucose metabolism reflect ongoing neuronal activity, the neural bases of different cognitive processes and emotional states can be discerned using PET. Findings from recent studies in schizophrenia, affective disorders, obsessive-compulsive disorders, anxiety disorders, and dementia are reviewed with a special emphasis on how these findings may' be useful in developing a more comprehensive framework for understanding …

Literature Review: Stress Reactance In Psoriatic Patients, W. Michael Hooten, Md

Jefferson Journal of Psychiatry

The association between stress and psoriasis is well documented. A subgroup of psoriatic patients appear to be high stress reactors who can identify specific psychosocial stresses which exacerbate their psoriasis. In contrast, low stress reactors report no association between stress and the exacerbation of psoriasis. In differentiating high versus low stress reactors, a review of the literature suggests: 1) a neurogenic mediated disease process; 2) high stress reactors' disease course is not confounded by underlying psychopathology and, 3) high stress psoriatics experience more disease related stress than low stress reactors.