Psychiatry Commons^™

Pimavanserin 34 Mg At Bedtime For The Treatment Of Insomnia In 6 Veterans With Posttraumatic Stress Disorder, Melissa B Jones, Ritwick Agrawal, Amir Sharafkhaneh, Gursimrat Bhatti, Ruosha Li, Laura Marsh, Ricardo E Jorge

Faculty, Staff and Student Publications

No abstract provided.

Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos

Journal of Wellness

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center.

Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience …

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Assessing The Neuropsychiatric Sequelae Of Ketamine After Use For Acute Agitation, Steven Sun Md, Henry Slone, Katherine B. Martin Md, Edward R. Norris Md, Fapa, Fapm

Department of Psychiatry

No abstract provided.

Synthetic Contraceptive Hormones Occlude The Ability Of Nicotine To Reduce Ethanol Consumption In Ovary-Intact Female Rats, Erin E. Maher, Ashley M. White, Ashley Craig, Shailesh N. Khatri, Percell T. Kendrick Jr., Mary E. Matocha, Emma O. Bondy, Nikhil Pallem, Grace W. Breakfield, Madison Botkins, Olivia Sweatt, William C. Griffin, Brent A. Kaplan, Jessica Jane Weafer, Joshua S. Beckmann, Cassandra D. Gipson

Markey Cancer Center Faculty Publications

Rates of tobacco and alcohol use in women are rising, and women are more vulnerable than men to escalating tobacco and alcohol use. Many women use hormonal birth control, with the oral contraceptive pill being the most prevalent. Oral contraceptives contain both a progestin (synthetic progesterone) and a synthetic estrogen (ethinyl estradiol; EE) and are contraindicated for women over 35 years who smoke. Despite this, no studies have examined how synthetic contraceptive hormones impact this pattern of polysubstance use in females. To address this critical gap in the field, we treated ovary-intact female rats with either sesame oil (vehicle), the …

Texas Youth Depression And Suicide Research Network (Tx-Ydsrn) Research Registry And Learning Healthcare Network: Rationale, Design, And Baseline Characteristics, Madhukar H. Trivedi, Abu Minhajuddin, Holli Slater, Regina Baronia, Joseph C. Blader, Jamon Blood, Ryan Brown, Cynthia Claassen, Melissa Defilippis, Cynthia Garza

School of Medicine Publications

Highlights

• TX-YDSRN will improve understanding of youth with depression and suicidal behaviors.

• TX-YDSRN consists of the UT Southwestern Network Hub and 12 medical school “Nodes”.

• The Research Registry will follow 2500 Texas youth for 2 years.

• This report includes the first 1000 youth enrolled in the Research Registry study.

Abstract

Background

American youth are seriously impacted by depression and suicide. The Texas Youth Depression and Suicide Research Network (TX-YDSRN) Participant Registry Study was initiated in 2020 to develop predictive models for treatment outcomes in youth with depression and/or suicidality. This report presents the study rationale, design and baseline characteristics of …

Prevalent Distribution Of Conscious Processes On Either Side Of The Brain, Sohail Adnan, Mubasher Shah, Muhammad Fateen Rashed, Sadaf Nawab

Journal of Mind and Medical Sciences

Objectives. The brain has an intrinsic tendency for the lateralization of its functions. For instance, the left hemisphere assists in the comprehension and motor expression of language. What remains uncertain is whether conscious processes are also more prevalent in one hemisphere of the brain than the other. The epistemic goal of this research was to address this particular issue. Materials and Methods. We observed the rare pathological event of proximal occlusion of the middle cerebral artery (MCA), which halts blood flow to the central two-thirds of a hemisphere, and examined its effects on consciousness. We aggregated individual scores for eyes-opening …

From Covid-19 To Long Covid; The Forms Of The Neurological Manifestations, Sana Ahuja, Sufian Zaheer

Journal of Mind and Medical Sciences

Ever since the SARS-CoV-2 infection was declared a global pandemic in 2020, numerous multisystemic manifestations have been discovered. The COVID-19 is known to cause a wide spectrum of neurological symptoms like fatigue, headache, brain fog, stroke, smell and taste disorders, encephalopathy and neurodegenerative disorders. The neurological manifestations are more prevalent in the post-COVID syndrome or long COVID. The National Institute for Health and Care Excellence and WHO defined Ongoing Symptomatic COVID as 4-12 weeks post infection and post COVID-19 syndrome as persistence of symptoms beyond 12 weeks. So far there are limited data available regarding the pathophysiology of neurological symptoms …

Evaluating The Effectiveness Of Chess As A Therapeutic Tool In The Comprehensive Management Of Adhd, Neilay Krishna Agarwal

Journal of Mind and Medical Sciences

Using databases such as PubMed and Google Scholar with the keywords "Chess" and "ADHD", this study was conducted to review the literature on the usefulness of chess in patients with ADHD. The most relevant articles were searched using the following criteria: English language, and all types of studies published in a medical journal. A total 12 articles were identified. Of a total of 12 articles, 4 met the inclusion criteria and were subsequently reviewed. The results of the review showed that chess therapy/training is effective in the management of ADHD patients in terms of reducing symptoms and severity. Due to …

Fibrinogen; A Predictor Of Injury Severity And Mortality Among Patients With Traumatic Brain Injury In Sub-Saharan Africa: A Cross-Sectional Observational Study, Michael Devereaux, Martha Sajatovic

Faculty Scholarship

Studies show that fibrinogen concentrations <2 g/L in patients with traumatic brain injury (TBI) is associated with increased mortality. However, little is known regarding fibrinogen levels and TBI severity as well as mortality in sub-Saharan Africa despite shouldering a high burden of TBI. We therefore set out to determine whether fibrinogen levels are associated with TBI severity and outcome. To determine the sensitivity and specificity of fibrinogen levels and the association with severity and mortality among TBI patients at Mulago Hospital. We prospectively enrolled 213 patients with TBI aged between 13 and 60 years of age and presenting within 24 hours of injury. Patients with preexisting coagulopathy, concurrent use of anticoagulant or antiplatelet agents, preexisting hepatic insufficiency, diabetes mellitus and who were pregnant were excluded. Fibrinogen levels were determined using the Clauss fibrinogen assay. Logistic regression analyses were conducted to identify the association between fibrinogen level and 7-day outcomes. Majority of the patients were male (88.7%) and nearly half were aged 30 or less (48.8%). Fibrinogen levels <2 g/L were observed in 35.1% of the study participants. The average time spent in the study was 3.7 ± 2.4 days. The sensitivity and specificity using fibrinogen <2 g/L was 56.5% and 72.9% respectively. Fibrinogen levels predict TBI severity with an AUC = 0.656 (95% CI 0.58-0.73: P = .000) Fibrinogen levels <2 g/L (hypofibrinogenemia) were independently associated with severe TBI. (Adjusted odds ratio 2.87 CI, 1.34-6.14: P = .007). Levels above 4.5 g/L were also independently associated with injury severity (adjusted odds ratio 2.89, CI 1.12-7.48: P < .05) Fibrinogen levels more than 4.5 g/L were independently associated with mortality (OR 4.5, CI; 1.47-13.61, P < .05). The fibrinogen level is a useful tool in predicting severity including mortality of TBI. Fibrinogen levels may be used as an additional tool to screen TBI patients for injury severity especially among patients with Glasgow coma scale scores of <14.

Blood Pressure Variability And Early Neurological Outcomes In Acute And Subacute Stroke In Southwestern Uganda, Shirley M. Moore, Martha Sajatovic

Faculty Scholarship

Background: Greater blood pressure variability has detrimental effects on clinical outcome after a stroke; its effects are controversial and have not been evaluated in Sub-Saharan Africa (SSA). Methods: We conducted a prospective study of patients with CT head confirmed ischemic and hemorrhagic strokes admitted to a tertiary hospital within 7 days of onset of unilateral neurological deficits. Blood pressure variability indices, standard deviation (SD) and coefficient of variation (CV) of systolic and diastolic blood pressure between day 0 and day 7, were calculated with a subsequent modified Rankin Scale (mRS) score on day 14 post-stroke. Linear regression was performed to …

Comparing Two Telehealth Approaches For Treating Psychiatric Disorders In Primary Care, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Federally Qualified Health Centers (FQHCs) are community clinics that provide primary care in rural and other underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions.

A Blunted Th17 Cytokine Signature In Women With Mild Cognitive Impairment: Insights From Inflammatory Profiling Of A Community-Based Cohort Of Older Adults, Adam D. Bachstetter, Jenny Lutshumba, Edric D. Winford, Erin L. Abner, Barbra J. Martin, Jordan P. Harp, Linda J. Van Eldik, Frederick A. Schmitt, Donna M. Wilcock, Ann M. Stowe, Gregory A. Jicha, Barbara S. Nikolajczyk

Markey Cancer Center Faculty Publications

People with dementia have an increase in brain inflammation, caused in part by innate and adaptive immune cells. However, it remains unknown whether dementia-associated diseases alter neuro-immune reflex arcs to impact the systemic immune system. We examined peripheral immune cells from a community-based cohort of older adults to test if systemic inflammatory cytokine signatures associated with early stages of cognitive impairment. Human peripheral blood mononuclear cells were cultured with monocyte or T-cell-targeted stimuli, and multiplex assays quantitated cytokines in the conditioned media. Following T-cell-targeted stimulation, cells from women with cognitive impairment produced lower amounts of TH17 cytokines compared with cells …

Representation Of Racial And Ethnic Minorities And Their Preferences For Mood Stabilizing Treatment Selection For Bipolar Disorder: A Systematic Review, Francisco J. Barrera, Manuel Gardea, Juan Garzon, Ryan Toledo, Ana Paula Bonner, Andrea Maraboto, Mark Frye, Ihsan Salloum

Research Symposium

Background: The use of second-generation antipsychotics for bipolar disorder (BD) has increased in the past years¹Concerns on potential serious medical side effects and need for blood level monitoring of some traditional mood stabilizers along with other factors have influenced this change. Shared decision-making (SDM) strategies have been implemented in clinical settings due to their ability to engage patients in the process of treatment selection.² Within minority groups with mental illnesses, socioeconomic factors, individual concerns, and cultural variations in clinical presentations, are often overlooked or misrepresented when assessing the patient’s treatment preferences. Although several studies evaluating the …

Pro- And Anti-Inflammatory Biomarkers As Predictors Of Response To Valproate In Patients With Comorbid Alcohol Use And Bipolar Disorder-Preliminary Findings, Ilya Blokhin, Lisa Harlow, Eleonore Beurel, Feng Miao, Dana Ascherman, Claes Wahlestedt, Ihsan Salloum

Research Symposium

Objective/Hypothesis: Bipolar disorder (BD) has the highest association with alcohol and other substance use disorders compared to other major psychiatric disorders. This patient population is particularly challenging to treat. We have previously shown that some patients with co-occurring alcohol use and bipolar disorders respond to the GABAergic agonist valproate (VPA), which is known to modulates the dopaminergic system, and also as an epigenetic modifier. Predictors of therapeutic response to VPA in patients with AUD/BD are not known, and the subgroup which would benefit from VPA is still to be identified. Recent evidence suggests that AUD promotes a pro-inflammatory state while …

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …

An Electronic Health Record System Implementation In A Resource Limited Country—Lessons Learned, Sayed Karar, Muhammad Haroon Khan, Jasmit Shah, Nadeem Ahmed

Internal Medicine, East Africa

Electronic health records have revolutionized the medical world by improving medical care, refining provider documentation, standardizing care, and minimizing sentinel events. Successful implementation of electronic health records remains a daunting task and requires careful strategic planning and buy-in from key stakeholders. Much has been published in resource-rich settings and high-income countries about implementations of electronic health records. However, little is known about the experience in resource-limited settings where challenges remain unique and distinct from other parts of the world. Our intention is to share lessons learned during implementation of a web-based electronic health record at a tertiary care center in …

Demarcating Psychopathologies: Nosology, Validity, And The Taxonomic Problem In Psychiatric Medicine, Julia Zentz Kolak

Dissertations, Theses, and Capstone Projects

In this dissertation, I argue that the discussion surrounding the role of values in the conceptualization of mental disorders is reproduced in critical debates surrounding the issue of reliability and validity in a psychiatric nosology. In so doing, I oppose the conventional separation of the demarcation problem and the crisis of validity in psychiatric classification, arguing instead that they are inextricably linked. After drawing out the intersection between these literatures in the conceptual history of the DSM and its much-maligned transition to an etiologically neutral taxonomy of mental disorders, I consider Carl Hempel’s proposed conciliation between descriptive and theoretical systematization …

Medical Students' Attitudes And Beliefs Toward Psilocybin: Does Terminology And Personal Experience With Psychedelics Matter?, Antonio F Pagán, Claudia Lex, Jair C Soares, Thomas D Meyer

Faculty, Staff and Student Publications

BACKGROUND: Psilocybin and psychedelic-assisted therapy (PAT) have gained renewed interest due to recent findings that PAT can enhance therapeutic outcomes. In 2019, the U.S. Food & Drug Administration (FDA) approved breakthrough therapy status to psilocybin for the treatment of depression, but PAT has yet to be approved as a therapeutic treatment for mental health disorders. Should the FDA approve PAT, medical students will serve as gatekeepers to PAT.

METHODS: Medical students (

RESULTS: Regardless of the terminology utilized, medical students held overall positive attitudes but their attitudes were significantly more positive when the term "psilocybin" was used. Furthermore, experience with …

“Association Between Traumatic Life Events And Psychosis: A Case-Control Study In Western Kenya", Mohamed Aden Hillow, Lukoye Atwoli, Edith Kamaru Kwobah

Internal Medicine, East Africa

Globally close to 70% of the general population has experienced at least one traumatic life event (TLE). Although child and adulthood exposure to TLEs is considered a risk factor for the subsequent development of psychosis, few studies have examined the association between trauma and psychosis in the African population.

We sought to explore the association between TLEs and psychosis in patients with psychotic disorders (N = 254) and individuals without (N = 254). The participants were matched by age and sex. The study was conducted at a national referral hospital, the Life Events Checklist for DSM-5 (LEC-5) was used to …