The Department of Psychiatry and Behavioral Neurobiology

GRAND ROUNDS

 
 Sponsored by the UAB School of Medicine, Division of CME  
 2006/2007 PSYCHIATRY GRAND ROUNDS
The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Archived Grand Rounds Schedules
If you need to reference past schedules or presentations, the following schedules are archived for your convenience.  
 2001-2002    2002-2003   2003-2004  2004-2005 2005-2006

October 2006

Jodel G. Jampayas, MAJ, MC
Deputy Surgeon, Medical Review Boards
Mobilization SRP Team Physician Support
Staff Physician Regional Command Surgeon's Office
Command Surgeon's Office, 81st Regional Readiness Command
Birmingham, Alabama

Abstract:  Dr. Dowben together with Major Jampayas will present a lecture outlining current occupational aspects of Army Psychiatry.  This should help provide a context in which to better understand the current psychiatric and mental health treatment of our soldiers in Iraq and Afghanistan.  The presentation will also provide background information that will be beneficial for Lr. Dowben's subsequent grand rounds presentation, "Iraq and Afghanistan:  A psychiatrist's personal experience" scheduled for November 7.

Objectives:   To present
1)  an overview of current Army/military psychiatric practice. 
2)  treatment issues specific to the combat setting. 
3)  information concerning army fitness for duty requirements.

10/17/06
11:00am

Effective Presentations:  An Educational Perspective
John A. Caldwell, Ph.D.
Assistant Professor of Education in Medicine
Department of Medical Education
University of Alabama School of Medicine

Abstract:  Collectively participants and the session leader will examine the components of a presentation from a cognitive psychology point of view.  Discussion will focus on presentation design, delivery, and evaluation.

Objectives: 
1)  Provide participants a framework for the development and delivery of effective presentations. 
2)  Examine various aspects of a presentation and the underlying attributes.

We gratefully acknowledge an educational grant  from GlaxoSmithKline to support this presentation.

The Schizophrenia Prodrome - Current Perspectives
Sricharan Moturi, MD, MPH
PGY-III Resident in Psychiatry
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine
  
Abstract: 
First episode psychosis (or schizophrenia prodrome) has been a topic that has sparked significant interest and debate among the research and clinical academicians all around the world in the past decade. The questions these researchers asked themselves were “can we prevent the worsening or progression of schizophrenia –like illnesses by interventions at an earlier time when less subtle clinical or biological signs are present?” This would be the basis for this presentation that would incorporate various clinical facets and dilemmas associated with diagnosis and treatment of First episode psychosis.

Objectives: 
1.  To provide an introduction to schizophrenia prodrome with a few clinical vignettes
2.  To describe how to diagnose a psychosis prodrome and the frequent diagnostic dilemmas associated with it.
3.  To compare the current treatment perspectives vs. neurodevelopmental perspectives of “psychosis prodrome” research
4.  To discuss various biological and psychosocial interventions specific to schizophrenia prodrome

November 2006

Objectives:   To present
1)  current and recent experiences of an Army psychiatrist who served in OIF (Operation Iraqi Freedom) and OEF (Operation Enduring Freedom). 
2)  current mental health issues and other topical issues of interest.

 NO GRAND ROUNDS SCHEDULED

Abstract:  Dr. Fargason will review the literature on comorbid ADHA and substance abuse and their relationship to the growing problem of psychostimulant diversion in the community.  Clinical techniques for managing these problems will be discussed.

Objectives:   1)  Review comorbidity of ADHD and substance abuse.  2)  Discuss methods for treating the patient with both disorders.  3)  Review the neurophysiology of psychostimulant abuse and patterns of diversion in the population.  4)  Discuss means by which clinicians can properly treat the motivated patient while minimizing risks of diversion.

December 2006 

Objectives:   To inform the audience about basic neurobiology research going on in the department and to discuss recent evidence of a novel biochemical pathway activated by sodium valproate

Objectives:  At the end of this program,  participants should be able to:
1)  Review general information about bipolar disorder
2)  Discuss efficacy data of agents currently being used or considered for the acute and prophylactic treatment of bipolar disorder
3)  Describe and compare adverse effects related to the use of these agents
4)  Identify potential drug interactions between various bipolar therapies
5)  Explain goals of new therapies for bipolar disorder

 

Tailored Management of Schizophrenia in the Real World:  A Naturalistic Approach
Robert Conley, M.D.
Professor of Psychiatry and Pharmacy Science
University of Maryland Baltimore School of Medicine
Chief of Inpatient Research, Maryland Psychiatric Research Center
Baltimore, MD 

2006/2007 GRAND ROUNDS
"The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 1 hour in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the activity."

January 2007     February 2007     March 2007     April 2007      May 2007

January 2007

Imaging Early Brain Development in Normal and High Risk Children
John Gilmore, MD
Professor, Department of Psychiatry
University of North Carolina School of Medicine
Chapel Hill, NC

Abstract:
The presentation will provide an overview of human brain development in the first years of life and how early brain development is implicated in schizophrenia.

Objectives:   
1)  To understand the challenges of imaging very early brain development in humans
2)  To understand the major developmental events in the brain of 1-2 year olds
3)  To understand brain structure abnormalities observed in infants at risk for schizophrenia

 February 2007

Lesser known regulatory mechanisms of growth factor signaling; relevance to mental illness
Gautam N. Bijur,  Ph.D.
Assistant Professor
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

Abstract:
Growth factor-associated signaling pathways are typically described by regulation at the level of phosphorylation by kinases.  This presentation will describe some lesser known mechanisms by which growth factor-associated Akt/GSK3 signaling can be regulated within the context of bipolar disorder and schizophrenia.

Objectives: 
1) To understand the role of mitochondria in the pathology of schizophrenia and mood disorder.
2) Understand how the sequestration of Akt/GSK3 signaling within the mitochondria is a type of regulatory mechanism.
3) To understand how the protein phosphatase-1/I-2 protein complex also regulates GSK3 signaling.

References: 
Bijur, G.N., and Jope, R.S. Rapid accumulation of Akt in mitochondria following phosphatidylinositol 3-kinase activation. Journal of Neurochemistry 87:1427-1435 (2003).

King, T.D., Gandy, J.C., and Bijur G.N. The Protein Phosphatase-1/Inhibitor-2 Complex Regulates GSK-3 Dephosphorylation and Increases Sarcoplasmic/Endoplasmic Reticulum Calcium ATPase 2 Levels. Experimental Cell Research 312: 3693-3700 (2006).

 

Deconstructing the Vulnerability to Alcohol Dependence:  Importance of Glutamate-Dopamine Interactions
John Krystal, MD
Robert L. McNeil, Jr., Professor of Clinical Pharmacology
Department of Psychiatry
Deputy Chairman for Research
Yale University School of Medicine

Abstract & Objectives:
1.  To review the evidence that the heritable risk for alcoholism is associated with both impairments in reward/motivation and altered response to alcohol.
2. To review evidence implicating the glutamate and dopamine systems in both the motivational impairments and altered ethanol response related to alcohol vulnerability and alcohol dependence.
3.  To link the vulnerability to alcoholism to novel pharmacotherapy strategies for alcohol dependence and pathological drinking.

References:  
Krystal JH, Madonick S, Perry E, Gueorguieva R, Brush L, Wray Y, Belger A, D'Souza DC.  Potentiation of low dose ketamine effects by naltrexone: potential implications for the pharmacotherapy of alcoholism.  Neuropsychopharmacology. 2006 Aug;31(8):1793-800.

Petrakis IL, Limoncelli D, Gueorguieva R, Jatlow P, Boutros NN, Trevisan L, Gelernter J, Krystal JH.  Altered NMDA glutamate receptor antagonist response in individuals with a family vulnerability to alcoholism.  Am J Psychiatry. 2004 Oct;161(10):1776-82.

Krystal JH, Petrakis IL, Krupitsky E, Schutz C, Trevisan L, D'Souza DC.  NMDA receptor antagonism and the ethanol intoxication signal: from alcoholism risk to pharmacotherapy.

Ann N Y Acad Sci. 2003 Nov;1003:176-84.  Krystal JH, Petrakis IL, Mason G, Trevisan L, D'Souza DC.  N-methyl-D-aspartate glutamate receptors and alcoholism: reward, dependence, treatment, and vulnerability.  Pharmacol Ther. 2003 Jul;99(1):79-94.

Tissue Transglutaminase-a player in retinoic acid-induced neural differentiation
Janusz Tucholski, Ph.D.
Assistant Professor
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

Abstract:
The presentation will address the specific role of tTG in neurodifferentiation of human neuroblastoma cells, in potentiation of prosurvival cAMP-PKA-CREB pathway, and will address a possible tTG role in adult neurogenesis in the hippocampus.  The speaker will wrap up the presentation discussing the possible consequence of RA-induced de novo neurogenesis for treatment of depression.

Objectives:
1)   To discuss the role tissue translutaminase (tTG) in a process retinoic acid (RA)-induced neuronal differentiation in situ and a potential role of tTG in RA-driven neurogenesis in vivo.
2)   To present the amplification of  cAMP-PKA-CREB pathway by transamidation activity of tTG, as a possible mechanism that may promote neuronal survival and differentiation.
3)   To discuss a potential role of retinoic acid and cAMP-PKA-CREB pathway in adult neurogenesis and how its deficit may contribute to the etiology of depression.  

References:  
Tucholski J, Lesort M, Johnson GV (2001) Tissue transglutaminase is essential for neurite outgrowth in human neuroblastoma SH-SY5Y cells. Neuroscience 102:481-491.

Tucholski J, Johnson GV (2003) Tissue transglutaminase directly regulates adenylyl cyclase resulting in enhanced cAMP-response element-binding protein (CREB) activation. J Biol Chem 278:  26838-26843.

Jacobs S, Lie DC, DeCicco KL, Shi Y, DeLuca LM, Gage FH, Evans RM (2006) Retinoic acid is required  early during adult neurogenesis in the dentate gyrus.  Proc Natl Acad Sci USA 103:3902-3907.

Warner-Schmidt JL, Duman RS (2006) Hippocampal neurogenesis: opposing effects of stress and    antidepressant treatment. Hippocampus 16:239-249

March 2007

Cross Cultural Psychiatry
Nirmala Jetty, M.D.
PGY-III Resident in Psychiatry
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

Abstract:  Presentation of varied symptomatology in different cultures for the same condition or diagnosis and the need for psychiatrists to be aware of the differences.

Abstract:  Addiction is a chronic relapsing disorder characterized by the repeated use of substances or compulsive behaviors despite clear evidence of negative consequences.  Dopamine is believed to be involved in the acute reinforcing/reward effects of addiction mediated mainly by the mesolimbic dopamine circuit while the mesocortical dopamine circuit is likely to be involved in the conscious experience/decision of craving/seeking and compulsive administration/behavior.

Objectives:  
1.  To understand the neurobiological basis and changes that accompany addiction.
2.  An understanding of the neurobiology of addiction may offer potentials to guide prevention and treatment efforts for addiction in general.
 

References:  Select this link for a list of references

3/20/07
11:00am

Abstract:
This presentation will briefly summarize the current understanding of the neuropathology of mood disorders, then describe the role of brain derived neurotrophic factor (BDNF) in the development of mood disorders.

Objectives:
1. Review the current understanding of neurobiology of mood disorders.
2. Review the role of neurotrophic factors in the neuronal plasticity and the development of mood disorders.
3. Discuss the interaction between brain derived neurotrophic factor (BDNF) and FOXO3a transcription factor and it’s effect in neuronal plasticity.

 April 2007

Abstract:   
This presentation will focus on epidemiology and clinical features of PTSD in children.  Evidence based data will be presented regarding studies done so far on  this topic, treatment options, and the future direction of research.  Finally, case series will be presented based on clinical experiences.

Objectives:
1.  To describe post traumatic stress disorder in children.
2.  To provide evidence based data on post traumatic stress disorder
3.  To share clinical experiences on childhood PTSD

Abstract:   
Increasing awareness that prepubertal mania may occur more frequently than has been studies/recognized has led to a greater attention to Bipolar Disorder in the young child.

Objectives:    
To review the epidemiology,  phenomenology,  natural course, validity of diagnosis, differential diagnosis and treatment of Bipolar Disorder.

4/17/07
11:00am

Abstract:
Pseudoseizures present a difficult yet fascinating challenge, requiring significant coordination between neurologists and mental health professionals. The correct diagnostic techniques, treatments, causes and even name of this entity remain controversial.

Objectives: 
1.  To provide a description of pseudoseizures, including who they affect, their significant cost to society, and a discussion of possible causes.
2.  The practical aspects of diagnosis, differentiation from epileptic seizures and treatment options will be reviewed.

Abstract: 
This talk will address the stigma of mental illness in the general population as well as in the professional population.

Objectives: 
To increase awareness of the challenges these patients face at work and in the community.

 

May 2007

Twelfth Residents Versus Faculty Scholar's Bowl  
Moderated by Daniel C. Dahl, M.D.
Assistant Professor, Vice Chairman for Education and Training, Residency Training Director 
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

Abstract: 
A rapid-pace, information-packed hour of questions in which a two teams of our residents and faculty will compete against each other for the title of Scholar's Bowl Champions of 2007.  Dr. Dahl will serve as moderator and will provide a series of challenging psychiatric as well as general knowledge questions.   You won't want to miss it! 

Objectives: 
To stimulate review of the Psychiatric literature and the Psychiatry Resident In-Training Examination (PRITE) material.

 

The Management of Agitation in Dementia
Terri Steele, MD
Associate Professor
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

 Abstract:
 Dementia is frequently associated with behavioral disturbances resulting in agitation.  These disturbances can be from a variety of causes.  Treatment consists of both pharmacological and behavioral approaches.

Objectives: 
Participants will
1.  know the most common types of dementia.
2.  understand pharmacologic management as well as behavioral management.
 
 

5/15/07
11:00am

Abstract:
This lecture will present data from an ongoing clinical project investigating psychosocial and neurobiological variables in women and risk for postpartum depression, and their babies. The lecture will also present recent findings from a transgenic animal model that may shed light into the genetic and environmental factors that may influence pathological maternal behavior.

Objectives: 
During this presentation, the audience will:
1) Learn about clinical and psychosocial risk factors for post partum depression.
2) Learn about the neurobiological outcome of infants born to women at risk for depression.
3) Learn about the potential role of the hypothalamic-pituitary adrenal axis in mediating the negative consequences of  peripartum, and postpartum depressive symptoms, in the mother-infant dyad.
4) Learn about the role of gene-environment interaction in postpartum depression and anxiety.

References:
Marcus SM. Flynn HA. Blow FC. Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women's Health. 12:373-80, 2003.

Vazquez DM. Eskandari R. Zimmer CA. Levine S. Lopez JF. Brain 5-HT receptor system in the stressed infant rat: implications for vulnerability to substance abuse. Psychoneuroendocrinology. 27:245-72, 2002.

First Annual Research Symposium
Grand Rounds Series

The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 3 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Program:  Link to publicity flyer and list of poster presentations

"The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 1 hour in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the activity."

Questions or  comments concerning these activities?  Write, Call, FAX, or E-mail: 

Carol Schaffhausen, B.S.
The University of Alabama at Birmingham
Eye Foundation Hospital
Psychiatry - 3rd Floor
1720 University Blvd.
Birmingham, AL 35233
PHONE 934-1306  FAX 934-4659  cschaff@uabmc.edu

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