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Biomedical subjects

R Blanchard

Publications and source records attributed to R Blanchard.

At least 73 records · Page 4Linked to original sources
PubMed1990

Knowledge of hemodialysis and CAPD patients about their prescribed medicines.

A questionnaire was designed to determine and compare the extent of knowledge of 40 continuous ambulatory peritoneal dialysis (CAPD) and 40 hemodialysis (HD) patients about their medicines. It was administered orally to outpatients attending a clinic by an investigator unknown to the patients. Data were collected pertaining to the following target drugs: calcium supplements, phosphate binders, vitamins B and C and folic acid. HD and CAPD groups were closely matched for age and sex. Sixty percent of CAPD and 49% of HD patients were taking four or more medications. The dose of folic acid was accurately recalled by 91% and 71% of CAPD and HD patients. Indications for calcium supplements and phosphate binders were known by only 8% and 30% of CAPD patients compared to 72% and 73% of HD patients. More HD patients knew the indications for all target drugs (p less than 0.01). More CAPD than HD patients knew the expected duration of therapy (p less than 0.01). There was a trend between decreased knowledge of whether the medication was working with increasing age of CAPD patients. Most drug information was supplied by physicians, but many CAPD patients (21%) obtained information from lay sources. When given the opportunity to ask questions about their medicines, only 56% CAPD and 46% HD patients did so. The knowledge of CAPD and HD patients studied was grossly deficient in terms of indications, effectiveness, duration and action to be taken if doses were missed.

Adult↗
PubMed1989

The classification and labeling of nonhomosexual gender dysphorias.

This report suggests systematic strategies for the descriptive classification of nonhomosexual gender identity disorders, based on clinical observations and research findings. The classification of biological males is considered first. A review of cross-gender taxonomies shows that previous observers have identified and labeled a homosexual type far more consistently than any other category of male gender dysphoric. It is suggested that the apparent difficulty in differentiating reliably among the nonhomosexual types results from the sharing of many overlapping characteristics by the various groups. This is supported by a review of informal, mostly clinical, observations and by the findings of three studies designed to test the hypothesis that the nonhomosexual gender dysphorias, together with transvestism, constitute a family of related disorders in men. It is concluded that the main varieties of nonhomosexual gender dysphoria are more similar to each other than any of them is to the homosexual type. Two recommendations, based on the foregoing review, are offered for the classification of male gender dysphorics in research studies. When the number of subjects is small, they may be classified simply as homosexual or nonhomosexual. When the number is larger, the nonhomosexual cases may be classified as heterosexual, bisexual, or analloerotic (unattracted to male or female partners, but not necessarily devoid of sexual drive or activities).

Female↗
PubMed1989

Phallometric diagnosis of pedophilia.

We investigated the sensitivity of our phallometric test for pedophilia (and hebephilia). An initial sample of subjects included 47 men accused of sexual offenses against minors and 26 control subjects-men accused of offenses against adult women (exhibitionism, rape, or sexually sadistic activity). A second sample included 107 offenders against minors and 30 control subjects. In both samples, the offenders against minors were further classified according to the targets of their sexual offenses (girls, boys, or both) and according to the extent to which they admitted an erotic preference for the immature physique. Computerized diagnostic rules were developed with the first sample and cross-validated with the second. The sensitivity of the test in detecting pedophilia or hebephilia in complete nonadmitters is probably greater than or equal to 55% but is certainly less than 100%. Its specificity appears to be over 95%.

Adolescent↗
PubMed1989

The concept of autogynephilia and the typology of male gender dysphoria.

This study tested the hypothesis that all gender-dysphoric males who are not sexually aroused by men (homosexual) are instead sexually aroused by the thought or image of themselves as women (autogynephilic). Subjects were 212 adult male-to-female transsexuals. These were divided into four groups; one homosexual and three nonhomosexual. The three nonhomosexual groups were heterosexual, bisexual, and analloerotic (unattracted to male or female partners, but not necessarily devoid of all erotic behavior). A Core Autogynephilia Scale was developed to assess a subject's propensity to be sexually aroused by the fantasy of being a woman. The four transsexual groups were compared on this measure (and on several others), using Newman-Keuls multiple-range tests at p less than .05. As predicted, all three nonhomosexual groups were more likely than the homosexual group to report sexual stimulation by cross-gender fantasy. This finding supports the hypothesis that the major types of nonhomosexual gender dysphoria constitute variant forms of one underlying disorder, which may be characterized as autogynephilic gender dysphoria.

Factor Analysis, Statistical↗
PubMed1989

Fetal and neonatal von Willebrand factor (vWF) is unusually large and similar to the vWF in patients with thrombotic thrombocytopenic purpura.

We have investigated the distribution of vWF multimers in blood from the umbilical cord of infants delivered vaginally and by caesarean section, from heel-stick blood collected 1 d post-partum, and from fetuses undergoing evaluation for Rh compatibility. To examine vWF multimers, plasma was separated by electrophoresis on SDS-agarose gels, overlaid with 125I-anti-vWF, and analysed by densitometry of autoradiographs. Neonatal and fetal plasma contained unusually large von Willebrand factor multimers (ULvWFM), not present in normal adult plasma, in shed blood from adults, in maternal plasma at the time of birth, or in plasma from adults deficient in vitamin K-dependent coagulation proteins. We conclude that ULvWFM, similar in size to vWF present in the Weibel Paladie bodies of endothelial cells, the alpha granules of platelets, and the plasma of patients with TTP, is present in the fetal circulation, at birth, and shortly after delivery.

Antigens↗
PubMed1989

Prediction of regrets in postoperative transsexuals.

This study investigated whether heterosexual males are more likely to regret sex reassignment surgery than homosexual males or females. Subjects were 111 postoperative transsexuals who had been surgically reassigned for at least one year, representing a follow-up rate of 84.1%. Subjects' feelings about surgery were assessed with self-administered questionnaires. None of the 61 homosexual females or 36 homosexual males consciously regretted surgery, compared to 4 of the 14 heterosexual males: a significant difference. This finding suggests that heterosexual applicants for sex reassignment should be evaluated with particular caution, although a heterosexual preference is not an absolute contraindication for surgery.

Adaptation, Psychological↗
PubMed1987

Heterosexual and homosexual gender dysphoria.

This study investigated why more males than females complain of dissatisfaction with their anatomical sex (gender dysphoria). New referrals to a university gender identity clinic were dichotomously classified as heterosexual or homosexual. There were 73 heterosexual and 52 homosexual males; 1 heterosexual and 71 homosexual females. The average heterosexual male was 8 years older at inception than the homosexual groups. The heterosexual males reported that their first cross-gender wishes occurred around the time they first cross-dressed, whereas the homosexual groups reported that cross-gender wishes preceded cross-dressing by 3-4 years. Some history of fetishistic arousal was acknowledged by over 80% of the heterosexual males, compared to fewer than 10% of homosexual males and no homosexual females. The results suggest that males are not differentially susceptible to gender dysphoria per se, but rather that they are differentially susceptible to one of the predisposing conditions, namely, fetishistic transvestism.

Female↗
PubMed1987

Feminine gender identity and physical aggressiveness in heterosexual and homosexual pedophiles.

This study explored the differences among six groups of adult males in retrospective self-reports of childhood gender identity and physical aggressiveness. The three groups of homosexual men preferred prepubescent, pubescent, or physically mature sexual partners. The three groups of heterosexual men preferred prepubescent partners, normal sexual interaction with physically mature partners (controls), or anomalous interaction with physically mature partners. Childhood gender identity was measured with the Feminine Gender Identity Scale (FGIS), and boyhood aggressiveness was measured with the Physical Aggressiveness Scale (PAS). Duncan tests at the .05 level showed that the FGIS differentiated the homosexuals who preferred mature partners from the five other groups; whereas the PAS differentiated all homosexual groups from all heterosexual groups. These results suggest that male homosexuals in general tend to be unaggressive in boyhood, whereas only those who prefer mature sexual partners show significant levels of feminine identification.

Aggression↗
PubMed1987

Vaginoplasty outcome in male-to-female transsexuals.

This study investigated the cosmetic and functional adequacy of the neovagina in surgically reassigned male-to-female transsexuals. Subjects were 22 transsexuals with a mean postsurgical follow-up of 4.4 years. All were given structured interviews followed by pelvic examinations. The majority of subjects reported at least some postoperative sexual responsiveness. Vaginal depth, measured with a specially constructed probe, averaged 8.3 cm. Only a minority of subjects, however, complained that the neovagina was inadequate for coitus. It is possible that transsexuals accomplish coitus, despite short vaginas, by assuming positions that limit the depth of their partners' thrusting.

Adult↗
PubMed1986

The concept of courtship disorder.

Four phases of normal human male courtship behavior may be differentiated: location and initial appraisal of a potential partner; pretactile interaction (e.g., smiling at, posturing for, or talking to a prospective partner); tactile interaction (e.g., embracing, petting); and effecting genital union. A particular class of erotic anomalies may be seen as distorted counterparts of the four normal phases: voyeurism; exhibitionism and obscene telephoning; toucheurism and frotteurism; and the preferential rape pattern. Data from male samples are presented that show that two or more of these anomalies are often found in the same individual. These data suggest the existence of a discrete syndrome which may be described as a courtship disorder.

Adult↗
PubMed1985

Social desirability response set and systematic distortion in the self-report of adult male gender patients.

This study showed that the "socially desirable" presentation for a heterosexual male gender dysphoric is one that emphasizes traits and behaviors characteristic of "classic" transsexualism. Fifty-one homosexual and 64 heterosexual adult male gender patients were administered the Crowne-Marlowe (1964) Social Desirability Scale as well as eight questionnaire measures that tapped various features of the clinical history commonly given great weight in differential diagnosis. The tendency for a heterosexual subject to describe himself in terms of moral excellence or admirable personal qualities was significantly correlated with scores in the "transsexual" direction on all eight sexological measures; for the homosexual subjects, only one correlation was significant. It is argued that the patients most motivated to create a favorable impression on the examiner are likely to be those most anxious to obtain approval for sex reassignment surgery. Because, in this population, the socially desirable presentation is "feminine," it is possible that the differences in the histories produced by transvestites and heterosexual transsexuals are exaggerated to an unknown degree by the motivation of the latter to obtain approval for this operation. The findings do not diminish the important distinction between these groups, but they do suggest caution in interpreting the self-report data that have been used in comparing them.

Adult↗
PubMed1985

Typology of male-to-female transsexualism.

This study tested a prediction derived from the hypothesis that asexual and bisexual transsexualism are actually subtypes of heterosexual transsexualism. Two questionnaire scales measuring erotic attraction to males and females were administered to 163 male-to-female transsexuals. A cluster analysis of their scores divided the subjects into four groups: heterosexual, homosexual, bisexual, and asexual. Fisher Exact tests were used to compare the frequency with which subjects in the four clusters reported a history of erotic arousal in association with cross-dressing. As predicted, there were no differences among the asexual, bisexual, and heterosexual transsexuals, and all three groups included a much higher proportion of fetishistic cases than the homosexual group (p less than or equal to .0001, two-tailed). These findings support the view that male transsexuals may be divided into two basic types: heterosexual and homosexual.

Fetishism, Psychiatric↗
PubMed1985

Compliance and policy issues and recommendations related to revision of the National Interim Primary Drinking Water Regulations for Radionuclides.

This paper summarizes the deliberations and conclusions of the Compliance and Policy Committee of the National Workshop for Radioactivity in Drinking Water. Prior to and during the workshop the committee considered a total of 32 possible compliance and policy issues and determined that 22 were valid. The committee developed positions on seven of these and these positions are presented herein. The remaining 25 issues are also listed with the committee's evaluation of each.

Legislation as Topic↗
PubMed1985

The vitamin status of infants in a free living population.

In infancy an adequate intake of vitamins, either from natural sources or as supplements, is of the utmost importance. The vitamin status of 325 infants was studied with regard to their food intake, vitamin supplementation and health from birth to the third birthday. Only data on vitamins A, C, E and folic acid are presented here. The proportion of bottle-fed infants having a serum level of vitamin C less than 0.30 mg/dl was 4.0 times (P less than 0.002), and of vitamin E less than 0.35 mg/dl was 2.2 times (P less than 0.05) higher than that of breast-fed infants. The proportion of infants with folate level less than 6.0 ng/ml was identical in both groups. No infant was observed with a vitamin A serum level less than 40 mcg/dl. The daily food intake of vitamin C less than 80% of RNI was found n 40% of infants at 6 months, in 10% at 12, and in none at 18 months and afterwards. Vitamin A followed a similar trend. 95% of infants had vitamin E and 75% had folate intake less than 80% RNI. Obviously the mean serum levels of vitamins A and C were significantly higher in supplemented infants at 6, 12, 18 and 30 months than in those without supplements. Health indicators, measured by number of self-reported illness related symptoms, differed according to supplementation. These findings indicated that, even if optimal food intake could supply the recommended quantity of vitamins, the risk of marginal deficiency always remained higher in infants without supplementation.

Age Factors↗
PubMed1984

Randomized, double-blind comparison of cefotaxime, cefoxitin, cefazolin or placebo as prophylaxis during gastric, small bowel or complicated biliary surgery.

In a double-blinded trial, 142 patients were randomized to receive placebo, cefazolin, cefoxitin or cefotaxime during high-risk gastroduodenal, biliary tract or small bowel surgery. Of the 125 evaluable patient trials, postoperative wound infection or intra-abdominal sepsis developed in 14/29 (48%) of placebo controls, 8/24 (33%) cefazolin, 7/37 (19%) cefoxitin, and in 2/35 (6%) of cefotaxime recipients. When patients undergoing vagotomy and pyloroplasty with prior cimetidine therapy were excluded, cefotaxime was superior to cefoxitin prophylaxis (2/26 versus 7/28, P = 0.014). Cefotaxime may be useful as a prophylactic agent in high-risk upper gastrointestinal surgery.

Adult↗