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Biomedical subjects

S B Levine

Publications and source records attributed to S B Levine.

At least 55 records · Page 3Linked to original sources
PubMed1986

Selection of physical therapy students: interview methods and academic predictors.

The purpose of this study was to determine which preprofessional academic and personal characteristics were related to academic and clinical success in a physical therapy program. Individual interviews used for the class of 1982 (N = 25) and group interviews for the class of 1983 (N = 31) were studied to determine which interview type was the stronger predictor of later performance. Correlations of grade point averages (GPAs) and interview scores with academic and clinical grades were calculated. Stepwise regressions were performed to identify the stronger relationships. Preprofessional science and cumulative GPAs for the class of 1982 were moderately, but significantly correlated with cumulative GPAs in the program (r = .54, p less than .05, and r = .50, p less than .05, respectively). Only science GPA for the class of 1982 was retained in the stepwise regression (R2 = .31, p less than .006). All other correlations were low, and correlations for the class of 1983 were lower than for the class of 1982. Neither the academic nor personal characteristics studied were strong predictors of performance in the professional physical therapy educational program.

Achievement↗
PubMed1985

Uvulopalatopharyngoplasty: a comparison of two techniques.

Two groups of patients undergoing uvulopalatopharyngoplasty were studied. Group I patients underwent en bloc resection of tonsils and palate with the line of excision less than 1.5 cm anterior to the uvula-soft palate junction. Group II patients underwent tonsillectomy followed by palatectomy with a margin 1.5 to 2.0 cm anterior to the uvula-soft palate junction. Only 1 of 7 patients in Group I was objectively improved, whereas 11 of 13 patients in Group II improved. We conclude that a generous resection of soft palate and tonsillar tissue is mandatory for success of uvulopalatopharyngoplasty procedures.

Adult↗
PubMed1984

An essay on the nature of sexual desire.

The propensity to behave sexually--unlike the frequency of sexual behavior--is not a discrete quantifiable phenomenon. At every stage of adulthood, sexual desire is produced by the interaction of biologic drive, psychologic motivation and cognitive aspiration. Motivation, the most clinically vital of these components, can be understood within four contexts: sexual identity, quality of the current non-sexual relationship, reasons for specific episodes of sexual behavior and transference from past significant attachments. The common psychological inhibitions of sexual desire can be translated into motivations for not behaving sexually deriving from one or more of these contexts. The less frequent excesses of desire can also be understood from the vantage points of these contexts. Rather than continue to oversimplify the concept of sexual desire, the term should be recognized as a shorthand means of referring to the mind's capacity to integrate biologic, intrapsychic and interpersonal complexity.

Adolescent↗
PubMed1984

The effects of coronary bypass surgery on female sexual, psychological, and vocational adaptation.

This paper reports the first study of female sexual, psychological, and vocational adaptation to coronary artery bypass surgery (CABG). Semistructured interviews were used to obtain data on 17 women undergoing CABG. Four time periods were examined: prior to and after the onset of cardiac symptoms; four months and one year after CABG. Female sexual response differs from what is known about male adaptation to CABG in three ways: 1) women did not demonstrate a significant and profound decline in frequency of intercourse one year after surgery; 2) the component most vulnerable to disruption in women is desire, in men it is arousal; 3) women do not harbor the sexual fears commonly seen in men such as sudden death during intercourse or performance anxiety. Psychologically, women fared better than men, but were less likely to return to work. This indicates that more attention should be directed toward vocational counseling of working women undergoing CABG.

Adaptation, Psychological↗
PubMed1984

Sexual adaptation among single young adults with cystic fibrosis.

The sexual adaptation of 48 single young adults with cystic fibrosis and a comparably aged single group without chronic disease was assessed using interviews and questionnaires. The patients were also compared to a previously studied group of married patients with cystic fibrosis. Single female patients with cystic fibrosis began dating later, dated less often, felt less attractive, had less sexual desire, and had more sexual problems than did physically healthy female subjects. Single male patients with cystic fibrosis seemed to fare far better than their female counterparts and approximated the healthy male group in all parameters studied. For both the single and married groups with cystic fibrosis, no significant relationship between the severity of disease and sexual health was evident. The single patients were diagnosed at a significantly earlier age and their general health scores were poorer than the married patients. The vulnerability of female patients with cystic fibrosis to psychosexual disruption suggests that attention be focused on the differential effects of other chronic illnesses upon male and female adult sexual adaptation.

Adult↗
PubMed1983

Increasingly Ruth: toward understanding sex reassignment.

Both the clinician and the patient present accounts of a 44-year-old male's search for a comfortable gender identity. The juxtaposition of these two perspectives illustrates many of the dilemmas inherent in the therapy of gender dysphoria. Ruth underwent sex reassignment surgery in 1976--one year after the assumption of a full-time female gender role. Six months after surgery, she made a serious suicide attempt. At age 50, she has now consolidated her feminine gender identity and has become a thoughtful, unusually honest, articulate person. The physician's "objective" and the patient's retrospective perspectives provide evidence of the psychodynamic nature of transsexualism and the limitations of evaluation criteria for sex reassignment surgery.

Adult↗
PubMed1983

Intraoperative cholangiography. A review of indications and analysis of age-sex groups.

A retrospective review was performed of patients who had biliary tract stone formation as the primary diagnosis for hospitalization and indication for surgery. Five hundred and eighty-nine consecutive charts were reviewed of patients admitted between 1975 and 1979. Intraoperative cholangiography was performed in 166 patients of whom 22 had common duct exploration. Choledochotomy in this series was performed in 63 cases without utilizing pre-exploratory cholangiography. A normal intraoperative cholangiogram was found to be 100% accurate; however, an abnormal cholangiogram was associated with a 16% false positive rate of exploration of the common duct. The incidence of unsuspected common duct stones detected only by intraoperative cholangiography was 2.3%. Age-sex analysis confirms a 10-year mean age difference between men and women within the population of this study (p less than 0.001). This age-sex difference is maintained in patients without common duct pathology as well as in patients with sterile bile. However, the mean age difference between male and female patients with either demonstrable common duct obstruction by stones or infected bile as determined by routine intraoperative culture is not statistically significant. A review of the role of intraoperative cholangiography, and the experience at Northeastern Hospital is discussed.

Adult↗
PubMed1982

A modern perspective on nymphomania.

There is a stark contrast between the widespread myth of nymphomania and women who actually experience disruptive increases in sexual desire. Nymphomania can be defined in terms of three distinct elements: marked increase in sexual drive; extremely frequent partner sexual behavior; promiscuity. The essence of the problem, however, is the disruptive increase in desire. Causes often involve one or more of the following: acting out; atypical psychoses; alcohol and/or drug abuse; temporal lobe disorders; involvement with an inappropriate partner; response to another sexual dysfunction. Many of these women are unable to derive emotional satisfaction from sex.

Acting Out↗
PubMed1982

Sexual function in cystic fibrosis. Relationship to overall health status and pulmonary disease severity in 30 married patients.

An interview and questionnaire were used to investigate the sexual functioning of married patients with cystic fibrosis. Only 20 percent of patients older than 19 years were married. Nine of the 30 married patients had serious sexual problems. Although these problems were all manifested as decreased desired, they had diverse causes; five of the nine were attributed to the CF. Some patients function quite well sexually, even in the face of severe disease. Physicians can assure adult CF patients contemplating marriage that they have a reasonable chance for normal sexual functioning.

Adult↗
PubMed1981

Expressive psychotherapy with gender dysphoric patients.

The dictum that transsexualism is resistant to psychotherapy has led many investigators to view sex reassignment surgery (SRS) as the treatment of choice and dismiss psychotherapy as unfeasible. The Gender Identity Clinic at Case Western Reserve University, Cleveland, was organized to treat transsexuals with individual and group psychotherapy and SRS. Of 50 gender dysphoric (GD) patients, 70% have adjusted to nonsurgical solutions, 20% are receiving treatment, and 10% have received SRS and psychotherapy. The crux of psychotherapy is establishing a therapeutic alliance; this is aided by the context of the Gender Identity Clinic. Clinical evidence suggests that new therapeutic techniques may enable psychotherapy to become the treatment of choice with most GD patients and that psychotherapy and SRS are not mutually exclusive. Most patients request and benefit from psychotherapy after SRS.

Adolescent↗
PubMed1981

Transsexualism or the gender dysphoria syndromes.

Professional, patient and media forces tend to oversimplify the complexity of the gender dysphoria syndrome. Because sex reassignment surgery may be helpful to some patients with the syndrome and harmful to others, mental health professionals need to competently perform differential diagnoses of both the gender disorder and the associated psychopathologies. This frequently involves distinctions between subtle forms of psychosis, character pathologies of varying severity, and major developmental problems. Surgery should not be considered the only, or the best, treatment for the syndrome. Contrary to popular belief, psychotherapy can help many patients, especially those with secondary gender dysphoria.

Adult↗