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Biomedical subjects

S Levenstein

Publications and source records attributed to S Levenstein.

48 records · Page 3Linked to original sources
PubMed1978

A report of three years' experience of a Balint group in Cape Town.

Three years' experience as members of a group composed predominantly of general practitioners, and constituted to discuss psychological problems encountered in general practice, is reported. Without exception, present and past members found the experience valuable, and particular mention was made of members' increased insight into their own reactions in the doctor-patient relationship. It is hoped that the experience of this group will encourage general practitioners in other centres which do not already have such a group to consider forming similar groups.

Family Practice↗
PubMed1977

Anxiety and the general practitioner--a psychotherapeutic approach.

Much of the general practitioner's work is concerned with emotional problems, yet his undergraduate training does not equip him adequately for this purpose. Four theories of personality, each of which has contributed to modern psychotherapeutic practice, are reviewed, with specific reference to their formulations on the causation and treatment of anxiety, and the application of each of these viewpoints to specific problems in general practice. Finally, a plea is made for much greater provision for the teaching of psychology (especially therapeutic psychology) in the undergraduate medical curriculum.

Anxiety↗
PubMedDate not supplied

The very model of a modern etiology: a biopsychosocial view of peptic ulcer.

OBJECTIVE: Research on ulcer psychosomatics has plummeted since the early 1970s, to the applause of many who argue that ulcer is simply an infectious disease. The purpose of this article is to discuss the relevance of ulcer psychogenesis in the age of Helicobacter pylori. METHODS: A critical literature review was conducted. RESULTS: There is a substantial and methodologically sound body of prospective studies linking stress with the onset and course of peptic ulcer. Psychosocial factors can be estimated to contribute to 30% to 65% of ulcers, whether related to nonsteroidal antiinflammatory drugs, H. pylori, or neither. The observed association between stress and ulcer is accounted for, in part, by recall bias, misreported diagnoses, and confounding by low socioeconomic status (a source of stress and of ulcer risk factors, such as H. pylori and on-the-job exertion) and by distressing medical conditions (which lead to use of nonsteroidal antiinflammatory drugs). Of the residual, true association, a substantial proportion is accounted for by mediation by health risk behaviors, such as smoking, sleeplessness, irregular meals, heavy drinking, and, again, nonsteroidal antiinflammatory drugs. The remainder results from psychophysiologic mechanisms that probably include increased duodenal acid load, the effects of hypothalamic-pituitary-adrenal axis activation on healing, altered blood flow, and impairment of gastroduodenal mucosal defenses. CONCLUSIONS: Peptic ulcer is a valuable model for understanding the interactions among psychosocial, socioeconomic, behavioral, and infectious factors in causing disease. The discovery of H. pylori may serve, paradoxically, as a stimulus to researchers for whom the concepts of psychology and infection are not necessarily a contradiction in terms.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Maintenance treatment with H2 receptor antagonists for duodenal ulcer disease: toward a rational use.

Duodenal ulcer disease is a heterogenous condition characterized by episodes of recurrence and remission. Recurrences are often painful and may result in gross duodenal scarring and pyloric stenosis; bleeding and perforation can complicate the disease, requiring operative treatment and increasing mortality. Treatment should therefore maintain remission after ulcer healing, prevent possibly lethal complications, be safe and maintain efficacy over time. Maintenance treatment with H2 receptor antagonists reduces the rate of symptomatic relapse, but there is no evidence that it affects the complication rate. Tolerance develops in a subgroup of patients and seems to contribute to their poor response to long-term H2 antagonist therapy. It seems wise to prescribe maintenance treatment for 3 years following initial healing in patients with severe relapsing disease, or smokers with recurrent symptoms, and to continue it for life in selected individuals at increased risk of acute complications or of complication-related mortality.

Drug Tolerance↗