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Biomedical subjects

H Levenson

Publications and source records attributed to H Levenson.

At least 19 recordsLinked to original sources
PubMed2000

Radioiodine dosimetry in patients with end-stage renal disease receiving continuous ambulatory peritoneal dialysis therapy.

In patients with end-stage renal disease (ESRD), Na131I dosages for thyroid cancer may have to be reduced to avoid excess radiation doses to red marrow, because radioiodine is primarily excreted by kidneys. In ESRD patients receiving continuous ambulatory peritoneal dialysis (CAPD) therapy (three to five 2-L exchanges daily) creatinine clearance rates are very low (mean, 7 mL/min), and radioiodine clearance rates may be proportionately reduced. Thus, radioiodine kinetic studies were performed in two hypothyroid CAPD patients with thyroid cancer, in eight euthyroid CAPD patients, and in eight thyroid cancer patients with normal renal function. All received Na131I or Na123I orally, with serial blood, urine, and/or dialysate sampling for 24-70 h. Dosimetry calculations were performed using the MIRDOSE3 computer program. In CAPD patients, serum radioiodine half-times were 5 times longer, and radioiodine clearance rates by urine plus dialysate were 20% of those in patients with normal renal function. Na131I dosages for the two CAPD patients with thyroid cancer were reduced from 150 mCi [5.6 gigabecquerels (GBq)] to 26.6 mCi (0.98 GBq) and 29.9 mCi (1.11 GBq), respectively, resulting in radiation doses to red marrow and total body comparable to those in patients with normal renal function who received a mean of 148 mCi (5.5 GBq) Na131I. Thus, in patients receiving continuous ambulatory peritoneal dialysis therapy, 5-fold reductions in radioiodine clearance rates require 5-fold decreases in Na131I dosages to avoid excessive radiation doses to total body and red marrow.

Adult↗
PubMed1999

Recommendations for the future of training in brief dynamic psychotherapy.

The results of 2 large surveys (of practitioners and graduate school/internship training directors) indicate that there is a considerable amount of brief therapy being conducted by psychodynamically trained therapists. However, their training in this specialization does not appear to be adequate. Eleven recommendations (e.g., addressing therapists' attitudes toward brief therapy, studying training processes and outcomes, using videotapes for teaching and supervision) are set forth to foster improvements in such training. We conclude that it is critical that the sizeable number of psychodynamic therapists conducting brief therapy receive continuing in-depth training in this challenging and demanding field.

Attitude of Health Personnel↗
PubMed1995

Therapist's experience, training, and skill in brief therapy: a bicoastal survey.

California and Massachusetts psychologists (N = 850, 58% response rate) returned a questionnaire to ascertain clinicians' brief-therapy experience, training, self-assessed skill, and attitude. Results indicate respondents spend a considerable portion (40%) of their clinical time doing brief therapy. A disturbing finding is that one-third of those presently doing brief therapy reported that they had received little or no training in brief-therapy theory or techniques. Self-rated skill in brief therapy was found to be best predicted by a combination of one's experience, training, and attitude. We conclude that, while the number of therapists using brief therapy has increased rapidly and apparently will continue to increase due to the expansion of managed health care, many psychologists do not have adequate training to use brief therapy successfully. Implications of this finding in terms of its potentially harmful effects and suggestions for future training are discussed.

Adult↗
PubMed1991

Fatty infiltration of the liver: quantification with phase-contrast MR imaging at 1.5 T vs biopsy.

Quantification of hepatic fat content by application of MR phase-contrast imaging (Dixon method) at 1.5 T was compared with results of biopsy in 16 patients with a variety of liver abnormalities. Motion artifact was suppressed by employing six or eight averages of short TR in-phase (echo offset, 0 msec), out-of-phase (echo offset, 1.1 msec), and in-phase (echo offset, 2.2 msec) spin-echo pulse sequences. The 360 degree out-of-phase sequence was used to assess the impact of T2* decay on this method of estimating fat fraction. A standard two-echo long TR sequence also was obtained in all patients. Histologic preparations from the biopsy specimens were examined by a pathologist who had no knowledge of the MR results and were graded according to overall visual assessment as belonging to one of four categories of fat fraction. Results of the MR-calculated apparent fat fraction were compared directly with biopsy category and were also placed in MR fat fraction categories, allowing estimation of the statistical correlation between the biopsy and MR grading systems. Eight of eight patients with biopsy categories indicating a fat fraction of less than 0.25 were computed by MR to have a fat fraction of less than 0.1. Seven of eight patients with biopsy categories indicating a fat fraction of greater than 0.25 were computed by MR to have a fat fraction of at least 0.24. The MR-calculated apparent fat fraction category correlated significantly with the histologic biopsy category (r = .86, p less than .01). When compared with the in-phase image, decreased signal from liver was visually apparent on the 180 degree out-of-phase images in all cases in which the fat fraction was at least 0.24, but there was no indication of fatty liver on the standard T1- or T2-weighted images. Calculated T2 also showed no correlation with degree of fatty deposition. Correction for T2* decay by using the 360 degree out-of-phase acquisition in addition to the standard 0 degree and 180 degree out-of-phase images had little effect on fat fraction computation. Phase-contrast MR is a promising noninvasive method for quantitative assessment of fatty deposition in the liver.

Adult↗
PubMed1990

A computer model of the heart that obeys Starling's law.

We developed a computer model of the heart that accurately reproduces human left ventricular pressure wave morphology. The model factors beat-to-beat venous return in generating cardiac output and simulates congestive heart failure when the venous return exceeds the heart's pumping capacity. The blood pressure waveform produced by our model resembles experimental data with a greater than 98% correlation and the model incorporates Starling's transfer function. The model is useful for simulations of cardiovascular hemodynamics where accurate waveforms and venous return feedback or modeling failing hearts are important.

Blood Pressure↗
PubMed1988

Duration of chronic pain and the Minnesota Multiphasic Personality Inventory: profiles of industrially injured workers.

The present study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) in understanding the relationship between duration of chronic pain and psychiatric difficulties. The MMPI responses of workers' compensation patients with varying levels of low back pain chronicity were compared. One hundred ninety eight patients, divided into three groups according to length of disability, underwent social history interviews and completed the MMPI. In regard to the overall profile, the sample had elevations on the Hypochondriasis, Depression, and Hysteria scales. A series of analysis of variance designs revealed that those who were disabled for two or more years evidenced significantly more depression and psychopathology than those who were disabled for less than one year. Further statistical evaluation of 200 social history variables did not reveal significant differences between the three groups on most variables. In conjunction with previous research, the results suggested a causative link between disability and psychiatric disease.

Accidents, Occupational↗
PubMed1986

MMPI evaluation of erectile dysfunction: failure of organic vs. psychogenic decision rules.

This study examined previously published decision rules to ascertain the empirical utility of the MMPI in discriminating between organic and psychogenic erectile dysfunction. Subjects were 41 males who were being evaluated for prosthesis implant surgery. The mean overall 1-2-3 MMPI profile revealed diffuse somatic complaints, depression, and denial. Results indicate that the MMPI failed to discriminate between organic and psychogenic subgroups. Men with psychogenic erectile dysfunction evidenced neither significantly more nor less psychopathology on the MMPI than did those with objective organic findings.

Diagnosis, Differential↗
PubMed1984

Abuses of the borderline diagnosis: a clinical problem with teaching opportunities.

The authors identify six ways in which the borderline diagnosis is commonly abused to express countertransference hate, mask imprecise thinking, excuse treatment failures, justify the therapist's acting out, defend against sexual clinical material, and avoid pharmacologic and medical treatment interventions. The paper focuses on diagnostic abuses that trainees present to clinical supervisors and educators. It attempts to show educators how to discern these abuses and turn them into teaching opportunities. These abuses are seen not only in trainees; they also occur in the professional community as a whole. Clinicians should expect the same diagnostic rigor of themselves that they expect of their students.

Acting Out↗
PubMed1983

Recent life events and accidents: the role of sex differences.

In order to investigate how gender may moderate the manner in which life change affects behavior, 110 men and 54 women who had had industrial accidents were interviewed to assess what life change events they had experienced during the years before and after their injuries. For both sexes, increases in life events and associated stress had occurred prior to their accidents. Females reported higher levels of work-related events two years pre-accident, whereas men experienced a sharp increase in work events one year pre-accident. Post-accident, both males and females reported the greatest number of live changes with men experiencing more medical sequelae and women more separations from spouses and resumption of school. Results are discussed in terms of the possible effects of changing social and sex role expectations.

Accidents, Occupational↗
PubMed1981

First encounters: effects of intake procedures on patients, staff, and the organization.

To examine the influence of intake procedures on patients' appearance for therapy, information was gathered on two different intake procedures used on the outpatient service of a large mental health center. Prospective patients calling Team 1 were immediately assigned a therapist and given an appointment, while patients calling Team 2 were told a therapist would call them back to arrange an appointment. A review of the records of 308 patients who called the teams during four selected months in 1976-77 showed that Team 2's procedure resulted in patients being seen more promptly and in fewer patients being lost to the system. If this procedure were supplemented by therapists' calling patients before initial appointments, even fewer patients would be lost and fewer appointments broken. A suicide that occurred during the intake process is descrbed in order to highlight procedural and psychological issues in the agency's handling of the case.

Adult↗
PubMed1980

Success on a biofeedback task: effects of congruence-incongruence between locus of control and psychological differentiation.

Assessed the utility of the cognitive constructs of Locus of Control and Psychological Differentiation as co-determiners of success on a biofeedback task. Eighty male and female psychology undergraduate students were divided into four groups based on median splits of scores on Levenson's Internal Locus of Control scale and on Witkin's Group Embedded Figures Test. Thus, four groups of subjects were identified: field-independent internals (Fl-I; n = 17), field-dependent externals (FD-E; n = 23), field-dependent internals (FD-I; n = 19), and field-independent externals (Fl-E; n = 21). The first two groups consisted of individuals whose locus of control orientation was congruent with their perceptual style and the last two contained the incongruent subjects. Fifteen subjects were randomly selected from each of the four groups resulting in a total sample of 60 subjects. All subjects were told to decrease their GSR using biofeedback during each of five, 2-minute trials. A 1-minute rest period was provided between each trial. Analysis of variance revealed that congruent subjects decreased their GSR significantly (p less than .01) more than incongruent subjects. Scheffe's test revealed that all subjects were able to learn to significantly decrease GSR. Additional research designed to examine the utility of the congruence-incongruence dimensions in biofeedback seems warranted.

Biofeedback, Psychology↗
PubMed1978

Locus of control, learned helplessness, and control of heart rate using biofeedback.

Subjects were 24 male undergraduate students. False biofeedback was provided to give the impression of success or failure (helplessness) on a preliminary task. Authentic biofeedback was then provided for control of heart rate. Subjects were administered pre- and post-locus of control scales using Levenson's multidimensional scales. A significant relationship between locus of control and success or failure conditions added validity to Levenson's approach. Results and future research are discussed.

Aptitude↗