bluuebunny/crossref_metadata_2025 huggingface dataset:
Verbal Inflectional Morphology in L1 and L2 Spanish: A Frequency Effects Study Examining Storage Versus Composition
Authors: Bowden Harriet Wood , Gelfand Matthew P. , Sanz Cristina , Ullman Michael T.
Published: February 2010

This study examines the storage versus composition of Spanish inflected verbal forms in first language (L1) and second language (L2) speakers of Spanish. L2 participants were selected to have mid‐to‐advanced proficiency, high classroom experience, and low immersion experience, typical of medium‐to‐advanced foreign language learners. Participants were shown the infinitival forms of verbs from either Class I (the default class, which takes new verbs) or Classes II and III (nondefault classes) and were asked to produce either first‐person singular present tense or imperfect forms, in separate tasks. In the present tense, the L1 speakers showed inflected‐form frequency effects (i.e., higher frequency forms were produced faster, which is taken as a reflection of storage) for stem‐changing (irregular) verb forms from both Class I (e.g., pensar‐pienso) and Classes II and III (e.g., perder‐pierdo), as well as for non‐stem‐changing (regular) forms in Classes II/III (e.g., vender‐vendo), in which the regular transformation does not appear to constitute a default. In contrast, Class I regulars (e.g., pescar‐pesco), whose non‐stem‐changing transformation constitutes a default (e.g., it is applied to new verbs), showed no frequency effects. L2 speakers showed frequency effects for all four conditions (Classes I and II/III, regulars and irregulars). In the imperfect tense, the L1 speakers showed frequency effects for Class II/III (‐ía‐suffixed) but not Class I (‐aba‐suffixed) forms, even though both involve non‐stem‐change (regular) default transformations. The L2 speakers showed frequency effects for both types of forms. The pattern of results was not explained by a wide range of potentially confounding experimental and statistical factors and does not appear to be compatible with single‐mechanism models, which argue that all linguistic forms are learned and processed in associative memory. The findings are consistent with a dual‐system view in which both verb class and regularity influence the storage versus composition of inflected forms. Specifically, the data suggest that in L1, inflected verbal forms are stored (as evidenced by frequency effects) unless they are both from Class I and undergo non‐stem‐changing default transformations. In contrast, the findings suggest that at least these L2 participants may store all inflected verb forms. Taken together, the results support dual‐system models of L1 and L2 processing in which, at least at mid‐to‐advanced L2 proficiency and lower levels of immersion experience, the processing of rule‐governed forms may depend not on L1 combinatorial processes, but instead on memorized representations.
Cognitive Predictors of Generalization of Russian Grammatical Gender Categories
Authors: Kempe Vera , Brooks Patricia J. , Kharkhurin Anatoliy
Published: February 2010

This study explores how learners generalize grammatical categories such as noun gender. Adult native English speakers with no prior knowledge of Russian (N = 47, ages 17–55 years) were trained to categorize Russian masculine and feminine diminutive nouns according to gender. The training set was morphophonologically homogeneous due to similarities induced by the diminutive suffixes. Generalization was tested using simplex and diminutive nouns with trained or novel stems. Age, familiarity with other second languages, nonverbal intelligence, and verbal working memory capacity were used to predict performance. Compared to trained diminutives, learners showed equally high accuracy in gender categorization of transparent simplex nouns with trained stems and diminutive nouns with novel stems. Accuracy dropped significantly for nontransparent simplex nouns with trained stems and transparent simplex nouns with novel stems. Verbal working memory capacity predicted gender categorization of nontransparent nouns and vocabulary recall, whereas age, nonverbal intelligence, and prior experience with languages with transparent gender categories affected performance in nouns containing at least some degree of gender transparency. The findings indicate that pattern‐based and memory‐based learning processes coexist in adult learners. However, age affected performance on pattern‐based processes but not memory‐based processes like rote memorization of vocabulary and gender categorization of nontransparent nouns. This finding is interpreted in the context of proposals concerning the role of declarative and procedural memory in L2 learning.
Second Language Acquisition of Gender Agreement in Explicit and Implicit Training Conditions: An Event‐Related Potential Study
Authors: Morgan‐Short Kara , Sanz Cristina , Steinhauer Karsten , Ullman Michael T.
Published: February 2010

This study employed an artificial language learning paradigm together with a combined behavioral/event‐related potential (ERP) approach to examine the neurocognition of the processing of gender agreement, an aspect of inflectional morphology that is problematic in adult second language (L2) learning. Subjects learned to speak and comprehend an artificial language under either explicit (classroomlike) or implicit (immersionlike) training conditions. In each group, both noun‐article and noun‐adjective gender agreement processing were examined behaviorally and with ERPs at both low and higher levels of proficiency. Results showed that the two groups learned the language to similar levels of proficiency but showed somewhat different ERP patterns. At low proficiency, both types of agreement violations (adjective, article) yielded N400s, but only for the group with implicit training. Additionally, noun‐adjective agreement elicited a late N400 in the explicit group at low proficiency. At higher levels of proficiency, noun‐adjective agreement violations elicited N400s for both the explicit and implicit groups, whereas noun‐article agreement violations elicited P600s for both groups. The results suggest that interactions among linguistic structure, proficiency level, and type of training need to be considered when examining the development of aspects of inflectional morphology in L2 acquisition.
Use of simple noninvasive biomarkers to predict liver fibrosis in HIV/HCV coinfection in routine clinical practice
Authors: Macías J , González J , Ortega E , Tural C , Cabrero E , Burgos A , Pineda JA ,   on behalf of the GRAFIHCO Study Team
Published: February 2010

Background

Simple noninvasive tests to predict fibrosis, as an alternative to liver biopsy (LB), are needed. Of these, the aspartate aminotransferase (AST) to platelet ratio index (APRI) and the Forns index (FI) have been validated in HIV/hepatitis C virus (HCV) coinfection. However, these indexes may have lower diagnostic value in situations other than the circumscribed conditions of validation studies. We therefore examined the value of the APRI and FI in HIV/HCV‐coinfected patients for the detection of significant fibrosis in real‐life conditions.

Patients and methods

HIV/HCV‐coinfected patients who had participated in a multicentre cross‐sectional retrospective study were selected if they had undergone an LB within 24 months before the last visit. The predictive accuracy of the APRI and FI was measured using the areas under receiver‐operating‐characteristic curves (AUROCs). Diagnostic accuracy was determined using the positive (PPV) and negative (NPV) predictive values.

Results

A total of 519 coinfected individuals were included in the study. The AUROC [95% confidence interval (95% CI)] of the APRI was 0.67 (0.66–0.71) and that of the FI was 0.67 (0.62–0.71). The PPV of the APRI was 79% and its NPV was 66%. The PPV of the FI was 74% and its NPV was 64%. LB length was available and was ≥15 mm in 120 individuals. In this group, the PPV of the APRI was 85%, and that of the FI was 81%. Using these indexes, 22% of patients could be spared LB. Applying both models sequentially, 30% of patients could be spared LB.

Conclusions

In HIV/HCV‐coinfected patients, the diagnostic accuracy of the APRI in real‐life conditions was similar to that in the validation studies. The FI performed less well. However, combining the two indexes to make decisions on anti‐HCV therapy may prevent a significant proportion of patients from having to undergo LB.
HIV‐1 proviral resistance mutations: usefulness in clinical practice
Authors: Kabamba‐Mukadi B , Duquenne A , Henrivaux P , Musuamba F , Ruelle J , Yombi J‐C , Bodéus M , Vandercam B , Goubau P
Published: February 2010

Objectives

Transmitted HIV strains may harbour drug resistance mutations. HIV‐1 drug resistance mutations are currently detected in plasma viral RNA. HIV‐1 proviral DNA could be an alternative marker, as it persists in infected cells.

Methods

This was a prospective study assessing the prevalence and persistence of HIV‐1 drug resistance mutations in DNA from CD4 cells before and after protease inhibitor (PI)‐ or nonnucleoside reverse transcriptase inhibitor (NNRTI)‐based therapy initiation in 69 drug‐naïve patients.

Results

Before therapy, 90 and 66% of detected mutations were present in CD4 cells and plasma, respectively. We detected seven key mutations, and four of these (M184M/V, M184M/I, K103K/N and M46M/I) were only found in the cells. When treatment was started, 40 patients were followed; the mutations detected at the naïve stage remained present for at least 1 year. Under successful treatment, new key mutations emerged in CD4 cells (M184I, M184M/I and Y188Y/H).

Conclusions

The proportion of mutations detected in the DNA was statistically significantly higher than that detected in standard RNA genotyping, and these mutations persisted for at least 1 year irrespective of therapy. The pre‐existence of resistance mutations did not jeopardise treatment outcome when the drug concerned was not included in the regimen. Analysis of HIV‐1 DNA could be useful in chronic infections or when switching therapy in patients with undetectable viraemia.
A Puzzle about Consent in Research and in Practice
Authors: CHWANG ERIC
Published: February 2010

abstract

In this paper, I will examine a puzzling discrepancy between the way clinicians are allowed to treat their patients and the way researchers are allowed to treat their subjects: in certain cases, researchers are legally required to disclose quite a bit more information when obtaining consent from prospective subjects than clinicians are when obtaining consent from prospective patients. I will argue that the proper resolution of this puzzling discrepancy must appeal to a pragmatic criterion of disclosure for informed consent: that what needs to be disclosed in order for consent to be valid depends on what the patient/subject needs to know in order to make a decision. I will then use this pragmatic criterion of disclosure to argue that when obtaining consent researchers should be permitted to omit the same information clinicians are, given certain qualifications. I will also examine how this puzzle forces us to confront some perhaps surprising truths about valid consent. My broader aim in this paper is to examine, not so much the puzzle itself, but rather what this particular puzzle can teach us about more theoretical issues surrounding informed consent.
The spatial arrangement of the human large intestinal wall blood circulation
Authors: Kachlik David , Baca Vaclav , Stingl Josef
Published: February 2010

The aim of the study was to describe and depict the spatial arrangement of the colon microcirculatory bed as a whole. Various parts of the large intestine and terminal ileum were harvested from either cadaver or section material or gained peroperatively. Samples were then injected with India ink or methylmetacrylate Mercox resin for microdissection and corrosion casting for scanning electron microscopy. The results showed that extramural vasa recta ramified to form the subserous plexus, some of them passing underneath the colon taeniae. Branches of both short and long vasa recta merged in the colon wall, pierced the muscular layer and spread out as the submucous plexus, which extended throughout the whole intestine without any interruption. The muscular layer received blood via both the centrifugal branches of the submucous plexus and the minor branches sent off by the subserous plexus. The mucosa was supplied by the mucous plexus, which sent capillaries into the walls of intestinal glands. The hexagonal arrangement of the intestinal glands reflected their vascular bed. All three presumptive critical points are only gross anatomical points of no physiological relevance in healthy individuals. Neither microscopic weak points nor regional differences were proven within the wall of the whole large intestine. The corrosion casts showed a huge density of capillaries under the mucosa of the large intestine. A regular hexagonal pattern of the vascular bed on the inner surface was revealed. No microvascular critical point proofs were confirmed and a correlation model to various pathological states was created.
Recombination and the maintenance of plant organelle genome stability
Authors: Maréchal Alexandre , Brisson Normand
Published: February 2010

Like their nuclear counterpart, the plastid and mitochondrial genomes of plants have to be faithfully replicated and repaired to ensure the normal functioning of the plant. Inability to maintain organelle genome stability results in plastid and/or mitochondrial defects, which can lead to potentially detrimental phenotypes. Fortunately, plant organelles have developed multiple strategies to maintain the integrity of their genetic material. Of particular importance among these processes is the extensive use of DNA recombination. In fact, recombination has been implicated in both the replication and the repair of organelle genomes. Revealingly, deregulation of recombination in organelles results in genomic instability, often accompanied by adverse consequences for plant fitness. The recent identification of four families of proteins that prevent aberrant recombination of organelle DNA sheds much needed mechanistic light on this important process. What comes out of these investigations is a partial portrait of the recombination surveillance machinery in which plants have co‐opted some proteins of prokaryotic origin but have also evolved whole new factors to keep their organelle genomes intact. These new features presumably optimized the protection of plastid and mitochondrial genomes against the particular genotoxic stresses they face.

Contents

Summary
299

I.
Introduction
299

II.
Roles of recombination in organelle genome stability
301

III.
Recombination surveillance machinery in plant organelles
304

IV.
Conclusion and perspectives
312

Acknowledgements
313

References
313
The effect of transglutaminase on the properties of milk gels and processed cheese
Authors: DE SÁ ESTELA MARY FERNANDES , BORDIGNON‐LUIZ MARILDE T
Published: February 2010

The aim of this study was to investigate the influence of transglutaminase (TG) on rennet coagulation properties, and the impact on the properties of processed cheese. The TG was added before, at the same time as, and after the addition of rennet. The parameters moisture, total solids and proteins and physical parameters (syneresis index, wheying‐off and rheological behaviour) were measured. The manufacturing of the milk gels treated with transglutaminase after rennet addition was shown to be an effective means of improving the physical properties (reduced synereseis index and increased consistency index) of processed cheese, possible by the occurrence of enzymatic cross‐linking.
Psychoactive Substance Abuse and Dependence as a Risk Factor in Adolescent‐Attempted and ‐Completed Suicide
Authors: Kaminer Yifrah
Published: February 2010

Psychoactive substance abuse and psychoactive substance dependence among adolescents are considered to be high‐risk factors for attempted and completed suicide. The typical adolescent at risk for suicide in the United States is a Caucasian male who is likely to be intoxicated and is likely to commit suicide with a firearm without ever seeking treatment. Psychopathologies such as depression and conduct disorder and personality disorders accompanied by precipitating events are frequently present. This review will examine the association between substance abuse and/or substance dependence and suicidal behavior from an epidemiological perspective. Clinical implications and research directions will be offered in conclusion.
The Effect of Carbamazepine on Cocaine Use
Authors: Halikas James , Kuhn Kenneth , Carlson Gregory , Crea Frederick , Crosby Ross
Published: February 2010

Thirty‐five chronic cocaine users were offered carbamazepine in an open clinical trial as an adjunct to outpatient treatment for cocaine dependence. Nine patients refused ongoing carbamazepine treatment, 13 decreased their cocaine use from 65/100 days pretreatment to 2.8/100 days with treatment (2,562 days at risk), and 13 had a reduction from 78.1/100 days pretreatment to 35.1/100 days with treatment (2,790 total days at risk). The 9 carbamazepine refusers had virtually no change in their cocaine use. The degree of patient compliance with carbamazepine intake correlated directly with decreased cocaine use and with lowered craving intensity, frequency, and duration.
Six‐Month Follow‐Up of Short‐Term Pharmacotherapy for Cocaine Dependence
Authors: Kosten Thomas R. , Gawin Frank H. , Kosten Therese A. , Morgan Cindy , Rounsaville Bruce J. , Schottenfeld Richard , Kleber Herbert D.
Published: February 2010

This 6‐month follow‐up study of 43 of 72 patients who entered a 6‐week randomized clinical trial of pharmacotherapy for cocaine dependence found that self‐reported cocaine abstinence during the 6 months was significantly greater in patients treated with desipramine (44%) than in those treated with lithium (19%) or placebo (27%). The placebo group had more occurrences of depression (36% vs. 6%) and daily alcohol abuse (36% vs. 15%) than the medicated groups. The ability to abstain from cocaine use during the clinical trial was the strongest predictor of continued abstinence during the follow‐up, which showed that 53% remained abstinent after 6 months.
Personal Variables and the Attitudes of Medical Students Toward Substance Abuse
Authors: El‐Guebaly Nady , Hodgins David C. , Dudar Cheryl
Published: February 2010

Medical students at The University of Calgary were surveyed about their experiences with and attitudes toward alcohol abuse using the Children of Alcoholics Screening Test (CAST), the Codependency Assessment Inventory (CDAI), the CAGE's four questions, and the Substance Abuse Attitude Survey (SAAS). Nineteen percent of the 110 respondents showed strong evidence that they were the offspring of alcoholics (CAST ≥ 6), 22% reported strong codependency traits (CDAI ≥ 30), and 22% showed evidence of alcohol problems (CAGE ≥ 2). Among the five subscales of the SAAS, three showed a significant amount of variance determined by the personal variables investigated.
Intragastric Infusion of Ethanol by Alcoholics After Surgery for Head and Neck Cancer
Authors: Kranzler Henry R. , Ginther Laura , Ttofi Christopher
Published: February 2010

Alcohol abuse or dependence may complicate medical and surgical treatment. Two cases involving patients with head and neck cancer are presented to illustrate 1) continued drinking despite adverse medical consequences and 2) the need for careful assessment and appropriate intervention with alcohol‐dependent patients.
Adolescent Substance Abuse Treatment
Authors: Kaminer Yifrah , Tarter Ralph E. , Bukstein Oscar G. , Kabene Mostefa
Published: February 2010

The authors evaluated the level of agreement between unit staff and patients (treatment completers and noncompleters) regarding their perception of the efficacy of treatment modalities in a program for adolescent substance abusers. The results indicate statistically significant and clinically meaningful differences in perception of the value of three modalities: 1) individual treatment contracting, 2) therapeutic community meeting, and 3) educational counseling. The three groups did not differ on seven other variables. The authors hypothesize that the magnitude of agreement between staff and patients on the efficacy of treatment variables is associated with the likelihood of completing treatment among adolescent substance abusers.
The Importance of Drug Self‐Administration Studies in the Analysis of Abuse Liability
Authors: Foltin R.W.
Published: February 2010

The author discusses the rationale and procedures involved in analyzing research subjects'self‐administration of drugs of abuse. The discussion is limited to data obtained on abuse of caffeine, nicotine, anabolic steroids, and designer drugs. The studies were not chosen to represent an exhaustive discussion of the issues, but to illustrate the importance of obtaining experimental data from both human and non‐human subjects to better understand factors related to human drug abuse.
Predicting Success in a Community Treatment Program for Substance Abusers
Authors: Bachman Sara S. , Batten Helen Levine , Minkoff Kenneth , Higgins Richard , Manzik Nancy , Mahoney Diane
Published: February 2010

As reimbursement for hospital substance abuse programs becomes more limited, new addictions treatment alternatives are needed to provide high‐quality care while reducing costs. These new treatment alternatives are particularly needed in the community hospital setting. The authors describe an addictions day‐treatment (ADT) program developed on a community hospital psychiatric unit. Substance abuse patients were randomly assigned to an ADT or traditional inpatient treatment program. Study results show the relevance of ADT for most patients as a component of care in the continuum of programs that a community hospital psychiatric service may offer. ADT was at least as effective up to 18 months after discharge as traditional inpatient care. Moreover, ADT is less expensive than inpatient treatment, and ADT patients are as satisfied with their care as are inpatients.
Screening for Risk of HIV Exposure Using the A‐I‐D‐S Mnemonic
Authors: Mueller Timothy I. , Swift Robert M.
Published: February 2010

This study evaluates a screening tool, based on the acronym “A‐I‐D‐S,” for assessment of risk of HIV infection. Patients were asked if they were afraid they had been exposed to AIDS, had everused intravenous drugs or received blood products, had any diagnostic features of HIV infection, and had engaged in any high‐risk sexual behaviors. The rating of risk based on the A‐I‐D‐S study questionnaire correlated significantly with assessments of risk by the treating physician and based on chart review. The A‐I‐D‐S mnemonic proved to be rapid and accurate for assessing risk for HIV infection.
Substance Abuse Severity in Female Adolescents
Authors: Mezzich Ada C. , Tarter Ralph E. , Hsieh Ya‐Chen , Fuhrman Amy
Published: February 2010

The authors investigated the association between age at menarche and age at onset of substance use with frequency of alcohol consumption in mid‐adolescence; age at first DSM‐III‐R diagnosis of psychoactive substance use disorder (PSUD); severity of physical health, substance use, and psychosocial problems; and psychiatric disorders in female adolescents. Twenty‐eight PSUD female adolescents (age 14–18 years) were studied. Chronological age at first substance use, and not age at menarche, was associated with the four variables mentioned above. These findings indicate that substance use in this population is encompassed within significant psychiatric disturbance that most commonly precedes the onset of PSUD.
Drug Preference, Reported Drug Experience, and Stimulus Sensitivity
Authors: Milin Robert , Loh Elliot A , Wilson Allan
Published: February 2010

The authors performed three studies to determine if drug abusers preferring three different psychoactive substances (alcohol, cannabis, or cocaine) differed on subjective experience of their drug of preference as measured by modified versions of the Adjective Checklist (ACL; Gough and Heilbrun, 1983). In addition, the subject's stimulus sensitivity was measured by the Vando Reducer‐Augmenter (RA) scale. In all three studies, responses to the modified ACL (MACL and MACL‐18) differentiated drug of preference in over 80% of the cases. This suggests that subjects perceive a unique subjective experience from their drug of choice, which may constitute a basis for their drug preference. In the second and third studies, alcohol‐preferring subjects scored significantly lower on the RA scale than those who preferred either cannabis or cocaine, suggesting that they were more sensitive to stimuli. The results are discussed within the contexts of the optimum arousal and self‐medication theories of drug addiction.
Personality, Mood, and Psychiatric Symptoms Among Anabolic Steroid Users
Authors: Moss Howard B. , Panzak George L. , Tarter Ralph E.
Published: February 2010

The relationship between use of anabolic steroids (ASs) and specific personality dimensions was assessed in 50 male bodybuilders who were current or past users compared with a sample of 25 age‐matched, “natural” male bodybuilders who never used ASs. No personality differences were found. The relationship between current AS use and the presence of variations in mood state, hostility, and psychiatric symptomatology was then evaluated. Current AS users scored higher than non‐users only on psychometric scales measuring hostility, aggression, and somatization. Thus, reports that AS use was associated with significant psychopathology, other than aggression and somatization, could not be confirmed.
Psychiatric Comorbidity in Treatment‐Seeking Cocaine Abusers
Authors: Halikas James A. , Crosby Ross D. , Pearson Victoria L. , Nugent Sean M. , Carlson Gregory A.
Published: February 2010

The authors determined psychiatric diagnoses in 207 cocaine abusers seeking outpatient treatment, using the Diagnostic Interview Schedule (DIS) developed by the National Institute of Mental Health. A major proportion of subjects (62%) met diagnostic criteria for a current psychiatric disorder, and nearly three‐quarters (73%) met lifetime criteria for at least one psychiatric disorder other than substance abuse. Antisocial personality disorders, affective disorders, and anxiety disorders accounted for most of the psychiatric illnesses. Women were found to have significantly higher rates of current and lifetime psychopathology than men. The temporal relationship between substance abuse and the onset of affective and anxiety disorders was examined, with the particular finding that onset of anxiety disorders substantially predated regular cocaine use.
A Public Dual‐Diagnosis Detoxification Unit: Part III: Short‐Term Efficacy of Treatment
Authors: Wilens Timothy E. , Saley Paul , Renner John A. , O'Keefe Janice
Published: February 2010

Despite the frequency of alcohol and drug dependence in mentally ill people, data are not readily available on the detoxification and acute stabilization of psychiatric symptoms in this group. The authors have previously reported on a public dual‐diagnosis treatment model for homeless or homeless‐prone patients. They now report on a pilot prospective study investigating the efficacy of this short‐term treatment in stabilizing psychiatric symptoms. The Brief Psychiatric Rating Scale (BPRS) and Clinicians' Global Improvement (CGI) and Severity Scale (CGS) were used to assess treatment stabilization in alcohol‐dependent subjects referred with (n = 12) or without psychiatric disorders (n = 12). The psychiatrically referred group had significantly more psychiatric impairment and symptoms at admission than control subjects, but both groups showed similar progressive improvement in symptoms on hospitalization Days 2, 4, and 6 as assessed by both the BPRS and CGI (23% reduction by Day 6, all Ps < 0.001). These findings indicate that a public dual‐diagnosis detoxification unit appears effective in stabilizing psychiatric symptoms in this group of psychiatrically referred, alcohol‐dependent patients.
A Buprenorphine Stabilization and Rapid‐Taper Protocol for the Detoxification of Opioid‐Dependent Patients
Authors: Parran Theodore V. , Adelman Christopher L. , Jasinski Donald R.
Published: February 2010

Management of hospitalized opioid‐dependent patients can be problematic at times, especially when patients are medically unstable, elderly, or have acute or chronic pain syndromes. The authors report a case series of 65 patients detoxified on 74 separate occasions with the use of the partial μ‐agonist buprenorphine. The buprenorphine was administered subcutaneously as an initial stabilization dose, after which patients received a rapid taper over approximately 6 days. Ninety‐seven percent (n = 72) of the 74 episodes of detoxification were successfully managed with buprenorphine; 62% (n = 40) of the patients bad no symptoms of opioid withdrawal. All patients reported that this detoxification protocol was as comfortable or more comfortable than any previously encountered withdrawal experience. The results of this case series provide strong support for further studies of the role of buprenorphine in the short‐term detoxification of hospitalized opioid‐dependent patients.
The Colorado Physician Health Program. Observations at 7 Years
Authors: Dilts Stephen L. , Gendel Michael , Lepoff Ronald , Clark Cheryl , Radcliff Sue
Published: February 2010

The Colorado Physician Health Program, a statewide peer health assistance program for physicians, has functioned for 7 years as a freestanding, not‐for‐profit corporation. By use of an employee‐assistance model, the Program offers psychiatric evaluation, referral for treatment, and ongoing monitoring for treatment progress and ability to practice safely. A significant fraction of the physicians seen by the Program have problems or illnesses that either do not involve (or do not solely involve) substance abuse, and often such cases present diagnostic dilemmas.
Naltrexone and Brief Counseling to Reduce Heavy Drinking
Authors: Bohn Michael J. , Kranzler Henry R. , Beazoglou Despina , Staehler Beth A.
Published: February 2010

Naltrexone (NTX) has been shown to be safe and effective in reducing relapses among alcoholics. Among nondependent heavy drinkers, who are more numerous in the general population than are alcohol‐dependent drinkers, brief counseling has been shown to reduce alcohol consumption. The authors conducted a 6‐week randomized study of the effects of adding 25‐mg or 50‐mg daily doses of NTX to brief counseling in 14 nondependent heavy drinkers. NTX was well‐tolerated. Desire for alcohol, drinking frequency, frequency of heavy drinking, total alcohol consumption, and serum gamma‐glutamyl transpeptidase all decreased significantly during treatment. A placebo‐controlled trial is warranted to evaluate further the efficacy of NTX in this group of problem drinkers.
The Effects of Cocaine in Buprenorphine‐Maintained Outpatient Volunteers
Authors: Strain Eric C. , Preston Kenzie L. , Stitzer Maxine L. , Liebson Ira A. , Bigelow George E.
Published: February 2010

Previous data suggest that buprenorphine may decrease cocaine abuse. The authors investigated the influence of buprenorphine on cocaine effects in volunteer opioid and cocaine abusers. Results from cocaine challenge sessions (40 mg iv) before and during buprenorphine treatment (8 mg/day sublingual) and from weekly outpatient reports provided no evidence that buprenorphine attenuated the effects of cocaine; in fact, trends suggested an enhancement of cocaine effects. The combination of cocaine and buprenorphine did not produce adverse effects, but illicit opioid use decreased during treatment with buprenorphine. These results support further study of buprenorphine as a treatment for opioid abuse, but they do not suggest efficacy against cocaine abuse.
Comorbid Substance Abuse and Posttraumatic Stress Disorder
Authors: Brady Kathleen T. , Killeen Therese , Saladin Michael E. , Dansky Bonnie , Becker Sharon
Published: February 2010

To further explore the complex relationship between posttraumatic stress disorder (PTSD) and substance use disorders, the authors compared 30 women with PTSD in substance abuse treatment with 25 women without PTSD in substance abuse treatment on degree of addiction severity, psychopathology, and aftercare compliance. Women with PTSD were more likely to have been victims of sexual and physical abuse, particularly childhood abuse. They had significantly higher scores on the Addiction Severity Index, were more likely to have comorbid affective disorder, and less likely to comply with aftercare. These results suggest that screening for victimization and PTSD among women presenting for substance abuse treatment may have important prognostic and treatment implications.
Cognitive Readiness of Drug Injectors to Reduce AIDS Risks
Authors: Camacho L. Mabel , Williams Mark L. , Vogtsberger Kenneth N. , Simpson D. Dwayne
Published: February 2010

The impact of motivational factors on AIDS high‐risk behavior after participation in an AIDS intervention program was explored among 208 out‐of‐treatment injecting drug users (IDUs). It was hypothesized that lower risk behavior would be evident at follow‐up among IDUs who indicated higher concern about their susceptibility to AIDS prior to intervention. Results showed that this motivational indicator predicted lower risks 6 months after the intervention. Overall, this study indicates that psychoeducational AIDS interventions will be most beneficial to individuals with sufficient cognitive readiness to address drug‐ and AIDS‐related issues at a personal level. Assessments of risk and motivation levels of program participants should be used to tailor intervention strategies to meet individual needs.
Sexual and Physical Assault History and Posttraumatic Stress Disorder in Substance‐Dependent Individuals
Authors: Grice Dorothy E. , Brady Kathleen T. , Dustan Lorraine R. , Malcolm Robert , Kilpatrick Dean G.
Published: February 2010

The authors explored the relationship between sexual and physical assault and posttraumatic stress disorder (PTSD) in individuals seeking treatment for substance use disorders by giving 100 substance‐dependent inpatients (50 men, 50 women) a structured interview on traumatic life events and lifetime histories of sexual and physical assault. Sixty‐six percent of individuals had a history of sexual or physical assault. Half of the assault victims met DSM‐III‐R criteria for PTSD, whereas no one in the non‐assault group met criteria for PTSD. Type of assault and specific characteristics of victims were significantly associated with psychiatric disorders. Women bad higher rates of sexual assault history, serial assault, and familial assault than men. Individuals who bad experienced childhood assault bad earlier age at onset of substance dependence than those who had not experienced childhood assault. Sexual and physical assault histories and psychopathology should be assessed in all substance‐dependent individuals. More accurate and specific treatment planning may improve treatment outcomes.
Co‐occurrence of Psychiatric Disorders and Alcoholism in Untreated Alcoholic Patients in a VA Medical Walk‐in (Triage) Clinic Population
Authors: Liskow Barry , Samuelson Stephen , Powell Barbara , Campbell Jan
Published: February 2010

The authors identified 1,836 male veterans who were seeking treatment for various medical disorders at a walk‐in (triage) clinic and screened these patients for the presence of alcohol problems by administering a brief interview and the CAGE questionnaire. Patients who screened positive for alcohol problems and who had little or no prior treatment for these problems were then interviewed using a structured psychiatric interview to establish the presence of alcohol dependence and co‐occurring psychiatric disorders. The rate of alcohol dependence and co‐occurring disorders was substantial, and the pattern was consistent with studies of veteran patients surveyed in other clinical settings.
Safety and Efficacy of Bupropion Combined With Bromocriptine for Treatment of Cocaine Dependence
Authors: Montoya Ivan D. , Preston Kenzie L. , Cone Edward J. , Rothman Richard. , Gorelick David A.
Published: February 2010

Bupropion and bromocriptine have been used separately for treatment of cocaine dependence. This 8‐week, open‐label study tested the combination of bupropion and bromocriptine with the goal of obtaining an enhanced therapeutic effect with fewer side effects. Thirteen cocaine‐dependent (DSM‐III‐R criteria) subjects received bupropion (≤300 mg) plus bromocriptine (≤7.5 mg) daily, in addition to weekly individual standardized counseling. No serious adverse events were reported. There were significant (P < 0.01) reductions between pretreatment and posttreatment for patients' self‐reported weekly grams used, money spent on cocaine, and Beck Depression Inventory score; however, there were no significant changes in the results of urine toxicology tests for cocaine (qualitative and quantitative) or self‐reported drug craving. These results suggest that the combination of bupropion and bromocriptine may be safe and have some efficacy in treatment of cocaine dependence.
Recognition of Comorbid Psychopathology by Staff of a Drug Detoxification Unit
Authors: Craig Thomas J. , DiBuono Mark
Published: February 2010

The authors assessed the ability of the clinical staff of a 22‐bed drug detoxification unit to recognize comorbid general psychopathology by comparing the results of a psychiatric evaluation with a consecutive series (n = 131) of patients referred for consultation with a random sample (n = 91) of admissions not referred. Eighty‐four percent of the referred patients met DSM‐III‐R criteria for comorbid Axis I or Axis II condition as compared with 21% of the random sample. However, given that only 20% of all admissions are referred for psychiatric consultation, these findings suggest that a substantial proportion of admissions with comorbid psychiatric conditions go unrecognized in this setting, and they underscore the need for staff education in the recognition of comorbidity in the face of managed‐care initiatives.
Alcoholism in Russia
Authors: Levine Barrett C. , Nebelkopf Ethan. , Kay Wright Mary
Published: February 2010

The authors review the history and prevalence of alcoholism in Russia and describe current treatment efforts. As the Russian people struggle to establish political and economic democracy, the devastating cost of alcoholism threatens the success of Russian reforms. Initial results of applying Western treatment approaches in a Moscow patient population are promising and suggest the need for a more widespread integration of Russian and Western treatment efforts.
Psychiatric Disorders, Drug Use, and Medical Status in Injection Drug Users With HIV Disease
Authors: Batki Steven L. , Ferrando Stephen J. , Manfredi Luisa , London Julie , Pattillo Jerry , Delucchi Kevin
Published: February 2010

The authors reviewed records of 84 HIV‐infected methadone‐ maintenance treatment (MMT) patients for psychiatric disorders, HIV disease status, and urine drug‐test results. Sixty‐six patients (79%) required psychiatric consultation (P+). Their diagnoses are presented. P+ patients and patients not requiring consultation (P−) were compared for drug abuse, HIV status, and zidovudine (AZT) treatment while in MMT. P+ patients had a higher rate of drug‐positive urine tests than P− patients, were more likely to have progressed to AIDS, and were less likely to have AZT prescribed. Among injection drug users in MMT, current psychiatric comorbidity is common and may be associated with worsened drug‐abuse treatment and HIV disease outcome. (American Journal on Addictions 1996; 5:249–258)
Can Management by Outcome Invigorate Substance Abuse Treatment?: Microincentives and the Quality of Care
Authors: Bickel Warren K. , McLellan A. Thomas
Published: February 2010

Given the rapid changes in health care, the economic consequences of substance abuse and the contemporary problems of substance abuse treatment must be acknowledged and addressed. These problems include poor treatment outcomes, difficulty of recruiting and retaining treatment staff, and failure of treatment programs to adopt effective research innovations. The authors suggest that these problems result from the incentives of the current payment system. To correct this, they propose an outcome‐based incentive system to improve treatment outcome. This system is designed to enhance both treatment‐ and cost‐effectiveness while being flexible and sensitive to local community circumstances. (American Journal on Addictions 1996; 5:281–291)
AIDS‐Related Knowledge and High‐Risk Behaviors of Pregnant, Substance‐Dependent Women
Authors: Elk Ronith , Andres Robert , Helfgott Andrew , Rhoades Howard , Mangus Lorna , Mirza Iman , Burroughs Ramona , Grabowski John
Published: February 2010

The authors investigated AIDS‐related knowledge, high‐risk behaviors, and relationships between AIDS‐related knowledge, high‐risk behaviors, and sociodemographic characteristics of 41 pregnant women entering treatment who were dependent on cocaine or opiates. At entry, patients completed self‐report questionnaires on AIDS‐related knowledge and sexual and drug use practices. There was a high rate of understanding of risk associated with drug use and perinatal transmission of HIV. Knowledge of high‐risk sexual behavior varied, and knowledge of the medical consequences of HIV was modest. Engagement in several high‐risk behaviors was identified: lack of condom use, intravenous drug use, sharing of needles, sex with an injecting drug user, and exchanging sex for money or drugs. AIDS‐related knowledge and engagement in high‐risk behaviors were not significantly correlated. Authors discussed implications of these findings for developing effective HIV prevention strategies in this population. (American Journal on Addictions 1996; 5:292–300)
Addiction Among Immigrants and Migrants: Epidemiology and Treatment
Authors: Westermeyer Joseph
Published: February 2010

The author discusses the addiction problems of several categories of immigrants, “travelers,” and refugees and presents categories and case histories of various typical presentations along with recommendations for individual and organized community approaches to treatment of the classes of alcoholism, addiction, substance abuse, and comorbidity. (American Journal on Addictions 1996; 5:334–350)
A Review of Pharmacotherapies for Substance Abuse
Authors: Kosten Thomas R. , McCance Elinore
Published: February 2010

New pharmacotherapies have been developed for acute withdrawal and maintenance treatments of alcohol and opioid dependence but not for cocaine dependence. High‐dose, long‐acting benzodiazepines, beta‐blockers, and two antiseizure agents—carbamazepine and valproate—are being used for alcohol withdrawal. For maintenance treatment, opioid antagonists and various serotonergic agents, such as fluoxetine and ondansetron, show promise. For opioid dependence, clonidine‐naltrexone detoxification appears quite cost‐effective, and buprenorphine and LAAM (levo‐alpha‐acetylmethadol) show promise for both detoxification and maintenance. More work is needed, however, to discover an effective agent for target populations of cocaine abusers.
Clinical Epidemiology of Comorbid Dysthymia and Substance Disorder
Authors: Westermeyer Joseph , Eames Sandra E.
Published: February 2010

The authors sought to determine the 1‐year‐period prevalence and demographic characteristics of comorbid substance‐related disorder (SRD) and dysthymia, as well as the demographic characteristics of SRD‐dysthymia patients as compared with SRD‐only patients. Patients being treated at two university medical centers and abstinent less than 2 years were followed prospectively for 6 months to establish the diagnosis of dysthymia. A total of 642 patients were assessed, of whom 39 bad SRD‐dysthymia and 308 had SRD only. Data collection instruments included a demographic questionnaire and assessment of DSM Axis I psychiatric diagnoses. The 1‐yearprevalence rate was lower than noted in previous studies where there were less stringent criteria for dysthymia. The rate of dysthymia among these SRD patients closely resembled that observed in a general population study. SRD‐dysthymia patients and SRD‐only patients did not differ on most demographic characteristics. SRD‐dysthymia is not easily detected among recovering SRD patients because of the need for lengthy observation and the absence of special demographic characteristics.
Bromocriptine for Cocaine Dependence
Authors: Handelsman Leonard , Rosenblum Andrew , Palij Michael , Magura Stephen , Foote Jeffery , Lovejoy Meg , Stimmel Barry
Published: February 2010

On the basis of the dopamine depletion theory, bromocriptine has been tested to treat cocaine withdrawal and dependence. The authors conducted a 6‐week study with 1 week of pretreatment observation and 5 weeks of a randomized, double‐blind, placebo‐controlled clinical trial of bromocriptine for DSM‐III‐R‐defined cocaine dependence in methadone‐maintained male patients. The bromocriptine group (n= 24) did not differ from the placebo group (n= 26) in self‐reported cocaine use, proportion of positive urine toxicology samples, craving for cocaine, resistance to cocaine use, or mood symptoms between the pretreatment baseline and the last week of the clinical trial. Both groups showed significant reduction in self‐reported frequency of cocaine use, resistance to craving, and mood symptoms during participation in the protocol. The results of this study are consistent with recent clinical and laboratory findings in primary cocaine users. Despite initially promising pilot studies, recent evidence does not support the efficacy of bromocriptine to reduce cocaine use or craving.
Early Prediction of Initiation of Abstinence From Cocaine
Authors: Weiss Roger D. , Griffin Margaret L. , Hufford Cathryn , Muenz Larry R. , Najavits Lisa M. , Jansson Stephanie B. , Kogan Julia , Thompson Heather J.
Published: February 2010

The authors administered a five‐item craving questionnaire daily to 86 outpatients to determine whether initial craving scores predicted the likelihood of initiation of abstinence within a 30‐day period. Patients with higher mean craving scores during the first 3 days of the study were less likely to initiate abstinence. However the relationship between craving and abstinence initiation was not linear. Rather, patients in the top quartile of craving scores were significantly less likely to abstain than were patients in the lower three quartiles. The findings suggest that this rapid, easily administered craving questionnaire may have short‐term predictive validity.
Suicide and Alcoholism
Authors: Porsteinsson Anton , Duberstein Paul R. , Conwell Yeates , Cox Christopher , Forbes Nicholas , Caine Eric D.
Published: February 2010

Psychological autopsy data were used to test the hypothesis that alcoholic patients with comorbid drug use disorders who committed suicide (A+D; n = 26) are distinguishable from alcoholic suicide victims without a comorbid drug use disorder (A; n = 35). Dependent variables included demographics, suicidal behavior, psychiatric symptoms, and medical illness burden. The A group were older, white, and tended to be living alone. Analyses that controlled for age and sex indicated that As were more likely to have had a comorbid major depression and less likely to tell someone they were contemplating suicide. Scores on a measure of illness burden increased with age among the A group but not the A + D group, though the latter were more likely to be under a physician's care with increasing age. These differences should be considered when designing preventive measures.