bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness of Continuing Group Psychotherapy for Outpatients with Alcohol Dependence: 77‐Month Outcomes
Authors: Kim Jee Wook , Choi Yong Sung , Shin Kyung Chul , Kim Ok Hwa , Lee Dong Young , Jung Myung Hun , Lee Boung Chul , Kang Tae‐Cheon , Choi Ihn‐Geun 
Published: September 2011

Background:  Group psychotherapy (PT) is one of the most common interventions used to treat alcohol dependence (AD), and it is assumed to be effective. Despite its common clinical use, long‐term trials that have been conducted to examine the efficacy of group PT in the treatment of outpatients with AD are limited and often lack appropriate comparisons. On that basis, a long‐term comparative trial was performed with the main objective of evaluating the effectiveness of continuing group PT for outpatients with AD.Methods:  Quasi‐experimental trial was conducted from January 2004 to May 2010 in 177 AD subjects who had completed an inpatient 10‐week alcohol treatment program. Abstinence rates of the combined group (experimental group: outpatient individual PT plus group PT, N = 94) and the standard outpatient individual PT‐only group (comparison group, N = 83) were statistically compared using Kaplan–Meier survival analysis. Predictive factors of abstinence rate for alcohol were assessed using Cox regression analysis.Results:  Abstinence rates of the combined PT group were significantly high relative to those of the outpatient individual PT‐only group. Significant predictive factors for the alcohol abstinence rate were outpatient group PT and age. Even after controlling for confounding factors, outpatient group PT was a significant predictive factor for the alcohol abstinence rate.Conclusions:  Our findings indicate that for AD patients who had completed an inpatient 10‐week alcohol treatment, outpatient group PT appears to be an effective form of continuing care or aftercare within the context of an outpatient service delivery system.
Severity of Acute Illness is Associated with Baseline Readiness to Change in Medical Intensive Care Unit Patients with Unhealthy Alcohol Use
Authors: Clark Brendan J. , Smart Alexandra , House Robert , Douglas Ivor , Burnham Ellen L. , Moss Marc 
Published: September 2011

Background:  Unhealthy alcohol use predisposes to multiple conditions that frequently result in critical illness and is present in up to one‐third of patients admitted to a medical intensive care unit (ICU). We sought to determine the baseline readiness to change in medical ICU patients with unhealthy alcohol use and hypothesized that the severity of acute illness would be independently associated with higher scores on readiness to change scales. We further sought to determine whether this effect is modified by the severity of unhealthy alcohol use.
Methods:  We performed a cross‐sectional observational study of current regular drinkers in 3 medical ICUs. The Alcohol Use Disorders Identification Test was used to differentiate low‐risk and unhealthy alcohol use and further categorize patients into risky alcohol use or an alcohol use disorder. The severity of a patient’s acute illness was assessed by calculating the Acute Physiologic and Chronic Health Evaluation II (APACHE II) score at the time of admission to the medical ICU. Readiness to change was assessed using standardized questionnaires.
Results:  Of 101 medical ICU patients who were enrolled, 65 met the criteria for unhealthy alcohol use. The association between the severity of acute illness and readiness to change depended on the instrument used. A higher severity of illness measured by APACHE II score was an independent predictor of readiness to change as assessed by the Stages of Change Readiness and Treatment Eagerness Scale (Taking Action scale; p < 0.01). When a visual analog scale was used to assess readiness to change, there was a significant association with severity of acute illness (p < 0.01) that was modified by the severity of unhealthy alcohol use (p = 0.04 for interaction term).
Conclusions:  Medical ICU patients represent a population where brief interventions require further study. Studies of brief intervention should account for the severity of acute illness and the severity of unhealthy alcohol use as potential effect modifiers.
Thoracic Kyphosis Associated with Hemivertebra
Authors: Moissonnier Pierre , Gossot Pauline , Scotti Stefano 
Published: September 2011

ObjectiveTo radiographically assess the influence of thoracic hemivertebra on kyphosis and neurologic status in 45 dogs.Study DesignCase series.AnimalsFrench Bulldogs without neurologic signs (n = 41) and 4 dogs with compressive spinal cord disease associated with hemivertebra.MethodsThoracic spinal radiographs were divided into 3 groups: 1 = dogs with no hemivertebra, 2 = dogs with hemivertebra but no associated neurologic signs, and 3 = dogs with hemivertebra associated with clinical signs. Vertebral canal height, vertebral column angle, and the step between 2 adjacent vertebrae were measured in each group.ResultsVertebral canal height was not significantly different in the 3 groups; however, mean vertebral column angle was significantly (P < .001) different between groups 1 (178°) and 2 (169°), and group 3 (133°). Median cranial step was significantly different between groups (P < .001): 0 mm (group 1), 0.3 mm (group 2), 3 mm (group 3).ConclusionsVertebral canal height does not differ between normal dogs and dogs with thoracic hemivertebra. There is an important association between neurologic signs and kyphosis and subluxation.Clinical RelevanceVertebral realignment without vertebral canal opening could lead to spinal cord decompression in dogs affected by thoracic hemivertebra.
Use of the PleuralPort Device for Management of Pleural Effusion in Six Dogs and Four Cats
Authors: Brooks Aimee C. , Hardie Robert J. 
Published: September 2011

ObjectiveTo describe the placement technique, complications, and outcomes associated with use of the PleuralPort device for management of pleural effusion in dogs and cats.Study DesignCase Series.AnimalsSix dogs and 4 cats.MethodsMedical records of all animals with pleural effusion managed with the PleuralPort device were reviewed. Data regarding signalment, fluid analysis, placement technique, duration of function, duration of implantation, complications, and outcome were collected. Owners and referring veterinarians were contacted for follow‐up information.ResultsNine animals had chylous effusion and 1 dog had pleural carcinomatosis. Eleven ports were placed with 1 cat receiving bilateral ports. Four animals developed complications. One cat developed pneumothorax immediately after implantation and was euthanatized. In 2 dogs and 1 cat, the ports obstructed. The 6 remaining animals had functioning ports at time of death or resolution of effusion and no longer required use of the port. No significant port migration, irritation, or infection of the device was reported. Excluding the cat with pneumothorax, median duration of port function was 20 days (range 1–391), and median duration of port implantation was 391 days (range 6–723).ConclusionsThe PleuralPort device is a feasible option for the management of pleural effusion in dogs and cats.
The Development and Psychometric Validation of the Central Sensitization Inventory
Authors: Mayer Tom G. , Neblett Randy , Cohen Howard , Howard Krista J. , Choi Yun H. , Williams Mark J. , Perez Yoheli , Gatchel Robert J. 
Published: September 2011

Abstract:Central sensitization (CS) has been proposed as a common pathophysiological mechanism to explain related syndromes for which no specific organic cause can be found. The term “central sensitivity syndrome (CSS)” has been proposed to describe these poorly understood disorders related to CS. The goal of this investigation was to develop the Central Sensitization Inventory (CSI), which identifies key symptoms associated with CSSs and quantifies the degree of these symptoms. The utility of the CSI, to differentiate among different types of chronic pain patients who presumably have different levels of CS impairment, was then evaluated. Study 1 demonstrated strong psychometric properties (test–retest reliability = 0.817; Cronbach’s alpha = 0.879) of the CSI in a cohort of normative subjects. A factor analysis (including both normative and chronic pain subjects) yielded 4 major factors (all related to somatic and emotional symptoms), accounting for 53.4% of the variance in the dataset. In Study 2, the CSI was administered to 4 groups: fibromyalgia (FM); chronic widespread pain without FM; work‐related regional chronic low back pain (CLBP); and normative control group. Analyses revealed that the patients with FM reported the highest CSI scores and the normative population the lowest (P < 0.05). Analyses also demonstrated that the prevalence of previously diagnosed CSSs and related disorders was highest in the FM group and lowest in the normative group (P < 0.001). Taken together, these 2 studies demonstrate the psychometric strength, clinical utility, and the initial construct validity of the CSI in evaluating CS‐related clinical symptoms in chronic pain populations. ▪
Comparative Effectiveness in Pain‐Related Outcomes and Health Care Utilizations between Veterans with Major Depressive Disorder Treated with Duloxetine and Other Antidepressants: A Retrospective Propensity Score‐Matched Comparison
Authors: Shi Lizheng , Liu Jinan , Zhao Yang 
Published: September 2011

AbstractObjectives:  This study aimed to compare pain‐related outcomes and health care utilization among patients with major depressive disorder (MDD) treated with duloxetine versus other antidepressants in the Veterans Health Administration (VHA).Methods:  Patients initiating duloxetine or other antidepressants between October 1, 2005, and October 1, 2008 were extracted from the Veterans Integrated Service Network (VISN) 16 data warehouse. All patients included had at least 1 MDD diagnosis (ICD‐9‐CM: 296.2 or 296.3) and continuous eligibility in the 12 months prior to the initiation. Patients with prior diabetes (ICD‐9‐CM: 250.xx), schizophrenia (295.xx), or bipolar disorder (ICD‐9‐CM: 296.4x–296.8x) diagnosis were excluded. Duloxetine and nonduloxetine patients were matched via propensity scoring (1:1 ratio). Opioid use patterns, diagnosed substance abuse, self‐reported pain score, and health care utilization over the 12‐month postindex period were compared between cohorts.Results:  Compared with duloxetine‐treated patients (N = 439), nonduloxetine‐treated patients (N = 439) during the postindex period had more opioid scripts (4.8 vs. 3.6, P = 0.002), longer use of opioid (133 vs. 100 days, P = 0.004), and a higher prevalence of substance abuse (41.00% vs. 23.69%, P < 0.001). Nonduloxetine‐treated group had 12.0 more outpatient visits (41.8 vs. 29.8, P < 0.0001), 0.16 more hospital admissions (0.32 vs. 0.16, P = 0.001), and 2.36 more hospital days (3.37 vs. 1.01, P = 0.005). Additionally, nonduloxetine‐treated patients were more likely to be hospitalized (17.8% vs. 10.9%, P = 0.004) over the postindex period.Conclusion:  Controlling for cross‐cohort differences, veterans with MDD treated with duloxetine were associated with lower risks of opioid use and substance abuse and lower health care utilization than those treated with other antidepressants. ▪
Demographics of successful, unsuccessful and deferral visits at six blood centers over a 4‐year period
Authors: Custer Brian , Schlumpf Karen , Simon Toby L. , Spencer Bryan R. , Wright David J. , Wilkinson Susan L. ,   for the NHLBI Retrovirus Epidemiology Donor Study‐II (REDS‐II)
Published: September 2011

BACKGROUND: Descriptions of donor demographics are of value in formulating recruitment and retention strategies. The demographics of successful (SV), unsuccessful (UV; meaning a nonuseable unit), and deferred (DV) donor visits over a 4‐year period were investigated using Retrovirus Epidemiology Donor Study (REDS)‐II databases.STUDY DESIGN AND METHODS: Fourteen deferral categories were created that included low hematocrit (Hct) or hemoglobin (Hb), feeling unwell, malaria travel, malaria other, couldn't wait, blood pressure or pulse, medical diagnosis, medication, test results, higher‐risk behavior, variant Creutzfeldt‐Jakob disease (CJD), CJD, needle exposure or tattoo, and other. Rates per 10,000 donor presentations were determined for each category globally and for six subcategorizations (first‐time or repeat donor status, sex, race/ethnicity, age, education, and fixed or mobile donation location). Deferral rates were also calculated on simultaneous stratifications of donor status, sex, and race/ethnicity.RESULTS: Of 5,607,922 donor presentations there were 4,553,145 SVs (81.2%), 302,828 UVs (5.4%), and 751,381 DVs (13.4%). Overall rates of deferral ranged from 0.6 per 10,000 presentations for CJD, human growth hormone, or dura mater exposure to 777 per 10,000 presentations for low Hct or Hb. Deferral rates were remarkably different by first‐time or repeat donor status, sex, race/ethnicity, and other demographics. The highest overall deferral rate was 3953 per 10,000 presentations, or nearly 40% in first‐time, female, Asian donors, and the lowest rate was 5.6% in repeat, male, white donors.CONCLUSION: Successful donation visits according to demographic characteristics need to be placed within the context of all donor visits. Deferral rates indicate that the burden of donor deferral is high. Efforts to expand the diversity of the donor base through recruitment of minority donors may bring additional challenges because certain deferral reasons were proportionally much higher in these groups.
Ventricular Activation Sequence during Left Ventricular Pacing Promotes QRS Complex Oversensing in the Atrial Channel
Authors: JASTRZEBSKI MAREK 
Published: September 2011

Background:
Left ventricular (LV)‐only pacing has a significant effect on delay in depolarization of parts of the ventricles that are likely oversensed in the right atrial channel. The study aimed to assess the impact of ventricular activation sequence on QRS oversensing and far‐field endless‐loop pacemaker tachycardia (ELT) in patients who received cardiac resynchronization therapy (CRT) devices.
Methods:
The study examined 102 patients with CRT devices. Oversensing artifacts in the atrial channel were inspected on intracardiac electrograms, and their timing with respect to the beginning of QRS was determined during DDD‐right ventricular (RV), DDD‐LV, DDD‐biventricular (BiV), and AAI pacing modes. The occurrence of ELT during DDD‐LV pacing with a postventricular atrial refractory period (PVARP) of 250 ms was also assessed.
Results:
The timing of oversensing artifacts (in relation to the beginning of surface QRS) was dependent on ventricular activation sequence, occurring promptly following intrinsic activation via the right bundle branch (47.1 ± 26.4 ms), later during RV pacing (108.7 ± 22.5 ms) or BiV pacing (109.4 ± 23.1 ms), and significantly later, corresponding to the final part of the QRS, during LV pacing (209.6 ± 40.0 ms, range: 140–340 ms, P < 0.001). Oversensing was significantly more frequent during LV than during RV pacing (35.3% vs 22.5%, P < 0.001). Far‐field ELT was observed in six patients.
Conclusions:
Oversensing artifacts in the atrial channel are likely caused by depolarization of the basal part of the right ventricle. The novel mechanism of QRS oversensing outside PVARP, caused by a reversed ventricular activation sequence during LV‐only pacing, may be important in some CRT patients. (PACE 2011; 34:1682–1686)
Implantable Cardioverter‐Defibrillator Recipient Attitudes towards Device Deactivation: How Much do Patients Want to Know?
Authors: RAPHAEL CLAIRE E. , KOA‐WING MICHAEL , STAIN NOLAN , WRIGHT IAN , FRANCIS DARREL P. , KANAGARATNAM PRAPA 
Published: September 2011

Background:
Patients receiving implantable cardioverter‐defibrillators (ICDs) often have severely impaired left ventricular function and a poor prognosis. Having an ICD in situ effectively denies them the possibility of a quick, arrhythmic death. It is still unclear if and when the end of life and device deactivation should be discussed with patients and how much patients want to know prior to ICD implantation.
Methods:
Patients with an active ICD for chronic heart failure were interviewed regarding their attitude toward the ICD, their recollection of the consent procedure, and how they felt the end of life should be discussed with ICD patients (n = 54). Patients who had received ICD therapies (n = 25) were reviewed as a subgroup with extended questions regarding attitudes toward device deactivation.
Results:
Fifty‐four patients were recruited. Most patients were not aware that the ICD could be deactivated. The vast majority of patients (84%) wanted to be involved in the deactivation decision; 40% felt this discussion should be prior to ICD implantation but others felt the discussion should only occur if the patient was terminally ill (16%) or in the last few days of life (5%).
Conclusion:
Patients with ICDs are routinely counseled about the benefits of ICDs, but options for device deactivation are not well understood by patients. Most patients would like to be involved in deactivation decisions and we feel this should be discussed well in advance. (PACE 2011; 34:1628–1633)
The Use of Dabigatran Immediately After Atrial Fibrillation Ablation
Authors: WINKLE ROGER A. , MEAD R. HARDWIN , ENGEL GREGORY , KONG MELISSA H. , PATRAWALA ROB A. 
Published: September 2011

Dabigatran After AF Ablation. Introduction: Atrial fibrillation (AF) ablation requires postprocedural anticoagulation to prevent thromboembolic events because of the ablation procedure itself or due to recurrent AF postprocedure. Dabigatran is a new anticoagulant and may be useful after AF ablation to prevent thromboembolic events.
Methods and Results: We evaluated 123 consecutive patients who were started on dabigatran after AF ablation. Patients were given enoxaparin 0.5 mg/kg at the end of the procedure, which was repeated 12 hours later and then discontinued. Dabigatran was started 22 hours postablation with drug dose based on renal function. Primary outcomes were thromboembolic events, bleeding complications, and side effects over a 30‐day follow‐up period.The preablation anticoagulant was warfarin in 56 (45.5%) patients, dabigatran in 34 (27.6%), and aspirin in 26 (21.1%). Seven (5.7%) patients were on no anticoagulant before ablation. The patients on dabigatran before ablation with normal renal function had the drug stopped 36 hours preablation. There were no preprocedural or intraprocedural thromboembolic episodes or bleeding. Three patients received dabigatran 75 mg bid and the rest 150 mg bid. There were no postablation strokes, transient ischemic attacks, or systemic thromboemboli in any patient. Three patients discontinued dabigatran and were changed to warfarin, 2 because of gastrointestinal side effects and 1 because of a diffuse rash.
Conclusions: Dabigatran is safe and well tolerated after AF ablation. It did not cause bleeding complications and there were no thromboembolic events. Dabigatran appears to be an alternative to warfarin after AF ablation. (J Cardiovasc Electrophysiol, Vol. 23 p. 264‐268, March 2012.)
Left Atrial Deformation Imaging with Ultrasound Based Two‐Dimensional Speckle‐Tracking Predicts the Rate of Recurrence of Paroxysmal and Persistent Atrial Fibrillation After Successful Ablation Procedures
Authors: HAMMERSTINGL CHRISTOPH , SCHWEKENDIEK MARIEKE , MOMCILOVIC DIANA , SCHUELER ROBERT , SINNING JAN‐MALTE , SCHRICKEL JAN W. , MITTMANN‐BRAUN ERICA , NICKENIG GEORG , LICKFETT LARS 
Published: September 2011

Predict AF. Objective: Since predictors of recurrence of atrial fibrillation (AF) after ablation procedures are poorly defined, this prospective study was conducted to assess the value of left atrial (LA) deformation imaging with two‐dimensional speckle‐tracking (2D‐ST) to predict AF recurrences after successful ablation procedures.
Methods and results:
One hundred and three consecutive patients (age 58.1 ± 16.6 years, 72.8% male) with AF (76 paroxysmal, 27 persistent) and 30 matched controls underwent transthoracic echocardiography and 2D‐ST‐LA‐deformation analysis with assessment of LA‐radial and LA‐longitudinal strain (Sr, Sl), and velocities derived from the apical 4‐ and 2‐chamber views (4CV, 2CV). AF recurrence was assessed during 6 months of follow‐up. For determination of AF‐related LA changes, AF patients were compared to controls and patients with AF recurrences after ablation procedures (n = 30, 29.1%) were compared with patients who maintained sinus rhythm (n = 73, 70.9%). Atrial deformation capabilities were significantly reduced (P  <  0.0005) in patients with AF (4CVSl 17.8 ± 13.5%; 4CVSr 22.3 ± 14.9%; 4CV‐velocities 2.53 ± 0.97 seconds) when compared with controls (4CVSl 31.3 ± 12.4%; 4CVSr 30.3 ± 9.1%; 4CV‐velocities 3.48 ± 1.01 cm/s). Independent predictors for AF recurrence after ablation procedures were 2CV‐LA‐global‐strain (Sr, P = 0.03; Sl, P = 0.003), 4CV‐LA‐gobal‐strain (Sr, P = 0.03; Sl, P = 0.02), and regional LA‐septal wall‐Sl (P = 0.008). LA‐global‐strain parameters were superior to regional LA function analysis for the prediction of AF recurrences, with cutoff values (cov), hazard ratios (HR), positive and negative predictive values (PPV, NPV) were: 4CVSl cov, 10.79% (HR 27.8, P  <  0.0005; PPV 78.8%, NPV 93.9%), 4CVSr cov, −16.65% (HR 24.8, P < 0.0005; PPV 69.4%, NPV 96.6%), 2CVSl cov, 12.31% (HR 22.7, P  <  0.0005; PPV 75.8%, NPV 95.3%), and 2CVSr cov, −14.9% (HR 12.9, P < 0.0005; PPV 64.3%, NPV 93.2%).
Conclusion:
Compared with controls, AF itself seems to decrease LA deformation capabilities. The assessment of global LA strain with 2D‐ST identifies patients with high risk for AF recurrence after ablation procedures. This imaging technique may help to improve therapeutic guiding for patients with AF. (J Cardiovasc Electrophysiol, Vol. 23 p. 247‐255, March 2012.)