bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Tolerance and Locomotor Sensitization in Ethanol‐Naïve Adolescent Rhesus Macaques
Authors: Schwandt Melanie L. , Higley James D. , Suomi Stephen J. , Heilig Markus , Barr Christina S. 
Published: May 2008

Background:  Acute and chronic tolerance, as well as locomotor sensitization, have been linked to ethanol intake. This study examined the change in response between 2 acutely administered doses of ethanol in adolescent rhesus macaques, with the objective of investigating rapid tolerance and locomotor sensitization to the behavioral effects of ethanol, and whether these phenomena are related to voluntary ethanol consumption in nonhuman primates.Methods:  Rhesus macaques (n = 109, 42 males, 67 females) were administered 2 sequential intravenous doses of ethanol (2.2 g/kg for males, 2.0 g/kg for females) separated by a period of 5 to 30 days. Following each injection, subjects underwent a 30‐minute behavior assessment. Behavioral data were summarized using factor analysis, and compared between the 2 doses using repeated measures ANOVA. The relationship between behavioral response measures and the number of days between doses was analyzed using regression analyses. Following the second ethanol dose, subjects were given free access to an aspartame‐sweetened 8.4% ethanol solution for 1 hour a day for 4 weeks. Percent change in behavioral response measures from dose 1 to dose 2 was analyzed for associations with ethanol consumption using multiple regression analyses.Results:  Factor analysis yielded 3 factors: ataxia, stimulation, and jumping. From dose 1 to dose 2 there was a significant decrease in ataxia and a significant increase in stimulation. Peak blood ethanol concentration did not differ between doses. There were no significant associations between the number of days between doses and the magnitude of change in response for any of the behavioral measures. Percent change in stimulation from dose 1 to dose 2 was positively associated with subsequent oral ethanol consumption only in females tested in a social setting.Conclusions:  Adolescent rhesus macaques develop rapid tolerance to the motor‐impairing effects of alcohol, while at the same time developing locomotor sensitization. These changes in response are not necessarily short lived, and may persist for some time following the first ethanol dose. Clear and consistent associations between rapid tolerance and locomotor sensitization and ethanol intake levels have yet to be demonstrated, however.
Episodic and Working Memory Deficits in Alcoholic Korsakoff Patients: The Continuity Theory Revisited
Authors: Pitel Anne Lise , Beaunieux Hélène , Witkowski Thomas , Vabret François , De La Sayette Vincent , Viader Fausto , Desgranges Béatrice , Eustache Francis 
Published: May 2008

Background:  The exact nature of episodic and working memory impairments in alcoholic Korsakoff patients (KS) remains unclear, as does the specificity of these neuropsychological deficits compared with those of non‐Korsakoff alcoholics (AL). The goals of the present study were therefore to (1) specify the nature of episodic and working memory impairments in KS, (2) determine the specificity of the KS neuropsychological profile compared with the AL profile, and (3) observe the distribution of individual performances within the 2 patient groups.Methods:  We investigated episodic memory (encoding and retrieval abilities, contextual memory and state of consciousness associated with memories), the slave systems of working memory (phonological loop, visuospatial sketchpad and episodic buffer) and executive functions (inhibition, flexibility, updating and integration abilities) in 14 strictly selected KS, 40 AL and 55 control subjects (CS).Results:  Compared with CS, KS displayed impairments of episodic memory encoding and retrieval, contextual memory, recollection, the slave systems of working memory and executive functions. Although episodic memory was more severely impaired in KS than in AL, the single specificity of the KS profile was a disproportionately large encoding deficit. Apart from organizational and updating abilities, the slave systems of working memory and inhibition, flexibility and integration abilities were impaired to the same extent in both alcoholic groups. However, some KS were unable to complete the most difficult executive tasks. There was only a partial overlap of individual performances by KS and AL for episodic memory and a total mixture of the 2 groups for working memory.Conclusions:  Korsakoff’s syndrome encompasses impairments of the different episodic and working memory components. AL and KS displayed similar profiles of episodic and working memory deficits, in accordance with neuroimaging investigations showing similar patterns of brain damage in both alcoholic groups.
Dependence‐Induced Alcohol Drinking by Alcohol‐Preferring (P) Rats and Outbred Wistar Rats
Authors: Gilpin N. W. , Richardson H. N. , Lumeng L. , Koob G. F. 
Published: May 2008

Background:  Chronic intermittent alcohol vapor exposure and selective breeding procedures have been used separately for many years to model specific aspects of alcohol dependence. The purpose of the present investigation was to combine these 2 approaches by exposing alcohol‐preferring (P) rats to chronic intermittent alcohol vapor for extended periods of time and then testing them for operant alcohol responding in parallel with a group of outbred Wistar rats at multiple time points following the termination of vapor exposure.Methods:  P rats (n = 20) and Wistar rats (n = 18) were trained to respond for 10% (w/v) ethanol in an operant situation, then divided into groups matched for intake levels. Animals were then exposed to chronic intermittent alcohol vapor (14 hours ON/10 hours OFF) or air for 8 weeks. Rats were then tested for operant alcohol responding under various conditions and at multiple time points during alcohol withdrawal (6 hours) and protracted abstinence (1 to 15 days).Results:  Chronic alcohol vapor exposure produced similar increases in operant alcohol responding in P rats and Wistar rats during acute withdrawal and protracted abstinence.Conclusions:  These results illustrate the separate and combined effects of genetic selection for high alcohol preference and dependence on alcohol drinking behavior. Furthermore, these results confirm past findings that dependent rats consume more alcohol than nondependent controls well into abstinence following extended periods of alcohol vapor exposure.
Using Topiramate or Naltrexone for the Treatment of Alcohol‐Dependent Patients
Authors: Flórez Gerardo , García‐Portilla Paz , Álvarez Sandra , Saiz Pilar A. , Nogueiras Luis , Bobes Julio 
Published: May 2008

Background:  To compare topiramate versus naltrexone in the treatment of alcohol dependence.Methods:  A 6‐month naturalistic, randomized and open‐label, trial of topiramate versus naltrexone, with assessments at enrollment and after 3 and 6 months of treatment. The setting was an outpatient alcohol clinic. One hundred and two alcohol‐dependent patients who had been drinking heavily during the past month were included. Two randomized groups were created. In one, naltrexone was used as the therapeutic agent and, in the other, topiramate was chosen as the therapeutic agent. Both groups received psychological relapse prevention therapy. Outcome was measured using tools that assessed alcohol intake, cravings, disability, and quality of life; changes in biomarkers of alcohol intake were also used. With all the data, a secondary composite measure was created in order to assess each patient’s global alcohol intake and its consequences.Results:  Both groups showed substantial reduction in their drinking. Naltrexone patients had higher nicotine consumption throughout the study. Topiramate was better at reducing alcohol‐related cravings throughout the study. Both treatments had a similar mean cost throughout the study.Conclusions:  Both topiramate and naltrexone were efficacious in the treatment of alcohol dependence, and the treatment costs were similar. There is a trend for topiramate to be superior to naltrexone on critical measures of drinking; however, the study did not have adequate statistical power to establish this fact.
Naltrexone Alone and With Sertraline for the Treatment of Alcohol Dependence in Alaska Natives and Non‐Natives Residing in Rural Settings: A Randomized Controlled Trial
Authors: O’Malley Stephanie S. , Robin Robert W. , Levenson Aryeh L. , GreyWolf Iva , Chance Lawrence E. , Hodgkinson Colin A. , Romano Denise , Robinson Jane , Meandzija Boris , Stillner Verner , Wu Ran , Goldman David 
Published: May 2008

Background:  Access to specialty alcoholism treatment in rural environments is limited and new treatment approaches are needed. The objective was to evaluate the efficacy of naltrexone alone and in combination with sertraline among Alaska Natives and other Alaskans living in rural settings. An exploratory aim examined whether the Asn40Asp polymorphism of the μ‐opioid receptor gene (OPRM1) predicted response to naltrexone, as had been reported in Caucasians.Methods:  Randomized, controlled trial enrolling 101 Alaskans with alcohol dependence, including 68 American Indians/Alaska Natives. Participants received 16 weeks of either (1) placebo (placebo naltrexone + placebo sertraline), (2) naltrexone monotherapy (50 mg naltrexone + sertraline placebo) and (3) naltrexone + sertraline (100 mg) plus nine sessions of medical management and supportive advice. Primary outcomes included Time to First Heavy Drinking Day and Total Abstinence.Results:  Naltrexone monotherapy demonstrated significantly higher total abstinence (35%) compared with placebo (12%, p = 0027) and longer, but not statistically different, Time to First Heavy Drinking Day (p = 0.093). On secondary measures, naltrexone compared with placebo demonstrated significant improvements in percent days abstinent (p = 0.024) and drinking‐related consequences (p = 0.02). Combined sertraline and naltrexone did not differ from naltrexone alone. The pattern of findings was generally similar for the American Indian/Alaska Native subsample. Naltrexone treatment response was significant within the group of 75 individuals who were homozygous for OPRM1 Asn40 allele. There was a small number of Asp40 carriers, precluding statistical testing of the effect of this allele on response.Conclusions:  Naltrexone can be used effectively to treat alcoholism in remote and rural communities, with evidence of benefit for American Indians and Alaska Natives. New models of care incorporating pharmacotherapy could reduce important health disparities related to alcoholism.
Hyperglycemia as a Predictor of In‐Hospital Mortality in Elderly Patients without Diabetes Mellitus Admitted to a Sub‐Intensive Care Unit
Authors: Sleiman Intissar , Morandi Alessandro , Sabatini Tony , Ranhoff Anette , Ricci Antonella , Rozzini Renzo , Trabucchi Marco 
Published: May 2008

OBJECTIVES: To investigate the association between hyperglycemia and in‐hospital and 45‐day mortality in acutely ill elderly patients.DESIGN: Retrospective cohort.SETTING: Hospital medical patients admitted to a sub‐intensive care unit (sub‐ICU) for elderly patients, which is a level of care between ordinary wards and intensive care.PARTICIPANTS: One thousand two hundred twenty‐nine patients (mean age 79.6±8.4) admitted to the sub‐ICU from January 2003 to January 2006. Forty patients with acute myocardial infarction and 34 patients with extreme fasting glucose values (<60 or >500 mg/dL) were excluded. Eight hundred twenty‐two patients without a history of diabetes mellitus (DM) and 333 patients with a diagnosis of DM were selected and subdivided into three categories according to serum fasting blood glucose: 60 to 126 mg/dL (Group A), 127 to 180 mg/dL (Group B), and 181 to 500 mg/dL (Group C).MEASUREMENTS: Age, sex, mental and functional status, Acute Physiology Score, comorbid conditions, serum albumin, serum cholesterol, fasting serum glucose, and length of stay. In‐hospital mortality was the primary outcome, and 45‐day mortality was the secondary outcome.RESULTS: Total in‐hospital mortality was 14.5%. In patients with and without DM, mortality was 8.8% and 11.3%, respectively, in Group A; 13.6% and 17.3% in Group B, and 12.6% and 34.3% in Group C. After controlling for confounders, newly recognized hyperglycemia (>181 mg/dL) was independently associated with in‐hospital mortality (adjusted odds ratio=2.7, 95% confidence interval=1.6–4.8). Forty‐five‐day mortality in newly recognized hyperglycemic patients was 17.5%, 25.7%, and 42% in Groups A, B, and C, respectively, whereas it was 21.2% in patients with DM.CONCLUSION: In elderly patients, newly recognized hyperglycemia was associated with a higher mortality rate than in those with a prior history of DM. These data suggest that further randomized clinical trials are needed to assess the efficacy and the risk of a target glucose of greater than 180 mg/dL.
Prevention of Falls in Nursing Homes: Subgroup Analyses of a Randomized Fall Prevention Trial
Authors: Rapp Kilian , Lamb Sarah E. , Büchele Gisela , Lall Ranjit , Lindemann Ulrich , Becker Clemens 
Published: May 2008

OBJECTIVES: To evaluate the effectiveness of a multifactorial fall prevention program in prespecified subgroups of nursing home residents.DESIGN: Secondary analysis of a cluster‐randomized, controlled trial.SETTING: Six nursing homes in Germany.PARTICIPANTS: Seven hundred twenty‐five long‐stay residents; median age 86; 80% female.INTERVENTION: Staff and resident education on fall prevention, advice on environmental adaptations, recommendation to wear hip protectors, and progressive balance and resistance training.MEASUREMENTS: Time to first fall and the number of falls. Falls were assessed during the 12‐month intervention period. Univariate regression analyses were performed, including a confirmatory test of interaction.RESULTS: The intervention was more effective in people with cognitive impairment (hazard ratio (HR)=0.49, 95% confidence interval (CI)=0.35–0.69) than in those who were cognitively intact (HR=0.91, 95% CI=0.68–1.22), in people with a prior history of falls (HR=0.47, 95% CI=0.33–0.67) than in those with no prior fall history (HR=0.77, 95% CI=0.58–1.01), in people with urinary incontinence (HR=0.59, 95% CI=0.45–0.77) than in those with no urinary incontinence (HR=0.98, 95% CI=0.68–1.42), and in people with no mood problems (incidence rate ratio (IRR)=0.41, 95% CI=0.27–0.61) than in those with mood problems (IRR=0.74, 95% CI=0.51–1.09).CONCLUSION: The effectiveness of a multifactorial fall prevention program differed between subgroups of nursing home residents. Cognitive impairment, a history of falls, urinary incontinence, and depressed mood were important in determining response.
Successful Aging: The Contribution of Early‐Life and Midlife Risk Factors
Authors: Britton Annie , Shipley Martin , Singh‐Manoux Archana , Marmot Michael G. 
Published: May 2008

OBJECTIVES: To test whether early‐life factors (education, height, father's social position) and midlife social, behavioral, and psychosocial factors were associated with entering older age without disease and with good functioning.DESIGN: A longitudinal, British civil service–based cohort study. Participants were followed for 17 years to assess successful aging. This was defined as being free of major disease and in the top tertile of physical and cognitive functioning measured in 2002 to 2004.SETTING: Twenty London‐based Civil Service departments.PARTICIPANTS: Four thousand, one hundred forty men and 1,823 women, free of major disease at baseline in 1985 to 1988 (mean age 44, range 35–55).MEASUREMENTS: Behavioral, biological, and psychosocial risk factors; physical and cognitive functioning; and disease outcomes.RESULTS: Five hundred forty eight (12.8%) men and 246 (14.6%) women were successfully aging at follow‐up. Midlife socioeconomic position strongly predicted this (age‐adjusted odds ratio, highest vs lowest=7.1, 95% CI=3.4–14.6, for men and 7.7, 95% CI=4.9–12.1, for women). Height, education (in men), not smoking, diet, exercise, moderate alcohol (in women), and work support (in men) were related to a favorable older life after adjustment for age and socioeconomic position.CONCLUSION: Interventions to promote healthy adult behavior may attenuate harmful effects of less‐modifiable risk factors and reduce social inequalities.
Integrating Palliative Medicine into the Care of Persons with Advanced Dementia: Identifying Appropriate Medication Use
Authors: Holmes Holly M. , Sachs Greg A. , Shega Joseph W. , Hougham Gavin W. , Cox Hayley Deon , Dale William 
Published: May 2008

OBJECTIVES: To evaluate the feasibility of developing consensus recommendations for appropriate prescribing for patients with advanced dementia using a new conceptual framework and to determine the frequency of inappropriate medication use based on these recommendations in a small sample of patients with advanced dementia.DESIGN: Medication data were obtained using chart review. Recommendations for appropriate prescribing were achieved using a modified Delphi consensus panel.SETTING: Three long‐term care facilities.PARTICIPANTS: Thirty‐four patients with advanced dementia enrolled in the Palliative Excellence in Alzheimer Care Efforts Program were selected to evaluate medication use. Twelve geriatricians at the University of Chicago participated in the modified Delphi consensus panel.MEASUREMENTS: Prescription and over‐the‐counter medications were recorded for the 34 patients. Following the modified Delphi process, medications were characterized into one of four categories for use in palliative care patients with advanced dementia: never appropriate, rarely appropriate, sometimes appropriate, or always appropriate.RESULTS: Patients were taking an average of 6.5 medications at enrollment. Six patients were taking 10 or more medications daily. Consensus was reached ranking the appropriateness of 69 of 81 medication classes for patients with advanced dementia. Overall, 5% of the 221 medications prescribed at enrollment were considered to be never appropriate, and 10 of 34 patients (29%) had been taking a medication considered to be never appropriate.CONCLUSION: Based on these preliminary findings, consensus criteria for prescribing in advanced dementia are needed to decrease polypharmacy and reduce the use of medications that are of minimal benefit or high risk.
Human immunodeficiency virus type 1 incidence among blood donors in France, 1992 through 2006: use of an immunoassay to identify recent infections
Authors: Pillonel Josiane , Barin Francis , Laperche Syria , Bernillon Pascale , Le Vu Stéphane , Brunet Sylvie , Thierry Damien , Desenclos Jean‐Claude ,   the “Transfusion‐Transmissible Agents Working Group” of the French Society of Blood Transfusion
Published: May 2008

BACKGROUND: In France, blood donations found to be positive for the presence of human immunodeficiency virus type 1 (HIV‐1) are further tested to detect recent infections (≤180 days) using an enzyme immunoassay (EIA‐RI) developed in 2002. The characteristics of recently infected donors, estimates of HIV‐1 incidence, and the residual risk of transfusion‐transmitted HIV‐1 are presented, in both first‐time and repeat donors.STUDY DESIGN AND METHODS: Of the 1027 donations found to be HIV‐1–positive between 1992 and 2006, a total of 459 could be retrospectively tested with the EIA‐RI. Multivariate analysis was performed to determine the donor characteristics associated with recent infection. Incidence rates and residual risk obtained with the EIA‐RI were compared to classical cohort estimates derived from repeat donor histories.RESULTS: Of the 459 HIV‐1–positive donors studied, 105 (22.9%; 95% confidence interval [CI], 19.2‐27.0) were identified as recently infected. Factors independently associated with recent infection were repeat donor status (adjusted odds ratio [AOR], 4.0; 95% CI, 2.4‐6.9) and non‐B subtypes (AOR, 2.0; 95% CI, 1.2‐3.6). Incidence decreased from 4.3 (95% CI, 1.9‐9.4) in 1992 through 1994 to 1.3 (95% CI, 0.6‐2.8) per 105 in 2004 through 2006 in first‐time donors and from 3.2 (95% CI, 2.0‐5.0) to 0.8 (95% CI, 0.4‐1.4) per 105 in repeat donors. Incidence and residual risk estimates were similar to those obtained with the classical cohort method.CONCLUSION: This study suggests that the EIA‐RI can be used to estimate HIV‐1 incidence in a population with low HIV incidence. The estimated HIV‐1 incidence in the blood donor population confirms the extremely low risk (1 in 3,350,000 donations) of HIV‐infected blood donations entering the blood supply in France.
A computer‐assisted transfusion management system and changed transfusion practices contribute to appropriate management of blood components
Authors: Ohsaka Akimichi , Abe Katsumi , Ohsawa Toshiya , Miyake Noriko , Sugita Shio , Tojima Ikuko 
Published: May 2008

BACKGROUND: ABO‐incompatible blood transfusions attributable to inadequate identification (ID) of the patient or the blood unit are among the most serious of transfusion hazards. It has been unclear whether a computer‐assisted transfusion management system connected to a bar code ID system could contribute to the appropriate management of blood components, as well as to the prevention of mistransfusions.STUDY DESIGN AND METHODS: A transfusion management system has been developed that links the hospital information system, a bar code patient‐blood unit ID system, and an automated device for pretransfusion testing. The guidelines for issuing blood components from the transfusion service were also changed. The appropriateness of blood management was evaluated by monitoring the time to initiate transfusion after issuing a blood unit from the transfusion service (time after issuing [TAI]) and by calculating the number of units issued and subsequently returned, as well as the rate of date‐expired red cell (RBC) components.RESULTS: From July 2002 to December 2006, a total of 49,974 blood components were transfused without a single mistransfusion. The monitoring of TAI and the notice to use the issued blood immediately had the effect of shortening TAI in the inpatient ward. The number of issued and subsequently returned RBC components, as well as the rate of date‐expired RBC components, decreased significantly after the introduction of the system.CONCLUSION: A computer‐assisted transfusion management system and changing transfusion practices appear useful in preventing mistransfusions and in contributing to the appropriate management of blood components.