bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol Consumption Is Enhanced After Naltrexone Treatment
Authors: Juárez Jorge , Eliana Barrios De Tomasi 
Published: January 2007

Background: It is well known that alcohol increases opioid activity, which can contribute to the reinforcing effect of alcohol. Clinical studies have supported reductions in alcohol consumption among alcoholic patients during treatment with opioid antagonists (OAs) and its use is recommended for this purpose. Experimental studies have demonstrated opioid receptor up‐regulation after several days of OA treatment, which increases the availability of these receptors. On this basis, the physiological conditions in the period immediately after the OA treatment could increase the reinforcing value of alcohol and in this way enhance alcohol consumption.Methods: To test this hypothesis, 2 groups of Wistar male rats were used in the present study. After assessing the baseline of voluntary alcohol (10% v/v) consumption, subjects were treated with either the OA naltrexone (Ntx), (2 mg/kg/d/rat) or a saline solution (0.2 mL/d/male) for 7 days. Subsequently, all subjects were given a free choice between ethanol (10%) and water for 5 days. To study a possible cumulative effect, this procedure was sequentially repeated 4 times with each group. Water and food were available ad libitum throughout the experiment.Results: After each period of 7 days of Ntx use, alcohol consumption increased significantly with respect to the baseline and each equivalent period in the control group. When the subjects were exposed to alcohol again 1 week after the last of the 4 sequential periods, alcohol drinking was higher than the baseline in the Ntx group, but not in the control group. Water consumption was decreased during Ntx treatment in the control group in periods 1, 2, and 4. Food intake and body weight did not show differences between groups throughout the study; however, a decrease in food intake was observed over time regardless of treatment.Conclusion: These results show that alcohol intake may increase after the Ntx treatment, particularly when alcohol is not available during treatment with the OA, and that this may be due to a higher availability of opioid receptors in that period.
Effect of Depression Treatment on Depressive Symptoms in Older Adulthood: The Moderating Role of Pain
Authors: Mavandadi Shahrzad , Ten Have Thomas R. , Katz Ira R. , Durai U. Nalla B. , Krahn Dean D. , Llorente Maria D. , Kirchner JoAnn E. , Olsen Edwin J. , Van Stone William W. , Cooley Susan L. , Oslin David W. 
Published: January 2007

OBJECTIVES: To investigate whether pain severity and interference with normal work activities moderate the effects of depression treatment on changes in depressive symptoms over time in older adults in primary care.DESIGN: Patient‐randomized, clinical trial.SETTING: Multisite: three clinics located in Veterans Affairs Medical Centers.PARTICIPANTS: Adults aged 60 and older (n=524) who screened positive for depression and participated in the Primary Care Research in Substance Abuse and Mental Health for the Elderly Study.INTERVENTION: Integrated care versus enhanced specialty referral care.MEASUREMENTS: Pain severity, the degree to which pain interferes with work inside and outside of the home, and depressive symptoms were examined at baseline and 3, 6, and 12 months.RESULTS: Intention‐to‐treat analyses revealed that both treatment groups showed reduced depressive symptoms over time, although self‐reported pain moderated reductions in depressive symptoms. At higher levels of pain severity and interference with work activities, improvements in depressive symptoms were blunted. Furthermore, pain interference appeared to have a greater effect on depressive symptoms than did pain severity; in individuals with major depression, pain interference fully accounted for the moderating effects of pain severity on changes in depressive symptoms over time.CONCLUSION: Pain and its interference with functioning interfere with recovery from depression. Findings highlight the importance of addressing multiple domains of functioning (e.g., physical and social disability) and the degree to which pain and other forms of physical comorbidity may hinder or minimize treatment‐related improvements in depressive symptoms.
Combination of Oral Antidiabetic Agents with Basal Insulin Versus Premixed Insulin Alone in Randomized Elderly Patients with Type 2 Diabetes Mellitus
Authors: Janka Hans U. , Plewe Gerd , Busch Klaus 
Published: January 2007

OBJECTIVES: To compare initiation of insulin therapy by adding once‐daily insulin glargine to oral antidiabetic agents (OADs) with switching patients to premixed 30% regular, 70% human neutral protamine hagedorn insulin (70/30) without OADs.DESIGN: A 24‐week, multicenter, open, randomized (1:1), parallel study.SETTING: Three hundred sixty‐four poorly controlled patients with type 2 diabetes mellitus were treated with once‐daily morning insulin glargine with continued OADs (glimepiride+metformin) (glargine+OAD) or twice‐daily 70/30 alone. Insulin dosage in each group was titrated to target fasting blood glucose (FBG) of 100 mg/dL or less (≤5.6 mmol/L) using a weekly titration algorithm.PARTICIPANTS: This planned subgroup analysis of the original study was based on 130 insulin‐naive patients aged 65 and older with FBG of 120 mg/dL or greater (≥6.7 mmol/L) and hemoglobin (Hb)A1c levels between 7.5% and 10.5% on OADs (glargine+OAD, n=67; 70/30, n=63).MEASUREMENTS: HbA1c, FBG, hypoglycemia, insulin dose, and adverse events were recorded.RESULTS: HbA1c decreased from baseline to endpoint for both glargine+OAD (from 8.8% to 7.0%) and 70/30 (from 8.9% to 7.4%); adjusted mean HbA1c decrease for glargine+OAD and 70/30 was −1.9% and −1.4%, respectively (P=.003). More patients reached HbA1c of 7.0% or less without confirmed nocturnal hypoglycemia with glargine+OAD (n=37, 55.2%) than with 70/30 (n=19, 30.2%) (P=.006). FBG decreased significantly more with glargine+OAD (−57 mg/dL (−3.2 mmol/L)) than with 70/30 (−40 mg/dL (−2.2 mmol/L)) (P=.002). Patients treated with glargine+OAD experienced fewer episodes of any hypoglycemia (3.68/patient–year) than did those treated with 70/30 (9.09/patient–year) (P=.008).CONCLUSION: In elderly patients, addition of once‐daily morning glargine+OAD is a simple regimen to initiate insulin therapy, restoring glycemic control more effectively and with less hypoglycemia than twice‐daily 70/30 alone.
Improving Vision to Prevent Falls in Frail Older People: A Randomized Trial
Authors: Cumming Robert G. , Ivers Rebecca , Clemson Lindy , Cullen John , Hayes Maggie F. , Tanzer Michael , Mitchell Paul 
Published: January 2007

OBJECTIVES: To determine the efficacy of vision and eye examinations, with subsequent treatment of vision problems, for preventing falls and fractures in frail older people.DESIGN: Randomized, controlled trial.SETTING: Community in Sydney, Australia.PARTICIPANTS: Six hundred sixteen men and women aged 70 and older (mean age 81) recruited mainly from people attending outpatient aged care services.INTERVENTIONS: The intervention group received comprehensive vision and eye examinations conducted by a study optometrist. The optometrist arranged for new eyeglasses for 92 subjects and referred 24 for a home visit with an occupational therapist, 17 for glaucoma management, and 15 for cataract surgery. The control group received usual care.MEASUREMENTS: Falls and fractures during 12 months of follow‐up were ascertained according to self‐report using a monthly postcard system.RESULTS: Fifty‐seven percent of subjects fell at least once during follow‐up. Falls occurred more frequently in the group randomized to receive the vision intervention (65% fell at least once; 758 falls in total) than in the control group (50% fell at least once; 516 falls in total). The falls rate ratio using the negative binomial model was 1.57 (95% confidence interval (CI)=1.20–2.05, P=.001). Fractures were also more frequent in the intervention group (31 fractures) than the control group (18 fractures; relative risk from proportional hazards model 1.74, 95% CI=0.97–3.11, P=.06).CONCLUSION: In frail older people, comprehensive vision and eye assessment, with appropriate treatment, does not reduce, and may even increase, the risk of falls and fractures.
Alcohol Use, Physical Performance, and Functional Limitations in Older Men
Authors: Cawthon Peggy M. , Fink Howard A. , Barrett‐Connor Elizabeth , Cauley Jane A. , Dam Thuy‐Tien , Lewis Cora E. , Marshall Lynn M. , Orwoll Eric S. , Cummings Steven R. ,   for the Osteoporotic Fractures in Men Research Group
Published: January 2007

OBJECTIVES: To describe associations between recent alcohol intake, physical performance, and functional limitations in older men.DESIGN: Cross‐sectional study.SETTING: Six U.S. clinical centers.PARTICIPANTS: Five thousand nine hundred sixty‐two men aged 65 and older.MEASUREMENTS: Self‐reported functional limitations; problem drinking history (≥2 positive responses on the CAGE questionnaire); history of sustained excessive drinking (history of consumption of ≥5 drinks/day on most days); and alcohol intake categorized by drinks/week (0=abstainers, n=2,116; < 1=intermittent, n=739); 1 to <7= light, n=1,563; 7 to <14=low‐moderate, n=848; 14 to <21 =high‐moderate, n=459; and ≥21=heavy, n=237). Grip strength, leg power, chair stand, and walking tests were completed during a standard examination.RESULTS: After age adjustment, men with low‐moderate or high‐moderate intake generally performed 3% to 5% better on physical performance tests than abstainers; heavy drinkers performed similarly to abstainers. These associations lessened yet tended to remain significant after multivariate adjustment. Men with low‐moderate alcohol intake had the lowest odds of reporting a limitation in instrumental activities of daily living (multivariate‐adjusted odds ratio (OR)=0.52, 95% confidence interval (CI)=0.39–0.69) compared to abstainers; similar odds were seen for high‐moderate and heavy use. The association between alcohol intake and self‐reported physical limitation was U‐shaped, with the highest odds of physical limitation in abstainers (OR=1.0, referent) and heavy users (OR=0.88, 95% CI=0.58–1.36) and the lowest odds in low‐moderate users (OR=0.62, 95% CI=0.46–0.95).CONCLUSION: Moderate alcohol intake was associated with modestly better physical performance and lower odds of reporting a functional limitation in older men.
Epidemiology of Medicare Abuse: The Example of Power Wheelchairs
Authors: Goodwin James S. , Nguyen‐Oghalai Tracy U. , Kuo Yong‐Fang , Ottenbacher Kenneth J. 
Published: January 2007

OBJECTIVES: To determine the effect of neighborhood ethnic composition on power wheelchair prescriptions.DESIGN: The 5% noncancer sample of Medicare recipients in the Surveillance, Epidemiology and End Results (SEER)‐Medicare linked database, from 1994 to 2001.SETTING: SEER regions.PARTICIPANTS: Individuals covered by Medicare living in SEER regions without a cancer diagnosis.MEASUREMENTS: Individual characteristics (age, sex, ethnicity, justifying diagnosis, and comorbidity), primary diagnoses, neighborhood characteristics (percentage black, percentage Hispanic, percentage with <12 years education, and median income), and SEER region.RESULTS: The rate of power wheelchair prescriptions was 33 times greater in 2001 than in 1994, with a shift over time from justifying diagnoses more closely tied to mobility impairment, such as strokes, to less‐specific medical diagnoses, such as osteoarthritis. In multilevel, multivariate analyses, individuals living in neighborhoods with higher percentages of blacks or Hispanics were more likely to receive power wheelchairs (odds ratios=1.09 for each 10% increase in black residents and 1.23 for each 10% increase in Hispanic residents) after controlling for ethnicity and other characteristics at the individual level.CONCLUSION: These results support allegations that marketers promoting power wheelchairs have specifically targeted minority neighborhoods.
The Relationship of Indwelling Urinary Catheters to Death, Length of Hospital Stay, Functional Decline, and Nursing Home Admission in Hospitalized Older Medical Patients
Authors: Holroyd‐Leduc Jayna M. , Sen Saunak , Bertenthal Dan , Sands Laura P. , Palmer Robert M. , Kresevic Denise M. , Covinsky Kenneth E. , Seth Landefeld C. 
Published: January 2007

OBJECTIVES: To determine the association between indwelling urinary catheterization without a specific medical indication and adverse outcomes.DESIGN: Prospective cohort.SETTING: General medical inpatient services at a teaching hospital.PARTICIPANTS: Five hundred thirty‐five patients aged 70 and older admitted without a specific medical indication for urinary catheterization.INTERVENTION: Indwelling urinary catheterization within 48 hours of admission.MEASUREMENTS: Death, length of hospital stay, decline in ability to perform activities of daily living (ADLs), and new admission to a nursing home.RESULTS: Indwelling urinary catheters were placed in 76 of the 535 (14%) patients without a specific medical indication. Catheterized patients were more likely to die in the hospital (6.6% vs 1.5% of those not catheterized, P=.006) and within 90 days of hospital discharge (25% vs 10.5%, P<.001); the greater risk of death with catheterization persisted in a propensity‐matched analysis (hazard ratio (HR)=2.42, 95% confidence interval (CI)=1.04–5.65). Catheterized patients also had longer lengths of hospital stay (median, 6 days vs 4 days; P=.001); this association persisted in a propensity‐matched analysis (HR=1.46, 95% CI=1.03–2.08). Catheterization was not associated (P>.05) with decline in ADL function or with admission to a nursing home.CONCLUSION: In this cohort of older patients, urinary catheterization without a specific medical indication was associated with greater risk of death and longer hospital stay.
Blood Pressure and Survival in the Oldest Old
Authors: Oates Daniel J. , Berlowitz Dan R. , Glickman Mark E. , Silliman Rebecca A. , Borzecki Ann M. 
Published: January 2007

OBJECTIVES: To determine the relationship between blood pressure (BP) and all‐cause mortality in subjects aged 80 and older with hypertension.DESIGN: Retrospective cohort study with 5 years of follow‐up.SETTING: Ten Veterans AFFAIRS (VA) sites.PARTICIPANTS: Four thousand seventy‐one ambulatory patients aged 80 and older with hypertension.MEASUREMENTS: The outcome measure was likelihood of survival during the follow‐up period. Vital status was obtained from VA and Social Security files. Variables collected for adjustment in Cox regression models were baseline BP, medications, demographics, diagnoses, and health‐related quality of life (HRQoL); HRQoL information was available on 1,289 subjects based on Veterans Health Study Short From‐36 (SF‐36) questionnaire scores.RESULTS: Subjects with higher BP (up to a systolic BP (SBP) of 139 mmHg and a diastolic BP (DBP) of 89 mmHg) were less likely to die during follow‐up than subjects with lower BP. After baseline adjustments, the hazard ratio for a 10‐point increase in SBP was 0.82 (95% confidence interval (CI)=0.74–0.91), up to a SBP of 139 mmHg, and for DBP was 0.85 (95% CI=0.78–0.92), up to a DBP of 89 mmHg. There was no significant association between survival and BP levels in subjects with uncontrolled hypertension.CONCLUSION: In a cohort of very old, hypertensive veterans, in subjects with controlled BPs, subjects with lower BP levels had a lower 5‐year survival than those with higher BPs. This suggests that clinicians should use caution in their approach to BP lowering in this age group.
Effects of Statin Use on Muscle Strength, Cognition, and Depressive Symptoms in Older Adults
Authors: Agostini Joseph V. , Tinetti Mary E. , Han Ling , McAvay Gail , Foody JoAnne M. , Concato John 
Published: January 2007

OBJECTIVES: To determine the relationship between hydroxymethyl glutaryl coenzyme A reductase inhibitor (statin) use and proximal muscle strength, cognition, and depression in older adults.DESIGN: Observational cohort study.SETTING: Outpatient primary care clinics.PARTICIPANTS: Seven hundred fifty‐six community‐dwelling veterans aged 65 and older.MEASUREMENTS: Timed chair stands (a measure of proximal muscle strength), Trail Making Test Part B (a measure of cognition), and the Center for Epidemiologic Studies Depression Scale score were measured at baseline and 1‐year follow‐up. Participants were assessed for statin prescriptions (and indications for or contraindications to their use), concomitant medication use, comorbidities, and other potential confounders.RESULTS: Statin users (n=315) took a mean 6.6 medications, versus 4.6 for nonusers (n=441), and had a median duration of statin use of 727 days. Statin users were more likely to be white and had (as expected) more cardiac, cerebrovascular, and peripheral vascular disease. Based on multivariable models adjusting for pertinent covariates, statin users performed modestly better than nonusers for timed chair stands (−0.5 seconds; P=.04), Trail Making Test Part B (−7.7 seconds; P=.08), and depression scores (−0.2 points; P=.49) at follow‐up. Of potentially high‐risk participants (based on age, comorbidity, and number of medications), statin users also showed similar 1‐year changes as nonusers, although worsened depression scores were found in those with greater comorbidity (+0.88 points; P=.10).CONCLUSION: Older, community‐dwelling male participants taking maintenance statin therapy had similar outcomes to those of nonusers in tests of muscle strength, cognition, and depression, but further examination of benefits and harms in different subgroups is warranted.
Adding an Alcohol‐Related Risk Score to an Existing Categorical Risk Classification for Older Adults: Sensitivity to Group Differences
Authors: Wilson Sandra R. , Fink Arlene , Verghese Shinu , Beck John C. , Nguyen Khue , Lavori Philip 
Published: January 2007

OBJECTIVES: To evaluate a new alcohol‐related risk score for research use.DESIGN: Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol‐Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect postintervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research‐based risk factors.SETTING: Three primary care group practices in southern California.PARTICIPANTS: Six hundred sixty‐five patients aged 65 and older.MEASUREMENTS: A previously calculated, three‐level categorical classification of alcohol‐related risk and a newly developed quantitative risk score.RESULTS: Mean postintervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (P<.001). The difference between the combined report and usual care was significant (P<.001) and directly proportional to baseline risk. The three‐level risk classification did not reveal approximately 57.3% of the intervention effect detected by the risk score. The risk score also was sufficiently sensitive to detect the intervention effect within the subset of hypertensive patients (n=112; P=.001).CONCLUSION: As an outcome measure in intervention trials, the finely grained risk score is more sensitive than the trinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined.
Development of proficiency testing for detection of bacterial contamination of platelet products
Authors: Easley Samantha , Yomtovian Roslyn A. , Sullivan Patricia , Jacobs Michael R. 
Published: January 2007

BACKGROUND: Accrediting agencies now require quality control for minimizing platelet (PLT) bacterial contamination (PBC). A proficiency testing (PT) strategy for PBC testing was developed.STUDY DESIGN AND METHODS: During Phase 1, validation of the pH meter and an enhanced bacteria detection system (Pall eBDS)—methods used in our blood bank—was accomplished with two aliquots of an apheresis PLT unit inoculated with Escherichia coli (ATCC 25922, 70 CFU/mL) or Staphylococcus aureus (ATCC 27217, 46 CFU/mL) with an uninoculated aliquot serving as a negative control. Quantitative plate culture was the reference method. PLTs were stored on a rotator at 22°C. Units were sampled in duplicate at 0, 24, and 48 hours. pH testing was considered positive when the pH value was less than 6.6. eBDS was positive when the oxygen concentration was less than 9.4 percent. During Phase 2, synchronized PT of pH and eBDS was performed at four independent sites. PLT samples were inoculated and incubated as above, and aliquots were removed at Time 0 for eBDS testing and at 48 hours for pH testing.RESULTS: In Phase 1, on inoculated bags eBDS was positive at all time periods but pH was positive only at 48 hours. In Phase 2, synchronized results showed positive eBDS at Time 0 and positive pH at 48 hours on inoculated bags with agreement between paired sites.CONCLUSIONS: This strategy may serve as a useful model for developing PT materials for PBC detection. eBDS was able to identify low levels of PBC, and pH testing, only much higher levels. It is important to carefully coordinate and standardize handling of PT materials and reporting of results.
Impact of transfection with total RNA of K562 cells upon antigen presenting, maturation, and function of human dendritic cells from peripheral blood mononuclear cells
Authors: Gao Li , Fan Hua‐hua , Lu Hua‐zhong , Nie Xiao‐xuan , Liu Yan , Yang Yi‐ming , Qian Kai‐cheng , Gao Feng 
Published: January 2007

BACKGROUND: Vaccination of dendritic cells (DCs) with tumor antigens is a potential strategy to induce tumor‐specific immunity in tumor‐bearing patients. The purpose of this study was to investigate whether human monocyte‐derived DCs were able to present P210Bcr‐Ab1 protein and induce antigen‐specific cytotoxic T lymphocyte (CTL) responses in vitro after transfected with total RNA of K562 cells (K562‐RNA).STUDY DESIGN AND METHODS: DCs derived from human peripheral blood mononuclear cells were transfected with K562‐RNA with electroporation or DOTAP lipofection. The successful transfection was determined by reverse transcription‐polymerase chain reaction and Western blot. The phenotypes of the DCs were analyzed by flow cytometry (FCM), and cytotoxicity of CTL was assessed by propidium iodide staining followed by FCM analysis. The CD1a expression and purity of DCs were measured by FCM.RESULTS: The Bcr‐Abl fusion gene was detected in the DCs with 24 hours after the transfection. The transfected cell expressed increased levels of CD80, CD83, CD86, and HLA‐DR. Moreover, the transfected DCs strongly stimulated the T lymphocytes to gain cytotoxic activity against K562 cells. Culture medium containing 1 percent human plasma was the most effective for DC growth.CONCLUSION: Human DCs transfected with K562‐RNA effectively induce specific immune responses. This method can be used to induce tumor‐specific immune response and may have potential application in immunotherapy of tumors.