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Abstract Background The present study examined whether craving as measured by the obsessive-compulsive drinking scale (OCDS) predict long-term outcome in alcohol-dependent inpatients. Methods This was a 24-month prospective, observational study in 198 alcohol-dependent inpatients treated under standardized conditions. The primary outcome criterion was abstinence, defined as no subjective report or objective indication of alcohol consumption since discharge from treatment. The patients self-rated their craving for alcohol at the 6- and 12-month follow-ups by using the German version of the OCDS, which measures obsessive and compulsive aspects of craving. Univariate and logistic regression analyses with covariates were performed. Results Of the 104 patients interviewed at the 24-month follow-up, 60% (n = 62) were abstinent. We found significant associations between total OCDS scores at 6 months and outcome at 12 months and between total OCDS scores at 12 months and outcome at 24 months: the higher the OCDS total score at one follow-up evaluation, the less likely patients were to be abstinent at the subsequent one. The same association was found for each of the two OCDS subscales, control and consequences and drinking obsessions. Conclusions These results support earlier findings that OCDS scores can predict outcome in alcohol-dependent patients. This information can be used for the timely development of protective resources. Hence, decisions over the use of resources can be made on the basis of objectified parameters to develop a personalized treatment concept. Consequently, economic considerations can induce a reduction of high medical costs.

Abstract Objectives To study the value of demographic and alcohol-related variables for predicting 24-month treatment outcome in an outpatient setting. Methods Prospective observational study with 92 alcohol-dependent patients. Assessments were made by personal interviews at the beginning and end of therapy, and at the 24-month follow-up. Univariate and logistic regression analyses were performed. Results: The mean age was 46.0 (SD = 9.9) years. There were 58 males (65.2%) and 31 females (34.8%). Of the 67 patients interviewed at 2-year follow-up, 58% were abstinent and 79% improved. Differences between abstainers and non-abstainers were found for number of previous detoxifications, and number of patients attempted suicides. In addition, female gender and a higher number of prior treatments predicted negative treatment outcome. Conclusion Matching patients to different types of treatment by means of empirically based characteristics may help to improve outcome but research has failed to establish reliable predictors in that area. Data from this follow-up study confirm the role of certain clinical outcome predictors. Additionally, results give further evidence for outpatient treatment as an effective setting for alcohol-dependent patients as indicated by a favourable retention rate (84%) and outcome (minimum abstinence rate 44%).

This study is an evaluation of cognitive functioning in formerly opioid-dependent adults after at least 1 year of abstinence. Participants (45 formerly opioid-dependent patients, referred to as abstainers, and 45 matched healthy controls) completed a structured screening and subsequent cognitive test battery covering intelligence, learning and memory, attention, and executive functions. Many cognitive functions were comparable between long-term abstainers and healthy controls, and we found few relevant differences. Long-term abstainers seem to have subtle deficits in recognition performance. Based on our and earlier findings, opioid maintenance treatment may be seen as relatively safe with respect to cognitive dysfunction and cognitive functioning is of great relevance for the rehabilitation and daily functioning of substance-dependent people. [ABSTRACT FROM AUTHOR]

Background: Alcohol dependence is associated with deficits in decision making and increased impulsiveness. Therefore, we compared decision making in abstinent alcohol-dependent people ("abstainers") and matched healthy individuals ("comparison group") to determine whether impulsiveness or personality traits play a role in decision making. Methods: Abstainers (n = 40) were recruited from treatment facilities in and around Munich, Germany, and the comparison group (n = 40) through personal contacts and social media. We assessed decision making with the Iowa Gambling Task (IGT), impulsiveness with the Barratt Impulsiveness Scale (BIS-11) and personality traits with the NEO Five-Factor Inventory (NEO-FFI). Results: The comparison group performed significantly better in the IGT (mean profit € 159.50, SD 977.92) than the abstainers (mean loss - € 1,400.13, SD 1,362.10; p < .001) and showed significantly less impulsiveness in the BIS-11 (comparison group: mean 56.03, SD 7.80; abstainers: mean 63.55, SD 11.47; p < .001). None of the five personality traits assessed with the NEO-FFI differed significantly between the groups. Conclusion: The results confirm that abstinent alcohol-dependent people do not perform as well as healthy individuals in decision-making tasks and show greater impulsiveness, but in this study did not affect their decision-making ability. [ABSTRACT FROM AUTHOR]

Background: Rehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion. Methods: A total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity) at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncompleters for any reason. Results: A total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be married but live separated. Conclusion: Rates of treatment noncompletion in inpatient and outpatient rehabilitation programs correspond to results from previous research. Noncompletion is a significant correlate of relapse 1 year after treatment, and noncompleters show an elevated level of psychopathology. These findings may help rehabilitation treatment facilities to tailor specific therapies for these individuals to reduce risk for treatment noncompletion. [ABSTRACT FROM AUTHOR]

Background: The present study examined whether craving as measured by the obsessive-compulsive drinking scale (OCDS) predict long-term outcome in alcohol-dependent inpatients.Methods: This was a 24-month prospective, observational study in 198 alcohol-dependent inpatients treated under standardized conditions. The primary outcome criterion was abstinence, defined as no subjective report or objective indication of alcohol consumption since discharge from treatment. The patients self-rated their craving for alcohol at the 6- and 12-month follow-ups by using the German version of the OCDS, which measures obsessive and compulsive aspects of craving. Univariate and logistic regression analyses with covariates were performed.Results: Of the 104 patients interviewed at the 24-month follow-up, 60% (n = 62) were abstinent. We found significant associations between total OCDS scores at 6 months and outcome at 12 months and between total OCDS scores at 12 months and outcome at 24 months: the higher the OCDS total score at one follow-up evaluation, the less likely patients were to be abstinent at the subsequent one. The same association was found for each of the two OCDS subscales, control and consequences and drinking obsessions.Conclusions: These results support earlier findings that OCDS scores can predict outcome in alcohol-dependent patients. This information can be used for the timely development of protective resources. Hence, decisions over the use of resources can be made on the basis of objectified parameters to develop a personalized treatment concept. Consequently, economic considerations can induce a reduction of high medical costs. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the seroprevalence of Anaplasma (A.) marginale in Iowa feedlots and its association with morbidity, mortality, and treatment costs. A total of 659 calves were the subject of the study. Findings of the study emphasize the significance of implementing biosecurity and biocontainment strategies to prevent iatrogenic transmission of anaplasmosis during processing.

Objective--To compare sensitivity of a complement fixation (CF) test and competitive ELISA (cELISA) for detection of Anaplasma marginale in experimentally infected steers. Animals--40 crossbred (Angus-Simmental) steers. Procedures--Steers were inoculated with 2.6 X 109 A marginale-infected erythrocytes (day 0). Blood samples were collected on days 9, 13, 20, 28, 34, 41, 61, 96, 126, and 156 days after inoculation. The percentage of parasitized erythrocytes (PPE) was determined by microscopic examination of stained blood films, and sera were evaluated with the CF test and cELISA by use of USDA-approved methods. Sensitivity and agreement (κ statistic) between the 2 methods were determined. Persistent infections were confirmed by inoculation of blood obtained from infected steers into susceptible, splenectomized calves. Results--9 days after inoculation, sensitivity of the cELISA was 475%, whereas the CF test failed to identify seropositive steers. After day 13, sensitivity of the cELISA and CF test was 100% and 20%, respectively During peak parasitemia (day 20), sensitivity of the cELISA and CF test was 100%, Thereafter, sensitivity of the CF test fluctuated between 75% and 375%, whereas sensitivity of the cELISA remained at 100% Overall sensitivity of the cELISA and CF test was 94.8% and 265%, respectively (κ statistic, 0.039). Conclusions and Clinical Relevance--The cELISA had superior sensitivity for serologic detection of A marginale. The CF test and cELISA each had a high percentage of false-negative results during the prepatent period. These findings are relevant for export certification and anaplasmosis prevention or eradication programs. [ABSTRACT FROM AUTHOR]

A series of four field trials were conducted to evaluate the ability of a cleaning and disinfection procedure in swine lairage pens to reduce the prevalence of Salmonella enterica in slaughtered pigs. A cleaning and disinfection procedure was applied to lairage pens at a large Midwest abattoir. Each trial consisted of a cleaned (alkaline chloride detergent) and disinfected (H2O2 plus peracetic acid sanitizer) pen (treated) and a control pen, each holding 90 to 95 pigs for 2 to 3 h before slaughter. Ileocecal lymph nodes, cecal contents, and rectal contents were collected from 45 pigs from each study pen at harvest and cultured for S. enterica. In all trials, cleaning and disinfection reduced the prevalence of S. enterica-positive floor swabs in the treated pen (P < 0.05). However, the postharvest prevalence of S. enterica-positive pigs varied between trials. In trial 1, there was no significant difference in the prevalence of S. enterica in pigs between treatment and control groups. In trials 2 and 3, the prevalence of S. enterica was higher in pigs from treated pens versus pigs from control pens (91% versus 40%, P < 0.0001, and 91% versus 24%, P < 0.0001, respectively). In trial 4, the prevalence of S. enterica was lower in pigs from treated pens compared with pigs from control pens (5% versus 42%, P < 0.0001). This study indicates that cleaning and disinfection effectively reduces the amount of culturable S. enterica in lairage pens, but the ability of cleaned and disinfected pens to reduce the prevalence of S. enterica in market-weight pigs remains inconclusive. [ABSTRACT FROM AUTHOR]