Aetna's Compassionate Care Program: Sustained Value for Our Members with Advanced Illness.

In 2004, Aetna, a national health insurer, launched the Aetna Compassionate Care Program (ACCP) targeting members diagnosed with an advanced illness with a view to increase access to palliative care and hospice services. The objective of this study is to evaluate the impact of ACCP on health care utilization and hospice enrollment among enrolled members. This was a retrospective cohort study comparing participants in ACCP to a matched control group using a propensity score method.

Drug-induced eosinophilia.

Background: Drug reactions have been associated with increased blood eosinophil levels.

Objective: To review clinical characteristics, the diagnosis, and the management of drug-induced eosinophilia.

Methods: Pertinent articles were selected and reviewed in relation to a case presentation of drug-induced eosinophilia.

Assessing the Impact of Medication Adherence on Long-Term Cardiovascular Outcomes.

Background: Although guideline-recommended therapies reduce major adverse cardiovascular events (MACE) in patients after myocardial infarction (MI) or those with atherosclerotic disease (ATH), adherence is poor.

Objectives: The goal of this study was to determine the association between medication adherence levels and long-term MACE in these patients.

Methods: We queried the claims database of a large health insurer for patients hospitalized for MI or with ATH.

Abortive placode formation in the feather tract of the scaleless chicken embryo.

The featherless phenotype of the scaleless mutant provides a model for delineating the process of feather follicle formation. Initial studies established that the mutation affects the epidermis and suggested that epidermis is unable to respond to signals from underlying dermis, or propagate a reciprocal signal. The work presented here demonstrates that scaleless epidermis does indeed respond to the initial inductive signals from dermis, as indicated by the localization of nuclear beta-catenin and transient focal expression of genes expressed in the placode of wild-type feather rudiments.

Challenges in improving the quality of osteoporosis care for long-term glucocorticoid users: a prospective randomized trial.

Background: In light of widespread undertreatment for glucocorticoid-induced osteoporosis (GIOP), we designed a group randomized controlled trial to increase bone mineral density (BMD) testing and osteoporosis medication prescribing among patients receiving long-term glucocorticoid therapy.

Methods: Using administrative databases of a large US health plan, we identified physicians who prescribed long-term glucocorticoid therapy to at least 3 patients. One hundred fifty-three participating physicians were randomized to receive a 3-module Web-based GIOP intervention or control course.

Population-based assessment of adverse events associated with long-term glucocorticoid use.

Objective: The frequency of many adverse events (AEs) associated with low-dose glucocorticoid use is unclear. We sought to determine the prevalence of glucocorticoid-associated AEs in a large US managed care population.

Methods: Using linked administrative and pharmacy claims, adults receiving >or=60 days of glucocorticoids were identified.

Agreement and validity of pharmacy data versus self-report for use of osteoporosis medications among chronic glucocorticoid users.

Purpose: Pharmacy and linked claims databases are commonly used to determine medication receipt as a measure of quality of care. However, these data sources have not been previously compared with self-reported data for receipt of medications used for glucocorticoid-induced osteoporosis (GIOP).

Methods: Using databases from a national managed care organization (MCO), we identified 6282 chronic glucocorticoid users (60+ days in 18 months).

Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients.

Objective: To evaluate patient and physician factors associated with prevention of glucocorticoid-induced osteoporosis and to describe temporal trends in screening and prevention of glucocorticoid-induced osteoporosis.

Methods: Using databases from a national managed care organization, enrollees who had been prescribed glucocorticoids (taken for at least 60 days) during an 18-month period were identified. Administrative data from January 2001 through June 2003 and linked survey data from October 2003 were examined for measurement of bone mass, prescription of antiresorptive medication, and use of over-the-counter calcium and/or vitamin D treatment.

Expression and regulation of Groucho-related genes in the embryonic chicken feather bud.

The groucho-related gene (Grg) products modulate the transcriptional response to several extracellular signals, including the Wnts. In an effort to define the roles of Grgs in the morphogenesis of the feather bud, cDNAs encoding members of the Grg family were cloned from embryonic chick skin. In situ hybridization was used to localize transcripts for cGrg2, Grg3, Grg4, and Grg5 in embryos from day 6 through day 9.