Use of Veterans Health Administration Homeless Programs Among Transgender and Non-Transgender Veterans Experiencing Self-Reported Housing Instability.

Introduction: Transgender individuals have higher rates of housing instability than non-transgender individuals. This study assessed the extent to which unstably housed transgender veterans participated in Veterans Health Administration (VHA) Homeless Programs.

Methods: Using VHA medical record data for transgender (n=491) and nontransgender (n=473) veterans who self-reported housing instability during fiscal years 2013-2016, chi-square and t-tests identified differences in socio-demographic characteristics and services use; multiple logistic and negative binomial regression assessed the type and number of VHA Homeless Programs veterans used.

Motivational interview improves treatment entry in homeless veterans.

Motivational Interviewing (MI) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs. Some questions have been raised as to the effectiveness of MI in severely distressed populations. This study aims to assess the effectiveness of MI in a population of homeless, unemployed, and substance dependent veterans who are being wait-listed for entry into a residential treatment program.

Facial and ocular deposition of nebulized budesonide: effects of face mask design.

Background: In vivo case reports and in vitro studies have indicated that aerosol therapy using face masks can result in drug deposition on the face and in the eyes, and that face mask design may affect drug delivery.

Objective: To test different mask/nebulizer combinations for budesonide, a nebulized steroid used to treat pediatric patients with asthma.

Methods: Using high-performance liquid chromatography, drug delivery (inhaled mass), facial, and ocular deposition of budesonide aerosols were studied in vitro using a ventilated face facsimile (tidal volume, 50 mL; rate, 25 breaths/min, duty cycle 0.

Hypersomnolence, insomnia and the pathophysiology of upper airway resistance syndrome.

Objective: In order to test the hypothesis that upper airway resistance syndrome (UARS) is merely an extension of the pathophysiology of obstructive sleep apnea/hypopnea (OSA/H) to less severe pharyngeal collapse during sleep, we compared the severity of hypersomnolence and the prevalence of insomnia in UARS patients to the patterns observed for OSA/H patients. Our goal was to determine whether the severity of hypersomnolence and the prevalence of insomnia observed in UARS patients could have been predicted from the patterns observed among OSA/H patients.

Methods: We performed a retrospective study of a large consecutive patient series evaluated at an academic sleep disorders center, including 220 OSA/H patients and 137 UARS patients.

Aerosolized iloprost customized for the critically ill.

Background: Aerosolized iloprost, an inhaled synthetic analogue of prostacyclin, is an approved therapy for stage III and IV pulmonary hypertension. However, currently iloprost is delivered via a device that requires a clinically stable patient who can use a hand-held nebulizer. We designed separate aerosol delivery systems to nebulize iloprost to critically ill patients during (1) mechanical ventilation and (2) spontaneous breathing that requires a high fraction of inspired oxygen.