Does access to free medication reduce health system costs? An evaluation of the Dispensary of Hope program.

Cost-related medication nonadherence-when patients fail to take medication as prescribed because of the cost of the medication-has numerous consequences: more hospitalizations, avoidable deaths, and greater health care expenditures. Dispensary of Hope is a charitable medication access program that collects and distributes pharmaceuticals to pharmacies to dispense free of charge to patients with no insurance, low incomes, and chronic conditions. To estimate the differences in medical costs and utilization of hospital patients enrolled in the Dispensary of Hope program relative to those who were not enrolled.

Comprehensive Characterization of Cerebrovascular Dysfunction in Blast Traumatic Brain Injury Using Photoacoustic Microscopy.

Blast traumatic brain injury (bTBI) is a leading contributor to combat-related injuries and death. Although substantial emphasis has been placed on blast-induced neuronal and axonal injuries, co-existing dysfunctions in the cerebral vasculature, particularly the microvasculature, remain poorly understood. Here, we studied blast-induced cerebrovascular dysfunctions in a rat model of bTBI (blast overpressure: 187.

Polarization-based control of spin-orbit vector modes of light in biphoton interference.

We report the experimental generation of a class of spin-orbit vector modes of light via an asymmetric Mach-Zehnder interferometer, obtained from an input beam prepared in a product state of its spin and orbital degrees of freedom. These modes contain a spatially varying polarization structure which may be controllably propagated about the beam axis by varying the retardance between the vertical and horizontal polarization components of the light. Additionally, their transverse spatial intensity distributions may be continuously manipulated by tuning the input polarization parameters.

Prescribing Preferences in the First-Line Treatment for Patients With Metastatic Renal Cell Carcinoma in the United States.

Background: Despite existing guidelines for first-line treatment of metastatic renal cell carcinoma (mRCC), prescribing preferences in the United States have not been fully examined. The objectives of this study were to characterize US physicians' preferences and factors influencing first-line mRCC treatment.

Materials And Methods: A Web-based study presented physicians with hypothetical mRCC patient cases and recorded initial therapy preference and rationale.

Order and chaos in the rotation and revolution of two massive line segments.

As a generalization of Newton's two body problem, we explore the dynamics of two massive line segments interacting gravitationally. The extension of each line segment or slash (/) provides extra degrees of freedom that enable the interplay between rotation and revolution in an especially simple example. This slash-slash (//) body problem can thereby elucidate the dynamics of nonspherical space structures, from asteroids to space stations.

Neatness counts. How plating affects liking for the taste of food.

Two studies investigated the effect that the arrangement of food on a plate has on liking for the flavor of the food. Food presented in a neatly arranged presentation is liked more than the same food presented in a messy manner. A third study found that subjects expected to like the food in the neat presentations more than in the messy ones and would be willing to pay more for them.

Better but not ideal acceptance of routine inpatient HIV point-of-care testing among veterans in a high prevalence area.

Background: The most recent guidance statement from The American College of Physicians recommends that clinicians adopt human immunodeficiency virus screening as part of routine medical care. Inpatient HIV testing at the Vetarns Affairs Medical Center in Washington, DC has been predominantly targeted at patients with disclosed risk factors.

Method: We implemented the first voluntary inpatient HIV testing program within a Veterans Affairs hospital using the OraQuick Advance Rapid HIV-1/2 Antibody Test on both oral secretion and whole blood samples.

Molecular imaging of endothelial vascular cell adhesion molecule-1 expression and inflammatory cell recruitment during vasculogenesis and ischemia-mediated arteriogenesis.

Background: Inflammatory responses contribute to vascular remodeling during tissue repair or ischemia. We hypothesized that inflammatory cell recruitment and endothelial cell activation during vasculogenesis and ischemia-mediated arteriogenesis could be temporally assessed by noninvasive molecular imaging.

Methods And Results: Contrast ultrasound perfusion imaging and molecular imaging with microbubbles targeted to activated neutrophils, alpha(5)-integrins, or vascular cell adhesion molecule (VCAM-1) were performed in murine models of vasculogenesis (subcutaneous matrigel) or hind-limb ischemia produced by arterial occlusion in wild-type or monocyte chemotactic protein-1-deficient mice.

Use of electronic alerts to enhance hand hygiene compliance and decrease transmission of vancomycin-resistant Enterococcus in a hematology unit.

Background: Hand hygiene (HH) compliance among health care workers (HCWs) has been historically low and hampered by poor surveillance methods. This study evaluated the use of an electronic device to measure and impact HH compliance.

Methods: The study is a prospective, interventional study in a 30-bed academic medical center hematology unit.

Skeletal muscle capillary responses to insulin are abnormal in late-stage diabetes and are restored by angiotensin-converting enzyme inhibition.

Acute physiological hyperinsulinemia increases skeletal muscle capillary blood volume (CBV), presumably to augment glucose and insulin delivery. We hypothesized that insulin-mediated changes in CBV are impaired in type 2 diabetes mellitus (DM) and are improved by angiotensin-converting enzyme inhibition (ACE-I). Zucker obese diabetic rats (ZDF, n = 18) and control rats (n = 9) were studied at 20 wk of age.

Vasopressin is a physiological substrate for the insulin-regulated aminopeptidase IRAP.

Insulin-regulated aminopeptidase (IRAP) is a membrane aminopeptidase and is homologous to the placental leucine aminopeptidase, P-LAP. IRAP has a wide distribution but has been best characterized in adipocytes and myocytes. In these cells, IRAP colocalizes with the glucose transporter GLUT4 to intracellular vesicles and, like GLUT4, translocates from these vesicles to the cell surface in response to insulin.

High-resolution myocardial perfusion imaging in mice with high-frequency echocardiographic detection of a depot contrast agent.

High-resolution methods for assessing myocardial perfusion in murine models of cardiovascular disease are needed. We hypothesized that regional hypoperfusion could be assessed with ultrahigh-frequency myocardial contrast echocardiography (MCE) and a novel strategy of depot contrast enhancement. MCE was performed with 30-MHz transthoracic imaging 10 seconds and 10 minutes after intravenous administration of microbubbles in control mice, and in mice after left anterior descending coronary artery ligation.

Effect of microbubble ligation to cells on ultrasound signal enhancement: implications for targeted imaging.

Objectives: Molecular imaging with contrast-enhanced ultrasound (CEU) relies on the detection of microbubbles retained in regions of disease. The aim of this study was to determine whether microbubble attachment to cells influences their acoustic signal generation and stability.

Materials And Methods: Biotinylated microbubbles were attached to streptavidin-coated plates to derive density versus intensity relations during low- and high-power imaging.

Assessment of materials commonly utilized in health care: implications for bacterial survival and transmission.

Background: Contaminated environmental surfaces, equipment, and health care workers' hands have been linked to outbreaks of infection or colonization because of vancomycin-resistant enterococci (VRE) and Pseudomonas aeruginosa (PSAE). Upholstery, walls, and flooring may enhance bacterial survival, providing infectious reservoirs.

Objectives: Investigate recovery of VRE and PSAE, determine efficacy of disinfection, and evaluate VRE transmission from surfaces.

Detection of vancomycin-resistant enterococci before and after antimicrobial therapy: use of conventional culture and polymerase chain reaction.

Antimicrobial therapy can increase the colonization density of gastrointestinal vancomycin-resistant enterococci (VRE). Among previously VRE-colonized patients, we evaluated VRE colonization before and after initiation of antimicrobial therapy by means of polymerase chain reaction (PCR) and culture. Perianal swab samples were obtained at admission to the hospital and after receipt of antimicrobial therapy.

Comparison of PCR assay to culture for surveillance detection of vancomycin-resistant enterococci.

Direct multiplex PCR assay using vanA and vanB primers, which provides rapid results, was more sensitive than culture on selective media for samples collected by rectal swab (20 of 46 versus 8 of 46; P < 0.001) or perianal swab (17 of 58 versus 12 of 58; P = 0.059) for the detection of gastrointestinal colonization by vancomycin-resistant enterococci.

Influence of role models and hospital design on hand hygiene of healthcare workers.

We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) were observed in the old hospital and 417 (58%) in the new hospital.

Risk factors for acquisition of vancomycin-resistant enterococci among hematology-oncology patients.

The incidence of VRE has increased dramatically and hematology-oncology patients are at high risk for acquisition of colonization and development of infection. Therefore, we performed a prospective cohort study to determine risk factors for VRE acquisition among hematology-oncology patients. Patients admitted to a single unit at Northwestern Memorial Hospital, which was predominantly comprised of patients with hematologic malignancies and recipients of hematopoietic stem cell transplants, were enrolled.

Comparing attentional bias to smoking cues in current smokers, former smokers, and non-smokers using a dot-probe task.

Much evidence documents that individuals with emotional and drug-use disorders demonstrate biased attention toward stimuli associated with their disorder. This bias appears to diminish following successful treatment. Two studies examined whether current cigarette smokers show biased attention toward smoking-related images compared with non-smokers (Studies 1 and 2) and whether this bias is less pronounced in former smokers (Study 2).

Simultaneous comparison of cerebral dialysis and push-pull perfusion in the brain of rats: a critical review.

Over the last 30 years, studies of the in vivo activity of neurotransmitters and other endogenous factors in the brain have comprised a major effort in the neurosciences. Historically, the technology of push-pull perfusion was utilized as a major approach to investigations in this field. In the last 10 years, cerebral dialysis has been used as an alternative method essentially for the same scientific purpose, since the perfusion technique was viewed as difficult and excessively damaging to tissue.

Drinking patterns in genetic low-alcohol-drinking (LAD) rats after systemic cyanamide and cerebral injections of THP or 6-OHDA.

A key question related to the role of acetaldehyde and aldehyde adducts in alcoholism concerns their relationship to the genetic mechanisms underlying drinking. Experimentally, the low-alcohol-drinking (LAD) rat represents a standard rodent model having a strong aversion to alcohol. In these experiments, preferences for water vs.

Action of the 5-HT2A antagonist amperozide on alcohol-induced poikilothermia in rats.

Amperozide, a novel 5-HT2A receptor antagonist that releases dopamine from mesolimbic neurons suppresses alcohol drinking in rats. Because serotonergic neurons are implicated in both the central mechanisms underlying thermoregulation and the reinforcing effects of alcohol, this study was undertaken to determine whether the poikilothermic effects of alcohol on body temperature (Tb) would be altered by amperozide. In adult male Sprague-Dawley rats kept at an ambient temperature of 22 to 24 degrees C, a radio transmitter for continuous monitoring of Tb was first implanted intraperitoneally.

Differential efficacy of serotonergic drugs FG5974, FG5893, and amperozide in reducing alcohol drinking in P rats.

Amperozide (FG5606), a 5-HT2 receptor antagonist, is well known to suppress alcohol consumption in different rat models of drinking. The present study compared the efficacy of three drugs, FG5974, FG5893, and amperozide, which have differential affinities for 5-HT1A and 5-HT2A receptors, on alcohol drinking in the genetic alcohol-preferring (P) rat. After preference for alcohol vs.

Neuropeptide Y perfused in the preoptic area of rats shifts extracellular efflux of dopamine, norepinephrine, and serotonin during hypothermia and feeding.

This study examined the localized action of neuropeptide Y (NPY) on monoamine transmitter activity in the hypothalamus of the unrestrained rat as this peptide induced hypothermia, spontaneous feeding or both responses simultaneously. A guide tube was implanted in the anterior hypothalamic pre-optic area (AH/POA) of Sprague-Dawley rats. Then either control CSF vehicle or NPY in a dose of either 100 ng/microliter or 250 ng/microliter was perfused by push-pull cannulae in this structure in the fully sated, normothermic rat.