Obese children with type 1 diabetes have a higher prevalence of hypertension and dyslipidemia than healthy weight children with type 1 diabetes. The possible association of obesity with lower micro-/macroalbuminuria rates warrants further investigation.

Objectives To evaluate the feasibility and acceptability of an e-mail-delivered program to promote nutrition and physical activity in African-American college students. Participants 47 students (76% female, ages 18-20 y). Methods Students participated in a 24-week randomized controlled trial, receiving either general health information or the intervention focused on diet and physical activity. Results At baseline, 80.9% and 76.0% of participants reported interest in improving diet and physical activity, respectively. Participants evidenced poor nutrition behaviors and 46% were overweight or obese. At 24 weeks, most participants (70% control, 84% intervention) were “somewhat” or “very” satisfied with the program. The program was feasible to administrate, with the exception of measurement of physical activity using accelerometers. Conclusions An innovative e-mail-delivered program promoting positive health behaviors appears to be feasible and acceptable in African-American college students. Further research is needed to evaluate program efficacy in this population, including prevention of excess weight gain.

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Background & Aims Proton pump inhibitors (PPIs) have been associated with increased risk of infection, likely due to changes in intestinal epithelial permeability and the gastrointestinal microbiome. PPIs are frequently given to patients in the intensive care unit (ICU) to prevent stress ulcers. These patients are at risk for bloodstream infections (BSIs), so we investigated the relationship between PPI use and BSIs among patients in the ICU. Methods We performed a retrospective cohort study of adults (≥18 years) admitted to 1 of 14 ICUs within a hospital network of 3 large hospitals from 2008 through 2014. The primary exposure was PPI use for stress ulcer prophylaxis in the ICU. The primary outcome was BSI, confirmed by culture analysis, arising 48 hrs or more after admission to the ICU. Subjects were followed for 30 days after ICU admission or until death, discharge, or BSI. Multivariable Cox proportional-hazards modeling was used to test the association between PPIs and BSI, after controlling for patient comorbidities and other clinical factors. Results We analyzed data from 24,774 patients in the ICU, including 756 patients (3.1%) who developed BSIs while in the ICU. The cumulative incidence of BSI was 3.7% in patients with PPI exposure compared to 2.2% in patients without PPI exposure (log-rank test P<.01). After adjusting for potential confounders, PPI exposure was not associated with increased risk of BSI while in the ICU (adjusted hazard ratio, 1.08; 95% CI, 0.91–1.29). Comorbidities, antibiotic use, and mechanical ventilation were all independently associated with increased risk for BSIs. Conclusion In a retrospective study of patients in the ICU, administration of PPIs to prevent bleeding was not associated with increased risk of BSI. These findings indicate that concern for BSI should not affect decisions regarding use of PPIs in the ICU.

Background: Current detection methodologies are often unable to identify the location and extent of recurrent prostate cancer (PCa) leading potentially to 'futile' local therapies in the presence of metastatic disease. The use of 18 F-fluciclovine PET/CT may lead to better patient management.Objective: The aim of this study was to quantify the economic impact and cost-consequence of using 18 F-fluciclovine PET/CT in PCa recurrence. Study design: A decision analytic model based on recurrent PCa imaging guidelines. Setting: US hospital. Participants: PCa patients experiencing biochemical recurrence. Intervention: 18 F-fluciclovine PET/CT was compared to conventional imaging. Main outcome measure: Budget impact, correct diagnoses, futile treatments, and costconsequence (cost per correct diagnosis) Results: For a hypothetical hospital serving 500,000 individuals, the model showed the use of 18 F-fluciclovine reduced 'futile' therapies by 19.2%. Re-imaging costs were reduced by 40.2% ($8.2 million); however, when assuming diagnostic and staging costs only, the total costs increased from $31.2 to $34.6 million (10.9%), driven by 18 F-fluciclovine imaging agent and procedure costs. The cost per 'correct' diagnosis declined $30,673 (46.8%). When including subsequent 5-year patient management, the cost per 'correct' diagnosis declined $410,206 (49.2%). Conclusion: 18 F-fluciclovine PET/CT imaging may improve the clinical management of men with recurrent PCa with minimal increase in healthcare spending. ARTICLE HISTORY