Although there have been recently published methods and markers by which to differentiate Hunner's ulcer vs nonHunner's ulcer interstitial cystitis, our data demonstrate that standard clinical evaluation cannot reliably distinguish these groups. These findings suggest that cystoscopy is needed to accurately identify patients with Hunner's ulcer.

OBJECTIVE To characterize immune checkpoint inhibitor–associated diabetes mellitus (ICI-DM) in a single-institution case series. RESEARCH DESIGN AND METHODS Retrospective chart review of 18 patients with new-onset ICI-DM following anti–programmed cell death protein 1 (PD-1)/anti–programmed cell death protein ligand 1 (PD-L1) therapy for advanced carcinomas. RESULTS Of 18 patients, 9 had diabetic ketoacidosis (median glucose 27.92 mmol/L; median glucose before presentation 6.35 mmol/L). Median C-peptide at ICI-DM diagnosis was low, and it declined during follow-up. Median anti-PD-1/anti-PD-L1 duration before ICI-DM was 3.65 months (range 0.56–12.23 months). Time to ICI-DM onset was a median 1.4 months/3 ICI cycles and 6 months/10 cycles in those patients who were positive and negative for GAD65 autoantibodies, respectively. Time to ICI-DM onset was a median 2.5 months/3 ICI cycles and 4.8 months/8 cycles after anti-PD-L1 or anti-PD-1 therapy, respectively. Significant pancreatic atrophy was seen radiographically. CONCLUSIONS ICI-DM presents abruptly, appears irreversible, is characterized by pancreatic atrophy, and may occur both earlier following PD-L1 blockade compared with PD-1 inhibition and in those who have positive GAD65 autoantibodies.

Offspring of parents with exceptional longevity manifest lower prevalence of cardiovascular disease (CVD) but the role of lifestyle factors in this unique cohort is not known. Our study tested whether individuals with exceptional parental longevity have lesser prevalence of CVD independent of lifestyle factors. Prevalence of CVD and CVD risk factors was assessed in a population of community dwelling Ashkenazi Jewish adults aged 65-94 years. Participants included offspring of parents with exceptional longevity (OPEL, n=395), defined as having at least one parent living past the age of 95 years, and offspring of parents with usual survival (OPUS, n=450), defined as having neither parent survive to 95 years. Medical and lifestyle information was obtained using standardized questionnaires. Socioeconomic status was defined based on validated classification scores. Dietary intake was evaluated with the Block Brief Food Frequency Questionnaire (FFQ 2000) in a sub-group of the study population (n=234). Our study found no significant differences in the prevalence of obesity, smoking, alcohol use, physical activity, social strata scores and dietary intake between the two groups. After adjustment for age and sex, the OPEL demonstrated 29% lower odds of having hypertension (95% CI 0.53-0.95), 65% lower odds of having had a stroke (95% CI 0.14-0.88), and 35% lower odds of having CVD (95% CI 0.43-0.98), compared with OPUS. In conclusion, exceptional parental longevity is associated with lower prevalence of CVD independent of lifestyle, socioeconomic status and nutrition; thus, highlighting the potential role of genetics in disease-free survival among individuals with exceptional parental longevity.

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