than weekly, dosing. A total of 1808 women at 80 centers in 20 countries who were between 25 and 32 weeks of gestation and had received an initial course of either betamethasone or dexamethasone because of a high risk for preterm delivery were randomized to receive subsequent courses of either betamethasone or placebo at 2-week intervals until delivery or 33 weeks of gestation. A variety of maternal and neonatal outcomes were evaluated.There were no significant beneficial effects of the multiple courses of steroids. However, there was a significant difference in fetal growth between the 2 groups. At birth, the steroid-treated infants were smaller in weight, length, and head circumference.Even without the benefit of long-term follow-up of the infants, this study heightens concern for the neurodevelopmental future for these infants because of the apparent smaller brain size at birth. Therefore, this article adds to the literature that speaks in opposition to the use of multiple antenatal courses of steroids. One to a customer, please! Comment by Charles V. Bender, MD

One-time colonoscopic screening between 50 and 54 yr of age is cost-effective compared to no screening and screening at older ages in both men and women. Screening in men between 45 and 49 yr of age may be cost-effective compared to screening between 50 and 54 yr of age depending on societal willingness to pay.

Higher baseline glycosylated hemoglobin levels are independently associated with incident CKD and ESRD, among individuals with type 1 diabetes.

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