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01) and race (p = 0.03). read more Documented infections were similar between AB+ and AB- groups, except urinary tract infections. No statistically significant differences were noted in documented symptoms including pain, dyspnea, fever, lethargy, and alteration of mental state or length of stay.

Our study did not show differences in frequencies of documented symptoms with use of antimicrobials at EOL. Antimicrobial stewardship programs and further research can help with developing EOL care antimicrobial guidelines supporting patients and providers through shared decision-making.

Our study did not show differences in frequencies of documented symptoms with use of antimicrobials at EOL. Antimicrobial stewardship programs and further research can help with developing EOL care antimicrobial guidelines supporting patients and providers through shared decision-making.

Lipohypertrophy (LH) is caused by repetitively injecting insulin into the same location. This can lead to unpredictable insulin absorption and increased glucose variability (GV). A new medical device, ROTO Track, automatically guides the user to rotate abdominal insulin injections to avoid LH lesions. This study aimed to test whether the medical device could reduce the number of insulin injections in the same subcutaneous area as compared with non-aided standard insulin injection techniques.

In this proof-of-concept cross-over study, baseline data about injection site in the abdominal region were collected blinded for 1 week with a nonguiding version of the device and compared to 1 and 12 weeks of device guidance in 35 people with type 1 diabetes. The device registered time and location of abdominal injections. The primary endpoint was a “rotation score.” Secondary endpoints included number and size of LH, GV, and hemoglobin A1c.

The rotation score improved significantly from a baseline mean of 40.2% to 49.9% after 1 week (confidence interval 2.2-17.2%,

= .012) and improved further after 12 weeks to 52.2% (

< .001). After 12 weeks, LH was reduced both in median size from 9.2 (range [0.9-29.4]) cm

to 5.4 (range [0.0- 26.8]) cm

(

= .041) and mean count from 1.4 (range [1-2]) to 1.1 (range [0-2],

= .039) and the coefficient of variation of interstitial glucose was reduced from 38.6 to 35.1 (

= .009).

This proof-of-concept study indicates that the device improves rotation of insulin injections, and reduces LH and GV.

This proof-of-concept study indicates that the device improves rotation of insulin injections, and reduces LH and GV.

We examined whether dynamic color range indicator (DCRI) and blood sugar mentor (BSM) features in a new blood glucose meter could improve interpretation of results and encourage patient action.

One hundred and thirty three people with type 2 (T2D) (

 = 73) or type 1 diabetes (T1D) (

 = 60) evaluated information first without and then with DCRI or BSM guidance using interactive exercises.

Subjects improved their ability to categorize results into low, in range, or high glycemic ranges by 29% (T2D) and 22% (T1D) (each

 < .001). There was significantly greater willingness to act on high and low results shown with DCRI or BSM screens. Subjects also expressed a high degree of satisfaction with these features.

Use of DCRI and BSM in this meter may help patients improve their diabetes management decisions.

Use of DCRI and BSM in this meter may help patients improve their diabetes management decisions.

To study the relationship between race and outcomes of patients with firearm injuries hospitalized in the United States.

The 2016 National Inpatient Sample was used. Patients were included if they had a principal diagnosis of firearm injury. Exclusion criteria were age <16 years and elective admissions. The primary outcome was in-hospital mortality. Secondary outcomes were morbidity (traumatic shock, prolonged mechanical ventilation, acute respiratory distress syndrome [ADRS], and ventilator-associated pneumonia [VAP]), and resource utilization (length of stay and total hospitalization charges and costs).

The sample included 31 335 patients; 52% were Black and 29% were Caucasian. The mean age was 32 years and 88% were male. Black patients had lower odds of mortality (adjusted odds ratio (aOR) 0.41 (95% CI 0.32-0.53),

< .01). However, compared with Caucasians, Blacks had higher mean total hospitalization charges (adjusted mean difference (aMD) $14 052 (CI $1469-$26 635),

= .03) and costs (aMD $3248 (CI $654-$5842),

= .01) despite similar mean length of stay (aMD 0.70 (CI -0.05-1.45),

= .07). Both racial groups had similar rates of traumatic shock (aOR 0.91 (0.72-1.15),

= .44), prolonged mechanical ventilation (aOR 0.82 (0.63-1.09),

= .17), ARDS (aOR 1.18 (0.45-3.07),

= .74) and VAP (aOR 1.27 (0.47-3.41),

= .63).

Black patients with firearm injuries had a lower adjusted odds of in-hospital mortality compared with other races. However, despite having a similar hospital length of stay and in-hospital morbidity, -Black patients had higher total hospitalization costs and charges.

Black patients with firearm injuries had a lower adjusted odds of in-hospital mortality compared with other races. However, despite having a similar hospital length of stay and in-hospital morbidity, -Black patients had higher total hospitalization costs and charges.A growing suite of connected devices including Bluetooth or cellular-enabled glucose monitoring devices, smart insulin pens, pumps, fitness trackers, blood pressure, and heart rate and weight monitors present a golden opportunity to build a data-driven clinical practice model including remote monitoring capability and virtual care. This paper will discuss this approach using diabetes as a case study and smart insulin pens as a use case. As payment and practice approaches evolve, there is growing interest from both patients and their health care teams in virtual care made possible by remote monitoring capability. Here, we will define the category of smart insulin pens, describe the hallmarks of a data-driven practice model, and delineate the steps to take to incorporate remote monitoring capability with smart insulin pens into diabetes care for injection therapy patients.