School socioeconomic disparities in e-cigarette susceptibility and use among central Texas middle school students.

Social-ecological theory posits that health-related behavior is shaped by the environments and settings that surround us. We examined e-cigarette susceptibility and ever use prevalence among central Texas middle school students by the level of economic disadvantage (ED) of their school. As a secondary aim, we explored gender and ethnic differences (Hispanic vs. White) in e-cigarette susceptibility across school ED levels. A cross-sectional analysis was conducted of baseline data collected in 2017 as part of the CATCH My Breath study. Participants (n = 5278) were 6th grade students from 23 central Texas public middle schools. E-cigarette susceptibility/use and demographics were self-reported; school ED was determined by Texas Education Agency. Analyses included chi-square tests and multi-level logistic regression. E-cigarette susceptibility and use varied by school ED for total sample (p < .0001) and by ethnicity (p ≤ .003). While e-cigarette susceptibility was higher in boys (p < .001), no gender differences were found for e-cigarette use. Students in the highest school ED quartile (Q4) (lowest SES) had significantly higher odds of e-cigarette susceptibility (AOR = 2.01; 95% CI: 1.49-2.71) and use (AOR = 8.12, 95% CI: 2.58-26.30) compared with Q1 students. Significant gender differences in e-cigarette susceptibility persisted within school ED quartiles 1-3 (p ≤ .001); no gender differences were found for Q4 (p = .537). Despite overall higher e-cigarette susceptibility for Hispanic students, they had similar prevalence as White students within three school ED quartiles. Findings underscore a higher risk for e-cigarette susceptibility/use among central Texas sixth graders attending high ED schools and provide foundation for further exploration of the school socioeconomic context in adolescent e-cigarette use.

Ruptured common femoral vein pseudoaneurysm from a common femoral arteriovenous fistula presenting as lower extremity steal after radiofrequency ablation of the great saphenous vein.

Radiofrequency ablation of the superficial venous systems has become one of the mainstays of minimally invasive approaches to varicose veins and chronic venous insufficiency. These procedures have high rates of success with scarce complications. This case report highlights a patient with a common femoral arteriovenous fistula presenting with lower extremity steal after radiofrequency ablation treatment of the great saphenous vein. During operative repair of the arteriovenous fistula, a pseudoaneurysm of the common femoral vein ruptured. We review the current literature and highlight the importance of expanding the scope of complications that can occur from seemingly straightforward minimally invasive venous procedures. Informed consent was obtained for publication of this report.

The use of prealbumin and C-reactive protein for monitoring nutrition support in adult patients receiving enteral nutrition in an urban medical center.

BACKGROUND: Serum prealbumin (PAB) is commonly used to assess protein status and is often used to monitor the response to nutrition support. However, during inflammation, the liver synthesizes acute-phase proteins such as C-reactive protein (CRP) at the expense of PAB. OBJECTIVE: The purpose of this retrospective study was to determine whether changes in PAB reflect the delivery of adequate nutrients or changes in inflammatory status in hospitalized adults (≥18 years) receiving enteral nutrition (n = 154). METHODS: Protein and energy intake were compared to changes in PAB, assessed at baseline and twice weekly. C-reactive protein was assessed when PAB was <18 mg/dL to determine the presence and severity of inflammation. RESULTS: In a sample of mostly critically ill patients, there was no significant difference in change in PAB for those receiving ≥60% of calorie needs (2.74 ± 9.50 mg/dL) compared to <60% of calorie needs (2.48 ± 9.36 mg/dL; P = .86). Changes in PAB correlated only with changes in CRP (r = -0.544, P < .001). In a subgroup analysis of 62 patients with repeated measures of PAB and CRP, PAB increased significantly only in the bottom 2 tertiles for calorie delivery and the lowest tertile for protein delivery. CONCLUSIONS: These results indicate that PAB may not be a sensitive marker for evaluating the adequacy of nutrition support in critically ill patients with inflammation. Only change in CRP was able to significantly predict changes in PAB, suggesting that an improvement in inflammation, rather than nutrient intake, was responsible for the increases in PAB levels.