Flexible Sigmoidoscopy Rather than Colonoscopy Is Adequate for the Diagnosis of Ipilimumab-Associated Colitis.

OBJECTIVES: Treatment with ipilimumab, a cytotoxic T lymphocyte antigen-4 approved for metastatic melanoma can result in clinically significant immune-mediated drug injury in the form of colitis. Timely diagnosis and response are essential for optimal management. The aims of our study were to determine the percentage of our patients with ipilimumab-associated colitis in which the colitis could be diagnosed by flexible sigmoidoscopy only and to describe the variations in endoscopic and histologic findings as well as the patients' clinical courses. METHODS: We retrospectively reviewed 244 patients with metastatic melanoma, treated them with ipilimumab, and characterized the endoscopic and histologic features for those who developed colitis. RESULTS: Of the 68 patients who presented with diarrhea, 33 were diagnosed as having ipilimumab-associated colitis. Endoscopically, all of them had involvement of the left side of the colon; none of the patients were noted to have isolated right colon involvement. CONCLUSIONS: Ipilimumab-associated colitis can be diagnosed with a flexible sigmoidoscopy alone, obviating the need for full colonoscopy.

Our Health Is in Our Hands: A Social Marketing Campaign to Combat Obesity and Diabetes.

PURPOSE: Design, implement, and evaluate a 6-week social marketing campaign (SMC) to raise awareness of obesity and increase involvement in type 2 diabetes prevention, nutrition, and fitness programs offered by the Brooklyn Partnership to Drive Down Diabetes (BP3D) in two low-income, urban communities. DESIGN: This was a nonexperimental, formative research, mixed-methods study. SETTING: The study took place in Central Brooklyn and East New York, two of the most impoverished, high-need communities in New York City. SUBJECTS: Participants were black and Hispanic adults, who were 18+ years of age and residing in the priority communities. INTERVENTION: Advertisements in English and Spanish encouraging healthier eating habits and advocating for better food options were displayed on New York City bus shelters, buses, and subway cars operating in the priority communities. Social media, Web sites, and print material were used to promote the campaign message. MEASURES: Social media metrics and a street intercept postsurvey informed the campaign's success. ANALYSIS: Quantitative data were analyzed using descriptive statistics. RESULTS: One hundred advertisements in English and Spanish were posted. After an 18-month followup, there were over 11,000 visits to the Facebook page. Results from the postsurvey (n = 171) suggest the SMC motivated participants who recognized the advertisements to improve their health behaviors. CONCLUSION: A multifaceted SMC that coincides with prevention programs can effectively raise attention to health issues and activities in a high-risk population at a relatively low cost.