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Adherence to guidelines for surveillance colonoscopy in patients with ulcerative colitis at a Canadian quaternary care hospital.

https://arctichealth.org/en/permalink/ahliterature148080
Source
Can J Gastroenterol. 2009 Sep;23(9):613-7
Publication Type
Article
Date
Sep-2009
Author
Dan Kottachchi
Derek Yung
John K Marshall
Author Affiliation
Department of Internal Medicine, McMaster University, Hamilton, ON, Canada.
Source
Can J Gastroenterol. 2009 Sep;23(9):613-7
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Biopsy - statistics & numerical data
Canada - epidemiology
Cell Transformation, Neoplastic - pathology
Colitis, Ulcerative - complications - diagnosis
Colon - pathology
Colonic Neoplasms - epidemiology - etiology - prevention & control
Colonic Polyps - epidemiology - etiology - pathology
Colonoscopy - statistics & numerical data
Female
Gastroenterology - standards
Guideline Adherence - statistics & numerical data
Hospitals, University - statistics & numerical data
Humans
Intestinal Mucosa - pathology
Male
Mass Screening - methods
Middle Aged
Physician's Practice Patterns - standards
Practice Guidelines as Topic
Precancerous Conditions - epidemiology - etiology - pathology
Retrospective Studies
Severity of Illness Index
Abstract
Patients with ulcerative colitis (UC) are at high risk of colonic dysplasia. Therefore, surveillance colonoscopy to detect early dysplasia has been endorsed by many professional organizations.
To determine whether gastroenterologists at Hamilton Health Sciences (Hamilton, Ontario) adhere to recommendations for UC surveillance issued by the Canadian Association of Gastroenterology and to retrospectively assess the incidence and type of dysplasia found and the subsequent outcome of patients with dysplasia (ie, colorectal cancer [CRC], colectomy, dysplasia recurrence).
A retrospective chart review of all patients with UC undergoing colonoscopy screening at Hamilton Health Sciences from January 1980 to January 2005, was performed. Patients were classified by the extent of colonic disease: limited left-sided colitis (LSC), pancolitis and any disease extent with concurrent primary sclerosing cholangitis.
A total of 141 patients fulfilled eligibility criteria. They underwent 921 endoscopies, including 453 for surveillance, which were performed by 20 endoscopists. Overall, screening was performed on 90% of patients, and surveillance at the appropriate time in 74%. There was a statistically significant increase in the mean number of biopsies per colonoscopy after the guidelines were published (P
Notes
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PubMed ID
19816624 View in PubMed
Less detail

Altered expression of CK7 and CK20 in preneoplastic and neoplastic lesions in ulcerative colitis.

https://arctichealth.org/en/permalink/ahliterature87376
Source
APMIS. 2007 Nov;115(11):1219-26
Publication Type
Article
Date
Nov-2007
Author
Stenling Roger
Lindberg Jan
Rutegård Jörgen
Palmqvist Richard
Author Affiliation
Dept. of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. roger.stenling@vll.se
Source
APMIS. 2007 Nov;115(11):1219-26
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - epidemiology - pathology - surgery
Adolescent
Adult
Age of Onset
Aged
Child
Colitis, Ulcerative - complications - pathology - surgery
Colonoscopy
Colorectal Neoplasms - epidemiology - pathology - surgery
Female
Humans
Immunohistochemistry
Intestinal Mucosa - cytology - pathology
Keratin-20 - metabolism
Keratin-7 - metabolism
Male
Middle Aged
Precancerous Conditions - epidemiology - pathology
Abstract
This study is based on all patients with ulcerative colitis from a defined catchment area in Northern Sweden in a still ongoing colonoscopy surveillance programme, which started in 1977. From this material we selected tissue from eight groups of patients consisting of normal control biopsies (5), inactive colitis (10), active colitis (10), findings of low-grade dysplasia (10), high-grade dysplasia (6), aneuploidy (without dysplasia and with subsequent dysplasia) (10), and ulcerative colitis-associated cancers (5). The samples were evaluated according to immunohistochemical expression of CK7 and CK20. Colonic mucosa from normal controls and inactive colitis was found to be completely negative for CK7. In 9 out of 10 patients with active colitis, CK7 was sparsely expressed in a patchy manner and connected with active epithelial inflammatory areas. 7 out of 10 patients with low-grade dysplasia and 3 out of 6 with high-grade dysplasia were positive for CK7. Samples with aneuploidy without dysplasia were completely negative, while 2 out of 6 showing subsequent dysplasia were positive. Of the five cancers, two were positive for CK7. CK20 was expressed in nearly all samples but relatively more in the lower part of the crypts in neoplasia-associated lesions. Our results indicate a possible relationship between expression of CK7 and CK20 and neoplastic development of colorectal mucosa in patients with ulcerative colitis. Further studies are needed to elucidate whether these findings have clinical significance.
PubMed ID
18092953 View in PubMed
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Anemia and iron deficiency in inflammatory bowel disease: an open, prospective, observational study on diagnosis, treatment with ferric carboxymaltose and quality of life.

https://arctichealth.org/en/permalink/ahliterature108423
Source
Scand J Gastroenterol. 2013 Sep;48(9):1027-32
Publication Type
Article
Date
Sep-2013
Author
Ragnar Befrits
Ola Wikman
Lars Blomquist
Henrik Hjortswang
Per Hammarlund
Antal Bajor
Daniel Klintman
Håkan Blom
Author Affiliation
Department of Gastroenterology and Hepatology, Karolinska University Hospital, 17176 Stockholm, Sweden. ragnar.befrits@karolinska.se
Source
Scand J Gastroenterol. 2013 Sep;48(9):1027-32
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Administration, Intravenous
Adolescent
Adult
Aged
Aged, 80 and over
Anemia - blood - diagnosis - drug therapy - etiology
Colitis, Ulcerative - complications
Crohn Disease - complications
Erythrocyte Indices
Female
Ferric Compounds - adverse effects - therapeutic use
Ferritins - blood
Guideline Adherence
Hematinics - adverse effects - therapeutic use
Hemoglobins - metabolism
Humans
Iron - deficiency
Male
Maltose - adverse effects - analogs & derivatives - therapeutic use
Middle Aged
Practice Guidelines as Topic
Prospective Studies
Quality of Life
Sweden
Transferrin - metabolism
Young Adult
Abstract
Iron deficiency and anemia are being increasingly recognized as a complication of inflammatory bowel disease (IBD). The aim of this study was to observe, in a non-interventional way, how Swedish gastroenterologists adhere to guidelines in IBD outpatients treated with intravenous ferric carboxymaltose (FCM), and the result of treatment.
Altogether 394 IBD patients (Crohn's disease (CD) 60%, ulcerative colitis (UC) 40%) from 14 centers were included. Group A (n = 216) was observed from November 2008 and group B (n = 178) from March 2010. Time of observation ranged from 12 to 29 months.
S-Ferritin (?mol/l) and transferrin saturation (T-Sat; %) were recorded at baseline in 62% and 50% in group A. Median values for Hb, ferritin and T-Sat at baseline were 111 g/l, 10 ?mol/l and10%, respectively, and 134 g/l, 121 ?mol/l and 20% after iron treatment (p
PubMed ID
23889159 View in PubMed
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Anemia in a population-based IBD cohort (ICURE): still high prevalence after 1 year, especially among pediatric patients.

https://arctichealth.org/en/permalink/ahliterature264655
Source
Inflamm Bowel Dis. 2014 Dec;20(12):2266-70
Publication Type
Article
Date
Dec-2014
Author
Daniel Sjöberg
Tommy Holmström
Märit Larsson
Anne-Lie Nielsen
Lars Holmquist
Anders Rönnblom
Source
Inflamm Bowel Dis. 2014 Dec;20(12):2266-70
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anemia - epidemiology - etiology
Child
Child, Preschool
Colitis, Ulcerative - complications - diagnosis - epidemiology
Crohn Disease - complications - diagnosis - epidemiology
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Middle Aged
Prevalence
Prognosis
Prospective Studies
Risk factors
Sweden - epidemiology
Young Adult
Abstract
Prevalence of anemia in patients with inflammatory bowel disease (IBD) is uncertain because of scarcity of population-based studies. The aim of this study was to evaluate prevalence of anemia in a population-based cohort of newly diagnosed patients with IBD to identify risk factors for anemia and to describe contemporary anemia-specific treatment during the first year.
All patients with ulcerative colitis or Crohn's disease in the IBD Cohort of Uppsala Region cohort (n = 790) and hemoglobin levels at the time of diagnosis were eligible for inclusion. The WHO definition of anemia was used.
Seven hundred forty-nine (95%) of the patients with IBD were included. Five hundred eighty of 749 (77%) patients had measured hemoglobin levels at 12-month follow-up. The prevalence of anemia at the time of diagnosis was 227/749 (30%). After 1 year, it was 102/580 (18%). Anemia was more common among newly diagnosed patients with Crohn's disease compared with ulcerative colitis (42% versus 24%, P
PubMed ID
25268635 View in PubMed
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Association between bowel symptoms, symptom severity, and quality of life in Swedish patients with fecal incontinence.

https://arctichealth.org/en/permalink/ahliterature141316
Source
Scand J Gastroenterol. 2011 Jan;46(1):6-12
Publication Type
Article
Date
Jan-2011
Author
Susanna Walter
Henrik Hjortswang
Katarina Holmgren
Olof Hallböök
Author Affiliation
Institution of Clinical and Experimental Medicine (IKE), Division of Gastroenterology, Linköping University, Sweden. Susanna.Walter@lio.se
Source
Scand J Gastroenterol. 2011 Jan;46(1):6-12
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Colitis, Ulcerative - complications
Fecal Incontinence - complications
Female
Humans
Middle Aged
Prospective Studies
Quality of Life
Questionnaires
Severity of Illness Index
Sweden
Abstract
The association between abdominal symptoms, disease severity of fecal incontinence (FI), and quality of life (QoL) is not yet clear. We hypothesized that it would become clearer by prospective diary data. We also aimed to compare QoL of FI patients with ulcerative colitis (UC) patients in relapse and remission.
Sixty-five consecutive female patients with FI recorded bowel symptoms prospectively on diary cards. QoL was evaluated with the disease specific short health scale questionnaire (SHS). Patients with UC in remission and relapse were used as a reference group regarding SHS.
FI patients had median 3.5 leakage episodes/week. In all, 48% of bowel movements were associated with urgency. Urgency was correlated to decreased QoL according to SHS domains: symptoms (Rho = 0.54, p = 0.0002), function (Rho = 0.48, p = 0.0008), and disease related worry (Rho = 0.32, p = 0.027). Abdominal pain and bloating, reported by nearly half of patients, correlated to deceased QoL but not to number of leakages. QoL of patients with FI compared to UC in active phase (n = 35) was similar. FI patients had decreased QoL compared to UC in remission (n = 94) in all dimensions of SHS: symptoms (p
PubMed ID
20735152 View in PubMed
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Association between psoriasis and inflammatory bowel disease: a Danish nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature285157
Source
Br J Dermatol. 2016 Sep;175(3):487-92
Publication Type
Article
Date
Sep-2016
Author
A. Egeberg
L. Mallbris
R B Warren
H. Bachelez
G H Gislason
P R Hansen
L. Skov
Source
Br J Dermatol. 2016 Sep;175(3):487-92
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Colitis, Ulcerative - complications - epidemiology
Crohn Disease - complications - epidemiology
Denmark - epidemiology
Epidemiologic Methods
Female
Humans
Male
Psoriasis - complications - epidemiology
Abstract
Psoriasis, Crohn disease (CD) and ulcerative colitis (UC) are chronic inflammatory disorders with overlapping genetic architecture. However, data on the frequency and risk of CD and UC in psoriasis are scarce and poorly understood.
To investigate the association between CD and UC in patients with psoriasis.
All Danish individuals aged = 18 years between 1 January 1997 and 31 December 2012 were linked in nationwide registers. Psoriasis severity was defined in two models: hospital visits and medication. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios (IRRs) were estimated by Poisson regression.
In the total cohort (n = 5 554 100) there were 75 209 incident cases of psoriasis, 11 309 incident cases of CD and 30 310 incident cases of UC, during follow-up. The adjusted IRRs (95% confidence intervals) of CD were 1·28 (1·03-1·59), 2·56 (1·87-3·50), 2·85 (1·72-4·73) and 3·42 (2·36-4·95) in patients with mild psoriasis, severe psoriasis (hospital), severe psoriasis (medication) and psoriatic arthritis, respectively. Similarly, the adjusted IRRs of UC were 1·49 (1·32-1·68), 1·56 (1·22-2·00), 1·96 (1·36-2·83) and 2·43 (1·86-3·17), respectively. The 10-year incidence of CD was 2-5 per 1000 patients and of UC 7-11 per 1000 patients, depending on psoriasis severity and the presence of psoriatic arthritis. Additionally, an increased risk of incident psoriasis was found following CD or UC.
We observed a psoriasis-associated increased risk of CD and UC, which was higher in severe psoriasis, and an increased risk of psoriasis in patients with inflammatory bowel disease. Increased focus on gastrointestinal symptoms in patients with psoriasis may be warranted.
PubMed ID
26959083 View in PubMed
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Autoimmunity and susceptibility to Hodgkin lymphoma: a population-based case-control study in Scandinavia.

https://arctichealth.org/en/permalink/ahliterature80588
Source
J Natl Cancer Inst. 2006 Sep 20;98(18):1321-30
Publication Type
Article
Date
Sep-20-2006
Author
Landgren Ola
Engels Eric A
Pfeiffer Ruth M
Gridley Gloria
Mellemkjaer Lene
Olsen Jørgen H
Kerstann Kimberly F
Wheeler William
Hemminki Kari
Linet Martha S
Goldin Lynn R
Author Affiliation
Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7236, USA. landgreo@mail.nih.gov
Source
J Natl Cancer Inst. 2006 Sep 20;98(18):1321-30
Date
Sep-20-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Arthritis, Rheumatoid - complications - epidemiology
Autoimmune Diseases - complications - epidemiology
Case-Control Studies
Colitis, Ulcerative - complications - epidemiology
Denmark - epidemiology
Disease Susceptibility
Female
Hodgkin Disease - epidemiology - immunology
Humans
Logistic Models
Lupus Erythematosus, Systemic - complications - epidemiology
Male
Middle Aged
Odds Ratio
Purpura, Thrombocytopenic, Idiopathic - complications - epidemiology
Registries
Risk assessment
Risk factors
Sarcoidosis - complications - epidemiology
Sweden - epidemiology
Abstract
BACKGROUND: Personal history of autoimmune diseases is consistently associated with increased risk of non-Hodgkin lymphoma. In contrast, there are limited data on risk of Hodgkin lymphoma following autoimmune diseases and almost no data addressing whether there is a familial association between the conditions. METHODS: Using population-based linked registry data from Sweden and Denmark, 32 separate autoimmune and related conditions were identified from hospital diagnoses in 7476 case subjects with Hodgkin lymphoma, 18,573 matched control subjects, and more than 86,000 first-degree relatives of case and control subjects. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) as measures of relative risks for each condition using logistic regression and also applied multivariable hierarchical regression models. All P values are two-sided. RESULTS: We found statistically significantly increased risks of Hodgkin lymphoma associated with personal histories of several autoimmune conditions, including rheumatoid arthritis (OR = 2.7, 95% CI = 1.9 to 4.0), systemic lupus erythematosus (OR = 5.8, 95% CI = 2.2 to 15.1), sarcoidosis (OR = 14.1, 95% CI = 5.4 to 36.8), and immune thrombocytopenic purpura (OR = infinity, P = .002). A statistically significant increase in risk of Hodgkin lymphoma was associated with family histories of sarcoidosis (OR = 1.8, 95% CI = 1.01 to 3.1) and ulcerative colitis (OR = 1.6, 95% CI = 1.02 to 2.6). CONCLUSIONS: Personal or family history of certain autoimmune conditions was strongly associated with increased risk of Hodgkin lymphoma. The association between both personal and family histories of sarcoidosis and a statistically significantly increased risk of Hodgkin lymphoma suggests shared susceptibility for these conditions.
PubMed ID
16985251 View in PubMed
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Benign anal lesions, inflammatory bowel disease and risk for high-risk human papillomavirus-positive and -negative anal carcinoma.

https://arctichealth.org/en/permalink/ahliterature21351
Source
Br J Cancer. 1998 Dec;78(11):1534-8
Publication Type
Article
Date
Dec-1998
Author
M. Frisch
B. Glimelius
A J van den Brule
J. Wohlfahrt
C J Meijer
J M Walboomers
H O Adami
M. Melbye
Author Affiliation
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen.
Source
Br J Cancer. 1998 Dec;78(11):1534-8
Date
Dec-1998
Language
English
Publication Type
Article
Keywords
Abscess - complications
Adult
Aged
Aged, 80 and over
Analysis of Variance
Anus Diseases - complications
Anus Neoplasms - epidemiology - etiology - virology
Carcinoma in Situ - epidemiology - etiology - virology
Carcinoma, Squamous Cell - epidemiology - etiology - virology
Case-Control Studies
Colitis, Ulcerative - complications
Crohn Disease - complications
Female
Fissure in Ano - complications
Humans
Inflammatory Bowel Diseases - complications
Male
Middle Aged
Papillomavirus, Human
Papovaviridae Infections - complications
Rectal Fistula - complications
Research Support, Non-U.S. Gov't
Sex Factors
Tumor Virus Infections - complications
Abstract
A central role in anal carcinogenesis of high-risk types of human papillomaviruses (hrHPV) was recently established, but the possible role of benign anal lesions has not been addressed in hrHPV-positive and -negative anal cancers. As part of a population-based case-control study in Denmark and Sweden, we interviewed 417 case patients (93 men and 324 women) diagnosed during the period 1991-94 with invasive or in situ anal cancer, 534 patients with adenocarcinoma of the rectum and 554 population controls. Anal cancer specimens (n = 388) were tested for HPV by the polymerase chain reaction. Excluding the 5 years immediately before diagnosis, men, but not women, with anal cancer reported a history of haemorrhoids [multivariate odds ratio (OR) 1.8; 95% confidence interval (CI) 1.04-3.2] and unspecific anal irritation (OR 4.5; CI 2.3-8.7) significantly more often than controls. Women with anal cancer did not report a history of benign anal lesions other than anal abscess to any greater extent than controls, but they had used anal suppositories more often (OR 1.5; CI 1.1-2.0). Patients with hrHPV in anal cancer tissue (84%) and those without (16%) reported similar histories of most benign anal lesions, but anal fissure or fistula was more common among hrHPV-positive cases. Ulcerative colitis and Crohn's disease, reported by
PubMed ID
9836490 View in PubMed
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Cancer in patients with ulcerative colitis.

https://arctichealth.org/en/permalink/ahliterature23346
Source
Int J Cancer. 1995 Jan 27;60(3):330-3
Publication Type
Article
Date
Jan-27-1995
Author
L. Mellemkjaer
J H Olsen
M. Frisch
C. Johansen
G. Gridley
J K McLaughlin
Author Affiliation
Danish Cancer Society, Division for Cancer Epidemiology, Copenhagen.
Source
Int J Cancer. 1995 Jan 27;60(3):330-3
Date
Jan-27-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Colitis, Ulcerative - complications
Colorectal Neoplasms - epidemiology - etiology
Denmark
Female
Follow-Up Studies
Humans
Liver Neoplasms - epidemiology - etiology
Male
Middle Aged
Registries
Research Support, U.S. Gov't, P.H.S.
Risk
Abstract
A cohort of 5,546 ulcerative colitis patients was identified from the Danish Hospital Discharge Register for 1977-1989. Patients not included in the cohort comprised those with proctitis, those treated in outpatient clinics and those for whom follow-up was less than 1 year. The cohort was linked to the Danish Cancer Registry in order to assess the risks for colorectal and other cancers. The linkage revealed a significant increase in the number of colorectal cancers over that in the general population (RR = 1.8; n = 42; 95% CI = 1.3-2.4) with consistent relative risks during early and late follow-up. The relative risk was considerably higher among younger (20-39 years: RR = 22; n = 8; 95% CI = 9.7-44) than older patients (> or = 60 years: RR = 1.3; n = 25; 95% CI = 0.8-1.9), but the risk difference between patients and the general population was approximately constant across all ages. In addition, we observed a significant increase in the relative risk of hepatobiliary cancers (RR = 2.3; n = 9; 95% = 1.0-4.3) and a slight but significant increase in the relative risk of non-melanoma skin cancer (RR = 1.4; n = 37; 95% CI = 1.0-1.9). In summary, our population-based study confirms the increased risk of colorectal cancer among patients with ulcerative colitis and provides new leads suggesting that hepatobiliary cancer and non-melanoma skin cancer should be considered as possible sites for future patient monitoring.
PubMed ID
7829239 View in PubMed
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Cancer risk in extensive ulcerative colitis.

https://arctichealth.org/en/permalink/ahliterature27519
Source
Ann Surg. 1978 Dec;188(6):824-8
Publication Type
Article
Date
Dec-1978
Author
J. Kewenter
H. Ahlman
L. Hultén
Source
Ann Surg. 1978 Dec;188(6):824-8
Date
Dec-1978
Language
English
Publication Type
Article
Keywords
Adult
Colitis, Ulcerative - complications - radiography
Colonic Neoplasms - etiology
Follow-Up Studies
Humans
Intestinal Neoplasms - etiology
Intestine, Large
Neoplasms, Multiple Primary - etiology
Rectal Neoplasms - etiology
Risk
Time Factors
Abstract
Two hundred thirty-four patients with extensive ulcerative colitis from the city of Göteborg, Sweden have been followed up and the cumulative risk of development of cancer of the large bowel was estimated. These patients constitute all persons in this region who developed an extensive ulcerative colitis between 1951 and 1974. All patients were followed up until December 1975. The mean observation time was 8.5 years, median value six years. Fifteen patients developed carcinoma of the large bowel. Five of the 15 patients were still alive in December 1975. The expected number of colorectal carcinomas in a matched reference group was 0.49. The cumulative incidence of carcinoma 25 years after the onset of colitis for the whole group of patients was 34% and for those who developed the disease before 25 years of age it was 43%.
PubMed ID
736660 View in PubMed
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91 records – page 1 of 10.