Disproportionately Increasing Incidence of Inflammatory Bowel Disease in Female Patients and the Elderly: An Update Analysis from the Global Burden of Disease Study 2021
INTRODUCTION: To update the global burden of inflammatory bowel disease (IBD) using data from the Global Burden of Disease 2021. METHODS: Data from Global Burden of Disease 2021 were analyzed to assess the IBD burden. RESULTS: In 2021, there were 375,140 new cases and 3.83 million total cases of IBD. Elderly onset IBD accounted for 11% of incidences. 167 countries increased IBD incidence rate, with rates rising in female patients (APC: +0.06%) and the elderly (APC: +0.14%) but stable in male patients and the overall population. DISCUSSION: Although the global burden of IBD has decreased overall, it has increased in female patients and the elderly.
Meta-analysis comparing the effects of statins on the risk ofClostridium difficilediarrhea
Background and AimCurrently available staging systems for cholangiocarcinoma (CCA) are not applicable to patients with unresectable stage. A new clinical staging system for perihilar CCA (pCCA) subtype has been recently developed in a US cohort, with a good performance in predicting survival of all pCCA patients. We aimed to determine outcomes of pCCA patients and evaluate predictive performance of this staging system in an Asian population.MethodsAll 141 patients diagnosed with pCCA between 2003 and 2012 were identified. Clinical information was retrospectively abstracted. Patients were classified into four stages based on the new staging system. Survival predictors were analyzed using the Cox proportional hazard analysis.ResultsOf the 141 pCCA patients, 38 (27%), 101 (72%), and 2 (1%) received resection, palliative biliary drainage ± chemotherapy, and best supportive care, respectively. Survival predictors included resectable disease, tumor size, distant metastasis, and cancer antigen 19‐9 ≥ 1000 U/mL. When classified by clinical stages, 13, 4, 99, and 25 patients were in stages I, II, III, and IV, with median survivals of 18.4, 7.3, 6.3, and 2.6 months; and hazard ratio (95% confidence interval) of 1.0 (reference), 1.7 (0.5–5.5), 3.2 (1.5–6.7), and 10.8 (4.6–25.0), respectively.ConclusionThe clinical staging system has a limited performance in differentiating stage II pCCA patients from stage III patients in the Thai cohort. This can be due to differences in patient characteristics and treatment modalities between the Asian and White pCCA populations. However, the median survivals of patients with other stages are significantly different.