RESUMEN
INTRODUCTION: There are limited data on the familial risk of distal eosinophilic gastrointestinal diseases (EGIDs) in patients with eosinophilic esophagitis (EoE). We analyzed the risk of eosinophilic gastritis/gastroenteritis (EG/EGE) and eosinophilic colitis (EC) as forms of distal EGIDs using International Disease Classification-9/10 codes in subjects with EoE and their relatives. METHODS: The Utah Population Database is a resource that links genealogy information and medical records in Utah. We identified EGIDs in probands and their first-degree (FDRs), second-degree (SDRs), and third-degree (TDRs) relatives in the Utah Population Database. Relative risk and 95% confidence intervals were estimated. All individuals with inflammatory bowel disorder were eliminated to avoid misdiagnosis with EGIDs. RESULTS: We included 8,455 subjects with EoE, 396 with EG/EGE, and 172 with EC. Probands with EoE were at increased risk of EG/EGE and EC. Risks of EG/EGE were increased among FDRs and SDRs of probands with EoE , even without concomitant EoE in the relatives. Increased risk of EG/EGE in FDRs and SDRs was also present for EoE probands without EG/EGE or EC. We observed no isolated familial aggregation of EG/EGE after excluding cases with comorbid EoE. EC probands without EoE were at increased risk of EG/EGE, but no evidence of familial risk of EC was observed. DISCUSSION: The relative risk of EG/EGE is significant among relatives of patients with EoE, suggesting that shared genetic factors exist among these EGIDs. EG/EGE and EC showed limited familial clustering, although sample sizes were small.
Asunto(s)
Colitis Microscópica , Enteritis , Esofagitis Eosinofílica , Gastritis , Gastroenteritis , Humanos , Esofagitis Eosinofílica/epidemiología , Esofagitis Eosinofílica/diagnóstico , Predisposición Genética a la Enfermedad , Enteritis/epidemiología , Enteritis/diagnóstico , Gastritis/diagnóstico , Gastroenteritis/complicacionesAsunto(s)
Colestasis/cirugía , Enfermedad Hepática en Estado Terminal/cirugía , Ictericia Obstructiva/cirugía , Cirrosis Hepática Alcohólica/cirugía , Trasplante de Hígado , Complicaciones Posoperatorias/cirugía , Stents , Suturas/efectos adversos , Anastomosis Quirúrgica , Colestasis/diagnóstico , Colestasis/etiología , Constricción Patológica/diagnóstico , Constricción Patológica/etiología , Constricción Patológica/cirugía , Endoscopía del Sistema Digestivo , Humanos , Ictericia Obstructiva/diagnóstico , Ictericia Obstructiva/etiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiologíaAsunto(s)
Colecistectomía Laparoscópica , Cálculos Biliares/diagnóstico por imagen , Síndrome de Mirizzi/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Femenino , Cálculos Biliares/cirugía , Humanos , Síndrome de Mirizzi/cirugía , Complicaciones Posoperatorias/cirugía , StentsRESUMEN
This is a case report of endoscopic ultrasound guided transmural drainage of a large infected pancreatic necrosis. The infected necrosis was treated by placement of a fully covered metal stent with subsequent endoscopic necrosectomy to remove solid debris. The case is notable for the fact that the patient developed infection of a long-standing and previously stable area of walled-off pancreatic necrosis 2 years after it formed. We believe this is the longest time ever reported between necrotizing pancreatitis and the development of infected pancreatic necrosis.
Asunto(s)
Educación en Salud/organización & administración , Conocimientos, Actitudes y Práctica en Salud , Autoexamen , Neoplasias Cutáneas/prevención & control , Detección Precoz del Cáncer , Femenino , Humanos , Masculino , Educación del Paciente como Asunto/organización & administración , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Medición de Riesgo , Estados UnidosRESUMEN
PURPOSE: To compare the incidence, progression, and duration of retinopathy of prematurity (ROP) in low-birth-weight Hispanic and white non-Hispanic infants. METHODS: A total of 671 white non-Hispanic infants and 128 Hispanic infants with birth weights less than 1751 g were retrospectively evaluated to determine the incidence of both ROP and subthreshold or worse ROP. Multiple regression analysis was used to control for birth weight, gestational age at birth, year of birth, and newborn intensive care unit as contributing factors in the risk of ROP. The duration of ROP in untreated infants was calculated and compared for the two ethnic groups. RESULTS: There was no significant difference in the percentage of infants with ROP in the white non-Hispanic group (38.3%) versus the Hispanic group (41.4%). There was also no significant difference between white non-Hispanics (11.8%) and Hispanics (15.6%) in the risk of developing subthreshold or worse ROP. Multiple regression analysis showed no contribution of ethnicity to the risk of developing ROP (t = -0.34, p = 0.74) or subthreshold or worse ROP (t = 0.75, p = 0.45). The average duration of untreated ROP in white non-Hispanics (8.6 +/- 5.4 weeks) and Hispanics (8.9 +/- 7.0 weeks) also was not significantly different. However, Hispanic infants showed significantly higher variance in duration than white non-Hispanic infants (p = 0.04). CONCLUSIONS: ROP occurs with similar frequency in Hispanic and white non-Hispanic premature infants, as does subthreshold or worse ROP. Some Hispanic infants had an unusually short or long duration of ROP before regression, implying that the natural history of ROP may be somewhat different for the two ethnic groups.