Risk of inflammatory bowel disease in patients with chronic obstructive pulmonary disease: A nationwide, population-based study

BACKGROUND There is a growing evidence regarding an increased risk of inflammatory bowel disease(IBD)among patients with airway diseases.AIM To investigate the influence of chronic obstructive pulmonary disease(COPD)on the risk of IBD.METHODS A nationwide,population-based study was conducted using data from the National Health Insurance Service database.A total of 1303021 patients with COPD and 6515105 non-COPD controls were identified.The COPD group was divided into the severe and the mild COPD group according to diagnostic criteria.The risk of IBD in patients with COPD compared to controls was analyzed by Cox proportional hazard regression models.The cumulative incidences of IBD were compared between the groups.RESULTS The COPD group had higher incidences of IBD compared to non-COPD controls(incidence rate,9.98 vs 7.18 per 100000 person-years,P<0.001).The risk of IBD in the COPD group was increased by 1.38(adjusted hazard ratio(HR);95%CI:1.25-1.52).The incidence rate of IBD was higher in the severe COPD group than in the mild COPD group(12.39 vs 9.77 per 100000 person-year,P<0.001).The severity of COPD was associated with an increased risk of IBD(adjusted HR 1.70 in severe COPD,95%CI:1.27-2.21 and adjusted HR 1.35 in mild COPD,95%CI:1.22-1.49)CONCLUSION The incidences of IBD were significantly increased in COPD patients in South Korea and the risk of developing IBD also increased as the severity of COPD increased.

Prevalence of clonorchiasis in patients with gastrointestinal disease: A Korean nationwide multicenter survey

AIM: To investigate prevalence of Clonorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea.METHODS: Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire.RESULTS: Of 3080 patients with gastrointestinal diseases, 396 (12.9%) had clonorchiasis and 1140 patients (37.2%) had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 (20.9%) patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than non-infected patients [34/396 (8.6%) vs 145/2684 (5.4%), P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation (P = 0.008). Choledocholithiasis, cholecystolithiasis, cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis.CONCLUSION: Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite.

Severe Sinus Bradycardia in Anorexia Nervosa-A Case Report

A case of anorexia nervosa complicated with severe sinus bradycardia and low T3 syndrome was reported.

Cyanocobalamin and 25-Hydroxy Vitamin D Levels in Gout Patients: An Overlooked Issue

Gout is one of the most frequent type of inflammatory arthritis in developed countries. The elevation of serum uric acid levels and the deposition of monosodium urate crystals in joints and/or soft tissues are the mechanisms of pathogenesis. Uric acid is a product of the metabolic cleavage of purine nucleotides and organ meats, beef, pork, and lamb, anchovies, sardines, herring, mackerel, scallops, gravy and beer are known to be very rich in purine. On the other hand, some of these foods are also the main sources of vitamin B12 (cyanocobalamin). As a chronic inflammatory arthritis corticosteroids are frequently prescribed for gout patients, meaning a higher risk for osteoporosis which may be blocked by daily calcium and vitamin D replacement. However, there are no recommendations about screening or replacement of Gout patients for vitamin D and B12. Herein, we evaluated our patients retrospectively to document their vitamin levels and also to find the factors associated with vitamin deficiency. Totally, 90 patients, 71 (79.9%) male and 19 (20.1%) female patients with a median diagnostic age of 55 (19 - 80) were included. Thirty six (40%) patients were newly diagnosed (group 1) but 54 (60%) patients had established diseases (group-2) with median disease duration of 36 (11-240) months. Nearly half (47.2%) of the patients in group-1 and 37% of the patients in group-2 had vitamin B 12 deficiency. Similarly, 38.9% in each group had vitamin D deficiency and 52.8% in group-1 and 44.4% in group-2 had vitamin D insufficiency. In conclusion, we strongly recommend routine screening and replacement of vitamin B12 and D for patients with Gout.