Association Between Thiopurine Use And Nonmelanoma Skin Cancers In Patients With Inflammatory Bowel Disease: A Meta-analysis

‘TOWIE’ Star Sam Faiers Reportedly Diagnosed With Crohn’s Disease After ‘Celebrity Big Brother’ Mystery Illness

sam faiers

E-mail: v.subramanian@leeds.ac.uk Received 13March2013; Accepted 5November2013 Advance online publication 14January2014 OBJECTIVES: Thiopurines are the mainstay of treatment for patients with inflammatory bowel disease (IBD). Thiopurine therapy increases the risk of nonmelanoma skin cancers (NMSCs) in organ transplant patients. The data on NMSC in patients with IBD on thiopurines is conflicting. METHODS: We searched electronic databases for full journal articles reporting on the risk of developing NMSC in patients with IBD on thiopurine and hand searched the reference lists of all retrieved articles. Pooled adjusted hazard ratios and 95% confidence intervals (CIs) were determined using a random-effects model. Publication bias was assessed using Funnel plots and Egger’s test. Heterogeneity was assessed using Cochran’s Q and the I2 statistic. RESULTS: Eight studies involving 60,351 patients provided data on the risk of developing NMSC in patients with IBD on thiopurines. The pooled adjusted hazards ratio of developing NMSC after exposure to thiopurines in patients with IBD was 2.28 (95% CI: 1.50 to 3.45). There was significant heterogeneity (I2=76%) between the studies but no evidence of publication bias. Meta regression analysis suggested that the population studied (hospital-based vs. population-based) and duration of follow-up contributed significantly to heterogeneity. Grouping studies based on population studied and duration showed higher hazard rations in hospital-based and shorter duration studies. CONCLUSIONS: The risk of developing NMSC in patients with IBD on thiopurines is only modestly elevated. The difference in pooled risk between population-based and hospital-based studies suggests the possibility that ascertainment bias could have contributed to this increased risk.

go to this web-site http://www.nature.com/ajg/journal/vaop/ncurrent/abs/ajg2013451a.html

Locum Consultant Gastroenterologist, N.Ireland

The call comes after a UK-wide audit from the society revealed that nearly half of UK hospitals do not provide an out-of-hours endoscopy service, despite 60% of acute upper gastrointestinal bleeding episodes occurring out of normal working hours. According to the British Society of Gastroenterology (BSG), more than 700 lives could be saved each year if all hospitals offered a 24-hour service. Addressing a meeting at Number 11, Downing Street yesterday to raise awareness of gastroenterological conditions, BSG president, professor Chris Hawkey, said: Our audit has shown that about 80,000 patients a year are admitted with gastrointestinal bleeding, which has an 8% mortality rate. Yet only 55% of trusts at the moment provide a comprehensive out-of-hours GI bleeding service we need to get this to 100%, he added. The BSG is also calling for six new standards of care for patients with inflammatory bowel disease to be implemented by all UK commissioners by October 2010. Readers’ comments (1) Anonymous | 26-Jun-2009 8:24 pm The B.S.G. is correct in calling for a 24/7 service. In my experience, during almost 20 years of endoscopy nursing, most bleeds and other emergencies occurred outside of the normal working day. The equipment is available and I believe that the service should be funded. Patients deserve prompt effective diagnosis and treatment.

look what i found http://www.nursingtimes.net/nursing-practice/clinical-zones/gastroenterology/gastroenterology-experts-call-for-24-hour-service-in-all-uk-hospitals/5003247.article

Gastroenterology experts call for 24-hour service in all UK hospitals

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They report the 23-year-old has lost a stone and a half since her appearance on ‘CBB’ in January. Sam Faiers A source told The Mirror: She is suffering from lots of ulcers, so she needs to give them time to heal before she looks at the long term effects of diagnosis. At the moment, she is just trying to cope with the excruciating stomach cramps. That has been the most difficult thing. Now, she is working with her gastroenterologist to see if she can work around her illness. Sam wont let things hold her back, shes dealing with it in the best way she can. She knows she cant change anything, but she can educate herself about the disease. Crohn’s disease is a long-term condition involving inflammation of the lining of the digestive system and can sometimes require surgery. A spokeswoman for Sam said: I can confirm Sam has very recently been diagnosed with Crohns Disease. During her time in ‘Celebrity Big Brother’ Sam was escorted from the house to hospital. A representative for Sam told Digital Spy: “Sam left the house yesterday morning to attend an appointment with a consultant for an ongoing medical concern. Sam Faiers

breaking news http://www.huffingtonpost.co.uk/2014/02/20/sam-faiers-crohns-disease_n_4824012.html

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