Incidence, clinical characteristics and management of inflammatory bowel disease in Spain: large-scale epidemiological study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD—Crohn’s disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)—during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100, 000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31–56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Coarse particulate air pollution and daily mortality a global study in 205 cities

Please read abstract in the article.The National Natural Science Foundation of China; the Ministry of Science and Technology, Taiwan; the Medical Research Council-UK; Fundação para a Ciência e a Tecnologia; the Australian Research Council the European Union’s Horizon 2020 Project Exhaustion ; the Natural Environment Research Council UK; the Australian National Health and Medical Research Council; and an Emerging Leader Fellowship of the Australian National Health and Medical Research Council.http://www.atsjournals.org/journal/ajrccm2023-06-07hj2023Geography, Geoinformatics and Meteorolog

Short-term association between air temperature and mortality in seven cities in Norway: A time series analysis.

BACKGROUND The association between ambient air temperature and mortality has not been assessed in Norway. This study aimed to quantify for seven Norwegian cities (Oslo, Bergen, Stavanger, Drammen, Fredrikstad, Trondheim and Tromsø) the non-accidental, cardiovascular and respiratory diseases mortality burden due to non-optimal ambient temperatures. METHODS We used a historical daily dataset (1996-2018) to perform city-specific analyses with a distributed lag non-linear model with 14 days of lag, and pooled results in a multivariate meta-regression. We calculated attributable deaths for heat and cold, defined as days with temperatures above and below the city-specific optimum temperature. We further divided temperatures into moderate and extreme using cut-offs at the 1st and 99th percentiles. RESULTS We observed that 5.3% (95% confidence interval (CI) 2.0-8.3) of the non-accidental related deaths, 11.8% (95% CI 6.4-16.4) of the cardiovascular and 5.9% (95% CI -4.0 to 14.3) of the respiratory were attributable to non-optimal temperatures. Notable variations were found between cities and subgroups stratified by sex and age. The mortality burden related to cold dominated in all three health outcomes (5.1%, 2.0-8.1, 11.4%, 6.0-15.4, and 5.1%, -5.5 to 13.8 respectively). Heat had a more pronounced effect on the burden of respiratory deaths (0.9%, 0.2-1.0). Extreme cold accounted for 0.2% of non-accidental deaths and 0.3% of cardiovascular and respiratory deaths, while extreme heat contributed to 0.2% of non-accidental and to 0.3% of respiratory deaths. CONCLUSIONS Most of the burden could be attributed to the contribution of moderate cold. This evidence has significant implications for enhancing public-health policies to better address health consequences in the Norwegian setting

sj-docx-1-sjp-10.1177_14034948241233359 – Supplemental material for Short-term association between air temperature and mortality in seven cities in Norway: A time series analysis

Supplemental material, sj-docx-1-sjp-10.1177_14034948241233359 for Short-term association between air temperature and mortality in seven cities in Norway: A time series analysis by Liliana Vázquez Fernández, Alfonso Diz-Lois Palomares, Ana M. Vicedo Cabrera, Birgitte Freiesleben De Blasio, Francesco Di Ruscio, Torbjørn Wisløff and Shilpa Rao in Scandinavian Journal of Public Health</p

Long-Term Safety of In Utero Exposure to Anti-TNF\u3b1 Drugs for the Treatment of Infl ammatory Bowel Disease: Results from the Multicenter European TEDDY Study

OBJECTIVES: The long-term safety of exposure to anti-tumor necrosis factor (anti-TNF) drugs during pregnancy has received little attention. We aimed to compare the relative risk of severe infections in children of mothers with infl ammatory bowel disease (IBD) who were exposed to anti-TNF drugs in utero with that of children who were not exposed to the drugs. METHODS: Retrospective multicenter cohort study. Exposed cohort: children from mothers with IBD receiving anti-TNF medication (with or without thiopurines) at any time during pregnancy or during the 3 months before conception. Non-exposed cohort: children from mothers with IBD not treated with anti-TNF agents or thiopurines at any time during pregnancy or the 3 months before conception.The cumulative incidence of severe infections after birth was estimated using Kaplan\u2013Meier curves, which were compared using the log-rank test. Cox-regression analysis was performed to identify potential predictive factors for severe infections in the offspring. RESULTS: The study population comprised 841 children, of whom 388 (46%) had been exposed to anti-TNF agents. Median follow-up after delivery was 47 months in the exposed group and 68 months in the non-exposed group. Both univariate and multivariate analysis showed the incidence rate of severe infections to be similar in non-exposed and exposed children (1.6% vs. 2.8% per person-year, hazard ratio 1.2 (95% confi dence interval 0.8\u20131.8)). In the multivariate analysis, preterm delivery was the only variable associated with a higher risk of severe infection (2.5% (1.5\u20134.3). CONCLUSIONS: In utero exposure to anti-TNF drugs does not seem to be associated with increased short-term or long-term risk of severe infections in children

Coarse particulate air pollution and daily mortality:a global study in 205 cities

Abstract Rationale: The associations between ambient coarse particulate matter (PM2.5–10) and daily mortality are not fully understood on a global scale. Objectives: To evaluate the short-term associations between PM2.5–10 and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide. Methods: We collected daily mortality (total, cardiovascular, and respiratory) and air pollution data from 205 cities in 20 countries/regions. Concentrations of PM2.5–10 were computed as the difference between inhalable and fine PM. A two-stage time-series analytic approach was applied, with overdispersed generalized linear models and multilevel meta-analysis. We fitted two-pollutant models to test the independent effect of PM2.5–10 from copollutants (fine PM, nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide). Exposure–response relationship curves were pooled, and regional analyses were conducted. Measurements and Main Results: A 10 μg/m³ increase in PM2.5–10 concentration on lag 0–1 day was associated with increments of 0.51% (95% confidence interval [CI], 0.18%–0.84%), 0.43% (95% CI, 0.15%–0.71%), and 0.41% (95% CI, 0.06%–0.77%) in total, cardiovascular, and respiratory mortality, respectively. The associations varied by country and region. These associations were robust to adjustment by all copollutants in two-pollutant models, especially for PM2.5. The exposure–response curves for total, cardiovascular, and respiratory mortality were positive, with steeper slopes at lower exposure ranges and without discernible thresholds. Conclusions: This study provides novel global evidence on the robust and independent associations between short-term exposure to ambient PM2.5–10 and total, cardiovascular, and respiratory mortality, suggesting the need to establish a unique guideline or regulatory limit for daily concentrations of PM2.5–10