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Tytuł:
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Microscopic colitis in Denmark and Sweden: incidence, putative risk factors, histological assessment and endoscopic activity.
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Autorzy:
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Davidson S; a Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.; b Department of Clinical Sciences Malmö , Lund University , Lund, Sweden.; c Department of Gastroenterology and Nutrition , Skåne University Hospital , Malmö , Sweden.
Sjöberg K; b Department of Clinical Sciences Malmö , Lund University , Lund, Sweden.; c Department of Gastroenterology and Nutrition , Skåne University Hospital , Malmö , Sweden.
Engel PJH; a Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.; d Department of Pathology , Zealand University Hospital , Roskilde , Denmark.
Lo Rinc E; e Department of Pathology , Skåne University Hospital , Lund , Sweden.
Fiehn AK; a Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.; f Department of Pathology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.
Vigren L; b Department of Clinical Sciences Malmö , Lund University , Lund, Sweden.; c Department of Gastroenterology and Nutrition , Skåne University Hospital , Malmö , Sweden.
Munck LK; a Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.; g Department of Medicine , Zealand University Hospital , Køge , Denmark.
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Źródło:
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Scandinavian journal of gastroenterology [Scand J Gastroenterol] 2018 Jun - Jul; Vol. 53 (7), pp. 818-824. Date of Electronic Publication: 2018 May 31.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: London : Informa Healthcare
Original Publication: Oslo : Universitetsforlager
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MeSH Terms:
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Colitis, Microscopic/*diagnosis
Colitis, Microscopic/*drug therapy
Colitis, Microscopic/*epidemiology
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Biopsy ; Denmark/epidemiology ; Drug Prescriptions ; Endoscopy ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Proton Pump Inhibitors/therapeutic use ; Risk Factors ; Selective Serotonin Reuptake Inhibitors/therapeutic use ; Sex Distribution ; Sweden/epidemiology ; Young Adult
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Contributed Indexing:
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Keywords: Microscopic colitis; endoscopy; epidemiology; pathology
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Substance Nomenclature:
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0 (Anti-Inflammatory Agents, Non-Steroidal)
0 (Proton Pump Inhibitors)
0 (Serotonin Uptake Inhibitors)
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Entry Date(s):
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Date Created: 20180602 Date Completed: 20181106 Latest Revision: 20221207
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Update Code:
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20240105
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DOI:
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10.1080/00365521.2018.1476583
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PMID:
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29852792
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Objective: The significantly higher incidence rates of microscopic colitis (MC) in Denmark compared to Sweden remains unexplained.
Methods: Consecutive patients with newly diagnosed MC in the neighbouring regions of Skåne in 2011-2015 and Zealand in 2010-2016 were prospectively identified. Data on large bowel endoscopies and biopsies rates were retrieved. Information on putative factors were obtained from registers and literature. Interobserver agreement between pathologists from both regions on 40 blinded hematoxylin and eosin (H&E)-stained colon biopsies (collagenous colitis (CC), lymphocytic colitis (LC), non-specific inflammation and normal) was evaluated using kappa statistics.
Results: The mean annual incidence per 10 5 inhabitants in Skåne and Zealand 2010-2015 was 5.9 (95% CI 4.6-7.3) versus 16.4 (95% confidence intervals (95% CI) 13.6-19.2) for CC and 2.7 (95% CI 1.0-4.3) versus 11.1 (95% CI 8.8-13.4) for LC, respectively. Number of endoscopies with biopsy per 1000 and the rate of MC per endoscopy with biopsy was higher in Zealand (34-52/1000) than in Skåne (12-21/1000). The kappa value for overall agreement between pathologists was good (0.72; 95% CI 0.64-0.79). Prescription of proton pump inhibitors and selective serotonin reuptake inhibitors was higher in Skåne in the relevant age groups and prescription of non-steroidal anti-inflammatory drugs and smoking rate higher in Zealand. Alcohol consumption was higher in Denmark than in Sweden.
Conclusion: The incidence of MC and number of cases per colonic biopsy was higher in Zealand and could not be readily explained by endoscopy or biopsy rates, differences in histological assessment or putative risk factors.
