Manifestations of inflammatory bowel disease in patients of Haitian and Cape Verdean descent.

OBJECTIVE: Several studies have reported unique ethnic phenotypes of inflammatory bowel disease (IBD). An appreciation of disease manifestations in different populations may improve clinical outcomes. There are no studies examining IBD in patients of Haitian or Cape Verdean descent. We sought to define the IBD phenotype in these populations. MATERIALS AND METHODS: This was a retrospective review comparing Haitian and Cape Verdean immigrant IBD patients to Caucasians, all receiving care at Boston Medical Center in Boston, Massachusetts, USA. The following variables were analyzed: family history, smoking history, vaccinations/cancer screening, age of diagnosis, disease duration, disease location, medication use, and complications. RESULTS: Thirty-one Haitians and 21 Cape Verdeans were matched to Caucasian controls. Haitians (mean age 42 years) and Cape Verdeans (mean age 47 years) with Crohn's disease were diagnosed with IBD later than Caucasians (mean age 31 years, p = 0.04 and 0.02, respectively). Haitians with Crohn's were less likely to have a history of tobacco use compared to Caucasians (13% vs. 51%, p = 0.02). Cape Verdeans with Crohn's were less likely to have perianal involvement (0% vs. 50%, p = 0.01). Haitians with IBD were less likely to have ever used glucocorticoids (48% vs. 76%, p = 0.02). There was no difference in vaccination rates, cancer screening, or disease complications. CONCLUSIONS: This study demonstrates differences in IBD presentation and disease course among Haitians and Cape Verdeans. Our results suggest a more mild disease in these ethnic groups. Future studies are needed to identify the influence of environmental factors.

Terminology in coloproctology.

On the matter of the terminology used for large intestine, its sections and different pathologies, a general observation would be that there is a quantity of different sections, words and interchanges that in the end cause some distress in the medical community. The correct terminology assists in the understanding between doctors, some terms, though are standard and unchangeable. Some of those terms are somewhat false but can always be used in a better way. When the relevant knowledge exists, then cooperation between doctors is easier and could help in avoiding mistakes in the future.

Banco de dados em coloproctologia: proposta de classificaçäo de doenças e operaçöes colorretais para estudos clínicos / Databases in coloproctology: proposal of classification of diseases and colorectal surgeries for clinical studies

A ampla disseminaçäo no uso de computadores pessoais tornou mais fácil a criaçäo de bancos de dados na prática médica, visando manter análises periódicas das atividades clínicas. Um passo importante na criaçäo de um banco de dados é o uso de classificaçäo numérica dos dados para simplificar a inserçäo de informaçöes e reduzir erros na recuperaçäo dos mesmos devido a diferenças ortográficas ou nomenclatura médica. Os autores näo tem conhecimento de uma classificaçäo específica que tenha sido publicada para uso em Coloproctologia. Visando facilitar a realizaçäo do banco de dados do Serviço de Coloproctologia do Hospital Säo José, Joinville, foi elaborada uma classificaçäo de doenças e operaçöes em cirurgia colorretal que tem sido utilizada com sucesso em um banco de dados incluindo mais de 2.000 pacientes consecutivos e 600 operaçöes. Acreditamos que a definiçäo de uma classificaçäo simples é única de doenças e procedimentos em cirurgia colorretal possa contribuir para a criaçäo de bancos de dados compatíveis em diferentes centros, com benefícios na análise comparativa dos dados