Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review.

BACKGROUND & AIMS: The incidence of inflammatory bowel disease (IBD) is increasing internationally, particularly in nations with historically low rates. Previous reports of the epidemiology of pediatric-onset IBD identified a paucity of data. We systematically reviewed the global trends in incidence and prevalence of IBD diagnosed in individuals <21 years old over the first 2 decades of the 21st century. METHODS: We systematically reviewed studies indexed in MEDLINE, EMBASE, Airiti Library, and SciELO from January 2010 to February 2020 to identify population-based studies reporting the incidence and/or prevalence of IBD, Crohn's disease, ulcerative colitis, and/or IBD-unclassified. Data from studies published before 2000 were derived from a previously published systematic review. We described the geographic distribution and trends in children of all ages and limiting to very early onset (VEO) IBD. RESULTS: A total of 131 studies from 48 countries were included. The incidence and prevalence of pediatric-onset IBD is highest in Northern Europe and North America and lowest in Southern Europe, Asia, and the Middle East. Among studies evaluating trends over time, most (31 of 37, 84%) studies reported significant increases in incidence and all (7 of 7) reported significant increases in prevalence. Data on the incidence and prevalence of VEO-IBD are limited to countries with historically high rates of IBD. Time trends in the incidence of VEO-IBD were visually heterogeneous. CONCLUSIONS: Rates of pediatric-onset IBD continue to rise around the world and data are emerging from regions where it was not previously reported; however, there remains a paucity of data on VEO-IBD and on pediatric IBD from developing and recently developed countries.

Parental coping with retinoblastoma diagnosis.

OBJECTIVE: To characterize coping and distress among parents of children with retinoblastoma, and to uncover their association with perceived health literacy, self-efficacy, and social support. METHODS: This was a cross-sectional study performed in the retinoblastoma clinics of Beijing Children's Hospital, Jilin Eye Hospital and Changchun Hospital in China. Parents of children with retinoblastoma (n = 104) completed a print Mandarin language questionnaire consisting of four sections: (i) demographic information, (ii) mini-mental adjustment to cancer scale, (iii) hospital anxiety and depression scale, and (iv) perceived health literacy, self-efficacy, and social support scales. Scores were tabulated for each measure and analyzed by bivariate correlation. RESULTS: Moderate anxiety affected 59.2% of parents, and 77.7% experienced low, moderate, or high levels of depression. Combined anxiety and depression was positively correlated with helplessness/hopelessness (R = 0.42, p < .01) and anxious preoccupation (R = 0.247, p < .05), and negatively correlated with perceived self-efficacy (R = -0.228, p < .05). Perceived social support from a partner was negatively correlated with depression (R = -0.207, p < .05) and helplessness/hopelessness (R = -0.271, p < .01). CONCLUSIONS: Knowledge of how parents cope with their child's cancer diagnosis can help healthcare teams understand how best to support their psychosocial needs.

Associations between occurrence of birth defects and hydraulic fracturing activities in Barnett shale region, Texas.

The impacts of hydraulic fracturing (HF) on birth defects have been suggested by previous studies but remain largely inconclusive. In this study, we assessed whether pregnant women who lived in areas with high HF activities had increased risks of giving birth to offspring with overall or specific birth defects, including atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), microcephaly (MIC), and hydrocephaly without spina bifida (HSB). All live births between 1999 and 2014 among the residents in the four core counties of Denton, Johnson, Tarrant, and Wise in the Barnett Shale region, Texas, were analyzed. Standardized Morbidity Ratio (SMR) and Poisson regressions were applied for statistical analysis. Compared to the statewide risk, the risks of ASD, VSD, and PDA in four selected counties with high HF activities were significantly higher. The Annual Natural Gas Production from HF was significantly correlated with risks of ASD, PDA, MIC, and total birth defect after adjusting for counties and years. No significant associations of HF activities were found with VSD and HSB. This ecological study suggested that hydraulic fracturing might be associated with the increased risk of some birth defects in the Barnett Shale Region, TX, which warrants further investigations due to the limitation of an ecological study design.