Background: Esophageal cancer is the sixth leading cause of cancerrelated deaths and the eighth most common cancer worldwide with a 5-year survival rate of less than 25%. Here we report the incidence, risk factors and treatment options that are available currently, and moving into the future. Methods: We retrospectively analyzed the Surveillance Epidemiology and End Results (SEER) database made available by the National Cancer Institute in the USA. Specifically we extracted data from the years 2004-2015. Results: In total we identified 23,804 patients with esophageal adenocarcinoma and 13,919 patients with esophageal squamous cell carcinoma. Males were at an increased risk of developing both types of esophageal cancer when compared to females. Most cases of adenocarcinoma were diagnosed as poorly differentiated grade III (42%), and most cases of squamous cell carcinoma were diagnosed as moderately differentiated grade II (39.5%). The most common stage of presentation for both adenocarcinoma (36.9%) and squamous cell (26.8%) carcinoma was stage IV. The worst outcomes for adenocarcinoma were noted with grade III tumors (hazard ratio
Esophagitis dissecans superficialis (EDS) is a rare and underdiagnosed esophageal lesion characterized by sloughing of the esophageal mucosa that has been associated with medications, various autoimmune disorders, and exposure to some chemical irritants. Anatomically, EDS is most commonly seen in the middle and distal thirds of the esophagus. When present, EDS is best treated by discontinuing the offending agent and initiating pharmacologic therapy with proton pump inhibitors. Steroids may also be effective if the etiology is autoimmune in nature. Our case highlights a 65-year-old female diagnosed with EDS after incidental ingestion of hair dye containing resorcinol and para-phenylenediamine (PPD).
Background:
The “remission theory” is an emerging concept that suggests that the presence of human immunodeficiency virus (HIV) results in decreased disease severity in patients with inflammatory bowel disease. This theory is based upon evidence that implicates CD4 T-lymphocytes in the pathogenesis of both Crohn’s disease and ulcerative colitis. This study sought to elucidate the legitimacy of this theory.
Methods:
A retrospective cohort analysis of all adult in-patient hospitalizations for inflammatory bowel disease (IBD) using the 2016 National Inpatient Sample (NIS) was conducted. Our study population included patients admitted with IBD who were infected with HIV. We compared our study group to patients who also had IBD but were not infected with HIV. Baseline demographic characteristics, resource utilization, and in-hospital mortality rates were extracted for both groups.
Results:
A total of 58,979 patients were admitted for IBD in 2016. Of those patients, we identified 145 who also had HIV. We found that patients with ulcerative colitis and HIV had a shorter length of hospital stay (4.1 vs 5.9 days; p-value <0.01), lower hospital charge ($35,716 vs $52,893; p-value <0.01), and lower hospital cost ($7,814 vs $13,395; p-value <0.01) than those who did not have HIV. In patients with Crohn’s disease, the presence of HIV resulted in decreased colonoscopy rates (0% vs 17.4%; p-value <0.01); however, the rate of esophagogastroduodenoscopies was not statistically significant (7.1% vs 14.7%; p-value 0.106).
Conclusion:
In this retrospective population-based study, we found that patients with ulcerative colitis and concurrent HIV had a milder course of the disease compared to ulcerative colitis patients who were not infected with HIV. These findings support the remission theory in that HIV may play a role in inflammatory bowel disease.
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