RESUMEN
Objective:To evaluate the relationship between inflammatory bowel disease (IBD) and diabetes mellitus.Methods:The database of PubMed, EMBASE and Cochrane were searched by computer, and the related studies on the relationship between IBD and diabetes were collected. The retrieval time was from the database establishment to November 2, 2019. The heterogeneity analysis was conducted by Cochran Q test and I2 value. The relative risk ( RR) and 95% confidence interval ( CI) were used as the research indexes to conduct Meta analysis. Sensitivity analysis and publication bias test were also carried out. Results:Twelve observational studies were included in the study, and 216 024 IBD patients were included. Meta analysis showed that there was a significant correlation between IBD and diabetes ( RR = 1.27, 95% CI 1.09 - 1.49), and the risk of diabetes in IBD patients was 1.27 times higher than that of the general population. The results of subgroup analysis showed that: compared with the general population, the risk of type 2 diabetes mellitus (T2DM) in patients with ulcerative colitis (UC) increased ( RR = 1.44, 95% CI 1.25 -1.66), while the risk of type 1 diabetes mellitus (T1DM) had no significant difference. Compared with the general population, the risk of T1DM and T2DM in patients with Crohn′s disease (CD) both increased (T1DM: RR = 1.34, 95% CI 1.05 - 1.71; T2DM: RR = 1.44, 95% CI 1.01 - 2.07). Conclusions:There is a relationship between IBD and diabetes mellitus, and the risk of diabetes is increased in IBD patients.
RESUMEN
Objective To improve the quality of the management of the elderly patients with cancer in Sichuan province,and to understand the attitudes and perspectives of elderly surgeons and oncologists for the management and treatment of elderly patients with cancer.Methods A face-toface questionnaire interview was conducted with oncologists (n 64) and geriatricians (n =64).128 physicians were involved in this study.Results The cancer management and therapeutics were deemed appropriate at present by 9.38％ (6/64)of the geriatricians and 25.00％ (16/64)of the oncologists.The 39.06％ (25/64) of geriatricians used to notice geriatric syndromes,while 81.25％ (52/64)of oncologists never concerned about the geriatric syndrome(P=0.011).As for the causes of the therapy-associated toxicity,oncologist versus geriatrician payed an attention to malnutrition (100.00％ vs.100.00％ in both groups),to mobility disorders(65.63％ vs.65.63％,84/128 in both groups),to cognitive impairment/mood disorder (89.06％ in geriatrician group vs.75.00％ in oncologist group,P=0.038).For the factors affecting treatment decisions,a physical ability attention (oncologists vs geriatricians:70.31％ vs.92.19％;P =0.002),and comorbidity (oncologists vs geriatricians:62.50％ vs.79.69％,P =0.032) had statistically significant difference.In addition,lack of geriatrics knowledge was also reported by more oncologists.However,one hundred percent of participants wanted very much to cooperate with each other in their clinical work.When responding to the clinical scenario,the 10.94％ (7/64)of geriatricians and 32.81％ (21/64)of oncologists chose modified treatment for 65-74 years old patient with cancer(P =0.003).When the age of the patients was 75-84 years old,only 12.50 ％ (8/64) of geriatricians prefer end-of-life care,while 31.25 ％ (20/64) of oncologists chose it (P =0.010).Conclusions Selection of treatment decisions in the elderly patients with cancer affect by ageing.Both oncologists and geriatricians are concerned with the elderly patients with cancer,ageing syndrome,total sickness and functional status.And these doctors support an establishment of a multi disciplinary team cooperation for the elderly patients with cancer.Therefore,the establishment of mutual cooperation between the two professionals is necessary and feasible.