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Epidemiology of inflammatory bowel disease in South America: A systematic review

World Journal of Gastroenterology 2019年第47期25卷 6866-6875页

作者： sriharan selvaratnam Santiago Gullino Lisa Shim Eric Lee Alice Lee Sudarshan Paramsothy Rupert W Leong Department of Gastroenterology and Hepatology Macquarie University Hospital

BACKGROUND The worldwide epidemiology of inflammatory bowel disease(IBD)is rapidly changing.Increasing Crohn’s disease(CD)and ulcerative colitis(UC)incidence and prevalence have been recorded in developing regions such as Asia,Africa and Eastern Europe where it was previously thought to be uncommon.Whether this is also the case in South America is not well known.Demonstration that developing regions worldwide have increasing IBD incidence would indicate that environmental change plays a significant role in the development of IBD.AIM To report the incidence,prevalence and disease characteristics of CD and UC within the South American continent.METHODS A systematic review was conducted by searching published studies in major international and regional databases(MEDLINE,EMBASE and Scopus)between January 1990 and December 2018.Outcomes considered were incidence,prevalence,phenotype,environmental and genetic factors,ethnicity and gender.A pair of independent reviewers screened and reviewed all identified articles.RESULTS One hundred and sixty two citations were initially retrieved with 18 studies included in this systematic review.The majority of included studies were from Brazil(n=13,72%).The incidence of UC ranged from 4.3-5.3/100000 personyears whilst the incidence of CD ranged from 0.74-3.5/100000 person-years.Prevalence ranged from 15.0-24.1/100000 inhabitants for UC and from 2.4-14.1/100000 inhabitants for CD.The incidence and prevalence of both UC and CD has increased significantly in Brazil over the past 21 years.Pancolitis was the most common disease distribution in patients with UC whilst colonic involvement was the most common distribution in CD.People residing in urban areas were at higher risk of developing both CD and UC.CONCLUSION The IBD burden in South America is increasing at a rate possibly even greater than other developing regions around the world.There is a paucity of highquality epidemiological studies and further robust and representative data are required to further explore modifiable risk fac

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis South America Epidemiology

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A Case Study on Climate Change Response and Adaptation: Fictional Aysese Islands in the South Pacific

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American Journal of Climate Change 2014年第5期3卷 455-473页

作者： Amy Cannon Peter Lalor Shobha sriharan Chunlei Fan Gulnihal Ozbay Department of Agriculture and Natural Resources Delaware State University Dover DE USA University of the Sunshine Coast Sunshine Coast Queensland Australia School of Agriculture Virginia State University Petersburg VA USA School of Computer Mathematical and Natural Sciences Morgan State University Baltimore MD USA

The Intergovernmental Panel on Climate Change (IPCC), established by the United Nations and World Meteorological Organization, has determined that humans have very likely influenced a net warming to the Earth from the increase of greenhouse gases, aerosols and land use changes. This warming has caused the amount of ice on the Earth to continue to decrease and sea levels to rise. In addition, extreme precipitation events are happening more often in selected regions of the world. A case study that assesses the impacts of, and adaptations to, these changes in climate is presented here. Two modeling programs, Sim CLIM and Train CLIM, (CLIM Systems, Hamilton, New Zealand) were used to support assessments for water supply, coastal zones and tropical cyclones in a fictitious island group in the South Pacific region. In the case study, a consulting group was “hired” to carry out these assessments. A final analysis and synthesis report were created to help the Ministry of the Environment of the made-up nation decide how to improve the governmental actions to address the real concerns posed by changing climate and sea level. Although a simulated island group is used in this article, there are sincere concerns about climate change and extreme weather events in this part of the world. It is important to address the real and dangerous threat that these islands and people face in the wake of a changing climate and a growing global society.

关键词： Climate Change Case Study Water Supply Coastal Zone Erosion Tropical Cyclones

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