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OBJECTIVE: The aim of this study is to report on the incidence of microscopic colitis (MC), any possible relation with inflammatory bowel disease (IBD), concomitant drug consumption, related diseases and the clinical course of the diseases. METHODS: Both new cases of IBD and MC were registered at the same time in the same geographical area. The study started in the county of Uppsala 2005-2006, and other parts of the surrounding health region were included 2007-2009. Established morphological criteria were used, i.e. a layer of subepithelial collagen band >/= 10 mum in collagenous colitis (CC) with concomitant inflammation and at least 20 lymphocytes per 100 epithelial cells in lymphocytic colitis (LC). RESULTS: The authors found 272 new cases of MC, 154 with CC and 118 with LC. The mean age-adjusted incidence was 7.0/1,000,000 for CC and 4.8/100,000 for LC. The clinical course was dominated by single episodes with diarrhea or intermittent symptoms, but 14% suffered from chronic diarrhea. In 10% of the cases, diagnosis was made in individuals without chronic watery diarrhea. Although not systematically tested, concomitant celiac disease was found in approximately 5% of the patients. CONCLUSIONS: The incidence of MC in Uppsala health region is similar to other studied areas. The majority of patients had a self-limiting or easily treated condition, but 14% need a more or less continuous medication. Ten percent of the patients demonstrate other symptoms than chronic watery diarrhea. The possibility of concomitant celiac disease should be considered in new cases of MC., Thorn, Mari Sjoberg, Daniel Ekbom, Anders Holmstrom, Tommy Larsson, Marit Nielsen, Anne-Lie Holmquist, Lars Thelander, Ulrika Wanders, Alkwin Ronnblom, Anders eng Research Support, Non-U.S. Gov't England 2013/06/01 06:00 Scand J Gastroenterol. 2013 Jul;48(7):825-30. doi: 10.3109/00365521.2013.800993. Epub 2013 May 31.

Study Design. A cross-sectional study of physicians and physiotherapists in primary care. Objectives. To survey how familiar clinicians were with evidence-based guidelines for back pain and their opinion about their clinical usefulness and to compare self-reported practice behavior with the guidelines. Summary of Background Data. Guidelines, based on empirical evidence, are meant to ensure that patients get the most effective treatment. These evidence-based guidelines should steer clinical praxis, but clinicians may not read, let alone heed, them. Methods. Using a questionnaire, the authors surveyed all physicians and physiotherapists in primary health care in Orebro County, Sweden (N = 235). Results. Forty-two percent of the physicians and 37% of the physiotherapists were unfamiliar with the content of the guidelines, and 40% of the physicians and 25% of the physiotherapists were unfamiliar with the concept of "red flags." Less than half of the clinicians, 47%, were familiar both with the content of the guidelines and the concept of red flags. Their opinion about the guidelines showed that 54% of the physicians and 56% of the physiotherapists agreed that the guidelines were useful in clinical praxis. Concerning the self-reported practice behavior, the majority indicated that they followed the key points in the guidelines. Conclusions. A relatively large proportion of clinicians were unfamiliar with the content of evidence-based guidelines and/or with the concept of red flags. The process of implementing research into clinical practice is in need of an overhaul, and the impact of guidelines on clinical practice may be questioned.

In a population based epidemiological survey of juvenile chronic arthritis (JCA), performed in Western Sweden in 1983, an incidence of 12/100,000 was found. The estimated prevalence was 56/100,000. Subgroup distribution showed a preponderance of mono- and pauciarticular forms. The peak age of onset was between 0 and 4 years of age. Girls predominated over boys in a ratio of 3:2. Overall, 30% were antinuclear antibody (ANA) positive, 9% rheumatoid factor (RF) positive, and eye involvement occurred in 10% of the children. The results suggest differences in population based studies of JCA compared with previously reported hospital based series.