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To assess the existing evidence of associations between assisted conception and cerebral palsy (CP), autism spectrum disorders (ASD), and developmental delay. Data Sources: Forty-one studies identified in a systematical PubMed and Excerpta Medica Database (EMBASE) search for articles published from January 1, 1996, to April 1, 2008. Study Selection: Studies written in English comparing children born after assisted conception with children born after natural conception assessing CP, ASD, and developmental delay, based on original data with a follow-up of 1 year or more. Main Exposures: In vitro fertilization (IVF) with or without intracytoplasmic sperm injection or ovulation induction with or without subsequent intrauterine insemination. Main Outcome Measures: Cerebral palsy, ASD, and developmental delay. Results: Nine CP studies showed that children born after IVF had an increased risk of CP associated with preterm delivery. In our meta-analysis including 19 462 children exposed to IVF, we estimated a crude odds ratio of 2.18 (95% confidence interval, 1.71-2.77). Eight ASD studies and 30 studies on developmental delay showed inconsistent results. No studies assessed the risk of CP, ASD, or developmental delay in children born after ovulation induction exclusively.

Systemic sclerosis is a risk factor for cancer, particularly smoking- and alcohol-related cancers. Men with systemic sclerosis generally are at higher cancer risk than women. Both primary and secondary cancer preventive measures are needed in the care of patients with systemic sclerosis.

This study assessed the risk of skin cancer following transplantation of 4 types of solid organs, and the risk of skin cancer in patients with chronic diseases that lead to organ transplantations. A population-based cohort of 5279 Danish patients who underwent heart, lung, renal and liver transplantation, and 77,782 patients with chronic heart, lung, renal and liver diseases during 1977-2006 were included in the study. Linkage to the Danish Cancer Registry allowed complete follow-up for basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated. The SIR for squamous cell carcinoma was highest among heart (SIR = 113; 95% CI: 74-166), then renal (SIR = 81; 95% CI: 68-96), lung (SIR = 65; 95% CI: 28-128) and liver (SIR = 60; 95% CI: 27-113) recipients. SIR for squamous cell carcinoma was 4.8 (95% CI: 2.2-9.0) among renal failure patients, but not greatly elevated among patients with the other chronic diseases studied. Organ transplantation is a risk factor for squamous cell carcinoma, with immunosuppressive treatments being the most likely explanation for the association.

ObjectivesThe purpose of this investigation was to assess 30-day mortality among Danish inflammatory bowel diseases (IBD) patients and to examine the prognostic impact of hospital total colectomy volume, age, gender and comorbidity.DesignCohort study.SettingThe authors compared 30-day survival over the period 1996–2010 among 2889 IBD patients with total colectomy identified in the Danish National Registry of Patients. This registry covers all hospitals in Denmark. Postoperative survival patterns for patients with ulcerative colitis and Crohn's disease were compared, using proportional hazard regression. The regression model accounted for the timing of surgery, hospital total colectomy volume, age, gender and comorbidity.ParticipantsPatients were enrolled in the study if they had a hospital registry diagnosis of IBD, with accompanying procedure codes for total colectomy (see codes in online appendix table 1). Hospitalisations were described as elective or emergency, and patients were categorised as having Crohn's disease, ulcerative colitis or as a mixed group.Outcome measuresPrimary outcome measure was 30-day mortality.ResultsAmong 2889 IBD patients with total colectomy, 1439 (50%) underwent surgery during an emergency hospitalisation. Thirty-day mortality was 5.3% (76/1439) among emergency cases compared with 1% (14/1450) among elective cases. The highest mortality (8.1%; 11 of 136) was observed among Crohn's patients undergoing emergency surgery. The mortality of patients with ulcerative colitis undergoing emergency surgery was 5.2% (55/1056). After elective surgery, the 30-day mortality was 0.9% (8/938) among patients with ulcerative colitis and 1.5% (3/201) among Crohn's disease patients. Low hospital total colectomy volume, comorbidity and high age were associated with increased 30-day mortality in ulcerative colitis patients undergoing emergency surgery.ConclusionEmergency total colectomy among patients with ulcerative colitis and particularly Crohn's disease is associated with substantial 30-day mortality.