Background: This systematic literature review of the epidemiology of Guillain-Barré syndrome (GBS) identifies trends in incidence rates by age, study method and cause of disease. It is important to have a reliable estimate of incidence to determine and investigate any changes: no previous systematic reviews of GBS have been found. Methods: After critical assessment of the reliability of the reported data, incidence rates were extracted from all relevant papers published between 1980 and 2008, identified through searches of Medline, Embase and Science Direct. Results: Sixty-three papers were included in this review; these studies were prospective, retrospective reviews of medical records or retrospective database studies. Ten studies reported on the incidence in children (0–15 years old), and found the annual incidence to be between 0.34 and 1.34/100,000. Most studies investigated populations in Europe and North America and reported similar annual incidence rates, i.e. between 0.84 and 1.91/100,000. A decrease in incidence over the time between the 1980s and 1990s was found. Up to 70% of cases of GBS were caused by antecedent infections. Conclusions: Our best estimate of the overall incidence of GBS was between 1.1/100,000/year and 1.8/100,000/year. The incidence of GBS increased with age after 50 years from 1.7/100,000/year to 3.3/100,000/year.

Objective To determine the value of patient-reported symptoms in diagnosing endometriosis.Design A national case-control study.Setting Data from the UK General Practice Research Database for years 1992-2001.Sample A total of 5540 women aged 15-55 years, diagnosed with endometriosis, each matched to four controls without endometriosis.Methods Data were analysed to determine whether specific symptoms were highly indicative of endometriosis. Odds ratios for these symptoms were derived by conditional logistic regression analysis. . Women with endometriosis were also found to consult the doctor more frequently than the controls and were twice as likely to have time off work.Conclusions Specific symptoms and frequent medical consultation are associated with endometriosis and appear useful in the diagnosis. Endometriosis may coexist with or be misdiagnosed as pelvic inflammatory disease or IBS.

Objective  To investigate whether the increased chances of having a diagnosis of irritable bowel syndrome (IBS) and pelvic inflammatory disease (PID) in women with endometriosis is due to misdiagnosis or co‐morbidity.Design  A case–control study of women aged 15–55 years with endometriosis and matched controls.Setting  Data from the UK’s General Practice Research Database for the years 1992–2001.Sample  A total of 5540 women aged 15–55 years, diagnosed with endometriosis, each matched to four controls without endometriosis. The index date was defined as the date of diagnosis.Methods  Data were analysed to determine whether women with endometriosis were more likely to receive a diagnosis of PIDor IBS than women without endometriosis. Odds ratios were calculated for endometriosis associated with IBS and PID before and after the index date.Main outcome measures  Diagnosis of IBS or PID before and after the index date.Results  Compared with the controls, women with endometriosis were 3.5 times more likely to have received a diagnosis of IBS (OR 3.5 [95% CI: 3.1–3.9]). Even after women had been diagnosed with endometriosis, they were still two and a half times more likely to receive a new diagnosis of IBS when compared with the controls (OR 2.5 [95% CI: 2.2–2.8]). Similarly, women with endometriosis were more likely than those without endometriosis to have been treated for PID both before (OR 5.9 [95% CI: 5.1–6.9]) and after (OR 3.8 [95% CI: 3.1–4.6]) being diagnosed with endometriosis.Conclusions  Women with endometriosis are more likely to be diagnosed with IBS and PID than controls, even after a definitive diagnosis of endometriosis has been reached.

(AMCO) and are increasingly used either palliatively or as a bridge to surgery (BTS) in patients in whom a definitive surgical approach is unsuitable. We evaluated short-term outcomes of malignant colorectal obstructive patients treated with SEMS in our institution over a 3-year period. Methods A prospectively maintained database was reviewed to identify all patients who presented to our institution with AMCO between August 2010 and 2013 and who were treated with a SEMS either temporarily or permanently. Additional data was retrieved from chart and pathology reviews. A single colorectal surgeon inserted all stents under both endoscopic and fluoroscopic guidance. Data was analysed using SPSSv21 (SPSS Inc., Chicago, IL, USA) and presented as median (interquartile range). Continuous variables were assessed using analysis of variance. A p value <0.05 was considered statistically significant. Results Sixteen patients each had a single stent inserted during the study period, either palliatively (n = 11) or as a BTS (n = 5). Their median (IQR) age was 75 (21) years and 12 (75%) patients were males. Most tumours were located in the sigmoid colon (6/16, 37%). The technical and clinical success rates were both 87.5% (14/16) and there were no SEMS-related perforations. The two unsuccessful stenting cases both had metastatic disease and required emergency surgery while five patients with potentially curable disease proceeded to elective resections. There was no procedure-related mortality. There was no difference in the median length of stay (LOS) post SEMS insertion in the palliative group compared to the BTS group [4 (4) vs. 5 (3), p = 0.2]. However, the median (IQR) LOS post acute surgery was longer than elective surgery [45 (30) vs. 14 (8) days, p = 0.018]. All patients in the BTS group were stoma-free post-operatively, while both patients who had emergency surgery ended up with permanent stomas. Finally, the stent complication rate was 6.2% (1/16), secondary to migration in a patient who was stented palliatively. The latter patient did not undergo further attempted stenting as his obstructive symptoms had been alleviated. Conclusion AMCO poses significant challenges in management due to the frailty of the presenting patients and the high morbidity/mortality rates associated with emergency surgery. Although limited by a small sample size, our study shows that SEMS are a favourable alternative to emergency surgery for the management of AMCO. Further larger scale studies looking at long-term survival and oncological outcomes are awaited. Disclosure of Interest None Declared. Introduction Colorectal cancer (CRC) is the fourth most common cancer in the UK and was responsible for more than 15,000 deaths in 2011. PWE-018 HSPC1 INHIBITORS POTENTIATE THE EFFECT OF 5-FU IN PRIMARY COLORECTAL CANCER CELL MODEL1 Less than 50% of patients with Dukes stage C and D survive more than 5 years. Following treatment, cell metabolism rate and apoptosis were assessed using MTS and caspase-3 assay. Results In HT29, 17-DMAG was effective in i...

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IntroductionThe NHS Bowel Cancer Screening Programme (BCSP) offers biennial screening for all adults in England aged 60–74 years using a guaiac-based faecal occult blood test (gFOBt). This feasibility study investigated anecdotal evidence that people who originate from Nepal account for a higher than expected proportion of gFOBt-positive subjects who have a normal outcome at follow-up colonoscopy (false-positive). The BCSP Southern Hub serves several geographical areas with relatively high proportions of Nepali subjects (e.g. Aldershot, Reading and Ashford).MethodsData for subjects aged 60–74 invited for screening in the Southern Hub (roll-out to September 2014) were extracted from the BCSP database (BCSS). Because information about subjects’ ethnicity is not recorded on BCSS, Nepali subjects were identified using an algorithm that was based on surname and postcode of residence (subject residing in an area where ≥8% of the BCSP-invited population had a Nepali surname). Data on uptake, gFOBt-positivity and false-positivity were compared between Nepali and non-Nepali men and women invited for screening.ResultsWe identified 5,274 Nepali subjects (43.5% women) amongst the 6,218,071 subjects invited for screening during the study period. Compared with the non-Nepali population, uptake of screening was significantly higher amongst Nepalis (61.9% vs. 58.3%; odds ratio [OR] 1.16, 95% Confidence Interval [95%CI] 1.10,1.23), more so amongst Nepali men (OR 1.26, 95%CI 1.17,1.35) than women (OR 1.09, 95%CI 1.00,1.19). Positivity was high in the Nepali population (7.6% vs. 2.0%; OR 4.01, 95%CI 3.53,4.57) and higher for women (OR 5.13, 95%CI 4.22,6.23) than men (OR 3.20, 95%CI 2.69,3.81). False-positivity was markedly higher in the Nepali population (OR 2.37 95%CI 1.77,3.18). More than half of gFOBt-positive Nepali women (50.6%) had a normal outcome at colonoscopy (false-positive), compared with 24.4% in non-Nepali women (OR 3.18 95%CI 2.09,4.84). The proportion of Nepali men with a false-positive outcome was also greater than amongst non-Nepali men (OR 1.75, 95%CI 1.12,2.75).ConclusionCompared with non-Nepali gFOBT-positive subjects, false-positivity was high in the Nepali community living in the south of England. The reasons for high false-positivity, implications for colonoscopy resource and exposure of subjects to unnecessary risk will be addressed in further work. The study area will be extended to include other Nepali communities living in London and a validation exercise will be undertaken to test the algorithm used to identify Nepali subjects.Disclosure of InterestNone Declared