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Hamilton PG, Buhler K, Kaplan G, Lu C, Seow C, Novak K, Panaccione R, Ma C. A180 PLACEBO RATES IN MICROSCOPIC COLITIS RANDOMIZED TRIALS: APPLICATIONS FOR FUTURE DRUG DEVELOPMENT USING A HISTORICAL CONTROL ARM. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991156 DOI: 10.1093/jcag/gwac036.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background There remains a need to develop effective medical therapies for patients with microscopic colitis (MC) who do not respond, are intolerant, or relapse on budesonide. Conducting randomized trials in MC is logistically and ethically challenging: budesonide is highly effective, and therefore, some institutional review boards have not allowed trials that randomize MC patients to placebo. However, comparing an investigational drug to budesonide is statistically infeasible: powering a non-inferiority study against a budesonide comparator arm with 90% power for a 10% non-inferiority margin would require over 700 subjects, yet fewer than 400 patients have been randomized in all historical MC trials. Therefore, alternative trial designs should be explored in MC, including the use of a historical control arm. Purpose To conduct a systematic review and meta-analysis to determine the proportion of placebo responders in MC trials that will inform future trials using a historical placebo comparator, and evaluate factors associated with placebo response. Method EMBASE, MEDLINE, and CENTRAL were searched from inception to January 7, 2022, and supplemented with conference abstracts to identify randomized controlled trials (RCTs) using a placebo comparator in adult patients with confirmed MC (either lymphocytic, collagenous, or mixed populations but excluding incomplete MC). The proportion of clinical and histologic responders in the placebo arms were pooled using random-effect models, statistical heterogeneity was evaluated using the I2 method, and the Freeman-Tukey double arcsine transformation was used to compute 95% confidence intervals (CI) using the score statistic and exact binomial method. All analyses were conducted in Stata 17.0. Result(s) Twelve placebo controlled RCTs were included, evaluating a total of 391 patients (163 randomized to placebo). The pooled placebo clinical response rate was 24.4% [95% CI 12.4%, 38.4%] (Figure 1), with substantial heterogeneity (I2=60.8%, p<0.01). The pooled histologic response rate was 19.9% [95% CI: 5.3%, 39.0%], with substantial heterogeneity (I2=66.4%, p<0.01). Subgroup analysis demonstrated higher placebo responses in lymphocytic colitis (39.9% [95% CI: 23.9%, 56.7%]) compared to collagenous colitis (19.8% [95% CI: 5.9%, 37.8%]), but not by allowance of baseline anti-diarrheals. Leave-one-out meta-analysis showed a reduction in heterogeneity after removal of Miehlke et al. 2014 (placebo response 21.0% [95% CI: 11.5%, 32.1%], I2=28.6%, p=0.17). Image ![]()
Conclusion(s) Approximately 1 in 4 patients in MC trials will respond clinically to placebo and 1 in 5 will demonstrate a histologic response, although with substantial heterogeneity. T his highlights the need for standardized outcome definitions in MC trials and can serve to inform a Bayesian prior estimate for future trials that may consider using a historical placebo comparator. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest P. Hamilton: None Declared, K. Buhler: None Declared, G. Kaplan Grant / Research support from: Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire, Consultant of: AbbVie, Janssen, Pfizer, Amgen, Takeda, and Gilead, C. Lu Consultant of: Abbvie, Janssen, Ferring, and Takeda, Speakers bureau of: Janssen and Abbvie, C. Seow Consultant of: Advisory Boards: Janssen, Abbvie, Takeda, Ferring, Shire, Pfizer, Sandoz, Pharmascience, Fresenius Kabi, Amgen, Speakers bureau of: Janssen, Abbvie, Takeda, Ferring, Shire, Pfizer, Pharmascience, K. Novak Grant / Research support from: AbbVie and Janssen, Consultant of: Advisory board fees from AbbVie, Janssen, Pfizer, Ferring, and Takeda, speaker’s fees from AbbVie, Janssen, and Pfizer, R. Panaccione Consultant of: Abbott, AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Eli Lilly, Ferring, Galapagos, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pendopharm, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz, Satisfai Health, Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Theravance Biopharma, Trellus, Viatris, UCB. Advisory Boards for: AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pfizer, Progenity, Protagonist Therapeutics, Roche, SandozShire, Sublimity Therapeutics, Takeda Pharmaceuticals, Speakers bureau of: AbbVie, Amgen, Arena Pharmaceuticals, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Gilead Sciences, Janssen, Merck, Organon, Pfizer, Roche, Sandoz, Shire, Takeda Pharmaceuticals, C. Ma Grant / Research support from: Ferring, Pfizer, Consultant of: AbbVie, Alimentiv, American College of Gastroenterology, Amgen, AVIR Pharma Inc, BioJAMP, Bristol Myers Squibb, Celltrion, Ferring, Fresenius Kabi, Janssen, McKesson, Mylan, Sanofi/Regeneron, Takeda, Pendopharm, Pfizer, Roche, Speakers bureau of: : AbbVie, Amgen, AVIR Pharma Inc, Alimentiv, Bristol Myers Squibb, Ferring, Fresenius Kabi, Janssen, Takeda, Pendopharm, and Pfizer
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St-Pierre J, Rosentreter R, Kiraly A, Hart Szostakiwskyj J, Novak K, Panaccione R, Kaplan G, Devlin S, Seow C, Ingram R, Ma C, Wilson S, Medellin A, Lu C. A192 EFFICACY OF USTEKINUMAB IN SMALL BOWEL STRICTURES OF FIBROSTENOTIC CROHN'S DISEASE AS ASSESSED BY INTESTINAL ULTRASOUND. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991175 DOI: 10.1093/jcag/gwac036.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Small bowel Crohn’s disease (CD) strictures can lead to debilitating obstructive symptoms and the deterioration of quality of life. Imaging modalities such as intestinal ultrasound (IUS) are invaluable in the diagnosis of strictures. The use of IUS in CD is rapidly growing, is cost-effective, easily repeatable, and similar in accuracy to magnetic resonance enterography. Evidence for medical management of fibrostenotic CD has been limited to anti-tumor necrosis factor biologics. Studies on the efficacy of other biologic therapies for strictures such as ustekinumab, a p40/interleukin 12 and 23 inhibitor, are lacking. Purpose The objective of this study was to evaluate the efficacy of ustekinumab in the treatment of small bowel strictures on IUS. Method This retrospective cohort study evaluated the IUS changes of terminal ileal (TI) CD strictures at baseline and 12 months following ustekinumab initiation from 2016 to 2020 at a single tertiary care center. Strictures identified were defined as 1) increased bowel wall thickness (BWT) > 3mm, 2) narrowed luminal apposition, and 3) presence of pre-stenotic dilation (PSD) or the inability to pass the colonoscope through the narrowed area. Changes in sonographic parameters (BWT, luminal size, PSD, length, hyperemia, inflammatory fat, dysfunctional peristalsis) were recorded at baseline prior to initiation of ustekinumab and compared 12 months after treatment. Differences from baseline to 12 months were paired within-person and statistical analysis was performed using paired T-tests for continuous variables and McNemar’s test for categorical variables. Result(s) Of the 18 patients identified, 55% (n = 10) were male, median age was 49 years (Q1-Q3: 33-63 years) at initial scan, with median CD duration of 10 years (Q1-Q3: 8-20 years). The majority of TI strictures were surgically naïve (67%, n = 12). Between pre- and 12-month post ustekinumab therapy scans, there was significant improvement in BWT [8.2 mm vs 7.2 mm, p = 0.048], however there was no significant difference in the presence of peri-enteric inflammatory fat (p = 0.10), mean stricture length (17.7 vs 21.7 cm, p = 0.18), and mean stricture lumen diameter (3.3 mm vs 2.7 mm, p = 0.44) (Table 1). There was also no significant difference in the presence of stricture-associated peri-enteric fat (89% vs 67%, p = 0.10), stricture-associated hyperemia (83% vs 89%, p = 0.65) or dysfunctional peristalsis (50% vs 61%, p = 0.41) (Table 1). Image ![]()
Conclusion(s) Our study is the first to report the efficacy of ustekinumab in small bowel CD strictures using IUS at baseline and 12 months. This study shows that although ustekinumab leads to improvement in overall sonographic appearance of bowel thickness, it does not improve luminal narrowing nor PSD, two hallmark criteria of fibrostenosis. More extensive studies with larger sample sizes evaluating ustekinumab, or combination therapies, are required to identify their role in stricturing CD. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Coward S, Benchimol EI, Bernstein C, Avina-Zubieta JA, Bitton A, Hracs L, Jones J, Kuenzig E, Lu L, Murthy SK, Nugent Z, Otley AR, Panaccione R, Pena-Sanchez JN, Singh H, Targownik LE, Windsor JW, Kaplan G. A35 FORECASTING THE INCIDENCE AND PREVALENCE OF INFLAMMATORY BOWEL DISEASE: A CANADIAN NATION-WIDE ANALYSIS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991201 DOI: 10.1093/jcag/gwac036.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Canada is currently in the third epidemiological stage in the evolution of IBD: compounding prevalence. A high incidence of IBD, in conjunction with low mortality, leads to a steadily rising prevalence over time. By understanding historical epidemiological trends, we can forecast incidence and prevalence into the future to inform healthcare systems in Canada of the rising burden of IBD to society. Purpose To analyze past epidemiological trends in order to forecast the overall incidence and prevalence of IBD, Crohn’s disease (CD), and ulcerative colitis (UC) and stratified by age (<18, 18-64, 65+). Method Canadian population-based administrative data was acquired from: AB, BC, SK, MB, QC, and ON. Data were age and sex standardized to the matching year and provincial data aggregated into a representative sample of the Canadian population for prevalence (2002-2014) and incidence (2007-2014: 5-year washout period). Incidence and prevalence (per 100,000 persons) were calculated, with 95% confidence intervals (CI), using Canadian population estimates from Statistics Canada for IBD, CD, UC (IBD-unclassifiable+UC). Autoregressive Integrated Moving Average models were created, and rates forecasted from 2014 to 2035 with 95% prediction intervals (PI). Poisson (or negative binomial) for incidence and log binomial regression for prevalence estimated the Average Annual Percentage Change (AAPC), with 95% CIs, of the forecasted data. Result(s) The 2014 incidence of IBD in Canada was 28.4 per 100,000 (95%CI: 27.8, 29.0) and forecasted to significantly increase (AAPC: 0.58%; 95%CI: 0.04, 1.04) from 30.0 per 100,000 in 2023 to 32.1 (95%PI: 27.9, 36.3) in 2035. Pediatric onset IBD was 13.9 per 100,000 (95%CI: 13.0, 14.9) in 2014 and is forecasted to significantly increase to 18.0 per 100,000 (95%PI: 15.7, 20.2) in 2035 with an AAPC of 1.23% (95%CI: 0.76, 1.63). Adult and elderly onset incidence rates were forecasted to remain stable. Prevalence of IBD increased between 2002 (389 per 100,000) and 2014 (636 per 100,000) and is forecasted to continue to climb by an AAPC of 2.44% (95%CI: 2.34, 2.53). In 2023, the prevalence of IBD is 825 per 100,000. By 2035 prevalence is forecasted to climb to 1075 per 100,000 (95%PI: 1047, 1103) with 470,000 Canadians living with IBD. Prevalence across all age strata were forecasted to significantly increase. The highest AAPC was seen in the elderly (2.76%; 95%CI: 2.73, 2.79) with a prevalence of 841 per 100,000 (95%CI: 834, 849) in 2014 and forecasted to climb to 1534 per 100,000 (95%PI: 1519, 1550) in 2035. Image ![]()
Conclusion(s) Incidence of IBD continues to rise in Canada, driven by pediatric-onset IBD. In 2023, over 320,000 Canadians (0.83%) will be living with IBD. By 2035 prevalence will exceed 1% of the population with approximately 470,000 individuals in Canada with IBD. Future research should establish the environmental determinates of IBD that may influence temporal trends in the incidence of IBD, while healthcare systems adapt to the compounding prevalence of IBD. Please acknowledge all funding agencies by checking the applicable boxes below CIHR, Other Please indicate your source of funding; The Leona M. and Harry B. Helmsley Charitable Trust Disclosure of Interest S. Coward: None Declared, E. Benchimol Consultant of: Hoffman La-Roche Limited and Peabody & Arnold LLP for matters unrelated to medications used to treat inflammatory bowel disease and McKesson Canada and the Dairy Farmers of Ontario for matters unrelated to medications used to treat inflammatory bowel disease., C. Bernstein Grant / Research support from: Unrestricted educational grants from Abbvie Canada, Janssen Canada, Pfizer Canada, Bristol Myers Squibb Canada, and Takeda Canada. Has received research grants from Abbvie Canada, Amgen Canada, Pfizer Canada, and Sandoz Canada and contract grants from Janssen, Abbvie and Pfizer, Consultant of: Abbvie Canada, Amgen Canada, Bristol Myers Squibb Canada, JAMP Pharmaceuticals, Janssen Canada, Pfizer Canada, Sandoz Canada, and Takeda., Speakers bureau of: Abbvie Canada, Janssen Canada, Pfizer Canada and Takeda Canada, J. A. Avina-Zubieta: None Declared, A. Bitton: None Declared, L. Hracs: None Declared, J. Jones Consultant of: Janssen, Abbvie, Pfizer, Takeda, Speakers bureau of: Janssen, Abbvie, Pfizer, Takeda, E. Kuenzig: None Declared, L. Lu: None Declared, S. Murthy: None Declared, Z. Nugent: None Declared, A. Otley Grant / Research support from: Unrestricted educational grants from AbbVie Canada and Janssen Canada, Consultant of: Advisory boards of AbbVie Canada, Janssen Canada and Nestle, R. Panaccione Consultant of: Abbott, AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Eli Lilly, Ferring, Galapagos, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pendopharm, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz, Satisfai Health, Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Theravance Biopharma, Trellus, Viatris, UCB. Advisory Boards for: AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Speakers bureau of: AbbVie, Amgen, Arena Pharmaceuticals, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Gilead Sciences, Janssen, Merck, Organon, Pfizer, Roche, Sandoz, Shire, Takeda Pharmaceuticals, J.-N. Pena-Sanchez: None Declared, H. Singh Consultant of: Pendopharm, Amgen Canada, Bristol Myers Squibb Canada, Roche Canada, Sandoz Canada, Takeda Canada, and Guardant Health, Inc., L. Targownik Grant / Research support from: Investigator initiated funding from Janssen Canada, Consultant of: [Advisory board] AbbVie Canada, Takeda Canada, Merck Canada, Pfizer Canada, Janssen Canada, Roche Canada, and Sandoz Canada, J. Windsor: None Declared, G. Kaplan Grant / Research support from: Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire, Consultant of: Gilead, Speakers bureau of: AbbVie, Janssen, Pfizer, Amgen, and Takeda
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Khan R, Kuenzig E, Tang A, Im J, Widdifield J, McCurdy J, Kaplan G, Benchimol E. A177 RISK OF VENOUS THROMBOEMBOLISM IN COVID-19 PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A POPULATION-BASED MATCHED COHORT STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991269 DOI: 10.1093/jcag/gwac036.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Venous thromboembolism (VTE), is associated with significant morbidity and mortality. Inflammation increases the risk of VTE, and it is a well-recognised complication of both inflammatory bowel disease (IBD) and COVID-19. Purpose To compare the risk of VTE among individuals with and without IBD following a positive COVID-19 test. Method Using health administrative data from Ontario, Canada we conducted a retrospective matched cohort study.All Ontario residents with a positive SARS-CoV-2 PCR test between January 1,2020 and December 30,2021 who had been diagnosed with IBD prior to their COVID-19 infection (identified using a validated algorithm) were matched to 5 individuals without IBD based on year of birth, sex, mean neighbourhood income quintile, date of positive COVID-19 test, and rural/urban residence. Individuals with a cancer diagnosis in the 5 years prior to their first COVID-19 positive test were excluded. Individuals were followed from positive COVID-19 PCR test until VTE event, death, migration out of Ontario or March 31, 2022.VTEs were identified from emergency department or hospitalization data using ICD-10 codes. Incidence rate of VTEs among individuals with IBD were assessed at 1, 6 and 12 months. Proportional cause-specific hazards models compared the risk of VTEs in people with and without IBD, treating death as a competing risk and controlling for vaccination status (2nd dose ≥14 days prior to positive COVID-19 test) and a history of VTE (VTE in the 5 years prior to infection). Result(s) There were 4293 people with IBD (44% Crohn’s disease, mean age ±SD 46.1±17.2 y) matched to 20,207 with out IBD (mean age 45.3±16.8 y) with a positive SARS-CoV-2 PCR test. Within 1 month of a positive COVID-19 test, the crude incidence rate of VTE in individuals with IBD was 4.77(95%CI, 4.75-4.80) per 100,000 person-days compared to 8.25(95%CI, 8.20-8.30) per 100,000 among people without IBD.Within 6 months, these rates were 1.86(95%CI, 1.86-1.87) and 2.12(95%CI, 2.11-2.12) per 100,000 person-days among people with and without IBD, respectivley. Within 12 months, these rates were 1.59(95% CI, 1.58-1.59) and 1.42(95% CI, 1.42-1.42) per 100,000 person-days among people with and without IBD, respectively.After adjusting for vaccination status and history of VTE there was no difference in the risk of VTE for people with and without IBD (HR 1.08, 95%CI, 0.64 to 1.83). Conclusion(s) IBD patients with COVID-19 were not more likely to experience a VTE infection compared with the general popluation. The risk of VTE was highest soon after COVID-19 and declined thereafter. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Coward S, Benchimol EI, Bernstein C, Avina-Zubieta JA, Bitton A, Hracs L, Jones J, Kuenzig E, Lu L, Murthy SK, Nugent Z, Otley AR, Panaccione R, Pena-Sanchez JN, Singh H, Targownik LE, Windsor JW, Kaplan G. A210 THE BURDEN OF IBD HOSPITALIZATION IN CANADA: AN ASSESSMENT OF THE CURRENT AND FUTURE BURDEN IN A NATION-WIDE ANALYSIS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991188 DOI: 10.1093/jcag/gwac036.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Hospitalizations pose a significant burden on both the individual and the healthcare system. Those with inflammatory bowel disease (IBD) are at increased risk of hospitalization as compared to the general population due to flaring of disease activity and complications related to IBD. The advent of biologics over the past twenty years may have influenced the rates of hospitalization for IBD. Purpose To assess current and forecast the overall hospitalization rates of those with IBD stratified by types of hospitalizations (all cause hospitalizations, IBD-related, and IBD-specific). Method Population-based administrative data on hospitalization of IBD (2002-2014) were obtained from: AB, BC, MB, and SK. Data were age and sex standardized to the matching year and aggregated into a representative sample of the Canadian population. Hospitalization rates were assessed as follows: 1. All cause hospitalizations: all admissions regardless of indication; 2. IBD-specific: an admission directly resulting from IBD (e.g., IBD-flare); 3. IBD-related: an admission for IBD, or a symptom or comorbidity associated with IBD (e.g. rheumatoid arthritis). Using prevalence estimates from the provinces, hospitalization rates (per 100 persons with IBD) were calculated, with 95% confidence intervals (CI). Autoregressive Integrated Moving Average models were created to estimate number of hospitalizations and corresponding prevalence to forecast hospitalization rates to 2030 with 95% prediction intervals (PI). Poisson (or negative binomial) regression estimated the Average Annual Percentage Change (AAPC), with 95% CIs, of the forecasted data. Result(s) In 2002 there were 35.3 per 100 (95%CI: 34.7, 35.9) all cause hospitalizations for IBD patients and this decreased to 24.9 per 100 (24.5, 25.2) in 2014. Similar trends were seen for IBD-specific hospitalizations [16.8 per 100 (95%CI: 16.4, 17.2) in 2002 to 8.7 per 100 (95%CI: 8.5, 9.0) in 2014] and IBD-related (22.6 per 100 (95%CI: 22.1, 23.1) in 2002 to 13.4 per 100 (95%CI: 13.2, 13.7) in 2014). When forecasted out to 2030 all hospitalization types were significantly decreasing—the AAPC for all cause hospitalizations was -2.12% (95%CI: -2.31, -1.93), -3.77% (95%CI: -4.63, -3.08) for IBD-specific, and -3.09% (95%CI: -3.65, -2.62) for IBD-related. By 2030, the rates of hospitalization are forecasted to be 17.0 per 100 (95%PI: 16.2, 17.9), 4.6 per 100 (95%PI: 3.7, 5.4), and 7.9 per 100 (95%PI: 6.9, 8.9) for all cause, IBD-specific, and IBD-related, respectively. Image ![]()
Conclusion(s) In Canada, rates of hospitalizations for those with IBD have decreased from 2002 to 2014. The use of anti-TNF therapy in conjunction with the evolution of clinical monitoring, management and guidelines, likely has contributed to dropping hospitalization rates. Forecast models estimate a continued drop in hospitalization rates out to 2030. Importantly, healthcare resource planning should account for the shift from hospital-based to clinic-centric models of IBD care. Please acknowledge all funding agencies by checking the applicable boxes below CIHR Disclosure of Interest S. Coward: None Declared, E. Benchimol Consultant of: Hoffman La-Roche Limited and Peabody & Arnold LLP for matters unrelated to medications used to treat inflammatory bowel disease and McKesson Canada and the Dairy Farmers of Ontario for matters unrelated to medications used to treat inflammatory bowel disease., C. Bernstein Grant / Research support from: Unrestricted educational grants from Abbvie Canada, Janssen Canada, Pfizer Canada, Bristol Myers Squibb Canada, and Takeda Canada. Has received research grants from Abbvie Canada, Amgen Canada, Pfizer Canada, and Sandoz Canada and contract grants from Janssen, Abbvie and Pfizer, Consultant of: Abbvie Canada, Amgen Canada, Bristol Myers Squibb Canada, JAMP Pharmaceuticals, Janssen Canada, Pfizer Canada, Sandoz Canada, and Takeda., Speakers bureau of: Abbvie Canada, Janssen Canada, Pfizer Canada and Takeda Canada, J. A. Avina-Zubieta: None Declared, A. Bitton: None Declared, L. Hracs: None Declared, J. Jones Consultant of: Janssen, Abbvie, Pfizer, Takeda, Speakers bureau of: Janssen, Abbvie, Pfizer, Takeda, E. Kuenzig: None Declared, L. Lu: None Declared, S. Murthy: None Declared, Z. Nugent: None Declared, A. Otley Grant / Research support from: Unrestricted educational grants from AbbVie Canada and Janssen Canada, Consultant of: Advisory boards of AbbVie Canada, Janssen Canada and Nestle, R. Panaccione Consultant of: Abbott, AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Eli Lilly, Ferring, Galapagos, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pendopharm, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz, Satisfai Health, Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Theravance Biopharma, Trellus, Viatris, UCB. Advisory Boards for: AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Speakers bureau of: AbbVie, Amgen, Arena Pharmaceuticals, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Gilead Sciences, Janssen, Merck, Organon, Pfizer, Roche, Sandoz, Shire, Takeda Pharmaceuticals, J.-N. Pena-Sanchez: None Declared, H. Singh Consultant of: Pendopharm, Amgen Canada, Bristol Myers Squibb Canada, Roche Canada, Sandoz Canada, Takeda Canada, and Guardant Health, Inc.,, L. Targownik Grant / Research support from: Investigator initiated funding from Janssen Canada, Consultant of: [Advisory board] AbbVie Canada, Takeda Canada, Merck Canada, Pfizer Canada, Janssen Canada, Roche Canada, and Sandoz Canada, J. Windsor: None Declared, G. Kaplan Grant / Research support from: Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire, Consultant of: Gilead, Speakers bureau of: AbbVie, Janssen, Pfizer, Amgen, and Takeda
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Coward S, Murthy SK, Singh H, Benchimol EI, Kuenzig E, Kaplan G. A154 CANCERS ASSOCIATED WITH INFLAMMATORY BOWEL DISEASE IN CANADA: A POPULATION-BASED ANALYSIS OF CASES AND MATCHED CONTROLS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991163 DOI: 10.1093/jcag/gwac036.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Individuals with inflammatory bowel disease (IBD) are known to have a higher risk of digestive tract cancers and cancers associated with immunosuppression. As the IBD population is ageing, age-related cancers may be more commonly diagnosed. Purpose To assess whether IBD patients were at a higher odds of incident cancers than their matched controls stratified by age above and below 65 years. Method A population-based surveillance study was conducted in Alberta, Canada (April 1, 2002 to March 30, 2018). A validated algorithm identified cases of IBD. Each case was age and sex matched to up to 10 non-IBD cases from the general population and linked to the Alberta provincial cancer registry to extract pathology-confirmed incident cancer. Controls were removed if they were not residents of Alberta at the time the matched case was diagnosed with IBD. Only incident cancers diagnosed after the diagnosis of IBD (or matched indexed date for controls) were considered. Age was calculated based on year of inclusion in the cohort or, if applicable, the year of cancer diagnosis. Cancer diagnoses were classified: bladder, biliary and liver, breast, cervix, colorectal, endometrium, gastrointestinal, gynecological, head and neck, hematological, kidney, lung, melanoma, neurological, non-melanoma, pancreas, prostate, renal and bladder, small intestine, thyroid, and miscellaneous. Odds ratios (OR), with 95% confidence intervals (CI), compared IBD cases to matched controls using conditional logistic regression. Stratified analysis at age 65 (<65 and ≥65) was done for all cancers. Result(s) Overall, 3695 incident cancers were diagnosed among 35,763 individuals with IBD as compared to 22,687 cancers among 289,212 controls (OR:1.12; 95%CI: 1.08, 1.16). Those less than 65 years old were at higher odds of developing cancer (1.20; 95%CI: 1.15, 1.26) than those ≥65 (0.97; 95%CI: 0.90, 1.04). Those with IBD had a higher odds biliary and liver (7.41; 95%CI: 5.58, 9.84) and gastrointestinal (2.26; 95%CI: 2.06, 2.48), which including: colorectal (1.78; 95%CI: 1.57, 2.02), pancreas (7.79; 95%CI: 5.53, 10.97), and small intestine (6.59; 95%CI: 4.65, 9.35). Melanoma and non-melanoma, head and neck, and thyroid cancers did not have an increased odds but hematological, lung, neurological, and kidney cancers did show an increased odds among those with IBD. Cancers outside of the gastrointestinal tract were at a lower odds for IBD patients, including: bladder (0.68; 95%CI: 0.54, 0.87), breast (0.72; 95%CI: 0.64, 0.81), gynecological (incl. cervix (0.68; 95%CI: 0.61, 0.78) and endometrium (0.48; 95%CI: 0.34, 0.66), and prostate (0.64; 95%CI: 0.57, 0.73). Image ![]()
Conclusion(s) Under the age of 65, individuals with IBD have a higher odds of being diagnosed with cancer than the general population, with cancers of the digestive tract driving this association across the age spectrum. Healthcare providers should be aware of higher occurrence of hematological, neurological, lung and renal cancers in those with IBD. Please acknowledge all funding agencies by checking the applicable boxes below CIHR Disclosure of Interest S. Coward: None Declared, S. Murthy: None Declared, H. Singh Consultant of: Pendopharm, Amgen Canada, Bristol Myers Squibb Canada, Roche Canada, Sandoz Canada, Takeda Canada, and Guardant Health, Inc., E. Benchimol Consultant of: Hoffman La-Roche Limited and Peabody & Arnold LLP for matters unrelated to medications used to treat inflammatory bowel disease and McKesson Canada and the Dairy Farmers of Ontario for matters unrelated to medications used to treat inflammatory bowel disease., E. Kuenzig: None Declared, G. Kaplan Grant / Research support from: Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire, Consultant of: Gilead, Speakers bureau of: AbbVie, Janssen, Pfizer, Amgen, and Takeda
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Sharifi N, Ma C, Seow C, Quan J, Hracs L, Caplan L, Markovinović A, Herauf M, Windsor J, Coward S, Buie M, Gorospe J, Panaccione R, Kaplan G. A195 DURABILITY OF SEROLOGICAL RESPONSES AFTER SECOND, THIRD AND FOURTH DOSE OF SARS-COV-2 VACCINATION IN INFLAMMATORY BOWEL DISEASE: A PROSPECTIVE COHORT STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991316 DOI: 10.1093/jcag/gwac036.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Adequate serological responses following two-dose regimens and additional doses of SARS-CoV-2 vaccination have been demonstrated for the vast majority of those with IBD. However, antibody levels following 2nd, 3rd, and 4th dose SARS-CoV-2 vaccination may decrease over time in the IBD population. Purpose We assessed the durability of serological responses to 2nd, 3rd, and 4th dose SARS-CoV-2 vaccination over time in a cohort of IBD patients. Method Adults with IBD who received at least one dose of a SARS-CoV-2 vaccine (n=559) were evaluated for serological response to the spike protein of SARS-CoV-2 using the Abbott IgG II Quant assay with a seroconversion threshold of ≥ 50 AU/mL. The geometric mean titer (GMT) with 95% confidence intervals (CI) were calculated and stratified by weeks (1–8, 8–16, 16–24, 24+ weeks) after each vaccine dose. We compared stratified GMTs with Mann–Whitney U tests using a significance level of 0.05. Result(s) Our cohort (n=559) comprised the following patient characteristics: 82.8% were 18–65 years-old (n = 463), 53.1% were female (n =297), and 71.6% had Crohn’s disease (n =400). IBD medications were classified in the following mutually exclusive groups: No immunosuppressives 10.5% (n = 59), anti-TNF monotherapy 35.8% (n = 200), immunomodulatory monotherapy 2.1% (n =12 ), vedolizumab 11.8% (n =66 ), ustekinumab 20.4% (n =114 ), tofacitinib 1.2% (n =7 ), combination therapy 15.9% (n = 89), and prednisone 2.1% (n =12). For vaccine type, 85.6% and 82.3% had Pfizer for 3rd and 4th dose, respectively, while the remainder had Moderna. Seroconversion rates 1–8 weeks after 3rd and 4th dose were both 99.9%. Figure 1 compares GMTs with 95% CI by weeks after each vaccine dose. GMTs are highest 1–8 weeks after 2nd dose (4053 AU/mL; 95% CI: 3468, 4737 AU/mL; n=337), 3rd dose (12116 AU/mL; 10413, 14098 AU/mL; n=256), and 4th dose (14337 AU/mL; 10429, 19710 AU/mL; n=67). Subsequently, antibody levels decay from 1–8 weeks to 8–16 weeks (p<0.001) for 2nd dose (mean difference: –2224 AU/mL), 3rd dose (mean difference: –7526 AU/mL), and 4th dose (mean difference: –9715 AU/mL). Compared to 16–24 weeks after 2nd dose, antibody levels 24+ weeks after were similar (GMTs: 795 AU/mL vs. 1043 AU/mL, p=0.52). For third dose, antibody levels 8–16 weeks and 16–24 weeks after vaccination were similar (4590 AU/mL vs. 4073 AU/mL, p=0.73) along with 16–24 weeks compared to 24+ weeks after vaccination (4073 AU/mL vs. 5876 AU/mL, p=0.18). Image ![]()
Conclusion(s) Within 1–8 weeks after each dose of vaccine, serological responses spikes with each subsequent dose yielding a higher GMT. While antibody levels decay 8–16 weeks after each dose, similar GMT levels beyond 16 weeks may indicate durability of antibody levels over a longer duration of time. Disclosure of Interest None Declared
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Coward S, Benchimol EI, Bernstein C, Avina-Zubieta JA, Bitton A, Hracs L, Jones J, Kuenzig E, Lu L, Murthy SK, Nugent Z, Otley AR, Panaccione R, Pena-Sanchez JN, Singh H, Targownik LE, Windsor JW, Kaplan G. A169 THE DIRECT COSTS OF INFLAMMATORY BOWEL DISEASE IN CANADA: A POPULATION-BASED ANALYSIS OF HISTORICAL AND CURRENT COSTS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991147 DOI: 10.1093/jcag/gwac036.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Inflammatory bowel disease (IBD) is a costly disease to manage due to hospitalizations, regular ambulatory monitoring, and expensive pharmaceutical therapies. While hospitalization rates have fallen, the increased use of biologics have escalated the cost of care to the healthcare system. Purpose To assess historical direct healthcare costs of the IBD population in Canada. Method Population-based administrative costing data were obtained from: Alberta, British Columbia, and Manitoba. Costs were calculated based on administrative data (2009 to 2016) which captured: hospitalizations, physician costs, ambulatory care such as: emergency visits, day surgery, and colonoscopy (AB only), and medication costs of IBD-specific medications, such as: mesalamine, biologics, steroids, and immunomodulators. Costs were converted to 2020 dollars using the consumer price index. Average annual cost per person (ACPP) was calculated for each province. Using province specific IBD prevalence estimates these ACPP were meta-analyzed to obtain the annual weighted costs, with 95% confidence intervals (CI), and these costs underwent meta-regression to ascertain the average annual change in cost per year. An Autoregressive Integrated Moving Average model was created to estimate the ACPP in 2023 with 95% prediction intervals (PI). Canada-wide total direct care costs of IBD patients, in billions (B), were calculated using the ACPP, Canada-specific IBD prevalence estimates (historical and forecasted), and total Canadian population calculations from Statistics Canada (historical and forecasted). Result(s) In 2009 the ACPP was $7000 (95%CI: 5389, 8610), representing $1.18B (95%CI: 0.91B, 1.45B) in direct healthcare costs in Canada for all IBD patients. The ACPP in 2016 was increased to $10,336 (95%CI: 6803, 13869), which equates to $2.37B (95%CI: 1.56B, 3.18B) per year in direct healthcare costs. From 2009 to 2016, the ACPP increased an average of $450 (95%CI: 132, 767) per year. If these historical trends continue to 2023 the ACPP is forecasted to be $13,333 (95%PI: 12827, 13839) per person per year. The largest contributor to these costs is medications—accounting for an estimated 50% of the total costs of IBD patients. Image ![]()
Conclusion(s) The direct healthcare cost of IBD has risen steadily from 2009 to 2016 when the healthcare system spent over $10,000 per person with IBD and $2.37B nationwide. The primary driver of costs is medical management. Forecast models estimate that the annual cost may be over $13,000 per person in 2023. However, these estimates do not account for advent and increased uptake of novel biologics and small molecules, nor the downward cost pressure of biosimilars. These costs are those paid directly by the healthcare system and do not account for those born by the individual—it is estimated that the true cost of IBD (direct and indirect) is much higher. Please acknowledge all funding agencies by checking the applicable boxes below CIHR Disclosure of Interest S. Coward: None Declared, E. Benchimol Consultant of: Hoffman La-Roche Limited and Peabody & Arnold LLP for matters unrelated to medications used to treat inflammatory bowel disease and McKesson Canada and the Dairy Farmers of Ontario for matters unrelated to medications used to treat inflammatory bowel disease., C. Bernstein Grant / Research support from: Unrestricted educational grants from Abbvie Canada, Janssen Canada, Pfizer Canada, Bristol Myers Squibb Canada, and Takeda Canada. Has received research grants from Abbvie Canada, Amgen Canada, Pfizer Canada, and Sandoz Canada and contract grants from Janssen, Abbvie and Pfizer, Consultant of: Abbvie Canada, Amgen Canada, Bristol Myers Squibb Canada, JAMP Pharmaceuticals, Janssen Canada, Pfizer Canada, Sandoz Canada, and Takeda., Speakers bureau of: Abbvie Canada, Janssen Canada, Pfizer Canada and Takeda Canada, J. A. Avina-Zubieta: None Declared, A. Bitton: None Declared, L. Hracs: None Declared, J. Jones Consultant of: Janssen, Abbvie, Pfizer, Takeda, Speakers bureau of: Janssen, Abbvie, Pfizer, Takeda, E. Kuenzig: None Declared, L. Lu: None Declared, S. Murthy: None Declared, Z. Nugent: None Declared, A. Otley Grant / Research support from: Unrestricted educational grants from AbbVie Canada and Janssen Canada, Consultant of: Advisory boards of AbbVie Canada, Janssen Canada and Nestle, R. Panaccione Consultant of: Abbott, AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Eli Lilly, Ferring, Galapagos, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pendopharm, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz, Satisfai Health, Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Theravance Biopharma, Trellus, Viatris, UCB. Advisory Boards for: AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Speakers bureau of: AbbVie, Amgen, Arena Pharmaceuticals, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Gilead Sciences, Janssen, Merck, Organon, Pfizer, Roche, Sandoz, Shire, Takeda Pharmaceuticals, J.-N. Pena-Sanchez: None Declared, H. Singh Consultant of: Pendopharm, Amgen Canada, Bristol Myers Squibb Canada, Roche Canada, Sandoz Canada, Takeda Canada, and Guardant Health, Inc.,, L. Targownik Grant / Research support from: Investigator initiated funding from Janssen Canada, Consultant of: [Advisory board] AbbVie Canada, Takeda Canada, Merck Canada, Pfizer Canada, Janssen Canada, Roche Canada, and Sandoz Canada, J. Windsor: None Declared, G. Kaplan Grant / Research support from: Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire, Consultant of: Gilead, Speakers bureau of: AbbVie, Janssen, Pfizer, Amgen, and Takeda
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Kaplan G, Berg M, Friedrich C, Schimanski CC, Heyne von Haußen R, Bergmann F. Erratum: Endosonographisch gesteuerte Feinnadelbiopsie vs. Feinnadelaspiration von Pankreaskarzinomen. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2022. [DOI: 10.1055/a-0658-7795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mutlu LC, Tülübaş F, Alp R, Kaplan G, Yildiz ZD, Gürel A. Serum YKL-40 level is correlated with apnea hypopnea index in patients with obstructive sleep apnea sindrome. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2017; 21:4161-4166. [PMID: 29028081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Obstructive sleep apnea syndrome (OSAS) has been associated with elevated biochemical markers of inflammation. Although the exact mechanism is unknown, both sleep deprivation and hypoxemia are believed to be important causative factors. YKL-40, also known as chitinase-like protein, has been shown to be related to various inflammatory conditions including atherosclerosis, diabetes, cancer, and asthma. The present study aimed to evaluate the relationship between YKL-40 levels and the Apnea Hypopnea Index (AHI) in patients with obstructive sleep apnea syndrome. PATIENTS AND METHODS The study was conducted at the Sleep Unit of the Namik Kemal University Research Center. From January 2013 to December 2013, 120 patients diagnosed with OSAS by polysomnography and 40 subjects without OSAS were recruited. Patients in both groups were matched by age, sex, and body mass index (BMI). They were further divided into groups of mild, moderate and severe OSAS based on their AHI value. Serum YKL-40 concentrations were measured by the enzyme-linked immunosorbent assay (ELISA). RESULTS OSAS patients showed significantly elevated YKL-40 levels compared to the control group; 102,05 (23.14) pg/ml in the control group vs. 144.81 (65.53) pg/ml in the OSAS group. A Spearman correlation analysis showed that serum YKL-40 levels were significantly and positively correlated with AHI (r = 0.434, p < 0.001) and oxygen desaturation index (r = 0.374, p < 0.001). CONCLUSIONS The study demonstrated that high serum YKL-40 levels correlated with the severity of OSAS and might serve as a nonspecific biomarker for prediction and progression of the disease.
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Kellar A, Kaplan G, Panaccione R, DeBruyn J, Wilson S, Novak K. A SIMPLE ULTRASOUND SCORE FOR THE ACCURATE DETECTION AND MONITORING OF PEDIATRIC INFLAMMATORY BOWEL DISEASE. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Eksteen B, Heatherington J, Oshiomogo J, Panaccione R, Kaplan G, Ghosh S. Retraction notice to: PS124-Efficacy and Safety of Induction Dosing of Vedolizumab for Reducing Biliary Inflammation in Primary Sclerosing Cholangitis (PSC) in Individuals with Inflammatory Bowel Disease [J Hepatol 64 (2016) S199]. J Hepatol 2017; 66:254. [PMID: 28042931 DOI: 10.1016/j.jhep.2016.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Eksteen B, Heatherington J, Oshiomogo J, Panaccione R, Kaplan G, Ghosh S. RETRACTED: Efficacy and Safety of Induction Dosing of Vedolizumab for Reducing Biliary Inflammation in Primary Sclerosing Cholangitis (Psc) in Individuals with Inflammatory Bowel Disease. J Hepatol 2016; 64:S199. [PMID: 27769522 DOI: 10.1016/s0168-8278(16)01707-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The abstract authors and presenters of PS124 - EFFICACY AND SAFETY OF INDUCTION DOSING OF VEDOLIZUMAB FOR REDUCING BILIARY INFLAMMATION IN PRIMARY SCLEROSING CHOLANGITIS (PSC) IN INDIVIDUALS WITH INFLAMMATORY BOWEL DISEASE submitted and presented at ILC 2016 have raised concerns that the source data in some cases are inconsistent and requires further evaluation to determine the true magnitude of effect. Hence given the potential impact of this study in PSC at the authors request this abstract, until such time the data can be more completely presented in manuscript form, is being retracted.
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Globus O, Leibovitch L, Maayan-Metzger A, Schushan-Eisen I, Morag I, Mazkereth R, Glasser S, Kaplan G, Strauss T. The use of short message services (SMS) to provide medical updating to parents in the NICU. J Perinatol 2016; 36:739-43. [PMID: 27195981 DOI: 10.1038/jp.2016.83] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 03/30/2016] [Accepted: 04/07/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Premature delivery and prolonged hospitalization of infants in the neonatal intensive care unit (NICU) are very stressful for parents. As technology has advanced, short message services (SMS) have been used increasingly in the medical disciplines. To date, the use of SMS for updating patients and families regarding medical information has not been reported. We implemented the SMS technique to daily update the parents regarding the health status of their preterm infant. The objective of this study was to evaluate the use of SMS technology and to assess its impact on the parents and the nursing staff. STUDY DESIGN Parents and nurses completed questionnaires at two time periods: pre-SMS implementation (pre-SMSi) and post-SMS implementation (post-SMSi). The parent questionnaires included statements about medical information delivery, communication and trust between parents and medical staff, parental anxiety and overall satisfaction. The nurse questionnaires included statements about the expected and actual impact on their workload. RESULTS Comparison of the parents' responses at the two time periods indicated that in the post-SMSi time period, they felt that the physician was more available when needed (P=0.002), they were more comfortable about approaching the physician (P=0.001) and more satisfied with the medical information provided by the staff (P=0.03). In the post-SMSi period, 78.1% of the nurses noted that the SMS communication is a convenient and user-friendly method. CONCLUSIONS SMS updating is an easy and user-friendly technology that enriches the modalities of information delivery to parents of hospitalized preterm infants. It is a complementary and useful tool for encouraging and improving personal communication between parents and medical staff and should be considered part of quality improvement in health care.
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Dankner R, Olmer L, Kaplan G, Chetrit A. The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women. Qual Life Res 2016; 25:2889-2896. [PMID: 27138965 DOI: 10.1007/s11136-016-1291-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years. METHODS During the years 2000-2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnosed diabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality. RESULTS A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71-6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25-3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01). CONCLUSIONS Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.
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Kellar A, Kaplan G, Panaccione R, DeBruyn J, Wilson S, Novak K. 28: Monitoring Pediatric Inflammatory Bowel Disease – A Retrospective Analysis of Transabdominal Ultrasound. Paediatr Child Health 2015. [DOI: 10.1093/pch/20.5.e43a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Johnson-Lawrence V, Kaplan G, Galea S. Socio-economic patterning in adulthood and depressive symptoms among a community sample of older adults in the United States. Public Health 2015; 129:594-6. [PMID: 25753277 DOI: 10.1016/j.puhe.2015.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 12/02/2014] [Accepted: 01/19/2015] [Indexed: 10/23/2022]
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Sparks S, Kaplan A, DeCambre M, Kaplan G, Holmes N. Eosinophilic cystitis in the pediatric population: a case series and review of the literature. J Pediatr Urol 2013; 9:738-44. [PMID: 23391564 DOI: 10.1016/j.jpurol.2012.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/06/2012] [Indexed: 11/18/2022]
Abstract
PURPOSE Eosinophilic cystitis is a rarely seen condition in the pediatric population with indistinct symptomatology and non-standardized treatment protocols. We review our experience of treating patients with this condition. MATERIALS AND METHODS We retrospectively reviewed the records of four patients from a single institution who have been diagnosed and treated for eosinophilic cystitis. In addition, the literature was reviewed for cases of pediatric eosinophilic cystitis. Our patients were added and compared to this cohort. RESULTS Our patients included 3 females and 1 male who range in age from 5 days to 18 years (5 days, 1 month, 7 years, 18 years). Both of the infants presented with a suprapubic mass and bilateral hydroureteronephrosis. The two older patients both had dysuria while the 18 yo also complained of fatigue, flank pain, and hematuria. Only 2 of the 4 patients were found to have significant peripheral eosinophilia and only one patient had eosinophiluria. All of the patients were diagnosed via cystourethroscopy with biopsy. Treatment in each case consisted of a combination of steroids, antihistamines, and antibiotics. CONCLUSIONS The presentation of eosinophilic cystitis is varied and diagnosis requires a high index of suspicion. Cystourethroscopy with biopsy is essential to establish the diagnosis as there is no typical appearance of the lesions or presenting signs/symptoms. Most cases of eosinophilic cystitis are responsive to medical therapy although in some cases recurrence may be noted.
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Hoit G, Hinkewich C, Tiao J, Porgo V, Moore L, Moore L, Tiao J, Wang C, Moffatt B, Wheeler S, Gillman L, Bartens K, Lysecki P, Pallister I, Patel S, Bradford P, Bradford P, Kidane B, Holmes A, Trajano A, March J, Lyons R, Kao R, Rezende-Neto J, Leblanc Y, Rezende-Neto J, Vogt K, Alzaid S, Jansz G, Andrusiek D, Andrusiek D, Bailey K, Livingston M, Calthorpe S, Hsu J, Lubbert P, Boitano M, Leeper W, Williamson O, Reid S, Alonazi N, Lee C, Rezende-Neto J, Aleassa E, Jennings P, Jennings P, Mador B, Hoffman K, Riley J, Vu E, Alburakan A, Alburakan A, Alburakan A, Mckee J, Bobrovitz N, Gabbe B, Gabbe B, Hodgkinson J, Hodgkinson J, Ali J, Ali J, Grant M, Roberts D, Holodinsky J, Cooper C, Santana M, Kruger K, Hodgkinson J, Waggott M, Da Luz L, Banfield J, Santana M, Dorigatti A, Birn K, Bobrovitz N, Zakirova R, Davies D, Das D, Gamme G, Pervaiz F, Almarhabi Y, Brainard A, Brown R, Bell N, Bell N, Jowett H, Jowett H, Bressan S, Hogan A, Watson I, Woodford S, Hogan A, Boulay R, Watson I, Howlett M, Atkinson P, Chesters A, Hamadani F, Atkinson P, Azzam M, Fraser J, Doucet J, Atkinson P, Muakkassa F, Sathivel N, Chadi S, Joseph B, Takeuchi L, Bradley N, Al Bader B, Kidane B, Harrington A, Nixon K, Veigas P, Joseph B, O’Keeffe T, Bracco D, Rezende-Neto J, Azzam M, Lin Y, Bailey K, Bracco D, Nash N, Alhabboubi M, Slobogean G, Spicer J, Heidary B, Joos E, Berg R, Berg R, Sankarankutty A, Zakrison T, Babul S, Lockhart S, Faux S, Jackson A, Lee T, Bailey K, Pemberton J, Green R, Tallon J, Moore L, Turgeon A, Boutin A, Moore L, Reinartz D, Lapointe G, Turgeon A, Stelfox H, Turgeon A, Nathens A, Neveu X, Stelfox H, Turgeon A, Nathens A, Neveu X, Moore L, Turgeon A, Bratu I, Gladwin C, Voaklander D, Lewis M, Vogt K, Eckert K, Williamson J, Stewart TC, Parry N, Gray D, L’Heureux R, Ziesmann M, Kortbeek J, Brindley P, Hicks C, Fata P, Engels P, Ball C, Paton-Gay D, Widder S, Vogt K, Hernandez-Alejandro R, Gray D, Vanderbeek L, Forrokhyar F, Anatharajah R, Howatt N, Lamb S, Sne N, Kahnamoui K, Lyons R, Walters A, Brooks C, Pinder L, Rahman S, Walters A, Kidane B, Parry N, Donnelly E, Lewell M, Mellow R, Hedges C, Morassutti P, Bulatovic R, Morassutti P, Galbraith E, McKenzie S, Bradford D, Lewell M, Peddle M, Dukelow A, Eby D, McLeod S, Bradford P, Stewart TC, Parry N, Williamson O, Fraga G, Pereira B, Sareen J, Doupe M, Gawaziuk J, Chateau D, Logsetty S, Pallister I, Lewis J, O’Doherty D, Hopkins S, Griffiths S, Palmer S, Gabbe B, Xu X, Martin C, Xenocostas A, Parry N, Mele T, Rui T, Abreu E, Andrade M, Cruz F, Pires R, Carreiro P, Andrade T, Lampron J, Balaa F, Fortuna R, Issa H, Dias P, Marques M, Fernandes T, Sousa T, Inaba K, Smith J, Okoye O, Joos E, Shulman I, Nelson J, Parry N, Rhee P, Demetriades D, Ostrofsky R, Butler-Laporte G, Chughtai T, Khwaja K, Fata P, Mulder D, Razek T, Deckelbaum D, Bailey K, Pemberton J, Evans D, Anton H, Wei J, Randall E, Sobolev B, Scott BB, van Heest R, Frankfurter C, Pemberton J, McKerracher S, Stewart TC, Merritt N, Barber L, Kimmel L, Hodgson C, Webb M, Holland A, Gruen R, Harrison K, Hwang M, Hsee L, Civil I, Muizelaar A, Baillie F, Leeper T, Stewart TC, Gray D, Parry N, Sutherland A, Hart M, Gabbe B, Tuma F, Coates A, Farrokhyar F, Faidi S, Gastaldo F, Paskar D, Reid S, Faidi S, Petrisor B, Bhandari M, Loh WL, Ho C, Chong C, Rodrigues G, Gissoni M, Martins M, Andrade M, Cunha-Melo J, Rizoli S, Abu-Zidan F, Cameron P, Bernard S, Walker T, Jolley D, Fitzgerald M, Masci K, Gabbe B, Simpson P, Smith K, Cox S, Cameron P, Evans D, West A, Barratt L, Rozmovits L, Livingstone B, Vu M, Griesdale D, Schlamp R, Wand R, Alhabboubi M, Alrowaili A, Alghamdi H, Fata P, Essbaiheen F, Alhabboubi M, Fata P, Essbaiheen F, Chankowsky J, Razek T, Stephens M, Vis C, Belton K, Kortbeek J, Bratu I, Dufresne B, Guilfoyle J, Ibbotson G, Martin K, Matheson D, Parks P, Thomas L, Kirkpatrick A, Santana M, Kline T, Kortbeek J, Stelfox H, Lyons R, Macey S, Fitzgerald M, Judson R, Cameron P, Sutherland A, Hart M, Morgan M, McLellan S, Wilson K, Cameron P, Sorvari A, Chaudhry Z, Khawaja K, Ali A, Akhtar J, Zubair M, Nickow J, Sorvari A, Holodinsky J, Jaeschke R, Ball C, Blaser AR, Starkopf J, Zygun D, Kirkpatrick A, Roberts D, Ball C, Blaser AR, Starkopf J, Zygun D, Jaeschke R, Kirkpatrick A, Santana M, Stelfox H, Stelfox H, Rizoli S, Tanenbaum B, Stelfox H, Redondano BR, Jimenez LS, Zago T, de Carvalho RB, Calderan TA, Fraga G, Campbell S, Widder S, Paton-Gay D, Engels P, Ferri M, Santana M, Kline T, Kortbeek J, Stelfox H, Nathens A, Lashoher A, McFarlan A, Ahmed N, Booy J, McDowell D, Nasr A, Wales P, Roberts D, Mercado M, Vis C, Kortbeek J, Kirkpatrick A, Lall R, Stelfox H, Ball C, Niven D, Dixon E, Stelfox H, Kirkpatrick A, Kaplan G, Hameed M, Ball C, Qadura M, Sne N, Reid S, Coates A, Faidi S, Veenstra J, Hennecke P, Gardner R, Appleton L, Sobolev B, Simons R, van Heest R, Hameed M, Sobolev B, Simons R, van Heest R, Hameed M, Palmer C, Bevan C, Crameri J, Palmer C, Hogan D, Grealy L, Bevan C, Palmer C, Jowett H, Boulay R, Chisholm A, Beairsto E, Goulette E, Martin M, Benjamin S, Boulay R, Watson I, Boulay R, Watson I, Watson I, Savoie J, Benjamin S, Martin M, Hogan A, Woodford S, Benjamin S, Chisholm A, Ondiveeran H, Martin M, Atkinson P, Doody K, Fraser J, Leblanc-Duchin D, Strack B, Naveed A, vanRensburg L, Madan R, Atkinson P, Boulva K, Deckelbaum D, Khwaja K, Fata P, Razek T, Fraser J, Verheul G, Parks A, Milne J, Nemeth J, Fata P, Correa J, Deckelbaum D, Bernardin B, Al Bader B, Khwaja K, Razek T, Atkinson P, Benjamin S, Sproul E, Mehta A, Galarneau M, Mahadevan P, Bansal V, Dye J, Hollingsworth-Fridlund P, Stout P, Potenza B, Coimbra R, Madan R, Marley R, Salvator A, Pisciotta D, Bridge J, Lin S, Ovens H, Nathens A, Abdo H, Dencev-Bihari R, Parry N, Lawendy A, Ibrahim-Zada I, Pandit V, Tang A, O’Keeffe T, Wynne J, Gries L, Friese R, Rhee P, Hameed M, Simons R, Taulu T, Wong H, Saleem A, Azzam M, Boulva K, Razek T, Khwaja K, Mulder D, Deckelbaum D, Fata P, Plourde M, Chadi S, Forbes T, Parry N, Martin G, Gaunt K, Bandiera G, Bawazeer M, MacKinnon D, Ahmed N, Spence J, Sankarankutty A, Nascimento B, Rizoli S, Ibrahim-Zada I, Aziz H, Tang A, Friese R, Wynne J, O’keeffe T, Vercruysse G, Kulvatunyou N, Rhee P, Sakles J, Mosier J, Wynne J, Kulvatunyou N, Tang A, Joseph B, Rhee P, Khwaja K, Fata P, Deckelbaum D, Razek T, Dias P, Issa H, Fortuna R, Sousa T, Abreu E, Bracco D, Khwaja K, Fata P, Deckelbaum D, Razek T, Bracco D, Khwaja K, Fata P, Deckelbaum D, Razek T, Norman D, Li J, Pemberton J, Al-Oweis J, Khwaja K, Fata P, Deckelbaum D, Razek T, Albuz O, Karamanos E, Vogt K, Okoye O, Talving P, Inaba K, Demetriades D, Elhusseini M, Sudarshan M, Deckelbaum D, Fata P, Razek T, Khwaja K, MacPherson C, Sun T, Pelletier M, Hameed M, Khalil MA, Azzam M, Valenti D, Fata P, Deckelbaum D, Razek T, Brown R, Simons R, Evans D, Hameed M, Inaba K, Vogt K, Okoye O, Gelbard R, Moe D, Grabo D, Demetriades D, Inaba K, Karamanos E, Okoye O, Talving P, Demetriades D, Inaba K, Karamanos E, Pasley J, Teixeira P, Talving P, Demetriades D, Fung S, Alababtain I, Brnjac E, Luz L, Nascimento B, Rizoli S, Parikh P, Proctor K, Murtha M, Schulman C, Namias N, Goldman R, Pike I, Korn P, Flett C, Jackson T, Keith J, Joseph T, Giddins E, Ouellet J, Cook M, Schreiber M, Kortbeek J. Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review. Can J Surg 2013. [DOI: 10.1503/cjs.005813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Koboroff A, Kaplan G, Rogers L. Clever strategists: Australian Magpies vary mobbing strategies, not intensity, relative to different species of predator. PeerJ 2013; 1:e56. [PMID: 23638394 PMCID: PMC3628829 DOI: 10.7717/peerj.56] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 03/03/2013] [Indexed: 11/20/2022] Open
Abstract
Anti-predator behaviour of magpies was investigated, using five species of model predators, at times of raising offspring. We predicted differences in mobbing strategies for each predator presented and also that raising juveniles would affect intensity of the mobbing event. Fourteen permanent resident family groups were tested using 5 different types of predator (avian and reptilian) known to be of varying degrees of risk to magpies and common in their habitat. In all, 210 trials were conducted (across three different stages of juvenile development). We found that the stage of juvenile development did not alter mobbing behaviour significantly, but predator type did. Aerial strategies (such as swooping) were elicited by taxidermic models of raptors, whereas a taxidermic model of a monitor lizard was approached on the ground and a model snake was rarely approached. Swooping patterns also changed according to which of the three raptors was presented. Our results show that, in contrast to findings in other species, magpies vary mobbing strategy depending on the predator rather than varying mobbing intensity.
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Li X, Bethune L, Jia Y, Lovell R, Proescholdt T, Benz S, Schell T, Kaplan G, McChesney D. Surveillance of Salmonella Prevalence in Animal Feeds and Characterization of the Salmonella Isolates by Serotyping and Antimicrobial Susceptibility. Foodborne Pathog Dis 2012; 9:692-8. [DOI: 10.1089/fpd.2011.1083] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fiest K, Dykeman J, Patten S, Kaplan G, Wiebe S, Jette N. The Relationship between Depression & Epilepsy: A Systematic Review and Meta-Analysis (P01.042). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kaplan G, Galea S, Riddle M. O4-2.4 Complexity, epidemiology and the understanding of "what if". Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976b.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wolfson MC, Kaplan G, Lynch J, Ross N, Backlund E. Relation between income inequality and mortality: empirical demonstration. West J Med 2010; 172:22-4. [PMID: 18751209 DOI: 10.1136/ewjm.172.1.22] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To assess the extent to which observed associations between income inequality and mortality at population level are statistical artifacts. Design Indirect "what if" simulation using observed risks of mortality at individual level as a function of income to construct hypothetical state-level mortality specific for age and sex as if the statistical artifact argument were 100% correct. Method Data from the 1990 census for the 50 US states plus Washington, DC, were used for population distributions by age, sex, state, and income range; data disaggregated by age, sex, and state from the Centers for Disease Control and Prevention were used for mortality; and regressions from the national longitudinal mortality study were used for the individual-level relation between income and risk of mortality. Results Hypothetical mortality, although correlated with inequality (as implied by the logic of the statistical artifact argument), showed a weaker association with the level of income inequality in each state than the observed mortality. Conclusions The observed associations in the United States at the state level between income inequality and mortality cannot be entirely or substantially explained as statistical artifacts of an underlying individual-level relation between income and mortality. There remains an important association between income inequality and mortality at state level above anything that could be accounted for by any statistical artifact. This result reinforces the need to consider a broad range of factors, including the social milieu, as fundamental determinants of health.
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Brown J, Kaplan G, Rogers LJ, Vallortigara G. Perception of biological motion in common marmosets (Callithrix jacchus): by females only. Anim Cogn 2010; 13:555-64. [PMID: 20052512 DOI: 10.1007/s10071-009-0306-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 12/06/2009] [Accepted: 12/06/2009] [Indexed: 12/01/2022]
Abstract
The ability to perceive biological motion (BM) has been demonstrated in a number of species including humans but the few studies of non-human primates have been relatively inconclusive. We investigated whether common marmosets (Callithrix jacchus) are able to perceive biological motion, using a novel method to test non-human primates. Marmosets (7 male and 7 female) were trained to remove a cover from a container and look inside it, revealing a computer screen. Then they were presented with images on this computer screen consisting of a novel BM pattern (a walking hen) and 4 manipulations of that pattern (a static frame of this pattern and inverted, scrambled, and rotating versions of the pattern). The behavioural responses of the marmosets were recorded and used to assess discrimination between stimuli. BM was attended to by females but not males, as shown by active inspection behaviour, mainly movement of the head towards the stimulus. Females paid significantly less attention to all of the other stimuli. This indicates the females' ability to attend to biological motion. Females showed slightly more attention to the inverted BM than to the static, scrambled, and rotating patterns. The males were less attentive to all of the stimuli than were the females and, unlike the females, responded to all stimuli in a similar manner. This sex difference could be due to an inability of males to recognise BM altogether or to a lesser amount of curiosity. Considered together with the findings of previous studies on chicks and humans, the results of the present study support the notion of a common mechanism across species for the detection of BM.
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