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| 1 | Vitamin D improves inflammatory bowel disease outcomes:Basic science and clinical review显示文摘Vitamin D deficiency is commonly diagnosed among patients with inflammatory bowel disease(IBD).Patients with IBD are at risk of low bone density and increased fractures due to low vitamin D levels,long standing disease,and frequent steroid exposures;as a result,it is well established that vitamin D supplementation in this population is important.There is increasing support for the role of vitamin D in strengthening the innate immune system by acting as an immunomodulator and reducing inflammation in experimental and human IBD.The active form of vitamin D,1,25(OH)D3,acts on T cells to promote T helper(Th)2/regulatory T responses over Th1/Th17 responses;suppresses dendritic cell inflammatory activity;induces antibacterial activity;and regulates cytokine production in favor of an antiinflammatory response.Murine and human IBD studies support a therapeutic role of vitamin D in IBD.Risk factors for vitamin D deficiency in this population include decreased sunlight exposure,disease duration,smoking,and genetics.Vitamin D normalization is associated with reduced risk of relapse,reduced risk of IBD-related surgeries,and improvement in quality of life.Vitamin D is an inexpensive supplement which has been shown to improve IBD outcomes.However,further research is required to determine optimal serum vitamin D levels which will achieve beneficial immune effects,and stronger evidence is needed to support the role of vitamin D in inducing disease response and remission,as well as maintaining this improvement in patients’disease states. | Krista M Reich Richard N Fedorak Karen Madsen Karen I Kroeker | 2014 | World Journal of Gastroenterology2014，20，17： | 34 |
| 2 | Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting显示文摘AIM: To validate the Rockall scoring system for predicting outcomes of rebleeding, and the need for a surgical procedure and death. METHODS: We used data extracted from the Registry of Upper Gastrointestinal Bleeding and Endoscopy including information of 1869 patients with non-variceal upper gastrointestinal bleeding treated in Canadian hospitals. Risk scores were calculated and used to classify patients based on outcomes. For each outcome, we used χ2 goodness-of-fit tests to assess the degree of calibration, and built receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the discriminative ability of the scoring system. RESULTS: For rebleeding, the χ2 goodness-of-fit test indicated an acceptable fit for the model [χ2 (8) = 12.83, P = 0.12]. For surgical procedures [χ2 (8) = 5.3, P = 0.73] and death [χ2 (8) = 3.78, P = 0.88], the tests showed solid correspondence between observed proportions and predicted probabilities. The AUC was 0.59 (95% CI: 0.55-0.62) for the outcome of rebleeding and 0.60 (95% CI: 0.54-0.67) for surgical procedures, representing apoor discriminative ability of the scoring system. For the outcome of death, the AUC was 0.73 (95% CI: 0.69-0.78), indicating an acceptable discriminative ability. CONCLUSION: The Rockall scoring system provides an acceptable tool to predict death, but performs poorly for endpoints of rebleeding and surgical procedures. | Robert A Enns Yves M Gagnon Alan N Barkun David Armstrong Jamie C Gregor Richard N Fedorak RUGBE Investigators Group | 2006 | World Journal of Gastroenterology2006，12，48： | 14 |
| 3 | Distance management of inflammatory bowel disease:Systematic review and meta-analysis显示文摘AIM:To review the effectiveness of distance management methods in the management of adult inflammatory bowel disease(IBD)patients.METHODS:A systematic review and meta-analysis of randomized controlled trials comparing distance management and standard clinic follow-up in the management of adult IBD patients.Distance management intervention was defined as any remote management method in which there is a patient self-management component whereby the patient interacts remotely via a self-guided management program,electronic interface,or self-directs open access to clinic follow up.The search strategy included electronic databases(Medline,PubMed,CINAHL,The Cochrane Central Register of Controlled Trials,EMBASE,KTPlus,Web of Science,and SCOPUS),conference proceedings,and internet search for web publications.The primary outcome was the mean difference in quality of life,and the secondary outcomes included mean difference in relapse rate,clinic visit rate,and hospital admission rate.Study selection,data extraction,and risk of bias assessment were completed by two independent reviewers.RESULTS:The search strategy identified a total of4061 articles,but only 6 randomized controlled trials met the inclusion and exclusion criteria for the systematic review and meta-analysis.Three trials involved telemanagement,and three trials involved directed patient self-management and open access clinics.The total sample size was 1463 patients.There was a trend towards improved quality of life in distance management patients with an end IBDQ quality of life score being 7.28(95%CI:-3.25-17.81)points higher than standard clinic follow-up.There was a significant decrease in the clinic visit rate among distance management patients mean difference-1.08(95%CI:-1.60--0.55),but no significant change in relapse rate or hospital admission rate.CONCLUSION:Distance management of IBD significantly decreases clinic visit utilization,but does not significantly affect relapse rates or hospital admission rates. | Vivian W Huang Krista M Reich Richard N Fedorak | 2014 | World Journal of Gastroenterology2014，20，3： | 9 |
| 4 | Dietary and metabolomic determinants of relapse in ulcerative colitis patients: A pilot prospective cohort study显示文摘AIM To identify demographic, clinical, metabolomic, and lifestyle related predictors of relapse in adult ulcerative colitis(UC) patients.METHODS In this prospective pilot study, UC patients in clinical remission were recruited and followed-up at 12 mo to assess a clinical relapse, or not. At baseline information on demographic and clinical parameters was collected. Serum and urine samples were collected for analysis of metabolomic assays using a combined direct infusion/liquid chromatography tandem mass spectrometry and nuclear magnetic resolution spectroscopy. Stool samples were also collected to measure fecal calprotectin(FCP). Dietary assessment was performed using a validated self-administered food frequency questionnaire. RESULTS Twenty patients were included(mean age: 42.7 ± 14.8 years, females: 55%). Seven patients(35%) experienced a clinical relapse during the follow-up period. While 6 patients(66.7%) with normal body weight developed a clinical relapse, 1 UC patient(9.1%) who was overweight/obese relapsed during the follow-up(P = 0.02). At baseline, poultry intake was significantly higher in patients who were still in remission during follow-up(0.9 oz vs 0.2 oz, P = 0.002). Five patients(71.4%) with FCP > 150 μg/g and 2 patients(15.4%) with normal FCP(≤ 150 μg/g) at baseline relapsed during the follow-up(P = 0.02). Interestingly, baseline urinary and serum metabolomic profiling of UC patients with or without clinical relapse within 12 mo showed a significant difference. The most important metabolites that were responsible for this discrimination were trans-aconitate, cystine and acetamide in urine, and 3-hydroxybutyrate, acetoacetate and acetone in serum. CONCLUSION A combination of baseline dietary intake, fecal calprotectin, and metabolomic factors are associated with risk of UC clinical relapse within 12 mo. | Ammar Hassanzadeh Keshtel iFloris F van den Brand Karen L Madsen Rupasri Mandal Rosica ValchevaKaren I Kroeker Beomsoo Han Rhonda C Bell Janis Cole Thomas Hoevers David S Wishart Richard N Fedorak Levinus A Dieleman | 2017 | World Journal of Gastroenterology2017，23，21： | 9 |
| 5 | TP53 codon 72 Arg/Arg polymorphism is associated with a higher risk for inflammatory bowel disease development显示文摘AIM: To investigate the association between tumor protein 53(TP53) codon 72 polymorphisms and the risk for inflammatory bowel disease(IBD) development.METHODS: Numerous genetic and epigenetic drivers have been identified for IBD including the TP53 gene. Pathogenic mutations in TP53 gene have only been reported in 50% of colorectal cancer(CRC) patients. A single nucleotide polymorphism(SNP) in the TP53 gene resulting in the presence of either arginine(Arg)or proline(Pro) or both at codon 72 was shown to alter TP53 tumor-suppressor properties. This SNP has been investigated as a risk factor for numerous cancers,including CRC. In this study we analyzed TP53 codon 72 polymorphism distribution in 461 IBD,181 primary sclerosing cholangitis patients and 62 healthy controls. Genotyping of TP53 was performed by sequencing and restriction fragment length polymorphism analysis of genomic DNA extracted from peripheral blood. RESULTS: The most frequent TP53 genotype in IBD patients was Arg/Arg occurring in 54%-64% of cases(and in only 32% of controls). Arg/Pro was the most prevalent genotype in controls(53%) and less common in patients(31%-40%). Pro/Pro frequency was not significantly different between controls and IBD patients. CONCLUSION: The data suggests that the TP53 codon 72 Arg/Arg genotype is associated with increased risk for IBD development. | Natalia Volodko Mohamed Salla Bertus Eksteen Richard N Fedorak Hien Q Huynh Shairaz Baksh | 2015 | World Journal of Gastroenterology2015，21，36： | 9 |
| 6 | Varicella zoster meningitis complicating combined anti-tumor necrosis factor and corticosteroid therapy in Crohn's disease显示文摘Opportunistic viral infections are a well-recognized complication of anti-tumor necrosis factor (TNF) therapy for inflammatory bowel disease (IBD). Cases of severe or atypical varicella zoster virus infection, both primary and latent reactivation, have been described in association with immunosuppression of Crohn's disease (CD) patients. However, central nervous system varicella zoster virus infections have been rarely described, and there are no previous reports of varicella zoster virus meningitis associated with anti-TNF therapy among the CD population. Here, we present the case of a 40-year-old male with severe ileocecal-CD who developed a reactivation of dermatomal herpes zoster after treatment with prednisone and adalimumab. The reactivation presented as debilitating varicella zoster virus meningitis, which was not completely resolved despite aggressive antiviral therapy with prolonged intravenous acyclovir and subsequent oral valacyclovir. This is the first reported case of opportunistic central nervous system varicella zoster infection complicating anti-TNF therapy in the CD population. This paper also reviews the literature on varicella zoster virus infections of immunosuppressed IBD patients and the importance of vaccination prior to initiation of anti-TNF therapy. | Christopher Ma Brennan Walters Richard N Fedorak | 2013 | World Journal of Gastroenterology2013，19，21： | 5 |
| 7 | Human Anti–Tumor Necrosis Factor Monoclonal Antibody (Adalimumab) in Crohn’s Disease: the CLASSIC-I Trial显示文摘 | Stephen B. Hanauer William J. Sandborn Paul Rutgeerts Richard N. Fedorak Milan Lukas Donald MacIntosh Remo Panaccione Douglas Wolf Paul Pollack | 2006 | Gastroenterology2006，，2： | 4 |
| 8 | Urinary NMR metabolomic profiles discriminate inflammatory bowel disease from healthy显示文摘 | Natasha S. Stephens Jesse Siffledeen Xiaorong Su Travis B. Murdoch Richard N. Fedorak Carolyn M. Slupsky | 2012 | Journal of Crohn’s and Colitis2012，，： | 4 |
| 9 | Validation of a point-of-care desk top device to quantitate fecal calprotectin and distinguish inflammatory bowel disease from irritable bowel syndrome显示文摘 | Michael J. Sydora Beate C. Sydora Richard N. Fedorak | 2011 | Journal of Crohn’s and Colitis2011，，2： | 3 |
| 10 | VsL#3 Probi- otie mixture induces remission in patients with active ulecrati colitis显示文摘 | Bibiloni R Fedorak R N Tannoek Gw | 2005 | Am JGastmenteml2005，100，： | 1 |
| 11 | Postoperative Crohns dis- ease显示文摘 | Penner RM Madsen KL Fedorak RN | 2005 | Inflamm Bowel Dis2005，11，8： | 1 |
| 12 | Adalimumab versus infliximab for the treatment of moderate to severe ulcerative colitis in adult patients na?ve to anti-TNF therapy: An indirect treatment comparison meta-analysis显示文摘 | Kristian Thorlund Eric Druyts Edward J. Mills Richard N. Fedorak John K. Marshall | 2014 | Journal of Crohn’s and Colitis2014，，： | 1 |
| 13 | The role of probiotics in management of irritable bowel syndrome显示文摘 | Borowiec AM Fedorak RN | 2007 | Curr Gastroenterol Rep2007，9，5： | 1 |
| 14 | Misoprostol provides a colonic mucosal protective effect during acetic acid-induced colitis in rats 显示文摘 | Fedorak RN Empey LR MacArthur C | 1990 | Gastroenterology1990，98，3： | 1 |
| 15 | Quality of life in inflammatory bowel disease显示文摘 | Love JR Irvine EJ Fedorak R | 1992 | Journal of Clinical Gastroenterology1992，14，1： | 1 |
| 16 | VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis显示文摘 | Bibiloni R Fedorak R N Tannock G W | 2005 | Am J Gastroenterol2005，100，7： | 1 |
| 17 | Assessment of the Potential Health Risk Associated with the Dissemination of Micro-organisms from a Landfill Site 显示文摘 | Fedorak P M Rogers R E | 1991 | Waste Manage Res1991，9，： | 1 |
| 18 | Polyacrylamide added as a nitrogen source stimulates methanogenesis in consortia from various wastewaters 显示文摘 | Haveroen M E Mackinnon M D Fedorak P M | 2005 | Water Research2005，39，14： | 1 |
| 19 | Probiotics and prebiotics in gastrointestinal disorders显示文摘 | Fedorak RN Madsen KL | 2004 | Curt Opin Gastroenterol2004，20，2： | 1 |
| 20 | Probiotics,and prebiotics in gastrointestinal disorders显示文摘 | Fedorak RN Madsen KL | 2004 | Curr Opin Gastroenterol2004，20，： | 1 |
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