The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Jordan E Axelrad - One of the best experts on this subject based on the ideXlab platform.
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Gastrointestinal Infection and risk of microscopic colitis a nationwide case control study in sweden
Gastroenterology, 2021Co-Authors: Hamed Khalili, Jordan E Axelrad, Ola Olen, Bjorn Roelstraete, Mauro Damato, Jonas F LudvigssonAbstract:ABSTRACT Background and aims Gastrointestinal Infections have been linked to changes in the composition and function of gut microbiome and development of inflammatory bowel diseases. We therefore sought to examine the relationship between gastroenteritis and risk of microscopic colitis (MC). Methods We conducted a case-control study of all adult MC patients diagnosed between 1990-2016 in Sweden matched to up to 5 general population controls according to age, sex, calendar year, and county. Cases of MC were identified using SNOMED codes from the ESPRESSO study, a cohort of Gastrointestinal pathology reports from all 28 pathology centers in Sweden. We used logistic regression modeling to estimate adjusted odds ratios (aORs) and 95% CIs. Results Through December of 2016, we matched 13,468 MC cases to 64,479 controls. The prevalence of previous diagnosed Gastrointestinal Infection was 7.5% among MC patients which was significantly higher than in controls (3.0%, Pcomparison Conclusion In a nationwide study, we found that Gastrointestinal Infection, particularly Clostridioides difficile is associated with an increased risk of subsequent MC.
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systematic review Gastrointestinal Infection and incident inflammatory bowel disease
Alimentary Pharmacology & Therapeutics, 2020Co-Authors: Jordan E Axelrad, Ken Cadwell, Jeanfrederic Colombel, Shailja C ShahAbstract:Background The initiating events of chronic Gastrointestinal (GI) inflammation in Crohn's disease (CD) and ulcerative colitis (UC) are not well-defined, but GI Infections are implicated. Aims To define the role of GI Infections in risk of incident inflammatory bowel disease (IBD) and synthesise the current body of relevant translational data to provide biological context for associations between GI Infections and IBD risk. Methods We systematically reviewed electronic databases through February 2020. Clinical studies that provided risk estimates of the association between GI Infections and incident IBD were included. Inclusion criteria were broader for translational studies aiming to define mechanisms of GI Infections and predisposition to or protection from IBD. Results Of the studies identified, 63 met full inclusion criteria. Among studies of clinical gastroenteritis, bacteria-specifically, Salmonella species, Campylobacter species and Clostridioides difficile-demonstrated consistent positive associations with risk of incident IBD. Of viruses, norovirus was associated with increased risk of incident CD. Regarding inverse associations with incident IBD, Helicobacter pylori and helminth Infections were associated with a generally consistent reduced risk of IBD. Based on a qualitative analysis of the translational data, putative mechanisms involve multiple microbial and immunologic pathways. Conclusions Based on this systematic review, certain enteric pathogens are associated with an increased risk of incident IBD, while others are potentially protective. Prospective studies are required to clarify the clinical implications of these enteric pathogens on the risk and course of IBD, and possible therapeutic or preventative benefit.
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Gastrointestinal Infection increases odds of inflammatory bowel disease in a nationwide case control study
Clinical Gastroenterology and Hepatology, 2019Co-Authors: Jordan E Axelrad, Ola Olen, Johan Askling, Benjamin Lebwohl, Hamed Khalili, Michael C Sachs, Jonas F LudvigssonAbstract:Background & Aims Gastrointestinal Infections have been associated with later development of inflammatory bowel diseases (IBD). However, studies have produced conflicting results. We performed a nationwide case–control study in Sweden to determine whether gastroenteritis is associated with the development of Crohn’s disease (CD) or ulcerative colitis (UC). Methods Using the Swedish National Patient Register, we identified 44,214 patients with IBD (26,450 with UC; 13,387 with CD; and 4377 with IBD-unclassified) from 2002 to 2014 and matched them with 436,507 individuals in the general population (control subjects). We then identified patients and control subjects with reported episodes of gastroenteritis (from 1964 to 2014) and type of pathogen associated. We collected medical and demographic data and used logistic regression to estimate odds ratios (ORs) for IBD associated with enteric Infection. Results Of the patients with IBD, 3105 (7.0%) (1672 with UC, 1050 with CD, and 383 with IBD-unclassified) had a record of previous gastroenteritis compared with 17,685 control subjects (4.1%). IBD cases had higher odds for an antecedent episode of Gastrointestinal Infection (aOR, 1.64; 1.57–1.71), bacterial Gastrointestinal Infection (aOR, 2.02; 1.82–2.24), parasitic Gastrointestinal Infection (aOR, 1.55; 1.03–2.33), and viral Gastrointestinal Infection (aOR, 1.55; 1.34–1.79). Patients with UC had higher odds of previous Infection with Salmonella, Escherichia coli, Campylobacter, or Clostridium difficile compared to control subjects. Patients with CD had higher odds of previous Infection with Salmonella, Campylobacter, Yersinia enterocolitica, C difficile, amoeba, or norovirus compared to control subjects. Increasing numbers of gastroenteritis episodes were associated with increased odds of IBD, and a previous episode of gastroenteritis remained associated with odds for IBD more than 10 years later (aOR, 1.26; 1.19–1.33). Conclusions In an analysis of the Swedish National Patient Register, we found previous episodes of gastroenteritis to increase odds of later development of IBD. Although we cannot formally exclude misclassification bias, enteric Infections might induce microbial dysbiosis that contributes to the development of IBD in susceptible individuals.
Hong Shan - One of the best experts on this subject based on the ideXlab platform.
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evidence for Gastrointestinal Infection of sars cov 2
Gastroenterology, 2020Co-Authors: Fei Xiao, Meiwen Tang, Xiaobin Zheng, Ye Liu, Hong ShanAbstract:No abstract available Keywords: ACE2; Gastrointestinal Infection; Oral-Fecal Transmission; SARS-CoV-2.
Jonas F Ludvigsson - One of the best experts on this subject based on the ideXlab platform.
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Gastrointestinal Infection and risk of microscopic colitis a nationwide case control study in sweden
Gastroenterology, 2021Co-Authors: Hamed Khalili, Jordan E Axelrad, Ola Olen, Bjorn Roelstraete, Mauro Damato, Jonas F LudvigssonAbstract:ABSTRACT Background and aims Gastrointestinal Infections have been linked to changes in the composition and function of gut microbiome and development of inflammatory bowel diseases. We therefore sought to examine the relationship between gastroenteritis and risk of microscopic colitis (MC). Methods We conducted a case-control study of all adult MC patients diagnosed between 1990-2016 in Sweden matched to up to 5 general population controls according to age, sex, calendar year, and county. Cases of MC were identified using SNOMED codes from the ESPRESSO study, a cohort of Gastrointestinal pathology reports from all 28 pathology centers in Sweden. We used logistic regression modeling to estimate adjusted odds ratios (aORs) and 95% CIs. Results Through December of 2016, we matched 13,468 MC cases to 64,479 controls. The prevalence of previous diagnosed Gastrointestinal Infection was 7.5% among MC patients which was significantly higher than in controls (3.0%, Pcomparison Conclusion In a nationwide study, we found that Gastrointestinal Infection, particularly Clostridioides difficile is associated with an increased risk of subsequent MC.
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Gastrointestinal Infection increases odds of inflammatory bowel disease in a nationwide case control study
Clinical Gastroenterology and Hepatology, 2019Co-Authors: Jordan E Axelrad, Ola Olen, Johan Askling, Benjamin Lebwohl, Hamed Khalili, Michael C Sachs, Jonas F LudvigssonAbstract:Background & Aims Gastrointestinal Infections have been associated with later development of inflammatory bowel diseases (IBD). However, studies have produced conflicting results. We performed a nationwide case–control study in Sweden to determine whether gastroenteritis is associated with the development of Crohn’s disease (CD) or ulcerative colitis (UC). Methods Using the Swedish National Patient Register, we identified 44,214 patients with IBD (26,450 with UC; 13,387 with CD; and 4377 with IBD-unclassified) from 2002 to 2014 and matched them with 436,507 individuals in the general population (control subjects). We then identified patients and control subjects with reported episodes of gastroenteritis (from 1964 to 2014) and type of pathogen associated. We collected medical and demographic data and used logistic regression to estimate odds ratios (ORs) for IBD associated with enteric Infection. Results Of the patients with IBD, 3105 (7.0%) (1672 with UC, 1050 with CD, and 383 with IBD-unclassified) had a record of previous gastroenteritis compared with 17,685 control subjects (4.1%). IBD cases had higher odds for an antecedent episode of Gastrointestinal Infection (aOR, 1.64; 1.57–1.71), bacterial Gastrointestinal Infection (aOR, 2.02; 1.82–2.24), parasitic Gastrointestinal Infection (aOR, 1.55; 1.03–2.33), and viral Gastrointestinal Infection (aOR, 1.55; 1.34–1.79). Patients with UC had higher odds of previous Infection with Salmonella, Escherichia coli, Campylobacter, or Clostridium difficile compared to control subjects. Patients with CD had higher odds of previous Infection with Salmonella, Campylobacter, Yersinia enterocolitica, C difficile, amoeba, or norovirus compared to control subjects. Increasing numbers of gastroenteritis episodes were associated with increased odds of IBD, and a previous episode of gastroenteritis remained associated with odds for IBD more than 10 years later (aOR, 1.26; 1.19–1.33). Conclusions In an analysis of the Swedish National Patient Register, we found previous episodes of gastroenteritis to increase odds of later development of IBD. Although we cannot formally exclude misclassification bias, enteric Infections might induce microbial dysbiosis that contributes to the development of IBD in susceptible individuals.
Robert W Platt - One of the best experts on this subject based on the ideXlab platform.
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effect of breastfeeding on Gastrointestinal Infection in infants a targeted maximum likelihood approach for clustered longitudinal data
The Annals of Applied Statistics, 2014Co-Authors: Mireille E Schnitzer, Mark J Van Der Laan, Erica E M Moodie, Robert W PlattAbstract:The PROmotion of Breastfeeding Intervention Trial (PROBIT) cluster-randomized a program encouraging breastfeeding to new mothers in hospital centers. The original studies indicated that this intervention successfully increased duration of breastfeeding and lowered rates of Gastrointestinal tract Infections in newborns. Additional scientific and popular interest lies in determining the causal effect of longer breastfeeding on Gastrointestinal Infection. In this study, we estimate the expected Infection count under various lengths of breastfeeding in order to estimate the effect of breastfeeding duration on Infection. Due to the presence of baseline and time-dependent confounding, specialized “causal” estimation methods are required. We demonstrate the double-robust method of Targeted Maximum Likelihood Estimation (TMLE) in the context of this application and review some related methods and the adjustments required to account for clustering. We compare TMLE (implemented both parametrically and using a data-adaptive algorithm) to other causal methods for this example. In addition, we conduct a simulation study to determine (1) the effectiveness of controlling for clustering indicators when cluster-specific confounders are unmeasured and (2) the importance of using data-adaptive TMLE.
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targeted maximum likelihood estimation for marginal time dependent treatment effects under density misspecification
Biostatistics, 2013Co-Authors: Mireille E Schnitzer, Erica E M Moodie, Robert W PlattAbstract:SUMMARY Targeted maximum likelihood methods have been proposed to estimate treatment effects for longitudinal data in the presence of time-dependent confounders. This class of methods has been mathematically proven to be doubly robust and to optimize the asymptotic estimating efficiency among the class of regular, semi-parametric estimators when all estimated density components are correctly specified. We show that methods previously proposed to build a one-step estimator with a logistic loss function generalize to a generalized linear loss function, and so may be applied naturally to an outcome that can be described by any exponential family member. We evaluate several methods for estimating unstructured marginal treatment effects for data with two time intervals in a simulation study, showing that these estimators have competitively low bias and variance in an array of misspecified situations, and can be made to perform well under near-positivity violations. We apply the methods to the PROmotion of Breastfeeding Intervention Trial data, demonstrating that longer term breastfeeding can protect infants from Gastrointestinal Infection.
Madhusudan Grover - One of the best experts on this subject based on the ideXlab platform.
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the functional organic dichotomy postinfectious irritable bowel syndrome and inflammatory bowel disease irritable bowel syndrome
Clinical Gastroenterology and Hepatology, 2009Co-Authors: Madhusudan Grover, Hans H Herfarth, Douglas A DrossmanAbstract:Gastroenterologists often encounter situations when the clinical and pathophysiological features that typically distinguish functional from organic disorders overlap. This "blurring of boundaries" can occur with post-infectious irritable bowel syndrome (PI-IBS), a subset of IBS and a newly described entity IBD-IBS. The key associating features include pain and usually diarrheal symptoms that are disproportionate to the observed pathology, microscopic inflammation, and often a co-association with psychological distress. A previous initiating Gastrointestinal Infection is required for PI-IBS and assumed for IBD-IBS. Using this perspective we discuss the clinical and pathophysiological features of PI-IBS and IBD-IBS and the growing evidence for the overlapping features of these two disorders in terms of alteration of gut flora, immune dysregulation, and role of stress. A unifying model of PI-IBS and IBD-IBS is proposed that may have important clinical and research implications. It obligates us to reframe our understanding of illness and disease from the dualistic biomedical model into a more integrated biopsychosocial (BPS) perspective.
