Publications by authors named "Charles Bernstein"
Goals: We sought to understand the clinical course and risk of dysplasia in persons with UC who achieve near or complete normalization of histology.
Background: Histologic remission and normalization in ulcerative colitis (UC) is associated with improved clinical outcomes. We sought to understand the clinical course and risk of dysplasia in persons with UC who achieve near or complete normalization of histology.
Evidence suggests that the gut microbiome may play a role in multiple sclerosis (MS). However, the majority of the studies have focused on gut bacterial communities; none have examined the fungal microbiota (mycobiota) in persons with pediatric-onset multiple sclerosis (POMS). We examined the gut mycobiota in persons with and without POMS through a cross-sectional examination of the gut mycobiota from 46 participants' stool samples (three groups: 18 POMS, 13 acquired monophasic demyelinating syndromes [monoADS], and 15 unaffected controls).
View Article and Find Full Text PDFBackground: Current inflammatory bowel disease (IBD) treatments often fail to achieve lasting remission and have adverse effects. Vagus nerve stimulation (VNS) offers a promising therapy due to its anti-inflammatory effects. Its invasive nature, however, has led to the development of non-invasive methods like transcutaneous auricular VNS (taVNS).
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- The study investigates how using small datasets to select an optimal cutoff score for the Patient Health Questionnaire-9 (PHQ-9) can lead to inaccurate results.
- Researchers evaluated whether data-driven methods for cutoff selection resulted in scores that were significantly different from the true population optimal score and if these methods produced biased accuracy estimates.
- Findings showed that many small studies frequently failed to identify the correct optimal cutoff score, particularly in smaller samples, leading to an overestimation of test sensitivity.
Current Endoscopic Scoring Systems in Inflammatory Bowel Disease: Strengths and Limitations.
Gastrointest Endosc Clin N Am
January 2025
There are several available endoscopic scoring systems that are designed to assess disease activity in inflammatory bowel disease. The most widely known is the Mayo endoscopic subscore for ulcerative colitis. These schemas are not routinely used in clinical practice, largely due to their complexity or lack of granularity, although they are standard for outcomes measurement in large clinical trials.
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- Researchers developed a microbiome-based diagnostic test for inflammatory bowel disease (IBD) by analyzing 5,979 fecal samples, identifying significant bacterial alterations related to IBD.* ! * The study created diagnostic models using ten bacterial species for ulcerative colitis and nine for Crohn's disease, achieving high accuracy (areas under the curve >0.90) in distinguishing IBD from healthy controls.* ! * A new multiplex droplet digital PCR test was also developed, which outperformed the standard fecal calprotectin test, indicating the potential for a noninvasive multibacteria biomarker panel in IBD diagnosis.* !
Article Synopsis
- The study looked at how bad experiences during childhood can affect people's health later, especially those with certain diseases like rheumatoid arthritis and multiple sclerosis.
- Researchers found that many people with these diseases also had mental health issues, and most of them reported having bad childhood experiences.
- They concluded that dealing with mental health problems can help those who had tough childhoods and have these diseases, suggesting that mental health care is important for their overall well-being.
Healthy First-Degree Relatives From Multiplex Families vs Simplex Families Have Higher Subclinical Intestinal Inflammation, a Distinct Fecal Microbial Signature, and Harbor a Higher Risk of Developing Crohn's Disease.
Gastroenterology
January 2025
Background & Aims: Unaffected first-degree relatives (FDRs) from families with ≥2 affected FDRs with Crohn's disease (CD, multiplex families) have a high risk of developing CD, although the underlying mechanisms driving this risk are poorly understood. We aimed to identify differences in biomarkers between FDRs from multiplex vs simplex families and investigate the risk of future CD onset accounting for potential confounders.
Methods: We assessed the Crohn's and Colitis Canada Genetic Environmental Microbial cohort of healthy FDRs of patients with CD.
Introduction: Little is known about patterns of opioid prescribing in inflammatory bowel disease (IBD), but pain is common in persons with IBD. We estimated the incidence and prevalence of opioid use in adults with IBD and an unaffected reference cohort and assessed factors that modified opioid use.
Methods: Using population-based health administrative data from Manitoba, Canada, we identified 5233 persons with incident IBD and 26 150 persons without IBD matched 5:1 on sex, birth year, and region from 1997 to 2016.
Background: The interplay between diet and the gut microbiota in multiple sclerosis (MS) is poorly understood. We aimed to assess the interrelationship between diet, the gut microbiota, and MS.
Methods: We conducted a case-control study including 95 participants (44 pediatric-onset MS cases, 51 unaffected controls) enrolled from the Canadian Pediatric Demyelinating Disease Network study.
Article Synopsis
- * It identified factors influencing healthcare costs, such as age, sex, type of initial treatment, and access to mental health care, highlighting that average costs were about CA$15,168 per child.
- * The researchers developed a predictive model that could help identify children likely to incur high costs, aiming to find ways to manage expenses while maintaining quality care for these patients.
Objective: In the face of the ongoing circulation of SARS-CoV-2, the durability of neutralization post-COVID-19 vaccination in immune-mediated inflammatory disease (IMID) is a key issue, as are the effects of medications.
Methods: Adults (n = 112) with inflammatory bowel disease, psoriasis/psoriatic arthritis, rheumatoid arthritis, spondylarthritis, and systemic lupus were recruited from participating Canadian medical centers from 2021 to 2023. We focused on log-transformed neutralization (lentivirus methods) as a continuous outcome, with separate models for wild-type and Omicron strains BA.
Introduction: To study digestive system cancer risks in individuals with inflammatory bowel diseases (IBDs) in the biologic era.
Methods: We used population-level administrative and cancer registry data from Ontario, Canada, (1994-2020) to compare people with IBD to matched controls (1:10 by sex and birth year) on trends in age-sex standardized cancer incidence and risk ratios of incident cancers and cancer-related deaths.
Results: Among 110,919 people with IBD and 1,109,190 controls, colorectal cancer incidence (per 100,000 person-years) declined similarly in people with ulcerative colitis (average annual percentage change [AAPC] -1.
Background: Helicobacter pylori infection is prevalent worldwide and can lead to peptic ulcer disease (PUD) and gastric cancer. Effective diagnosis and treatment of H. pylori infection by gastroenterologists and family physicians is crucial.
View Article and Find Full Text PDFBackground & Aims: To date, it is unclear how environmental factors influence Crohn's disease (CD) risk and how they interact with biological processes. This study investigates the association between environmental exposures and CD risk and evaluates their association with pre-disease biomarkers.
Methods: We studied 4289 healthy first-degree relatives (FDRs) of patients with CD from the Crohn's and Colitis Canada - Genetic, Environmental, Microbial (CCC-GEM) project.
Article Synopsis
- People with multiple sclerosis (MS) often have anxiety, which can make their condition worse.
- Researchers wanted to see how a specific genetic score related to anxiety in people with MS.
- They found that having a higher genetic risk for anxiety was linked to more anxiety symptoms in MS patients, similar to those with anxiety alone.
When Should I Get My Next COVID-19 Vaccine? Data From the Surveillance of Responses to COVID-19 Vaccines in Systemic Immune-Mediated Inflammatory Diseases (SUCCEED) Study.
J Rheumatol
July 2024
Objective: To determine how serologic responses to coronavirus disease 2019 (COVID-19) vaccination and infection in immune-mediated inflammatory disease (IMID) are affected by time since last vaccination and other factors.
Methods: Post-COVID-19 vaccination, data, and dried blood spots or sera were collected from adults with rheumatoid arthritis, inflammatory bowel disease, systemic lupus erythematosus, ankylosing spondylitis and spondylarthritis, and psoriasis and psoriatic arthritis. The first sample was collected at enrollment, then at 2 to 4 weeks and 3, 6, and 12 months after the latest vaccine dose.
Objective: To compare diet and the modified dietary inflammatory index (mDII) between individuals with pediatric-onset multiple sclerosis (PoMS), monophasic acquired demyelinating syndromes (monoADS), and controls.
Methods: The association between diet, mDII, and disease status was examined in 131 individuals with PoMS/monoADS/controls (38/45/48) using logistic regression.
Results: The associations between diet and PoMS were modest, reaching significance for whole grain intake (adjusted odds ratio, aOR=0.
Background: We sought to understand the trends in media use, and how consumption and source affected mental health of persons with inflammatory bowel disease during the early parts of the pandemic. Dissemination of news during the coronavirus disease 2019 (COVID-19) pandemic was integral to educating the public but also could be harmful if constantly consumed, leading to worsening anxiety.
Methods: We performed a survey study in autumn 2020 during the second wave of COVID-19 in Manitoba.
Background: Fecal microbiota transplantation (FMT) is a promising treatment for active ulcerative colitis (UC). Understanding patient preferences can identify treatment features that may impact treatment decisions, improve shared decision-making, and contribute to patient-centered care, which is especially important in the context of novel treatments like FMT.
Objectives: We aimed to quantify preferences for active UC treatments, specifically FMT and biologics, and identify patient characteristics associated with different preference patterns.
Background: We aimed to establish a cohort of persons with Crohn's disease (CD) enrolled from 14 Canadian centers to describe the contemporary presentation of CD in Canada.
Methods: All enrollees were at least 18 years old and underwent chart review for phenotype documentation by Montreal Classification at time of enrollment, comorbidities, inflammatory bowel disease (IBD) and other surgeries, and use IBD and other therapies.
Results: Of 2112 adults, 59% were female, and the mean age was 44.
Article Synopsis
- Colonoscopic surveillance is important for patients with colonic inflammatory bowel disease (IBD) due to their higher risk of colorectal cancer (CRC), and a new prediction model has been developed for assessing this risk.
- The study analyzed data from 6 cohorts across North America and Europe, including 3731 patients, to create and validate this model using predictive variables and a statistical approach known as Cox proportional hazards modeling.
- The model showed good accuracy in predicting advanced colorectal neoplasia (aCRN) over 5-10 years, but further research is needed to validate its effectiveness across different populations and to determine how it impacts surveillance strategies.