Publications by authors named "Jeffrey Critch"

Background: Patients with inflammatory bowel disease (IBD) exhibit considerable interindividual variability in medication response, highlighting the need for precision medicine approaches to optimize and tailor treatment. Pharmacogenetics (PGx) offers the ability to individualize dosing by examining genetic factors underlying the metabolism of medications such as thiopurines. Pharmacogenetic testing can identify individuals who may be at risk for thiopurine dose-dependent adverse reactions including myelosuppression.

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  • * Among children treated with ADA, 63% achieved steroid-free clinical remission after one year, compared to 59% for those treated with IFX, indicating no significant difference in effectiveness.
  • * Children on ADA experienced less treatment intensification compared to those on IFX, suggesting that ADA may be associated with a lower need for increased treatment over time.
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Aim: To assess contemporary outcomes in children with acute severe ulcerative colitis [ASUC] at initial presentation.

Methods: Between April 2014 and January 2019, children aged <17 years, with new onset ASUC (Paediatric Ulcerative Colitis Activity Index [PUCAI ≥65) were prospectively followed in a Canadian inception cohort study. 16S rRNA amplicon sequencing captured microbial composition of baseline faecal samples.

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  • A study of 1,399 children with inflammatory bowel disease (IBD) sought to understand how delays in diagnosis affect health outcomes, revealing a median diagnostic delay of 4.2 months, with longer delays seen in those with Crohn's disease (CD).
  • Diagnostic delay was linked to a 2.5-fold increase in strictures/internal fistulae and negatively impacted growth, with each additional month of delay resulting in lower height-for-age scores.
  • The findings indicate that delays in diagnosis can lead to worse complications in IBD patients, particularly in CD, and highlight the need for quicker diagnoses to improve pediatric health outcomes.
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The implementation of nutrition policies and guidelines in Canadian schools has increased the availability and consumption of nutrient-rich foods while reducing access to and consumption of foods and beverages that are high in sugars, sodium, and saturated fats. Positive changes in health outcomes for children and youth, such as improved body mass indices, have been observed. However, observed impacts of school nutrition policies on academic performance have been mixed.

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Nutrition for Healthy Term Infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada. It was republished in September 2012, with recommendations on infant feeding from birth to six months of age. The statement was most recently updated in April 2014, with recommendations for feeding older infants and young children from six to 24 months of age.

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Nutrition for healthy term infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada that was most recently updated in September 2012 with recommendations from birth to six months of age. This practice point outlines the development process, principles of infant feeding, and recommendations for clinicians. Health professionals involved in counselling families about infant nutrition are advised to read the statement in its entirety, because the underlying discussions expand upon and clarify the advice summarized in the principles and recommendations.

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Objective: We compared the minimal important difference (MID) with the minimal detectable change (MDC) generated by distribution-based methods.

Study Design: Studies of two quality-of-life instruments (Chronic Respiratory Questionnaire [CRQ] and Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ]) and two physician-rated disease-activity indices (Pediatric Ulcerative Colitis Activity Index [PUCAI] and Pediatric Crohn's Disease Activity Index [PCDAI]) provided longitudinal data. The MID values were calculated from global ratings of change (small change for CRQ and RQLQ; moderate for PUCAI and PCDAI) using receiver-operating characteristic (ROC) curve and mean change.

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Objective: We compared the minimal important difference (MID) values obtained by the receiver operating characteristics (ROC) curve approach using different strategies on four outcome measures to guide the optimal use of ROC curve.

Study Design And Setting: Studies of two psychometric scales (Rhinoconjunctivitis Quality-of-Life Questionnaire [RQLQ] and Chronic Respiratory Questionnaire [CRQ]) and two clinimetric indices (Pediatric Ulcerative Colitis Activity Index [PUCAI] and Pediatric Crohn's Disease Activity Index [PCDAI]) instruments provided prospective longitudinal data. The MID was calculated from 7- and 15-point global ratings of change dichotomized in multiple ways, using the ROC curve method.

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As an update to previously published recommendations for the management of Helicobacter pylori infection, an evidence-based appraisal of 14 topics was undertaken in a consensus conference sponsored by the Canadian Helicobacter Study Group. The goal was to update guidelines based on the best available evidence using an established and uniform methodology to address and formulate recommendations for each topic. The degree of consensus for each recommendation is also presented.

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