Annual Report Division of Gastroenterology Department of Medicine - Jewish General Hospital April 1, 2009-May

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Annual Report Division of Gastroenterology Department of Medicine - Jewish General Hospital April 1, 2009-May 31 2010 I Highlights There are no new developments to report in GI in the past academic year. II Evaluation of Past Academic Year 1) Teaching Activities Total clinical teaching hours Dr. S. Blum, Dr. A. Cohen, Gastroenterology 300 hrs/yr. Dr. G. Friedman, Dr. N. Hilzenrat consult service for each Dr. A. Szilagyi, Dr. P. Galiatsatos physician Post-graduate teaching hours Dr. A. Cohen, Dr. G. Friedman Training of 400 hours/year interventional Endoscopy fellows GI Pathology Conference Dr. Esther Lamoureux, Dr. L. Alpert GI Radiology Conference Dr. M. Rosenbloom GI Medical Rounds McGill interhospital GI rounds Wednesdays 8-9 am (alternate week) Wednesdays 8-9 am (alternate week) Thursdays 12:00 1:00 pm (every alternate week) Wednesdays 5-6 pm MED 1: McGill Gastrointestinal Physiology Small Group Tutor, Unit IV: Dr. A. Cohen, Dr. G. Friedman, Dr. N. Hilzenrat and Dr. A. Szilagyi total number of hours: 16/physician Total Clinical Teaching hours: Residents: CTU: 80 hours OPD: 800 Students: CTU: 80 hours OPD: 200

2) Research Activities Dr. Albert Cohen MLN0002 In Crohn s (13007): A Phase 3, Randomized, Placebo Controlled, Blinded, Multicenter Study of the Induction and Maintenance of Clinical Response and Remission by MLN0002 in Patients with Moderate to Severe Crohn s Disease. Quintiles/CRO PRA Int. MLN0002 In Crohn s (C13006): A Phase 3, Randomized, Placebo-Controlled, Blinded, Multicentre Study of the Induction and Maintenance of Clinical Response and Remission by MLN0002 in Patients with Moderate to Severe Ulcerative Colitis. MLN0002 in UC and Crohn s (C13008) Extension Study An Open-Label Phase 3 Study: An Open-Label 3 Study to determine the long-term efficacy and safety of MLN0002 in Patients with Ulcerative Colitis and Crohn s Disease. (Quintiles/CRO PRA Int) IN UC and Crohn s (Cl C0168T62: A Multi-centre International Study of the Long- Term Safety of Infliximab (Remicade) in ulcerative colitis. Advanced Biologics/PRA International-CRO Adalimumab S/C in Ulcerative Colitis Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of the Human Anti- TNF Monoclonal Antibody Adalimumab for the Induction and Maintenance of Clinical Remission in Subjects with Moderately to Severely Active Ulcerative Colitis. Multicenter International Trial Sponsor: Abbott Laboratories Open-label Adalimumab S/C in Ulcerative Colitis Extension study of placebo controlled trial. Multicenter International Trial Sponsor: Abbott Laboratories Quebec Genetic Consortium- Identification of the genes responsible for inflammatory bowel disease. This study represents collaboration between gastroenterologists throughout Quebec, involving all medical faculties in conjunction with the Whitehead Institute and the National Health Institute, Bethesda, MD. Multicenter International trial co-investigator: Dr. A. Szilagyi, Dr. G. Friedman, Dr. S. Blum, Dr. N. Hilzenrat 2003 to present Dr. Nir Hilzenrat

The incidence of diabetes following interferon treatment in patients with HCV Site principal investigator: Hilzenrat Nir Co-investigator: Kader T Funding: Jewish General Hospital, GI Research Group 2004-date. Dr. Andrew Szilagyi Differential effects of lactose on fecal microflora in adult Lactase Persistent and Lactase Non-Persistent healthy subjects ( Danone Institute).This trial is registered At ClinicalTrials.gov ID NCT00599859 Epidemiological study of Inflammatory bowel diseases and relationships to diet, vitamin D levels and genetics of lactase and NOD2, OCTN1/2. Adaptability to fructose in fructose intolerant subjects: On going since January 2008. 3) Clinical Activities Office visits Dr. A. Cohen Monday to Friday 8-4 pm Dr. G. Friedman Monday to Friday 8-4 pm 17 334 visits/year Dr. A. Szilagyi Monday to Friday 8-4 pm Dr. N. Hilzenrat Monday to Friday 8-4 pm Dr. P. Galiatsatos Monday to Friday 8-4 pm Endoscopy laboratory Monday to Friday 8-4 pm 8771 procedures/year Cholangiopancreatography (ERCP) Mondays and Thursdays 1-4 pm 280 procedures/year Anemia Clinic Monday, Thursday 1:30-4:00 pm 300 procedures/yr Inflammatory Bowel Disease Clinics Monday to Friday 8-12 pm 3500 visits/year Clinical trials in inflammatory bowel disease have continued to flourish. We are participating in numerous international clinical trials under the direction of our research nurse, Stefania D Aleo. Hepatology clinic Dr. N. Hilzenrat Monday to Friday 8-4 pm 4806 visits/year

Maria Stavrakis and Paul Plaisir are our research nurses in Hepatology. Activities include conduction of clinical trails in Hepatology as well as teaching and monitoring of patients undergoing anti-viral therapy for chronic hepatitis. GI Service In-patient activities revolve around the GI consulting service which is attended by our staff physician on a two week rotating schedule throughout the year. The volume of consultations is approximately 2400/year, the majority of which involve endoscopic procedures. 4) Academic Staff Dr. Jonathan Wyse has been recruited and will be launching gastrointestinal endoscopic ultrasound at the Jewish General Hospital. He has trained under the mentorship of Dr. Anand Sahai who is considered to be a world leader in his field. He has also successfully completed his Masters in Epidemiology and will certainly strengthen the academic profile of our division. 5) Publications Dr. A. Cohen Alexandra-Chloé Villani, Mathieu Lemire, Geneviè Fortin, Edouard Louis, Mark S Silverberg, Catherine Collette, Nobuyasu Baba, Cécile Libioulle, Jacques Belaiche, Alain Bitton, Daniel Gaudet, Albert Cohen, Diane Langelier, Paul R Fortin, Joan E Wither, Marika Sarfati, Paul Rutgeerts, John D Rioux, Severine Vermeire, Thomas J Hudson, Denis Franchimont. Common Variants in the NLRP3 region contribute to Crohn s disease susceptibility. Nature Genetics, 2009;41(1): 71 Dr. A. Szilagyi Deferential impact of lactose/lactase phenotype on colonic microflora. A Szilagyi, I Shrier, D Heilpern JS Je SH Park, G Chong C Lalonde L-F Cote, BH Lee. Can J Gastroenterol 24; 373-379; 2010. High fructose intake fails to induce symptomatic adaptation but may induce intestinal carriers. Heilpern D, Abbas RN, Gladman S, Menard M, Lee BH, Szilagyi A. Gastroenterology Insights. http://www.pagepress.org/gi, Vol 2;e3, 2010. Szilagyi A. Determinants of Geographic Patterns of Diseases: Interaction of Lactose/Lactase status and Sunshine Exposure. Szilagyi A. Med Hypotheses. 2010 May 8. [Epub ahead of print]pmid: 20457495] Dr. P. Galiatsatos

Chong G, Jarry Jonathan, Marcus V, Galiatsatos, P, Foulkes Wd. High Frequency of exon deletions and putative founder effects in French Canadian Lynch Syndrome families. Human Mutation 2009;30(8):E797-812.. Galiatsatos, P, Gologan A, Lamoureux E. Autistic enterocolitis : fact or fiction? Canadian Journal of Gastroenterology 2009, 23(2):95-98. III Objectives and Priorities The main objectives of the division for the coming year are progress in terms of renovation and expansion of our space. Respectfully submitted by: Albert Cohen, MD Chief, Division of Gastroenterology Jewish General Hospital