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Clinical impact of immunomonitoring in the treatment of inflammatory bowel disease

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World Journal of gastroenterology 2017年第3期23卷 414-425页

作者： Donal Tighe Deirdre mc namara Department of gastroenterology Adelaide and Meath Incorporating the National Children’s Hospital TallaghtSchool of Clinical MedicineTrinity College DublinTrinity Academic Gastroenterology Group24 DublinIreland

Despite improvement in outcomes, loss of response(LOR) to tumor necrosis factor-alpha (TNFα) therapies is a big concern in the management of inflammatory bowel disease. LOR is associated with flares of disease, increased hospitalisation rates, need for surgical interventions, and decline in quality of life. LOR may be multifactorial, but immunogenicity makes a significant contribution. Traditionally doses of anti-TNFα have been adjusted based on clinical response, using a standard approach. Immunomonitoring involves the measurement of anti-TNFα trough and antibody levels. It takes into account the underlying pharmacokinetics of anti-TNFα therapies. Expanding on this a treat to target approach may be used, where doses are intensified, or tailored to the individual based on the measurement of anti-TNFα trough and antibody levels. This review looks at the history, evolution, and clinical impact that immunomonitoring is having in the treatment of inflammatory bowel disease. It will focus on the role of immunomonitoring in helping to achieve long lasting deep remission and mucosal healing. It will explore the different options in terms of best measuring trough and antibody levels, explore possible advantages of immunomonitoring, and discuss its role in best optimising response, at induction, during the maintenance phase of treatment, as well as a role in withdrawing or switching therapy.

关键词： Inflammatory bowel disease Ulcerative colitis Immunomonitoring loss of response AntiTNFα trough and antibody levels Crohn’s disease immunogenicity

Planning for Community Relocations Due to Climate Change in Fiji

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国际灾害风险科学学报：英文版 2015年第3期6卷 315-319页

作者： Karen E.mc namara Helene Jacot Des Combes School of geography Planning and Environmental ManagementThe University of Queensland Pacific Centre for Environment and Sustainable Development University of the South Pacific

As a consequence of the impacts of climate change, some households and entire communities across the Pacific are making the complex and challenging decision to leave their homelands and relocate to new environments that can sustain their livelihoods. This short article charts how the residents of Vunidogoloa village in Fiji relocated in early 2014 to reduce their vulnerability to encroaching sea level and inundation events that regularly devastated the community. As a consequence of the Vunidogoloa relocation, this article also explores how the Fiji government is planning for similar resettlement transitions, including vulnerability and adaptation assessments to develop a list of potential community relocations and the development of national relocation guidelines. This study draws from key informant interviews(n = 8) with government officials, as well as representatives from intergovernmental and local nongovernmental organizations,who are involved in the relocation issue. given the speed at which these national, top-down initiatives are being forged and especially in light of the absence of any mention of relocation in Fiji’s 2012 climate change policy, careful and inclusive engagement across all scales and stakeholders,including communities 'earmarked' for relocation, is paramount.

关键词：气候变化社区重定位斐济风险计划海水平上升

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Impact of biliary stent-related events in patients diagnosed with advanced pancreatobiliary tumours receiving palliative chemotherapy

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World Journal of gastroenterology 2016年第26期22卷 6065-6075页

作者： Angela Lamarca Christina Rigby Mairéad g mc namara Richard A Hubner Juan W Valle Department of Medical Oncology The Christie NHS Foundation Trust Institute of Cancer Sciences University of Manchester Manchester Academic Health Science Centre

AIM: To determine the impact(morbidity/mortality) of biliary stent-related events(SRE)(cholangitis or stent obstruction) in chemotherapy-treated pancreaticobiliary ***: All consecutive patients with advanced pancreatobiliary cancer and a biliary stent in-situ prior to starting palliative chemotherapy were identified retrospectively from local electronic case-note records(Jan 13 to Jan 15). The primary end-point was SRE rate and the time-to-SRE(defined as time from first stenting before chemotherapy to date of SRE). Progressionfree survival and overall survival were measured from the time of starting chemotherapy. Kaplan-Meier, Cox and Fine-gray regression(univariate and multivariable) analyses were employed, as appropriate. For the analysis of time-to-SRE, death was considered as a competing ***: Ninety-six out of 693 screened patients were eligible; 89% had a metal stent(the remainder were plastic). The median time of follow-up was 9.6 mo(range 2.2 to 26.4). Forty-one patients(43%)developed a SRE during follow-up [cholangitis(39%), stent obstruction(29%), both(32%)]. There were no significant differences in baseline characteristics between the SRE group and no-SRE groups. Recorded SRE-consequences were: none(37%), chemotherapy delay(24%), discontinuation(17%) and death(22%). The median time-to-SRE was 4.4 mo(95%CI: 3.6-5.5). Patients with severe comorbidities(P ge was an independent prognostic factor for overall survival(P = 0.029) in the multivariable analysis adjusted for primary tumour site, performance status and development of SRE(SRE group vs no-SRE group).CONCLUSION: SREs are common and impact on patient's morbidity. Our results highlight the need for prospective studies exploring the role of prophylactic strategies to prevent/delay SREs.

关键词： Advanced biliary tract cancer Pancreatic cancer Biliary obstruction Biliary stent Stent-related even

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日本纺织工业结构的调整

中国纺织 1998年第8期 38-39页

作者： mc namara D.L. 何志贵

全球对发展中国家纺织业持续的关注和投资以及在这些国家企业间的竞争,导致了东西方最大的纺织厂商之间的一场危机。如今这场危机已发生了戏剧性的变化,朝着追求低成本竞争的相对优势的方向发展。但更成功的产业结构调整是在用户、设备... 详细信息

全球对发展中国家纺织业持续的关注和投资以及在这些国家企业间的竞争,导致了东西方最大的纺织厂商之间的一场危机。如今这场危机已发生了戏剧性的变化,朝着追求低成本竞争的相对优势的方向发展。但更成功的产业结构调整是在用户、设备生产商和纺织生产商之间产业改组的同步协调发展,及整个纺织行业的贸易商、技术公司和企业主为了共同的利益、重振本国的纺织企业而找到新的适当的市场位置。

关键词：日本纺织工业结构调整

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应用动态胸片评估囊性纤维化致肺部病变加重的治疗

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国际医学放射学杂志 2022年第4期 485-485页

作者： T.S.Fitz Maurice C.mc Cann D.S.Nazareth P.S.mc namara M.J.Walshaw 任航莹

摘要尽管肺活量测定是管理囊性纤维化（CF）病人肺部病变加重的重要标志，但它是一个强迫性的操作并产生气溶胶，因此在某些病人中可能难以执行。动态胸片（DCR）在透

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Small bowel Dieulafoy lesions: An uncommon cause of obscure bleeding in cirrhosis

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World Journal of gastrointestinal Endoscopy 2016年第16期8卷 568-571页

作者： grainne Holleran Mary Hussey Deirdre mc namara Trinity Academic gastroenterology group Trinity College DublinTrinity Centre for Health SciencesTallaght Hospital

Dieulafoy lesions(DLs) are an uncommon cause of gastrointestinal bleeding, accounting for up to 2% of cases overall. They are largely under recognised and difficult to treat. Up to 95% occur in the stomach, and only case reports document their occurrence in the small bowel(SB). Little is known about their pathophysiology, although there have been associations made previously with chronic liver disease, thought to be due to the erosive effects of alcohol on the mucosa overlying the abnormally dilated vessels. We present a case series of 4 patients with a long duration of obscure gastrointestinal bleeding, who were diagnosed with small intestinal DLs and incidentally diagnosed with chronic liver disease. The histories describe the challenges in both diagnosis and treatment of small intestinal DLs. Our case series suggest a previously unreported link between chronic liver disease and SB DLs which may be due to anatomical vasculature changes or a shift in angiogenic factors as a consequence of portal hypertension or liver cirrhosis.

关键词： Obscure gastrointestinal bleeding Dieulafoy lesions Cirrhosis Portal hypertension Capsule endoscopy Double balloon enteroscopy

全身性强直-阵挛性癫痫发作敏感基因位于染色体10q25～q26

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世界核心医学期刊文摘(神经病学分册) 2006年第1期 9-10页

作者： Puranam R.S. Jain S. Kleindienst A.M. J.O. mc-namara 郭俊 Department of Neurobiology 401 Bryan Research Building Duke University Medical Center Research Drive Durham NC 27710 United States Dr.

Inheritance patterns in twins and multiplex families led us to hypothesize that two loci were segregating in subjects with juvenile myoclonic epilepsy (JME), one predisposing to generalized tonic-clonic seizures (gTCS) and a second to myoclonic seizures. We tested this hypothesis by performing genomewide scan of a large family (Family 01) and used the results to guide analyses of additional families. A locus was identified in Family 01 that was linked to gTCS (10q25-q26). Model-based multipoint analysis of the 10q25-q26 locus showed a logarithm of odds (LOD) score of 2.85; similar results were obtained with model-free analyses (maximum nonparametric linkage NPL of 2.71; p = 0.0019). Analyses of the 10q25-q26 locus in 10 additional families assuming heterogeneity revealed evidence for linkage in four families; model-based and model-free analyses showed a heterogeneity LOD (HLOD) of 2.01 (α= 0.41) and maximum NPL of 2.56 (p = 0.0027), respectively, when all subjects with gTCS were designated to be affected. Combined analyses of all 11 families showed an HLOD of 4.04 (α= 0.51) and maximum NPL score of 4.20 (p = 0.000065). Fine mapping of the locus defined an interval of 4.45Mb. These findings identify a novel locus for gTCS on 10q25-q26 and support the idea that distinct loci underlie distinct seizure types within an epilepsy syndrome such as JME.

关键词：癫痫发作基因座阵挛 q26 全身性

睾丸微石症与睾丸肿瘤的相关性:大型多中心儿童样本研究

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国际医学放射学杂志 2018年第1期 96-96页

作者： A.T.Trout J.Chow E.R.mc namara K.Darge R.R.grueso M.Munden 张俊峰 Department of Radiology Divisions of Pathology and Biostatistics and EpidemiologyCincinnati Children ’s Hospital Medical Center

摘要目的在不同地区的大型儿童样本中,回顾性明确睾丸微石症与睾丸肿瘤的相关强度。材料与方法获取2000年1月—2014年5月间北美地区6个不同研究型儿童医院

关键词：睾丸微石症睾丸肿瘤