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Discontinuation of therapy in inflammatory bowel disease: Current views

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World Journal of Clinical Cases 2024年第10期12卷 1718-1727页

作者： Antonio Meštrović marko Kumric Josko Bozic Department of Gastroenterology University Hospital of SplitSplit 21000Croatia Department of Pathophysiology University of Split School of MedicineSplit 21000Croatia

The timely introduction and adjustment of the appropriate drug in accordance with previously well-defined treatment goals is the foundation of the approach in the treatment of inflammatory bowel disease(IBD).The therapeutic approach is still evolving in terms of the mechanism of action but also in terms of the possibility of maintaining *** patients with achieved long-term remission,the question of de-escalation or discontinuation of therapy arises,considering the possible side effects and economic burden of long-term *** each of the drugs used in IBD(5-aminosalycaltes,immunomodulators,biological drugs,small molecules)there is a risk of ***,studies show that more than 50%of patients who discontinue therapy will *** on the findings of large studies and meta-analysis,relapse of disease can be expected in about half of the patients after therapy withdrawal,in case of monotherapy with aminosalicylates,immunomodulators or biological ***,longer relapse-free periods are recorded with withdrawal of medication in patients who had previously been on combination therapies immunomodulators and anti-tumor necrosis *** needs to be stressed that randomised clinical trials regarding withdrawal from medications are still *** making a decision on discontinuation of therapy,it is important to distinguish potential candidates and predictive factors for the possibility of disease *** calprotectin level has currently been identified as the strongest predictive factor for *** other predictive factors have also been identified,such as:High Crohn's disease activity index or Harvey Bradshaw index,younger age(40 years),smoking,young age of disease onset,steroid use 6-12 months before *** important factor in the decision to withdraw medication is the success of re-treatment with the same or other *** decision to discontinue therapy must be based on in

关键词： Inflammatory bowel disease Therapy discontinuation Therapy de-escalation Ulcerative colitis Crohn’s disease

Growth differentiation factor-15 serum concentrations reflect disease severity and anemia in patients with inflammatory bowel disease

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World Journal of Gastroenterology 2024年第13期30卷 1899-1910页

作者： Ante Tonkic marko Kumric Ivna Akrapovic Olic Doris Rusic Piero marin Zivkovic Daniela Supe Domic Zeljko Sundov Ivan Males Josko Bozic Biology of Neoplasms University of Split School of MedicineSplit 21000Croatia Department of Pathophysiology University of Split School of MedicineSplit 21000Croatia Department of Gastroenterology University Hospital of SplitSplit 21000Croatia Department of Pharmacy University of Split School of MedicineSplit 21000Croatia Department of Medical Laboratory Diagnostics University Hospital of SplitSplit 21000Croatia Department of Health Studies University of SplitSplit 21000Croatia Department of Internal Medicine University of Split School of MedicineSplit 21000Croatia Department of Surgery University Hospital of SplitSplit 21000Croatia

BACKGROUND Population of patients with inflammatory bowel disease(IBD)is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and ***-differentiation factor-15(GDF-15)is often overexpressed under stress conditions,such as inflammation,malignancies,heart failure,myocardial ischemia,and many *** To explore the association between GDF-15 and IBD as serum concentrations of GDF-15 were shown to be an independent predictor of poor outcomes in multiple *** additional aim was to determine possible associations between GDF-15 and multiple clinical,anthropometric and laboratory parameters in patients with *** This cross-sectional study included 90 adult patients diagnosed with IBD,encompassing both Crohn’s disease(CD)and ulcerative colitis(UC),and 67 healthy age-and sex-matched *** patients underwent an extensive workup,including colonoscopy with subsequent histopathological *** activity was assessed by two independent gastroenterology consultants specialized in IBD,employing well-established clinical and endoscopic scoring ***-15 serum concentrations were determined following an overnight fasting,using electrochemiluminescence *** In patients with IBD,serum GDF-15 concentrations were significantly higher in comparison to the healthy controls[800(512-1154)pg/mL vs 412(407-424)pg/mL,Pectively).Finally,an association between GDF-15 and indices of anemia was ***,negative correlations were found between GDF-15 and serum iron levels(r=-0.248,P=0.021),as well as GDF-15 and hemoglobin(r=-0.351,P=0.021).Accordingly,in comparison to I

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Growth-differentiation factor-15 Anemia Extraintestinal manifestations

Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines

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Oncology Research 2024年第5期32卷 807-815页

作者： marko SKELIN BRUNA PERKOV-STIPIČIN SANJA VUŠKOVIĆ marINAŠANDRK PLEHAČEK ANE BAŠIĆ DAVIDŠARČEVIĆ MAJA ILIĆ IVAN KREČAK Pharmacy Department General Hospital ofŠibenik-Knin CountyŠibenikCroatia Faculty of Medicine University of RijekaRijekaCroatia Undergraduate Study in Nursing University of Applied SciencesŠibenikCroatia Department of Oncology University Hospital Center ZagrebZagrebCroatia Pharmacies Joukhadar Sveta NedeljaCroatia Pharmacies Prima Pharme ZagrebCroatia Pharmacy Department General Hospital ZadarZadarCroatia Pharmacy Department General Hospital PulaPulaCroatia Department of Internal Medicine General Hospital ofŠibenik-Knin CountyŠibenikCroatia

Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)***,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically *** study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer ***:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each *** examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer ***:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR ***,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous *** proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current *** the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)*** variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer ***:One-third of the current ESMO CPG recommendations are supported by the highest level of *** well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

关键词： ESMO guidelines Clinical practice guidelines Level of evidence Grade of recommendation

Outcomes of long-acting injectable antipsychotics use in pregnancy:A literature review

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World Journal of Psychiatry 2024年第4期14卷 582-599页

作者： Ana V Pejčić Srdjan M Stefanović MilošN Milosavljević Vladimir S Janjić marko M Folić Nevena D Folić Jovana Z Milosavljević Department of Pharmacology and Toxicology Faculty of Medical SciencesUniversity of KragujevacKragujevac 34000Serbia Department of Pharmacy Faculty of Medical SciencesUniversity of KragujevacKragujevac 34000Serbia Department of Clinical Pharmacology University Clinical Center KragujevacKragujevac 34000Serbia Department of Psychiatry Faculty of Medical SciencesUniversity of KragujevacKragujevac 34000Serbia Clinic for Psychiatry University Clinical Center KragujevacKragujevac 34000Serbia Center for Pharmaceutical and Pharmacological Research Faculty of Medical SciencesUniversity of KragujevacKragujevac 34000Serbia Department of Pediatrics Faculty of Medical SciencesUniversity of KragujevacKragujevac 34000Serbia Pediatric Clinic University Clinical Center KragujevacKragujevac 34000Serbia Department of Anatomy Faculty of Medical SciencesUniversity of KragujevacKragujevac 34000Serbia

BACKGROUND Women with a history of serious psychotic disorders are at increased risk of disease relapse during ***-acting injectable(LAI)antipsychotics have been widely used to improve adherence and prevent relapse in patients with various severe psychotic disorders,but there is a lack of high-quality data from previous research on the safety of LAI antipsychotics during *** To summarize relevant data on maternal,pregnancy,neonatal,and developmental outcomes from published cases of LAI antipsychotic use in *** A literature search was performed through November 11,2023,using three online databases:PubMed/MEDLINE,Scopus,and Web of *** reports or case series that reported information about the outcomes of pregnancy in women who used LAI antipsychotics at any point in pregnancy,with available full texts,were *** statistics,narrative summation,and tabulation of the extracted data were *** A total of 19 publications satisfied the inclusion criteria:3 case series,15 case reports,and 1 conference *** reported the outcomes of LAI antipsychotic use in 74 women and 77 *** use of secondgeneration LAI antipsychotics was reported in the majority(n=47;61.0%)of ***-generation LAI antipsychotics were administered during 30 pregnancies(39.0%).Most of the women(approximately 64%)had either satisfactory control of symptoms or no information about relapse,while approximately 12%of them had developed gestational diabetes mellitus.A minority of cases reported adverse outcomes such as stillbirth,spontaneous abortion,preterm birth,low birth weight,congenital anomalies,and neurological manifestations in ***,there were no reports of negative long-term developmental *** Currently available data seem reassuring,but further well-designed studies are required to properly evaluate the risks and benefits of LAI antipsychotic use during pregnancy.

关键词： Antipsychotic agents Long-acting injectable Pregnancy Outcome Review

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机器人辅助心电信号监测及康复训练系统

高技术通讯 2024年第5期34卷 535-544页

作者：卢振利朱健美单长考刘燕赵宇 Pencic marko Cavic'Maja Ilieva Roumiana Mernik marjan 常熟理工学院商学院盐城224051 盐城工学院机械工程学院常熟215500 常熟理工学院电气与自动化工程学院常熟215500 诺维萨德大学技术科学学院塞尔维亚诺维萨德21000 索菲亚工业大学管理学院保加利亚索菲亚1000 马里博尔大学电气工程和计算机科学学院斯洛文尼亚马里博尔462000

在心电信号的基础上设计心脏康复训练系统,本文总结了机器人辅助心脏康复研究国内外现状,从心电监测、机器人辅助康复系统设计上进行阐述。在心电监测装置上实现上下位机通信,在机器人辅助系统设计中,通过使用Visual Studio、Coppeliasi... 详细信息

在心电信号的基础上设计心脏康复训练系统,本文总结了机器人辅助心脏康复研究国内外现状,从心电监测、机器人辅助康复系统设计上进行阐述。在心电监测装置上实现上下位机通信,在机器人辅助系统设计中,通过使用Visual Studio、Coppeliasim及Kinect设备三者进行通信,控制仿真机器人完成康复动作并严格识别、判定患者康复动作合格程度,以此来帮助心脏病患者进行康复动作训练。

关键词：心电监测人机交互心脏康复

The first cavefish in the Dinaric Karst?Cave colonization made possible by phenotypic plasticity in Telestes karsticus

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Zoological Research 2023年第4期44卷 821-833页

作者： MateoČupić Zoran marčić marko Lukić Romana Gračan Helena Bilandžija Division of Molecular Biology Ruđer BoškovićInstituteZagreb 10000Croatia Department of Biology Faculty of ScienceZagreb 10000Croatia Croatian Biospeleological Society Zagreb 10000Croatia

Cave animals are an excellent model system for studying adaptive *** present,however,little is known about the mechanisms that enable surface colonizers to survive in the challenging environment of *** possibility is that these species have the necessary genetic background to respond with plastic changes to the pressures of underground *** gain insight into this process,we conducted a comparative study with the fish species Telestes karsticus,which occurs in a hydrological system consisting of an interconnected stream and a *** showed that *** resided year-round and spawned in Sušik cave,making it the first known cavefish in the Dinaric *** and surface populations differed in morphological and physiological characteristics,as well as in patterns of gene expression without any evidence of genetic *** test whether observed trait differences were plastic or genetic,we placed adult fish from both populations under light/dark or constant dark *** laboratory conditions erased all morphometric differences between the two morphs,suggesting phenotypic plasticity is driving the divergence of shape and size in wild *** pigmentation and increased fat deposition exhibited by cave individuals were also observed in surface fish kept in the dark in the *** study also revealed that specialized cave traits were not solely attributed to developmental plasticity,but also arose from adult responses,including ***,we conclude that *** can adapt to cave conditions,with phenotypic plasticity playing an important role in the process of cave colonization.

关键词： Maladaptive and adaptive phenotypic plasticity Troglobionts and stygobionts Endemic leuciscid fish Acclimatization European cavefish Cave adaptations Gene expression differences

Surgical Management of Mitral Valve Infective Endocarditis with Accidental Finding of Open Pulmonary Tuberculosis

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World Journal of Cardiovascular Surgery 2024年第5期14卷 61-67页

作者： Ahmad Al Khaddour Mohammed Alharthi Alawab M. Mesallam Mohamed Agawi Mahmoud Ghalwash Ahmed Gotbi Mohamed Abdel Hafez Fouly marko Samanovic Nelson David Vega Murad El Gharbi Fawaz Altaf King Abdullah Medical Complex Jeddah KSA

Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.

关键词： Tuberculosis (TB) Mycobacterium tuberculosis (MTB) Heater-Cooler and Bypass Machine New York Heart Association (NYHA)

Optimal orthogonalization processes

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Science China Mathematics 2022年第1期65卷 203-220页

作者： marko Huhtanen Pauliina Uusitalo Department of Electrical and Information Engineering University of OuluOulu 90570Finland

Two optimal orthogonalization processes are devised toorthogonalize,possibly approximately,the columns of a very large and possiblysparse matrix A∈C^(n×k).Algorithmically the aim is,at each step,to optimallydecrease nonorthogonality of all the columns of *** process relies on using translated small rank *** is a polynomial orthogonalization process forperforming the Löwdin *** steps rely on using iterative methods combined,preferably,with preconditioning which can have a dramatic effect on how fast thenonorthogonality *** speed of orthogonalization depends on howbunched the singular values of A are,modulo the number of steps *** methods put the steps of the Gram-Schmidt orthogonalizationprocess into perspective regardingtheir(lack of)*** constructions are entirely operatortheoretic and can be extended to infinite dimensional Hilbert spaces.

关键词： optimal orthogonalization sparse matrix Gram-Schmidt orthogonalization Lowdin orthogonalization polynomial orthogonalization implicit orthogonalization preconditioning Gram matrix frame inequality

Base lubricants for green stamping:The effects of their structure and viscosity on tribological performance

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Friction 2023年第9期11卷 1741-1754页

作者： marko POLAJNAR LucijaČOGA Mitjan KALIN Laboratory for Tribology and Interface Nanotechnology Faculty of Mechanical EngineeringUniversity of LjubljanaLjubljana 1000Slovenia

The requirements for green and sustainable manufacturing mean that stamping lubricants must be continuously re-evaluated and *** this investigation,the tribological performance of four base oils with different chemical structures(paraffinic and naphthenic)and viscosities(2 and 20 cSt),as well as water,was evaluated for the stamping of steel sheets and compared with a non-lubricated *** lubricants reduce the coefficient of friction and maintain a similar wear coefficient for steel sheets as in dry ***-viscosity(LV)naphthenic oil performs very like both high-viscosity(HV)oils.A surprising exception is the LV paraffinic oil,with several-times-higher friction and wear compared to dry *** is due to the excellent wetting-spreading and very low cohesion forces that enable oil to escape from extremely thin-film contacts because the viscosity is so low,leading to lubricant *** contrast,HV oils provide a sufficiently thick lubricating film,while strong cohesive forces help in the film’s strength,lessening wear,and reducing *** thin-film lubrication with LV oils,such as when stamping,it is thus extremely important that the lubricant’s wetting behaviour and viscosity are sufficient to provide enough film in the contact and prevent starvation,thus ensuring lower friction,less wear,and a longer lifetime of the contact.

关键词： stamping viscosity water paraffinic oil naphthenic oil wetting