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Therapeutic drug monitoring in inflammatory bowel disease:The dawn of reactive monitoring

World Journal of Gastroenterology 2021年第37期27卷 6231-6247页

作者： Farah Albader Petra Anna Golovics Lorant Gonczi Talat Bessissow waqqas afif Peter Laszlo Lakatos Department of Internal Medicine McGill UniversityMontreal H3G1A4QuebecCanada Division of Gastroenterology Hungarian Defence ForcesMedical CentreBudapest H-1062Hungar Division of Gastroenterology McGill UniversityMontreal H3G 1A4QuebecCanada First Department of Medicine Semmelweis UniversityBudapest H-1083Hungary Division of Gastroenterology McGill University Health CentreMontreal H3G 1A4QuebecCanada

Inflammatory bowel disease(IBD)is a chronic condition that significantly affects the quality of life of its *** drugs have been the mainstay treatment in the management of IBD patients but despite their significant contribution,there remains a proportion of patients that do not respond or lose response to *** drug monitoring(TDM)involves measuring levels of serum drug concentrations and anti-drug *** of biologic drugs initially emerged to understand treatment failure in other immune mediated inflammatory *** was then introduced in IBD to rationalize primary non-response or secondary loss of response,given that low serum drug concentrations or the formation of anti-drug antibodies are variably associated with treatment *** aim of this narrative review is to provide an overview regarding the current use of TDM in clinical practice and to present the evidence available regarding its use in both proactive and reactive clinical settings in preventing and managing treatment *** review also presents the existing evidence regarding the association of various clinical outcomes with specific thresholds of drug concentrations,in everyday practice.A narrative review of published articles and conference abstracts regarding the use of TDM in IBD management,through an electronic search using PubMed and *** has proven to be superior and more cost effective in guiding management of patients with treatment failure compared to empiric dose escalation or change in *** a trend towards an association between clinical outcomes and drug concentrations,proactive TDM based strategies have not been shown to achieve clear benefit in long-term *** the clinical setting,TDM has proven to be useful in managing IBD patients,and its use in the reactive setting,as an additional tool to help manage patients with treatment failure,is being promoted as newer guidelines and consensus groups implement

关键词： Therapeutic drug monitoring Inflammatory bowel disease Biologic therapies Loss of response Reactive Proactive

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Benefits of implementing a rapid access clinic in a high-volume inflammatory bowel disease center:Access, resource utilization and outcomes

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World Journal of Gastroenterology 2020年第7期26卷 759-769页

作者： Sofia Nene Lorant Gonczi Zsuzsanna Kurti Isabelle Morin Kelly Chavez Christine Verdon Jason Reinglas Rita Kohen Talat Bessissow waqqas afif Gary Wild Ernest Seidman Alain Bitton Peter Laszlo Lakatos Division of Gastroenterology McGill University Health CentreQuebecMontreal H3G1A4Canada First Department of Medicine Semmelweis UniversityBudapest H-1083Hungary

BACKGROUND Emergency situations in inflammatory bowel diseases(IBD)put significant burden on both the patient and the healthcare *** To prospectively measure Quality-of-Care indicators and resource utilization after the implementation of the new rapid access clinic service(RAC)at a tertiary IBD *** Patient access,resource utilization and outcome parameters were collected from consecutive patients contacting the RAC between July 2017 and March 2019 in this observational *** comparing resource utilization and healthcare costs,emergency department(ED)visits of IBD patients with no access to RAC services were evaluated between January 2018 and January *** to appointment,diagnostic methods,change in medical therapy,unplanned ED visits,hospitalizations and surgical admissions were calculated and *** 488 patients(Crohn’s disease:68.4%/ulcerative colitis:31.6%)contacted the RAC with a valid medical *** time to visit with an IBD specialist following the index contact was 2 *** had objective clinical and laboratory assessment(C-reactive protein and fecal calprotectin in 91%and 73%).Fast-track colonoscopy/sigmoidoscopy was performed in 24.6%of the patients,while computed tomography/magnetic resonance imaging in only 8.1%.Medical therapy was changed in 54.4%.ED visits within 30 d following the RAC visit occurred in 8.8%(unplanned ED visit rate:5.9%).Diagnostic procedures and resource utilization at the ED(n=135 patients)were substantially different compared to RAC users:Abdominal computed tomography was more frequent(65.7%,P<0.001),coupled with multiple specialist consults,more frequent hospital admission(P<0.001),higher steroid initiation(P<0.001).Average medical cost estimates of diagnostic procedures and services per patient was$403 CAD vs$1885 CAD comparing all RAC and ED *** Implementation of a RAC improved patient care by facilitating easier access to IBD specific medical care,optimized resource uti

关键词： Crohn’s disease Ulcerative colitis Rapid access Quality-of-care Emergency department

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Effectiveness, safety, and drug sustainability of biologics in elderly patients with inflammatory bowel disease: A retrospective study

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World Journal of Gastroenterology 2022年第33期28卷 4823-4833页

作者： Gustavo Drugg Hahn Jean-Frederic LeBlanc Petra Anna Golovics Panu Wetwittayakhlang Abdulrahman Qatomah Anna Wang Levon Boodaghians Jeremy Liu Chen Kiow Maryam Al Ali Gary Wild waqqas afif Alain Bitton Peter Laszlo Lakatos Talat Bessissow Division of Gastroenterology IBD CenterMcGill University Health CenterMontreal H3G 1A4QuebecCanada School of Medicine Graduate Course Sciences in Gastroenterology and HepatologyUniversidade Federal do Rio Grande do SulPorto Alegre 90000-000Brazil Division of Gastroenterology McGill University Health CentreMontreal H3G 1A4QuebecCanada Department of Gastroenterology Hungarian Defense ForcesMedical CentreBudapest 1134Hungary Unit of Gastroenterology and Hepatology Division of Internal MedicineFaculty of MedicinePrince of Songkla UniversitySongkhla 90110Thailand Department of Gastroenterology Centre Hospitalier de l’Universitede MontrealMontreal H2X 3E4QuebecCanada

BACKGROUND Biologic therapy resulted in a significant positive impact on the management of inflammatory bowel disease(IBD) however data on the efficacy and side effects of these therapies in the elderly is *** To evaluate retrospectively the drug sustainability, effectiveness, and safety of the biologic therapies in the elderly IBD *** Consecutive elderly(≥ 60 years old) IBD patients, treated with biologics [infliximab(IFX), adalimumab(ADAL), vedolizumab(VDZ), ustekinumab(UST)] followed at the McGill University Inflammatory Bowel Diseases Center were included between January 2000 and *** was measured by clinical scores at 3, 6-9 and 12-18 mo after initiation of the biologic therapy. Patients completing induction therapy were included. Adverse events(AEs) or serious AE were collected during and within three months of stopping of the biologic *** We identified a total of 147 elderly patients with IBD treated with biologicals during the study period, including 109 with Crohn’s disease and 38 with ulcerative colitis. Patients received the following biologicals: IFX(28.5%), ADAL(38.7%), VDZ(15.6%), UST(17%). The mean duration of biologic treatment was 157.5(SD = 148) wk. Parallel steroid therapy was given in 34% at baseline,19% at 3 mo, 16.3% at 6-9 mo and 6.5% at 12-18 mo. The remission rates at 3, 6-9 and 12-18 mo were not significantly different among biological therapies. Kaplan-Meyer analysis did not show statistical difference for drug sustainability(P = 0.195), time to adverse event(P = 0.158) or infection rates(P = 0.973) between the four biologics studied. The most common AEs that led to drug discontinuation were loss of response, infusion/injection reaction and *** Current biologics were not different regarding drug sustainability, effectiveness, and safety in the elderly IBD population. Therefore, we are not able to suggest a preferred sequencing order among biologicals.

关键词： Inflammatory bowel disease Biologics Elderly Efficacy Safety Adverse events

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Remission of type 2 diabetes mellitus

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World Journal of Diabetes 2024年第7期15卷 1384-1389页

作者： afif Nakhleh Elya Halfin Naim Shehadeh Institute of Endocrinology Diabetes and MetabolismRambam Health Care CampusHaifa 3109601Israel Diabetes and Endocrinology Clinic Maccabi Healthcare ServicesHaifa 3299001Israel The Azrieli Faculty of Medicine Bar-Ilan UniversitySafed 1311502Israel

The surge in type 2 diabetes mellitus(T2DM)is tightly linked to obesity,leading to ectopic fat accumulation in internal *** management has become a cornerstone of T2DM treatment,with evidence suggesting that significant weight loss can induce ***,defined as sustained hemoglobin(HbA1c)below 6.5% for at least 3 months without medication,can be achieved through various approaches,including lifestyle,medical,and surgical *** bariatric surgery offers significant remission rates,particularly for patients with severe *** lifestyle modifications,including lowcalorie diets and exercise,have also demonstrated significant *** like incretin-based agents show robust results in improving beta-cell function,achieving glycemic control,and promoting weight *** complete remission without medication may not be attainable for everyone,especially those with severe insulin resistance or deficiency,early and aggressive glycemic control remains a crucial *** HbA1c below 6.5%from the time of diagnosis reduces the risk of long-term complications and ***,considering a broader definition of remission,encompassing individuals with sustained control on medication,could offer a more comprehensive and inclusive approach to managing this chronic disease.

关键词： Type 2 diabetes mellitus Remission Lifestyle intervention Metabolic bariatric surgery Glucose-lowering medications Weight management medications

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Cognitive Behavioral Therapy for Tinnitus in Adults: A Review of Efficacy in Quality-of-Life Enhancement

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第5期13卷 384-402页

作者： Mohamad afif Yamout The School of Advanced Education Research and Accreditation (SAERA) Castell Spain

Background: Tinnitus, characterized by the perception of sounds without an external source, significantly affects quality of life. Cognitive Behavioral Therapy (CBT) has emerged as a promising approach for managing tinnitus-related distress and enhancing psychological well-being. Objectives: This review aims to analyze the effectiveness of CBT in tinnitus management, focusing on alleviating distress, enhancing coping mechanisms, and improving overall well-being. Methods: PubMed and World of Science databases were systematically searched using keywords related to tinnitus, CBT, and quality of life. English, peer-reviewed studies focusing on adult populations were included. Studies involving pediatric populations or not meeting inclusion criteria were excluded. Data extraction was performed using PRISMA guidelines, with a narrative synthesis approach for analysis. Methodological quality and risk of bias were assessed using appropriate tools. The search engine initially identified 155 studies that met the inclusion criteria for the systematic review. However, upon further evaluation, 140 of these studies were excluded due to their non-randomized design. Of the remaining 15 studies, 11 were found to be partially accessible but ultimately excluded from the review as they did not meet the full accessibility criteria. Therefore, only four studies remained in the review, deemed suitable for inclusion based on their randomized design and full accessibility. Results: Studies by Beukes et al. [1]-[3] and Simoes et al. [4] evaluated CBT’s effectiveness. With internet-based CBT, Beukes et al. demonstrated reductions in tinnitus distress, negative cognitions, and comorbidities. Simoes et al. proposed combination treatments for tinnitus management. The review outcome suggests that CBT is an effective treatment for tinnitus, as it can help reduce tinnitus distress and improve quality of life. However, limitations in sample sizes and follow-up durations highlight the need for furthe

关键词： Tinnitus CBT Quality of Life Cognitive Behavioral Therapy

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Systemic oncological therapy in breast cancer patients on dialysis

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World Journal of Clinical Oncology 2024年第6期15卷 730-744页

作者： Salman Khan Ghada Araji Ekrem Yetiskul Praneeth Reddy Keesari Fadi Haddadin Zaid Khamis Varun Chowdhry Muhammad Niazi Sarah afif Meekoo Dhar Suzanne El-Sayegh Department of Internal Medicine Northwell Health-Staten Island University HospitalStaten IslandNY 10305United States Department of Hematology and Oncology Northwell Health-Staten Island University HospitalStaten IslandNY 10305United States Department of Internal Medicine CUNY School of MedicineNew YorkNY 10031United States

The advancement of renal replacement therapy has significantly enhanced the survival rates of patients with end-stage renal disease(ESRD)over ***-ever,this prolonged survival has also been associated with a higher likelihood of cancer diagnoses among these patients including breast *** cancer treatment typically involves surgery,radiation,and systemic therapies,with ap-proaches tailored to cancer type,stage,and patient ***,renal replacement therapy complicates systemic therapy due to altered drug clearance and the necessity for dialysis *** review emphasizes the need for opti-mized dosing and administration strategies for systemic breast cancer treatments in dialysis patients,aiming to ensure both efficacy and ***,ch-allenges in breast cancer screening and diagnosis in this population,including soft-tissue calcifications,are highlighted.

关键词： Breast cancer Systemic therapy Renal replacement therapy Dialysis End-stage renal disease Hormone therapy Chemotherapy

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THE LERAY-SCHAUDER CONDITION FOR 1-SET WEAKLY-CONTRACTIVE AND(ws)-COMPACT OPERATORS

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Acta Mathematica Scientia 2014年第2期34卷 263-273页

作者： afif BEN AMAR Department of Mathematics Faculty of Sciences

Abstract The main purpose of this article is to prove a collection of new nxea point theorems for （ws）-compact and so-called 1-set weakly contractive operators under Leray- Schauder boundary condition. We also introduce the concept of semi-closed operator at the origin and obtain a series of new fixed point theorems for such class of operators. As consequences, we get new fixed point existence for （ws）-compact （in particular nonexpansive） self mappings unbounded closed convex subset of Banach spaces. The main condition in our results is formulated in terms of axiomatic measures of weak noncompactness. Later on, we give an application to generalized Hammerstein type integral equations.

关键词： Measure of weak noncompactness weakly condensing and weakly nonexpan-sire (ws)-compact operator fixed point theorems semi-closed at the origin

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A COMPOUND POISSON MODEL FOR LEARNING DISCRETE BAYESIAN NETWORKS

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Acta Mathematica Scientia 2013年第6期33卷 1767-1784页

作者： Abdelaziz GHRIBI afif MASMOUDI Laboratory of Physic-Mathematics University of Sfax Laboratory of Probability and Statistics University of Sfax

We introduce here the concept of Bayesian networks, in compound Poisson model, which provides a graphical modeling framework that encodes the joint probability distribution for a set of random variables within a directed acyclic graph. We suggest an approach proposal which offers a new mixed implicit estimator. We show that the implicit approach applied in compound Poisson model is very attractive for its ability to understand data and does not require any prior information. A comparative study between learned estimates given by implicit and by standard Bayesian approaches is established. Under some conditions and based on minimal squared error calculations, we show that the mixed implicit estimator is better than the standard Bayesian and the maximum likelihood estimators. We illustrate our approach by considering a simulation study in the context of mobile communication networks.

关键词： Bayesian network compound Poisson distribution multinomial distribution implicit approach mobile communication networks

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Monte Carlo Simulations of Mixed Highly Frustrated Systems

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Chinese Physics Letters 2002年第8期19卷 1187-1190页

作者： K.afif M.Hamedoun 等 LaboratoiredeMagnetisme FacultedesSciencesBP1014RabatMorocco LaboratoiredePhysiquedessolides FacultedesSciencesDharMahrazFesMorocco

We have performed Monte Carlo simulations on the mixed highly frustrated K2CuxMn1-xF4 and FexMn1-xTiO3 systems. Transitions of random systems with well-established universality classes are obtained. This study allows us to investigate mainly the usual and re-entrant spin glass and criticality associated with these states. The ratio x of substitution (or dilution) is found to have a large influence on the nature of this criticality.

关键词： Monte Carlo methods

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Thermodynamic Investigation of a Solar Energy Cogeneration Plant Using an Organic Rankine Cycle in Supercritical Conditions

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Fluid Dynamics & Materials Processing 2022年第5期18卷 1243-1251页

作者： Larbi afif Nahla Bouaziz Research Lab Energetic and Environment National Engineering School of TunisTunis El Manar UniversityBelvedereTunis1002Tunisia

In the present work,a novel Organic Rankine Cycle(ORC)configuration is used for a low-grade heat source cogeneration *** investigation is conducted accordingly into the simultaneous production of electricity and *** proposed configuration relies on concentrated solar power(as heat source)and ambient air(for cooling).Furthermore,two gas ejectors are added to the system in order to optimize the thermodynamic efficiency of the organic Rankine *** results show that the thermodynamic and geometric parameters related to these ejectors have an important effect on the overall system *** order to account for the related environmental impact,the following working fluids are considered:HCFC-124,HFC-236fa,HFO-1234yf and *** shown by the numerical simulations,the fluid R1234yf presents the minimal heat consumption and therefore provides an optimal thermal efficiency for the ORC cycle(which is around 29%).However,the refrigerant R236fa displays the highest refrigeration performances with a performance coefficient reaching a value as high as 0.38.

关键词： ORC energy efficiency solar energy ejector

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