Background There is limited evidence on the effectiveness of biological therapy in stricturing complications in patients with Crohn’s disease. Aim The study aims to determine the effectiveness of anti-tumor necrosis factor (TNF) agents in Crohn’s disease complicated with symptomatic strictures. Methods In this multicentric and retrospective study, we included adult patients with symptomatic stricturing Crohn’s disease receiving their first anti-TNF therapy, with no previous history of biological, endoscopic or surgical therapy. The effectiveness of the anti-TNF agent was defined as a composite outcome combining steroid-free drug persistence with no use of new biologics or immunomodulators, hospital admission, surgery or endoscopic therapy during follow-up. Results Overall, 262 patients with Crohn’s disease were included (53% male; median disease duration, 35 months, 15% active smokers), who received either infliximab ( N = 141, 54%) or adalimumab ( N = 121, 46%). The treatment was effective in 87% and 73% of patients after 6 and 12 months, respectively, and continued to be effective in 26% after a median follow-up of 40 months (IQR, 19–85). Nonetheless, 15% and 21% of individuals required surgery after 1 and 2 years, respectively, with an overall surgery rate of 32%. Postoperative complications were identified in 15% of patients, with surgical site infection as the most common. Starting anti-TNF therapy in the first 18 months after the diagnosis of Crohn’s disease or the identification of stricturing complications was associated with a higher effectiveness (HR 1.62, 95% CI 1.18–2.22; and HR 1.55, 95% CI 1.1–2.23; respectively). Younger age, lower albumin levels, strictures located in the descending colon, concomitant aminosalicylates use or presence of lymphadenopathy were associated with lower effectiveness. Conclusions Anti-TNF agents are effective in approximately a quarter of patients with Crohn’s disease and symptomatic intestinal strictures, and 68% of patients are free of surgery after a median of 40 months of follow-up. Early treatment and some potential predictors of response were associated with treatment success in this setting.
Background: Anti-TNF α represent one of the main treatment approaches for the management of inflammatory bowel diseases (IBD). Therefore,the evaluation of their treatment patterns over time provides valuable insights about the clinical value of therapies and associated costs. Aims:To assess the treatment patterns with the first anti-TNF α in IBD.Methods: Retrospective, observational study.Results: 310 IBD patients were analyzed along a 5-year follow-up period. 56.2% of Crohn's disease (CD) patients started with adalimumab (ADA), while 43.8% started with infliximab (IFX). 12.9% of ulcerative colitis (UC) patients initiated with ADA, while 87.1% initiated with IFX. Treatment intensification was required in 28.9% of CD and 37.1% of UC patients. Median time to treatment intensification was shorter in UC than in CD (5.3 vs. 14.3 months; p = 0.028). Treatment discontinuation due to reasons other than remission were observed in 40.7% of CD and 40.5% of UC patients, although, in UC patients there was a trend to lower discontinuation rates with IFX (36.6%) than with ADA (66.7%). Loss of response accounted for approximately one-third of discontinuations, in both CD and UC.Conclusions: Around one-third of IBD biologic-naive patients treated with an anti-TNF α required treatment intensification (earlier in UC) and around 40% discontinued the anti-TNF α due to inappropriate disease control.
RESUMENLa investigación que actualmente se está llevando a cabo en el área del Procesamiento del Lenguaje Natural está todavía lejos de conseguir niveles profundos de compresión del lenguaje. Para poder construir sistemas inteligentes que traten con la representación del significado, es necesario en el ámbito de las tecnologías del lenguaje, la creación de recursos semánticos de amplia cobertura. El objetivo principal de nuestra investigación es el establecimiento de clases para la representación eventiva en un sistema computacional. La unidad básica de representación es el rasgo, concretamente hemos considerado cuatro rasgos: dinamicidad, telicidad, duración y gradualidad. A partir de la combinación de estos rasgos semánticos hemos establecido un conjunto de clases eventivas que nos permite caracterizar el comportamiento verbal. Para establecer estas clases hemos tenido en cuenta los posibles cambios eventivos que puede sufrir una unidad verbal según el contexto, representando así la composicionalidad del significado eventivo. Por ello hemos considerado la prototipicidad de los sentidos verbales, y la sensibilidad de las diferentes clases al contexto. El total de clases definidas se clasifica en dos grupos, las clases simples: estados, procesos y puntos, cuya combinación da lugar a las clases complejas: culminaciones, realizaciones y graduales. ABSTRACTResearch currently being conducted in the area of Natural Language Processing is still far from achieving deep levels of understanding of language. To build intelligent systems that deal with the representation of meaning, it is necessary in the field of language technologies, to create wide coverage semantic resources. The main goal of our research is the establishment of classes for representing events in a computational system. The basic unit of representation is the feature; we have considered four specific features: dynamism, telicity, duration and gradual change. From the combination of these semantic features we have established a set of event classes that allows us to characterize verbal behavior. To establish these classes we took into account possible event changes that a verbal unit may suffer because of the context, thus representing the compositionality of event meaning. Therefore we have considered the prototypicity of verbal senses, and the sensitivity of the different classes to the context. The total 2 JUAN APARICIO, IRENE CASTELLÓN Y MARTA COLL-FLORIT ANU.FILOL.ESTUD.LINGÜÍST., 1/2011, pp. 1-29, ISSN: 2014-1408 number of defined classes is classified into two groups, simple classes: states, processes and points, the combination of which gives rise to the complex classes: culminations, accomplishments and graduals.
Background: Ethnotaxonomy seeks to understand how members of a culture name and categorize biological organisms in their local language. This research examined the ethnotaxonomy of plants among the Mixtec people in the municipality of San Miguel el Grande, Oaxaca, Mexico. Methods:We conducted a collaborative research between 2019 and 2020 with 42 Mixtec men and women between 38 and 100 years of age, in the ten communities that make up the municipality. We focused on classification, nomenclature and plant identification.Results: There is a more or less hierarchical classification that contemplates both cognitive and utilitarian aspects. The nomenclature shows that the Mixtec of the study area have taken into account the characteristics of the plants-cultural, experiential, and ecological-to name them. Identification is based on multiple morphological, ecological, cultural and experiential mechanisms. Conclusion:The botanical ethnotaxonomy of San Miguel el Grande is rich and varied, revealing that plants play an important role in the lives of people. However, it seems that the disuse of some plants and the Spanish language is conditioning the maintenance of Mixtec plant names.
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