28 results on '"Kraev K"'
Search Results
2. The creative vanguard at Magnitogorsk
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Kraev, K. B. and Stephanov, U. G.
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- 1978
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3. School of advanced techniques
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Kraev, K. B.
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- 1979
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4. The review of the work of plants in showing a patron's help to state farms and collective farms in the development of inventiveness rationalizing in the Tenth Five-Year Plan
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Kraev, K.
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- 1977
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5. Expression of CD68+ Cells in Synovial Tissue from Patients with PsA and its Association with Disease Activity Indices: A Clinical Pilot Study.
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Popova-Belova S, Geneva-Popova M, Popova V, and Kraev K
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Introduction: Investigating CD68+ positive cells in the synovial tissue is crucial for understanding the pathogenesis of psoriatic arthritis (PsA) and developing targeted treatment strategies. The role of CD68+ positive cells in the synovial tissue of patients with PsA for joint destruction has not been fully studied., Objective: The objective of the study was to examine the presence of CD68+ cells in the synovial tissue of patients with PsA, particularly those with high inflammatory activity., Methods: Synovial tissue samples were collected during knee joint replacement surgeries from patients with PsA (16 patients) and gonarthrosis (25 patients). Immunohistochemical methods were employed to detect CD68+ cell expression in the tissue samples. The results were analyzed by histologists, and the staining intensity and percentage of positively stained cells were evaluated. The data were then divided into three groups for statistical analysis: negative, weakly positive, and strongly positive histological samples. Routine indices for disease activity, VAS, DAPSA, PASDAI, and mCPDAI were used to assess PsA activity in all patients and to assess correlations with CD68+ positive cells in the synovial tissue. Statistical analysis was performed using SPSS version 26.0 (SPSS Inc., Chicago, IL, USA)., Results: The expression of CD68+ positive cells was significantly higher in patients with PsA compared to those with activated gonarthrosis (p < 0.001). The indices for disease activity, VAS, DAPSA, PASDAI, mCPDAI, and mCPDAI showed a significant positive relationship with the expression of CD68 + cells on synovial tissue in patients with PsA (p < 0.01) Conclusion: The findings of the study confirm the increased numbers of CD68+ cells in PsA vs. gonathrosis synovium. This suggests the need to explore therapeutic approaches aimed at suppressing or blocking CD68+ cells to potentially mitigate joint damage., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2024
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6. Artificial Intelligence in Breast Cancer Diagnosis and Treatment: Advances in Imaging, Pathology, and Personalized Care.
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Uchikov P, Khalid U, Dedaj-Salad GH, Ghale D, Rajadurai H, Kraeva M, Kraev K, Hristov B, Doykov M, Mitova V, Bozhkova M, Markov S, and Stanchev P
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Breast cancer is the most prevalent cancer worldwide, affecting both low- and middle-income countries, with a growing number of cases. In 2024, about 310,720 women in the U.S. are projected to receive an invasive breast cancer diagnosis, alongside 56,500 cases of ductal carcinoma in situ (DCIS). Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life. About 65% of women with the BRCA1 and 45% with the BRCA2 gene variants develop breast cancer by age 70. While these genes account for 5% of breast cancers, their prevalence is higher in certain populations. Advances in early detection, personalised medicine, and AI-driven diagnostics are improving outcomes by enabling a more precise analysis, reducing recurrence, and minimising treatment side effects. Our paper aims to explore the vast applications of artificial intelligence within the diagnosis and treatment of breast cancer and how these advancements can contribute to elevating patient care as well as discussing the potential drawbacks of such integrations into modern medicine. We structured our paper as a non-systematic review and utilised Google Scholar and PubMed databases to review literature regarding the incorporation of AI in the diagnosis and treatment of non-palpable breast masses. AI is revolutionising breast cancer management by enhancing imaging, pathology, and personalised treatment. In imaging, AI can improve the detection of cancer in mammography, MRIs, and ultrasounds, rivalling expert radiologists in accuracy. In pathology, AI enhances biomarker detection, improving HER2 and Ki67 assessments. Personalised medicine benefits from AI's predictive power, aiding risk stratification and treatment response. AI also shows promise in triple-negative breast cancer management, offering better prognosis and subtype classification. However, challenges include data variability, ethical concerns, and real-world validation. Despite limitations, AI integration offers significant potential in improving breast cancer diagnosis, prognosis, and treatment outcomes.
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- 2024
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7. Risk factors related to amputation in diabetic foot patients: single center outcomes.
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Kostov G, Doykov M, Hristov B, Amaliev G, Kraev K, Doykov D, Tilkiyan E, Dimov L, and Dimov R
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- Humans, Risk Factors, Male, Female, Middle Aged, Aged, Retrospective Studies, Prognosis, Diabetic Foot surgery, Amputation, Surgical statistics & numerical data
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Aim: This study aimed at identifying factors that worsen the prognosis of diabetic foot, one of the most common complications seen in patients with diabetes., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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8. Surgical treatment of pulmonary hydatid disease: a nine-year single-center experience.
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Uchikov P, Ali N, Sandeva M, Kraev K, Eneva K, Hristov B, Kraeva M, Dzhambazova E, Taneva D, Tenchev T, and Uchikov A
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- Humans, Male, Female, Adult, Middle Aged, Young Adult, Adolescent, Aged, Retrospective Studies, Treatment Outcome, Echinococcosis, Pulmonary surgery, Echinococcosis, Pulmonary diagnostic imaging
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Introduction: Hydatidosis is one of the most critical parasitic zoonotic diseases worldwide. Lungs are the second most common site of the disease., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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9. Artificial Intelligence Algorithms and Their Current Role in the Identification and Comparison of Gleason Patterns in Prostate Cancer Histopathology: A Comprehensive Review.
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Khalid U, Gurung J, Doykov M, Kostov G, Hristov B, Uchikov P, Kraeva M, Kraev K, Doykov D, Doykova K, Valova S, Chervenkov L, Tilkiyan E, and Eneva K
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The development of the Gleason grading system has proven to be an irreplaceable tool in prostate cancer diagnostics within urology. Despite the advancements and developments in diagnostics, there remains a discrepancy in the grading process among even the most experienced pathologists. AI algorithms have demonstrated potential in detecting cancer and assigning Gleason grades, offering a solution to the issue of significant variability among pathologists' evaluations. Our paper explores the evolving role of AI in prostate cancer histopathology, with a key focus on outcomes and the reliability of various AI algorithms for Gleason pattern assessment. We conducted a non-systematic review of the published literature to examine the role of artificial intelligence in Gleason pattern diagnostics. The PubMed and Google Scholar databases were searched to gather pertinent information about recent advancements in artificial intelligence and their impact on Gleason patterns. We found that AI algorithms are increasingly being used to identify Gleason patterns in prostate cancer, with recent studies showing promising advancements that surpass traditional diagnostic methods. These findings highlight AI's potential to be integrated into clinical practice, enhancing pathologists' workflows and improving patient outcomes. The inter-observer variability in Gleason grading has seen an improvement in efficiency with the implementation of AI. Pathologists using AI have reported successful outcomes, demonstrating its effectiveness as a supplementary tool. While some refinements are still needed before AI can be fully implemented in clinical practice, its positive impact is anticipated soon.
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- 2024
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10. Exploring the impact of curcumin on osteoarthritis symptomatology: correlations and insights from a Bulgarian cohort.
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Kraev K, Uchikov P, Hristov B, Kraeva M, Basheva-Kraeva Y, Doykov M, Popova-Belova S, and Geneva-Popova M
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- Humans, Bulgaria, Male, Female, Middle Aged, Aged, Cohort Studies, Curcumin therapeutic use, Osteoarthritis drug therapy, Anti-Inflammatory Agents, Non-Steroidal therapeutic use
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Introduction: Osteoarthritis is a prevalent degenerative joint disorder associated with pain and functional impairment. Curcumin, a natural anti-inflammatory compound, has garnered attention for its potential therapeutic benefits in osteoarthritis management., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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11. Combined laser and mechanical lithotripsy for endoscopic management of Bouveret's syndrome: A case report.
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Hristov B, Doykov D, Stanchev D, Nacheva-Georgieva E, Kraev K, Uchikov P, Kostov G, Valova S, Tilkiyan E, Doykova K, and Doykov M
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- Humans, Syndrome, Lithotripsy, Laser methods, Female, Intestinal Fistula therapy, Intestinal Fistula surgery, Male, Aged, Gastric Outlet Obstruction surgery, Gastric Outlet Obstruction etiology, Gastric Outlet Obstruction therapy, Gallstones surgery, Gallstones therapy, Gallstones complications, Gallstones diagnostic imaging, Lithotripsy methods
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Bouveret's syndrome (BS) represents an exceedingly rare clinical entity characterized by gastric outlet obstruction induced by a gallstone passing through a cholecystoduodenal, cholecystogastric or choledochoduodenal fistula and impacting in the duodenum or pylorus. Endoscopy is the preferred first-line therapy. It has a favorable safety profile, but requires high level of expertise to achieve stone clearance., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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12. The expanding role of artificial intelligence in the histopathological diagnosis in urological oncology: a literature review.
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Gurung J, Doykov M, Kostov G, Hristov B, Uchikov P, Kraev K, Doykov D, Doykova K, Valova S, Nacheva-Georgieva E, and Tilkiyan E
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- Humans, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms diagnosis, Prostatic Neoplasms pathology, Prostatic Neoplasms diagnosis, Kidney Neoplasms pathology, Kidney Neoplasms diagnosis, Male, Algorithms, Carcinoma, Renal Cell pathology, Carcinoma, Renal Cell diagnosis, Artificial Intelligence, Urologic Neoplasms pathology, Urologic Neoplasms diagnosis
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The ongoing growth of artificial intelligence (AI) involves virtually every aspect of oncologic care in medicine. Although AI is in its infancy, it has shown great promise in the diagnosis of oncologic urological conditions. This paper aims to explore the expanding role of artificial intelligence in the histopathological diagnosis in urological oncology. We conducted a focused review of the literature on AI in urological oncology, searching PubMed and Google Scholar for recent advancements in histopathological diagnosis using AI. Various keyword combinations were used to find relevant sources published before April 2nd, 2024. We approached this article by focusing on the impact of AI on common urological malignancies by incorporating the use of different AI algorithms. We targeted the capabilities of AI's potential in aiding urologists and pathologists in histological cancer diagnosis. Promising results suggest AI can enhance diagnosis and personalized patient care, yet further refinements are needed before widespread hospital adoption. AI is transforming urological oncology by improving histopathological diagnosis and patient care. This review highlights AI's advancements in diagnosing prostate, renal cell, and bladder cancer. It is anticipated that as AI becomes more integrated into clinical practice, it will have a greater influence on diagnosis and improve patient outcomes., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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13. The Role of Artificial Intelligence in the Diagnosis and Treatment of Ulcerative Colitis.
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Uchikov P, Khalid U, Vankov N, Kraeva M, Kraev K, Hristov B, Sandeva M, Dragusheva S, Chakarov D, Petrov P, Dobreva-Yatseva B, and Novakov I
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Background and Objectives: This review aims to delve into the role of artificial intelligence in medicine. Ulcerative colitis (UC) is a chronic, inflammatory bowel disease (IBD) characterized by superficial mucosal inflammation, rectal bleeding, diarrhoea and abdominal pain. By identifying the challenges inherent in UC diagnosis, we seek to highlight the potential impact of artificial intelligence on enhancing both diagnosis and treatment methodologies for this condition., Method: A targeted, non-systematic review of literature relating to ulcerative colitis was undertaken. The PubMed and Scopus databases were searched to categorize a well-rounded understanding of the field of artificial intelligence and its developing role in the diagnosis and treatment of ulcerative colitis. Articles that were thought to be relevant were included. This paper only included articles published in English., Results: Artificial intelligence (AI) refers to computer algorithms capable of learning, problem solving and decision-making. Throughout our review, we highlighted the role and importance of artificial intelligence in modern medicine, emphasizing its role in diagnosis through AI-assisted endoscopies and histology analysis and its enhancements in the treatment of ulcerative colitis. Despite these advances, AI is still hindered due to its current lack of adaptability to real-world scenarios and its difficulty in widespread data availability, which hinders the growth of AI-led data analysis., Conclusions: When considering the potential of artificial intelligence, its ability to enhance patient care from a diagnostic and therapeutic perspective shows signs of promise. For the true utilization of artificial intelligence, some roadblocks must be addressed. The datasets available to AI may not truly reflect the real-world, which would prevent its impact in all clinical scenarios when dealing with a spectrum of patients with different backgrounds and presenting factors. Considering this, the shift in medical diagnostics and therapeutics is coinciding with evolving technology. With a continuous advancement in artificial intelligence programming and a perpetual surge in patient datasets, these networks can be further enhanced and supplemented with a greater cohort, enabling better outcomes and prediction models for the future of modern medicine.
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- 2024
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14. Solitary primary intraosseous xanthoma of the mandible in a 15-year-old boy: a case report.
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Georgiev A, Genova S, Uchikov P, Kraev K, Kraeva M, Chakarov D, and Uchikov A
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- Humans, Male, Adolescent, Tomography, X-Ray Computed, Mandible pathology, Mandible diagnostic imaging, Mandible surgery, Biopsy, Xanthomatosis pathology, Xanthomatosis diagnosis, Xanthomatosis surgery, Mandibular Diseases pathology, Mandibular Diseases diagnostic imaging, Mandibular Diseases surgery, Mandibular Diseases diagnosis
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Background: A xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor., Case Report: A 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods., Conclusion: The diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis., (© 2024. The Author(s).)
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- 2024
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15. Ecdysterone and Turkesterone-Compounds with Prominent Potential in Sport and Healthy Nutrition.
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Todorova V, Ivanova S, Chakarov D, Kraev K, and Ivanov K
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- Humans, Plant Extracts pharmacology, Sports Nutritional Physiological Phenomena, Diet, Healthy methods, Athletic Performance, Ecdysterone pharmacology
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The naturally occurring compounds ecdysterone and turkesterone, which are present in plants, including Rhaponticum carthamoides Willd. (Iljin), Spinacia oleracea L., Chenopodium quinoa Willd., and Ajuga turkestanica (Regel) Briq, are widely recognized due to their possible advantages for both general health and athletic performance. The current review investigates the beneficial biological effects of ecdysterone and turkesterone in nutrition, highlighting their roles not only in enhancing athletic performance but also in the management of various health problems. Plant-based diets, associated with various health benefits and environmental sustainability, often include sources rich in phytoecdysteroids. However, the therapeutic potential of phytoecdysteroid-rich extracts extends beyond sports nutrition, with promising applications in treating chronic fatigue, cardiovascular diseases, and neurodegenerative disorders.
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- 2024
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16. Prognostic models of drug-induced neutralizing antibody formation in patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis treated with TNF-α blockersockers.
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Kraev K, Hristov B, Uchikov P, Kraeva M, Geneva-Popova M, Popova S, Basheva-Kraeva Y, Stoyanova NS, and Mitkova-Hristova V
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- Humans, Prognosis, Male, Female, Middle Aged, Adult, Antirheumatic Agents therapeutic use, Models, Theoretical, Spondylitis, Ankylosing drug therapy, Spondylitis, Ankylosing immunology, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid immunology, Arthritis, Psoriatic drug therapy, Arthritis, Psoriatic immunology, Tumor Necrosis Factor-alpha antagonists & inhibitors, Tumor Necrosis Factor-alpha immunology, Antibodies, Neutralizing
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Aim: This study aimed to construct prognostic mathematical models utilizing multifactorial regression analysis to assess the risk of developing drug-induced neutralizing antibodies in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis treated with tumor necrosis factor alpha blockers., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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17. A Comparison between Bulgarian Tanacetum parthenium Essential Oil from Two Different Locations.
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Lechkova B, Benbassat N, Karcheva-Bahchevanska D, Ivanov K, Peychev L, Peychev Z, Dyankov S, Georgieva-Dimova Y, Kraev K, and Ivanova S
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- Bulgaria, Terpenes chemistry, Terpenes analysis, Camphor chemistry, Camphor analysis, Plant Oils chemistry, Bicyclic Monoterpenes, Oils, Volatile chemistry, Tanacetum parthenium chemistry, Gas Chromatography-Mass Spectrometry
- Abstract
Tanacetum parthenium L. (Asteraceae) is a perennial herbaceous plant with a long-standing historical use in traditional medicine. Recently Tanacetum parthenium L. essential oil has been associated with a promising potential for future applications in the pharmaceutical industry, in the cosmetics industry, and in agriculture. Investigations on the essential oil (EO) have indicated antimicrobial, antioxidant, and repellent activity. The present study aimed to evaluate the chemical composition of Bulgarian T. parthenium essential oil from two different regions, to compare the results to those reported previously in the literature, and to point out some of its future applications. The essential oils of the air-dried flowering aerial parts were obtained by hydrodistillation using a Clevenger-type apparatus. The chemical composition was evaluated using gas chromatography with mass spectrometry (GC-MS). It was established that the oxygenated monoterpenes were the predominant terpene class, followed by the monoterpene hydrocarbons. Significant qualitative and quantitative differences between both samples were revealed. Camphor (50.90%), camphene (16.12%), and bornyl acetate (6.05%) were the major constituents in the feverfew EO from the western Rhodope Mountains, while in the EO from the central Balkan mountains camphor (45.54%), trans-chrysanthenyl acetate (13.87%), and camphene (13.03%) were the most abundant components.
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- 2024
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18. Rare case of enteric type of urachal adenocarcinoma: A case report.
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Uchikov P, Ali N, Kraev K, Hristov B, Ivanov A, Doykov M, Koleva-Ivanova M, Mollova-Kyosebekirova A, Kraeva M, Chakarov D, Sandeva M, Dobreva-Yatseva B, and Antonov P
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Urachal adenocarcinomas, constituting 10 % of bladder adenocarcinomas, pose a significant challenge with limited literature. A 43-year-old male presented with haematuria and abdominal pain, leading to surgical intervention for a 13 cm pelvic tumor. Histopathology identified an intestinal-type primary urachal adenocarcinoma, staged as IIIA, no recurrence on follow-up. Early detection is crucial for improved outcomes in these rare malignancies. While surgery remains the primary treatment, outcomes vary, emphasizing the need for research on standardized protocols. Enhanced awareness and interdisciplinary collaboration are vital for effective management. Comprehensive guidelines are essential for optimizing patient prognoses in urachal adenocarcinomas., (© 2024 The Author(s).)
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- 2024
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19. Coexistence of ankylosing spondylitis and Behçet's disease: Successful treatment with upadacitinib.
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Kraev K, Uchikov P, Hristov B, Kraeva M, Basheva-Kraeva Y, Popova-Belova S, Sandeva M, Chakarov D, Dragusheva S, and Geneva-Popova M
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- Female, Humans, Adult, Heterocyclic Compounds, 3-Ring therapeutic use, HLA-B51 Antigen, Spondylitis, Ankylosing complications, Spondylitis, Ankylosing diagnosis, Spondylitis, Ankylosing drug therapy, Behcet Syndrome complications, Behcet Syndrome diagnosis, Behcet Syndrome drug therapy
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Background: Ankylosing spondylitis (AS) and Behçet's disease (BD) are distinct inflammatory disorders, but their coexistence is a rare clinical entity. This case sheds light on managing this complex scenario with Janus kinase (JAK) inhibitors., Case Presentation: A 42-year-old woman presented with a decade-long history of lower back pain, nocturnal spinal discomfort, recurrent eye issues, oral and genital ulcers, hearing loss, pus formation in the left eye, and abdominal pain. Multidisciplinary consultations and diagnostic tests confirmed AS (HLA-B27 positivity and sacroiliitis) and BD (HLA-B51). Elevated acute-phase markers were observed., Conclusion: This case fulfills diagnostic criteria for both AS and BD, emphasizing their coexistence. Notably, treatment with upadacitinib exhibited promising efficacy, underscoring its potential as a therapeutic option in patients with contraindications for conventional treatments. Our findings illuminate the intricate management of patients presenting with these two diverse systemic conditions and advocate for further exploration of JAK inhibitors in similar cases., (© 2024 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)
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- 2024
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20. Artificial Intelligence in the Diagnosis of Colorectal Cancer: A Literature Review.
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Uchikov P, Khalid U, Kraev K, Hristov B, Kraeva M, Tenchev T, Chakarov D, Sandeva M, Dragusheva S, Taneva D, and Batashki A
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Background: The aim of this review is to explore the role of artificial intelligence in the diagnosis of colorectal cancer, how it impacts CRC morbidity and mortality, and why its role in clinical medicine is limited., Methods: A targeted, non-systematic review of the published literature relating to colorectal cancer diagnosis was performed with PubMed databases that were scouted to help provide a more defined understanding of the recent advances regarding artificial intelligence and their impact on colorectal-related morbidity and mortality. Articles were included if deemed relevant and including information associated with the keywords., Results: The advancements in artificial intelligence have been significant in facilitating an earlier diagnosis of CRC. In this review, we focused on evaluating genomic biomarkers, the integration of instruments with artificial intelligence, MR and hyperspectral imaging, and the architecture of neural networks. We found that these neural networks seem practical and yield positive results in initial testing. Furthermore, we explored the use of deep-learning-based majority voting methods, such as bag of words and PAHLI, in improving diagnostic accuracy in colorectal cancer detection. Alongside this, the autonomous and expansive learning ability of artificial intelligence, coupled with its ability to extract increasingly complex features from images or videos without human reliance, highlight its impact in the diagnostic sector. Despite this, as most of the research involves a small sample of patients, a diversification of patient data is needed to enhance cohort stratification for a more sensitive and specific neural model. We also examined the successful application of artificial intelligence in predicting microsatellite instability, showcasing its potential in stratifying patients for targeted therapies., Conclusions: Since its commencement in colorectal cancer, artificial intelligence has revealed a multitude of functionalities and augmentations in the diagnostic sector of CRC. Given its early implementation, its clinical application remains a fair way away, but with steady research dedicated to improving neural architecture and expanding its applicational range, there is hope that these advanced neural software could directly impact the early diagnosis of CRC. The true promise of artificial intelligence, extending beyond the medical sector, lies in its potential to significantly influence the future landscape of CRC's morbidity and mortality.
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- 2024
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21. Comprehensive Exploration of Antinuclear Antibodies (ANAs): Unveiling Clinical Significance, Associations with Cancer, and the Nuances of Differential Diagnosis in Positive ANA Patients.
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Kraev K, Hristov B, Uchikov P, Kraeva M, Basheva-Kraeva Y, Valova S, Koleva-Ivanova M, Popova-Belova S, Sandeva M, Chakarov D, and Geneva-Popova M
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This comprehensive review delves into the complex realm of antinuclear antibodies (ANAs), expanding beyond their traditional involvement in autoimmune rheumatic disorders. By digging into historical changes, diagnostic complexity, and clinical significance, the debate reveals the shifting relationships between ANAs, particularly with cancer. Specialized studies provide practical insights on ANA testing processes, standardization, and upcoming challenges. Examining prevalence trends in the United States provides a time dimension to ANA dynamics, linking autoimmune and oncological considerations. The debate delves into the complexity of lupus erythematosus, emphasizing ANAs' diverse presentations and their potential as flexible diagnostic and prognostic indicators. The complex relationship between ANAs and cancer is highlighted, demonstrating their potential as early markers or indicators of malignancies. Looking ahead, this synthesis anticipates advances in personalized medicine and collaborative research, putting ANAs at the forefront of advanced diagnostics and treatments for autoimmune disorders and cancer. This synthesis envisions a future for ANA research in which these antibodies play a critical role in promoting personalized treatment, enhancing diagnostics, and fostering collaborative initiatives that cross traditional boundaries. As ANAs grow more prominent at the junction of autoimmune illnesses and cancer, this synthesis lays the path for further research and novel advances in understanding, diagnosing, and treating complicated medical conditions.
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- 2024
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22. Estimating reference values of parenchymal stiffness of normal pancreatic parenchyma by means of point shear wave elastography.
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Hristov B, Nacheva-Georgieva E, Stanchev D, Kraev K, Uchikov P, Kostov G, Valova S, Tilkiyan E, Doykova K, and Doykov M
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- Reference Values, Pancreas diagnostic imaging, Elasticity Imaging Techniques methods
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Introduction: There are numerous imaging modalities available to describe pancreatic parenchyma. None of the broadly accepted diagnostic methods uses elasticity as an indicator of tissue damage., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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23. Surgical Innovations in Tracheal Reconstruction: A Review on Synthetic Material Fabrication.
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Khalid U, Uchikov P, Hristov B, Kraev K, Koleva-Ivanova M, Kraeva M, Batashki A, Taneva D, Doykov M, and Uchikov A
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- Animals, Humans, Databases, Factual, Postoperative Period, PubMed, Plastic Surgery Procedures
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Background and Objectives : The aim of this review is to explore the recent surgical innovations in tracheal reconstruction by evaluating the uses of synthetic material fabrication when dealing with tracheomalacia or stenotic pathologies, then discussing the challenges holding back these innovations. Materials and Methods : A targeted non-systematic review of published literature relating to tracheal reconstruction was performed within the PubMed database to help identify how synthetic materials are utilised to innovate tracheal reconstruction. Results : The advancements in 3D printing to aid synthetic material fabrication have unveiled promising alternatives to conventional approaches. Achieving successful tracheal reconstruction through this technology demands that the 3D models exhibit biocompatibility with neighbouring tracheal elements by encompassing vasculature, chondral foundation, and immunocompatibility. Tracheal reconstruction has employed grafts and scaffolds, showing a promising beginning in vivo. Concurrently, the integration of resorbable models and stem cell therapy serves to underscore their viability and application in the context of tracheal pathologies. Despite this, certain barriers hinder its advancement in surgery. The intricate tracheal structure has posed a challenge for researchers seeking novel approaches to support its growth and regeneration. Conclusions : The potential of synthetic material fabrication has shown promising outcomes in initial studies involving smaller animals. Yet, to fully realise the applicability of these innovative developments, research must progress toward clinical trials. These trials would ascertain the anatomical and physiological effects on the human body, enabling a thorough evaluation of post-operative outcomes and any potential complications linked to the materials or cells implanted in the trachea.
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- 2023
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24. Examining the Safety Profile of Janus Kinase (JAK) Inhibitors in the Management of Immune-Mediated Diseases: A Comprehensive Review.
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Kraev K, Geneva-Popova MG, Hristov BK, Uchikov PA, Belova-Popova SD, Kraeva MI, Basheva-Kraeva YM, Stoyanova NS, Mitkova-Hristova VT, Koleva-Ivanova MS, Taneva DI, and Ivanov AS
- Abstract
Janus kinase (JAK) inhibitors have heralded a paradigm shift in the management of immune-mediated diseases. While their efficacy is well-established, the safety concerns associated with these agents, particularly regarding thromboembolic events (TE), remain a focus of extensive research and clinical scrutiny. This comprehensive literature review embarks on an exploration of the multifaceted landscape of JAK inhibitors, providing insights into their safety profiles across diverse immune-mediated diseases. The introduction highlights the transformative influence of JAK inhibitors in the treatment of immune-mediated diseases. Historically, the therapeutic arsenal for these conditions included corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologics. The advent of JAK inhibitors has revolutionized this landscape, although concerns about their safety persist. This review strives to comprehensively evaluate their safety, amalgamating knowledge from multiple studies and trials. The subsequent sections delve into the safety of specific JAK inhibitors in the context of rheumatoid arthritis, inflammatory bowel diseases, and dermatologic conditions and their associations with venous thromboembolism. The evolving understanding of TE risk, particularly the intricate relationship between these agents and immune-mediated diseases, is meticulously unravelled. The concluding remarks underscore the dynamic nature of TE risk assessment with regard to immune-mediated diseases involving JAK inhibitors. It underscores that risk assessment is multifactorial, influenced not only by the choice of JAK inhibitor but also by the nuances of the underlying immune-mediated disease and the unique patient characteristics. This review offers a holistic perspective on TE risks associated with JAK inhibitors and contributes to the ongoing dialogue regarding their safety in the realm of immune-mediated diseases.
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- 2023
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25. Exploring the Novel Dimension of Immune Interactions in Pain: JAK Inhibitors' Pleiotropic Potential.
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Kraev K, Geneva-Popova M, Hristov B, Uchikov P, Popova S, Kraeva M, Basheva-Kraeva Y, Sheytanov I, Petranova T, Stoyanova N, and Atanassov M
- Abstract
This review explores the link between immune interactions and chronic pain, offering new perspectives on treatment. It focuses on Janus kinase (JAK) inhibitors' potential in pain management. Immune cells' communication with neurons shapes neuroinflammatory responses, and JAK inhibitors' effects on pain pathways are discussed, including cytokine suppression and microglial modulation. This review integrates studies from rheumatoid arthritis (RA) pain and central sensitization to highlight connections between immune interactions and pain. Studies on RA joint pain reveal the shift from cytokines to sensitization. Neurobiological investigations into central sensitization uncover shared pathways in chronic pain. Clinical evidence supports JAK inhibitors' efficacy on pain-related outcomes and their effects on neurons and immune cells. Challenges and future directions are outlined, including interdisciplinary collaboration and dosing optimization. Overall, this review highlights JAK inhibitors' potential to target immune-mediated pain pathways, underscoring the need for more research on immune-pain connections.
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- 2023
- Full Text
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26. Hepatico-Duodenal Fistula Following Iatrogenic Strasberg Type E4 Bile Duct Injury: A Case Report.
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Hristov B, Doykov D, Stanchev D, Kraev K, Uchikov P, Kostov G, Valova S, Tilkiyan E, Doykova K, and Doykov M
- Abstract
Introduction: Gallstone disease (GSD) is among the most common disorders worldwide. Gallstones are established in up to 15% of the general population. Laparoscopic cholecystectomy (LC) has become the "gold standard" for treatment of GSD but is associated with a higher rate of certain complications, namely, bile duct injury (BDI). Biliary fistulas (BF) are a common presentation of BDI (44.1% of all patients); however, they are mainly external. Post-cholecystectomy internal BF are exceedingly rare., Case Report: a 33-year Caucasian female was admitted with suspected BDI after LC. Strasberg type E4 BDI was established on endoscopic retrograde cholangiopancreatography (ERCP). Urgent laparotomy established biliary peritonitis. Delayed surgical reconstruction was planned and temporary external biliary drains were positioned in the right and left hepatic ducts. During follow-up, displacement of the drains occurred with subsequent evacuation of bile through the external fistula, which resolved spontaneously, without clinical and biochemical evidence of biliary obstruction or cholangitis. ERCP established bilio-duodenal fistula between the left hepatic duct (LHD) and duodenum, with a stricture at the level of the LHD. Endoscopic management was chosen with staged dilation and stenting of the fistulous tract over 18 months until fistula maturation and stricture resolution. One year after stent extraction, the patient remains symptom free., Discussion: Management of post-cholecystectomy BDI is challenging. The optimal approach is determined by the level and extent of ductal lesion defined according to different classifications (Strasberg, Bismuth, Hannover). Type E BDI are managed mainly surgically with a delayed surgical approach generally deemed preferable. Only three cases of choledocho-duodenal fistulas following LC BDI currently exist in the literature. Management is controversial, with expectant approach, surgical treatment (biliary reconstruction), or liver transplantation being described. Endoscopic treatment has not been described; however, in the current paper, it proved to be successful. More reports or larger case series are needed to confirm its applicability and effectiveness, especially in the long term.
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- 2023
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27. Assessment of TNF-α expression in unstable atherosclerotic plaques, serum IL-6 and TNF-α levels in patients with acute coronary syndrome and rheumatoid arthritis.
- Author
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Popova V, Geneva-Popova M, Kraev K, and Batalov A
- Subjects
- Biomarkers, C-Reactive Protein analysis, Humans, Interleukin-6, Tumor Necrosis Factor-alpha metabolism, Acute Coronary Syndrome, Arthritis, Rheumatoid, Plaque, Atherosclerotic
- Abstract
The role of inflammatory cytokines is well researched in acute coronary syndrome (ACS) and rheumatoid arthritis (RA), but not in the presence of both conditions. This study aimed to compare TNF-α expression, serum TNF-α, IL-6, and hs-CRP in ACS patients with RA (n = 46) with ACS patients without RA (n = 49) and healthy controls (n = 50). TNF-α expression was assessed from coronary artery samples, taken during coronary artery bypass surgery. Serum levels TNF-α, IL-6, and hs-CRP were measured 24 and 48 h after cardiac surgery. Stronger TNF-α expression was observed in the ACS patients with RA versus the ACS patients without RA, p = 0.001. Serum TNF-α, IL-6, and hs-CRP at the 24th h were significantly elevated in both patient groups and distinguished them from the healthy controls with accuracy ranging from 80 to 99%. At the 48th h, serum TNF-α and IL-6 in the ACS group without RA decreased to those of the healthy controls but remained high in the group with RA. ACS cases with RA could be correctly identified from the levels of IL-6 (AUC = 0.885, 95% CI 0.791 to 0.938) and TNF-α (AUC = 0.852, 95%CI 0.720 to 0.922). Our results suggest that the presence of RA in ACS cases is likely to provoke stronger TNF-α expression on atherosclerotic plaques, aggravate the pro-inflammatory response, and sustain it even after the cardiac stress is lowered. In ACS cases with RA, long-term monitoring and control of TNF-α and IL-6 levels can be a useful preventive strategy., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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28. Drug-neutralizing Antibodies against TNF-α blockers as Biomarkers of Therapy Effect Evaluation.
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Kraev K, Geneva-Popova M, Popova V, Popova S, Maneva A, Batalov A, Stankova T, Delcheva G, and Stefanova K
- Subjects
- Adalimumab immunology, Adalimumab therapeutic use, Adult, Aged, Arthritis, Psoriatic metabolism, Arthritis, Psoriatic physiopathology, Arthritis, Rheumatoid physiopathology, Blood Sedimentation, C-Reactive Protein metabolism, Case-Control Studies, Etanercept immunology, Etanercept therapeutic use, Female, Humans, Male, Middle Aged, Spondylitis, Ankylosing physiopathology, Treatment Outcome, Young Adult, Antibodies, Neutralizing immunology, Arthritis, Psoriatic drug therapy, Arthritis, Rheumatoid drug therapy, Spondylitis, Ankylosing drug therapy, Tumor Necrosis Factor Inhibitors immunology, Tumor Necrosis Factor Inhibitors therapeutic use
- Abstract
Introduction: TNF-α blocker therapy is part of the treatment with biologics used in the management of inflammatory joint diseases. In recent years, drug-induced neutralizing antibodies have been shown to have a negative effect on the course of the disease process., Aim: To investigate drug-induced neutralizing antibodies against TNF-α blocking drugs used in patients with inflammatory joint diseases and their effect on the clinical course of the disease., Materials and Methods: The study included 121 (56.8%) patients with rheumatoid arthritis, 50 (23.5%) patients with ankylosing spondylitis, 42 (19.7%) patients with psoriatic arthritis, and 31 sex and age-matched healthy controls. The patients were monitored at 0, 6, 12, and 24 months after initiation of TNF-α blocker treatment. The demographic data, vital signs and the parameters of inflammatory activity (C-reactive protein, erythrocyte sedimentation rate, and disease activity indices) were analyzed in all patients. Drug-induced anti-TNF-α blockers antibodies (adalimumab and etanercept) were analyzed using ELISA. Statistical analysis was performed with SPSS v. 24., Results: Drug-induced neutralizing antibodies against adalimumab were obtained in 11.57% of patients at 6 month, in 17.64% at 12 month, and in 24.8% at 24 month. Drug-induced neutralizing antibodies to etanercept were not demonstrated in patients followed up at 6 months, at 7.77% at 12 months, and at 9.63% at 24 months. Between the presence of neutralizing antibodies to blockers of TNF-α and indices available for disease activity, there is a strong positive correlation and Pearson Correlation = 0.701, p=0.001. Patients with poor clinical response and available antibodies against adalimumab at 12 months were 82.36% and patients treated with etanercept 71.42%. The difference between the two groups was non-significant (U = 0.527, p> 0.05). Patients with poor clinical response and available anti-adalimumab antibodies at 24 month were 75%, and in patients treated with etanercept - 87.50%, the difference between the two groups not being able to reach significance (U = 0.623, p> 0.05)., Conclusion: Drug-induced neutralizing antibodies against TNF-α blockers (adalimumab and etanercept) have a negative effect on the course of inflammatory joint disease and can be used as reliable biomarker to assess the effect of the treatment with these drugs., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2020
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