Golimumab in real-world practice in patients with ulcerative colitis:Twelve-month results

BACKGROUND The introduction of biologics has revolutionized the management of the chronic inflammatory bowel disease,ulcerative colitis(UC),with many patients experiencing significant improvements not only in their symptoms but in other outcomes relevant to individuals and society as a whole.In Germany,there are no prospective data>3 mo that assess the work productivity,daily activities and quality of life(QoL)of patients with moderate-to-severe UC treated with golimumab.AIM To assess change in work productivity,capacity for daily activities and QoL in UC patients treated with golimumab in Germany.METHODS The validated Work Productivity Activity Impairment(WPAI)Questionnaire was used to analyze the change in work productivity,the capacity for daily activities after three months(primary endpoint)and disease specific and health related QoL(HRQoL)up to 1 year(secondary endpoints).The changes in work productivity and activity impairment were evaluated every three months until month twelve compared to baseline.Disease-specific and health-related QoL were assessed with the inflammatory bowel disease questionnaire and with the short-form 12 health survey questionnaire(SF-12).RESULTS This prospective non-interventional study included 287 patients.The analysis population was comprised of 282 patients who had completed at least two visits.At baseline,61%of patients had moderate UC and 18%had severe UC.Furthermore,75%of patients worked full-time or part-time at baseline.A total of 212 patients who were employed at the start of the study(employed population)were evaluated for the primary endpoint.Golimumab significantly reduced all WPAI sub-scores compared to baseline after three,six,nine and twelve months after the start of treatment(P<0.0001).In addition,disease-specific QoL and HRQoL,as measured by the SF-12 questionnaire,improved significantly with golimumab at all evaluation times(P<0.0001 in each case vs baseline).CONCLUSION Treatment of moderate-to-severe UC with golimumab leads to significant improvements in patient´s work productivity,daily activity and QoL over twelve months.

Age-related differences in response to peginterferon alfa-2a/ribavirin in patients with chronic hepatitis C infection

AIM: To evaluate the safety and efficacy of pegylated interferon alfa-2a and ribavirin therapy in elderly patients with chronic hepatitis C infection.

An Assessment of Awareness of Specialists in Adequate Diagnostics of Chronic Pancreatitis in Kazakhstan

Our national center of gastroenterology provides highly specialized care, including chronic pancreatitis. Another area of our activities is educational programs, including postgraduate and fellows’ courses. Thereby, we have noted significant gaps in the knowledge of the specialists that involved in the chronic pancreatitis management. The most critical downsides are related to insufficient attention to etiology and risk factors, using outdated classifications, the lack of knowledge in arsenal of diagnostic techniques, polypharmacy or application of low level of evidence treatment methods. Finally, we have made amendments in the National Clinical Protocol in Chronic Pancreatitis [1], updated the State Educational Standard for residents of the gastroenterological profile [2]. The aim of the study was the analysis of the basic knowledge among different specialists in the management of chronic pancreatitis (CP) around the country. This qualitative study consists of two parts, including focus group interviews followed by interviews with the specialists across the country, which was conducted during the period 2015-2018. In this paper, we present results of diagnostic approaches at the different levels of medical care. The general practitioners have noted the absence of modern methods of laboratory and visual diagnostics in their routine practice, therefore explaining the plenty of the complicated forms. Another issue is the low specialist’s adherence to clinical guidelines, poor knowledge of the risk factors and overestimation of the clinical presentation value except malnutrition symptoms. On the other hand, surgeons and other specialists are not ready to implement modern diagnostic tools and methods in their practice. Obviously, in accordance with the results of our study, our educational center should conduct a number of training activities, as well as develop new algorithms for medical care specialists.

Effect of Health Education on Knowledge Attitude Practice towards Malaria among Basic Schools Pupils in Taiz

Background: Malaria is one of the main health problems in Yemen. Health education is essential for the control of diseases such as malaria. School-age children represent 25% of Yemen’s population. Schools children can convey the knowledge and skills that they acquire at school to the community, thus increasing general community awareness about malaria. Aim to determine the impact of school-based malaria education intervention on knowledge, attitude and practice of school children towards malaria prevention and control. Methods: We conducted a community-based trial, intervention and non-intervention comparison (exposed & non-exposed), in four randomly selected districts (rural and urban) of Taiz governorate. This study was conducted in four districts of Taiz governorate. The study population was 2130 pupils of grade 6, 7, and 8 in primary schools, chosen from four randomly selected districts;two of them were rural and the others urban. Four schools and their pupils (1065 pupils) were chosen for the study and assigned as an intervention group and four schools with their pupils (1065) were chosen for the study and assigned as a non-intervention (1065 pupils). Data were collected using questioner in intervention and non-intervention schools (three months apart). The major intervention activities included lectures about malaria, distribution of educational materials. χ2 was used to analyze differences. Results: Health education activities in schools were associated with the increased knowledge of malaria symptoms and methods of prevention. The mean knowledge of malaria symptoms is higher in the intervention schools 4.4 ± 1.9, compared with 2.1 ± 1.4 in the non-intervention group. With statistically significant difference (P < 0.001), also the positive attitude and practice toward malaria was higher to be (48%) in the intervention group;compared with (35%) in the non-intervention group the difference was statistically significant. The knowledge of mode of malaria transmission was higher in the intervention schools to be (86.2%) compared with (59.1%) in the non-intervention group, with statistically significant deference (P value <0.001). The knowledge of fever as a main malaria symptom was higher to be (90.4%) in the intervention schools compared with (63.6%) in the non-intervention schools with statistically significant deference. Conclusions and Recommendation: This study concludes that the health education intervention in primary schools in Taize governorate had a positive impact on the knowledge, attitude and practice of pupils. We recommend to conduct similar methods of the health education activities in schools with suitable modifications to reach all schools level.

China’s Emerging Role in the New Arab World

The Arab Spring has changed the political landscape in the Arab world.The spring which began as genuine grass-root movement designed to create more equitable social projects,was steered by Western powers and local Islamists in different directions with these powers heavily intervening to control and/or weaken Arab states.China has pursued a policy of non-intervention in the domestic affairs of Arab states,and letting the peoples decide their own future.China may have miscalculated when it allowed NATO to interfere in Libya.That intervention had catastrophic consequences for China and Libya.Consequently,China,in collaboration with Russia decided not to repeat the same experience in Syria especially since foreign intervention in this case will be even more catastrophic.China vetoed Security Council draft resolutions calling for regime change in Syria and insisted on letting the Syrians decide peacefully their future course of action.Further,China under the new leadership has suggested for the first time a four-point program to settle the Arab-Israeli conflict.The article argues that the Chinese-Russian approach to the Syrian crisis is bound to have long-term implications for the future of the Arab world.As the signs of the positive contributions of that approach are emerging,China should proceed to reinforce these contributions through a concerted approach to engage with the new regimes in the Arab world,strengthen the China-Arab States Cooperation Forum,correct the imbalances of Sino-Arab trade,especially with the countries of the Arab Spring,focus on investing in these countries in labor-intensive industries,putting the four-point proposal on the agenda of ArabIsraeli negotiations,and,most importantly,deal with the question of the Israeli nuclear capabilities and the potential of Israel going to war against Iran,a scenario which will represent a major setback to the Chinese achievements in the region.