9 results on '"Ghazal, Stephanie"'
Search Results
2. Reducing Low-Value Practices a Functional-Contextual Consideration to Aid in De-Implementation Efforts
- Author
-
Farmer, Ryan L., Zaheer, Imad, Duhon, Gary J., and Ghazal, Stephanie
- Abstract
Through innovation in research and self-correction, it is inevitable that some practices will be replaced or be discredited for one reason or another. De-implementation of discredited and low-value practices is a necessary step for school psychologists' maintenance of evidence-based practices and to reduce unnecessary costs and risk. However, efforts to clarify de-implementation frameworks and strategies are ongoing. The scope of this paper follows McKay et al. in considering the potential for de-implementation strategies to be informed by applied behavior analysis and operant learning theory. We conceptualize low-value practice as sets of behaviors evoked by their context and maintained by their consequences, and thus de-implementation as behavior reduction. We discuss the need for future research given this perspective.
- Published
- 2021
- Full Text
- View/download PDF
3. Morphea, Eosinophilic Fasciitis and Cancer: A Scoping Review.
- Author
-
Joly-Chevrier, Maxine, Gélinas, Alexa, Ghazal, Stephanie, Moussa, Sarah, McCuaig, Catherine C., Piram, Maryam, Mereniuk, Alexandra, Litvinov, Ivan V., Osman, Mohammed, Pehr, Kevin, and Netchiporouk, Elena
- Subjects
TUMOR risk factors ,MEDICAL databases ,FASCIITIS ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,RISK assessment ,DESCRIPTIVE statistics ,SCLERODERMA (Disease) ,LITERATURE reviews ,MEDLINE ,DISEASE complications - Abstract
Simple Summary: Morphea and eosinophilic fasciitis (EF) are cutaneous autoimmune fibrosing diseases. We conducted a scoping review following PRISMA-ScR guidelines to ascertain the association between cancer and morphea/EF, focusing specifically on the paraneoplastic phenomenon, risk of subsequent cancer and development of morphea/EF as a consequence of cancer treatment. We identified that morphea patients, particularly those with generalized disease, might be at an increased risk of secondary malignancy, notably skin and pancreatic cancer. EF, on the other hand, occurred as a paraneoplastic disease in 10% of patients, primarily associated with hematologic malignancies. While reports of radiotherapy and chemotherapy-induced morphea are numerous, immunotherapy-induced morphea/EF cases are emerging. Interestingly, all immunotherapy-induced cases occurred with PD-1 inhibitors. Morphea is an autoimmune fibrotic skin disease. Eosinophilic fasciitis (EF) is considered to belong to the severe spectrum of morphea. We conducted a scoping review assessing the risk of secondary cancer among morphea/EF patients, paraneoplastic morphea/EF and morphea/EF developing secondary to cancer therapy. The search was conducted using MEDLINE, Embase, Cochrane databases for articles published from inception to September 2022 following the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines with no language or date restrictions. Two hundred and one studies were included. Of these, 32 studies reported on secondary cancer in morphea/EF patients, 45 on paraneoplastic morphea/EF and 125 on cancer-treatment-induced morphea/EF. While the current evidence remains limited, data suggest an increased risk of secondary cutaneous and possibly pancreatic malignancy in morphea patients, particularly the generalized subtype. There were insufficient data for EF. On the other hand, paraneoplastic morphea was anecdotal, whereas several observational studies suggested that ~10% of EF cases may be paraneoplastic, primarily in the context of hematologic malignancies. Radiotherapy-induced morphea is rare, seen in ~0.2% of treated patients and is usually localized to the treatment site, except in patients with pre-existing autoimmunity. While chemotherapy-induced cases are reported, immunotherapy morphea/EF cases are emerging and are preferentially seen with PD-1 and not CTLA-4 inhibitors. This study is limited by the type of articles included (case reports, case series and observational studies), and hence, additional research on this important topic is needed. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
4. Localized Scleroderma Burden: A Scoping Review Focusing on the Health-Related Quality of Life, Mental Health, and Productivity.
- Author
-
Ghazal, Stephanie, Zhang Huang, Han, Gabrielli, Sofianne, Khoury, Lauren, Pehr, Kevin, Veilleux, Mylene, Chédeville, Gaëlle, McCuaig, Catherine, Piram, Maryam, and Netchiporouk, Elena
- Published
- 2024
- Full Text
- View/download PDF
5. Reducing Low-Value Practices a Functional-Contextual Consideration to Aid in De-Implementation Efforts.
- Author
-
Farmer, Ryan L., Zaheer, Imad, Duhon, Gary J., and Ghazal, Stephanie
- Subjects
OPERANT behavior ,BEHAVIORAL assessment ,SCHOOL psychologists - Abstract
Through innovation in research and self-correction, it is inevitable that some practices will be replaced or be discredited for one reason or another. De-implementation of discredited and low-value practices is a necessary step for school psychologists' maintenance of evidence-based practices and to reduce unnecessary costs and risk. However, efforts to clarify de-implementation frameworks and strategies are ongoing. The scope of this paper follows McKay et al. in considering the potential for de-implementation strategies to be informed by applied behavior analysis and operant learning theory. We conceptualize low-value practice as sets of behaviors evoked by their context and maintained by their consequences, and thus de-implementation as behavior reduction. We discuss the need for future research given this perspective. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
6. A case of toxic epidermal necrosis–like cutaneous eruption as the first manifestation and clue to the diagnosis of systemic lupus erythematosus: A case report.
- Author
-
Zargham, Hanieh, Ghazal, Stephanie, Watters, Kevin, and Nguyen, Khue Huu
- Published
- 2020
- Full Text
- View/download PDF
7. Cutaneous Manifestations of Coronavirus Disease 2019 (COVID-19) Infection—What Do We Know So Far?
- Author
-
Ghazal, Stephanie, Litvinov, Ivan V., Aljahani, Naif, Jfri, Abdulhadi, and Netchiporouk, Elena
- Published
- 2020
- Full Text
- View/download PDF
8. Defining the Criteria for Reflex Testing for BRAF Mutations in Cutaneous Melanoma Patients.
- Author
-
Zhou, Sarah, Sikorski, Daniel, Xu, Honghao, Zubarev, Andrei, Chergui, May, Lagacé, François, Miller Jr., Wilson H., Redpath, Margaret, Ghazal, Stephanie, Butler, Marcus O., Petrella, Teresa M., Claveau, Joël, Nessim, Carolyn, Salopek, Thomas G., Gniadecki, Robert, Litvinov, Ivan V., Moulin, Alexandre, and Michielin, Olivier
- Subjects
GENETIC mutation ,ONCOGENES ,MELANOMA ,METASTASIS ,MEDICAL protocols ,TREATMENT delay (Medicine) ,CELLULAR signal transduction ,GENETIC markers ,DECISION making ,GENETIC techniques ,TUMOR markers ,DECISION making in clinical medicine ,MITOGEN-activated protein kinases ,SYMPTOMS - Abstract
Simple Summary: Reflex molecular testing is an emerging concept in oncology that, for a variety of cancers, was demonstrated to reduce the time to treatment initiation, thus potentially impacting survival outcomes. In advanced melanoma, BRAF mutation testing is critical in predicting treatment response with targeted therapy (i.e., BRAF/MEK inhibitors). Certain features were identified in melanomas that harbor BRAF mutations (e.g., primary lesions located on the trunk, diagnosed in patients <50, visibly pigmented tumors and, at times, with ulceration or specific dermatoscopic features). For select advanced melanoma patients, delays in determining mutational status present a significant barrier to the prompt initiation of treatment, which can adversely impact patient outcomes, especially in the metastatic setting due to a rapidly progressive disease. Treatment in these cases needs to start promptly by a medical oncologist. Ordering BRAF testing by preceding members of the treating team will allow medical oncologists to initiate treatment at the first visit. According to poor survival outcomes, we propose that patients with thick tumors (>4.0 mm) or >2 mm tumors with ulceration (i.e., stage ≥IIB) should potentially be considered for systemic therapy, thus justifying reflex BRAF testing. We overview current BRAF mutation testing recommendations and methods used in the United States, Canada, and Europe. Targeted therapy has been developed through an in-depth understanding of molecular pathways involved in the pathogenesis of melanoma. Approximately ~50% of patients with melanoma have tumors that harbor a mutation of the BRAF oncogene. Certain clinical features have been identified in BRAF-mutated melanomas (primary lesions located on the trunk, diagnosed in patients <50, visibly pigmented tumors and, at times, with ulceration or specific dermatoscopic features). While BRAF mutation testing is recommended for stage III–IV melanoma, guidelines differ in recommending mutation testing in stage II melanoma patients. To fully benefit from these treatment options and avoid delays in therapy initiation, advanced melanoma patients harboring a BRAF mutation must be identified accurately and quickly. To achieve this, clear definition and implementation of BRAF reflex testing criteria/methods in melanoma should be established so that patients with advanced melanoma can arrive to their first medical oncology appointment with a known biomarker status. Reflex testing has proven effective for a variety of cancers in selecting therapies and driving other medical decisions. We overview the pathophysiology, clinical presentation of BRAF-mutated melanoma, current guidelines, and present recommendations on BRAF mutation testing. We propose that reflex BRAF testing should be performed for every melanoma patient with stages ≥IIB. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
9. Treatment Guidelines for Atopic Dermatitis Since the Approval of Dupilumab: A Systematic Review and Quality Appraisal Using AGREE-II.
- Author
-
Ghazal S, Ridha Z, D'Aguanno K, Nassim D, Quaiattini A, Netchiporouk E, Poulin Y, Kalia S, Marcoux D, Piguet V, and Jack C
- Abstract
Introduction: Since its approval for adults with moderate-to-severe atopic dermatitis (AD) in 2017, dupilumab has been incorporated into clinical practice guidelines (CPGs). However, recommendations differ internationally, and the quality assessment of their development is unclear., Objective: We aimed to systematically review and appraise the quality of CPGs for adult AD reported since 2017 and map the recommendations for dupilumab initiation relative to conventional systemic therapy (CST)., Materials and Methods: A literature search was conducted in June 2020 in MEDLINE, EMBASE, SCOPUS, and CINAHL. Twelve CPGs were retrieved. Methodological quality was assessed using the validated Appraisal of Guidelines for Research & Evaluation II tool (AGREE-II). Recommendations were extracted and compared., Results: AGREE-II median scores per domain of the CPGs were (%, r = range): scope/purpose, 78% (50-96); stakeholder involvement, 54% (28-85); rigor of development, 39% (21-63); clarity of presentation, 85% (69-100); applicability, 27% (6-51); and editorial independence, 76% (42-100). Neither met the threshold of 70% quality criteria for rigor of development nor the applicability domains. Three CPGs met the criteria for recommendation without modification. CPGs' approach to dupilumab initiation was as follows: second line, preferred over CST and nbUVB ( n = 1/12 CPG); second line, equivalent to CST or nbUVB ( n = 3/12 CPGs); third line, after nbUVB or CST ( n = 5/12 CPGs); and fourth line after nbUVB and CST ( n = 2/12). No consensus was reached for n = 1/12 CPG., Conclusion and Relevance: Dupilumab is now incorporated into CPGs for adult AD. These CPGs exhibited good quality in scope/purpose, clarity, and editorial independence domains. However, none met AGREE-II criteria for methodological rigor/applicability. Gaps were found in mechanisms for updates, facilitators/barriers, resource implications, and stakeholder involvement. Only n = 3/12 CPGs met quality criteria for recommendation without modifications. Of these, two favored a conservative sequential approach for the initiation of dupilumab relative to CST, while one did not reach consensus. Our findings highlight divergent recommendations AD treatment, underlining a need to incorporate quality criteria into future guideline development., Competing Interests: CJ reports grants from Innovaderm Research, McGill University Department of Medicine, MITACS, Canadian Dermatology Foundation, and Eczema Society of Canada, as well as grants, involvement in clinical studies, and/or consultancy work for Sanofi, Eli Lilly, AbbVie, Novartis, Bausch, Pfizer, Amgen, Celgene, Janssen, Boehringer Ingelheim, Asana, Leo, and UCB. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ghazal, Ridha, D'Aguanno, Nassim, Quaiattini, Netchiporouk, Poulin, Kalia, Marcoux, Piguet and Jack.)
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.