Afreen Shariff

Overview:

During my training at Duke, I developed a keen interest in understanding more about novel cancer therapies and its effect on the endocrine system. I currently see patients with patients with general endocrine disorders and focus heavily on immunotherapy associated endocrinopathies. I work specifically in the areas of streamlined and evidence based clinical care in collaboration with oncology. My research involves identifying factors that predispose patients to develop these immune related adverse events.
In addition, I focus on outcomes of patients with diabetes who belong to different ethnic groups, specifically South Asians. I like to put culture in the center of the discussion when discussing lifestyle changes with patients. This makes it easier and more acceptable for patients to incorporate lifestyle changes which are critical in managing diabetes effectively.

Positions:

Assistant Professor of Medicine

Medicine, Endocrinology, Metabolism, and Nutrition
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.B.B.S. 2008

University of Hyderabad (India)

Internal Medicine Residency

East Carolina University, Brody School of Medicine

Fellowship in Endocrinology, Metabolism and Nutrition, Medicine

Duke University School of Medicine

Publications:

What's the Price? Toxicities of Targeted Therapies in Breast Cancer Care.

Agents with mechanisms novel to breast cancer care have been approved to treat breast cancer. These agents include drugs that target cyclin-dependent kinases, phosphoinositide 3-kinase PI3KCA gene mutations, PARP, checkpoint regulation, and novel antibody-drug conjugates. However, these novel approaches bring a risk of toxicities quite different from those of conventional cytotoxic chemotherapy. Here, we review these agents and discuss related adverse events, with particular attention to endocrine, pulmonary, and dermatologic toxicities. Endocrine toxicities associated with novel cancer therapies for breast cancer are distinct and often present with symptoms related to the specific hormonal deficiencies and rarely hormonal excess. Given the complex and sometimes irreversible nature of these toxicities, once recognized, transdisciplinary management with an endocrinologist experienced with managing drug-related toxicities is encouraged. Drug-related pneumonitis is a serious concern with new targeted therapies. Presentation may not be easily distinguished, and a multidisciplinary team approach can optimize patient care. Heightened awareness is crucial for early detection and treatment. Management should follow recommendations provided by the National Cancer Institute Common Terminology Criteria for Adverse Events and agent-specific guidelines. Cutaneous toxicities from anticancer therapies represent a common and often poorly characterized challenge for patients with breast cancer. Although our understanding of dermatologic effects from novel therapies continues to improve, the breadth of toxicities spans all dermatologic conditions. Targeted therapies offer effective and often novel therapeutic strategies for patients with breast cancer but also bring new adverse event profiles. In this era, it will be important both to closely follow monitoring recommendations and to remain vigilant for emerging toxicities.
Authors
Anders, CK; LeBoeuf, NR; Bashoura, L; Faiz, SA; Shariff, AI; Thomas, A
MLA Citation
Anders, Carey K., et al. “What's the Price? Toxicities of Targeted Therapies in Breast Cancer Care.Am Soc Clin Oncol Educ Book, vol. 40, May 2020, pp. 55–70. Pubmed, doi:10.1200/EDBK_279465.
URI
https://scholars.duke.edu/individual/pub1441394
PMID
32421449
Source
pubmed
Published In
Am Soc Clin Oncol Educ Book
Volume
40
Published Date
Start Page
55
End Page
70
DOI
10.1200/EDBK_279465

Low-Carbohydrate and Very-Low-Carbohydrate Diets in Patients With Diabetes.

Low-carbohydrate diets have been advocated as an effective method for promoting weight loss in overweight and obese individuals and preventing and treating type 2 diabetes. This article reviews the differences between various low-carbohydrate eating plans and discusses the benefits and drawbacks of such a diet based on available evidence. It also offers practical pointers for clinicians.
Authors
Merrill, JD; Soliman, D; Kumar, N; Lim, S; Shariff, AI; Yancy, WS
MLA Citation
Merrill, Jennifer D., et al. “Low-Carbohydrate and Very-Low-Carbohydrate Diets in Patients With Diabetes.Diabetes Spectr, vol. 33, no. 2, May 2020, pp. 133–42. Pubmed, doi:10.2337/ds19-0070.
URI
https://scholars.duke.edu/individual/pub1441395
PMID
32425450
Source
pubmed
Published In
Diabetes Spectrum : a Publication of the American Diabetes Association
Volume
33
Published Date
Start Page
133
End Page
142
DOI
10.2337/ds19-0070

Using social media to create a professional network between physician-trainees and the American Society of Nephrology.

Twitter is the fastest growing social media network. It offers participants the ability to network with other individuals. Medical societies are interested in helping individuals network to boost recruitment, encourage collaboration, and assist in job placement. We hypothesized that the American Society of Nephrology (ASN) successfully used Twitter to create a network between participants and itself to stay connected with its members. Tweets from 3 Twitter networking sessions during Kidney Week 2011 were analyzed for content. These messages were used to create a network between all participants of the networking sessions. The network was analyzed for strength and influence by calculating clustering coefficients (CC) and eigenvector centrality (EC) scores, respectively. Eight moderators and 9 trainees authored 376 Twitter messages. Most tweets by trainees (64%) and moderators (61%) discussed 1 of 3 themes: networking, education, or navigating Kidney Week 2011. A total of 25 online network connections were established during the 3 sessions; 20% were bidirectional. The CC for the network was 0.300. All moderators formed at least 1 connection, but 7 of the 9 trainees failed to make any connections. ASN made 5 unidirectional and 0 bidirectional connections with a low EC of 0.108. ASN was unable to form powerful connections with trainees through Twitter, but medical societies should not be discouraged by the results reported in this investigation. As societies become more familiar with Twitter and understand the mechanisms to develop connections, these societies will have a greater influence within increasingly stronger networks.
Authors
Shariff, AI; Fang, X; Desai, T
MLA Citation
Shariff, Afreen I., et al. “Using social media to create a professional network between physician-trainees and the American Society of Nephrology.Adv Chronic Kidney Dis, vol. 20, no. 4, July 2013, pp. 357–63. Pubmed, doi:10.1053/j.ackd.2013.03.005.
URI
https://scholars.duke.edu/individual/pub1273178
PMID
23809288
Source
pubmed
Published In
Adv Chronic Kidney Dis
Volume
20
Published Date
Start Page
357
End Page
363
DOI
10.1053/j.ackd.2013.03.005

Is content really king? An objective analysis of the public's response to medical videos on YouTube.

Medical educators and patients are turning to YouTube to teach and learn about medical conditions. These videos are from authors whose credibility cannot be verified & are not peer reviewed. As a result, studies that have analyzed the educational content of YouTube have reported dismal results. These studies have been unable to exclude videos created by questionable sources and for non-educational purposes. We hypothesize that medical education YouTube videos, authored by credible sources, are of high educational value and appropriately suited to educate the public. Credible videos about cardiovascular diseases were identified using the Mayo Clinic's Center for Social Media Health network. Content in each video was assessed by the presence/absence of 7 factors. Each video was also evaluated for understandability using the Suitability Assessment of Materials (SAM). User engagement measurements were obtained for each video. A total of 607 videos (35 hours) were analyzed. Half of all videos contained 3 educational factors: treatment, screening, or prevention. There was no difference between the number of educational factors present & any user engagement measurement (p NS). SAM scores were higher in videos whose content discussed more educational factors (p<0.0001). However, none of the user engagement measurements correlated with higher SAM scores. Videos with greater educational content are more suitable for patient education but unable to engage users more than lower quality videos. It is unclear if the notion "content is king" applies to medical videos authored by credible organizations for the purposes of patient education on YouTube.
Authors
Desai, T; Shariff, A; Dhingra, V; Minhas, D; Eure, M; Kats, M
MLA Citation
Desai, Tejas, et al. “Is content really king? An objective analysis of the public's response to medical videos on YouTube.Plos One, vol. 8, no. 12, 2013, p. e82469. Pubmed, doi:10.1371/journal.pone.0082469.
URI
https://scholars.duke.edu/individual/pub1273181
PMID
24367517
Source
pubmed
Published In
Plos One
Volume
8
Published Date
Start Page
e82469
DOI
10.1371/journal.pone.0082469

Tweeting the meeting: an in-depth analysis of Twitter activity at Kidney Week 2011.

In recent years, the American Society of Nephrology (ASN) has increased its efforts to use its annual conference to inform and educate the public about kidney disease. Social media, including Twitter, has been one method used by the Society to accomplish this goal. Twitter is a popular microblogging service that serves as a potent tool for disseminating information. It allows for short messages (140 characters) to be composed by any author and distributes those messages globally and quickly. The dissemination of information is necessary if Twitter is to be considered a tool that can increase public awareness of kidney disease. We hypothesized that content, citation, and sentiment analyses of tweets generated from Kidney Week 2011 would reveal a large number of educational tweets that were disseminated to the public. An ideal tweet for accomplishing this goal would include three key features: 1) informative content, 2) internal citations, and 3) positive sentiment score. Informative content was found in 29% of messages, greater than that found in a similarly sized medical conference (2011 ADA Conference, 16%). Informative tweets were more likely to be internally, rather than externally, cited (38% versus 22%, p<0.0001), thereby amplifying the original information to an even larger audience. Informative tweets had more negative sentiment scores than uninformative tweets (means -0.162 versus 0.199 respectively, p<0.0001), therefore amplifying a tweet whose content had a negative tone. Our investigation highlights significant areas of promise and improvement in using Twitter to disseminate medical information in nephrology from a scientific conference. This goal is pertinent to many nephrology-focused conferences that wish to increase public awareness of kidney disease.
Authors
Desai, T; Shariff, A; Shariff, A; Kats, M; Fang, X; Christiano, C; Ferris, M
MLA Citation
Desai, Tejas, et al. “Tweeting the meeting: an in-depth analysis of Twitter activity at Kidney Week 2011.Plos One, vol. 7, no. 7, 2012, p. e40253. Pubmed, doi:10.1371/journal.pone.0040253.
URI
https://scholars.duke.edu/individual/pub1273160
PMID
22792254
Source
pubmed
Published In
Plos One
Volume
7
Published Date
Start Page
e40253
DOI
10.1371/journal.pone.0040253

Research Areas:

Immune Checkpoint Inhibitors
Immune-related Adverse Events
Immunotherapy
Immunotherapy--Complications