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Farag A, Scott LD, Perkhounkova Y, Saeidzadeh S, Hein M. Corrigendum to "A human factors approach to evaluate predictors of acute care nurses occupational fatigue" [Appl. Ergon. 100 (2022) 103647-1-10]. Appl Ergon 2024; 118:104222. [PMID: 38184388 DOI: 10.1016/j.apergo.2023.104222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2024]
Affiliation(s)
- A Farag
- University of Iowa, College of Nursing, Iowa City, IA, USA.
| | - L D Scott
- University of Wisconsin Madison, School of Nursing, Wisconsin, Madison, USA
| | - Y Perkhounkova
- University of Iowa, College of Nursing, Iowa City, IA, USA.
| | - S Saeidzadeh
- University of Wisconsin Madison, School of Nursing, Wisconsin, Madison, USA
| | - M Hein
- University of Iowa, College of Nursing, Iowa City, IA, USA.
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Hasegawa M, Sasaki M, Umemoto Y, Hayashi R, Hatanaka A, Hosoki M, Farag A, Matsuura K, Yoshida T, Shimada K, Hamabe L, Takahashi K, Tanaka R. Exploring sleep heart rate variability: linear, nonlinear, and circadian rhythm perspectives. Front Vet Sci 2024; 11:1386425. [PMID: 38665772 PMCID: PMC11044001 DOI: 10.3389/fvets.2024.1386425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Background Heart rate variability (HRV) is believed to possess the potential for disease detection. However, early identification of heart disease remains challenging, as HRV analysis in dogs primarily reflects the advanced stages of the disease. Hypothesis/objective The aim of this study is to compare 24-h HRV with sleep HRV to assess the potential utility of sleep HRV analysis. Animals Thirty healthy dogs with no echocardiographic abnormalities were included in the study, comprising 23 females and 7 males ranging in age from 2 months to 8 years (mean [standard deviation], 1.4 [1.6]). Methods This study employed a cross-sectional study. 24-h HRV and sleep HRV were measured from 48-h Holter recordings. Both linear analysis, a traditional method of heart rate variability analysis, and nonlinear analysis, a novel approach, were conducted. Additionally, circadian rhythm parameters were assessed. Results In frequency analysis of linear analysis, the parasympathetic index nHF was significantly higher during sleep compared to the mean 24-h period (mean sleep HRV [standard deviation] vs. mean 24 h [standard deviation], 95% confidence interval, p value, r-family: 0.24 [0.057] vs. 0.23 [0.045], 0.006-0.031, p = 0.005, r = 0.49). Regarding time domain analysis, the parasympathetic indices SDNN and RMSSD were also significantly higher during sleep (SDNN: 179.7 [66.9] vs. 156.6 [53.2], 14.5-31.7, p < 0.001, r = 0.71 RMSSD: 187.0 [74.0] vs. 165.4 [62.2], 13.2-30.0, p < 0.001, r = 0.70). In a geometric method of nonlinear analysis, the parasympathetic indices SD1 and SD2 showed significantly higher values during sleep (SD1: 132.4 [52.4] vs. 117.1 [44.0], 9.3-21.1, p < 0.001, r = 0.70 SD2: 215.0 [80.5] vs. 185.9 [62.0], 17.6-40.6, p < 0.001, r = 0.69). Furthermore, the circadian rhythm items of the parasympathetic indices SDNN, RMSSD, SD1, and SD2 exhibited positive peaks during sleep. Conclusion The findings suggest that focusing on HRV during sleep can provide a more accurate representation of parasympathetic activity, as it captures the peak circadian rhythm items.
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Affiliation(s)
- Mizuki Hasegawa
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
- Yokohama Isogo Animal Hospital, Yokohama, Kanagawa, Japan
| | - Mayuko Sasaki
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Yui Umemoto
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Rio Hayashi
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Akari Hatanaka
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Marino Hosoki
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Ahmed Farag
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Katsuhiro Matsuura
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine University of Florida, Gainesville, FL, United States
| | - Tomohiko Yoshida
- Department of Small Animal Medical Center, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
| | - Kazumi Shimada
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Lina Hamabe
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Ken Takahashi
- Department of Pediatrics, Juntendo University, Urayasu Hospital, Chiba, Japan
| | - Ryou Tanaka
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
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Mandour AS, Farag A, Yoshida T, Tanaka R. Editorial: Novel paradigms in cardiothoracic and abdominal disorders in veterinary practice. Front Vet Sci 2024; 11:1369276. [PMID: 38650856 PMCID: PMC11034436 DOI: 10.3389/fvets.2024.1369276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/04/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Ahmed S. Mandour
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Ahmed Farag
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Tomohiko Yoshida
- Department of Veterinary Surgery, Division of Veterinary Research, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
| | - Ryou Tanaka
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
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Elfadadny A, Ragab RF, AlHarbi M, Badshah F, Ibáñez-Arancibia E, Farag A, Hendawy AO, De los Ríos-Escalante PR, Aboubakr M, Zakai SA, Nageeb WM. Antimicrobial resistance of Pseudomonas aeruginosa: navigating clinical impacts, current resistance trends, and innovations in breaking therapies. Front Microbiol 2024; 15:1374466. [PMID: 38646632 PMCID: PMC11026690 DOI: 10.3389/fmicb.2024.1374466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 04/23/2024] Open
Abstract
Pseudomonas aeruginosa, a Gram-negative bacterium, is recognized for its adaptability and opportunistic nature. It poses a substantial challenge in clinical settings due to its complicated antibiotic resistance mechanisms, biofilm formation, and capacity for persistent infections in both animal and human hosts. Recent studies revealed a potential zoonotic transmission of P. aeruginosa between animals, the environment, and human populations which highlights awareness of this microbe. Implementation of the One Health approach, which underscores the connection between human, animal, and environmental health, we aim to offer a comprehensive perspective on the current landscape of P. aeruginosa management. This review presents innovative strategies designed to counteract P. aeruginosa infections. Traditional antibiotics, while effective in many cases, are increasingly compromised by the development of multidrug-resistant strains. Non-antibiotic avenues, such as quorum sensing inhibition, phage therapy, and nanoparticle-based treatments, are emerging as promising alternatives. However, their clinical application encounters obstacles like cost, side effects, and safety concerns. Effectively addressing P. aeruginosa infections necessitates persistent research efforts, advancements in clinical development, and a comprehension of host-pathogen interactions to deal with this resilient pathogen.
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Affiliation(s)
- Ahmed Elfadadny
- Laboratory of Internal Medicine, Cooperative Division of Veterinary Sciences, Tokyo University of Agriculture and Technology, Fuchu, Japan
- Department of Internal Medicine, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Rokaia F. Ragab
- Laboratory of Internal Medicine, Cooperative Division of Veterinary Sciences, Tokyo University of Agriculture and Technology, Fuchu, Japan
- Department of Biochemistry, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Maha AlHarbi
- Department of Biology, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Farhad Badshah
- State Key Laboratory of Animal Biotech Breeding, Institute of Animal Science, Chinese Academy of Agricultural Science, Beijing, China
| | - Eliana Ibáñez-Arancibia
- PhD Program in Sciences Mentioning Applied Molecular and Cell Biology, La Frontera University, Temuco, Chile
- Laboratory of Engineering, Biotechnology and Applied Biochemistry – LIBBA, Department of Chemical Engineering, Faculty of Engineering and Science, La Frontera University, Temuco, Chile
- Department of Biological and Chemical Sciences, Faculty of Natural Resources, Catholic University of Temuco, Temuco, Chile
| | - Ahmed Farag
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Amin Omar Hendawy
- Department of Animal and Poultry Production, Faculty of Agriculture, Damanhour University, Damanhour, Egypt
| | - Patricio R. De los Ríos-Escalante
- Department of Biological and Chemical Sciences, Faculty of Natural Resources, Catholic University of Temuco, Temuco, Chile
- Nucleus of Environmental Sciences, Faculty of Natural Resources, Catholic University of Temuco, Temuco, Chile
| | - Mohamed Aboubakr
- Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Qaliobiya, Egypt
| | - Shadi A. Zakai
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wedad M. Nageeb
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Dulaimy K, Pham RH, Farag A. The Impact of COVID on Health Systems: The Workforce and Telemedicine Perspective. Semin Ultrasound CT MR 2024:S0887-2171(24)00025-8. [PMID: 38527671 DOI: 10.1053/j.sult.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Kal Dulaimy
- Department of Radiology, UMass Chan Medical School-Baystate Medical Center, Springfield, MA
| | - Richard H Pham
- B.S. Biology student, Class of 2025, University of Massachusetts-Amherst, Amherst, MA
| | - Ahmed Farag
- Department of Radiology, UMass Chan Medical School-Baystate Medical Center, Springfield, MA.
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Farag A, Pham RH, Dulaimy K. The Financial Impact of COVID on Radiology Health Systems. Semin Ultrasound CT MR 2024:S0887-2171(24)00024-6. [PMID: 38527670 DOI: 10.1053/j.sult.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Ahmed Farag
- Department of Radiology, UMass Chan Medical School-Baystate Medical Center, Springfield, MA
| | - Richard H Pham
- B.S. Biology student, Class of 2025, University of Massachusetts-Amherst, Amherst, MA
| | - Kal Dulaimy
- Department of Radiology, UMass Chan Medical School-Baystate Medical Center, Springfield, MA.
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Eltobgy A, Aljabali A, Farag A, Elshorbgy M, Hamed M, Hamouda E, Hamouda H, Refaey N, Kabeel M, Amro S, Abouheseba T, Tarek M. Effects of pubic hair grooming on women's sexual health: a systematic review and meta-analysis. BMC Womens Health 2024; 24:171. [PMID: 38468306 PMCID: PMC10926629 DOI: 10.1186/s12905-024-02951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/04/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Pubic hair grooming involves the partial or complete removal of pubic hair, and it is a common practice among men and women. Grooming is more prevalent in women, who employ various methods such as shaving, waxing and laser removal. However, it is associated with variable rates of post-grooming adverse outcomes including lacerations and sexually transmitted infections (STIs). To the best of our knowledge, this is the first systematic review and meta-analysis comparing women's sexual health outcomes between those who groom and those who don't. METHODS We followed the MOOSE guidelines and conducted a computerized-based search using (PubMed, Web of Science, Scopus, and Ovid Medline), till June 20th, 2022, for eligible studies using the relevant keywords; (pubic hair grooming) OR (pubic hair removal OR Genital hairless OR Bikini hair removal OR pubic hair depilation). Cross-sectional studies included which compared grooming practices among women in terms of motivation and health outcomes. Women's satisfaction and incidence of STIs were pooled as standardized mean difference (SMD) and odds ratio (OR) respectively. RESULTS Twenty-Two cross-sectional studies were included in our review with 73,091 participant.The odds of having gram-negative gonorrheal and chlamydial infection in Pubic hair groomers were found to be statistically significant (OR = 1.55, 95% CI [1.31, 1.84], P < 0.001) (OR = 1.56, 95% CI [1.32, 1.85], P < 0.001] respectively. There was no difference between groomer and non-groomer women regarding viral infections such as genital herpes (OR = 1.40, 95% CI [0.56, 3.50], P = 0.47) and Condyloma acuminata (OR = 1.75, 95% CI [0.51, 6.01], P = 0.37). The most common grooming side effect is genital itching (prevalence = 26.9%, P < 0.001). Non-electrical razor (prevalence = 69.3%, P < 0.001) is the most common grooming method. White women (prevalence = 80.2%, P < 0.001) remove pubic hair more frequently compared to black women (prevalence = 12.2%, P < 0.001). Women practice complete grooming (50.3%, P < 0.001) of the pubic hair more frequently than partial grooming (33.1%, P < 0.001). There are no differences in women's satisfaction between the two groups (SMD = 0.12, 95% CI [-0.16, 0.40], P = 0.39). CONCLUSION This review aligns with previous observational studies regarding sexual health outcomes of pubic hair grooming. There is a need to raise awareness among women regarding the safe practice of pubic hair grooming, emphasizing the clarification of hazards and benefits.
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Affiliation(s)
- Asmaa Eltobgy
- Department of Obstetrics and Gynecology, Faculty of Medicine For Girls, Al-Azhar University, Cairo, Egypt.
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt.
| | - Ahmed Aljabali
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Ahmed Farag
- Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Mohammad Elshorbgy
- Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Mona Hamed
- Faculty of Medicine, Gharyan University, Gharyan, Libya
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Esraa Hamouda
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Heba Hamouda
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Neveen Refaey
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Marwa Kabeel
- Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Cairo, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Sarah Amro
- Faculty of Medicine, Najah National University, Nablus, Palestine
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Toka Abouheseba
- Faculty of Medicine, Asyut University, Asyut, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
| | - Mohammed Tarek
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Medical Research Group of Egypt (MRGE), Al-Azhar University, P.O. Box 3050, Cairo, Egypt
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Farag A, Elfadadny A, Mandour AS, Ngeun SK, Aboubakr M, Kaneda M, Tanaka R. Potential protective effects of L-carnitine against myocardial ischemia/reperfusion injury in a rat model. Environ Sci Pollut Res Int 2024; 31:18813-18825. [PMID: 38349499 DOI: 10.1007/s11356-024-32212-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 01/22/2024] [Indexed: 03/09/2024]
Abstract
Myocardial ischemia/reperfusion (I/R) injury is a growing concern for global public health. This study seeks to explore the potential protective effects of L-carnitine (LC) against heart ischemia-reperfusion injury in rats. To induce I/R injury, the rat hearts underwent a 30-min ligation of the left anterior descending coronary artery, followed by 24 h of reperfusion. We evaluated cardiac function through electrocardiography and heart rate variability (HRV) and conducted pathological examinations of myocardial structure. Additionally, the study investigated the influence of LC on myocardial apoptosis, inflammation, and oxidative stress in the context of I/R injury. The results show that pretreatment with LC led to improvements in the observed alterations in ECG waveforms and HRV parameters in the nontreated ischemic reperfusion model group, although most of these changes did not reach statistical significance. Similarly, although without a significant difference, LC reduced the levels of proinflammatory cytokines when compared to the values in the nontreated ischemic rat group. Furthermore, LC restored the reduced expressions of SOD1, SOD2, and SOD3. Additionally, LC significantly reduced the elevated Bax expressions and showed a nonsignificant increase in Bcl-2 expression, resulting in a favorable adjustment of the Bcl-2/Bax ratio. We also observed a significant enhancement in the histological appearance of cardiac muscles, a substantial reduction in myocardial fibrosis, and suppressed CD3 + cell proliferation in the ischemic myocardium. This small-scale, experimental, in vivo study indicates that LC was associated with enhancements in the pathological findings in the ischemic myocardium in the context of ischemia/reperfusion injury in this rat model. Although statistical significance was not achieved, LC exhibits potential and beneficial protective effects against I/R injury. It does so by modulating the expression of antioxidative and antiapoptotic genes, inhibiting the inflammatory response, and enhancing autonomic balance, particularly by increasing vagal tone in the heart. Further studies are necessary to confirm and elaborate on these findings.
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Affiliation(s)
- Ahmed Farag
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan.
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
| | - Ahmed Elfadadny
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhur University, Damanhur, Egypt
| | - Ahmed S Mandour
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Sai Koung Ngeun
- Laboratory of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Mohamed Aboubakr
- Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Qaliobiya, Egypt
| | - Masahiro Kaneda
- Laboratory of Veterinary Anatomy, Division of Animal Life Science, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
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Fadah K, Khalafi S, Corey M, Sotelo J, Farag A, Siddiqui T, Abolbashari M. Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention. Cardiol Res Pract 2024; 2024:4217162. [PMID: 38454917 PMCID: PMC10919973 DOI: 10.1155/2024/4217162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/27/2024] [Indexed: 03/09/2024] Open
Abstract
Patients with severe calcific native aortic valve stenosis (AS) who require valve replacement have two options, surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). TAVR was approved in late 2011 for extremely high-risk patients and was subsequently approved for high-risk (2012), intermediate-risk (2016), and low-risk (2019) patients. In 2019, TAVR procedures surpassed SAVR procedures for the first time in the United States. The approach to anesthesia for this procedure has also evolved. Initially, general anesthesia (GA) was preferred, but currently, conscious sedation (CS) is favored. This review aims to clarify the indications and contraindications for both approaches, as well as the advantages of one approach over the other. Recent studies show that conscious sedation has better outcomes in terms of all-cause mortality, procedure complications such as stroke, myocardial infarction, infection requiring antibiotics, acute kidney injury, and the need for inotropes or vasopressors.
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Affiliation(s)
- Kahtan Fadah
- Division of Cardiology, Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA
| | - Seyed Khalafi
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Drive, El Paso, TX 79905, USA
| | - Miller Corey
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Drive, El Paso, TX 79905, USA
| | - Jose Sotelo
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA
| | - Ahmed Farag
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA
| | - Tariq Siddiqui
- Tash Medical Clinic, 7812 Gateway Blvd E, El Paso, TX 79915, USA
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Samir H, Swelum AA, Farag A, El-Sherbiny HR. Emotional temperaments in advanced pregnant goats and its relationship with the feto-maternal blood flow and placentome echotexture. Vet Res Commun 2024:10.1007/s11259-024-10330-2. [PMID: 38379058 DOI: 10.1007/s11259-024-10330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024]
Abstract
The current study aimed to investigate the effect of xylazine sedation (non-sedated versus sedated conditions) and animal temperament on the fetal and maternal hemodynamics during the late stage of gestation in goats. In addition, it aimed to study the concentrations of cortisol and the echotexture of the placentome. Fourteen goats were assigned into two equal groups (n = 7, each) based on the animal's emotional temperament (calm versus nervous groups). All goats were examined for assessment of the blood flow within the fetal aorta (FA), umbilical artery (UMA), and middle uterine artery (MUA) using color-pulsed Doppler ultrasonography. Goats were exposed to light sedation using the recommended dose of xylazine (0.05 mg/Kg Bw) intramuscularly. Goats in each group were reassessed for the studied parameters after sedation. Blood samples were drawn to determine the concentrations of cortisol. Placentome echotexture pixel intensity (PXI) was evaluated using computer image analysis software. Results revealed the significant impact of the xylazine sedation on the Doppler indices of the blood flow within the measured arteries (FA, UMA, and MUA), the PXI of placentome echotexture, and cortisol concentrations. The emotional temperament of goats had significant effects on the blood flow parameters of the MUA and UMA, concentrations of cortisol, and the PXI of the placentome. The interaction effect (sedation x temperament) was noticed in the measured parameters of the UMA blood flow, fetal heart rate, and cortisol concentrations. In conclusion, xylazine sedation and emotional temperaments induced alterations in the echotexture of the placentomes as well as the hemodynamic parameters of late-stage pregnant goats without affecting the pregnancy outcomes.
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Affiliation(s)
- Haney Samir
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
| | - Ayman A Swelum
- Department of Theriogenology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Farag
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Hossam R El-Sherbiny
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
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Elhaieg A, Farag A, Elfadadny A, Yokoi A, Hendawy H, Mandour AS, Tanaka R. Effect of experimental periodontitis on cardiac functions: a comprehensive study using echocardiography, hemodynamic analysis, and histopathological evaluation in a rat model. Front Vet Sci 2023; 10:1327484. [PMID: 38179330 PMCID: PMC10764594 DOI: 10.3389/fvets.2023.1327484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Periodontitis is a prevalent and severe dental condition characterized by the gradual degradation of the bone surrounding the teeth. Over the past two decades, numerous epidemiological investigations have suggested a potential link between periodontitis and cardiovascular disease. However, the complex mechanistic relationship between oral health issues and cardiovascular disorders remains unclear. Aim This study aimed to explore comprehensively the cardiac function through various methods, including conventional echocardiography, intraventricular pressure gradient (IVPG) analysis, speckle tracking echocardiography (STE), and hemodynamics analysis. Methods Ligature-induced periodontitis was established in a group of rats while the second group served as sham. The successful establishment of the periodontitis model was confirmed through staining and radiographic examination of the affected mandibles. Results X-ray films and methylene blue staining revealed alveolar bone resorption in the affected first molar in the model rats, confirming the successful induction of periodontitis. The rats with periodontitis displayed a decrease in ejection fraction compared to the sham group, accompanied by a decrease in mid-to-apical IVPG and mid IVPG. Lower values of strain rate were recorded in the apical segment of the septum, the middle segment of the septum, and the basal segment of the lateral free wall in the periodontitis group, which was associated with histopathological examination showing some degree of myocardial tissue damage. Conversely, rats with periodontitis showed an increase in heart rate, end-systolic volume, and arterial elastance when compared to the sham rats. However, they also exhibited a decrease in stroke work, stroke volume, cardiac output, and end-systolic pressure. Conclusion This study suggests that experimental periodontitis may lead to cardiac dysfunction especially compromised systolic function and myocardial relaxation, potentially indicating an increased risk of cardiovascular events in clinical periodontitis cases. The comprehensive assessment of cardiac function, hemodynamics, and histopathological evaluation underscores the profound impact of periodontitis on heart functions within this specific experimental model.
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Affiliation(s)
- Asmaa Elhaieg
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Ahmed Farag
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Elfadadny
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhur University, Damanhour, Egypt
| | - Aimi Yokoi
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Hanan Hendawy
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed S. Mandour
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
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Elkassem AMA, Mresh R, Farag A, Rothenberg S, Lirette ST, Smith AD, Kulkarni T. Pulmonary Surface Irregularity Score as a New Quantitative CT Marker for Idiopathic Pulmonary Fibrosis-a Pilot Study. J Digit Imaging 2023; 36:2382-2391. [PMID: 37670182 PMCID: PMC10584743 DOI: 10.1007/s10278-023-00896-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023] Open
Abstract
The purpose of this study is to evaluate the accuracy and inter-observer agreement of a quantitative pulmonary surface irregularity (PSI) score on high-resolution chest CT (HRCT) for predicting transplant-free survival in patients with IPF. For this IRB-approved HIPAA-compliant retrospective single-center study, adult patients with IPF and HRCT imaging (N = 50) and an age- and gender-matched negative control group with normal HRCT imaging (N = 50) were identified. Four independent readers measured the PSI score in the midlungs on HRCT images using dedicated software while blinded to clinical data. A t-test was used to compare the PSI scores between negative control and IPF cohorts. In the IPF cohort, multivariate cox regression analysis was used to associate PSI score and clinical parameters with transplant-free survival. Inter-observer agreement for the PSI score was assessed by intraclass correlation coefficient (ICC). The technical failure rate of the midlung PSI score was 0% (0/100). The mean PSI score of 5.38 in the IPF cohort was significantly higher than 3.14 in the negative control cohort (p < .001). In the IPF cohort, patients with a high PSI score (≥ median) were 8 times more likely to die than patients with a low PSI score (HR: 8.36; 95%CI: 2.91-24.03; p < .001). In a multivariate model including age, gender, FVC, DLCO, and PSI score, only the PSI score was associated with transplant-free survival (HR:2.11 per unit increase; 95%CI: 0.26-3.51; p = .004). Inter-observer agreement for the PSI score among 4 readers was good (ICC: 0.88; 95%CI: 0.84-0.91). The PSI score had high accuracy and good inter-observer agreement on HRCT for predicting transplant-free survival in patients with IPF.
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Affiliation(s)
- Asser M Abou Elkassem
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, 35249, USA.
| | - Rafah Mresh
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, 35249, USA
| | - Ahmed Farag
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, 35249, USA
| | - Steven Rothenberg
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, 35249, USA
| | - Seth T Lirette
- Department of Data Science, University of Mississippi Medical Center, Translational Research Center, 2500 N. State St., Jackson, MS, 39216, USA
| | - Andrew D Smith
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, 35249, USA
| | - Tejaswini Kulkarni
- Department of Medicine, University of Alabama at Birmingham, 1900 University Blvd, Birmingham, AL, 35294, USA
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Vianna R, Gaynor JJ, Selvaggi G, Farag A, Garcia J, Tekin A, Tabbara MM, Ciancio G. Liver Inclusion Appears to Be Protective Against Graft Loss-Due-to Chronic But Not Acute Rejection Following Intestinal Transplantation. Transpl Int 2023; 36:11568. [PMID: 37779512 PMCID: PMC10538304 DOI: 10.3389/ti.2023.11568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023]
Abstract
In intestinal transplantation, while other centers have shown that liver-including allografts have significantly more favorable graft survival and graft loss-due-to chronic rejection (CHR) rates, our center has consistently shown that modified multivisceral (MMV) and full multivisceral (MV) allografts have significantly more favorable acute cellular rejection (ACR) and severe ACR rates compared with isolated intestine (I) and liver-intestine (LI) allografts. In the attempt to resolve this apparent discrepancy, we performed stepwise Cox multivariable analyses of the hazard rates of developing graft loss-due-to acute rejection (AR) vs. CHR among 350 consecutive intestinal transplants at our center with long-term follow-up (median: 13.5 years post-transplant). Observed percentages developing graft loss-due-to AR and CHR were 14.3% (50/350) and 6.6% (23/350), respectively. Only one baseline variable was selected into the Cox model indicating a significantly lower hazard rate of developing graft loss-due-to AR: Transplant Type MMV or MV (p < 0.000001). Conversely, two baseline variables were selected into the Cox model indicating a significantly lower hazard rate of developing graft loss-due-to CHR: Received Donor Liver (LI or MV) (p = 0.002) and Received Induction (p = 0.007). In summary, while MMV/MV transplants (who receive extensive native lymphoid tissue removal) offered protection against graft loss-due-to AR, liver-containing grafts appeared to offer protection against graft loss-due-to CHR, supporting the results of other studies.
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Affiliation(s)
- Rodrigo Vianna
- Department of Surgery, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Jeffrey J. Gaynor
- Department of Surgery, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Gennaro Selvaggi
- Department of Surgery, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Ahmed Farag
- Department of Surgery, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
- Department of Surgery, Zagazig University School of Medicine, Zagazig, Egypt
| | - Jennifer Garcia
- Department of Pediatrics, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Akin Tekin
- Department of Surgery, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Marina M. Tabbara
- Department of Surgery, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Gaetano Ciancio
- Department of Surgery, Miami Transplant Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
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14
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Yoshida T, Uemura A, Tanaka R, Farag A, Mandour AS, Hamabe L, Matsumoto K. Secondary right atrial thrombosis in three dogs: Antithrombotics therapy and echocardiographic follow-up. Vet Med Sci 2023; 9:1973-1979. [PMID: 37491011 PMCID: PMC10508537 DOI: 10.1002/vms3.1210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/09/2023] [Accepted: 07/06/2023] [Indexed: 07/27/2023] Open
Abstract
Three dogs were diagnosed with right atrial thrombosis, thought to be secondary to systemic diseases. Specifically, two cases had hyperadrenocorticism and one case was diagnosed with pancreatitis with acute renal injury. In all cases, the thrombi were found within the right atrium, necessitating a differentiation from cardiac neoplasia. In all three cases, the structures assumed to be thrombi had irregular margins with interspersed hypoechoic regions, which were later confirmed as thrombi based on the responsiveness to therapy. All three cases were prescribed with the combination of clopidogrel and rivaroxaban.The thrombi gradually disappeared after initiation of the combination therapy. Complete resolution of right atrial thrombosis was noted in each dog treated with clopidogrel and rivaroxaban. This combination therapy appears to be safe and well tolerated. Diligent observation of the echocardiographic findings and clinical course allows the diagnosis of thrombosis.
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Affiliation(s)
- Tomohiko Yoshida
- Department of Clinical Veterinary MedicineObihiro University of Agriculture and Veterinary MedicineHokkaidoJapan
| | - Akiko Uemura
- Department of Clinical Veterinary MedicineObihiro University of Agriculture and Veterinary MedicineHokkaidoJapan
| | - Ryou Tanaka
- Department of Veterinary SurgeryTokyo University of Agriculture and TechnologyTokyoJapan
| | - Ahmed Farag
- Department of Veterinary SurgeryTokyo University of Agriculture and TechnologyTokyoJapan
- Faculty of Veterinary Medicine, Department of SurgeryAnesthesiology, and Radiology, Zagazig UniversityZagazigEgypt
| | - Ahmed S. Mandour
- Department of Veterinary SurgeryTokyo University of Agriculture and TechnologyTokyoJapan
- Faculty of Veterinary Medicine, Department of Animal Medicine (Internal Medicine)Suez Canal UniversityIsmailiaEgypt
| | - Lina Hamabe
- Department of Veterinary SurgeryTokyo University of Agriculture and TechnologyTokyoJapan
| | - Kotaro Matsumoto
- Department of Clinical Veterinary MedicineObihiro University of Agriculture and Veterinary MedicineHokkaidoJapan
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Negm S, Farag A, Shafiq A, Moursi A, Abdelghani AA. Endoscopic management of acute sigmoid volvulus in high risk surgical elderly patients: a randomized controlled trial. Langenbecks Arch Surg 2023; 408:338. [PMID: 37635200 PMCID: PMC10460710 DOI: 10.1007/s00423-023-03071-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 08/15/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Most patients with sigmoid volvulus are of old age with multiple comorbidities. So, the risk of surgery for those elderly patients is usually associated with increased rates of morbidity and mortality. Early intervention is required for managing sigmoid volvulus to avoid its serious complications; therefore, early endoscopic untwist of sigmoid colon can be performed followed by endoscopic fixation of sigmoid colon under sedation in this category of the patients to avoid development of high risk surgical complications following surgical fixation of sigmoid colon or sigmoidectomy after initial simple loop colostomy procedure to relieve obstruction. METHODS This prospective randomized controlled clinical trial included all patients who developed acute sigmoid volvulus and were referred to the Zagazig University Hospital Emergency Department between December 2020 and August 2022. The study was prospectively approved by Zagazig University Faculty of Medicine Institutional Review Board (Approval Number: 9989/23-10-2022) and was retrospectively submitted in http://clinicaltrials.gov in November 2022 ( http://clinicaltrials.gov ID: NCT05620446). Included eligible patients were simply randomized at a 1:1 ratio to "Endoscopic Group (EG)" or "Surgical Group (SG)" via drawing of sealed envelopes containing computer-generated random numbers prepared by a third party before start of intervention. RESULTS Sample size included 18 patients divided into 2 equal groups. (1) Endoscopic group included 9 patients who were subjected to endoscopic untwist of sigmoid colon followed by endoscopic fixation of sigmoid colon under sedation; (2) Surgical group included 9 patients who were subjected to surgical fixation of sigmoid colon or sigmoidectomy after initial simple loop colostomy under general anesthesia. In comparison between both groups, there were statistically significant differences regarding length of hospital stay and procedure time. Unfortunately, there were no statistically significant differences regarding postoperative complications and co-morbidities. Eight patients in the endoscopy group demonstrated excellent quality of life, and one demonstrated good quality of life; unlike the surgical group, there were 3 patients with excellent quality of life, 5 patients with good quality of life, and 1 patient with poor quality of life. So there was statistically significant difference regarding quality of life between both groups. During the 9-month follow-up period, both groups demonstrated no cases of recurrence post-fixation. CONCLUSION Endoscopic management of acute sigmoid volvulus is effective and safe in elderly high risk surgical patients (either in managing the intestinal obstruction caused by volvulus or in definitive treatment of volvulus).
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Affiliation(s)
- Said Negm
- Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Ahmed Farag
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Shafiq
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Adel Moursi
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
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16
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Aboubakr M, Farag A, Elfadadny A, Alkafafy M, Soliman A, Elbadawy M. Antioxidant and anti-apoptotic potency of allicin and lycopene against methotrexate-induced cardiac injury in rats. Environ Sci Pollut Res Int 2023; 30:88724-88733. [PMID: 37440131 DOI: 10.1007/s11356-023-28686-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Abstract
This study aimed to explore whether allicin (ALC) and lycopene (LP) could offer protection against the harmful effects of methotrexate (MTX), a type of chemotherapy drug known for its severe side effects, on the heart of rats. In this experiment, seven groups of rats (n = 7) were used. The first group was given saline as a control vehicle, the second group was given ALC at a dosage of 20 mg/kg orally, the third group was given LP at a dosage of 10 mg/kg orally, and the fourth group was given MTX at a dosage of 20 mg/kg intraperitoneally on the 15th day of the experiment. The remaining three groups received treatments, including ALC + MTX, LP + MTX, and ALC + LP + MTX. After the administration of MTX, the concentrations of serum cardiac biomarkers, such as Creatine kinase (CK), Lactate dehydrogenase (LDH), and creatine kinase-myoglobin binding (CK-MB) were found to increase. Also, MTX caused a notable rise in malondialdehyde (MDA) levels and significant declines in the levels of glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) in the heart tissues of rats. In addition, MTX caused alterations in the cardiac histopathology and enhanced the caspase-3 expression in the cardiac tissues, indicating the occurrence of apoptosis. The antioxidant properties of ALC and/or LP were effectively reduced cardiac toxicity and apoptosis induced by MTX. The administration of ALC and/or LP was found to alleviate these effects caused by MTX.
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Affiliation(s)
- Mohamed Aboubakr
- Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, 13736 Moshtohor, Toukh, Qaliobiya, Egypt.
| | - Ahmed Farag
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Elfadadny
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhur University, Damanhur, Egypt
| | - Mohamed Alkafafy
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia
| | - Ahmed Soliman
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Mohamed Elbadawy
- Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, 13736 Moshtohor, Toukh, Qaliobiya, Egypt
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Mandour AS, Farag A, Helal MAY, El-Masry G, Al-Rejaie S, Takahashi K, Yoshida T, Hamabe L, Tanaka R. Non-Invasive Assessment of the Intraventricular Pressure Using Novel Color M-Mode Echocardiography in Animal Studies: Current Status and Future Perspectives in Veterinary Medicine. Animals (Basel) 2023; 13:2452. [PMID: 37570261 PMCID: PMC10417806 DOI: 10.3390/ani13152452] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/06/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The assessment of diastolic function has received great interest in order to comprehend its crucial role in the pathophysiology of heart failure and for the early identification of cardiac events. Silent changes in the intraventricular flow (IVF) dynamics occur before the deterioration of the cardiac wall, although they cannot be detected using conventional echocardiography. Collective information on left ventricular (LV) pressures throughout the cardiac cycle has great value when dealing with patients with altered hemodynamics. Accurate pressure measurement inside the ventricle can be obtained by invasive methods to determine the LV diastolic pressures, which reflect the myocardial relaxation and compliance. However, catheterization is only feasible in the laboratory setting and is not suitable for clinical use due to its disadvantages. In contrast, echocardiography is simple, safe, and accessible. Color M-mode echocardiography (CMME) is an advanced cardiac evaluation technique that can measure the intraventricular pressure differences (IVPDs) and intraventricular pressure gradients (IVPGs) based on the Doppler shift of the IVF. Recently, the assessment of IVPD and IVPG has gained growing interest in the cardiovascular literature in both animal and human studies as a non-invasive method for the early diagnosis of cardiac dysfunctions, especially diastolic ones. The usability of IVPD and IVPG has been reported in various surgically induced heart failure or pharmacologically altered cardiac functions in rats, dogs, cats, and goats. This report aims to give an overview of the current studies of CMME-derived IVPD and IVPG in animal studies and its feasibility for clinical application in veterinary practice and to provide the prospects of the technique's ability to improve our understanding.
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Affiliation(s)
- Ahmed S. Mandour
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo 183-0054, Japan
| | - Ahmed Farag
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo 183-0054, Japan
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Mahmoud A. Y. Helal
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo 183-0054, Japan
- Animal Medicine Department, Faculty of Veterinary Medicine, Benha University, Moshtohor, Benha 13736, Egypt
| | - Gamal El-Masry
- Agricultural Engineering Department, Faculty of Agriculture, Suez Canal University, Ismailia 41522, Egypt
| | - Salim Al-Rejaie
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh 11564, Saudi Arabia
| | - Ken Takahashi
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Bunkyo, Tokyo 113-8421, Japan
| | - Tomohiko Yoshida
- Department of Veterinary Surgery, Division of Veterinary Research, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Lina Hamabe
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo 183-0054, Japan
| | - Ryou Tanaka
- Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo 183-0054, Japan
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Farag A, Mandour AS, Kaneda M, Elfadadny A, Elhaieg A, Shimada K, Tanaka R. Effect of trehalose on heart functions in rats model after myocardial infarction: assessment of novel intraventricular pressure and heart rate variability. Front Cardiovasc Med 2023; 10:1182628. [PMID: 37469485 PMCID: PMC10353053 DOI: 10.3389/fcvm.2023.1182628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/09/2023] [Indexed: 07/21/2023] Open
Abstract
Background Myocardial infarctions remain a leading cause of global deaths. Developing novel drugs to target cardiac remodeling after myocardial injury is challenging. There is an increasing interest in exploring natural cardioprotective agents and non-invasive tools like intraventricular pressure gradients (IVPG) and heart rate variability (HRV) analysis in myocardial infarctions. Trehalose (TRE), a natural disaccharide, shows promise in treating atherosclerosis, myocardial infarction, and neurodegenerative disorders. Objectives The objective of this study was to investigate the effectiveness of TRE in improving cardiac functions measured by IVPG and HRV and reducing myocardial remodeling following myocardial infarction in rat model. Methods Rats were divided into three groups: sham, myocardial infarction (MI), and trehalose-treated MI (TRE) groups. The animals in the MI and TRE groups underwent permanent ligation of the left anterior descending artery. The TRE group received 2% trehalose in their drinking water for four weeks after the surgery. At the end of the experiment, heart function was assessed using conventional echocardiography, novel color M-mode echocardiography for IVPG evaluation, and HRV analysis. After euthanasia, gross image scoring, histopathology, immunohistochemistry, and quantitative real-time PCR were performed to evaluate inflammatory reactions, oxidative stress, and apoptosis. Results The MI group exhibited significantly lower values in multiple IVPG parameters. In contrast, TRE administration showed an ameliorative effect on IVPG changes, with results comparable to the sham group. Additionally, TRE improved HRV parameters, mitigated morphological changes induced by myocardial infarction, reduced histological alterations in wall mass, and suppressed inflammatory reactions within the infarcted heart tissues. Furthermore, TRE demonstrated antioxidant, anti-apoptotic and anti-fibrotic properties. Conclusion The investigation into the effect of trehalose on a myocardial infarction rat model has yielded promising outcomes, as evidenced by improvements observed through conventional echocardiography, histological analysis, and immunohistochemical analysis. While minor trends were noticed in IVPG and HRV measurements. However, our findings offer valuable insights and demonstrate a correlation between IVPG, HRV, and other traditional markers of echo assessment in the myocardial infarction vs. sham groups. This alignment suggests the potential of IVPG and HRV as additional indicators for future research in this field.
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Affiliation(s)
- Ahmed Farag
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed S. Mandour
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Masahiro Kaneda
- Laboratory of Veterinary Anatomy, Division of Animal Life Science, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Ahmed Elfadadny
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhur University, Damanhur El-Beheira, Egypt
| | - Asmaa Elhaieg
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Kazumi Shimada
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
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Negm S, Farag A, Shafiq A, Allah EA, Shehata M, Orban YA, Saleh M, Abdelghani AA. Endoscopic management of low output recurrent colonic fistula or leak after anterior resection for rectal cancer: a randomized controlled trial. Surg Endosc 2023:10.1007/s00464-023-10092-z. [PMID: 37145174 PMCID: PMC10338381 DOI: 10.1007/s00464-023-10092-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/19/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Colonic anastomotic leak and fistula following anterior resection surgery for rectal cancer are associated with high mortality rates. The incidence of occurrence varies from 2 to 25% and it is difficult to accurately calculate the incidence of fistula and leak post anterior resection, as most of them are asymptomatic. Endoscopic management of fistula and leak has become the first line of management after conservative management in many gastrointestinal surgical centers with the advantages of being less invasive, shorter length of post-operative hospital stay, effective and rapid recovery in comparison to revision surgery. Effective endoscopic management for colonic fistula or leak depends on the clinical status of the patient and fistula characters (time-to-occur and size and site of defect), and device availability. METHODS This prospective randomized controlled clinical trial included all patients who developed the manifestations of low output recurrent colonic fistula or leak after colonic anterior resection for rectal cancer at Zagazig University Hospital between (December 2020 and August 2022). Sample size was 78 patients divided into two equal groups. Endoscopic group (EG): included 39 patients who underwent endoscopic management. Surgical group (SG): included 39 patients who underwent surgical management. RESULTS The investigators randomized eligible 78 patients into two groups: 39 patients in SG and 39 patients in EG. The median size of the fistula or leak was nine (range: 7-14) mm in EG, versus ten (range: 7-12) mm in SG. Clipping and Endo-stitch device were used in 24 patients versus 15 patients, respectively, in EG while primary repair with ileostomy, and resection & anastomosis were used in 15 patients versus 24 patients, respectively, in SG. Recurrence, abdominal collection, and mortality were the post procedure's complications with incidence of occurrence of 10.3, 7.7 and 0%, respectively, in EG versus 20.5, 20.5 and 2.6%, respectively, in SG. Excellent, good, and poor were the parameters for quality of life with incidence of occurrence of 43.6, 54.6 and 0%, respectively, in EG versus 28.2, 33.3 and 38.5%, respectively, in SG. Median hospital stay was one (range: 1-2) day in endoscopic group, and seven (range: 6-8) days in SG. CONCLUSION Endoscopic intervention may offer a successful modality in managing low output recurrent colonic fistula or leak after anterior resection for rectal cancer that did not respond to conservative measures in stable patients. CLINICALTRIALS gov ID: NCT05659446.
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Affiliation(s)
- Said Negm
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Ahmed Farag
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Shafiq
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ehab Abd Allah
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Shehata
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yasser A Orban
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Saleh
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amr A Abdelghani
- General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Maksoud SAE, F.i.el-dossoki F, Abdelhamed M, Farag A. Some new synthesized gemini cationic surfactants as corrosion inhibitors for carbon steel in hydrochloric acid solution.. [DOI: 10.21203/rs.3.rs-2679512/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
The effect of newly synthesized gemini surfactants on the corrosion of carbon steel in 1 M HCl was investigated. The outcomes show that the inhibition effectiveness of the compounds is affected by the increasing concentration and the capability to produce micelles in an aqueous solution. Weight loss, potentiodynamic polarization, and electrochemical impedance spectroscopy (EIS) techniques were used in the investigation. The obtained results show that these surfactants behave as good corrosion inhibitors. With increasing surfactant concentrations, the inhibition efficiency of the investigated compounds increases. The results show that the inhibition efficiency for the best inhibitor has 97.9% at 100 ppm. Changes in impedance parameters (charge transfer resistance, Rct, and double-layer capacitance, Cdl) were indicative of surfactant adsorption on the metal surface, resulting in the formation of a protective film, according to EIS results. The measurements of potentiodynamic polarisation revealed that the inhibitors are mixed type. Physical and chemical adsorption are demonstrated by these gemini surfactants. and is governed by the Langmuir adsorption isotherm. The morphology of the C-steel surface and the protective film on the surface were studied using SEM, AFM, and XPS characterization. The results of the various procedures agreed very well.
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21
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Farag A, Mandour AS, Hendawy H, Elhaieg A, Elfadadny A, Tanaka R. A review on experimental surgical models and anesthetic protocols of heart failure in rats. Front Vet Sci 2023; 10:1103229. [PMID: 37051509 PMCID: PMC10083377 DOI: 10.3389/fvets.2023.1103229] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Heart failure (HF) is a serious health and economic burden worldwide, and its prevalence is continuously increasing. Current medications effectively moderate the progression of symptoms, and there is a need for novel preventative and reparative treatments. The development of novel HF treatments requires the testing of potential therapeutic procedures in appropriate animal models of HF. During the past decades, murine models have been extensively used in fundamental and translational research studies to better understand the pathophysiological mechanisms of HF and develop more effective methods to prevent and control congestive HF. Proper surgical approaches and anesthetic protocols are the first steps in creating these models, and each successful approach requires a proper anesthetic protocol that maintains good recovery and high survival rates after surgery. However, each protocol may have shortcomings that limit the study's outcomes. In addition, the ethical regulations of animal welfare in certain countries prohibit the use of specific anesthetic agents, which are widely used to establish animal models. This review summarizes the most common and recent surgical models of HF and the anesthetic protocols used in rat models. We will highlight the surgical approach of each model, the use of anesthesia, and the limitations of the model in the study of the pathophysiology and therapeutic basis of common cardiovascular diseases.
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Affiliation(s)
- Ahmed Farag
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
- *Correspondence: Ahmed Farag
| | - Ahmed S. Mandour
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
- Ahmed S. Mandour
| | - Hanan Hendawy
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Asmaa Elhaieg
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Ahmed Elfadadny
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhur University, Damanhur El-Beheira, Egypt
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
- Ryou Tanaka
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22
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Boles MSR, El-Sayed RF, Shawali HAS, Farag A, Fawzy FS, Awadallah MY. Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons? Egypt J Radiol Nucl Med 2023. [DOI: 10.1186/s43055-023-00989-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
Abstract
Abstract
Background
Surgeons find treating perianal fistula difficult because insufficient drainage and failure to eradicate perianal sepsis could increase the risk of recurrence and postoperative complications. For better planning of the most suitable surgical technique, surgeons must consider the risk factors of recurrence with an accurate pre-operative assessment of perianal fistulae.
The most common imaging method for grading primary perianal fistulas, identifying their complications, and locating occult extensions is magnetic resonance imaging (MRI). However, surgeons may find it challenging to read the lengthy reports of complex tracts, particularly for complicated patients. The creation of three-dimensional (3D) models has gained traction recently as a genuinely useful diagnostic tool for pre-operative planning. The authors evaluated the value of these surgical models. Inspecting the 3D models in addition to the routine two-dimensional study caused four out of five skilled colorectal surgeons to re-evaluate how far the fistulae extended. This made promise that 3D models would be helpful, simple to understand, and quick to interpret for colorectal surgeons. The purpose of the study is to assess the value of adding 3D modelling of MRI to standard two-dimensional MRI protocol for more accurate delineation of perianal fistula and its complications aiming at better surgical outcomes.
Results
Regarding 3D models, the highest degree of accuracy was in detecting supra-levator extension (100%) by both the third radiologist and the surgeon. There was a statistically high diagnostic inter-observer agreement between both, with a p-value < 0.0001. The highest inter-observer agreement was in the supra-levator extension (50/50, 100%), and the lowest agreement was in the side branches detection (44/50, 88%).
Conclusions
Pre-operative 3D MRI modelling provided the surgeon with a pre- and intra-operative road map that improved the surgeon’s orientation and ability to see complex perianal fistulas and their consequences, especially those with supra levator extension, thus helping the surgeon achieve better surgical results and decrease the preoperative risk factors of recurrence. Surgeons should utilise it in complex and recurrent cases reducing preoperative risk factors and improving outcomes. Although this technique is expensive, its cost–benefit ratio is low relative to recurrent hospitalisation and complications.
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23
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Li Y, Hu H, Farag A, Feeney T, Allegro I, Lemmer U, Paetzold UW, Howard IA. Enhancement of Amplified Spontaneous Emission by Electric Field in CsPbBr 3 Perovskites. Nano Lett 2023; 23:1637-1644. [PMID: 36852434 PMCID: PMC9999453 DOI: 10.1021/acs.nanolett.2c02944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Perovskite gain materials can sustain continuous-wave lasing at room-temperature. A first step toward the unachieved goal of electrically excited lasing would be an improvement in gain when electrical stimulation is added to the optical. However, to date, electrical stimulation supplementing optical has reduced gain performance. We find that amplified spontaneous emission (ASE) in a CsPbBr3 perovskite light-emitting diode (LED) held under invariant subthreshold optical excitation can be turned on/off by the addition/removal of an electric field. A positive bias voltage leads to a factor of 3 reduction in the optical ASE threshold, the cause of which can be attributed to an enhancement of the radiative rate. The slow components (10 s time scale) of the modulation in the photoluminescence and ASE when the voltage is changed suggest that the relocation of mobile ions trigger the increased radiative rate and observed lowering of ASE thresholds.
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Affiliation(s)
- Yang Li
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
| | - Hang Hu
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
| | - Ahmed Farag
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
| | - Thomas Feeney
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
| | - Isabel Allegro
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
| | - Uli Lemmer
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
| | - Ulrich W. Paetzold
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
| | - Ian A. Howard
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse
13, 76131 Karlsruhe, Germany
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Negm S, Mousa B, Shafiq A, Abozaid M, Allah EA, Attia A, AbdelKader T, Farag A. Endoscopic management of refractory leak and gastro-cutaneous fistula after laparoscopic sleeve gastrectomy: a randomized controlled trial. Surg Endosc 2023; 37:2173-2181. [PMID: 36326931 PMCID: PMC10017559 DOI: 10.1007/s00464-022-09748-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Gastro-cutaneous fistula is a rare complication after laparoscopic sleeve gastrectomy (LSG) with incidence of occurrence 1-2%. Most of gastro-cutaneous fistulae do not respond to conservative management and need intervention either surgically or endoscopically. METHODS This prospective randomized clinical study included referred patients who had LSG performed at our department or other centers, and complicated with post-LSG leak or gastro-cutaneous fistula between December/2019 and March/2021. Included patients were ASA Physical status I-II. Primary and secondary outcomes were recurrence of the fistula and mortality in each group after the intervention during the 18 months follow-up period, respectively. RESULTS Thirty patients were randomized into two groups: Surgery Group (SG, n = 15) and Endoscopy Group (EG, n = 15). Mean age of patients was 42.3 ± 8.7 and 42.6 ± 8.3 years-old in SG and EG, respectively. Females constituted 73.3% and 80% in SG and EG, respectively. Median time-to-gastric leak post LSG was six (range: 4-7) days in both groups. SG patients were surgically managed with primary repair of the gastric fistula and gastrojejunostomy in 13 patients or converting SG into Roux-en-Y gastric bypass in two patients, while EG patients were endoscopically managed with stitching, stenting, stenting and dilation, and clipping and dilation in 5, 4, 4 and 2 patients, respectively. Incidence of recurrent leak during 1st week was significantly higher in SG than EG (p < 0.001). No mortality reported in EG, while 2 patients died in SG (p = 0.48). CONCLUSION Endoscopic intervention may offer a successful modality in managing post-LSG gastric leak and gastro-cutaneous fistula that do not respond to conservative measures in stable patients.
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Affiliation(s)
- Said Negm
- grid.31451.320000 0001 2158 2757Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Bassam Mousa
- grid.31451.320000 0001 2158 2757Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Shafiq
- grid.31451.320000 0001 2158 2757Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Abozaid
- grid.31451.320000 0001 2158 2757Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ehab Abd Allah
- grid.31451.320000 0001 2158 2757Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Adel Attia
- grid.31451.320000 0001 2158 2757Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Taha AbdelKader
- grid.415762.3Shepeen alkom teaching hospital, Ministry of health, Monufia, Egypt
| | - Ahmed Farag
- grid.31451.320000 0001 2158 2757Faculty of Medicine, Zagazig University, Zagazig, Egypt
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25
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Farag A, Mashhour AN, Raslan MM, Khalifa AS, Elbarmelgi MY. The Functional Luminal Imaging Probe (FLIP): A Good Tool for Adjustment of anal Canal Dimensions During Operative Management of Fecal Incontinence. Surg Innov 2023:15533506231157438. [PMID: 36790084 DOI: 10.1177/15533506231157438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE Fecal incontinence is a troublesome problem in the field of colorectal surgery. The main aim of this study was to adjust the anal canal resistance during operative management of anal incontinence using Endo-FLIP. METHODS This was a prospective cohort study held at Cairo university hospital. Hundred forty-eight incontinent patients treated by different surgical procedures were included. During the procedure the Endo-FLIP was applied to adjust the anal canal dimensions (ACL and ACD) so the ACR could be adjusted based on the flow equation. These were also assessed pre-operatively with Endo-FLIP system and the flow equation calculator. The clinical severity of the disease and outcome after surgical procedures were assessed and correlated to the physiologic parameters. RESULTS ACL, ACD and ACR had had significant correlations to the degree of incontinence (P < .001). ACL, ACD and ACR showed statistically significant change with primary repair and gluteus maximus transposition operations. After treatment of fecal incontinence, in good responders' group, the mean resting anal canal resistance increased significantly to 4649.05 ± 1161.49 (postoperative) while in poor responders' group it was 1919.9 ± 1077.73. CONCLUSIONS The Endo-flip can be used to measure the anal canal geometric parameters (ACL and ACD) and then anal canal resistance could be calculated by the flow equation - pre-and post-operatively- which help the adjustment of the surgical repair of sphincter injury in fecal incontinence patients which may improve the surgical outcome.
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Affiliation(s)
- Ahmed Farag
- 63527Cairo University Kasr Alainy Faculty of Medicine, Egypt
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26
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Farag A, Hendi NI, Diab RA. Does pericapsular nerve group block have limited analgesia at the initial post-operative period? Systematic review and meta-analysis. J Anesth 2023; 37:138-153. [PMID: 36342537 PMCID: PMC9870839 DOI: 10.1007/s00540-022-03129-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
Perioperative pain management related to hip surgical procedures is challenging. Pericapsular nerve group (PENG) block is a novel technique that is assumed to provide better analgesia in addition to its post-operative motor-sparing effect. In this review, we aim to assess the safety and efficacy of PENG block on pain management in patients undergoing hip surgeries. Fifteen clinical trials with a total of 837 patients were included. Pain scores favored PENG group when compared to FICB group (fascia iliaca compartment block) or analgesics-only group, but the difference could only be detected in the early post-operative period. Afterward, it seems to lose its superiority, and no difference could be detected. In addition, cumulative opioid consumption favored PENG group at 24 h but not at 48 h. Regarding patients' satisfaction, our analysis showed results favoring PENG group, but there was no difference in time to first opioid or length of hospital stay. The incidence of vomiting was lower in PENG, but there was no difference in the incidence of nausea, pruritis, and dizziness. PENG provides better analgesia and lower opioid consumption in the initial post-operative period. Current evidence is not enough, and further high-quality randomized controlled trials with larger sample sizes are required.
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Affiliation(s)
- Ahmed Farag
- Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt.
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27
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Farag A, Mandour AS, Hamabe L, Yoshida T, Shimada K, Tanaka R. Novel protocol to establish the myocardial infarction model in rats using a combination of medetomidine-midazolam-butorphanol (MMB) and atipamezole. Front Vet Sci 2022; 9:1064836. [PMID: 36544554 PMCID: PMC9760920 DOI: 10.3389/fvets.2022.1064836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Background Myocardial infarction (MI) is one of the most common cardiac problems causing deaths in humans. Previously validated anesthetic agents used in MI model establishment are currently controversial with severe restrictions because of ethical concerns. The combination between medetomidine, midazolam, and butorphanol (MMB) is commonly used in different animal models. The possibility of MMB combination to establish the MI model in rats did not study yet which is difficult because of severe respiratory depression and delayed recovery post-surgery, resulting in significant deaths. Atipamezole is used to counter the cardiopulmonary suppressive effect of MMB. Objectives The aim of the present study is to establish MI model in rats using a novel anesthetic combination between MMB and Atipamezole. Materials and methods Twenty-five Sprague Dawley (SD) rats were included. Rats were prepared for induction of the Myocardial infarction (MI) model through thoracotomy. Anesthesia was initially induced with a mixture of MMB (0.3/5.0/5.0 mg/kg/SC), respectively. After endotracheal intubation, rats were maintained with isoflurane 1% which gradually reduced after chest closing. MI was induced through the left anterior descending (LAD) artery ligation technique. Atipamezole was administered after finishing all surgical procedures at a dose rate of 1.0 mg/kg/SC. Cardiac function parameters were evaluated using ECG (before and after atipamezole administration) and transthoracic echocardiography (before and 1 month after MI induction) to confirm the successful model. The induction time, operation time, and recovery time were calculated. The success rate of the MI model was also calculated. Results MI was successfully established with the mentioned anesthetic protocol through the LAD ligation technique and confirmed through changes in ECG and echocardiographic parameters after MI. ECG data was improved after atipamezole administration through a significant increase in heart rate (HR), PR Interval, QRS Interval, and QT correction (QTc) and a significant reduction in RR Interval. Atipamezole enables rats to recover voluntary respiratory movement (VRM), wakefulness, movement, and posture within a very short time after administration. Echocardiographic ally, MI rats showed a significant decrease in the left ventricular wall thickness, EF, FS, and increased left ventricular diastolic and systolic internal diameter. In addition, induction time (3.440 ± 1.044), operation time (29.40 ± 3.663), partial recovery time (10.84 ± 3.313), and complete recovery time (12.36 ± 4.847) were relatively short. Moreover, the success rate of the anesthetic protocol was 100%, and all rats were maintained for 1 month after surgery with a survival rate of 88%. Conclusion Our protocol produced a more easy anesthetic effect and time-saving procedures with a highly successful rate in MI rats. Subcutaneous injection of Atipamezole efficiently counters the cardiopulmonary side effect of MMB which is necessary for rapid recovery and subsequently enhancing the survival rate during the creation of the MI model in rats.
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Affiliation(s)
- Ahmed Farag
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan,Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt,*Correspondence: Ahmed Farag
| | - Ahmed S. Mandour
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan,Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt,Ahmed S. Mandour
| | - Lina Hamabe
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Tomohiko Yoshida
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Kazumi Shimada
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Japan,Ryou Tanaka
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28
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Roman Boles MS, Awadallah MY, Shawali HAS, Farag A, El-Sayed RF. Role of transperineal ultrasound in evaluation of patients with perianal inflammatory disorders. Egypt J Radiol Nucl Med 2022. [DOI: 10.1186/s43055-022-00812-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The aim of this study was to study the degree of accuracy of transperineal ultrasound (TPUS) in pre-operative evaluation and follow-up of cases with perianal inflammatory disorders in relation to MRI findings. Thirty patients with symptoms and signs of perianal inflammatory disorders underwent TPUS and pelvic MRI examinations. The radiologist who performed the TPUS was blinded to MR findings and was asked to comment on the site of the internal opening and extension of the tract, any related side branches or collections.
Results
The overall accuracy of TPUS in detection of the site of internal opening of perianal tracts was 83.33%, with sensitivity of 91.30%. TPUS showed sensitivity, specificity and accuracy of 100% in detection of horseshoe collections. The overall accuracy of TPUS in detection of perianal abscesses was 93.33% with specificity of 100%. TPUS showed sensitivity of 50.00%, specificity of 92.31% and accuracy of 86.67% in visualization of side branches. TPUS showed sensitivity of 33.33%, specificity of 88.89% and overall accuracy of 83.33% in detection of supralevator extension of perianal tracts. TPUS correctly classified (23/30) perianal tracts with accuracy of 76.7%.
Conclusions
TPUS can be used as a first diagnostic tool in patients with perianal inflammatory disorders and related pathologies, particularly horseshoe collections which can change the operative decision made by the surgeon. TPUS can be used in repeated follow-up during the course of management of perianal inflammatory disorders or when other imaging modalities are unavailable or contra-indicated.
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Negm S, Mousa B, Shafiq A, Abozaid M, Allah EA, Attia A, Abozaid E, Farag A. Laparoscopic Drainage Versus Interventional Radiology for Management Of Appendicular Abscess : A Randomized Controlled Trial.. [DOI: 10.21203/rs.3.rs-1975645/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background:
Laparoscopic drainage of appendicular abscess has become a novel technique due to its advantages over interventional radiology like complete exploration of the abdomen, exclusion of other pathologies, excision of the appendix at same session, better cosmesis, decrease incidence of wound infection & incisional hernia, better visualization of surgical field, fine handling of edematous tissue and drainage of multiple collections.
Methods:
This prospective randomized controlled clinical trial included all patients who developed the manifestations of appendicular abscess and referred to the Zagazig University Hospital Emergency Department between January 2020 and February 2022. The study was prospectively approved by Zagazig University Faculty of Medicine Institutional Review Board (Approval Number: 55342/24.1.2020), and was retrospectively submitted in clinicaltrials.gov in 15/6/2022 (ClinicalTrials.gov ID: NCT05419440). The sample size was 172 patients divided into two equal group, laparoscopic group involved 86 patients (group1), interventional radiology group involved 86 patients (group2).
Results:
“Group 1 (laparoscopic drainage group) included 86 patients: 55.8% were males, with a mean age of 41.2 (± 12.2) years-old, while in group 2 (interventional radiology group) included 86 patients: 51.2% were males, with a mean age of 36.8 (± 10.9) years-old. The reported complications were bowel injury, fecal fistula, recurrence, pelvic collection and mortality with incidence rates of occurrence 1(1.2%), 3 (3.5%), 0 (0%), 0 (0%), 0(0%) respectively in group (1) while in group(2) were 5(5.8%), 0(0%), 3(3.5%), 8(9.3%), 1(1.2%) respectively. Regarding quality of life in both groups were excellent, good, poor with incidence rates of 48(55.8%), 38(44.2%), 0(0%) respectively in group (1), and 12(14%), 59(68.6%), 15(17.4%) respectively in group(2).
Conclusion:
Laparoscopic management of appendicular abscess can be safely applied in a good experienced hand with no mortality & morbidity, without the need for interval appendectomy.
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Abstract
Prompt diagnosis of pulmonary embolism is essential to avert morbidity and mortality. There are a number of diagnostic options for identification of a pulmonary embolism, including laboratory and imaging investigations. While computed tomography pulmonary angiography (CTPA) has largely supplanted nuclear medicine ventilation/perfusion studies, there remain significant limitations in the optimal performance of CTPA. Dual-energy computed tomography has the ability to overcome many of the limitations of standard of care CTPA, including rescue of poor contrast boluses and the ability to evaluate pulmonary perfusion defects.
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Affiliation(s)
- Ahmed Farag
- Department of Radiology, UMass Chan Medical School-Baystate, Springfield, MA
| | - Jordan Fielding
- Department of Radiology, UMass Chan Medical School-Baystate, Springfield, MA
| | - Tara Catanzano
- Department of Radiology, UMass Chan Medical School-Baystate, Springfield, MA.
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31
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Ruiz-Preciado MA, Gota F, Fassl P, Hossain IM, Singh R, Laufer F, Schackmar F, Feeney T, Farag A, Allegro I, Hu H, Gharibzadeh S, Nejand BA, Gevaerts VS, Simor M, Bolt PJ, Paetzold UW. Monolithic Two-Terminal Perovskite/CIS Tandem Solar Cells with Efficiency Approaching 25. ACS Energy Lett 2022; 7:2273-2281. [PMID: 35844471 PMCID: PMC9274764 DOI: 10.1021/acsenergylett.2c00707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Monolithic two-terminal (2T) perovskite/CuInSe2 (CIS) tandem solar cells (TSCs) combine the promise of an efficient tandem photovoltaic (PV) technology with the simplicity of an all-thin-film device architecture that is compatible with flexible and lightweight PV. In this work, we present the first-ever 2T perovskite/CIS TSC with a power conversion efficiency (PCE) approaching 25% (23.5% certified, area 0.5 cm2). The relatively planar surface profile and narrow band gap (∼1.03 eV) of our CIS bottom cell allow us to exploit the optoelectronic properties and photostability of a low-Br-containing perovskite top cell as revealed by advanced characterization techniques. Current matching was attained by proper tuning of the thickness and bandgap of the perovskite, along with the optimization of an antireflective coating for improved light in-coupling. Our study sets the baseline for fabricating efficient perovskite/CIS TSCs, paving the way for future developments that might push the efficiencies to over 30%.
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Affiliation(s)
- Marco A. Ruiz-Preciado
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
- Email
for M,A.R.-P.:
| | - Fabrizio Gota
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Paul Fassl
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Ihteaz M. Hossain
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Roja Singh
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Felix Laufer
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Fabian Schackmar
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Thomas Feeney
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Ahmed Farag
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Isabel Allegro
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Hang Hu
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Saba Gharibzadeh
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Bahram Abdollahi Nejand
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
| | - Veronique S. Gevaerts
- TNO
Partner in Solliance, Department of Solar
Technology and Applications, High Tech Campus 21, NL-5656 AE Eindhoven, The Netherlands
| | - Marcel Simor
- TNO
Partner in Solliance, Department of Solar
Technology and Applications, High Tech Campus 21, NL-5656 AE Eindhoven, The Netherlands
| | - Pieter J. Bolt
- TNO
Partner in Solliance, Department of Solar
Technology and Applications, High Tech Campus 21, NL-5656 AE Eindhoven, The Netherlands
| | - Ulrich W. Paetzold
- Institute
of Microstructure Technology, Karlsruhe
Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Light
Technology Institute, Karlsruhe Institute
of Technology, Engesserstrasse 13, 76131 Karlsruhe, Germany
- Email for U.W.P.”
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Negm S, Mousa B, Shafiq A, Abozaid M, Allah EA, Attia A, Abozaid E, Farag A. Laparoscopic Drainage Versus Interventional Radiology In Management Of Appendicular Abscess: A Randomized Controlled Trial.. [DOI: 10.21203/rs.3.rs-1794654/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background:
Laparoscopic drainage of appendicular abscess has become a novel technique due to its advantages over interventional & open surgery like complete exploration of the abdomen, exclusion of other pathologies, excision of the appendix at same session, better cosmoses, decrease incidence of wound infection & incisional hernia, better visualization of surgical field, fine handling of edematous tissue and drainage of multiple collections.
Methods:
This prospective randomized controlled clinical trial included all patients who developed the manifestations of appendicular abscess and referred to the Zagazig University Hospital Emergency Department between January 2020 and February 2022. The study was prospectively approved by Zagazig University Faculty of Medicine Institutional Review Board (Approval Number: 55342/24.1.2020), and was retrospectively submitted in clinicaltrials.gov in June 2022 (ClinicalTrials.gov ID: NCT05419440). The sample size was 172 patients divided into two equal group, laparoscopic group involved 86 patients (group1), interventional radiology group involved 86 patients (group2).
Results:
172 patients divided into equal groups, group (1) laparoscopic drainage group included 86 patients, 48(55.8%) patients of them were male, 38 (44.2%) patients were female, with the age of the patients range from 16–60 years with median of the age (41.2 ± 12.2), group (2) interventional radiology group included 86 patients, 44 (51.2%) patients were male, 42 (48.8%) patients were female, with age range from 16–60 years, with the median of age (36.8 ± 10.9). The complications in both groups were bowel injury, fecal fistula, recurrence, pelvic collection and mortality with incidence of occurrence 1(1.2%), 3 (3.5%), 0 (0%), 0 (0%), 0(0%) respectively in group (1) while in group(2) were 5(5.8%), 0(0%), 3(3.5%), 8(9.3%), 1(1.2%) respectively. Regarding quality of life in both groups were excellent, good, poor with incidence of 48(55.8%), 38(44.2%), 0(0%) respectively in group (1), and 12(14%), 59(68.6%), 15(17.4%) respectively in group(2).
Conclusion:
Laparoscopic management of appendicular abscess can be safely applied in a good experienced hand with no mortality & morbidity, without the need for interval appendectomy.
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Kasolo Y, Farag A. 152 Ct-derived fractional flow reserve – outcomes from a district general hospital-led service. IMAGING 2022. [DOI: 10.1136/heartjnl-2022-bcs.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Negm S, Mohamed H, Shafiq A, AbdelKader T, Ismail A, Yassin M, Mousa B, Abozaid M, Orban YA, Al Alawi M, Farag A. Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial. World J Emerg Surg 2022; 17:24. [PMID: 35610657 PMCID: PMC9131571 DOI: 10.1186/s13017-022-00429-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/12/2022] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Peptic ulcer perforation is a common life-threatening surgical emergency. Graham omental patch is performed for plugging of perforated peptic ulcer. Many endoscopic methods have been used to treat acute perforated peptic ulcer such as over the scope clips, standard endoscopic clips, endoscopic sewing and metallic stents. The main idea in endoscopic management of acute perforated peptic ulcer is early decontamination and decrease sepsis by interventional radiologic drainage. METHODS This is a prospective randomized controlled clinical trial. This study included patients who were developed acute perforated peptic ulcer manifestations and were admitted to our hospital between December 2019 and August 2021. Sample size was 100 patients divided into 2 equal groups. Endoscopic group (EG): included 50 patients who were subjected to endoscopic management. Surgical group (SG): included 50 patients who were subjected to surgical management. RESULTS One hundred patients were randomized into 2 groups: SG (50) and EG (50). Median age of patients was 36 (range 27:54) and 47 (range 41:50) years-old in SG and EG, respectively. Males constituted 72% and 66% in SG and EG, respectively. Median length of postoperative hospital stay was 1 (range: 1-2) days in EG, while in SG was 7 (range 6-8) days. Postoperative complications in SG patients were 58% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (11%, 5%, 5%, 3%, 2% and 3%, respectively). Postoperative complications in EG patients were 24% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (10%, 0%, 2%, 0%, 0% and 0%, respectively). CONCLUSION Combined endoscopic and interventional radiological drainage can effectively manage acute perforated peptic ulcer without the need for general anesthesia, with short operative time, in high risk surgical patients with low incidence of morbidity & mortality.
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Affiliation(s)
- Said Negm
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hatem Mohamed
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Shafiq
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Adel Ismail
- Ismailia Teaching Oncology Hospital, Ismailia, Egypt
| | | | - Bassam Mousa
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | | | | | - Ahmed Farag
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Tabbara MM, Farag A, Ciancio G. Renal cell carcinoma with inferior vena cava tumor thrombus initially misdiagnosed as bland thrombus due to hypercoagulable state. SAGE Open Med Case Rep 2022; 10:2050313X221102019. [PMID: 35619748 PMCID: PMC9128047 DOI: 10.1177/2050313x221102019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/29/2022] [Indexed: 11/26/2022] Open
Abstract
Renal cell carcinoma with inferior vena cava tumor thrombus can be misdiagnosed as an inferior vena cava thrombosis if not evaluated carefully with imaging. We describe a case of renal cell carcinoma with inferior vena cava tumor thrombus that was initially misdiagnosed as an inferior vena cava thrombosis due to a possible hypercoagulable state. After 7 months of anticoagulation therapy with no improvement, a right radical nephrectomy and thrombectomy was performed without cardiopulmonary bypass, and a diagnosis of papillary renal cell carcinoma with a level-IIId tumor thrombus was confirmed with no presence of a bland thrombus. We demonstrate the complexity of identifying and treating renal cell carcinoma with venous tumor thrombus and the importance of differentiating between a malignant thrombus and a bland thrombus.
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Affiliation(s)
- Marina M. Tabbara
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
- Miami Transplant Institute, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL, USA
| | - Ahmed Farag
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
- Miami Transplant Institute, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL, USA
- Department of Surgery, School of Medicine, Zagazig University, Zagazig, Egypt
| | - Gaetano Ciancio
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
- Miami Transplant Institute, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL, USA
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
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36
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Gota F, Schmager R, Farag A, Paetzold UW. Energy yield modelling of textured perovskite/silicon tandem photovoltaics with thick perovskite top cells. Opt Express 2022; 30:14172-14188. [PMID: 35473167 DOI: 10.1364/oe.447069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/26/2022] [Indexed: 06/14/2023]
Abstract
Recent advances in solution processing of micrometer-thick perovskite solar cells over textured silicon bottom solar cells allowed a new promising approach for the fabrication of 2T perovskite/silicon tandem photovoltaics, combining optimal light management in the textured bottom cell with the ease of solution processing. Detailed simulations are needed to assess the performances of this morphology configuration (thick perovskite configuration). In this work, in-depth optical and energy yield (EY) simulations are performed to compare the thick perovskite configuration with other relevant morphology configurations for 2T perovskite/silicon tandem photovoltaics. Under standard test conditions, the total photogenerated current of the thick perovskite configuration is 1.3 mA cm-2 lower (-3.4% relative) than the one of the conformal perovskite on textured silicon configuration for non-encapsulated cells and only 0.8 mA cm-2 (-2.1% relative) for encapsulated cells. Under realistic outdoor conditions, EY modelling for a wide range of locations shows that, while conformal perovskite on textured silicon configuration remains the optimal configuration, thick perovskite configuration exhibits a mere ∼2.5% lower annual EY. Finally, intermediate scenarios are investigated with the angle of the perovskite front-side texture differing from the silicon texture and critical angles for efficient light management in these configurations are identified.
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Ciancio G, Tabbara MM, Farag A, Salerno T. Renal cell carcinoma with right atrium tumor thrombus treated with radical nephrectomy and tumor thrombectomy in a patient with previous coronary artery bypass graft: a case report. Am J Clin Exp Urol 2022; 10:123-128. [PMID: 35528464 PMCID: PMC9077144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
Renal cell carcinoma (RCC) with inferior vena cava (IVC) and right atrium (RA) tumor thrombus (TT) is a rare occurrence and its resection is surgical challenge. Management becomes even more difficult when the TT causes hepatic vein obstruction and leads to Budd-Chiari syndrome. We report a case of 68-year-old male with right RCC with IVC and RA TT with associated Budd-Chiari syndrome. Surgical management was performed without cardiopulmonary bypass (CPB) and re-sternotomy due to the patient's previous history of coronary artery bypass grafting (CABG) for 3 vessel coronary artery disease. Through a transabdominal approach, the diaphragm was dissected off the IVC and the RA was gently pulled into the abdomen and clamped under transesophageal echocardiogram (TEE) control. As use of CPB in these surgeries is associated with increased morbidity and mortality, this organ transplant-based approach is encouraged for patients requiring resection of RCC with supradiaphragmatic TT.
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Affiliation(s)
- Gaetano Ciancio
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
- Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
- Department of Urology, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
| | - Marina M Tabbara
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
- Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
| | - Ahmed Farag
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
- Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
- Department of Surgery, Zagazig University School of MedicineZagazig, Egypt
| | - Tomas Salerno
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
- Division of Cardiothoracic Surgery, University of Miami Miller School of Medicine, Jackson Memorial HospitalMiami, FL, USA
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Negm S, Amin M, Shafiq A, Atef B, Yassin M, Farag A. The short-term outcome of distal mesogastric fixation after laparoscopic sleeve gastrectomy: a randomized controlled trial. Surg Today 2022; 52:510-513. [PMID: 35099602 DOI: 10.1007/s00595-022-02459-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The proposed etiology of leakage after laparoscopic sleeve gastrectomy may be the axial rotation of the stomach owing to the loss of abdominal ligament fixation along the greater curvature of the stomach. The mechanism of increased intra-gastric pressure due to axial gastric rotation may place a great deal of stress on the staple lines, leading to an increased incidence of leakage. Other complications may occur, including vomiting, food intolerance or persistent reflux. METHODS This study was registered in ClinicalTrials.gov (ID: NCT04834323). This study included patients who were admitted to our center to undergo laparoscopic sleeve gastrectomy. Cases were collected in the period from December 2019 to December 2020. The study population included 83 patients, who were divided into the following two groups: Group 1 included 42 patients who received distal mesogastric fixation after laparoscopic sleeve gastrectomy; Group 2 included 41 patients who received laparoscopic sleeve gastrectomy alone without distal mesogastric fixation. RESULTS No leakage or axial rotation occurs after laparoscopic sleeve gastrectomy with distal fixation, while in patients without distal fixation, leakage and axial rotation occurred with no statistically significant differences between the two groups. Leakage and axial rotation occurred two times more frequently among patients who received laparoscopic sleeve gastrectomy without distal fixations. CONCLUSION Distal mesogastric fixation after laparoscopic sleeve gastrectomy decreased the axial gastric rotation and subsequently decreased gastric leakage.
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Affiliation(s)
- Said Negm
- Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Mohamed Amin
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Shafiq
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Baher Atef
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Ahmed Farag
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Abd El-Fattah D, Hashem F, Farag A. Potentiality of Using Mycorrhizae and Pseudomonas fluorescens in Reducing the Effect of Water Shortage on Broccoli Plants. Arab Universities Journal of Agricultural Sciences 2021; 0:0-0. [DOI: 10.21608/ajs.2021.98841.1424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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40
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González J, Jue JS, Farag A, Ciancio GC. [Renal allograft transplant: Anatomic description.]. ARCH ESP UROL 2021; 74:922-932. [PMID: 34851307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Renal transplantation remains the best treatment option of renal replacement for end-stagechronic kidney disease. Surgical advances in graft quality and implantation techniques have improved transplantation during the last two decades. This has reduced both urologic and vascular complications after implantation. A detailed understanding of renal graft and transplantation anatomy is important to reduce transplantation morbidity. The aim of this article is to provide a detailed anatomic description of the kidney and regions usually involved in human renal transplantation (iliac fossa and left lumbar fossa), to provide basic instructions for thenovice transplant surgeon, and to improve the anatomic knowledge of the experienced transplant surgeon.
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Affiliation(s)
- Javier González
- Servicio de Urología. Hospital General Universitario Gregorio Marañón. Madrid. España
| | - Joshua S Jue
- Department of Urology. Lenox Hill Hospital. Northwell Health. Zucker School of Medicine at Hofstra/Northwell. New York. NY. USA
| | - Ahmed Farag
- Department of Surgery, Miami Transplant Institute. University of Miami Miller School of Medicine. Jackson Memorial Hospital. Miami. FL. USA. Department of Surgery. Zagazig University School of Medicine. Zagazig. Egypt
| | - Gaetano Ciancio Ciancio
- Department of Surgery, Department of Urology, and Miami Transplant Institute. University of Miami Miller School of Medicine. Jackson Memorial Hospital. Miami. FL. USA
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Barnard E, Sheaffer K, Hampton S, Measel ML, Farag A, Shaw C. Ergonomics and Work-Related Musculoskeletal Disorders: Characteristics Among Female Interventionists. Cureus 2021; 13:e18226. [PMID: 34722032 PMCID: PMC8544652 DOI: 10.7759/cureus.18226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 12/11/2022] Open
Abstract
Interventional radiology is a procedural specialty that performs minimally invasive operations under image guidance. Currently, there are inadequate ergonomic protocols for work-related musculoskeletal disorder (WMSD) prevention in interventional radiology (IR), and there is a paucity of information discerning gender differences in WMSDs. This article reviews current literature that addresses WMSDs in female physicians practicing interventional and fluoroscopic procedures, including interventional radiology, interventional cardiology, electrophysiology, vascular surgery, orthopedic surgery, neurosurgery, and gastroenterology. We searched PubMed and EBSCOhost databases for ergonomic studies that reported female physician WMSDs in the specialties listed above. After a thorough evaluation for inclusion based on eligibility criteria, 11 studies were included. From this search, there was poor female representation, averaging 25.7% of respondents. Several characteristics identified across the studies were that women were generally shorter, wore smaller glove sizes, and were younger than their male colleagues. Seventy-two percent of female proceduralists reported WMSDs versus 46.6% of their male colleagues. Additionally, women may experience more upper extremity pain than lumbar pain, which men commonly reported. Potential contributing factors to WMSDs are the size and design of procedural tools and the possible predisposition of female physicians to experience upper extremity WMSDs while performing the same operations as men. As more women enter medicine and pursue careers in procedural fields like interventional radiology, it is essential to address these discrepancies and develop ergonomically sound solutions for women.
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Affiliation(s)
- Emily Barnard
- Medicine, Mercer University School of Medicine, Savannah, USA
| | | | - Sarah Hampton
- Medicine, Mercer University School of Medicine, Savannah, USA
| | - Megan L Measel
- Biomedical Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Ahmed Farag
- Interventional Radiology, Baylor University Medical Center, Dallas, USA
| | - Cathyrn Shaw
- Interventional Radiology, Baylor University Medical Center, Dallas, USA
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42
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Benzo R, Farag A, Whitaker K, Xiao Q, Carr L. A comparison of occupational physical activity and sedentary behavior patterns of nurses working 12-h day and night shifts. International Journal of Nursing Studies Advances 2021. [DOI: 10.1016/j.ijnsa.2021.100028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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43
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Dorgham NA, Hegazy R, Farag A, Dorgham DA. Frontal fibrosing alopecia: a retrospective clinical review of 58 Egyptian patients with treatment outcome and long-term follow-up. J Eur Acad Dermatol Venereol 2021; 36:e212-e213. [PMID: 34657326 DOI: 10.1111/jdv.17747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/30/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022]
Affiliation(s)
- N A Dorgham
- Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - R Hegazy
- Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Farag
- Dermatology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - D A Dorgham
- Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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44
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Farag A, Gaynor JJ, Gaviria FD, Ruiz P, Ciancio G. Nonneoplastic Renal Parenchymal Changes in Renal Cell Carcinoma With Tumor Thrombus. Cureus 2021; 13:e16531. [PMID: 34466305 PMCID: PMC8396416 DOI: 10.7759/cureus.16531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction: Renal cell carcinoma may extend into the inferior vena cava (IVC) by the tumour thrombus (TT). Renal cell carcinoma with tumour thrombus (RCC/TT) could be associated with multiple collaterals making the surgery in cases of venous involvement very complex and challenging. The pathologic findings of non-neoplastic parenchymal changes in radical nephrectomy specimens of RCC/TT have not been well described. Methods: We conducted a retrospective study of 200 nephrectomies for RCC/TT during eight years. We only included 22 patients who had a full histopathological examination of the resected nephrectomies, including the non-neoplastic parenchymal tissues. Results: Median tumour thrombus level was III (range: II-IV), and median tumour diameter was 9.3 (range: 4-17) cm. Clear cell RCC was the most common tumour diagnosis in this cohort. Non-neoplastic renal pathologies included: (1) Global Glomerulosclerosis (GGS) in 90.9% (1-9% GGS in 15, 10-30% GGS in 4, >30% GGS in 1); (2) Interstitial fibrosis in 90.9% (mild in nine, moderate in nine, severe in 2); (3) Acute tubular injury in 14 (63.6%) patients; (4) Chronic inflammation in 77.3% (5-25% in 10, 26-50% in 7); (5) Arteriolosclerosis in all patients (mild, moderate and severe in 12, 9 and 1 patients, respectively); (6) Arteriolosclerosis: as none in 12, mild in six, moderate in four patients; (7) Focal Segmental Glomerulosclerosis in one patient. Our findings suggest that non-neoplastic parenchymal changes occur in the presence of RCC/TT. Neither tumour extension (via T-stage) nor tumour thrombus level were associated with the degree of any of these non-neoplastic parenchymal changes. Conclusions: Knowledge of the existence of these non-neoplastic parenchymal changes in addition to determining the tumour margin(s) will be important in caring for and early determining whether any specific medical intervention(s) to help preserve renal function in the remaining contralateral kidney becomes warranted.
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Affiliation(s)
- Ahmed Farag
- Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, USA.,Surgery, Zagazig University School of Medicine, Zagazig, EGY
| | - Jeffrey J Gaynor
- Surgery, The University of Miami Miller School of Medicine, Miami, USA
| | - Felipe D Gaviria
- Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, USA
| | - Phillip Ruiz
- Surgery, The University of Miami Miller School of Medicine, Miami, USA
| | - Gaetano Ciancio
- Surgery, The University of Miami Miller School of Medicine, Miami, USA
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45
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Ciancio G, Farag A, Salerno T. Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus in Two Patients With Previous Coronary Artery Bypass Graft: Strategy for Surgical Removal. Front Surg 2021; 8:676245. [PMID: 34041262 PMCID: PMC8141792 DOI: 10.3389/fsurg.2021.676245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/09/2021] [Indexed: 11/14/2022] Open
Abstract
Surgical management of renal cell carcinoma (RCC) with tumor thrombus (TT) extending into the inferior vena cava (IVC) and up to the hepatic veins and right atrium (RA) continues to be problematic and a challenging surgical operation. It becomes even more complicated when performing a re-sternotomy and cardiopulmonary bypass (CPB) in patients with previous coronary artery bypass grafting (CABG). Here, we report on two patients with previous CABG who presented with RCC and TT extending into the hepatic vein and above the diaphragm. These two patients underwent successful surgical resection and TT thrombectomy without the need of CBP. Recommendations are made for successfully accomplishing such surgical resections, including adequate prior preparation for the possible need to perform re-sternotomy and CPB with a coordinated team effort.
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Affiliation(s)
- Gaetano Ciancio
- Department of Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States.,Division of Transplantation, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States.,Division of Urology, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States.,Miami Transplant Institute, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ahmed Farag
- Department of Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States.,Division of Transplantation, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States.,Miami Transplant Institute, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States.,Department of Surgery, Zagazig University School of Medicine, Zagazig, Egypt
| | - Tomas Salerno
- Division of Cardiothoracic Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States
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Bessar AA, Nada MG, Wadea FM, Elsayed AE, Farag A, Bessar MA. Hepatic Hilar and Celiac Plexus Nerve Blocks as Analgesia for Doxorubicin-Eluting Microsphere Chemoembolization Procedures for Hepatocellular Carcinoma: A Nonblinded Randomized Clinical Trial. J Vasc Interv Radiol 2021; 32:1179-1185. [PMID: 33974972 DOI: 10.1016/j.jvir.2021.04.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To investigate whether hepatic hilar and celiac plexus nerve blocks provide safe and effective analgesia to patients undergoing doxorubicin-eluting embolics transarterial chemoembolization (DEE-TACE) for hepatocellular carcinoma. MATERIALS AND METHODS In this prospective, randomized trial, 92 patients undergoing DEE-TACE for hepatocellular carcinoma were enrolled. The control group received standard intraprocedural local anesthetic, intra-arterial lidocaine, and intravenous analgesia; the study group underwent additional hepatic hilar and celiac plexus nerve blocks. Intra-arterial lidocaine, intravenous and oral narcotic and antiemetic requirements after the procedure, pain, patient satisfaction, adverse events, and hospital stay were compared. RESULTS The nerve block group reported less pain during and after the procedure at days 1 and 7 (P < .001), although differences resolved by week 2. The control group received more intra-arterial lidocaine (P < .001) and required approximately double the amount of narcotic analgesia during and after the procedure, extending to 3 weeks after the procedure (P < .001), as well as less antiemetics (P < .001). No differences in adverse events, hospital stay, and overall patient satisfaction were noted. CONCLUSIONS Hepatic hilar and celiac plexus nerve blocks before procedures can result in lower pain during and after procedures in patients undergoing DEE-TACE. Furthermore, nerve blocks result in lower opioid consumption and opioid-related complications for 3 weeks following procedures.
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Affiliation(s)
- Ahmed A Bessar
- Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt.
| | - Mohamad G Nada
- Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Fady M Wadea
- Department of Internal Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Ashraf E Elsayed
- Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Farag
- Department of Surgery, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Manar A Bessar
- Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
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Barnard E, Dambaeva A, Gibney B, Tenewitz C, Farag A, Vatakencherry G. Abstract No. 470 “Day in the Life of IR” YouTube Series: recruiting undergraduate and medical students to interventional radiology. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Khayat A, Abboud R, Farag A, Vatakencherry G. Abstract No. 140 Impact of program director panel on medical student confidence in the NRMP during the COVID-19 pandemic. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Raissi D, Yu Q, Gabriel G, Acosta L, Myers B, Farag A. Abstract No. 120 Single-center large series of transpulmonary/transpleural hepatic tumor microwave ablation: safety and efficacy of the “lung seal technique”. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ciancio G, Farag A, Gaynor JJ, Morsi M, Chen L, Burke GW. Midline Rotation of the Right Renal Hilum During Hand-Assisted Laparoscopic Living Donor Nephrectomy. JSLS 2021; 25:e2021.00018. [PMID: 34248334 PMCID: PMC8241287 DOI: 10.4293/jsls.2021.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND/OBJECTIVES Laparoscopic living donor nephrectomy (LLDN) of the right kidney is currently considered as part of standard of care; however, dealing with the renal hilum when performing ligation/division of its renal vessels is still a main concern. Here, we describe a simple-to-perform technique, i.e., flipping the fully mobilized right kidney to the midline so that the renal artery becomes anteriorly, which offers better visualization and easier dissection of the renal vessels (achieving maximized lengths) when performing hand-assisted LLDN of the right kidney. METHODS Living donors who underwent hand-assisted LLDN of the right kidney, along with their respective renal transplant recipients, were included in this report. Donor characteristics included renal artery and vein lengths; recipient characteristics included creatinine at months 12 - 36. Graft vein and arterial anastomosis data were also reported. RESULTS Nineteen living donors and 19 recipients, with median donor and recipient ages being 39 (24 - 60) and 53 (3 - 81) years, respectively, were included. None of the 38 patients had intra- or postoperative complications. Donor renal vein was anastomosed to the right external iliac vein (n = 16), right common iliac vein (n = 2), and inferior vena cava (n = 1). Gonadal vein (n = 1) and deceased donor iliac vein (n = 2) were used to increase the right renal vein length in 3 cases. Four donor kidneys had 2 arteries reconstructed side by side. None of the recipients developed any vascular or urological complications. CONCLUSIONS The laparoscopic technique described is safe and allows better visualization of the right hilum, mainly the renal artery, and helps in stapling the renal vein and renal artery.
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Affiliation(s)
- Gaetano Ciancio
- Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL
| | - Ahmed Farag
- Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL
| | - Jeffrey J Gaynor
- Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL
| | - Mahmoud Morsi
- Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL
| | - Linda Chen
- Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL
| | - George W Burke
- Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL
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