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Gheita TA, Raafat HA, El-Bakry SA, Elsaman A, El-Saadany HM, Hammam N, El-Gazzar II, Samy N, Elsaid NY, Al-Adle SS, Tharwat S, Ibrahim AM, Fawzy SM, Eesa NN, Shereef RE, Ismail F, Elazeem MIA, Abdelaleem EA, El-Bahnasawy A, Selim ZI, Gamal NM, Nassr M, Nasef SI, Moshrif AH, Elwan S, Abdel-Fattah YH, Amer MA, Mosad D, Mohamed EF, El-Essawi DF, Taha H, Salem MN, Fawzy RM, Ibrahim ME, Khalifa A, Abaza NM, Abdalla AM, El-Najjar AR, Azab NA, Fathi HM, El-Hadidi K, El-Hadidi T. Rheumatoid arthritis study of the Egyptian College of Rheumatology (ECR): nationwide presentation and worldwide stance. Rheumatol Int 2023; 43:667-676. [PMID: 36617362 PMCID: PMC9995404 DOI: 10.1007/s00296-022-05258-2] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/04/2022] [Indexed: 01/09/2023]
Abstract
To depict the spectrum of rheumatoid arthritis (RA) in Egypt in relation to other universal studies to provide broad-based characteristics to this particular population. This work included 10,364 adult RA patients from 26 specialized Egyptian rheumatology centers representing 22 major cities all over the country. The demographic and clinical features as well as therapeutic data were assessed. The mean age of the patients was 44.8 ± 11.7 years, disease duration 6.4 ± 6 years, and age at onset 38.4 ± 11.6 years; 209 (2%) were juvenile-onset. They were 8750 females and 1614 males (F:M 5.4:1). 8% were diabetic and 11.5% hypertensive. Their disease activity score (DAS28) was 4.4 ± 1.4 and health assessment questionnaire (HAQ) 0.95 ± 0.64. The rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) were positive in 73.7% and 66.7% respectively. Methotrexate was the most used treatment (78%) followed by hydroxychloroquine (73.7%) and steroids (71.3%). Biologic therapy was received by 11.6% with a significantly higher frequency by males vs females (15.7% vs 10.9%, p = 0.001). The least age at onset, F:M, RF and anti-CCP positivity were present in Upper Egypt (p < 0.0001), while the highest DAS28 was reported in Canal cities and Sinai (p < 0.0001). The HAQ was significantly increased in Upper Egypt with the least disability in Canal cities and Sinai (p = 0.001). Biologic therapy intake was higher in Lower Egypt followed by the Capital (p < 0.0001). The spectrum of RA phenotype in Egypt is variable across the country with an increasing shift in the F:M ratio. The age at onset was lower than in other countries.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Hala A Raafat
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samah A El-Bakry
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Ahmed Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Nora Y Elsaid
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Suzan S Al-Adle
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Amira M Ibrahim
- Rheumatology Department, Faculty of Medicine, Kafr El-Skeikh University, Kafr El-Shaikh, Egypt
| | - Samar M Fawzy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rawhya El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mervat I Abd Elazeem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Enas A Abdelaleem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Amany El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Zahraa I Selim
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Nada M Gamal
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Maha Nassr
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Abdel Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Shereen Elwan
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Marwa A Amer
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa Mosad
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
| | - Dina F El-Essawi
- Internal Medicine Department, Rheumatology Unit (NCRRT), Atomic Energy Authority (AEA), Cairo, Egypt
| | - Hanan Taha
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Rasha M Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Kalyoubia, Egypt
| | - Maha E Ibrahim
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Asmaa Khalifa
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Nouran M Abaza
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Noha A Azab
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Khaled El-Hadidi
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tahsin El-Hadidi
- Rheumatology Department, Military Academy, Agouza Rheumatology Center, Giza, Egypt
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Taha AMI, Abdalla AM, Hassan RA, Elkhateb AI, Ali AM. Outflow Reconstruction in Right Lobe Living Donor Liver Transplant: Middle Hepatic Vein Reconstruction Versus Separate Tributaries to Inferior Vena Cava Anastomosis. EXP CLIN TRANSPLANT 2023; 21:245-250. [PMID: 36987800 DOI: 10.6002/ect.2022.0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
OBJECTIVES In right lobe living donor liver transplant, proper reconstruction of the segment 5 vein and segment 8 vein is essential. Herein, we compared 2 different techniques for segment 5 vein reconstruction. MATERIALS AND METHODS This prospective nonrandomized study included all recipients of modified right lobe living donor liver transplant who had reconstruction of the segment 5 vein, with or without segment 8 veins, from October 2018 to October 2021. Patients were grouped into group A (classical technique) and group B (modified technique). For group A, the segment 5 (and segment 8, if present) vein was anastomosed in an end-to-side fashion to a polytetrafluoroethylene synthetic graft positioned parallel to the cut surface of the liver graft; then, during implant, its proximal end was anastomosed to recipient's middle hepatic or middle-left hepatic veins unified orifice. In group B (modified technique), the stumps of segment 5 (and segment 8 if present) were anastomosed in an end-to-end fashion to 2 different polytetrafluoroethylene grafts; then during implant, the other ends of the segment 5 grafts were anastomosed directly to the inferior vena cava. Postoperative segment 5 vein patency and graft recovery were compared. RESULTS Forty patients were included: 22 in group A and 18 group B. There were no significant differences in the demographic data or characteristics of donors, grafts, and recipients between the groups. There was better patency in segment 5 synthetic grafts in group A at all time points compared with group B, but this difference was statistically significant only at 1 month (18 [81.8%] vs 9 [50%, respectively; P = .046).There was no statistically significant difference in the markers of graft recovery in both groups. CONCLUSIONS Reconstruction of the segment 5 vein by polytetrafluoroethylene synthetic graft in a fashion to resemble the native middle hepatic vein in modified right lobe living donor liver transplant has better patency than anastomosis of the segment 5 vein in an end-to-end fashion to the synthetic graft and then to the inferior vena cava. Both techniques did not affect graft recovery.
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Affiliation(s)
- Ahmed M I Taha
- From the HPB Surgery and Liver Transplantation Unit, Surgery Department, El-Rajhi Liver Hospital, Assiut University, Egypt
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3
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Hammam N, Bakhiet A, El-Latif EA, El-Gazzar II, Samy N, Noor RAA, El-Shebeiny E, El-Najjar AR, Eesa NN, Salem MN, Ibrahim SE, El-Essawi DF, Elsaman AM, Fathi HM, Sallam RA, El Shereef RR, Ismail F, Abd-Elazeem MI, Said EA, Khalil NM, Shahin D, El-Saadany HM, ElKhalifa M, Nasef SI, Abdalla AM, Noshy N, Fawzy RM, Saad E, Moshrif A, El-Shanawany AT, Abdel-Fattah YH, Khalil HM, Hammam O, Fathy AA, Gheita TA. Development of machine learning models for detection of vision threatening Behçet's disease (BD) using Egyptian College of Rheumatology (ECR)-BD cohort. BMC Med Inform Decis Mak 2023; 23:37. [PMID: 36803463 PMCID: PMC9938580 DOI: 10.1186/s12911-023-02130-6] [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: 08/07/2022] [Accepted: 02/03/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Eye lesions, occur in nearly half of patients with Behçet's Disease (BD), can lead to irreversible damage and vision loss; however, limited studies are available on identifying risk factors for the development of vision-threatening BD (VTBD). Using an Egyptian college of rheumatology (ECR)-BD, a national cohort of BD patients, we examined the performance of machine-learning (ML) models in predicting VTBD compared to logistic regression (LR) analysis. We identified the risk factors for the development of VTBD. METHODS Patients with complete ocular data were included. VTBD was determined by the presence of any retinal disease, optic nerve involvement, or occurrence of blindness. Various ML-models were developed and examined for VTBD prediction. The Shapley additive explanation value was used for the interpretability of the predictors. RESULTS A total of 1094 BD patients [71.5% were men, mean ± SD age 36.1 ± 10 years] were included. 549 (50.2%) individuals had VTBD. Extreme Gradient Boosting was the best-performing ML model (AUROC 0.85, 95% CI 0.81, 0.90) compared with logistic regression (AUROC 0.64, 95%CI 0.58, 0.71). Higher disease activity, thrombocytosis, ever smoking, and daily steroid dose were the top factors associated with VTBD. CONCLUSIONS Using information obtained in the clinical settings, the Extreme Gradient Boosting identified patients at higher risk of VTBD better than the conventional statistical method. Further longitudinal studies to evaluate the clinical utility of the proposed prediction model are needed.
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Affiliation(s)
- Nevin Hammam
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Ali Bakhiet
- Computer Science Department, Higher Institute of Computer Science and Information Systems, Culture and Science City, Giza, Egypt
| | - Eiman Abd El-Latif
- grid.7155.60000 0001 2260 6941Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Iman I. El-Gazzar
- grid.7776.10000 0004 0639 9286Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nermeen Samy
- grid.7269.a0000 0004 0621 1570Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Rasha A. Abdel Noor
- grid.412258.80000 0000 9477 7793Rheumatology Unit, Internal Medicine Department, Tanta University, Gharbia, Egypt
| | - Emad El-Shebeiny
- grid.411775.10000 0004 0621 4712Rheumatology Unit, Internal Medicine Department, Menoufia University, Menoufia, Egypt
| | - Amany R. El-Najjar
- grid.31451.320000 0001 2158 2757Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Nahla N. Eesa
- grid.7776.10000 0004 0639 9286Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed N. Salem
- grid.411662.60000 0004 0412 4932Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Soha E. Ibrahim
- grid.7269.a0000 0004 0621 1570Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dina F. El-Essawi
- grid.429648.50000 0000 9052 0245Internal Medicine Department, Rheumatology and Rehabilitation Clinic, National Centre for Radiation Research and Technology, Egyptian Atomic Energy Authority (AEA), Cairo, Egypt
| | - Ahmed M. Elsaman
- grid.412659.d0000 0004 0621 726XRheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanan M. Fathi
- grid.411170.20000 0004 0412 4537Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Rehab A. Sallam
- grid.10251.370000000103426662Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Rawhya R. El Shereef
- grid.411806.a0000 0000 8999 4945Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Faten Ismail
- grid.411806.a0000 0000 8999 4945Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mervat I. Abd-Elazeem
- grid.411662.60000 0004 0412 4932Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Emtethal A. Said
- grid.411660.40000 0004 0621 2741Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Noha M. Khalil
- grid.7776.10000 0004 0639 9286Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina Shahin
- grid.10251.370000000103426662Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Hanan M. El-Saadany
- grid.412258.80000 0000 9477 7793Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Marwa ElKhalifa
- grid.7155.60000 0001 2260 6941Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samah I. Nasef
- grid.33003.330000 0000 9889 5690Rheumatology and Rehabilitation Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Ahmed M. Abdalla
- grid.417764.70000 0004 4699 3028Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Nermeen Noshy
- grid.411660.40000 0004 0621 2741Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Rasha M. Fawzy
- grid.411660.40000 0004 0621 2741Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Ehab Saad
- grid.412707.70000 0004 0621 7833Rheumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Abdelhafeez Moshrif
- grid.411303.40000 0001 2155 6022Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt
| | - Amira T. El-Shanawany
- grid.411775.10000 0004 0621 4712Rheumatology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Yousra H. Abdel-Fattah
- grid.7155.60000 0001 2260 6941Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hossam M. Khalil
- grid.411662.60000 0004 0412 4932Ophthalmology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Osman Hammam
- grid.252487.e0000 0000 8632 679XDepartment of Rheumatology and Rehabilitation, Faculty of Medicine, New Valley University, New Valley, Egypt
| | - Aly Ahmed Fathy
- grid.252487.e0000 0000 8632 679XOphthalmology Department, Faculty of Medicine, Al-Azhar Assiut University, Assiut, Egypt
| | - Tamer A. Gheita
- grid.7776.10000 0004 0639 9286Rheumatology Department, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
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ElAdle SS, Latif EA, Abdel-Fattah YH, Shebini EE, El-Gazzar II, El-Saadany HM, Samy N, El-Mallah R, Salem MN, Eesa N, Shereef RE, El Khalifa M, Tharwat S, Nasef SI, Ibrahim ME, Khalil NM, Abdalla AM, Abd Elazeem MI, Noor RA, Sallam R, El-Bahnasawy A, Shanawany AE, Senara S, Fathi HM, Bakry SAE, Elsaman A, Najjar AE, Ragab U, Talaat EA, Hammam N, El-Hindawy AK, Gheita TA, Ismail F. Metabolic Syndrome in Behçets Disease Patients: Keep an Eye on the Eye. Curr Rheumatol Rev 2023; 19:180-188. [PMID: 35692166 DOI: 10.2174/1573397118666220610123242] [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: 01/21/2022] [Revised: 03/31/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is characterized by insulin resistance, high blood pressure/ sugar, dyslipidemia, and obesity. Whether MetS and its components affect the development of Behçet's Disease (BD) remains unclear. AIMS The aim was to determine the frequency of MetS among BD patients and to study its relationship with disease characteristics. METHODS The study included 1028 adult BD patients recruited from 18 specialized rheumatology centers. 51 healthy matched control were considered. Behçet Disease Current Activity Form (BDCAF) and the BD damage index (BDI) were estimated. Adult Treatment Panel-III criteria were used to define MetS. RESULTS The mean age of patients was 36.8 ± 10.1 years, M:F 2.7:1 and disease duration 7.01 ± 5.2 years. Their mean BDCAF was 5.1 ± 4.6 and BDI 5.5 ± 2.8. MetS was present in 22.8% of patients and in 5.9% of control (3.9 fold higher-risk). Patients with MetS had a significantly increased age at onset (31.8 ± 9.2 vs. 29 ± 8.5 years) and higher frequency of genital ulcers (96.2% vs. 79.7%), skin involvement (73.1% vs. 50.4%), arthritis (48.3% vs. 29.1%) (p<0.0001) and CNS manifestations (18.8% vs. 13%) (p=0.042) compared to those without it. Eye involvement was significantly increased in those with MetS (82.1% vs. 74.2%) (p=0.003) with increased frequency of posterior uveitis (67.1% vs. 43.5%), retinal vessel occlusion (35.9% vs. 21.3%), retinal vasculitis (41.9% vs. 26.4%) (p<0.0001) and vitritis (37.2% vs. 24%) (p=0.001). BDCAF was significantly lower (3.9 ± 4.3 vs. 5.6 ± 4.6) and BDI higher (7.4 ± 2.7vs5 ± 2.6) (p<0.0001). CONCLUSION BD patients with MetS are predisposed to mucocutaneous, musculoskeletal, neuropsychiatric and ocular manifestations with consequently increased damage. The involvement of the deeper structures of the eye should alarm rheumatologists to keep in mind that all patients should have an eye examination, especially those with MetS.
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Affiliation(s)
- Suzan S ElAdle
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eiman Abdel Latif
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Emad El Shebini
- Internal Medicine Department, Rheumatology Unit, Menoufia University, Menoufia, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Faculty of Medicine, Rheumatology Unit, Ain-Shams University, Cairo, Egypt
| | - Reem El-Mallah
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Faculty of Medicine, Rheumatology Unit, Beni-Suef University, Beni-Suef, Egypt
| | - Nahla Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rawhya El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Marwa El Khalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Rheumatology Unit, Dakahlia, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Maha Emad Ibrahim
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Faculty of Medicine, Cairo University, Rheumatology Unit, Cairo, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mervat I Abd Elazeem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Rasha Abdel Noor
- Internal Medicine Department, Rheumatology Unit, Tanta University, Gharbia, Egypt
| | - Rehab Sallam
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Amany El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Amira El Shanawany
- Rheumatology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Soha Senara
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Samah A El Bakry
- Internal Medicine Department, Faculty of Medicine, Rheumatology Unit, Ain-Shams University, Cairo, Egypt
| | - Ahmed Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amany El Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Usama Ragab
- Internal Medicine Department, Clinical Immunology Unit, Zagazig University, Sharkia, Egypt
| | - Esraa A Talaat
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Aya K El-Hindawy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
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5
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Eesa NN, Abdel Nabi H, Owaidy RE, Khalifa I, Radwan AR, NourEl-Din AM, Amer MA, ElShereef RR, Hassan E, Ismail F, El-Gazzar II, Khalil NM, Moshrif AH, Abualfadl E, Tharwat S, Fathi HM, Abd Elazeem MI, El-Shebini E, Samy N, Noshy N, El-Bahnasawy AS, Abdalla AM, Abousehly OS, Mohamed EF, Nasef SI, Elsaman AM, ElKhalifa M, Salem MN, Abaza NM, Fathy HM, Abdel Salam N, El-Saadany HM, El-Najjar AR, El-Hammady DH, Hammam N, Mohammed RH, Gheita TA. Systemic lupus erythematosus children in Egypt: Homeland spectrum amid the global situation. Lupus 2021; 30:2135-2143. [PMID: 34528835 DOI: 10.1177/09612033211043010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This study aims to present the manifestations of juvenile systemic lupus erythematosus (JSLE) across Egypt, to focus on age at onset and gender-driven influence on disease characteristics, and to compare findings to other countries. METHODS The study included 404 Egyptian children with systemic lupus erythematosus (SLE) presenting to one of the specialized rheumatology centers corresponding to 13 major governorates. Juvenile cases age was ≤ 16°years at the time of recruitment. The SLE Disease Activity Index (SLEDAI) and damage index (DI) were assessed. RESULTS The mean age was 13.2 ± 2.4°years; 355 females and 49 males (7.2:1), and the disease duration was 2.3 ± 1.6 years, while age at disease onset was 11.1 ± 2.5°years. Their SLEDAI was 13.5 ± 12.3, and DI, 0.36 ± 0.78. The overall estimated prevalence of childhood-SLE patients in the recruited cohort in Egypt was 1/100,000 population (0.24/100000 males and 1.8/100000 females). 7.4% developed pre-pubertal SLE (≤ 7 years); 73.3%, peri-pubertal; and 19.3% during early adolescence. The differences according to age group were equal for gender and clinical manifestations except skin lesions present in 59.3% of pre-pubertal onset, 74.6% of peri-pubertal, and 84.2% of adolescents (p = 0.029), and renal involvement in 73.8% of peripubertal, 62.1% of pre-pubertal and 58.9% of adolescents (p = 0.03). Laboratory investigations, SLEDAI, and DI were similar among age categories. Lupus nephritis was more common in Egypt compared to JSLE from other countries. CONCLUSION Our large multicenter study identified that female gender influenced disease characteristics with more frequent skin involvement. Skin lesions were significantly higher in adolescents, while renal involvement in peri-pubertal children.
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Affiliation(s)
- Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hend Abdel Nabi
- Pediatrics Department, Rheumatology and Nephrology Unit, 68782Tanta University, Gharbia, Egypt
| | - Rasha El Owaidy
- Pediatrics Department, Rheumatology Unit, 68792Ain Shams University, Cairo, Egypt
| | - Iman Khalifa
- Pediatrics Department, Rheumatology and Nephrology Unit, 68900Helwan University, Cairo, Egypt
| | - Ahmed R Radwan
- Rheumatology Department, Faculty of Medicine, 68889Sohag University, Sohag, Egypt
| | - Abeer M NourEl-Din
- Pediatrics Department, 68787National Research Centre (NRC), Cairo, Egypt
| | - Marwa A Amer
- Rheumatology Department, Faculty of Medicine, 68789Alexandria University, Alexandria, Egypt
| | - Rawhya R ElShereef
- Rheumatology Department, Faculty of Medicine, 68877Minia University, Minia, Egypt
| | - Eman Hassan
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, 68789Alexandria University, Egypt
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, 68877Minia University, Minia, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, 63527Cairo University, Cairo, Egypt
| | - Abdel Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, 68820Al-Azhar University, Assuit, Egypt
| | - Esam Abualfadl
- Pediatrics Department, Rheumatology and Nephrology Unit, 68900Helwan University, Cairo, Egypt
- Qena/Luxor hospitals, Qena, Egypt
| | - Samar Tharwat
- Internal Medicine, Rheumatology Unit, 68780Mansoura University, Dakahlia, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, 158405Fayoum University, Fayoum, Egypt
| | - Mervat I Abd Elazeem
- Rheumatology Department, Faculty of Medicine, 158411Beni-Suef University, Beni-Suef, Egypt
| | - Emad El-Shebini
- Internal Medicine Department, Rheumatology Unit, 68872Menoufiya University, Menoufiya, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, 68792Ain-Shams University, Cairo, Egypt
| | - Nermeen Noshy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, 68792Ain-Shams University, Cairo, Egypt
| | - Amany S El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, 68780Mansoura University, Dakahlia, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, 435387Aswan University, Aswan, Egypt
| | - Osama S Abousehly
- Rheumatology Department, Faculty of Medicine, 68889Sohag University, Sohag, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), 68820Al-Azhar University, Cairo, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Ahmed M Elsaman
- Rheumatology Department, Faculty of Medicine, 68889Sohag University, Sohag, Egypt
| | - Marwa ElKhalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, 68789Alexandria University, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, 158411Beni-Suef University, Beni-Suef, Egypt
| | - Nouran M Abaza
- Rheumatology Department, Faculty of Medicine, 68792Ain Shams University, Cairo, Egypt
| | - Hanan M Fathy
- Pediatrics Department, Rheumatology and Nephrology Unit, 68789Alexandria University, Alexandria, Egypt
| | - Nancy Abdel Salam
- Pediatrics Department, Rheumatology and Nephrology Unit, 68789Alexandria University, Alexandria, Egypt
| | | | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, 68799Zagazig University, Sharkia, Egypt
| | - Dina H El-Hammady
- Rheumatology Department, Faculty of Medicine, 68900Helwan University, Cairo, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, 68797Assuit University, Assuit, Egypt
- Rheumatology Department, 8785University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Reem Ha Mohammed
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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6
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Gheita TA, Hammam N, Fawzy SM, Abd El-Latif E, El-Gazzar II, Samy N, El-Hammady DH, Abdel Noor R, El-Shebini E, El-Najjar AR, Eesa NN, Salem MN, Ibrahim SE, El-Essawi DF, Elsaman AM, Senara S, Fathi HM, Sallam RA, El Shereef RR, Abd Elazeem MI, Fawzy RM, Khalil NM, Shahin D, El-Saadany HM, ElKhalifa M, Nasef SI, Abdalla AM, Noshy N, Said EA, Saad E, Moshrif AH, El-Shanawany AT, Abdel-Fattah YH, Raafat HA, Khalil HM. Development and validation of a Behçet's Disease Damage Index for adults with BD: An Explicit, Composite and Rated (ECR) tool. Int J Rheum Dis 2021; 24:1071-1079. [PMID: 34288457 DOI: 10.1111/1756-185x.14166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/19/2021] [Revised: 05/12/2021] [Accepted: 06/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Behçet's disease (BD) is a chronic multisystem variable vessel vasculitis. Disease damage is irreversible and permanent. Validated tools evaluating damage are limited. Enhancements in the clinical treatment of vasculitis will take place from the development of refined and exclusive indices for individual vasculitic syndromes including BD and attempting their international validation. OBJECTIVES This aim was to develop and validate a simple BD Damage Index (BDI). METHODS This was a nationwide study including 1252 BD patients. The work consisted of 3 stages. Stage 1: items generation for score content. Stage 2: items selection for the draft score was performed by an expert rheumatologist. Stage 3: the content validity of the draft score was assessed and BDI, Vasculitis Damage Index (VDI), Antineutrophil cytoplasmic antibody-associated Vasculitis Index of Damage (AVID) and Combined Damage Assessment Index (CDAI) were calculated and compared. RESULTS The mean age of the BD patients was 36.1 ± 9.9 years. Stages 1 and 2 resulted in a BDI instrument containing 73 items with a maximum score of 100. Stage 3, the VDI, CDAI, AVID, and BDI were 2.9 ± 2.2, 3.1 ± 2.3, 3.1 ± 2.3 and 5.1 ± 2.9, respectively. High correlations (r = .9) between comparable damage scores assured acceptable concurrent validity. CONCLUSION The proposed BDI represents a new robust and potentially useful tool when dealing with BD chronic status.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt.,Division of Rheumatology, University of California San Francisco, San Francisco, CA, USA
| | - Samar M Fawzy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eiman Abd El-Latif
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nermeen Samy
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Dina H El-Hammady
- Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Rasha Abdel Noor
- Internal Medicine Department, Rheumatology Unit, Tanta University, Gharbia, Egypt
| | - Emad El-Shebini
- Internal Medicine Department, Rheumatology Unit, Menoufia University, Menoufia, Egypt
| | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed N Salem
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Soha E Ibrahim
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dina F El-Essawi
- Rheumatology Unit (NCRRT), Internal Medicine Department, Atomic Energy Authority (AEA), Cairo, Egypt
| | - Ahmed M Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Soha Senara
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Rehab A Sallam
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Rawhya R El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mervat I Abd Elazeem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Rasha M Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Noha M Khalil
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina Shahin
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Marwa ElKhalifa
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt.,Division of Rheumatology, Internal Medicine Department III, Medical University of Vienna, Vienna, Austria
| | - Nermeen Noshy
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Emtethal A Said
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Ehab Saad
- Rheumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Abdel Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt
| | - Amira T El-Shanawany
- Rheumatology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hala A Raafat
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hossam M Khalil
- Ophthalmology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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7
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Gheita TA, Noor RA, Abualfadl E, Abousehly OS, El-Gazzar II, El Shereef RR, Senara S, Abdalla AM, Khalil NM, ElSaman AM, Tharwat S, Nasef SI, Mohamed EF, Noshy N, El-Essawi DF, Moshrif AH, Fawzy RM, El-Najjar AR, Hammam N, Ismail F, ElKhalifa M, Samy N, Hassan E, Abaza NM, ElShebini E, Fathi HM, Salem MN, Abdel-Fattah YH, Saad E, Abd Elazim MI, Eesa NN, El-Bahnasawy AS, El-Hammady DH, El-Shanawany AT, Ibrahim SE, Said EA, El-Saadany HM, Selim ZI, Fawzy SM, Raafat HA. Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint. Lupus 2021; 30:1526-1535. [PMID: 33951965 DOI: 10.1177/09612033211014253] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. PATIENTS AND METHOD This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. RESULTS The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17-79 years), disease duration 4 years (0-75 years) while the median age at disease onset was 25 years (4-75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). CONCLUSION SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rasha Abdel Noor
- Internal Medicine Department, Rheumatology Unit, Tanta University, Gharbia, Egypt
| | - Esam Abualfadl
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.,Qena/Luxor Hospitals, Qena, Egypt
| | - Osama S Abousehly
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rawhya R El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Soha Senara
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed M ElSaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Samar Tharwat
- Rheumatology Unit, Internal Medicine, Mansoura University, Dakahlia, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
| | - Nermeen Noshy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Dina F El-Essawi
- Internal Medicine Department, Rheumatology Unit, Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt
| | - Abdel Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt
| | - Rasha M Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt.,Rheumatology Department, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Marwa ElKhalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Eman Hassan
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nouran M Abaza
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Emad ElShebini
- Internal Medicine Department, Rheumatology Unit, Menoufiya University, Menoufiya, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ehab Saad
- Rheumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mervat I Abd Elazim
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amany S El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Dina H El-Hammady
- Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Amira T El-Shanawany
- Rheumatology Department, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
| | - Soha E Ibrahim
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Emtethal A Said
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt
| | - Zahraa I Selim
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Samar M Fawzy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala A Raafat
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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8
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El-Berry MF, Sadeek SA, Abdalla AM, Nassar MY. Facile, controllable, chemical reduction synthesis of copper nanostructures utilizing different capping agents. INORG NANO-MET CHEM 2020. [DOI: 10.1080/24701556.2020.1837162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mohamed F. El-Berry
- Chemistry Department, Faculty of Science, Zagazig University, Zagazig, Egypt
- Military Technical Research Centre, Cairo, Egypt
| | - Sadeek A. Sadeek
- Chemistry Department, Faculty of Science, Zagazig University, Zagazig, Egypt
| | | | - Mostafa Y. Nassar
- Chemistry Department, Faculty of Science, Benha University, Benha, Egypt
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9
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Gheita TA, Salem MN, Eesa NN, Khalil NM, Gamal NM, Noor RA, Moshrif AH, Shereef RE, Ismail F, Noshy N, Fawzy RM, Elshebini E, Khalifa I, Saadany HE, Tharwat S, El-Najjar A, Fattah YA, Sallam R, El-Bahnasawy AS, Gharbia O, Hassan E, ElShanawany A, Mohamed EF, Senara S, Ismail M, Nasef SI, Abdalla AM, Elessawi D, Fawzy SM, Alfadl EA, Khalifa A, Abaza NM. Rheumatologists' practice during the Coronavirus disease 2019 (COVID-19) pandemic: a survey in Egypt. Rheumatol Int 2020; 40:1599-1611. [PMID: 32710198 PMCID: PMC7380140 DOI: 10.1007/s00296-020-04655-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Received: 06/06/2020] [Accepted: 07/11/2020] [Indexed: 12/18/2022]
Abstract
The aim of this work is to trace how rheumatologists all over Egypt are approaching the COVID-19 pandemic and what changes it has brought about in the patients' care with special attention to its effect on vulnerable rheumatic disease (RD) patients. This survey further aims to help inform the rheumatology community about the changes in practice during the COVID-19 pandemic. The survey included 26 questions distributed to University staff members across Egypt members of the Egyptian College of Rheumatology (ECR). It takes 5-10 min to fill out. The practice setting of participating rheumatologists included University Teaching Hospitals that are the main rheumatology and clinical immunology service providers for adults and children RD patients. There was an overall agreement across the country in the responses to the survey that took a median time of 7 min to fill in. Potential changes in rheumatology outpatient practice by staff members evolved since the COVID-19 pandemic. None of the university rheumatology staff members has prescribed chloroquine or HCQ to prevent or treat COVID-19 in a non-hospitalized patient who was not previously on it. Twenty-three recommended decrease/avoid NSAIDs if the RD patient had confirmed COVID-19 or symptoms. There is an agreement to the key emerging frontline role of rheumatologists in treating COVID-19. During the pandemic, RD cases requiring admission were dealt with by several modified strategies. The overall agreement among the different university rheumatology departments during such critical situation has provoked the ECR to consider providing provisional guidelines for dealing with RD patients during this global catastrophe.
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Affiliation(s)
- Tamer A. Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed N. Salem
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Nahla N. Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha M. Khalil
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nada M. Gamal
- Rheumatology Department, Faculty of Medicine, Assuit University, Asyut, Egypt
| | - Rasha Abdel Noor
- Rheumatology Unit, Internal Medicine Department, Tanta University, Gharbia, Tanta, Egypt
| | | | - Rawhya El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Nermeen Noshy
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Rasha M. Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Benha, Egypt
| | - Emad Elshebini
- Rheumatology Unit, Internal Medicine Department, Menoufiya University, Menoufiya, Egypt
| | - Iman Khalifa
- Pediatric Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Hanan El Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Tanta, Egypt
| | - Samar Tharwat
- Rheumatology Unit Internal Medicine Department, Faculty of Medicine, Mansoura University, Dakahlia, Mansoura, Egypt
| | - Amany El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Zagazig, Egypt
| | - Yousra Abdel Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rehab Sallam
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Mansoura, Egypt
| | - Amany S. El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Mansoura, Egypt
| | - Ola Gharbia
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Mansoura, Egypt
| | - Eman Hassan
- Rheumatology Unit Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amira ElShanawany
- Rheumatology Department, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
| | - Eman F. Mohamed
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Soha Senara
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mervat Ismail
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Samah I. Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Ahmed M. Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Dina Elessawi
- Rheumatology Unit Internal Medicine Department, Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt
| | - Samar M. Fawzy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Esam Abu Alfadl
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
- Qena/Luxor Hospitals, Qena, Egypt
| | - Asmaa Khalifa
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Nouran M. Abaza
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - The ECR COVID19-Study Group
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Rheumatology Department, Faculty of Medicine, Assuit University, Asyut, Egypt
- Rheumatology Unit, Internal Medicine Department, Tanta University, Gharbia, Tanta, Egypt
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Asyut, Egypt
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Benha, Egypt
- Rheumatology Unit, Internal Medicine Department, Menoufiya University, Menoufiya, Egypt
- Pediatric Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Tanta, Egypt
- Rheumatology Unit Internal Medicine Department, Faculty of Medicine, Mansoura University, Dakahlia, Mansoura, Egypt
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Zagazig, Egypt
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Mansoura, Egypt
- Rheumatology Unit Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Rheumatology Department, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
- Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
- Rheumatology Unit Internal Medicine Department, Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
- Qena/Luxor Hospitals, Qena, Egypt
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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10
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Alghamdi MA, Al-Eitan LN, Elsy B, Abdalla AM, Mutwakil Mohammed H, Salih AGA, Al Hilal Al Ghamdi S. Aberrant right subclavian artery in a cadaver: a case report of an aortic arch anomaly. Folia Morphol (Warsz) 2020; 80:726-729. [PMID: 32748949 DOI: 10.5603/fm.a2020.0081] [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: 04/18/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 11/25/2022]
Abstract
In early embryogenesis, aortic anomalies occur as a consequence of disorders in the development of the primitive aortic arches system. Aberrant right subclavian artery, also known as arteria lusoria, is one of the important congenital anomalies of the aortic arch, in which the right subclavian artery arises from the arch of aorta instead of the brachiocephalic trunk. During routine dissection of a female cadaver, we observed retro-oesophageal aberrant right subclavian artery arising as the fourth branch from the aortic arch. In this case, the brachiocephalic trunk was absent. Early detection of aortic arch anomalies through diagnostic interventions is helpful to avoid complications during surgical procedures.
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Affiliation(s)
- M A Alghamdi
- Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia. .,Genomics and Personalised Medicine Unit, College of Medicine, King Khalid University, Abha, Saudi Arabia.
| | - L N Al-Eitan
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid, Jordan.,Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - B Elsy
- Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - A M Abdalla
- Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - H Mutwakil Mohammed
- Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - A G A Salih
- Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - S Al Hilal Al Ghamdi
- Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia
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11
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Gheita TA, El-Latif EA, El-Gazzar II, Samy N, Hammam N, Abdel Noor RA, El-Shebeiny E, El-Najjar AR, Eesa NN, Salem MN, Ibrahim SE, El-Essawi DF, Elsaman AM, Fathi HM, Sallam RA, El-Shereef RR, Abd-Elazeem MI, Said EA, Khalil NM, Shahin D, El-Saadany HM, ElKhalifa MS, Nasef SI, Abdalla AM, Noshy N, Fawzy RM, Saad E, Moshrif AH, El-Shanawany AT, Abdel-Fattah YH, Khalil HM. Correction to: Behçet's disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature. Clin Rheumatol 2019; 38:2649-2650. [PMID: 31302857 DOI: 10.1007/s10067-019-04653-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The author wishes to correct the record and clarify that in the original version of this article in the Discussion section under "Prevalence over the country governorates" inadvertently presented incorrect data cited in the reference [30].
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Eiman Abd El-Latif
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt.,Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Rasha A Abdel Noor
- Internal Medicine Department, Rheumatology Unit, Tanta University, Tanta, Gharbia, Egypt
| | - Emad El-Shebeiny
- Internal Medicine Department, Rheumatology Unit, Menoufia University, Shebeen El-Kom, Menoufia, Egypt
| | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Soha E Ibrahim
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dina F El-Essawi
- Internal Medicine Department, Rheumatology Unit (NCRRT), Atomic Energy Authority (AEA), Cairo, Egypt
| | - Ahmed M Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Rehab A Sallam
- Rheumatology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - Rawhya R El-Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mervat I Abd-Elazeem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Emtethal A Said
- Rheumatology Department, Faculty of Medicine, Benha University, Benha, Kalubia, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina Shahin
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Marwa S ElKhalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt.,Internal Medicine Department III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Nermeen Noshy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Rasha M Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Benha, Kalubia, Egypt
| | - Ehab Saad
- Rheumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Abdel-Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt
| | - Amira T El-Shanawany
- Rheumatology Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Menoufia, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hossam M Khalil
- Ophthalmology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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12
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Hanafy AF, Abdalla AM, Guda TK, Gabr KE, Royall PG, Alqurshi A. Ocular anti-inflammatory activity of prednisolone acetate loaded chitosan-deoxycholate self-assembled nanoparticles. Int J Nanomedicine 2019; 14:3679-3689. [PMID: 31239660 PMCID: PMC6556883 DOI: 10.2147/ijn.s195892] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 11/24/2018] [Accepted: 03/11/2019] [Indexed: 12/30/2022] Open
Abstract
Background and purpose: Conventional topical ophthalmic aqueous solutions and suspensions are often associated with low bioavailability and high administration frequency, pulsatile dose and poor exposure to certain ocular parts. The aim of this study was to develop an ophthalmic nanoparticles loaded gel, for delivering prednisolone acetate (PA), to increase dosing accuracy, bioavailability, and accordingly, efficiency of PA in treating inflammatory ocular diseases. Methods: A novel formulation of self-assembled nanoparticles was prepared by the complexation of chitosan (CS) and, the counter-ion, sodium deoxycholate (SD), loaded with the poorly-water-soluble PA. Particle size, zeta potential, encapsulation efficiency (EE) and drug loading content (LC) of prepared nanoparticles were assessed. Moreover, the nanoparticles were characterized using differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FTIR). Drug release and eye anti-inflammatory potential of the prepared novel formulation was investigated. Results: Mean particle size of the nanoparticles have dropped from 976 nm ±43 (PDI 1.285) to 480 nm ±28 (PDI 1.396) when the ratio of CS-SD was decreased. The incorporation of 0.1-0.3% of polyvinyl alcohol (PVA), in the preparation stages, resulted in smaller nanoparticles: 462 nm ±19 (PDI 0.942) and 321 nm ±22 (PDI 0.454) respectively. DSC and FTIR results demonstrated the interaction between CS and SD, however, no interactions were detected between PA and CS or SD. Drug release of PA as received, in simulated tears fluid (pH 7.4), showed a twofold increase (reaching an average of 98.6% in 24 hours) when incorporated into an optimized nanoparticle gel formulation (1:5 CS-SD). Conclusion: The anti-inflammatory effect of PA nanoparticles loaded gel on female guinea pig eyes was significantly superior to that of the micronized drug loaded gel (P < 0.05).
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Affiliation(s)
- Ahmed F Hanafy
- Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, Taibah University, Medina, KSA.,Research and Development Department, Al Andalous for Pharmaceutical Industries, Giza, Egypt
| | - Ahmed M Abdalla
- Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, Taibah University, Medina, KSA
| | - Tawheda K Guda
- Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, Taibah University, Medina, KSA
| | - Khairy E Gabr
- Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, Taibah University, Medina, KSA.,Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Paul G Royall
- Institute of Pharmaceutical Science, King's College London, London, SE1 9NH, UK
| | - Abdulmalik Alqurshi
- Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, Taibah University, Medina, KSA
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13
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Gheita TA, El-Latif EA, El-Gazzar II, Samy N, Hammam N, Abdel Noor RA, El-Shebeiny E, El-Najjar AR, Eesa NN, Salem MN, Ibrahim SE, El-Essawi DF, Elsaman AM, Fathi HM, Sallam RA, El-Shereef RR, Abd-Elazeem MI, Said EA, Khalil NM, Shahin D, El-Saadany HM, ElKhalifa MS, Nasef SI, Abdalla AM, Noshy N, Fawzy RM, Saad E, Moshrif AH, El-Shanawany AT, Abdel-Fattah YH, Khalil HM. Behçet’s disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature. Clin Rheumatol 2019; 38:2565-2575. [DOI: 10.1007/s10067-019-04570-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/14/2019] [Accepted: 04/18/2019] [Indexed: 12/19/2022]
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14
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Abdel Fattah AR, Abdalla AM, Mishriki S, Meleca E, Geng F, Ghosh S, Puri IK. Correction to "Magnetic Printing of a Biosensor: Inexpensive Rapid Sensing To Detect Picomolar Amounts of Antigen with Antibody-Functionalized Carbon Nanotubes". ACS Appl Mater Interfaces 2018; 10:44199-44200. [PMID: 30520298 DOI: 10.1021/acsami.8b20426] [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: 06/09/2023]
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15
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Chan BS, Becker T, Chiew AL, Abdalla AM, Robertson TA, Liu X, Roberts MS, Buckley NA. Vasoplegic Shock Treated with Methylene Blue Complicated by Severe Serotonin Syndrome. J Med Toxicol 2018; 14:100-103. [PMID: 29134498 PMCID: PMC6013734 DOI: 10.1007/s13181-017-0637-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 08/02/2017] [Revised: 10/24/2017] [Accepted: 10/31/2017] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Management of severe vasoplegic shock in overdose can be very challenging. We describe a case of severe refractory vasodilatory shock in poisoning where methylene blue (MB) was used with success. However, the patient subsequently developed severe Serotonin Syndrome (SS) as a result of an interaction between serotonergic drugs and MB. CASE REPORT A 15-year-old male developed severe vasoplegic shock 1.5 hours after overdosing on several different medications including quetiapine slow release, quetiapine immediate release, desvenlafaxine slow release, venlafaxine, amlodipine, ramipril, fluoxetine, promethazine and lithium. His vasoplegic shock was resistant to high doses of noradrenaline and vasopressin. MB was administered 6.5 hours post ingestion and within 1 hour there was an improvement in his hemodynamic status and reduction of catecholamine requirements. Twelve hours post ingestion, he developed severe Serotonin Syndrome that lasted 5 days as a result of interaction between MB, a reversible monoamine oxidase inhibitor (MAO-I), and the antidepressants taken in overdose. MB had a calculated half-life of 38 hours. CONCLUSION MB is a useful additional strategy for severe drug induced vasodilatory shock and may be potentially life-saving. Clinicians should be aware that it can interact with other drugs and cause life-threatening Serotonin Syndrome. Lower doses or shorter durations may be wise in patients at risk of this interaction.
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Affiliation(s)
- Betty S Chan
- Clinical Toxicology Unit & Emergency Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia.
| | - Therese Becker
- Clinical Toxicology Unit & Emergency Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Angela L Chiew
- Clinical Toxicology Unit & Emergency Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Ahmed M Abdalla
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Tom A Robertson
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Xin Liu
- Therapeutics Research Centre, Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Michael S Roberts
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
- Therapeutics Research Centre, Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Nicholas A Buckley
- Department of Clinical Pharmacology, University of Sydney, Sydney, New South Wales, Australia
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16
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Fattah ARA, Abdalla AM, Mishriki S, Meleca E, Geng F, Ghosh S, Puri IK. Magnetic Printing of a Biosensor: Inexpensive Rapid Sensing To Detect Picomolar Amounts of Antigen with Antibody-Functionalized Carbon Nanotubes. ACS Appl Mater Interfaces 2017; 9:11790-11797. [PMID: 28319366 DOI: 10.1021/acsami.6b15989] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
When an antibody (Ab) is immobilized on its surface, a carbon nanotube (CNT) becomes a biosensor that detects the corresponding antigen (Ag) because Ag-Ab complexes formed on the CNT surface moderate the current flow through it. We synthesized a biological ink containing CNTs that are twice functionalized, first with magnetic nanoparticles and thereafter with the anti-c-Myc monoclonal Ab. The ink is pipetted and dynamically self-organized by an external magnetic field into a dense electrically conducting sensor strip that measures the decrease in current when a sample containing c-Myc Ag is deposited on it. Prototypes are rapidly fabricated materials that cost less than 20 cents (Canadian) for each sensor. With larger current decreases due to real-time specific Ag-Ab binding for higher c-Myc concentrations, the biosensor distinguishes between picomolar c-Myc concentrations within a minute, offering proof of concept of a simple, rapid, economical, and sensitive method to detect specific molecules recognizable by Abs.
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Affiliation(s)
- Abdel Rahman Abdel Fattah
- Department of Mechanical Engineering, ‡Department of Engineering Physics, §School of Biomedical Engineering, McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Ahmed M Abdalla
- Department of Mechanical Engineering, ‡Department of Engineering Physics, §School of Biomedical Engineering, McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Sarah Mishriki
- Department of Mechanical Engineering, ‡Department of Engineering Physics, §School of Biomedical Engineering, McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Elvira Meleca
- Department of Mechanical Engineering, ‡Department of Engineering Physics, §School of Biomedical Engineering, McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Fei Geng
- Department of Mechanical Engineering, ‡Department of Engineering Physics, §School of Biomedical Engineering, McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Suvojit Ghosh
- Department of Mechanical Engineering, ‡Department of Engineering Physics, §School of Biomedical Engineering, McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Ishwar K Puri
- Department of Mechanical Engineering, ‡Department of Engineering Physics, §School of Biomedical Engineering, McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
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17
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Abdalla AM, Sahu RP, Wallar CJ, Chen R, Zhitomirsky I, Puri IK. Nickel oxide nanotube synthesis using multiwalled carbon nanotubes as sacrificial templates for supercapacitor application. Nanotechnology 2017; 28:075603. [PMID: 27976630 DOI: 10.1088/1361-6528/aa53f3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A novel approach for the fabrication of nickel oxide nanotubes based on multiwalled carbon nanotubes as a sacrificial template is described. Electroless deposition is employed to deposit nickel onto carbon nanotubes. The subsequent annealing of the product in the presence of air oxidizes nickel to nickel oxide, and carbon is released as gaseous carbon dioxide, leaving behind nickel oxide nanotubes. Electron microscopy and elemental mapping confirm the formation of nickel oxide nanotubes. New chelating polyelectrolytes are used as dispersing agents to achieve high colloidal stability for both the nickel-coated carbon nanotubes and the nickel oxide nanotubes. A gravimetric specific capacitance of 245.3 F g-1 and an areal capacitance of 3.28 F cm-2 at a scan rate of 2 mV s-1 is achieved, with an electrode fabricated using nickel oxide nanotubes as the active element with a mass loading of 24.1 mg cm-2.
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Affiliation(s)
- Ahmed M Abdalla
- Department of Engineering Physics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
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18
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Abdel Fattah AR, Majdi T, Abdalla AM, Ghosh S, Puri IK. Nickel Nanoparticles Entangled in Carbon Nanotubes: Novel Ink for Nanotube Printing. ACS Appl Mater Interfaces 2016; 8:1589-1593. [PMID: 26735184 DOI: 10.1021/acsami.5b11700] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report the serendipitous discovery of a rapid and inexpensive method to attach nanoscale magnetic chaperones to carbon nanotubes (CNTs). Nickel nanoparticles (NiNPs) become entangled in CNTs after both are dispersed in kerosene by sonication and form conjugates. An externally applied magnetic field manipulates the resulting CNTs-NiNP ink without NiNP separation, allowing us to print an embedded circuit in an elastomeric matrix and fabricate a strain gage and an oil sensor. The new method to print a circuit in a soft material using an NiNP-CNT ink is more rapid and inexpensive than the complex physical and chemical means typically used to magnetize CNTs.
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Affiliation(s)
- Abdel Rahman Abdel Fattah
- Department of Mechanical Engineering and ‡Department of Engineering Physics McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Tahereh Majdi
- Department of Mechanical Engineering and ‡Department of Engineering Physics McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Ahmed M Abdalla
- Department of Mechanical Engineering and ‡Department of Engineering Physics McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Suvojit Ghosh
- Department of Mechanical Engineering and ‡Department of Engineering Physics McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
| | - Ishwar K Puri
- Department of Mechanical Engineering and ‡Department of Engineering Physics McMaster University , 1280 Main Street West, Hamilton, Ontario L8S 4L7, Canada
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Abdalla AM, Saeed AA, Abdulrahman BM, Al-Kaabba AF, Raat H. Correlates of ever-smoking habit among adolescents in Tabuk, Saudi Arabia. East Mediterr Health J 2009; 15:983-992. [PMID: 20187551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A cross-sectional questionnaire study of the correlates of ever-smoking among adolescents was made in Tabuk government schools in Saudi Arabia. Of 1505 students aged 12-19 years, 657 (43.7%) were ever-smokers (i.e. ever tried cigarette smoking, even 1 or 2 puffs); 65.0% of males and 23.1% of females. In logistic regression analysis significant predictors for ever-smoking were: male sex, belief that smoking helps people feel comfortable in social situations, owning something with a cigarette logo, having pocket money > or = 20 riyals/day, poor school performance and having friends or parents who smoked.
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Affiliation(s)
- A M Abdalla
- Department of Clinical Sciences, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
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20
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Moss SF, Sordillo EM, Abdalla AM, Makarov V, Hanzely Z, Perez-Perez GI, Blaser MJ, Holt PR. Increased gastric epithelial cell apoptosis associated with colonization with cagA + Helicobacter pylori strains. Cancer Res 2001; 61:1406-11. [PMID: 11245442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Gastric colonization by Helicobacter pylori is a risk factor for noncardia gastric cancer. The association between H. pylori and cancer may be attributable to increased epithelial cell turnover, possibly related to antigastric antibodies. Two previous studies reported a disproportionate increase in proliferation relative to apoptosis in patients with H. pylori strains expressing the virulence-related cagA gene. This has led to the hypothesis that an abrogation of apoptosis by cagA-positive strains may promote neoplasia. We, therefore, examined the effect of H. pylori on gastric epithelial proliferation, apoptosis, and the presence of serum antiparietal cell antibodies in a large prospective study. Proliferation and apoptosis were evaluated "blindly" using validated immunohistochemical methods in two antral and two gastric corpus biopsies from 60 patients with nonulcer dyspepsia, and results were correlated with the presence of serum antiparietal cell antibodies. H. pylori colonization was assessed by histology, biopsy urease test, and serology. Proliferation was increased 2-fold in both antrum and corpus in H. pylori-positive patients, was not related to H. pylori cagA status, and was positively correlated with histological gastritis. Apoptosis was increased in the antrum and body only in patients with cagA-positive H. pylori strains. Antiparietal cell antibodies were not more prevalent in H. pylori colonization, and their presence was inversely related to epithelial apoptosis scores we therefore conclude that in patients with nonulcer dyspepsia, H. pylori carriage is associated with increased proliferation. Futhermore the cag pathogenicity island is associated with increased apoptosis. Our results do not support the hypothesis that there is a relative deficiency of gastric epithelial cell apoptosis associated with the carriage of cagA-positive strains. Host factors may be more important than bacterial products in determining the long-term outcome of H. pylori colonization.
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Affiliation(s)
- S F Moss
- Department of Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York 10025, USA.
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21
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Stenberg G, Abdalla AM, Mannervik B. Tyrosine 50 at the subunit interface of dimeric human glutathione transferase P1-1 is a structural key residue for modulating protein stability and catalytic function. Biochem Biophys Res Commun 2000; 271:59-63. [PMID: 10777681 DOI: 10.1006/bbrc.2000.2579] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The dimer interface in human GSTP1-1 has been altered by site-directed mutagenesis of Tyr50. It is shown that the effects of some mutations of this single amino acid residue are as detrimental for enzyme function as mutations of Tyr8 in the active site. The dimeric structure is a common feature of the soluble glutathione transferases and the structural lock-and-key motif contributing to the subunit-subunit interface is well conserved in classes alpha, mu, and pi. The key residue Tyr50 in GSTP1-1 was replaced with 5 different amino acids with divergent properties and the mutant proteins expressed and characterized. Mutant Y50F is an improved variant, with higher thermal stability and higher catalytic efficiency than the wild-type enzyme. The other mutants studied are also dimeric proteins, but have lower stabilities and catalytic activities that are reduced by a factor of 10(2)-10(4) from the wild-type value. Mutants Y50L and Y50T are characterized by a markedly increased K(M) value for GSH, while the effect is mainly due to decreased k(cat) values for mutants Y50A and Y50R. In conclusion, residue 50 in the interface governs both structural stability and catalytic function.
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Affiliation(s)
- G Stenberg
- Department of Biochemistry, Biomedical Center, Uppsala University, Uppsala, SE-751 23, Sweden.
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22
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Peek RM, Wirth HP, Moss SF, Yang M, Abdalla AM, Tham KT, Zhang T, Tang LH, Modlin IM, Blaser MJ. Helicobacter pylori alters gastric epithelial cell cycle events and gastrin secretion in Mongolian gerbils. Gastroenterology 2000; 118:48-59. [PMID: 10611153 DOI: 10.1016/s0016-5085(00)70413-6] [Citation(s) in RCA: 136] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Human colonization with Helicobacter pylori increases the risk for distal gastric adenocarcinoma, possibly by altering gastric epithelial cell cycle events and/or gastrin secretion. This study aimed to determine whether H. pylori virulence-related characteristics affect apoptosis, proliferation, and gastrin levels in a rodent model of gastric adenocarcinoma. METHODS Mongolian gerbils were challenged with H. pylori wild-type or isogenic cagA(-) and vacA(-) mutants, and apoptotic and proliferating cells were identified by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling and proliferating cell nuclear antigen immunohistochemistry, respectively. Serum gastrin levels were determined by radioimmunoassay. RESULTS Gastric epithelial cell turnover was no different after infection with the wild-type, cagA(-), or vacA(-) strains. H. pylori infection significantly increased antral apoptosis 2-4 weeks after challenge, before apoptotic indices decreased to baseline. In contrast, antral proliferation rates were significantly higher 16-20 weeks after inoculation, but then decreased by 40 weeks. Antral proliferation was significantly related to serum gastrin levels, whereas antral apoptosis was inversely related to acute inflammation and lymphoid follicles. CONCLUSIONS In H. pylori-infected gerbils, enhanced antral apoptosis is an early and transient cell cycle event. Epithelial cell proliferation peaks later and is significantly related to increased gastrin levels, suggesting that epithelial cell growth in H. pylori-colonized mucosa may be mediated by gastrin-dependent mechanisms.
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Affiliation(s)
- R M Peek
- Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2279, USA.
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Moss SF, Valle J, Abdalla AM, Wang S, Siurala M, Sipponen P. Gastric cellular turnover and the development of atrophy after 31 years of follow-up: a case-control study. Am J Gastroenterol 1999; 94:2109-14. [PMID: 10445536 DOI: 10.1111/j.1572-0241.1999.01286.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Why only some patients colonized with Helicobacter pylori (H. pylori) develop atrophy, a preneoplastic change, is not known. Because gastric mucosal mass is dependent upon a balance between epithelial proliferation and turnover, we hypothesized that atrophy may develop due to increased apoptosis relative to proliferation. METHODS Gastric epithelial apoptosis was measured by terminal deoxyuridine nucleotide nick end labeling (TUNEL) assay and proliferation by Ki-67 immunohistochemistry in gastric corpus biopsies in a unique cohort of patients followed for 31 yr (1952-1983). Sixteen patients who developed atrophy over this time were selected (cases), with two matched controls, who did not develop atrophy, for each. Apoptosis and proliferation were measured in the corpus biopsies taken in 1952. RESULTS Cases (N = 16) and controls (N = 32) were well matched for age, sex, initial histology, and severity of H. pylori infection. In the initial (1952) biopsies, 4.3 +/- 1.7 cells (mean +/- SEM) per gland were Ki-67-positive in the cases, compared with 2.1 +/- 0.4 in controls (p = 0.48). 9.2 +/- 2.3 cells per gland were terminal deoxyuridine nucleotide nick end labeling-positive in cases, compared with 6.3 +/- 0.8 in controls (p = 0.29). Proliferation to apoptosis ratios were similar in both groups (cases, 0.38 +/- 0.16; controls 0.39 +/- 0.08, p = 0.37). CONCLUSIONS Patients who later developed atrophy, initially had mildly (but not statistically significant) increased gastric epithelial cell proliferation and apoptosis, compared with those patients who did not develop atrophy, suggesting increased cellular turnover in the atrophy group. However, in these patients with gastritis, the ratio of apoptosis to proliferation was not a determinant of risk for development of atrophy decades later.
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Affiliation(s)
- S F Moss
- St. Luke's-Roosevelt Hospital/Columbia University, New York, New York 10025, USA
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Abstract
Rheumatoid arthritis and gout are both common rheumatic diseases, but their coincidence is rare. We report the case of a 67-year-old Caucasian woman with rheumatoid arthritis who later developed tophaceous gout. The tophi disappeared with remarkable rapidity on treatment with allopurinol.
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Abdalla AM, Oliver JA. SV 40 virus transformed prostatic carcinoma in the hamster. II. Comparisons of lactate dehydrogenase isoenzymes with human prostatic cancer. Invest Urol 1971; 8:488-93. [PMID: 4326620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Abdalla AM, Oliver JA. SV40 virus transformed prostatic carcinoma in the hamster. I. Comparisons of lactate dehydrogenase isoenzymes with human prostatic cancer. Invest Urol 1971; 8:442-7. [PMID: 5541992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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