1
|
Nassar A, Vérité F, Pechereau F, Vitrani MA. Assistance by adaptative damping on a complex bimanual task in laparoscopic surgery. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03082-6. [PMID: 38453723 DOI: 10.1007/s11548-024-03082-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Laparoscopic surgery has improved outcomes in abdominal surgery, but presents kinematic restrictions for surgeons. Robotic comanipulation with adaptative damping has been investigated in simple laparoscopic tasks. The present protocol aimed to determine the contribution of adaptive damping in complex bimanual tasks approaching clinical setting. METHODS Fourteen residents in general surgery performed three exercises, and for each three repetitions without (classic repetitions) and three with robotic assistance (robotic repetitions) in a randomised order. The exercises chosen were trajectory, modified Pea on a Peg and intracorporeal suture. Task performance, gesture performance, workload and impression were measured. Also, a semi-directed interview was performed to collect the participants' feeling about companipulated robots and their potential application in clinical practice. RESULTS Adaptative damping assistance did not impact task performance, but allowed an economy of movement in the non-dominant hand during suture exercise (distance 916 ± 500 mm in classic vs. 563 ± 261 mm in robotic, p < 0.001). Perceived workload (p = 0.12) and user's impression were not different between classic and robotic repetitions, except novelty (p < 0.001). Participants' interviews revealed their interest for the robotic devices, particularly the gravity compensation, and were ready to use the adaptative damping provided an intermittent use, for example to dissect dangerous areas. CONCLUSION Adaptative damping applied by comanipulated robots does not influence the performance of the task, but improves the performance of the gesture itself, particularly for the non-dominant hand, and during the realisation of a complex task like suturing. For residents in digestive surgery, this assistance does increase workload, and they would use this help in the operating room under certain conditions.
Collapse
Affiliation(s)
- A Nassar
- Institut des Systèmes Intelligents et de Robotique, Sorbonne Universités, 4, Place Jussieu, 75005, Paris, France.
| | - F Vérité
- Institut des Systèmes Intelligents et de Robotique, Sorbonne Universités, 4, Place Jussieu, 75005, Paris, France
| | - F Pechereau
- Institut des Systèmes Intelligents et de Robotique, Sorbonne Universités, 4, Place Jussieu, 75005, Paris, France
| | - M A Vitrani
- Institut des Systèmes Intelligents et de Robotique, Sorbonne Universités, 4, Place Jussieu, 75005, Paris, France
| |
Collapse
|
2
|
Hashmi S, Shaheen M, Adil S, Ahmed P, Ahmed S, Ben Abdeljelil N, Alabdulwahab A, Albeihany A, Aldaama S, Al-Khabori M, Alkindi S, Almohareb F, Alsaeed A, Alseraihy A, Alshemari S, Ayas M, Chaudhri N, Da'na W, Dennison D, ElQuessar A, Elhaddad A, Ibrahim A, Hashem H, Jastaniah W, Mawardi H, Nassar A, Satti T, Torjemane L, Tabbara K, El Solh H, Albeirouti B, Aljurf M. Unique aspects of Graft-versus-host-disease management in the Eastern Mediterranean region: Report from the Eastern Mediterranean blood and marrow transplantation group: Special report. Hematol Oncol Stem Cell Ther 2023; 16:303-306. [PMID: 32413418 DOI: 10.1016/j.hemonc.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/02/2020] [Accepted: 04/10/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Shahrukh Hashmi
- Department of Adult Hematology and Stem Cell Transplantation, KFSHRC, Riyadh, Saudi Arabia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marwan Shaheen
- Department of Adult Hematology and Stem Cell Transplantation, KFSHRC, Riyadh, Saudi Arabia
| | - Salman Adil
- Aga Khan University Hospital, Karachi, Pakistan
| | - Parvez Ahmed
- Quaid-e-Azam International Hospital, Islamabad, Pakistan
| | - Syed Ahmed
- Department of Adult Hematology and Stem Cell Transplantation, KFSHRC, Riyadh, Saudi Arabia
| | | | | | | | - Saad Aldaama
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | | | - Fahad Almohareb
- Department of Adult Hematology and Stem Cell Transplantation, KFSHRC, Riyadh, Saudi Arabia
| | - Ahmed Alsaeed
- King Abdulaziz Medical City-National Guard Hospital, Jeddah, Saudi Arabia
| | - Amal Alseraihy
- Pediatric Hematology & Oncology, KFSHRC, Riyadh, Saudi Arabia
| | | | - Mouhab Ayas
- Pediatric Hematology & Oncology, KFSHRC, Riyadh, Saudi Arabia
| | - Naeem Chaudhri
- Department of Adult Hematology and Stem Cell Transplantation, KFSHRC, Riyadh, Saudi Arabia
| | | | | | - Asma ElQuessar
- Hematology, pediatric oncology, Ibn Rochd University Hospital, University of Hassan II, Casablanca, Morocco
| | | | - Ahmad Ibrahim
- Makassed Hospital, Lebanese University, Lebanon
- Middle East Hospital, Lebanese University, Lebanon
| | | | - Wasil Jastaniah
- King Abdulaziz Medical City-National Guard Hospital, Jeddah, Saudi Arabia
| | - Hani Mawardi
- King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Amr Nassar
- Prince Sultan Military Medical Center, Riyadh, Saudi Arabia
| | - Tariq Satti
- National Institute of Blood and Marrow Transplant, Rawalpindi, Pakistan
| | | | | | - Hassan El Solh
- Pediatric Hematology & Oncology, KFSHRC, Riyadh, Saudi Arabia
| | - Bassim Albeirouti
- King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia
| | - Mahmoud Aljurf
- Department of Adult Hematology and Stem Cell Transplantation, KFSHRC, Riyadh, Saudi Arabia
| |
Collapse
|
3
|
Gettinger S, Schenker M, De Langen J, Fischer J, Morgensztern D, Ciuleanu TE, Beck T, De Castro Carpeno J, Schumann C, Yang X, Telivala B, Deschepper K, Nadal E, Schalper K, Spires T, Balli D, Nassar A, Karam S, Bhingare A, Spigel D. 2MO First-line (1L) nivolumab (NIVO) + ipilimumab (IPI) in metastatic non-small cell lung cancer (mNSCLC): Clinical outcomes and biomarker analyses from CheckMate 592. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100107] [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: 12/13/2022]
|
4
|
El Zarif T, Pond G, Nassar A, Adib E, Freeman D, Thomas J, Kalluri U, Matar A, Kelly E, Curran C, Kadamkulam Syriac A, McClure H, Davidsohn M, Labaki C, Saliby R, Hobeika C, Nuzzo P, Berchuck J, Choueiri T, Sonpavde G. 116P Any regression of tumor (ART) as an intermediate endpoint in patients (pts) treated with immune checkpoint inhibitors (ICI): A pan-cancer analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.148] [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: 11/01/2022] Open
|
5
|
Welsh S, Sallam M, Nassar A. 929 The Incidence and Outcomes of Delayed Laparoscopic Cholecystectomy and Bile Duct Exploration on a Unit Adopting Index Admission Surgery for All Comers. a Review of 5750 Patients. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.259] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Aim
The timing of laparoscopic cholecystectomy (LC) for emergency biliary admissions remains inconsistent with national and international guidelines. The perception that LC is difficult in acute cholecystitis and the popularity of the two-session approach to pancreatitis and suspected choledocholithiasis result in delayed management.
Method
Analysis of prospectively maintained data in a unit adopting “intention to treat” during the index admission. The aim was to study the incidence of previous biliary admissions and compare the operative difficulty, complications, and postoperative outcomes with index admission LC.
Results
Of 5750 LC performed 20.8% had previous biliary admissions; one in 93% and two or more in 7%. Most presented with biliary colic (39.6%) and acute cholecystitis (27.6%). A previous biliary history was associated with increased operative difficulty (p<0.001), longer operating times (86.9 v 68.1 minutes, p<0.001), more post-operative complications (7.5% v 5.2%, p=0.002) and longer hospital stay (8.1 v 5.5 days, p<0.001). However, conversion and mortality rates showed no significant differences.
Conclusion
Index admission LC is superior to interval cholecystectomy and should be offered to all patients fit for general anaesthesia regardless of presenting complaints. Subspecialisation should be encouraged as a major factor in optimising resource utilisation and post-operative outcomes of biliary emergencies.
Collapse
Affiliation(s)
- S Welsh
- University Hospital Monklands , Glasgow , United Kingdom
| | - M Sallam
- University Hospital Monklands , Glasgow , United Kingdom
| | - A Nassar
- University Hospital Monklands , Glasgow , United Kingdom
| |
Collapse
|
6
|
Nassar A, Qandeel H, Khan K, Ng H, Hasanat S, Ashour H. 1282 Evaluation of the Basket in Catheter Technique for Transcystic Bile Duct Exploration and Suspected Ductal Stones. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.609] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
The ‘Basket-in-catheter’ (BIC) technique facilitates laparoscopic transcystic ductal exploration (LTCE) and increases its success rate, being easier and safer than inserting the basket alone. This study evaluates the benefits in confirmed and suspected ductal stones.
Method
Prospective preoperative, operative and postoperative data on consecutive single session ductal explorations was collected over 28 years and analysed. BIC became our default technique for the transcystic approach to confirmed or suspected bile duct stones.
Results
741 of 1225 (60.5%) attempted LTCE were performed using retrieval baskets without dilating the cystic duct (CD). BIC was used in 646 (87.2%). Of 386 (52.1%) patients undergoing successful stone retrieval 62.7% had clinical and radiological risk factors for ductal stones and 92.0% had positive intraoperative cholangiography. 355 (47.9%) patients had preoperative or operative risk factors for CBD stones and equivocal cholangiography in 25%. Basket trawling was negative and repeat cholangiography confirmed resolution of abnormalities. Choledochoscopy was utilised in 484/1225 (39.5%), either primarily or when blind trawling failed to extract stones. Retained stones occurred in 7 patients, six requiring ERCP. Bile leakage occurred in 6 patients. There were two open conversions, no biliary injuries and no mortality. Post-operative pancreatitis occurred in 7 and recurrent stones in 8 patients.
Conclusions
The BIC technique achieves successful LTCE without CD dilatation in 40%, reducing the need for choledochoscopy and choledochotomy. It facilitates safe and speedy CBD trawling when stones are suspected due to preoperative or operative risk factors or equivocal cholangiography and helps surgeons acquire and consolidate ductal exploration skills.
Collapse
Affiliation(s)
- A Nassar
- University Hospital Monklands, Airdrie, United Kingdom
| | | | - K Khan
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - H Ng
- Royal Alexandra Hospital, Paisley, United Kingdom
| | | | - H Ashour
- Hashemite University, Zarqa, Jordan
| |
Collapse
|
7
|
Abdel Hameed R, Al Elaimi M, Qureshi M, Nassar A, Abd el-kader M, Aljohani M, Arafa E. Green Recycling of Poly(ethylene terephthalate) Waste as Corrosion Inhibitor for Steel in Marine Environment. Egypt J Chem 2021. [DOI: 10.21608/ejchem.2021.54262.3145] [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: 10/22/2022]
|
8
|
Nassar A, Mostafa M, Khashaba SA. Photodynamic therapy versus candida antigen immunotherapy in plane wart treatment: a comparative controlled study. Photodiagnosis Photodyn Ther 2020; 32:101973. [PMID: 32841751 DOI: 10.1016/j.pdpdt.2020.101973] [Citation(s) in RCA: 8] [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: 05/12/2020] [Revised: 08/09/2020] [Accepted: 08/17/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Plane warts, mostly found on the face, present a challenge to treat as most destructive methods can lead to unpleasant cosmetic outcome. Alternative therapeutic methods should be evaluated. The aim of this study is to evaluate the clinical efficacy and adverse effects of photodynamic therapy with methylene blue and intense pulsed light in comparison to candida antigen immunotherapy in the treatment of plane warts. METHODS The study included 39 patients with plane warts assigned into 3 groups. Group I received photodynamic therapy using methylene blue followed by IPL illumination, group II received immunotherapy using 0.1 ml of candida albicans antigen and group III received 0.1 ml saline as a control. RESULTS Complete response was detected in (46.1%) of patients in group I compared to (61.5%) in group II and no response in group III. CONCLUSION Candida antigen immunotherapy is superior to photodynamic therapy in plane warts treatment with absence of recurrence and comparable side effects in both groups.
Collapse
Affiliation(s)
- A Nassar
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, 44519, Egypt.
| | - M Mostafa
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, 44519, Egypt.
| | - S A Khashaba
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, 44519, Egypt.
| |
Collapse
|
9
|
Ziade N, Nassar A. AB0730 ASSOCIATION OF SPONDYLOARTHRITIS AND FAMILIAL MEDITERRANEAN FEVER AND IMPACT ON DISEASE PHENOTYPE: A SYSTEMATIC REVIEW OF THE LITERATURE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6009] [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: 11/03/2022]
Abstract
Background:Spondyloarthritis (SpA) and Familial Meditaerranean fever (FMF) may co-exist in certain populations, and have some overlapping manifestations (oligo-arthritis, hip involvement). Their association may impact disease phenotype and may affect disease management.Objectives:To evaluate the association of SpA and FMF and its impact on disease phenotype and management.Methods:A systematic literature search was conducted with the keywords spondyloarthritis and familial mediterranean fever from Janurary 1990 to January 2020 in PubMed and using manual cross-reference methods.Results:The search retrieved 74 articles, out of which 37 articles were relevant to the study question; most of the articles were case reports, with some large cohort studies of FMF and SpA (Flowchart in Figure 1).In large FMF cohorts, the prevalence of SpA was higher compared to the general population (7.5-13%, OR around 10). M694V was a risk factor for SpA. These FMF-SpA patients were older at diagnosis, had lower fever attacks, and higher disease duration, inflammatory back pain, chronic arthritis, enthesopathy, persistent inflammation and higher resistance to Colchicine. In case series, they were responsive to anti-TNF therapy.In large SpA cohorts, MEFV mutation, particularly M694V, was found in 15-35% (even without associated FMF). In most cohorts, MEFV mutation carriers didn’t have any distinct disease phenotype, except for some reports of higher ESR, more hip involvement, higher BASFI and higher BASDAI. Genome-wide association studies and case reports suggest an implication for IL-1 and thus a role for Anakinra therapy in these patients.Conclusion:In FMF or SpA patients with resistance to conventional therapy, the evaluation of disease association should be performed as it may have significant impact on disease management.References:[1]Li et al, Plos Genetics 2019. Watad et al, Frontiers Immunol 2019. Atas et al, Rheumatol Int 2019. Cherqaoui et al, JBS 2017. Zhong et al. Plos One 2017. Ornek et al, Arch Rheumatol 2016. Cinar et al, Rheumatol Int 2008. Durmur et al, JBS 2007.Figure 1.Flowchart of the systematic literature search (Spondyloarthritis, Familial Mediterranean Fever; January 1990-2020).Disclosure of Interests:Nelly Ziade Speakers bureau: Abbvie, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi, Aref Nassar: None declared
Collapse
|
10
|
Abdelhakam D, Young PR, Jain MK, Nassar A, Copland JA, Tan W. Complete remission with immunotherapy: Case report of a patient with metastatic bladder cancer to the humerus. Urol Case Rep 2020; 30:101130. [PMID: 32123665 PMCID: PMC7036445 DOI: 10.1016/j.eucr.2020.101130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 02/07/2020] [Indexed: 12/22/2022] Open
Abstract
Bladder cancer is the sixth most common malignancy in the United States. Cisplatin combination regimens are first line therapy for patients with metastatic urothelial bladder cancer who are eligible candidates and no treatments have shown to improve outcome compared to chemotherapy for the past 20 years. Significant advances were made in past 2-3 years and the most significant was the introduction of checkpoints inhibitors in bladder cancer treatment. We present a patient diagnosed with metastatic urothelial carcinoma who progressed while on cisplatin/gemcitabine chemotherapy in the form of oligometastasis to the bone. He has achieved a durable complete response with atezolizumab.
Collapse
Affiliation(s)
- D Abdelhakam
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA.,Department of Clinical Pathology, Faculty of Medicine, Ainshams University, Cairo, Egypt
| | - P R Young
- Department of Urology, Mayo Clinic, Jacksonville, FL, USA
| | - M K Jain
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - A Nassar
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - J A Copland
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
| | - W Tan
- Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
11
|
AlDawsari G, Elhaddad A, El Fakih R, Ben Othman T, Ahmed P, Ghavamzadeh A, Bazarbachi A, Dasouki MJ, Fathy G, Alzahrani H, Samra M, Torjemane L, Satti TM, Shaheen M, Alfraih F, Ayas M, Alahmari A, Alhayli S, Nassar A, Abboud M, Abdelfattah R, El Solh H, Hashmi S, Elhassan T, Ahmed SO, Aljurf M. Outcome of hematopoietic stem cell transplantation (HCT) from HLA-matched related donor for Fanconi anemia (FA) in adolescents and adults: a retrospective study by Eastern Mediterranean Blood and Marrow Transplantation Group (EMBMT). Bone Marrow Transplant 2020; 55:1485-1490. [PMID: 32024988 DOI: 10.1038/s41409-020-0809-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 11/12/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022]
Abstract
Hematopoietic Stem Cell Transplantation (HSCT) is the only potentially curative treatment option for the hematologic complications that occur in patients with Fanconi anemia (FA). In this study, we present a retrospective multicenter analysis from the Eastern Mediterranean Blood and Marrow Transplantation Group (EMBMT) of matched related donor HSCT for FA in adolescents and adults transplanted between 1988 and 2015. Forty-five patients received HSCT with a median age at transplant of 18 years, the interquartile range (IQR) (15-23.5); 25 (55.6%) patients were females and 20 (44.4%) were males. Conditioning regimen was fludarabine-based in 29 (64.4%) patients, irradiation-based in five (11.1%) patients, and the remaining patients received other combinations. Indication for HSCT was bone marrow failure in 39 (86.7%) and myelodysplastic syndrome in six (13.3%) patients. Stem cell source was bone marrow in 22 (48.9%), peripheral blood in 20 (44.4%), umbilical cord blood in one (2.2%), and combination of bone marrow and cord blood in two (4.4%) patients. Twenty-seven (60%) patients engrafted and five (11.1%) had primary engraftment failure. The median time to neutrophil engraftment was 14 days (range 10-21 days); median time for platelet engraftment was 17 days (10-33 days). The probability of developing grade II-IV acute GVHD for all patients was 7.0% and chronic GVHD 36.6%. No new malignancies were reported. The OS probability was 53.6% (95% CI, 38.3-68.9%) with a median follow-up of 13 months (95% CI, 1-240). Our HLA-matched related HSCT results in AYA patients with FA compare favorably with other reported international registry data.
Collapse
Affiliation(s)
- Ghuzayel AlDawsari
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. .,Internal Medicine Department, Royal Commission Health Service Program, AL-Lulu Road18, Jubial Industrial City, 11994, Saudi Arabia.
| | - Alaa Elhaddad
- National Cancer Institute, Cairo University, Cairo, Egypt
| | - Riad El Fakih
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - Parvez Ahmed
- Armed Forces Institute of Transplantation, Rawalpindi, Pakistan
| | - Ardeshir Ghavamzadeh
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Bazarbachi
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Majed J Dasouki
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Gamal Fathy
- Nasser Institute for Research and Treatment, Cairo, Egypt
| | - Hazzaa Alzahrani
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohamed Samra
- National Cancer Institute, Cairo University, Cairo, Egypt
| | - Lamia Torjemane
- Centre National de Greffe de la Moelle Osseuse, Tunis, Tunisia
| | | | - Marwan Shaheen
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Feras Alfraih
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mouhab Ayas
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ali Alahmari
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Saud Alhayli
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Amr Nassar
- National Cancer Institute, Cairo University, Cairo, Egypt
| | - Miguel Abboud
- American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Hassan El Solh
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Shahrukh Hashmi
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Tusneem Elhassan
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Syed Osman Ahmed
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| |
Collapse
|
12
|
Mattar S, Nassar A, Ghulmiyyah L, Haddad S, Tamim H, Hobeika E. Factors that affect women's choice of their obstetrician and gynecologist: a survey of Lebanese women. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4648.2019] [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: 11/01/2022]
|
13
|
Choueiri T, Flaifel A, Xie W, Braun D, Ficial M, Jennings R, Nassar A, Escudier B, George D, Motzer R, Morris M, Powles T, Wang E, Huang Y, Freeman G, Signoretti S. PD-L1 status and clinical outcomes to cabozantinib, sunitinib and everolimus in patients with metastatic clear-cell RCC treated on CABOSUN and METEOR clinical trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.040] [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: 11/13/2022] Open
|
14
|
Baldomero H, Aljurf M, Zaidi SZA, Hashmi SK, Ghavamzadeh A, Elhaddad A, Hamladji RM, Ahmed P, Torjemane L, Abboud M, Tbakhi A, Khabori MA, El Quessar A, Bazuaye N, Bekadja MA, Adil S, Fahmy O, Ramzi M, Ibrahim A, Alseraihy A, Ben Abdejalil N, Sarhan M, Huneini MA, Mahmal L, ElSolh H, Hussain F, Nassar A, Al-Hashmi H, Hamidieh AA, Pasquini M, Kodera Y, Kröger N, Mohty M, Jaimovich G, Rolon JM, Paulson K, Greinix H, Weisdorf D, Horowitz M, Nunez J, Gratwohl A, Passweg J, Koh M, Szer J, Niederwieser D, Novitzky N. Narrowing the gap for hematopoietic stem cell transplantation in the East-Mediterranean/African region: comparison with global HSCT indications and trends. Bone Marrow Transplant 2018; 54:402-417. [PMID: 30082852 DOI: 10.1038/s41409-018-0275-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/31/2018] [Accepted: 04/03/2018] [Indexed: 11/09/2022]
Abstract
Hematopoietic Stem Cell Transplantation (HSCT) activity was evaluated in the African (AFR)/EMRO region and compared to the global activity for the years 2006-2013. Data were obtained from 1570 teams in the 6 WHO continental regions. Of these, 29 (1.85%) of all teams were active in 12 of the 68 AFR/EMRO countries. They reported 2.331 (3.3%) of the worldwide 71.036 HSCT, and a transplant rate of 32.8 (TR; HSCT/10 million inhabitants; worldwide 128.5). This reflects still the lowest regional TR despite an increase of 90% since 2006. HSCT activity in AFR/EMRO countries was characterized by a higher use of allogeneic compared to autologous HSCT, an almost exclusive use of family donors, including haploidentical family donors. These findings contrast with the prevalence of autologous over allogeneic HSCT, and a higher frequency of unrelated HSCT in other parts of the world. Of note, the increase by 200% in HSCT for hemoglobinopathies from 2006 to 2013 (72 per year) in the AFR/EMRO region. This reflects the specific role of HSCT for these disease categories with high prevalence and incidence in the AFR/EMRO region. This report provides information for the competent authorities to foster adequate infrastructure. It urges transplant organization to optimize their cooperation.
Collapse
Affiliation(s)
- Helen Baldomero
- Department of Medicine, WBMT Global Survey Office, Hematology, University Hospital, Basel, Switzerland
| | - Mahmoud Aljurf
- Department of Hematology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Syed Z A Zaidi
- Department of Adult Hematology and BMT, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Shahrukh K Hashmi
- Department of Hematology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Ardeshir Ghavamzadeh
- Tehran University of Medical Sciences, Hematology, Oncology and SCT Research Center, Tehran, Iran
| | - Alaa Elhaddad
- National Cancer Institute, Cairo University, Cairo, Egypt
| | | | - Parvez Ahmed
- Armed Forces Institute of Transplantation, Rawalpindi, Pakistan
| | - Lamia Torjemane
- Center National de Greffe de Moelle Osseuse de Tunis, Tunis, Tunisia
| | - Miguel Abboud
- American University Beirut Medical Center, Beirut, Lebanon
| | | | | | | | - Nosa Bazuaye
- University of Benin Teaching Hospital, Benin, Nigeria
| | | | - Salman Adil
- Aga Khan University Hospital, Karachi, Pakistan
| | - Omar Fahmy
- Nasser Institute, Cairo University, Cairo, Egypt
| | - Mani Ramzi
- Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Amal Alseraihy
- Department of Hematology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | | | | | | | | | - Hassan ElSolh
- Department of Hematology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Fazal Hussain
- Department of Hematology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Amr Nassar
- National Cancer Institute, Cairo University, Cairo, Egypt
| | | | - Amir Ali Hamidieh
- Tehran University of Medical Sciences, Hematology, Oncology and SCT Research Center, Tehran, Iran
| | - Marcelo Pasquini
- Center for International Blood and Marrow Transplant Research (CIBMTR), Milwaukee, WI, USA
| | - Yoshihisa Kodera
- Asia-Pacific Blood and Marrow Transplantation Group, Aichi Medical University, Nagakute, Japan
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Hospital, Hamburg, Germany
| | - Mohamed Mohty
- The European Blood and Marrow Transplant Group (EBMT), Hôpital Saint-Antoine, Paris, France
| | | | | | - Kristjan Paulson
- Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Hildegard Greinix
- Division of Hematology, Medical University of Graz, LKH-Univ. Klinikum Graz, Graz, Austria
| | | | - Mary Horowitz
- King Fahad Specialist Hospital, Damman, Saudi Arabia
| | | | - Alois Gratwohl
- Department of Medicine, WBMT Global Survey Office, Hematology, University Hospital, Basel, Switzerland
| | - Jacob Passweg
- Department of Medicine, WBMT Global Survey Office, Hematology, University Hospital, Basel, Switzerland
| | - Mickey Koh
- St George's Hospital and Medical School, London, UK
| | - Jeff Szer
- Clinical Haematology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Dietger Niederwieser
- Department of Hematology and Medical Oncology, University Hospital, Leipzig, Germany.
| | - Nicolas Novitzky
- African Blood and Marrow Transplantation Society, Bern, South Africa
| | | |
Collapse
|
15
|
Hashmi SK, Srivastava A, Rasheed W, Adil S, Wu T, Jagasia M, Nassar A, Hwang WY, Hamidieh AA, Greinix HT, Pasquini MC, Apperley JF, Aljurf M. Cost and quality issues in establishing hematopoietic cell transplant program in developing countries. Hematol Oncol Stem Cell Ther 2017; 10:167-172. [DOI: 10.1016/j.hemonc.2017.05.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 05/16/2017] [Indexed: 01/10/2023] Open
|
16
|
Chumsri S, Serie DJ, Mashadi-Hossein A, Tenner KS, Lauttia SL, Moreno-Aspitia A, McLaughlin SA, Nassar A, Warren S, Danaher P, Colon-Otero G, Lindman H, Joensuu H, Perez EA, Thompson EA. Abstract PD5-06: Prognostic value of molecular tumor infiltrating lymphocyte (mTIL) signatures in HER2-positive breast cancer patients in N9831 and FinHer/FinXX trials. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-pd5-06] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: While previous study showed that the enrichment of immune-related gene expression was associated with outcome in HER2+ patients receiving sequential or concurrent trastuzumab (H), stromal tumor infiltrating lymphocytes (sTIL) have not been consistently shown to associate with outcome in this group of patients. Given that TIL scoring may be subjective, we analyzed molecular signatures of different subsets of tumor infiltrating immune cell populations, using NanoStringTM gene expression data to assess molecular TIL (mTIL) signature enrichment and intrinsic subtype as a function of relapse-free survival (RFS).
Methods: NanoStringTM technology was used to quantify mRNA in samples from 1,280 patients in N9831, 168 patients in FinHer, and 170 patients in FinXX. In N9831, patients in arm A were treated with chemotherapy alone (AC-T), arm B received chemotherapy followed by sequential H (AC-T-H), and arm C received H concurrently with chemotherapy (AC-TH). In the FinHer trial, H was given concurrently for 9 weeks and either 1 year or 9 weeks in FinXX trial. Cox proportional hazard ratio (HR) was used to determine the association of each gene signature with RFS. Different immune subset signatures, including CD45, B-cells, CD8 T-cells, cytotoxic-cells, and T-cells were analyzed using algorithms developed by NanoString.
Results: In N9831, CD45, cytotoxic-cell, and T-cell signatures were significantly associated with improved RFS in patients receiving chemotherapy alone and AC-T-H. However, none of the mTIL signatures were significantly associated with outcome in patients receiving AC-TH. Patients lacking CD45 enrichment had better outcome when H was given concurrently with chemotherapy. The 10-year Kaplan-Meier estimates for RFS in arm B patients with CD45 enrichment or no enrichment were 81.3% and 72.6%, respectively (HR 0.63 [95% CI, 0.42-0.93]; p = 0.02), and in arm C were 83.6% and 79.8%, respectively (HR 0.79, 95%CI 0.49-1.28; p = 0.34). Among patients with HER2-enriched subtype, all of the mTIL signatures were associated with improved RFS in arm A (AC-T) and B (AC-T-H) but remained non-significant in arm C (AC-TH). In patients with luminal subtypes, mTIL signatures were not significantly associated with outcome in patients treated with chemotherapy alone. Similar findings were observed in the FinHer and FinXX trials, in which, none of mTIL signatures were significantly associated with outcome among patients who received H.
Conclusion: This analysis sheds light on previous discrepancy between immune-related gene signature and sTIL findings. Our data also suggests that the poor prognosis associated with lack of infiltrating immune cells can be partly overcome by the concomitant administration of H with chemotherapy. mTIL signatures, specifically CD45, cytoxic, and T cells, were prognostically associated with improved outcome in patients receiving chemotherapy without concurrent trastuzumab. Understanding the role of the immune system in response to H will require a higher degree of granularity than can be achieved by histological quantification of TILs. Further studies are needed to validate the significance of mTIL signatures as predictive or prognostic biomarker in HER+ patients.
Citation Format: Chumsri S, Serie DJ, Mashadi-Hossein A, Tenner KS, Lauttia SL, Moreno-Aspitia A, McLaughlin SA, Nassar A, Warren S, Danaher P, Colon-Otero G, Lindman H, Joensuu H, Perez EA, Thompson EA. Prognostic value of molecular tumor infiltrating lymphocyte (mTIL) signatures in HER2-positive breast cancer patients in N9831 and FinHer/FinXX trials [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD5-06.
Collapse
Affiliation(s)
- S Chumsri
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - DJ Serie
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Mashadi-Hossein
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - KS Tenner
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - SL Lauttia
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Moreno-Aspitia
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - SA McLaughlin
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Nassar
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - S Warren
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - P Danaher
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - G Colon-Otero
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - H Lindman
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - H Joensuu
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - EA Perez
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - EA Thompson
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL; Mayo Clinic, Jacksonville, FL; 3NanoString, Inc., Seattle, WA; Mayo Clinic, Rochester, MN; Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
17
|
Chakhtoura M, Nassar A, Arabi A, Cooper C, Harvey N, Mahfoud Z, Nabulsi M, El-Hajj Fuleihan G. Effect of vitamin D replacement on maternal and neonatal outcomes: a randomised controlled trial in pregnant women with hypovitaminosis D. A protocol. BMJ Open 2016; 6:e010818. [PMID: 26956166 PMCID: PMC4785305 DOI: 10.1136/bmjopen-2015-010818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The vitamin D recommended doses during pregnancy differ between societies. The WHO guidelines do not recommend routine prenatal supplementation, but they underscore the fact that women with the lowest levels may benefit most. The effects of routine supplementation during pregnancy on maternal and neonatal clinical outcomes have not been investigated in the Middle East, where hypovitaminosis D is prevalent. Our hypothesis is that in Middle Eastern pregnant women, a vitamin D dose of 3000 IU/day is required to reach a desirable maternal 25-hydroxyvitamin D [25(OH)D] level, and to positively impact infant bone mineral content (BMC). METHODS AND ANALYSIS This is a multicentre blinded randomised controlled trial. Pregnant women presenting to the Obstetrics and Gynaecology clinics will be approached. Eligible women will be randomised to daily equivalent doses of cholecalciferol, 600 IU or 3000 IU, from 15 to 18 weeks gestation until delivery. Maternal 25(OH)D and chemistries will be assessed at study entry, during the third trimester and at delivery. Neonatal anthropometric variables and 25(OH)D level will be measured at birth, and bone and fat mass assessment by dual-energy X-ray absorptiometry scan at 1 month. A sample size of 280 pregnant women is needed to demonstrate a statistically significant difference in the proportion of women reaching a 25(OH)D level ≥ 50 nmol/L at delivery, and a difference in infant BMC of 6 (10)g, for a 90% power and a 2.5% level of significance. The proportions of women achieving a target 25(OH)D level will be compared between the two arms, using χ(2). An independent t test will be used to compare mean infant BMC between the two arms. The primary analysis is an intention-to-treat analysis of unadjusted results. ETHICS AND DISSEMINATION The protocol has been approved by the Institutional Review Board at the American University of Beirut-Lebanon (IM.GEHF.22). The trial results will be published in peer-reviewed medical journals and presented at scientific conferences. TRIAL REGISTRATION NUMBER NCT02434380.
Collapse
Affiliation(s)
- M Chakhtoura
- Calcium Metabolism and Osteoporosis Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - A Nassar
- Department of Obstetrics and Gynecology, American University of Beirut, Beirut, Lebanon
| | - A Arabi
- Calcium Metabolism and Osteoporosis Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - N Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Z Mahfoud
- Department of Public Health, Weill Cornell Medical College, Doha, Qatar
| | - M Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - G El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
18
|
Liu Q, Nassar A, Farias K, Buccini L, Mangino MJ, Baldwin W, Bennett A, O'Rourke C, Iuppa G, Soliman BG, Urcuyo-Llanes D, Okamoto T, Uso TD, Fung J, Abu-Elmagd K, Miller C, Quintini C. Comparing Normothermic Machine Perfusion Preservation With Different Perfusates on Porcine Livers From Donors After Circulatory Death. Am J Transplant 2016; 16:794-807. [PMID: 26663737 DOI: 10.1111/ajt.13546] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/08/2015] [Accepted: 09/25/2015] [Indexed: 01/25/2023]
Abstract
The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs.
Collapse
Affiliation(s)
- Q Liu
- Cleveland Clinic, Cleveland, OH
| | | | | | | | - M J Mangino
- Virginia Commonwealth University, Richmond, VA
| | | | | | | | - G Iuppa
- Cleveland Clinic, Cleveland, OH
| | | | | | | | - T D Uso
- Cleveland Clinic, Cleveland, OH
| | - J Fung
- Cleveland Clinic, Cleveland, OH
| | | | | | | |
Collapse
|
19
|
Nassif J, Abbasi SA, Nassar A, Abu-Musa A, Eid AA. The role of NADPH-derived reactive oxygen species production in the pathogenesis of endometriosis: a novel mechanistic approach. J BIOL REG HOMEOS AG 2016; 30:31-40. [PMID: 27049074] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Endometriosis is defined as endometriotic tissue growing outside the uterine cavity. It is a common gynecological disorder in women of reproductive age and is associated with chronic pelvic pain and infertility. Despite several studies and theories to explain its cause, the exact pathogenesis of endometriosis remains unclear. Retrograde menstruation is the most plausible theory, however, it is not exclusive. The disparity between the actual prevalence of retrograde menstruation and the prevalence of endometriosis suggests that other factors may determine the susceptibility to endometriosis development. Oxidative stress has been associated with endometriosis. This study aimed to explore the role of NADPH oxidase family in the production of reactive oxygen species (ROS) and to determine whether ROS induce the proliferation of endometriotic implants via mammalian target of rapamycin (mTOR) signaling. Anonymous endometriotic tissue samples were collected from women undergoing laparoscopy for endometriosis. The samples were stained with dihydroethidium and fluorescent images of the slides were taken to detect ROS production. After extraction of RNA from the samples and c-DNA generation, quantitative real-time PCR, protein extraction and Western blot were performed to study gene and protein expression of NADPH oxidase 1 (NOX 1), mTOR and fibronectin. The results showed an increase in ROS levels and NOX 1 gene and protein expression in the endometriotic tissues compared to the normal surrounding tissue control. Also, mTOR and fibronectin, gene expression was found to be increased. Up regulation of NOX at gene and protein level leads to increased production of ROS in the endometriotic tissue, which in turn causes proliferation of the ectopic tissue via alteration of the mTOR signaling pathway. Increased fibronectin gene expression points towards tissue injury in endometriosis as compared to the normal surrounding tissue. This manuscript adds a new insight into the pathogenesis of endometriosis and serves as a background for development of new treatments for the disease-associated pain and infertility.
Collapse
Affiliation(s)
- J Nassif
- Department of Obstetrics and Gynecology, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - S A Abbasi
- Department of Obstetrics and Gynecology, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - A Nassar
- Department of Obstetrics and Gynecology, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - A Abu-Musa
- Department of Obstetrics and Gynecology, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - A A Eid
- Department of Anatomy, Cell Biology and Physiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
20
|
Khan J, Nassar M, Lau J, Qandeel H, Nassar A. Management of impacted bile duct stones encountered during laparoscopic bile duct exploration (LCBDE). Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
21
|
Rossi ED, Bizzarro T, Fadda G, Pontecorvi A, Bernet V, Nassar A. The cytological diagnosis of a 'benign thyroid lesion': is it a real safe diagnosis for the patient? Cytopathology 2015; 27:168-75. [PMID: 26388423 DOI: 10.1111/cyt.12267] [Citation(s) in RCA: 6] [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] [Accepted: 05/20/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE In fine needle aspiration cytology (FNAC), the category of benign thyroid lesions (BTL), which constitutes 65-70% of all thyroid FNAC, and can be correctly diagnosed by morphology alone, is an important entity. A diagnosis of BTL denotes a lesion managed with follow-up unless found in conjunction with compressive symptoms. Although this diagnosis can be quite simple, there are cases in which the scant cellular or colloid component may pose diagnostic issues. Herein, we describe the experiences of evaluating BTL at two large academic institutions. We evaluated the clinical importance of a correct diagnosis of BTL to define the exact inherent risk of a false-negative result (FNR). METHODS From January 2008 through to June 2013, 506 (3.6%) out of 15 850 patients with BTL underwent surgery. All nodules were sampled under sonographic guidance (US) and processed either with liquid-based cytology (LBC), Diff-Quik® smears or alcohol-Papanicolaou staining methods. RESULTS The histological follow-up of 506 BTL series included 493 benign and 13 malignant lesions. The latter group included four follicular carcinomas (FC), two classic variants of papillary thyroid carcinoma (PTC), one macrofollicular PTC and six follicular variants of PTC (FVPC). The malignancy rate for the BTL category was 2.5%. CONCLUSIONS When diagnosed by expert cytopathologists, BTL represents a robust diagnosis and might reduce the number of FNR. Additional diagnostic experience and a large case series could enable cytopathologists to recognise all the morphological entities of BTL. An important additional aid is the extensive sampling of the lesions to reduce issues related to a low cellularity.
Collapse
Affiliation(s)
- E D Rossi
- Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - T Bizzarro
- Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - G Fadda
- Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - A Pontecorvi
- Endocrinology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - V Bernet
- Endocrinology and Metabolic Diseases, Mayo Clinic, Jacksonville, FL, USA
| | - A Nassar
- Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
22
|
Abstract
OBJECTIVE To evaluate the risks and consequences of young maternal age on both the mother and the newborn. STUDY DESIGN A comprehensive literature review on the risks and consequences of adolescent pregnancy was performed. RESULTS Young maternal age is associated with an increased risk of maternal anemia, infections, eclampsia and preeclampsia, emergency cesarean delivery, postpartum depression and inadequate breastfeeding initiation. Infants of teenage mothers are more likely to be premature and have a low birth weight, and are at an increased risk for respiratory distress syndrome and autism later in life. CONCLUSIONS Adolescent pregnancy is a prevalent phenomenon associated with increased risks of both maternal and neonatal complications during and after pregnancy. Being aware of such adverse outcomes is imperative to improving prenatal and perinatal care. Pregnancy progression can also be influenced by the mother's culture, environment, and economic status; advancement in which may be a possible course for future improvement.
Collapse
Affiliation(s)
- D Jeha
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - I Usta
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - L Ghulmiyyah
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Nassar
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| |
Collapse
|
23
|
Gebeily S, Nassar A. Sustained benefit of natalizumab in pediatric multiple sclerosis with breakthrough activity: A case report. Mult Scler Relat Disord 2014. [DOI: 10.1016/j.msard.2014.09.196] [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: 11/27/2022]
|
24
|
Diago T, Quintini C, Di Benedetto F, Trenti L, Nassar A, Bertani H, Cautero N, Lauro A, Pinna AD, Miller CM. Intrahepatic blood flow redistribution after temporary occlusion of the middle hepatic vein during right lobe liver donation: report of a case. Transplant Proc 2014; 46:2437-9. [PMID: 25150605 DOI: 10.1016/j.transproceed.2013.09.058] [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] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/21/2013] [Accepted: 09/12/2013] [Indexed: 10/24/2022]
Abstract
INTRODUCTION One of the critical factors that influence graft function after live donor liver transplantation is the presence or absence of global or sectorial liver congestion. Many authors advocate for routine middle hepatic vein (MHV) reconstruction because it is often difficult to determine when the MHV or one of its major branches have functional significance. Predictive tests to assess hemodynamic and functional significance of the MHV and its tributaries are still under study. CASE REPORT We have described a novel intraoperative manipulation and Doppler ultrasonographic evaluation that led to the decision to include the MHV with the right lobe graft.
Collapse
Affiliation(s)
- T Diago
- Department of Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio.
| | - C Quintini
- Department of Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio
| | - F Di Benedetto
- Centro Trapianti di Fegato e Multiviscerale, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy
| | - L Trenti
- Department of Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio
| | - A Nassar
- Department of Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio
| | - H Bertani
- Department of Gastroenterology, Nuovo Ospedale S. Agostino, Modena, Italy
| | - N Cautero
- Centro Trapianti di Fegato e Multiviscerale, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy
| | - A Lauro
- U.O. Trapianti di Fegato e Multiorgano, Policlinico Sant'Orsola, Universtà di Bologna, Bologna, Italy
| | - A D Pinna
- U.O. Trapianti di Fegato e Multiorgano, Policlinico Sant'Orsola, Universtà di Bologna, Bologna, Italy
| | - C M Miller
- Department of Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
25
|
Urcuyo D, Nassar A, Liu Q, Baldwin W, Poggio E, Fairchild R, Miller C, Goldfarb D, Quintini C. Acellular Perfusion of Porcine Kidneys: Lessons Learned. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01195] [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: 11/25/2022]
|
26
|
Kaplanski J, Nassar A, Sharon-Granit Y, Jabareen A, Kobal SL, Azab AN. Lithium attenuates lipopolysaccharide-induced hypothermia in rats. Eur Rev Med Pharmacol Sci 2014; 18:1829-1837. [PMID: 24992627] [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: 06/03/2023]
Abstract
BACKGROUND Changes in body temperature are common features among patients with sepsis and septic shock. Similarly, systemic administration of bacterial endotoxin (lipopolysaccharide, LPS) to rats leads to an initial hypothermia followed by elevation in body temperature. These changes in body temperature are accompanied by increased levels of prostaglandin E2 (PGE2) in the hypothalamus. OBJECTIVE This study examined the effects of lithium and SB216763 - two different glycogen synthase kinase (GSK)-3 inhibitors - on LPS-induced changes in body temperature and hypothalamic PGE2 levels in endotoxemic rats. MATERIALS AND METHODS Endotoxemia was induced by intraperitoneal injection of LPS (10 mg/kg). Lithium (100 mg/kg) and SB216763 (5 mg/kg) were administered at 2 h before LPS. Body temperature and mortality were monitored during 48 h after LPS injection. In another protocol, rats were sacrificed at 2 h post LPS injection and then, blood, liver and hypothalamus were extracted for inflammatory mediators determination. RESULTS Lithium but not SB216763 significantly reduced LPS-induced hypothermia, while both compounds did not alter the subsequent elevation in body temperature. Moreover, only lithium significantly reduced hypothalamic PGE2 levels. On the other hand, both compounds significantly reduced plasma, hepatic and hypothalamic tumor necrosis factor-α and decreased plasma PGE2 levels. Both compounds did not alter LPS-induced mortality. CONCLUSIONS These results suggest that the attenuation of LPS-induced hypothermia by lithium may derive from its reduction of hypothalamic PGE2 levels.
Collapse
Affiliation(s)
- J Kaplanski
- Department of Clinical Biochemistry and Pharmacology; Department of Cardiology, Soroka University Medical Center; Department of Nursing, School for Community Health Professions - Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | | | | | | | | | | |
Collapse
|
27
|
Waghray A, Nassar A, Hashimoto K, Eghtesad B, Aucejo F, Krishnamurthi V, Uso TD, Srinivas T, Steiger E, Abu-Elmagd K, Quintini C. Combined intestine and kidney transplantation in a patient with encapsulating peritoneal sclerosis: case report. Am J Transplant 2013; 13:3274-7. [PMID: 24266976 DOI: 10.1111/ajt.12505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/24/2013] [Revised: 09/05/2013] [Accepted: 09/06/2013] [Indexed: 01/25/2023]
Abstract
Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of peritoneal dialysis characterized by fibrosis and calcification of the intestine that, in severe cases, can progress to intestinal failure and total parenteral nutrition dependency. Medical and surgical interventions carry a poor prognosis in these patients. We describe a case of a 36-year-old female with end-stage kidney disease and severe EPS not amenable to surgical intervention who underwent a combined intestinal and kidney transplantation. At 3 years posttransplantation, the patient has normal intestinal and kidney function. This represents, to our knowledge, the first report of severe EPS and end-stage kidney disease treated with a combined transplant.
Collapse
Affiliation(s)
- A Waghray
- Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) has evolved over the past two decades to become the standard of care for hematologic and lymphoid malignancies. Major ocular complications after allogeneic HSCT have been increasing in number and severity. Graft-versus-host disease (GVHD) remains a major cause of ocular morbidity after allogeneic HSCT. The main objective of this review is to elucidate the ocular complications in patients developing GVHD following HSCT. Ocular complications secondary to GVHD are common and include dry eye syndrome, acquisition of ocular allergy from donors with allergic disorders. Eyelid changes may occur in GVHD leading to scleroderma-like changes. Patients may develop poliosis, madarosis, vitiligo, lagophthalmos, and entropion. The cornea may show filamentary keratitis, superficial punctate keratitis, corneal ulcers, and peripheral corneal melting which may lead to perforation in severe cases. Scleritis may also occur which can be anterior or posterior. Keratoconjunctivis sicca appears to be the most common presentation of GVHD. The lacrimal glands may be involved with mononuclear cell infiltration of both the major and accessory lacrimal glands and decrease in tear production. Severe dry eye syndrome in patients with GVHD may develop conjunctival scarring, keratinization, and cicatrization of the conjunctiva. Therapy of GVHD includes systemic immunosuppression and local therapy. Surgical treatment in refractory cases includes surgical intervention to improve the manifestation of GVHD of the eye. This may include tarsorrhapy, prose lenses, punctal occlusions and corneal transplantation.
Collapse
Affiliation(s)
- Amr Nassar
- Adult Hematology/HSCT, King Faisal Cancer Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | | | | |
Collapse
|
29
|
Farra C, Nassar A, Arawi T, Ashkar H, Monsef C, Awwad J. The utilization of pre-implantation genetic testing in the absence of governance: a real-time experience. Clin Genet 2013; 86:177-80. [DOI: 10.1111/cge.12250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. Farra
- Human Genetics Unit, Department of Pathology and Laboratory Medicine
| | - A. Nassar
- Department of Obstetrics and Gynecology
| | - T. Arawi
- Salim El-Hoss Bioethics and Professionalism Program; American University of Beirut Faculty of Medicine; Beirut Lebanon
| | - H. Ashkar
- Human Genetics Unit, Department of Pathology and Laboratory Medicine
| | - C. Monsef
- Human Genetics Unit, Department of Pathology and Laboratory Medicine
| | - J. Awwad
- Department of Obstetrics and Gynecology
| |
Collapse
|
30
|
Nassar A, Sankey P, Osborne M, Sheehan D, Daniels I. Low Rate of Local Recurrence in Rectal Cancer Treated Without Short Course Radiotherapy; a Single Centre Experience. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.187] [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: 11/13/2022] Open
|
31
|
Ayas M, Nassar A, Hamidieh AA, Kharfan-Dabaja M, Othman TB, Elhaddad A, Seraihy A, Hussain F, Alimoghaddam K, Ladeb S, Fahmy O, Bazarbachi A, Mohamed SY, Bakr M, Korthof E, Aljurf M, Ghavamzadeh A. Reduced intensity conditioning is effective for hematopoietic SCT in dyskeratosis congenita-related BM failure. Bone Marrow Transplant 2013; 48:1168-72. [PMID: 23542225 DOI: 10.1038/bmt.2013.35] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 12/04/2012] [Accepted: 01/30/2013] [Indexed: 02/08/2023]
Abstract
BM failure (BMF) is a major and frequent complication of dyskeratosis congenita (DKC). Allogeneic hematopoietic SCT (allo-HSCT) represents the only curative treatment for BMF associated with this condition. Transplant-related morbidity/mortality is common especially after myeloablative conditioning regimens. Herein, we report nine cases of patients with DKC who received an allo-SCT at five different member centers within the Eastern Mediterranean Blood and Marrow Transplantation Registry. Between October 1992 and February 2011, nine DKC patients (male, 7 and female, 2), with a median age at transplantation of 19.1 (4.9-31.1) years, underwent an allo-HSCT from HLA-matched, morphologically normal-related donors (100%). Preparative regimens varied according to different centers, but was reduced intensity conditioning (RIC) in eight patients. Graft source was unstimulated BM in five cases (56%) and G-CSF-mobilized PBSCs in four (44%) cases. The median stem cell dose was 6.79 (2.06-12.4) × 10(6) cells/kg body weight. GVHD prophylaxis consisted of CsA in all nine cases; MTX or mycophenolate mofetil were added in five (56%) and two (22%) cases, respectively. Anti-thymocyte globulin was administered at various doses and scheduled in four (44%) cases. Median time-to-neutrophil engraftment was 21 (17-27) days. In one case, late graft failure was noted at 10.4 months post allo-HSCT. Only one patient developed grade II acute GVHD (11%). Extensive chronic GVHD was reported in one case, whereas limited chronic GVHD occurred in another four cases. At a median follow-up of 61 (0.8-212) months, seven (78%) patients were still alive and transfusion independent. One patient died of metastatic gastric adenocarcinoma and graft failure was the cause of death in another patient. This study suggests that RIC preparative regimens are successful in inducing hematopoietic cell engraftment in patients with BMF from DKC. Owing to the limited sample size, the use of registry data and heterogeneity of preparative as well as GVHD prophylaxis regimens reported in this series, we are unable to recommend a particular regimen to be considered as the standard for patients with this disease.
Collapse
Affiliation(s)
- M Ayas
- Adult Hematopoietic Stem Cell Transplantation Program, Oncology Centre, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Nassar A, Visscher DW, Degnim AC, Frank RD, Vierkant RA, Hartmann LC, Frost MH, Ghosh K. Abstract P5-01-08: Complex fibroadenoma is not an independent risk marker for breast cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p5-01-08] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Fibroadenoma (FA) is a relatively common benign breast tumor that can occur in women of any age, with a peak incidence during the second and third decades. The only previous study of this lesion reported that FAs are associated with a 2.2 times increased risk of developing invasive breast cancer (BC) compared to matched controls [1]. This relative risk may increase to 3.1 among patients with complex FA, and remains elevated for decades after diagnosis. However, this study did not thoroughly account for other forms of concomitant risk factors. Our investigative team sought to examine breast cancer risk among women with non-complex and complex FA, overall and stratified by other BC risk factors.
Materials and Methods: The study cohort included women between ages 18 to 85 in the Mayo Benign Breast Disease (BBD) Cohort who underwent excisional breast biopsy between 1967and1991 and were found to have a FA. FA was defined histologically as a combination of epithelial and stromal proliferation. Complex FA was defined as FA associated with any of the following features: sclerosing adenosis, epithelial calcifications, papillary apocrine change, and microcysts greater than 3.0 mm. The primary endpoint was a diagnosis of BC, determined using the Mayo medical record and questionnaire information from study participants. A single breast pathologist, blinded to the initial diagnosis and clinical outcome, performed pathology review. Observed vs. expected BC risk across levels of FA was assessed via standardized incidence ratios (SIRs), using age-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results (SEER) registry. Analyses were carried out overall and within subgroups of involution status (none, partial, complete) and overall histology (non-proliferative disease [NP], proliferative disease without atypia [PDWA] or atypical hyperplasia [AH]).
Results: Of 9097 women in the Mayo BBD Cohort, FA were identified in 2139- non-complex in 1903 (20.9%) and complex in 236 (2.6%). The greatest proportion of FA occurred in the 40–69 age range. The mean ages for women with non-complex FA and complex FA were 45.7 and 50.2 years respectively. The SIR of breast cancer in the overall BBD cohort was 1.5 (95% CI [1.4–1.6]). The SIR among women with non-complex FA was 1.5 (95% CI [1.3–1.8]), and for complex FA increased to 2.41 (95% CI [1.7–3.4]). However, women with complex FA were more likely to have other concomitant high-risk histologic features such as PDWA and incomplete involution. In stratified analyses accounting for involution status and PDWA, complex FA did not demonstrate an independent increase in BC risk.
Conclusion: Complex FA does not confer an increased risk for BC beyond other established histologic features. Therefore, women with complex FA should be managed based upon a risk level consistent with the major histologic category of PDWA and/or AH.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-08.
Collapse
|
33
|
|
34
|
Al-Zahrani H, Nassar A, Al-Mohareb F, Al-Sharif F, Mohamed S, Al-Anazi K, Patel M, Rasheed W, Saleh AJM, Bakr M, Ahmed S, Ibrahim K, Hussain F, Elkum N, Elhassan T, Nurgat Z, Chaudhri N, Aljurf M. Fludarabine-based conditioning chemotherapy for allogeneic hematopoietic stem cell transplantation in acquired severe aplastic anemia. Biol Blood Marrow Transplant 2010; 17:717-22. [PMID: 20736079 DOI: 10.1016/j.bbmt.2010.08.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 08/16/2010] [Indexed: 11/24/2022]
Abstract
Thirty-eight patients who met the diagnostic criteria for severe aplastic anemia underwent allogeneic hematopoietic stem cell transplantation (HSCT). The median patient age was 20 years (range, 14-36 years). Twenty-four patients were treatment-naïve, 11 had failed one or more previous courses of immunosuppressive therapy, and 3 had failed a previous HSCT. The conditioning regimen included fludarabine 30 mg/m(2)/day for 3 days (days -9, -8, and -7) and cyclophosphamide 50 mg/kg/day for 4 days (days -5, -4, -3, and -2). Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and short-course methotrexate. All patients underwent transplantation with unmanipulated bone marrow as the stem cell source. The median total nucleated cell (TNC) dose was 2.43 × 10(8)/kg (range, 0.60-6.7 × 10(8)/ kg). The conditioning regimen was well tolerated, with minimal treatment-related mortality. Engraftment was observed in all patients after transplantation; the median time to engraftment of neutrophils and platelets was 18 and 23 days, respectively. Twenty-five of the 27 patients with available chimeric studies at day 180 maintained donor chimerism. Acute GVHD grade ≥II was diagnosed in 4 patients (11%). Extensive chronic GVHD was observed in 8 patients (25%) who survived beyond day +100, at a median observation time of 43 months. Graft rejection with relapse of aplais was observed in one patient. The overall survival (OS) for the whole group was 79%. A trend toward improved OS was observed in the treatment-naïve patients (83% vs 71%), but this was statistically insignificant (P = .384). The fludarabine-based conditioning regimen used in this study with relatively young cohort of patients was well tolerated, with a low rate of rejection and treatment outcomes comparable to those seen in other, more intense and potentially more toxic conditioning regimens. Our results await validation in a larger study, optimally in a randomized controlled manner.
Collapse
Affiliation(s)
- Hazzaa Al-Zahrani
- Adult HSCT Program, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Nassar A, Bertheau Y, Dervin C, Narcy JP, Lemattre M. Ribotyping of Erwinia chrysanthemi Strains in Relation to Their Pathogenic and Geographic Distribution. Appl Environ Microbiol 2010; 60:3781-9. [PMID: 16349416 PMCID: PMC201887 DOI: 10.1128/aem.60.10.3781-3789.1994] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
16S and 23S rRNAs from Escherichia coli were used to study the relationship among a representative collection of strains of Erwinia chrysanthemi differing in their original host and geographical origin. Phenetic analysis of restriction fragment length polymorphisms allowed the distribution of the studied strains into seven clusters. These clusters were similar to those obtained by cladistic methods and appeared to correlate well with the established pathovars and biovars but to a lesser extent with geographical distribution. Except for two groups of strains defined as tropical and temperate isolates (clusters 3 and 4, respectively), our clustering correlated well with botanical classifications of host plants. However, the rRNA groupings were shown to be more discriminative than biovar analysis. To assess the relationship between rRNA clusters and pathogenicity, 12 representative strains from different clusters were tested for pathogenicity on different plants. The two typical symptoms, maceration and wilting, were observed for these strains. The occurrence of the tobacco hypersensitivity reaction for a subset of these strains is discussed in light of recent results concerning the presence of an hrp gene. Considering symptom expression only, rather than the capacity for plant infection, strains from the same cluster were shown to induce similar symptoms in test plants. Thus, since host specificity is still quite controversial, rRNA patterns may constitute a useful tool in taxonomic and epidemiological studies of Erwinia chrysanthemi species.
Collapse
Affiliation(s)
- A Nassar
- Station de Pathologie Végétale, Institut National de la Recherche Agronomique, 78026 Versailles Cedex, France
| | | | | | | | | |
Collapse
|
36
|
Nassar A, Cohen C, Siddiqui MT. Utility of glypican-3 and survivin in differentiating hepatocellular carcinoma from benign and preneoplastic hepatic lesions and metastatic carcinomas in liver fine-needle aspiration biopsies. Diagn Cytopathol 2009; 37:629-35. [PMID: 19405109 DOI: 10.1002/dc.21075] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Glypican-3 (GPC-3), a membrane-anchored heparin sulfate proteoglycan, has been shown to be expressed in approximately 80% of hepatocellular carcinoma (HCC) but not in benign hepatic lesions. Survivin, a novel inhibitor of apoptosis, and a prognostic marker, has also been expressed in HCC. We evaluated these two immunomarkers (GPC-3 and survivin) in differentiating HCC from benign and preneoplastic hepatic lesions and metastatic carcinomas, comparing them to HepPar-1 (hepatocyte paraffin-1) in liver fine-needle aspiration biopsies (FNAB).Immunohistochemistry for GPC-3, survivin and HepPar-1 was performed on 92 FNAB including HCC, hepatic cirrhosis, focal nodular hyperplasia (FNH), hepatic adenoma, dysplastic hepatic nodules and metastatic carcinomas. Immunostaining was scored as positive, if > or =10% of tumor cells stained.GPC-3 is immunoexpressed in 56.8% of HCC, but not in benign and preneoplastic hepatic lesions, or metastatic carcinomas; whereas survivin is expressed in HCC (86.4%), benign hepatic lesions (85.7%), dysplastic hepatic nodules (100%) and metastatic carcinomas (94.3%). HepPar-1 is immunoexpressed in HCC (72.7%), benign hepatic lesions (100%), dysplastic nodules (100%) and metastatic carcinomas (2.9%). The sensitivity and specificity of GPC-3, survivin and HepPar-1 for detection of HCC are 56.8 and 100%, 86.4 and 6.3%, 72.7 and 70.8%, respectively.GPC-3 is a reliable and more specific immunohistochemical marker than survivin for the diagnosis of HCC in FNAB. HepPar-1, although a more sensitive marker than GPC-3, has a lower specificity for detection of HCC. Our data supports the potentially significant diagnostic utility of GPC-3 in FNABs in differentiating primary malignant from benign and preneoplastic liver lesions, and metastatic carcinomas.
Collapse
Affiliation(s)
- A Nassar
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
| | | | | |
Collapse
|
37
|
Nassar A, Morshedi M, Mahony M, Srisombut C, Lin MH, Oehninger S. Pentoxifylline stimulates various sperm motion parameters and cervical mucus penetrability in patients with asthenozoospermia. Andrologia 2009. [DOI: 10.1111/j.1439-0272.1999.tb02836.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
38
|
Fata A, El-Ghandour A, Serour A, Ahmed E, Nassar A, Serag M, Serour G. O295 Complications of assisted reproductive technique among 1400 intra-cytoplasmic sperm injection cycles at Azhart unit. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60667-6] [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: 11/29/2022]
|
39
|
Tabbara KF, Al-Ghamdi A, Al-Mohareb F, Ayas M, Chaudhri N, Al-Sharif F, Al-Zahrani H, Mohammed SY, Nassar A, Aljurf M. Ocular findings after allogeneic hematopoietic stem cell transplantation. Ophthalmology 2009; 116:1624-9. [PMID: 19729097 DOI: 10.1016/j.ophtha.2009.04.054] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/27/2009] [Accepted: 04/27/2009] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To study the incidence, causes, and outcome of major ocular complications in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). DESIGN Retrospective, noncomparative, observational clinical study. PARTICIPANTS The study included a total of 620 patients who underwent allogeneic HSCT in the period from 1997 to 2007 at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. INTERVENTION Allogeneic HSCT. MAIN OUTCOME MEASURES Patients with ocular complications were referred to the ophthalmology division for complete ophthalmologic examination, including visual acuity, tonometry, Schirmer test, biomicroscopy, and dilated ophthalmoscopy. Laboratory investigations were performed whenever indicated. The incidence and causes of major ocular complications after allogeneic HSCT were determined. Visual acuity at 1 year after allogeneic HSCT was recorded. RESULTS Major ocular complications occurred in 80 (13%) of 620 patients who underwent allogeneic HSCT. There were 36 male patients (45%) and 44 female patients (55%) with a mean age of 29 years and an age range of 9 to 65 years. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporine and methotrexate in 69 patients, and cyclosporine, methotrexate and corticosteroids, or mycophenolate mofetil in 11 patients. The most frequently encountered ocular complications were chronic GVHD, dry eye syndrome without GVHD, corneal ulcers, cataract, glaucoma, cytomegalovirus retinitis, fungal endophthalmitis, and acquisition of allergic conjunctivitis from atopic donors. There was no correlation between the pattern of ocular complications and the transplanted stem cell source. Best-corrected visual acuity (BCVA) at 1 year after transplantation was less than 20/200 in 13 patients (16%), less than 20/50 in 17 patients (21%), and better than 20/50 in 50 patients (63%). CONCLUSIONS Ocular complications are common in patients undergoing allogeneic HSCT. Early recognition and prompt treatment are important. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Khalid F Tabbara
- The Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Aljurf M, Nassar A, Saleh AJ, Almhareb F, Alzahrani H, Walter C, Bakr M, Ahmed SO, Chaudhri N. Maternal acute lymphoctic leukemia with rearrangement of the mixed lineage leukemia gene occurring during pregnancy. Hematol Oncol Stem Cell Ther 2009; 2:399-402. [DOI: 10.1016/s1658-3876(09)50008-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
41
|
|
42
|
Hanley KZ, Siddiqui MT, Lawson D, Cohen C, Nassar A. Evaluation of new monoclonal antibodies in detection of estrogen receptor, progesterone receptor, and Her2 protein expression in breast carcinoma cell block sections using conventional microscopy and quantitative image analysis. Diagn Cytopathol 2009; 37:251-7. [DOI: 10.1002/dc.20989] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
43
|
Nofal A, Al-Makhzangy I, Attwa E, Nassar A, Abdalmoati A. Vascular endothelial growth factor in psoriasis: an indicator of disease severity and control. J Eur Acad Dermatol Venereol 2009; 23:803-6. [PMID: 19309427 DOI: 10.1111/j.1468-3083.2009.03181.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis is a chronic disease characterized by abnormal epidermal proliferation, inflammation and angiogenesis. It has been reported that vascular endothelial growth factor (VEGF) is overexpressed in lesional psoriatic skin and its serum levels are significantly elevated in patients with moderate to severe disease. OBJECTIVE This study aims to evaluate the possible role of VEGF in the pathogenesis of psoriasis, and its significance as an indicator of disease severity and control. METHODS Thirty patients with moderate to severe psoriasis and 10 healthy controls were subjected to baseline evaluation of VEGF. Patients were divided into three groups according to the received treatment: psoralen plus ultraviolet A (PUVA) thrice weekly (group 1), acitretin 50 mg daily (group 2), and combined PUVA twice weekly and acitretin 25 mg daily (group 3).Treatment continued for 16 weeks or up to clinical cure. Every patient was subjected to severity evaluation by Psoriasis Area and Severity Index (PASI) and measurement of serum VEGF before and after treatment. RESULTS Mean serum levels of VEGF were significantly elevated in patients (327 +/- 66.2 pg/mL) than control subjects (178 +/- 83.4 pg/mL). A highly significant correlation was found between VEGF and PASI score, but not with other variables. The best clinical response, the least side-effects and the highest reduction of VEGF serum levels were achieved by the combined therapy. CONCLUSION The present study supported the proposed role of VEGF in the pathogenesis of psoriasis, and suggested that it could serve as a good indicator of disease severity and control.
Collapse
Affiliation(s)
- A Nofal
- Department of Dermatology, Zagazig University, Zagazig, Egypt.
| | | | | | | | | |
Collapse
|
44
|
McKian KP, Reynolds CA, Anderson S, Vierkant RA, Visscher DW, Frost MH, Pankratz VS, Nassar A, Hartmann LC. A novel breast tissue feature strongly associated with risk of breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-5008] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #5008
Background: Accurate, individualized risk prediction for breast cancer is lacking. Tissue-based features, such as the terminal duct lobular unit (TDLU), may help to stratify women into different risk levels as breast lobules are the anatomic sites of origin of breast cancer. As women age, these lobular structures should regress, which results in reduced breast cancer risk. Regression, however, does not occur in all women.
 Materials and Methods: We have quantified the extent of lobule regression on a benign breast biopsy in 85 breast cancer cases and 142 age-matched controls from the Mayo Benign Breast Disease Cohort, by determining number of acini/lobule and lobular area. We also calculated Gail model 5-year predicted risks for these women.
 Results: There is a step-wise increase in breast cancer risk with increasing numbers of acini/lobule (p=0.0004). Adjusting for Gail model score, parity, histology, and family history did not attenuate this association.
 
 Lobular area was similarly associated with risk. The Gail model estimates were associated with risk of breast cancer (p=0.03). We examined the individual accuracy of these measures using the concordance (c) statistic. The Gail model c-statistic was 0.60 (95% CI; 0.50-0.70); the acinar count c-statistic was 0.65 (95% CI; 0.54-0.75). Combining acinar count and lobular area, the c-statistic was 0.68 (95% GI; 0.58-0.78). Adding the Gail model to these did not improve the c-statistic.
 
 Discussion: Novel, tissue-based features that reflect the status of a woman's normal breast lobules are strongly associated with breast cancer risk. These features appear to provide more accurate risk assessment than the currently used Gail model.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5008.
Collapse
|
45
|
Tabbara KF, Nassar A, Ahmed SO, Al Mohareb F, Aljurf M. Acquisition of vernal and atopic keratoconjunctivitis after bone marrow transplantation. Am J Ophthalmol 2008; 146:462-5. [PMID: 18614131 DOI: 10.1016/j.ajo.2008.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2008] [Revised: 05/05/2008] [Accepted: 05/07/2008] [Indexed: 12/30/2022]
Abstract
PURPOSE Vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) result from genetic and environmental factors. We present patients who had no history of atopic disorders before bone marrow transplantation (BMT) and who seem to have acquired VKC or AKC from their donors, who had atopic disorders. DESIGN Observational case series. METHODS The patients in this study were part of a cohort of patients who had undergone allogeneic hemapoietic stem cell transplantation (HSCT) from January 1997 through December 2007. Of 621 HSCT recipients, four recipients who were free of allergic disorders acquired VKC or AKC from their afflicted donors after HSCT. Each patient underwent complete ophthalmologic examination, determination of the total serum immunoglobulin (Ig) E, and conjunctival scrapings. RESULTS Four (0.64%) of 621 patients who had undergone HSCT acquired VKC or AKC after BMT. The donors had VKC or atopic dermatitis. In addition, in two of these four patients, asthma developed. One patient had elevated total serum IgE. Conjunctival scrapings of all four patients revealed the presence of eosinophils. One patient had concurrent graft-versus-host disease. CONCLUSIONS VKC and AKC are systemic allergic disorders characterized by local ocular manifestations. This report suggests the possibility of the acquisition of VKC or AKC after BMT by adoptive transfer.
Collapse
|
46
|
Lima DM, de Almeida BF, Cordioli R, Moura ET, Schimdtbauer I, Nassar A, Silva FM, Zigaib R, Forte D, Giannini F, Coelho J, Park M. Sequential Organ Failure Assessment score trends and sepsis survival in a Brazilian university hospital intensive care unit. Crit Care 2007. [PMCID: PMC4095518 DOI: 10.1186/cc5625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
47
|
Scheifele C, Nassar A, Reichart PA. Prevalence of oral cancer and potentially malignant lesions among shammah users in Yemen. Oral Oncol 2007; 43:42-50. [PMID: 16759897 DOI: 10.1016/j.oraloncology.2005.12.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 12/16/2005] [Accepted: 12/19/2005] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to assess the prevalence of oral precancerous lesions and squamous cell carcinoma (OSCC) in Yemeni users of shammah, a traditional smokeless tobacco habit known in the Arabian Peninsula. The study group comprised 199 male and one female shammah users who were interviewed via a standardised questionnaire and clinically examined in 48 Yemeni villages and cities. Cases with oral leukoplakia (OL) or mucosal burns (MB) were compared with users without any lesion. MB were detected in 31%, of which 46.8% were located on the tongue or floor of the mouth, and OL in 27%, of which 59.2% were located in the same region. In addition, two cases (1%) of apparent OSCC were identified. Statistically significant increased OR (95% CI) of OL were (a) 6.91 (2.66-17.95) for an average duration of the respective shammah application >5min.; (b) 4.90 (1.99-12.08) for a daily frequency of those applications >10; and (c) 4.22 (1.43-12.43) for a daily duration >6h of chewing qat, also a traditional habit in Yemen. Likewise, decreased OR were (a) 0.39 (0.18-0.85) for rinsing the mouth after the shammah application; (b) 0.36 (0.17-0.78) for successful attempts to stop the use in the past; and (c) 0.26 (0.09-0.72) for existing knowledge about the carcinogenicity of shammah that was present in only 19% overall. In conclusion, evidence was shown for a significant association between the prevalence of OL and the daily duration of shammah application in a dose-dependent manner. An appropriate public health program might help to reduce this potential OSCC burden in shammah users.
Collapse
Affiliation(s)
- C Scheifele
- Department of Oral Surgery and Dental Radiology, CharitéCentrum 3 für Zahnmedizin, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
| | | | | |
Collapse
|
48
|
Hilali M, Abdel-Gawad A, Nassar A, Abdel-Wahab A. Hematological and biochemical changes in water buffalo calves (Bubalus bubalis) infected with Trypanosoma evansi. Vet Parasitol 2006; 139:237-43. [PMID: 16567045 DOI: 10.1016/j.vetpar.2006.02.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2005] [Revised: 02/07/2006] [Accepted: 02/14/2006] [Indexed: 10/24/2022]
Abstract
Four water buffalo calves (Bubalus bubalis) were each inoculated intravenously with 10(6)T. evansi (camel isolate) and the fifth calf kept as non-infected control. The blood and sera of all calves were examined every 4 days during the first month post-inoculation (pi) and then once weekly until the end of the experiment (88 days pi). They were examined for hematological and biochemical changes, liver and kidney function tests. Hemoglobin concentration (Hb%), packed cell volume (PCV) and red blood cell count were significantly decreased. Total leucocytic count, lymphocytes and monocytes showed significant increase. Liver function tests revealed significant elevation in the activity of lactate dehydrogenase enzyme (LDH), globulin, total biliruben and indirect biliruben while alkaline phosphatase enzyme showed significant decrease. Kidney function tests revealed significant decrease of both creatinine and urea.
Collapse
Affiliation(s)
- M Hilali
- Parasitology Department, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt.
| | | | | | | |
Collapse
|
49
|
Affiliation(s)
- N J Bett
- Department of Surgery, St Helier NHS Trust Hospital, Wrythe Lane, Carshalton, Surrey SM5 1AA, UK
| | - A Nassar
- Department of Surgery, King Khalid Hospital, PO Box 9515, Jeddah 21423, Saudi Arabia
| | - M Abdulmoneum
- Department of Surgery, King Khalid Hospital, PO Box 9515, Jeddah 21423, Saudi Arabia
| | - A Darzi
- Department of Minimal Access Surgery, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - C Nduka
- Department of Minimal Access Surgery, St Mary's Hospital, Praed Street, London W2 1NY, UK
| |
Collapse
|
50
|
Affiliation(s)
- L Chagla
- Whiston Hospital, Prescot, Merseyside L35 5DR, UK
| | - R Kiff
- Whiston Hospital, Prescot, Merseyside L35 5DR, UK
| | - S T R MacSweeney
- Department of Surgery, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
| | - J C Postlethwaite
- Department of Surgery, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
| | - A Nassar
- Department of Surgery, King Khalid Hospital, PO Box 9515, Jeddah, Saudi Arabia
| |
Collapse
|