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Korayem IM, Ramadan R, Fayed H. Feasibility and early cosmetic outcome of modified lateral intercostal artery perforator flap after breast conservative surgery. BMC Surg 2024; 24:75. [PMID: 38431543 PMCID: PMC10908061 DOI: 10.1186/s12893-024-02367-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The lateral intercostal artery perforator (LICAP) flap aims at replacing the excised breast lump with axillary tissue rich blood supply. The purpose of this study is to report the initial results of a modification LICAP flap technique in terms of intraoperative technical feasibility and short-term cosmetic outcomes in the early postoperative period. METHODS Modified LICAP flap technique was performed on 36 female patients with pathologically proven BC located in the outer half of the breast in the period from June 1, 2021, to April 30, 2022. RESULTS The LICAP flap modification enabled performing the procedure with the patient in supine position without repositioning. The majority of the patients (90%) had satisfactory early cosmetic results as reported by the patients and oncoplastic independent surgeon. CONCLUSION Modified LICAP flap reconstruction is feasible to be performed with the patient in supine position without repositioning and it has satisfactory early cosmetic outcomes.
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Affiliation(s)
- Islam M Korayem
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Rabie Ramadan
- Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Haytham Fayed
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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2
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Abouegylah M, Elemary O, Ahmed AA, ElFeky AM, Fayed H, Gawish M, Mahmoud AA, Gawish A. Impact of breath hold on regional nodal irradiation and heart volume in field in left breast cancer adjuvant irradiation. Clin Transl Oncol 2024; 26:288-296. [PMID: 37382756 DOI: 10.1007/s12094-023-03256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE Compared to the free-breathing technique, adjuvant left breast irradiation after breast-conserving surgery or mastectomy using the breath-hold method significantly reduces the heart mean dose, Left anterior descending artery, and ipsilateral lung doses. Movement with deep inspiration may also reduce heart volume in the field and regional node doses. MATERIALS AND METHODS Pre-radiotherapy planning CT was performed in the free-breathing, and breath-hold techniques using RPM, demographic information, clinicopathological data, heart volume in the field, heart mean dose, LAD mean dose, and regional nodal doses were calculated in both free breathing and DIBH. Fifty patients with left breast cancer receiving left breast adjuvant radiation were enrolled. RESULTS There was no significant difference in axillary LN coverage between the two techniques, except for SCL maximum dose, Axilla I node maximum dose, and Axilla II minimum dose in favor of the breath hold technique. The mean age was 47.54 years, 78% had GII IDC, 66% had positive LVSI results, and 74% of patients had T2. The breath hold strategy resulted in considerably decreased mean heart dose (p = 0.000), LAD dose (p = 0.000), ipsilateral lung mean dose (p = 0.012), and heart volume if the field (p = 0.013). The mean cardiac dosage and the dose of the LAD were significantly correlated (p = 0.000, R = 0.673). Heart volume in the field and heart mean dosage was not significantly correlated (p = 0.285, r = - 0.108). CONCLUSION When compared to free breathing scans, DIBH procedures result in considerably reduced dosage to the OAR and no appreciable changes in dose exposure to regional lymph node stations in patients with left-sided breast cancer.
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Affiliation(s)
- Mohamed Abouegylah
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - O Elemary
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Amany Mostafa ElFeky
- Department of Clinical Oncology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Haytham Fayed
- Department of General Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mostafa Gawish
- Department of General Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amr A Mahmoud
- Department of Clinical Oncology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Ahmed Gawish
- Department of Radiation Oncology, University Hospital Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
- Department of Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Heidelberg University Hospital, Marburg, Germany.
- Department of Radiation Oncology, Marburg University Hospital, Marburg, Germany.
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3
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Saied MH, Rizk MM, El Sayed NAA, Mostafa SOA, Marzouk S, Fayed H. Sequencing of Chromosomal Locus 6q25.1 Revealed Two Significant SNPs rs2046210 and rs2046211 Associated with Breast Cancer: A Case-Control Study in Egyptian Women. Asian Pac J Cancer Prev 2022; 23:1359-1364. [PMID: 35485697 PMCID: PMC9375618 DOI: 10.31557/apjcp.2022.23.4.1359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Breast cancer (BC) is one of the major health problems affecting females in Egypt. Certain chromosomal loci abnormalities were proved to be associated with BC in different populations. One of them is chromosomal locus 6q25.1, that affects estrogen receptor gene (ESR) which controls ER receptor expression. Therefore, the aim of this study was to investigate locus 6q25.1 among group of Egyptian female BC patients and compare the results to healthy matched age controls. Methods: Formalin fixed paraffin embedded (FFPE) samples of sixty newly diagnosed BC patients were sequenced for locus 6q25.1 using genetic analyzer with capillary electrophoresis (3500 GA). The identified single nucleotide polymorphisms (SNPs) were compared to blood samples of forty controls. Realtime PCR using TaqMan probes was used for validation. Results: Two SNPs rs2046210 and rs2046211 were significantly associated with BC. Frequency of rs2046210-A minor allele was 30% in controls, while the frequency of rs2046211-G minor allele was 15%. Rs2046210-A allele was associated with increased risk of BC (P=0.0001), while rs2046211-G allele was associated with reduced risk of BC (P=0.021). Combined analysis of both SNPs showed that haplotype A/C was associated with increased risk of BC (P = 0.042). No significant correlation was found between rs2046210-A allele and ER status, while positive association was observed between rs204621-C allele and ER status (p= 0.005). Conclusion: Our data confirmed the important association between locus 6q25.1 and risk of BC in other populations. The frequencies of minor alleles of both significant SNPs will pave the way for a wider large-scale genome study and to be investigated with other BC risk factors.
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Affiliation(s)
- Marwa H Saied
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed M Rizk
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Salma Osama Ahmed Mostafa
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Salah Marzouk
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Haytham Fayed
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.,Department of Surgical Oncology and Breast Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Ramadan R, Koryem IM, Fayed H. Idiopathic granulomatous mastitis: Risk factors and management. Breast Dis 2022; 41:413-420. [PMID: 36530069 DOI: 10.3233/bd-220047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND IGM has a diagnostic and treatment dilemma. The etiology of IGM is unknown but some conditions have been discussed as predisposing factors including Oral Contraceptive Pills, pregnancy, breast feeding, reproductive age, hyperprolactinemia, infectious and autoimmune diseases. The current study aimed to determine possible risk factors for IGM and to evaluate our experience in its management. PATIENTS AND METHODS The study included forty patients with IGM and forty females with normal breasts as a control group. CST treatment was initiated for all patients; patients who responded completely were followed up without surgical intervention. Failure to respond to medical therapy or incidence of corticosteroid-related complications were considered indications for surgical treatment. All patients were followed up for 6 months to detect recurrence. RESULTS IGM had a significant higher incidence rate in young females within 5 years from the last lactation, smokers, those with hypperprolactinaemia, who had a history of breast feeding and those who received OCP (P = <0.001, <0.001, 0.006, 0.001, 0.023 and 0.027 respectively). The central part of the breast was more affected (9 cases (22.5%)). Multicenteric disease affected 8 cases (20%). Breast Mass was the most common presenting sign. After CST; the mass disappeared in 5 cases (12.5%), mass size reduced in 26 cases (65%) and mass size not affected in 9 cases (22.5%). Surgery was done in whom the mass size was reduced or not affected (35 cases (87.5%)). Disease recurrence was reported in 2 cases (5.7%). CONCLUSION IGM usually affects females in their childbearing period with multiple risk factors mainly parity, smoking, OCP and breast feeding with wide variation regarding the presenting manifestations. We should start with CST as there is always a chance to avoid unnecessary surgery and combination of both modalities can reduce the incidence of recurrence.
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Affiliation(s)
- Rabie Ramadan
- Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Islam M Koryem
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Haytham Fayed
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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5
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Fayed H, Schreiber BE, Denton CP, Coghlan JG. Impact of routine screening on detection, severity and outcome of pulmonary arterial hypertension in systemic sclerosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
It has been reported that up to 20% of systemic sclerosis (SSc) patients can be asymptomatic at the time of pulmonary arterial hypertension (PAH) diagnosis. The significant prevalence rate, lack of symptoms and high morbidity and mortality from SSc-PAH as well as the potential benefit from early intervention with the more widely available therapeutic options provide a strong rationale for active screening programs. The DETECT algorithm was developed in 2013 from a large prospective and multicentre study in SSc patients with higher risk of PAH.
The objective of this study was to examine the impact of a screening program on the early detection of SSc-PAH. We looked at serial patients diagnosed with SSc associated PAH (SSC-PAH) in a large national pulmonary hypertension referral centre.
Patients and methods
All newly diagnosed adult patients with SSc-PAH prospectively enrolled in a large national pulmonary hypertension referral centre. The current study included newly diagnosed patients between January 2006 and January 2018.
Results
Three-hundred and five patients were diagnosed with SSc-PAH in our centre between 2006 and 2018. Of these, 164 patients were diagnosed before 2013 (January 2006 - December 2012) and 141 after 2013 (January 2013 - January 2018). Demographics were similar at presentation between the two groups.
The non-invasive (WHO-FC, 6-MWD and NT-proBNP) and haemodynamic measurements (RAP, CI and SvO2) were used to calculate the ESC guidelines risk score. It was noted that higher proportion of patients in the post-2013 were in the higher risk categories than the pre 213 group (84.4% vs. 78%) but this was not found to be statistically significant (p value 0.356).
There was no statistically significant difference in survival between the two groups (Post 2013 group, 1-, 3- year and 5-year survival was 87.9%, 60.4% and 52.1%, respectively and pre-2013 group 1-, 3- year and 5-year survival 89.6%, 65.2% and 49%, respectively) with a log rank p value of 0.869. Applying Cox regression analysis of proportional hazard and adjusting for ESC risk score at baseline, predicted survival was not found to be statistically different between the two groups. The ESC risk category at baseline was a highly significant predictor of survival as expected.
Conclusion
There remains a strong rationale for active screening for PAH in SSc patients which has a poor prognosis despite advances in therapeutic strategies. However, the current screening programme does not seem to have resulted in significantly earlier detection in this cohort. It would be important to analyse other patient populations in order to understand the impact of screening programmes.
The current screening programs limitations may explain why we have not been able to detect more patients in the lower risk categories. Further development of these programs in order to overcome their shortfalls is direly needed.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): National Health ServiceRoyal Free NHS Trust Survival analysis
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Affiliation(s)
- H Fayed
- Royal Free Hospital, Cardiology, London, United Kingdom
| | | | - C P Denton
- Royal Free Hospital, London, United Kingdom
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6
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Brown J, Norrington K, Kotecha T, Martinez-Naharro A, Fayed H, Teresi L, Denton C, Schreiber B, Fontana M, Kellman P, Coghlan J, Knight DS. P5262Subclinical myocardial abnormalities in systemic sclerosis-associated versus non-connective tissue disease pulmonary hypertension by CMR multiparametric mapping. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Scleroderma (SSc)-associated pulmonary arterial hypertension (PAH) has the worst prognosis of all PAH subtypes despite having relatively more favourable haemodynamic and cardiac functional profiles. Myocardial abnormalities in SSc have been demonstrated by cardiovascular magnetic resonance (CMR) multiparametric tissue mapping. However, myocardial tissue characterisation studies across distinct PAH subtypes including SSc are limited.
Purpose
We compared indices of tissue characterisation by CMR multiparametric mapping between patients with SSc with and without PAH, non-connective tissue disease pulmonary hypertension (non-CTD PH) and healthy volunteers.
Methods
One-hundred and thirty-six patients underwent a CMR study over a 30-month period: 104 patients with systemic sclerosis, of whom 39 had SSc-PAH and 65 had no PH; 32 patients with idiopathic PAH, chronic thromboembolic PH or portopulmonary PH (non-CTD PH group). Patients underwent comprehensive CMR tissue characterisation including quantification of native myocardial T1 (MOLLI), myocardial T2 and ECV from automatically generated tissue maps along with conventional late gadolinium enhancement (LGE) imaging. Twenty age-matched controls underwent the same CMR study protocol. Patients were assessed for PH by right heart catheterisation.
Results
Native myocardial T1 and myocardial T2 and myocardial ECV are significantly elevated in SSc-PAH versus non-CTD PH (all p<0.05, Figure 1) despite no differences in LV systolic function between these patient cohorts. Patients with SSc have similar degrees of elevated T1, T2 and ECV irrespective of the presence or absence of PAH, suggesting a diffuse myocardial process due to SSc itself. Both SSc sub-groups have significantly higher T1, T2 and ECV compared with controls (all p<0.05).
All patients with SSc were subdivided by the presence or absence of ventricular insertion point LGE. Even in the absence of LGE, T1, T2 and ECV were significantly higher in SSc patients versus controls (all p<0.001). However, the presence of focal insertional LGE in SSc was not associated with different burdens of interstitial disease, as defined by median ECV. This highlights the unique role of multiparametric tissue maps in assessing diffuse myocardial involvement beyond the identification of focal LGE.
Conclusion
Subclinical abnormalities of the myocardium can be detected by CMR multiparametric tissue mapping in patients with SSc. The higher native myocardial T1 and T2 along with the elevated ECV in SSc-PAH are likely to be accounted for by SSc involvement itself. Abnormalities of the myocardial architecture could be a potential contributory reason for the poorer outcomes in SSc-PAH versus non-CTD PH despite the more favourable haemodynamics and right heart function observed in the former patient sub-group. Further work should be directed at determining the prognostic capacity of these metrics in SSc-PAH.
Acknowledgement/Funding
British Heart Foundation, Action Pharmaceuticals Ltd
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Affiliation(s)
- J Brown
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - K Norrington
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - T Kotecha
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - A Martinez-Naharro
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - H Fayed
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - L Teresi
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - C Denton
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - B Schreiber
- Royal Free Hospital, Pulmonary Hypertension Service, London, United Kingdom
| | - M Fontana
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
| | - P Kellman
- National Institutes of Health, Bethesda, United States of America
| | - J Coghlan
- Royal Free Hospital, Pulmonary Hypertension Service, London, United Kingdom
| | - D S Knight
- University College London, Department of Cardiac MRI, Royal Free Campus, London, United Kingdom
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7
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Fayed H, Ahmad M, Abdelkhalek R, Kotecha T, Brown J, Okonkwo N, Knight DS, Marino P, Schreiber B, Handler C, Denton CP, Coghlan JG. 4970Validation of ESC/ERS 2015 guidelines risk score in patients with scleroderma associated pulmonary arterial hypertension (SSc-PAH). Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The ESC/ERS 2015 guidelines presented a comprehensive risk assessment model with three risk categories based on different clinical and biomarkers data. Low, intermediate and high risk were defined with one-year mortality of <5%, 5–10% and >10%. Different groups suggested different methods of risk assessment based on this model.
Purpose
We applied three different methods to validate the ESC/ERS risk prediction model for one-year survival in SSc-PAH.
Methods
309 patients with SSc-PAH have been diagnosed and managed in our institution from 2006 to 2017. We used three different risk assessment models that have been previously suggested.
1. Suggested by the Swedish group 1: Having a score of 1 (low risk), 2 (intermediate risk) or 3 (high risk) resulting from the average of the sum obtained after grading each of the variables (whichever available) from 1 to 3 according to ESC/ERS guidelines cut-offs for WHO-functional class (FC), 6-minute walking distance (6MWD), NT-Pro BNP, right atrial pressure (RAP) and cardiac index (CI).
2. Suggested by the French group 2: Having none, 1, 2, 3 or 4 of the following low-risk criteria of; FC, 6MWD, RAP and CI.
3. Instead of the invasive data, The French group also suggested the use of a non-invasive model including NT-Pro BNP.
Patients were divided into different risk groups according to data obtained at baseline and at their 6-month follow-up. Survival analysis over a 5-year period was performed using Kaplan-Meier analysis.
Results
Overall median follow-up was 33.3 months. One year survival was significantly different between the risk groups (p<0.001) using either baseline or follow-up data. Applying the French group non-invasive model, almost two thirds of the population ended up in the higher risk group. Whilst applying the Swedish model, two thirds of the population ended up in the intermediate risk group. In all the models used, there were significantly less number of patients in the lower risk groups at onset with improvement of risk profile at follow up. An important advantage of the Swedish model, that it can be calculated even in the presence of missing data, a problem commonly encountered. The French models are easier to calculate but they cannot be applied when there is missing data.
5-year survival with different models
Conclusion
All models used were valuable in risk prediction of SSc-PAH both at onset and at follow up. However, each model has some caveats which should be considered. In all the methods used, the prevalence of high risk criteria is higher amongst the SSc-PAH population which indicates the higher risk profile at the time of diagnosis in comparison to other PAH populations, which could explain the poorer outcome.
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Affiliation(s)
- H Fayed
- Royal Free Hospital, London, United Kingdom
| | - M Ahmad
- Royal Free Hospital, London, United Kingdom
| | | | - T Kotecha
- Royal Free Hospital, London, United Kingdom
| | - J Brown
- Royal Free Hospital, London, United Kingdom
| | - N Okonkwo
- Royal Free Hospital, London, United Kingdom
| | - D S Knight
- Royal Free Hospital, London, United Kingdom
| | - P Marino
- Royal Free Hospital, London, United Kingdom
| | | | - C Handler
- Royal Free Hospital, London, United Kingdom
| | - C P Denton
- Royal Free Hospital, London, United Kingdom
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8
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Fayed H, Kotecha T, Ahmad M, Nihtyanova S, Schreiber B, Handler C, Denton CP, Knight DS, Coghlan JG. 3017Improved ten-year survival of systemic sclerosis-associated pulmonary arterial hypertension in the contemporary treatment era: a single centre retrospective study of 451 patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Fayed
- Royal Free Hospital, London, United Kingdom
| | - T Kotecha
- Royal Free Hospital, London, United Kingdom
| | - M Ahmad
- Royal Free Hospital, London, United Kingdom
| | | | | | - C Handler
- Royal Free Hospital, London, United Kingdom
| | - C P Denton
- Royal Free Hospital, London, United Kingdom
| | - D S Knight
- Royal Free Hospital, London, United Kingdom
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9
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Boldrini M, Baggiano A, Naharro AM, Kotecha T, Rezk T, Fayed H, Knight D, Moon J, Kellman P, Gillmore J, Hawkins P, Fontana M. 1161Accuracy of non contrast magnetic resonance for clinical diagnosis of cardiac amyloidosis - a 868 patient prospective study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Boldrini
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | | | - A M Naharro
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - T Kotecha
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - T Rezk
- University College London, National Amyloidosis Center, London, United Kingdom
| | - H Fayed
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - D Knight
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - J Moon
- Barts Health NHS Trust, London, United Kingdom
| | - P Kellman
- National Institute of Health (Home), Washington, United States of America
| | - J Gillmore
- University College London, National Amyloidosis Center, London, United Kingdom
| | - P Hawkins
- University College London, National Amyloidosis Center, London, United Kingdom
| | - M Fontana
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
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10
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Alhussini MA, Awad AT, Ashour MH, Abdelateef A, Fayed H. Breast Cancer Sentinel Node Detection: An Alternative Solution for Centers Lacking Nuclear Technology. Breast Care (Basel) 2016; 11:265-268. [PMID: 27721714 DOI: 10.1159/000448409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sentinel lymph node (SLN) has become the gold standard for all cases with no axillary nodal metastasis. The combined radioisotope and blue dye technique is adopted in most centers. The lack of the technology for radioisotope in our institution encouraged us to study the feasibility of methylene blue (MB) for SLN detection in breast cancer patients admitted to Alexandria Surgical Oncology Unit. METHODS A total of 144 cases were subjected to SLN detection by injecting 2 ml of MB 1%. This was followed by standard axillary lymph node dissection. The safety and accuracy of MB as a tracer for detection of SLN were studied. RESULTS The identification rate was 93.15%. The number of SLN identified ranged from 1 to 8 nodes with a mean of 1.75 ± 1.17. The sensitivity of MB dye technique was 96.3%. The false negative rate was 3.7%. The negative predictive value was 97.6% and the accuracy was 98.5%. CONCLUSIONS MB is a safe, reliable, cheap, and accurate alternative tracer for detection of SLN.
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Affiliation(s)
- Mahmoud A Alhussini
- Surgical Oncology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt, Alexandria, Egypt
| | - Ahmed T Awad
- Surgical Oncology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt, Alexandria, Egypt
| | - Mohamed H Ashour
- Surgery Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Ahmed Abdelateef
- Surgical Oncology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt, Alexandria, Egypt
| | - Haytham Fayed
- Surgical Oncology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt, Alexandria, Egypt
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11
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Darwish S, Youssof M, Fayed H, Hassan P, Awaad A. The Role of Peroxisome Proliferator-activated Receptor Gamma in Insulin Resistance Enhanced Alzheimer Disease Pathophysiology. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30476-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Alhussini M, Tarek A, Ghozlan N, Abdelateef A, Fayed H, Kholosy H, Elhusseiny G. PO47 USING LOCAL FLAPS FOR COVERAGE OF DEFECTS AFTER EXCISION OF ADVANCED MALIGNANT BREAST LESIONS. Breast 2013. [DOI: 10.1016/s0960-9776(13)70061-4] [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] Open
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13
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Abdel-Baki AS, Sakran T, Fayed H, Zayed E. Ultrastructural characteristics and histological impacts of Myxobolus naffari (Myxozoa: Myxosporea) infecting Nile labeo Labeo niloticus (Osteichthyes: Cichlidae). Dis Aquat Organ 2010; 90:207-213. [PMID: 20815329 DOI: 10.3354/dao02241] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We describe the ultrastructural characteristics and histological impacts of Myxobolus naffari Abdel-Ghaffar et al., 1998, which infects the Nile fish Labeo niloticus. The prevalence of infection was 65%, with the maximum rate occurring during winter and a lower rate during summer. The histological impacts were manifested as a fusion of the gill epithelia, hyperplasia at the ends of the plasmodia, and atrophy of the external surface of the plasmodia. The ultrastructural study revealed that the plasmodial wall was composed of a single unit membrane and bound externally by a thick layer of collagen fibers. The earliest recognizable stage was the disporous pansporoblast. The development of the parasite was asynchronous, with mature and immature spores randomly distributed throughout the plasmodium.
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Affiliation(s)
- A S Abdel-Baki
- Zoology Department, College of Science, King Saud University, P.O. Box 12455, Riyadh 11451, Saudi Arabia.
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Helmy MH, Ismail SS, Fayed H, El-Bassiouni EA. Effect of selenium supplementation on the activities of glutathione metabolizing enzymes in human hepatoma Hep G2 cell line. Toxicology 2000; 144:57-61. [PMID: 10781871 DOI: 10.1016/s0300-483x(99)00190-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cell culture is an important tool for studying injury to cells exposed to oxidative stress. The human hepatoblastoma derived Hep G2 cells retain their morphology and most of their function in culture and are therefore widely used as an in vitro model of human hepatocytes. Conventional cell culture media are deficient in selenium, which is essential for activation of glutathione peroxidase (GPx), a key enzyme in the defense against oxidative stress. Supplementation of the culture media with 1 microM sodium selenite increased the activities of total GPx by threefold and the selenium-dependent GPx by fourfold as compared to cells cultured in control media. The non-selenium-dependent GPx activity was unchanged. The activities of the other glutathione (GSH)-related enzymes were practically unchanged despite a tendency toward elevation. The activities of oxidized glutathione (GSSG) reductase and catalase increased by 22.4 and 27.4%, respectively. These relatively small increases did not carry statistical significance. Supplementation of tissue culture media with selenium may prove important, particularly for cell protection against oxidative stress.
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Affiliation(s)
- M H Helmy
- Department of Biochemistry, Medical Research Institute, University of Alexandria, Alexandria, Egypt
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Abstract
One hundred and twenty scabietic patients attending the outpatient clinic of the Department of Dermatology, Mansoura University Hospital, voluntarily participated in this uncontrolled, open label study to evaluate ivermectin 20 microg/kg as a scabietic after they had given their consent. The scabietic subjects included in this study were otherwise healthy, mentally competent, aged more than 18 years, and used no topical antiscabietic treatment in the week before ivermectin treatment, or during the 4-week study period. Patients were also required to show clinical evidence of scabies, and the microscopically demonstrated presence of Sarcoptes scabiei, their eggs, or their fecal pellets (scybala). A thorough history was taken, and a physical examination was conducted that included measurement of the pulse, blood pressure, temperature, and weight. For each participant, the distribution of scabies lesions was plotted on a body diagram, and the severity of disease was recorded as mild (10 or fewer lesions), moderate (11-49 lesions), or severe (50 or more lesions). Skin scrapings were examined for mites, eggs, or scybala. Urinalysis, stool analysis, a complete blood count, prothrombin time, and serum chemistry studies (serum creatinine, alanine aminotransferase (ALT), and total bilirubin) were performed before treatment, and 2 and 4 weeks after the drug was given. Ivermectin was administered as scored 6-mg tablets with water, and the dose was designed to provide 200 micrograms/kg (ivermectin was provided by Delta Pharma, Tenth of Ramadan City, Egypt). The patients were instructed to have recently worn clothing, sheets, and towels washed in a hot cycle the day after treatment. The patients were interviewed 3 days after treatment about any symptoms or subjective evidence of adverse reactions. Follow-up examinations were carried out 2 and 4 weeks after intake of ivermectin, and all examination procedures and laboratory investigations were repeated. Cure criteria included absence of nocturnal itching as well as dermatologic evidence of scabies, and negative skin scraping. Patients showing evidence of active scabies or having new lesions during the follow-up visits were given a second dose of ivermectin. All members of the household and immediate family were treated with either topical 5% permethrin cream or 1% gamma benzene hexachloride to reduce the chance of reinfestation.
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Affiliation(s)
- M Elmogy
- Department of Dermatology and Clinical Pathology, Mansoura Faculty of Medicine, Egypt
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Mitwalli A, Malik GH, Fayed H, Al-Mohaya S, Al-Wakeel J, Kechrid S, El Gamal H. Erythropoietin therapy in a pregnant woman on maintenance hemodialysis. Saudi J Kidney Dis Transpl 1994; 5:489-492. [PMID: 18583777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
A 25 year old Saudi female, sixth gravida, para four, on renal replacement therapy with regular dialysis for nearly two years, was diagnosed to be pregnant at 12 weeks, with a single viable fetus. She was managed with increased frequency of dialysis and increased doses of anti-hypertensive drugs. For the control of anemia, which was further worsened by the pregnancy, she was treated with r-HuEPO 125 to 150 u/kg 3 times/week along with iron and vitamin supplements to maintain hemoglobin of 90 gm/L. The pregnancy continued to 36 weeks and she had a spontaneous normal delivery of a male baby without any congenital defects, weighing 1605 grams with Apgar score of four at one minute and nine at five minutes.
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Affiliation(s)
- A Mitwalli
- Department of Nephrology, Security Forces Hospital, Riyadh, Saudi Arabia
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