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Assaf N, El Zibaoui R, Monsef C, Abi Nassif T, Abboud M, Yazbek S. Severe Transfusion-Dependent Thalassemia in Compound Heterozygote Palestinian Siblings with Two α-Globin Gene Defects, Hb Taybe D HBA1: C.119_121delCCA Mutation and HBA2: C.*94A > G Mutation. Hemoglobin 2024; 48:129-132. [PMID: 38626925 DOI: 10.1080/03630269.2024.2338850] [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: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/30/2024]
Abstract
Alpha and Beta Thalassemia are autosomal recessive anemias that cause significant morbidity and mortality worldwide, especially in the Middle East and North Africa (MENA) region where carrier rates reach up to 50%. We report the case of two siblings of Palestinian origin born who presented to our tertiary healthcare center for the management of severe transfusion dependent hemolytic anemia. Before presentation to our center, the siblings were screened for a-thalassemia using the Alpha-globin StripAssay. They were found to carry the α2 polyA-1 [AATAAA > AATAAG] mutation in the heterozygous form, which was insufficient to make a diagnosis. No pathogenic variants were detected on Sanger sequencing of the HBB gene. Full sequencing of the a-gene revealed compound heterozygous variants (HBA1:c.119_121delCCA and the previously detected HBA2:c.*+94A > G Poly A [A->G]) with trans inheritance. This report highlights the impact of non-deletional mutations on α-globin chain stability. The compound heterozygosity of a rare α-globin chain pathogenic variant with a polyadenylation mutation in the probands leads to clinically severe a-thalassemia. Due to the high carrier status, the identification of rare mutations through routine screening techniques in our populations may be insufficient. Ongoing collaboration among hematologists, medical geneticists, and counselors is crucial for phenotypic-genotypic correlation and assessment of adequate genetic testing schemes.
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Affiliation(s)
- Nada Assaf
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Roba El Zibaoui
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Carla Monsef
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Tania Abi Nassif
- Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Miguel Abboud
- Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Soha Yazbek
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Assaf N, Hanania N, Lefebvre C, Penther D, Salmeron G, Petitjean B, Terré C. Molecular characterization of adult IRF4 large B-cell lymphoma with spontaneous remission. Acta Oncol 2023; 62:948-952. [PMID: 37517001 DOI: 10.1080/0284186x.2023.2238546] [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: 05/02/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Nada Assaf
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Noor Hanania
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Christine Lefebvre
- Laboratoire d'Hématologie Biologique, Centre Hospitalier Universitaire de Grenoble Alpes (CHUGA), France
| | | | - Géraldine Salmeron
- Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
- UMR1184, University Paris-Saclay, France
- Department of Laboratory Medicine, Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Bruno Petitjean
- Anatomie et Cytologie Pathologiques, Centre Hospitalier Intercommunal de Poissy Saint Germain en Laye, France
| | - Christine Terré
- Department of Laboratory Medicine, Hemato-Oncologic Cytogenetics, Centre Hospitalier de Versailles, Le Chesnay, France
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Marque M, Chartier R, Donette I, Assaf N, Dast S, Sinna R. [The tube in tube thoracodorsal perforator flap phalloplasty]. ANN CHIR PLAST ESTH 2023; 68:378-384. [PMID: 36801117 DOI: 10.1016/j.anplas.2023.01.003] [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: 09/15/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 02/18/2023]
Abstract
This article deals with a clinical case of a tube in a tube TDAP phalloplasty in a 38 years old trans-man. While penis reconstruction surgery aroused an efflorescence of different operative techniques, the resulting female to male surgery sees these procedures boil down to two or three flaps. If we usually discuss before surgery about the way to lengthen the urinary tract, as the way to implant later for intercourse; the choice of the donor site remains too systematized. Surgeons commonly focus on the reconstructed site prior to the donor site. In this case, laxity in the back and reliability of direct closure make us harvest the thoracodorsal perforator flap. Dissection of perforators saves muscular function and direct closure afford an aesthetic result less visible than a graft on the forearm. The thin flap we harvest allows tube in tube phalloplasty so that phallus and urethra are being built in the same time. One case has been reported in the literature of thoracodorsal perforator flap phalloplasty with grafted urethra, but no case of tube within a tube TDAP phalloplasty.
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Affiliation(s)
- M Marque
- Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France
| | - R Chartier
- Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France
| | - I Donette
- Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France
| | - N Assaf
- Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France
| | - S Dast
- Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France
| | - R Sinna
- Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France.
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Assaf N, Chakhachiro Z. Intrachromosomal amplification 21: A driver of acute myeloid leukemia? EJHaem 2023; 4:857-858. [PMID: 37601843 PMCID: PMC10435686 DOI: 10.1002/jha2.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 08/22/2023]
Affiliation(s)
- Nada Assaf
- Department of Pathology and Laboratory Medicine American University of Beirut Medical Center Beirut Lebanon
| | - Zaher Chakhachiro
- Department of Pathology and Laboratory Medicine American University of Beirut Medical Center Beirut Lebanon
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El Karaaoui A, Ghazeeri G, Assaf N. Insight into the 8p23.1 duplication syndrome: Case report of a young women with infertility. Heliyon 2023; 9:e15515. [PMID: 37123967 PMCID: PMC10130207 DOI: 10.1016/j.heliyon.2023.e15515] [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: 01/09/2023] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 05/02/2023] Open
Abstract
Objective To report the case of a young woman with repeated conception failure, whose karyotype showed an unbalanced complex chromosomal rearrangement involving a large duplication harboring >115 genes and overlapping the 8p23.1 duplication syndrome region. The 8p23.1 duplication syndrome results from a tandem duplication on the short arm of chromosome 8 containing the 4 genes (GATA4, TNKS, SOX7, XKR6) responsible for the most common phenotypic features: developmental delay/learning disabilities, congenital heart disease and dysmorphism. Design Case report and review of the literature. Setting American University of Beirut Medical Center, department of Pathology and Laboratory medicine.Patient(s): Young woman referred to the genetic clinics for the workup of secondary idiopathic infertility with multiple unsuccessful inseminations and in vitro fertilizations. Interventions Peripheral blood karyotype analysis from the patient and her parents. Elucidation of the CCR required whole chromosome painting Fluorescent in Situ Hybridization and Chromosomal Microarray. Main outcome measures The few published reports on 8p23.1 duplication syndrome (<50 cases) describing carriers reveal a wide range of phenotypic consequences with heterogeneous severity. The main outcome is to further understand this syndrome. Results Chromosomal microarray analysis detected a large (12Mb) pathogenic Copy Number Variant (CNV) at 8p23.3p23.1, overlapping the 8p23.1 duplication syndrome region. This CNV, classified as pathogenic, was shown to carry little significance in our patient. Conclusions 8p23.1 duplication syndrome display a variable expressivity, ranging from overt syndromic features to minimal effect on the phenotype as shown in this case. Interpretation of prenatal detection of 8p23.1 duplication especially in preimplantation diagnosis is thus challenging. Nevertheless, this case emphasizes the importance of genetic testing in infertile patients displaying a normal phenotype.
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Affiliation(s)
- AbdulKarim El Karaaoui
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Ghina Ghazeeri
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Lebanon
| | - Nada Assaf
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
- Corresponding author. Department of Pathology and Laboratory Medicine, Cytogenetics division American University of Beirut Medical Center, P.O. Box 11-0236, Pathology and Laboratory Medicine Riad El-Solh, Beirut, 1107 2020, Lebanon.
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El Karaaoui AK, Assaf N. Using the SLIPTA checklist to assess laboratory readiness for Joint Commission International accreditation. Afr J Lab Med 2023; 12:2044. [PMID: 37063602 PMCID: PMC10091060 DOI: 10.4102/ajlm.v12i1.2044] [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: 07/28/2022] [Accepted: 12/13/2022] [Indexed: 04/05/2023] Open
Abstract
Background: The Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) helps prepare laboratories in low- and middle-income countries to achieve international accreditation aligned with the ISO 15189:2012 standards. Accreditation by the Joint Commission International (JCI) is among the highest sought by hospitals worldwide. While the readiness of laboratories with a five-star SLIPTA score to undergo ISO 15189:2012 accreditation was recently assessed, the compliance of the SLIPTA checklist with JCI is still unknown.Objective: The study evaluated the SLIPTA checklist’s utility in assessing laboratories to meet the JCI standards.Methods: We conducted a detailed gap analysis between SLIPTA and JCI laboratory standards from January 2021 to January 2022. We cross-matched the JCI standard requirements to SLIPTA clauses and categorised each standard into ‘met’, ‘partially met’, and ‘not met’. We highlighted similarities, discrepancies, and improvement areas.Results: A total of 109 JCI standards were included. The SLIPTA checklist completely met 61 standards, partially met four, but did not meet 44. The unmet JCI standards focused on the quality planning, control, and improvement sections. Healthcare organisation management and quality control processes, including selecting an accredited reference laboratory, collecting quality management data, creating of post-analytical policies and procedures, and validating monitoring systems, constitute the basis of this preparation.Conclusion: The SLIPTA checklist covers major quality management system elements of the JCI standards for laboratories. However, some components should be addressed to assure readiness for JCI accreditation.What this study adds: This study identified additional areas not covered by the SLIPTA checklist that are required for JCI accreditation.
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Affiliation(s)
- Abdul K. El Karaaoui
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nada Assaf
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Hanania N, Najem E, Tamim H, Assaf N, Majari G, Younes W, Abbas F, Berjawi G, Mahfouz R. Comparison between the accuracy of chest computerized tomography vs. reverse transcriptase polymerase chain reaction in a tertiary care center in Lebanon; along with their correlation to mortality, morbidity and symptoms in COVID-19 patients. Human Gene 2023:201150. [PMID: 37521007 PMCID: PMC9891785 DOI: 10.1016/j.humgen.2023.201150] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives Chest Computerized Tomography has been widely used in COVID patients' assessment. Hence the question arises as to whether there is any correlation between the Ct value and findings on Chest CT scan or clinical presentation of the patient. We wanted to test the hypothesis of whether low Ct values (≤30) in RT-PCR were associated with a high mortality rate, CT scan findings, or with comorbidities such as immunosuppression and lung disease. Methods The radiographic records and RT-PCR Ct values of 371 COVID patents diagnosed at the American University of Beirut Medical Center were reviewed. Results We found out that the sensitivity of chest CT scan compared to RT-PCR, the gold standard, turned out to be 74% (95% CI 69–79%). Specificity, on the other hand was 33% (95% CI 16–55%). The positive predictive value of CT was 94% (95% CI 91–97%) and the negative predictive value was 8% (95% CI 4–16%). low Ct values in RT-PCR were not associated with a higher mortality rate (p-value = 0.416). There was no significant positive association between low Ct value and suspicious CT scan findings (typical and indeterminate for COVID-19), with a p-value of 0.078. There was also no significant association between low Ct value and immunosuppression (p-value = 0.511), or lung disease (p-value =0.06). CT scan findings whether suspicious or not for COVID-19 infection, were not shown to be significantly associated with respiratory symptoms of any kind. No association was found between a history of lung disease, immunosuppression and suspicious CT scan findings for COVID-19. Conclusion As long as this pandemic exists, nucleic acid testing was and remains the gold standard of COVID-19 diagnosis worldwide and in our community as it has a superior diagnostic accuracy to CT scan and higher sensitivity (94% vs 74%).
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Key Words
- covid
- rt-pcr
- ct scan
- ct value
- sensitivity
- aubmc, american university of beirut medical center
- cad, coronary artery disease
- copd, chronic obstructive pulmonary disease
- covid, coronavirus disease
- ct, cycle threshold
- ct, computed tomography
- ed, emergency department
- kvp, kilovolt power
- mas, milliamperes
- mm, millimeters
- pcr, polymerase chain reaction
- rt-pcr, reverse transcriptase polymerase chain reaction
- rrt-pcr, real-time reverse transcriptase polymerase chain reaction
- who, world health organization
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Affiliation(s)
- Noor Hanania
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie Najem
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nada Assaf
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghaidaa Majari
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Wael Younes
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatmeh Abbas
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghina Berjawi
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rami Mahfouz
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon,Corresponding author at: Molecular Diagnostics Laboratory, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon
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Courbier G, Giroux PA, Assaf N, Dast S, Sinna R. [State of affairs and optimization of plastic surgery training in France]. ANN CHIR PLAST ESTH 2023; 68:1-13. [PMID: 36028408 DOI: 10.1016/j.anplas.2022.07.018] [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: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Concerns have been growing for several years among masters, as to the quality and quantity of training in plastic surgery in France. They are mainly based on the reduction in the working time of residents, the appearance of new residents from generation Z to be trained, and finally the multidisciplinarity of plastic surgery in the current context of overspecialization of training center. METHODS In order to objectify these concerns, a survey was carried out among French residents and young heads of plastic surgery to assess their training in the specialty since 2019. We then looked in the law for possibilities to alleviate these concerns. RESULTS All the respondents think that their training in the specialty is incomplete, and few of them have been able to supplement it with rotations outside the subdivision or visits from private practitioners. However, in the law, it is possible to carry out: three residents rotations outside the subdivision, clinics rotations and international exchanges. DISCUSSION At the end of this analysis, we propose three solutions to optimize training in plastic surgery in France: a system of exchange of residents, the opening of residents rotations in clinics, and finally, to facilitate the realization of operating aids with private practitioners. CONCLUSION With these solutions, the field of training for residents could extend from one region to the whole of France. These solutions could easily be applied to other specialties, surgical and medical.
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Affiliation(s)
- G Courbier
- Service de chirurgie plastique, reconstructrice et esthétique, CHU Amiens Sud, 1, rue du Professeur-Christian-Cabrol, 80000 Amiens, France.
| | - P-A Giroux
- Service de chirurgie plastique, reconstructrice et esthétique, CHU Amiens Sud, 1, rue du Professeur-Christian-Cabrol, 80000 Amiens, France
| | - N Assaf
- Service de chirurgie plastique, reconstructrice et esthétique, CHU Amiens Sud, 1, rue du Professeur-Christian-Cabrol, 80000 Amiens, France
| | - S Dast
- Service de chirurgie plastique, reconstructrice et esthétique, CHU Amiens Sud, 1, rue du Professeur-Christian-Cabrol, 80000 Amiens, France
| | - R Sinna
- Service de chirurgie plastique, reconstructrice et esthétique, CHU Amiens Sud, 1, rue du Professeur-Christian-Cabrol, 80000 Amiens, France
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Charafeddine F, Assaf N, Ismail A, Bulbul Z. Novel Trans-2,3-enoyl-CoA reductase-like Variant Associated with Catecholaminergic Polymorphic Ventricular Tachycardia Type 3. HeartRhythm Case Rep 2022; 9:171-177. [PMID: 36970382 PMCID: PMC10030308 DOI: 10.1016/j.hrcr.2022.12.013] [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: 12/24/2022] Open
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Assaf N, Lefebvre C, Raggueneau V, Guignedoux G, Marceau-Renaut A, Chevalier S, Tondeur S, Bories D, Benramdane R, Rousselot P, Terré C. AML with inv(16)/t(16;16) and high-risk cytogenetic abnormalities: atypical features and unfavorable outcome. Hematology 2022; 27:636-641. [PMID: 35622005 DOI: 10.1080/16078454.2022.2078027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Acute myeloid leukemia (AML) with inv(16)/t(16;16) is among the most frequent AML subtypes. It is recognized by the detection of the CBFB-MYH11 fusion which confers a favorable prognosis, irrespective of the presence of secondary cytogenetic abnormalities. However, the effect of additional genetic anomalies on the behavior of inv(16) AML is debatable. Recent case reports describe an unfavorable prognosis for those patients, characterized by early relapse and death. In this study, we present a series of patients with CBFB-MYH11 fusion and high-risk rearrangements to increase knowledge about this potentially distinct subgroup. METHODS All cases with inv(16)/ t(16;16) and one or more high risk abnormalities were reviewed at two tertiary healthcare centers between years 2006 and 2020 in terms of demographics, biological and clinical data. RESULTS Among the total 1447 and 1283 AML cases, the frequency was found to be 0,2% and 0.3%. Clinical data could be retrieved for 5 patients. Detected high-risk abnormalities included TP53 and 5q deletion, complex and monosomal karyotype. The median age was 67 years, with a majority of females (M:F = 1:1.5). Two out of 5 patients presented with therapy related AML, with short latency periods. All patients presented with thrombocytopenia and/or leukocytopenia. Bone marrow aspirates revealed atypical morphology and the detection of rare CBFB-MYH11 fusion transcripts. All 5 patients died, with a short mean overall survival of 5.8 months. DISCUSSION AND CONCLUSION Our series suggests that the presence of high risk abnormalities confers distinct biological features and poor prognosis to inv(16) AML.
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Affiliation(s)
- Nada Assaf
- Department of Pathology and Laboratory Medicine, Cytogenetics division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christine Lefebvre
- Laboratoire d'Hématologie Biologique, Centre Hospitalier Universitaire de Grenoble Alpes (CHUGA), La Tronche, France
| | - Victoria Raggueneau
- Department of Laboratory Medicine, Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Geoffroy Guignedoux
- Laboratoire d'Hématologie, Centre Hospitalier René Dubos Pontoise, Pontoise, France
| | - Alice Marceau-Renaut
- University of Lille, CNRS, Inserm, CHU Lille, Institut de Recherche contre le Cancer de Lille, UMR9020-UMR-S 1277-Canther-Cancer Heterogeneity, Plasticity and Resistance to Therapies, Lille, France
| | - Simon Chevalier
- Laboratoire d'Hématologie Biologique, Centre Hospitalier Universitaire de Grenoble Alpes (CHUGA), La Tronche, France
| | - Sylvie Tondeur
- Laboratoire d'Hématologie Biologique, Centre Hospitalier Universitaire de Grenoble Alpes (CHUGA), La Tronche, France
| | - Dominique Bories
- Department of Molecular Onco-Hematology Henri Mondor Hospital (APHP-UPEC), Créteil, France
| | - Riad Benramdane
- Laboratoire d'Hématologie, Centre Hospitalier René Dubos Pontoise, Pontoise, France
| | - Philippe Rousselot
- Department of Hematology, Centre Hospitalier de Versailles, France & University Paris-Saclay, UMR1184, Le Chesnay, France
| | - Christine Terré
- Department of Laboratory Medicine, Hemato-Oncologic Cytogenetics, Centre Hospitalier de Versailles, Le Chesnay, France
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Assaf N, Karaaoui AE. eP314: Rare unbalanced complex chromosomal rearrangement in a case of infertility: Insight into the 8p23.1 duplication syndrome. Genet Med 2022. [DOI: 10.1016/j.gim.2022.01.349] [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] Open
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12
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Assaf N, Chamseddine F, Taher A, Mahfouz R. Prevalence of thrombophilia-associated mutations and their clinical significance in a large cohort of Lebanese patients. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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13
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Farra C, Assaf N, Karaky N, Diab S, Zaatari G, Cortas N, Daher RT. Association between CYP2A6 genotypes and smoking behavior in Lebanese smokers. Meta Gene 2020. [DOI: 10.1016/j.mgene.2019.100616] [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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Chakhachiro Z, Saroufim M, Safadi B, Attieh M, Assaf N, Shamseddine G, Tamim H, Boulos F. Plasma cells and lymphoid aggregates in sleeve gastrectomy specimens: Normal or gastritis? Medicine (Baltimore) 2020; 99:e18926. [PMID: 32028400 PMCID: PMC7015648 DOI: 10.1097/md.0000000000018926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Lymphoid follicles/aggregates in gastric biopsies have been traditionally linked to Helicobacter pylori gastritis, and less commonly to other inflammatory and neoplastic conditions. The frequency of such aggregates in normal stomachs has yet to be adequately evaluated. This is especially relevant when it comes to diagnosing non-specific chronic gastritis in biopsy specimens with chronic inflammation but no evidence of H pylori infection. Sleeve gastrectomies represent an opportunity to study adequately preserved gastric mucosa in patients who are otherwise asymptomatic and lack a history of gastric disease.To study sleeve gastrectomy specimens to quantify the amount of lymphoid follicles/aggregates and lymphocytic infiltration in normal stomachs.Sixty-eight bariatric sleeve gastrectomies and 13 control specimens from Whipple resections were examined for multiple histologic features including type, quantity, and distribution of chronic inflammation and lymphoid follicles/aggregates. Presence of H pylori was documented by both Hematoxylin and eosin-stained (H&E) and immunohistochemistry (IHC). Clinical information including age, sex, medication intake, prior endoscopy, and/or H pylori infection was recorded. The patient population was divided in 2 groups, H pylori negative versus H pylori positive, and statistical analysis was performed by a biostatistician.Two hundred sixty three fundic sections from 68 bariatric patients were examined. Fifty three patients were found to be H pylori-negative, compared with 15 who were positive for H pylori. Among the H pylori-negative group, the average number of lymphoid aggregates was 3.33, compared with an average of 6.26 in the H pylori positive group (the difference was statistically significant with a P-value of .008). The average number of plasma cells per high power field was 2.15 in the H pylori negative group, compared and average of 5.07 in the H pylori positive group (the difference was also statistically significant with a P-value <.001). Clinically, 10 of the 53 H pylori-negative patients had esophagogastroduodenoscopy (EGD) that showed endoscopic mild non-erosive gastric erythema. The remaining had no documentation of symptoms or medication intake, including Non-steroidal anti-inflammatory drugs (NSAIDs) and Proton Pump Inhibitors (PPI).Our results suggest that the presence of lymphoid aggregates and plasma cells infiltration can be a normal finding in otherwise normal gastric mucosa, though more pronounced in H pylori infected patients.
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Affiliation(s)
| | | | | | | | - Nada Assaf
- Department of Pathology and Laboratory Medicine
| | | | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Assaf N, Nassif S, Tamim H, Bazarbachi A, Zaatari G, Chakhachiro Z. Diagnosing Lymphoproliferative Disorders Using Core Needle Biopsy Versus Surgical Excisional Biopsy: Three-Year Experience of a Reference Center in Lebanon. Clin Lymphoma Myeloma Leuk 2019; 20:e455-e460. [PMID: 32461041 DOI: 10.1016/j.clml.2019.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/16/2019] [Accepted: 11/11/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite current guidelines, a significant increase in the use of core needle biopsy (CNB) has been noted. Our aims were to determine the profile of patients referred for image-guided biopsies, to assess the diagnostic yield of these biopsies, and to learn whether CNB is an effective alternative to surgical excisional biopsy (SEB). PATIENTS AND METHODS All lymph node biopsy samples evaluated in the Department of Pathology and Laboratory Medicine from 2014 to 2017 were included. Patients' demographics, biopsy type, and final diagnosis were recorded and classified as diagnostic or nondiagnostic. The reasons for the latter were evaluated and follow-up was obtained, where available. RESULTS A total of 373 cases, 210 CNB and 163 SEB, were collected. The diagnostic yield was 79% for CNB compared to 97% for SEB. The choice of CNB versus SEB was not dependent on patient's age, gender, or clinical suspicion of malignancy. Failure to reach a diagnosis was due to insufficient or suboptimal tissue in most nondiagnostic CNBs. Lymphoma was equally diagnosed among CNB and SEB. CNB was at an advantage in diagnosing large B-cell lymphomas. CONCLUSION When performed adequately, CNB is a good substitute for SEB. Strict and specific guidelines need to be updated and adopted to indicate how and when it can be used, including the recommendation of concomitant complementary diagnostic laboratory testing such as flow cytometry. The latter should be readily available in order to not compromise the quality and accuracy of the diagnoses.
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Affiliation(s)
- Nada Assaf
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samer Nassif
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Bazarbachi
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghazi Zaatari
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zaher Chakhachiro
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Assi H, Tfayli A, Assaf N, Daya SA, Bidikian AH, Kawsarani D, Fermanian P, Zaatari G, Mahfouz R. Prevalence of T790M mutation among TKI-therapy resistant Lebanese lung cancer patients based on liquid biopsy analysis: a first report from a major tertiary care center. Mol Biol Rep 2019; 46:3671-3676. [PMID: 31147859 DOI: 10.1007/s11033-019-04797-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/03/2019] [Indexed: 01/16/2023]
Abstract
Lung adenocarcinoma patients have variable prognosis due to many factors. Detection of epidermal growth factor receptor (EGFR) activating mutations is one of the factors that implies the need for initiating a first-line EGFR tyrosine kinase inhibitor (TKI) treatment. However, T790M resistance mutation emergence during treatment accounts for most EGFR-TKI drug resistance. The traditional sample taken for T790M mutation analysis is tissue biopsy, but its numerous disadvantages have introduced liquid biopsy as a preferred method for testing. We studied the prevalence of T790M mutation among pulmonary adenocarcinoma patients in Lebanese patients based on liquid biopsy testing the circulating tumor DNA (ctDNA). We have reviewed the laboratory charts of 52 patients who developed resistance on treatment and referred to AUBMC for EGFR T790M Liquid Biopsy to analyze the mutational analysis results for EGFR T790M. In total, 82.6% of the tested lung cancer patients were positive for a specific EGFR mutation. Among these patients, a total 26.9% were positive for T790M, which is comparable to the international prevalence of this mutation. However, for those cases who developed resistance with circulating DNA showing an EGFR mutation, 50% were positive for T790M that is also comparable to the international literature. This is the first report from Lebanon to discuss the prevalence of T790M mutation using liquid biopsy among Lebanese population. An important landmark molecular epidemiology study that will be a reference to all oncologists in Lebanon and the region in assessing the potential for targeted therapy options in the country. In addition, the data will be of an asset to the building international literature related to this disease.
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Affiliation(s)
- Hazem Assi
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Arafat Tfayli
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nada Assaf
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, PO BOX 11-0236, Beirut, Lebanon
| | - Sarah Abou Daya
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, PO BOX 11-0236, Beirut, Lebanon
| | - Aram H Bidikian
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Dima Kawsarani
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, PO BOX 11-0236, Beirut, Lebanon
| | - Puzant Fermanian
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, PO BOX 11-0236, Beirut, Lebanon
| | - Ghazi Zaatari
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, PO BOX 11-0236, Beirut, Lebanon
| | - Rami Mahfouz
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, PO BOX 11-0236, Beirut, Lebanon.
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Rait J, Assaf N, Sharma A, Norman J, Andrews B. How accurate is pre-operative imaging in diagnosing acute appendicitis? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.347] [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: 10/28/2022]
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Assaf N, Nagrecha R, Campbell-Smith T, Chan S. Colorectal cancer diagnosis: How satisfied is your patient? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.224] [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: 12/01/2022]
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Assaf N, Andrews B, Rait J. Case report: Acute gastric necrosis; A rare complication of small bowel obstruction. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.124] [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: 10/28/2022]
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Mercut R, Sinna R, Vaucher R, Giroux P, Assaf N, Lari A, Dast S. Triple flap technique for vulvar reconstruction. ANN CHIR PLAST ESTH 2018; 63:343-348. [DOI: 10.1016/j.anplas.2018.03.007] [Citation(s) in RCA: 1] [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] [Received: 11/29/2017] [Accepted: 03/15/2018] [Indexed: 11/28/2022]
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22
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Almousawi HS, Assaf N, Herlin C, Alharbi M, Michel G, Sinna R, Dast S. Dorsal median lipectomy (the arrow technique): A new approach for the treatment of the circumferential truncal skin and fatty tissue excess. ANN CHIR PLAST ESTH 2017; 62:659-663. [PMID: 28778501 DOI: 10.1016/j.anplas.2017.06.009] [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: 03/06/2017] [Accepted: 06/29/2017] [Indexed: 11/17/2022]
Abstract
The increase in the number of patients who undergo massive weight loss surgery has led to an increasing number of patients who complain of circumferential abdominal skin and soft tissue excess. Currently, the only surgical option to treat soft tissue excess is vertical median abdominal lipectomy (fleur-de-lys technique). However, many patients are reluctant to undergo this surgery because of the position of the scar. We presented a new surgical approach to manage circumferential excess - dorsal median lipectomy (arrow technique) - in which the dorsal scar is well-tolerated by patients.
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Affiliation(s)
- H S Almousawi
- Department of plastic reconstructive and aesthetic surgery, university hospital of Picardie, 80054 Amiens, France
| | - N Assaf
- Department of plastic reconstructive and aesthetic surgery, university hospital of Picardie, 80054 Amiens, France
| | - C Herlin
- Department of plastic and craniofacial surgery, university hospital of Montpellier, Montpellier, France
| | - M Alharbi
- Department of plastic reconstructive and aesthetic surgery, university hospital of Picardie, 80054 Amiens, France
| | - G Michel
- Department of plastic reconstructive and aesthetic surgery, university hospital of Picardie, 80054 Amiens, France
| | - R Sinna
- Department of plastic reconstructive and aesthetic surgery, university hospital of Picardie, 80054 Amiens, France.
| | - S Dast
- Department of plastic reconstructive and aesthetic surgery, university hospital of Picardie, 80054 Amiens, France
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Sidhoum N, Dast S, Perez S, Assaf N, Herlin C, Sinna R. [Superficial Circumflex Iliac Artery Perforator flap (SCIP flap): Revival of the inguinal donor site?]. ANN CHIR PLAST ESTH 2017; 62:646-651. [PMID: 28456429 DOI: 10.1016/j.anplas.2017.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 03/23/2017] [Indexed: 11/17/2022]
Abstract
The SCIP flap based on a superficial circumflex iliac perforator artery (SCIA) was described for the first time by Koshima in 2004 as a large and thin groin flap, with a low morbidity. The purpose of this study is to demonstrate the benefits of SCIP flap to cover cutaneous defects. We present a retrospective study from January 2007 to August 2016. Twelve patients had a SCIP flap reconstruction in the plastic surgery department of Amiens hospital. Thirteen flaps were performed. The average preoperative doppler mapping time was 8minutes. The average size of flaps was 62.5cm2 [21; 180cm2]. The average time required for raising flaps was 61min [52; 82min]. It has not been observed any complication of the flap or donor site. The SCIP flap has a thin paddle and the donor site morbidity is minimal. The surgical technique is safe, accessible and precision is increased by preoperative color doppler mapping. The many strengths of the SCIP flap make it a must in the algorithm for defects management and come to revitalize the inguinal donor site.
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Affiliation(s)
- N Sidhoum
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens-Picardie, Salouel, 80054 Amiens cedex, France
| | - S Dast
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens-Picardie, Salouel, 80054 Amiens cedex, France
| | - S Perez
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens-Picardie, Salouel, 80054 Amiens cedex, France
| | - N Assaf
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens-Picardie, Salouel, 80054 Amiens cedex, France
| | - C Herlin
- Service de chirurgie plastique et craniofaciale, CHU de Montpellier, 34000 Montpellier, France
| | - R Sinna
- Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens-Picardie, Salouel, 80054 Amiens cedex, France.
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Dast S, Vaucher R, Rotari V, Assaf N, David E, Christian H, Sinna R. Les lambeaux cutanés minces dans la prise en charge des pertes de substance cutanée de la main et du membre supérieur. ANN CHIR PLAST ESTH 2017; 62:69-78. [DOI: 10.1016/j.anplas.2016.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 03/07/2016] [Indexed: 10/21/2022]
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Dast S, Dessena L, Assaf N, David E, Herlin C, Sinna R. [Ring finger reconstruction by Colson's flap]. ANN CHIR PLAST ESTH 2016; 62:104-108. [PMID: 27344423 DOI: 10.1016/j.anplas.2016.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/29/2016] [Indexed: 10/21/2022]
Abstract
Surgical treatment of complete cutaneous ring finger avulsion is a challenge in hand surgery. When replantation of the avulsed fragment is not technically feasible, the surgeon must consider reconstruction of soft tissue. Many surgical techniques have been described. We report a case of complete avulsion of the cutaneous sheath and nail of the fourth finger with preservation of mobility and collateral nerves. The reconstruction of soft tissue was performed by a Colson flap-graft. This simple and reliable technique of reconstruction allowed to obtain a functional and sensitive finger with a satisfactory cosmetic result.
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Affiliation(s)
- S Dast
- CHU d'Amiens, service de chirurgie plastique, reconstructrice et esthétique, Amiens, France
| | - L Dessena
- CHU d'Amiens, service de chirurgie plastique, reconstructrice et esthétique, Amiens, France
| | - N Assaf
- CHU d'Amiens, service de chirurgie plastique, reconstructrice et esthétique, Amiens, France
| | - E David
- CHU d'Amiens, unité de chirurgie de la main, Amiens, France
| | - C Herlin
- CHU d'Amiens, service de chirurgie plastique, reconstructrice et esthétique, Amiens, France
| | - R Sinna
- CHU d'Amiens, service de chirurgie plastique, reconstructrice et esthétique, Amiens, France.
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Nair P, Bizzari S, Rajah N, Assaf N, Al-Ali MT, Hamzeh AR. Genetics of multifactorial disorders: proceedings of the 6th Pan Arab Human Genetics Conference. J Transl Med 2016; 14:96. [PMID: 27095177 PMCID: PMC4837509 DOI: 10.1186/s12967-016-0854-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 04/06/2016] [Indexed: 11/10/2022] Open
Abstract
The 6th Pan Arab Human Genetics Conference (PAHGC), "Genetics of Multifactorial Disorders" was organized by the Center for Arab Genomic Studies (http://www.cags.org.ae) in Dubai, United Arab Emirates from 21 to 23 January, 2016. The PAHGCs are held biennially to provide a common platform to bring together regional and international geneticists to share their knowledge and to discuss common issues. Over 800 delegates attended the first 2 days of the conference and these came from various medical and scientific backgrounds. They consisted of geneticists, molecular biologists, medical practitioners, postdoctoral researchers, technical staff (e.g., nurses and lab technicians) and medical students from 35 countries around the world. On the 3rd day, a one-day workshop on "Genetic Counseling" was delivered to 26 participants. The conference focused on four major topics, namely, diabetes, genetics of neurodevelopmental disorders, congenital anomalies and cancer genetics. Personalized medicine was a recurrent theme in most of the research presented at the conference, as was the application of novel molecular findings in clinical settings. This report discusses a summary of the presentations from the meeting.
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Affiliation(s)
- Pratibha Nair
- Centre for Arab Genomic Studies, P.O. Box 22252, Dubai, UAE
| | - Sami Bizzari
- Centre for Arab Genomic Studies, P.O. Box 22252, Dubai, UAE
| | - Nirmal Rajah
- Centre for Arab Genomic Studies, P.O. Box 22252, Dubai, UAE
| | - Nada Assaf
- Centre for Arab Genomic Studies, P.O. Box 22252, Dubai, UAE
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Abstract
The surgical approach of gynecomastia, sexual reassignment surgery in female-to-male transsexuals and the increase of number of obese wishing to turn to plastic surgery led us to deepen the anatomical knowledge of the nipple areola complex (NAC) in men, poorly retailed in the literature. By inspiring us of the methodology of a Japanese study, we studied 50 healthy volunteers male, from 18 to 55 years old, from July till August 2015. We measured various distances relative to the NAC to define its vertical and horizontal position, as well as the internipple distance according to the size, to the weight and to the body mass index (BMI). At the end of the analysis, we were able to underline a lower vertical thoracic position of the NAC in the tall category of person, a more side horizontal position to the subject presenting a high BMI and a linear relation between the BMI and the internipple (Em) defined by (Em)=8.96×BMI. The surgeon's judgment and the desires of the patient are essentials basis of therapeutics decisions that could be lean on this anatomical study, which allowed to establish an idea of the cartography of the NAC in man. It will be interesting and necessary to confront it with other studies with larger scale.
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Affiliation(s)
- R Vaucher
- Service de chirurgie plastique, reconstructrice et esthétique, CHU d'Amiens, site Sud, 80054 Amiens cedex 1, France
| | - S Dast
- Service de chirurgie plastique, reconstructrice et esthétique, CHU d'Amiens, site Sud, 80054 Amiens cedex 1, France
| | - N Assaf
- Service de chirurgie plastique, reconstructrice et esthétique, CHU d'Amiens, site Sud, 80054 Amiens cedex 1, France
| | - R Sinna
- Service de chirurgie plastique, reconstructrice et esthétique, CHU d'Amiens, site Sud, 80054 Amiens cedex 1, France.
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Dast S, Assaf N, Dessena L, Almousawi H, Herlin C, Berna P, Sinna R. Change of paradigm in thoracic radionecrosis management. ANN CHIR PLAST ESTH 2016; 61:200-5. [PMID: 26831037 DOI: 10.1016/j.anplas.2015.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/19/2015] [Indexed: 11/26/2022]
Abstract
Classically, muscular or omental flaps are the gold standard in the management of thoracic defects following radionecrosis debridement. Their vascular supply and antibacterial property was supposed to enhance healing compared with cutaneous flaps. The evolution of reconstructive surgery allowed us to challenge this dogma. Therefore, we present five consecutive cases of thoracic radionecrosis reconstructed with cutaneous perforator flaps. In four patients, we performed a free deep inferior epigastric perforator (DIEP) flap and one patient had a thoracodorsal perforator (TDAP) flap. Median time healing was 22.6 days with satisfactory cutaneous covering and good aesthetic results. There were no flap necrosis, no donor site complications. We believe that perforator flaps are a new alternative, reliable and elegant option that questions the dogma of muscular flaps in the management of thoracic radionecrosis.
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Affiliation(s)
- S Dast
- Department of Plastic, Reconstructive and Aesthetic surgery, Amiens Picardie University, place Victor-Pauchet, 80054 Amiens, France
| | - N Assaf
- Department of Plastic, Reconstructive and Aesthetic surgery, Amiens Picardie University, place Victor-Pauchet, 80054 Amiens, France
| | - L Dessena
- Department of Plastic, Reconstructive and Aesthetic surgery, Amiens Picardie University, place Victor-Pauchet, 80054 Amiens, France
| | - H Almousawi
- Department of Plastic, Reconstructive and Aesthetic surgery, Amiens Picardie University, place Victor-Pauchet, 80054 Amiens, France
| | - C Herlin
- Department of Plastic, Reconstructive and Aesthetic surgery, Amiens Picardie University, place Victor-Pauchet, 80054 Amiens, France
| | - P Berna
- Department of Plastic, Reconstructive and Aesthetic surgery, Amiens Picardie University, place Victor-Pauchet, 80054 Amiens, France
| | - R Sinna
- Department of Plastic, Reconstructive and Aesthetic surgery, Amiens Picardie University, place Victor-Pauchet, 80054 Amiens, France.
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Michel G, Ho Quoc C, Assaf N, Delay E, Sinna R. Reconstruction dynamique de tendon d’Achille par lambeau perforant composite avec évaluation fonctionnelle. ANN CHIR PLAST ESTH 2015; 60:78-83. [DOI: 10.1016/j.anplas.2014.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/18/2014] [Indexed: 10/25/2022]
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Sinna R, Alharbi M, Assaf N, Perignon D, Qassemyar Q, Gianfermi M, Deguines JB, Regimbeau JM, Mauvais F. Management of the perineal wound after abdominoperineal resection. J Visc Surg 2013; 150:9-18. [PMID: 23434360 DOI: 10.1016/j.jviscsurg.2013.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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
Although many options are available for the management of perineal wounds after abdominoperineal resection, ranging from direct closure to flap reconstruction, treatment remains challenging. A better understanding of the aims, drawbacks and progress in perineal wound management after abdominoperineal rectal resection can help the surgeon make better choices for each patient, but it is very difficult to propose a single, optimal, evidence-based procedure for the management of pelvic exenteration. Recent progress provided by the extralevator abdominoperineal resection technique and perforator flap concepts have changed our conception of reconstruction leading to the different technical options highlighted in this review.
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Affiliation(s)
- R Sinna
- Department of Plastic, Reconstructive and Aesthetic Surgery, Amiens University Medical Center, Hôpital Nord, place Victor-Pauchet, 80054 Amiens cedex 01, France.
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Driver J, Ross J, Pandian M, Assaf N, Osimitz T, Holden L. Evaluation of predictive algorithms used for estimating potential postapplication, nondietary ingestion exposures to pesticides associated with children's hand-to-mouth behavior. J Toxicol Environ Health A 2013; 76:556-586. [PMID: 23751001 DOI: 10.1080/15287394.2013.785347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Postapplication exposure assessment related to indoor residential application of pesticide products requires consideration of product use information, application methods, chemical-specific deposition, time-dependent availability and transferability of surface residues, reentry time, and temporal location and macro- and microactivity/behavior patterns ( Baker et al., 2000 ). Children's mouthing behavior results in potential postapplication exposure to available pesticides in treated microenvironments through the nondietary ingestion route, in addition to the dermal or inhalation routes. Children's activities and associated behaviors may result in multiple or repeat contact of dermal areas (clothed and unclothed body areas and hands) with treated surfaces, or surfaces that may have indirect sources of residues. Further, some surfaces contacted may have transferable pesticide residues and others may not. Transfer of residues from the indoor residential environment to the dermal surface (e.g., hands) of an individual has been assumed to be linear as a function of time and number of contacts. However, studies suggest that this transfer process to the hands and other body areas may be rapidly saturable. In the most recent U.S. Environmental Protection Agency (EPA), Office of Pesticide Programs (OPP) "Residential Exposure Assessment Standard Operating Procedures" (U.S. EPA, 2012), the input variable for the number of dermal contacts (with treated surfaces) is an exponent, making the relationship nonlinear. Further, removal processes such as hand washing and transfer to untreated surfaces are important to consider. Predictive algorithms for estimating children's hand-to-mouth-related incidental ingestion exposures post pesticide application have been developed by the EPA/OPP and incorporated into probabilistic models. A review of literature addressing variables used to estimate potential incidental ingestion exposure is presented. Data relevant to input variables for predictive algorithms are discussed, including the results of a multiyear, pesticide transferable residue measurement program conducted by the Non-Dietary Exposure Task Force (NDETF) and the associated distributional characterization for this key variable. Sources of conservative bias in current hand-to-mouth, incidental ingestion exposure estimation and the role of biomonitoring to evaluate predicted exposures are discussed.
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Affiliation(s)
- J Driver
- infoscientific.com, Inc., & risksciences.net, LLC, Manassas, Virginia 20111, USA.
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Salem NA, Assaf N, Ahmed HH. Pleiotropic effects of rimonabant and simvastatin on obesity associated multiple metabolic risk factors in rats. Eur Rev Med Pharmacol Sci 2012; 16:797-807. [PMID: 22913213] [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: 06/01/2023]
Abstract
BACKGROUND Obesity, a worldwide health problem, is a metabolic disease currently associated with a cluster and progressive pathologies presenting several features of metabolic syndrome. OBJECTIVES The present study was undertaken to investigate the effect of rimonabant, simvastatin and their combination on obesity associated metabolic disorder mediators in adult male rats. MATERIALS AND METHODS Fifty adult male Wistar rats weighing (120 +/- 10 g) were divided into five groups: Group 1 was kept on standard rodent chow and served as normal diet control. Group 2 was given high fat diet (HFD) for twenty weeks and served as HFD control. Groups 3, 4 and 5 administered HFD for ten weeks and then orally received rimonabant (2 mg/kg/day), simvastatin (10 mg/kg/day), combination of both drugs, respectively for another ten weeks with continuing feeding HFD. RESULTS The current results showed that the treatment of HFD rats with either rimonabant or simvastatin significantly reduced body mass index, total cholesterol, triacylglycerides, low density lipoproteins, tumor necrosis factor alpha and monocyte chemoattractant protein-1, while increased adiponectin serum levels. Rimonabant showed to be more effective than simvastatin. Moreover, concomitant administration of rimonabant and simvastatin achieved the highest effect which nearly normalized most of the studied parameters as compared to singular therapy. CONCLUSION Rimonabant is the drug of primary choice as singular therapy for obesity. The adjunct therapy of rimonabant with simvastatin may be a novel and a promising therapeutic approach as it has a beneficial effect on the pathophysiological processes of obesity and its associated metabolic disorders.
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Affiliation(s)
- N A Salem
- Department of Narcotics, Ergogenic Aids and Poisons, National Research Centre, Cairo, Egypt.
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Assaf N, Oakeshott P. Use of, and attitudes to, long-acting reversible contraception in inner London further education college students. Int J STD AIDS 2011; 22:616. [PMID: 21998192 DOI: 10.1258/ijsa.2011.011100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Doz M, Assaf N, Trystram D, Godon-Hardy S, Boquet L, Chomette E, Reyes L, Fredy D, Meder J. P-12 L’embolisation des anévrismes intracrâniens rompus : étude de cout. J Neuroradiol 2004. [DOI: 10.1016/s0150-9861(04)96941-6] [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: 10/22/2022]
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Bekaert M, Fortin F, Oppenheim C, Lion S, Pierrefitte S, Assaf N, Debaets J, Meder J, Fredy D. IRM haute résolution de la plaque d’athérosclérose carotide. J Neuroradiol 2004. [DOI: 10.1016/s0150-9861(04)96929-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hochman J, Assaf N, Deckert-Schlüter M, Wiestler OD, Pe'er J. Entry routes of malignant lymphoma into the brain and eyes in a mouse model. Cancer Res 2001; 61:5242-7. [PMID: 11431365] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
We have recently developed a novel mouse model for studying the infiltration of malignant lymphoma to the eye and brain. After i.p. inoculation of variant S49 mouse lymphoma cells into young mice (optimum: day 7 postnatal), specific homing of these cells (named Rev-2-T-6) to the brain and eyes took place. This model offers an opportunity to study the routes of infiltration to these sites and spread thereof, as well as the molecular mechanisms that govern this metastasis. By applying a time course histopathological analysis, we demonstrate that infiltration of the brain and eyes can be visualized as early as days 9 and 14 after inoculation, respectively. The lymphoma cells enter the brain preferentially through the choroid plexus and cranial nerves. Infiltration of the rostral part occurs before the caudal part of the brain. Once within the brain, the cells spread within it as well as migrate along the optic nerve sheath into the eyes, where they continue to migrate along the choroid, ciliary body, iris, and into the anterior chamber of the eye. The orbit is also infiltrated by the lymphoma cells. However, this occurs independent of the brain-optic nerve-intraocular route.
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Affiliation(s)
- J Hochman
- Department of Cell and Animal Biology, Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem 91904, Israel.
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Assaf N, Hasson T, Hoch-Marchaim H, Pe'er J, Gnessin H, Deckert-Schlüter M, Wiestler OD, Hochman J. An experimental model for infiltration of malignant lymphoma to the eye and brain. Virchows Arch 1997; 431:459-67. [PMID: 9428935 DOI: 10.1007/s004280050124] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [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: 02/05/2023]
Abstract
Currently there is no adequate experimental model available whereby the lethal infiltration of malignant lymphoma to the eye and CNS can be studied. Variant S49 mouse lymphoma cells that exhibit cell-cell adhesion properties (named Rev-2-T-6) were inoculated intraperitoneally into Balb/C mice at the ages of 6-60 days postnatal. Mice inoculated between days 6-11 postnatal developed signs of eye and CNS involvement with an apparent peak (58% of mice) at day 7. None of the mice inoculated beyond day 11 exhibited such signs. Histological analysis of these sites revealed tumorous infiltrates into a variety of structures in the orbit, intraocular tissues, along the optic nerve and in the brain. Additional analysis of the histopathological data, based on the structures demonstrating the highest frequency of lymphoma infiltration, suggests preferred routes of lymphoma entry to the brain and eye. Thus, entry to the brain can occur mainly through the choroid plexus and cranial nerves or cranial nerve ganglia. Entry to the eye may occur from the brain (along the optic nerve), and through hematogenous infiltration of orbital structures. No data were found that would support retrograde infiltration of the lymphoma from the eye to the brain. These findings present an experimental model for addressing the molecular mechanisms that govern homing of malignant lymphoma to the eye and brain, as well as the development of experimental therapeutic modalities for malignant lymphoma in these organs.
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Affiliation(s)
- N Assaf
- Department of Cell and Animal Biology, Hebrew University of Jerusalem, Israel
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Saleh H, Masood S, Wynn G, Assaf N. Unsuspected metastatic renal cell carcinoma diagnosed by fine needle aspiration biopsy. A report of four cases with immunocytochemical contributions. Acta Cytol 1994; 38:554-61. [PMID: 8042422] [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] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Fine needle aspiration biopsy (FNAB) is currently considered a valid procedure in the diagnosis of various primary and metastatic neoplasms. It is also known that computed tomography (CT)-guided percutaneous FNAB of the kidney is very useful in diagnosing primary renal cell carcinoma (RCC) and has a high accuracy rate. Nonetheless, its usage in the detection of unsuspected metastatic RCC has been described rarely. Below we report four unusual cases of metastatic RCC discovered by FNAB. The patients presented with subcutaneous, pulmonary, adrenal and flank masses with no previous history of RCC. Immunocytochemical (ICC) stains, including cytokeratin, epithelial membrane antigen, vimentin and fat stain, were obtained on two cases and were very helpful in establishing the diagnosis. We suggest that cytopathologists consider metastatic RCC a possibility when evaluating patients with tumors of unknown origin and that FNAB can be useful in diagnosing unsuspected metastatic RCC, especially when assisted by ICC and fat stain.
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Affiliation(s)
- H Saleh
- Department of Pathology, University of Florida Health Science Center, Jacksonville
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Estorc J, Assaf N, Metge L, Lopez FM, Eledjam JJ, D'Athis F. [Abdominal injuries. Value of emergency abdominal echotomography]. Presse Med 1984; 13:2621-3. [PMID: 6239271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The purpose of this study was to evaluate the usefulness of abdominal ultrasonic tomography, among other methods, to detect visceral lesions in multiple traumas of the abdomen. Forty-seven case-records of abdominal traumas observed over an 8-month period were selected. We used a real-time sectorial ultrasound scanner with a 3.5 MHz probe. Positive results were obtained in 11 patients who were operated upon. None of the 33 patients with negative results and only one of the 3 patients with doubtful results underwent surgery. We found that suggestive symptoms were compatible with the absence of any severe visceral lesion and, conversely, that patients with multiple traumas but little suggestive symptoms could present with one or several intra-abdominal lesions. Abdominal ultrasonic tomography can rapidly be performed and its indications are different from, but wider than, those of peritoneal lavage. It is a safe and reliable emergency examination which does not interfere with resuscitation procedures.
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Estorc J, Assaf N, Romieu M, Louis JF, Lopez F, D'Athis F. [Value of emergency intravenous urography in closed injuries of the abdomen]. Nouv Presse Med 1982; 11:3726-7. [PMID: 7170175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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