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Hassan A, Atkinson KD. Local environment in yeast-based impedance biodosimeters strongly influences the measurable dose. Appl Radiat Isot 2024; 209:111323. [PMID: 38631246 DOI: 10.1016/j.apradiso.2024.111323] [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: 07/11/2023] [Revised: 03/12/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
This work investigates the feasibility of yeast-based impedance measurements for retrospective dosimetry applications. The local environment around yeast cells in a previously developed film-badge was modeled using Geant4. A greater dose response was observed when yeast cells were surrounded by an aluminum-polymer structure, which acted as a conversion layer. Bench-top experiments were conducted using a jar-based dosimeter design that directly combined a finely-ground aluminum conversion medium with yeast powder. It was shown when irradiated in the presence of aluminum grains, yeast cells yielded a higher impedance signal, thereby indicating greater radiation-induced damage. Finally, in separate irradiation experiments, lead and aluminum sheets were placed behind yeast samples and the dosimeters were irradiated to 1 Gy. A 2-fold increase in the impedance signal was shown when samples were positioned in close contact with the lead sheet compared to the aluminum sheet. In all experiments, it was shown that the local environment significantly influences radiative energy deposition in yeast cells.
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Affiliation(s)
- A Hassan
- Ontario Tech University, 2000 Simcoe Street, N, Oshawa, Ontario, L1G 0C5, Canada.
| | - K D Atkinson
- Ontario Tech University, 2000 Simcoe Street, N, Oshawa, Ontario, L1G 0C5, Canada
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2
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Hamdy O, Nassar AN, Hassan A, Hassan A, Eldesoky RT, Saleh G. Highly differentiated follicular carcinoma of the ovary with omental and peritoneal spread in a 22-year-old girl; A diagnostic and counseling challenge. Int J Surg Case Rep 2024; 117:109464. [PMID: 38461585 PMCID: PMC10940763 DOI: 10.1016/j.ijscr.2024.109464] [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: 12/11/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Highly differentiated follicular carcinoma of the ovary (HDFCO) is a rare type of thyroid carcinoma originating from struma ovarii, consisting of benign-appearing thyroid follicles spread outside the ovarian tissue. CASE PRESENTATION We present a 22-year-old girl who underwent left salpingo-oophorectomy, omental, and peritoneal biopsies for a complex left ovarian mass. Microscopic examination and Immunohistochemical staining led to the diagnosis of HDFCO with tumor deposits affecting the omental and peritoneal biopsies. The patient was counseled about the nature of her disease and the recommended treatment. Thyroidectomy was performed later, revealing a normal thyroid gland. The patient received an ablative dose of radioactive iodine (150 mci) and a suppressive dose of levothyroxine. This is one of the youngest reported patients ever. CLINICAL DISCUSSION To our knowledge, the patient presented in this case report is one of the youngest patients ever reported in the literature. In the recent WHO Classification of Female Genital Tumors, the term highly differentiated follicular carcinoma arising from struma ovarii (HDFCO) was introduced, to emphasize its low-grade malignant behavior. Due to its rare incidence, there is no standard treatment strategy, but a plan based on surgical intervention is suggested. CONCLUSION Malignant struma ovarii should be put in the differential diagnosis in young patients with suspicious ovarian masses. Adequate patient counseling remains a cornerstone in the journey of management.
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Affiliation(s)
- Omar Hamdy
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt.
| | - Abdullah N Nassar
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed Hassan
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Amany Hassan
- Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Rehab T Eldesoky
- Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Gehad Saleh
- Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Hassan A, Davies N. Expert Insight Into the Use of eHealth Interventions to Aid Medication Adherence During COVID-19. Patient Prefer Adherence 2024; 18:721-731. [PMID: 38529042 PMCID: PMC10962456 DOI: 10.2147/ppa.s437822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
Background and Aim The COVID-19 pandemic has transformed the way healthcare is delivered by the increased utilisation of eHealth tools to deliver remote patient consultations. These eHealth tools served various functions during COVID-19 including monitoring and surveillance of patients. Therefore, assessment of digital health interventions for monitoring medication adherence is crucial to maximise the potential benefits of eHealth. The aim of this study is to understand the perspectives of experts in medication adherence around eHealth interventions used to aid adherence during COVID-19. Methods The study was exploratory and utilized a mixed-method approach. Data was gathered from a survey distributed by the International society for Medication Adherence, and from arranging subsequent structured interviews. Purposive sampling was used to collect data from individuals who were rich in knowledge about the field of medication adherence. Template analysis was used to analyse the collected data. Results Twenty-one participants responded to the survey and 6 completed the interviews. Results showed that eHealth tools reduced barriers to medication adherence by improving health literacy of patients. The main strengths of eHealth technology used in COVID-19 highlighted by participants were convenience and user empowerment. Moreover, weaknesses and barriers included lack of cooperation between technology providers, lack of awareness of doctors about eHealth and patient's digital health literacy. Conclusion and Future Directions The increased utility of eHealth tools during COVID-19 highlighted their vital role in aiding medication adherence of patients. These technologies have both decreased and increased barriers to medication adherence through numerous ways. Future directions should focus on gaining the perspectives of patients on the use of eHealth interventions and its role in aiding medication adherence.
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Affiliation(s)
- Ahmed Hassan
- School of Medicine, Cardiff University, Cardiff, Wales
| | - Non Davies
- North Wales Medical School, Bangor University, Bangor, Wales
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Hassan A, Arujunan K, Mohamed A, Katheria V, Ashton K, Ahmed R, Subar D. Incidence of incisional hernia following liver surgery for colorectal liver metastases. Does the laparoscopic approach reduce the risk? A comparative study. Ann Hepatobiliary Pancreat Surg 2024:ahbps.23-138. [PMID: 38433531 DOI: 10.14701/ahbps.23-138] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 03/05/2024] Open
Abstract
Backgrounds/Aims No reports to compare incisional hernia (IH) incidence between laparoscopic and open colorectal liver metastases (CRLM) resections have previously been made. This is the first comparative study. Methods Single-center retrospective review of patients who underwent CRLM surgery between January 2011 and December 2018. IH relating to liver surgery was confirmed by computed tomography. Patients were divided into laparoscopic liver resection (LLR) and open liver resection (OLR) groups. Data collection included age, sex, presence of diabetes mellitus, steroid intake, history of previous hernia or liver resection, subcutaneous and peri-renal fat thickness, preoperative creatinine and albumin, American Society of Anesthesiologists (ASA) score, major liver resection, surgical site infection, synchronous presentation, and preoperative chemotherapy. Results Two hundred and forty-seven patients were included with a mean follow-up period of 41 ± 29 months (mean ± standard deviation). Eighty seven (35%) patients had LLR and 160 patients had OLR. No significant difference in the incidence of IH between LLR and OLR was found at 1 and 3 years, respectively ([10%, 19%] vs. [10%, 19%], p = 0.95). On multivariate analysis, previous hernia history (hazard ratio [HR], 2.22; 95% confidence interval [CI], 1.56-4.86) and subcutaneous fat thickness (HR, 2.22; 95% CI, 1.19-4.13) were independent risk factors. Length of hospital stay was shorter in LLR (6 ± 4 days vs. 10 ± 8 days, p < 0.001), in comparison to OLR. Conclusions In CRLM, no difference in the incidence of IH between LLR and OLR was found. Previous hernia and subcutaneous fat thickness were risk factors. Further studies are needed to assess modifiable risk factors to develop IH in LLR.
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Affiliation(s)
- Ahmed Hassan
- Department of General & HPB Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK
- Blackburn Research Innovation Development Group in General Surgery (BRIDGES), Royal Blackburn Hospital, Blackburn, UK
| | - Kalaiyarasi Arujunan
- Department of General & HPB Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK
| | - Ali Mohamed
- Department of General & HPB Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK
| | - Vickey Katheria
- Department of General & HPB Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK
| | - Kevin Ashton
- University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster, UK
| | - Rami Ahmed
- Department of General & HPB Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK
| | - Daren Subar
- Department of General & HPB Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK
- Blackburn Research Innovation Development Group in General Surgery (BRIDGES), Royal Blackburn Hospital, Blackburn, UK
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Hassan A, Alnaser IA. A Review of Different Manufacturing Methods of Metallic Foams. ACS Omega 2024; 9:6280-6295. [PMID: 38371845 PMCID: PMC10870358 DOI: 10.1021/acsomega.3c08613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 02/20/2024]
Abstract
Metallic foam is a popular topic due to its diverse industrial applications and unique combination of properties. Metallic foam is significantly lighter than nonfoam metal materials due to its porous structure, which incorporates a substantial amount of air or voids. This lower density makes metallic foam advantageous in applications in which weight reduction is critical. This makes it ideal for the aerospace, automotive, and construction industries; also, its versatile nature continues to make it an attractive material for various industrial applications such as impact absorbers, heat exchangers, and biomedical and marine engineering. However, the choice between metallic foam and nonfoam metal also depends on other factors like mechanical properties, cost, and specific application requirements. This review describes various fabrication methods of metallic foam that include the liquid metallurgy route which uses liquid or semiliquid metal, the powder metallurgy route uses metal in powder form, metal ion, and the metal vapor route which uses electrolytic deposition method to produce metallic foam. These methods include direct gas injection, adding blowing agents in solid or liquid metals, investment casting, the addition of a space holder in the precursor, metallic ion, vapor deposition on a polymer sponge, and many more. The morphology of metallic foam depends upon the method that is chosen for fabrication, and up to 98% porosity can be achieved by these methods. Additive manufacturing for metallic foam fabrication is an emerging field based on selective laser melting and electron beam melting principles. It has exceptional possibilities for generating complicated 3D shapes and customizing the material characteristics. The main purpose of this review article is to give significant insights into the various production procedures for metallic foams to researchers, engineers, and industry experts, assisting in the selection of acceptable methods depending on individual application needs. This review investigates the manufacturing conditions for metallic foams and finally discusses their advantages, drawbacks, and obstacles in mass production. The findings add to current efforts to expand metallic foam technology and encourage its wider application across diverse sectors, opening the path for future research and development.
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Affiliation(s)
- Ahmed Hassan
- Department of Mechanical
Engineering, King Saud University, Riyadh, 11451 Saudi Arabia
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Gritti MN, Farid P, Hassan A, Marshall AC. Cardiac Catheterization Interventions in the Right Ventricular Outflow Tract and Branch Pulmonary Arteries Following the Arterial Switch Operation. Pediatr Cardiol 2024:10.1007/s00246-024-03408-w. [PMID: 38341390 DOI: 10.1007/s00246-024-03408-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024]
Abstract
The arterial switch operation for d-transposition of the great arteries achieves anatomic repair but creates the potential for right ventricular outflow tract obstruction as a result of the LeCompte maneuver. The resultant right ventricular hypertension is generally well tolerated but a select group are referred for cardiac catheterization. The outcomes of these catheterizations have not been well described. The objective of this study was to describe the degree and nature of right ventricular outflow tract obstruction found during cardiac catheterization among patients following the arterial switch operation as well as determine the rate of intervention and assess the acute impact of any catheter intervention undertaken. We conducted a retrospective study of patients after arterial switch operation with the LeCompte maneuver and subsequent right heart catheterization. Descriptive statistics were reported, and paired sample t tests were used for analysis. 544 children had an arterial switch operation, of which 110 children (20%) had a cardiac catheterization procedure after surgery and 11% had a right heart catheterization. Of the right heart catheterizations, 90% had an intervention (balloon and/or stent). In the interventional group, the right ventricle to systemic pressure ratio decreased modestly, from 2/3 to half systemic, after balloon dilation and/or stent placement (p < 0.01). No serious complications were observed.
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Affiliation(s)
- Michael N Gritti
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Division of Paediatric Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Pedrom Farid
- Division of Paediatric Cardiology, The Hospital for Sick Children, Toronto, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Ahmed Hassan
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Paediatric Cardiology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Audrey C Marshall
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Paediatric Cardiology, The Hospital for Sick Children, Toronto, ON, Canada
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Odak I, Riemann L, Sandrock I, Cossmann A, Ramos GM, Hammerschmidt SI, Ritter C, Friedrichsen M, Hassan A, Dopfer-Jablonka A, Stankov MV, Weskamm LM, Addo MM, Ravens I, Willenzon S, Schimrock A, Ristenpart J, Janssen A, Barros-Martins J, Hansen G, Falk C, Behrens GMN, Förster R. Systems biology analysis reveals distinct molecular signatures associated with immune responsiveness to the BNT162b COVID-19 vaccine. EBioMedicine 2024; 99:104947. [PMID: 38160529 PMCID: PMC10792461 DOI: 10.1016/j.ebiom.2023.104947] [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: 08/24/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Human immune responses to COVID-19 vaccines display a large heterogeneity of induced immunity and the underlying immune mechanisms for this remain largely unknown. METHODS Using a systems biology approach, we longitudinally profiled a unique cohort of female high and low responders to the BNT162b vaccine, who were known from previous COVID-19 vaccinations to develop maximum and minimum immune responses to the vaccine. We utilized high dimensional flow cytometry, bulk and single cell mRNA sequencing and 48-plex serum cytokine analyses. FINDINGS We revealed early, transient immunological and molecular signatures that distinguished high from low responders and correlated with B and T cell responses measured 14 days later. High responders featured a distinct transcriptional activity of interferon-driven genes and genes connected to enhanced antigen presentation. This was accompanied by a robust cytokine response related to Th1 differentiation. Both transcriptome and serum cytokine signatures were confirmed in two independent confirmatory cohorts. INTERPRETATION Collectively, our data contribute to a better understanding of the immunogenicity of mRNA-based COVID-19 vaccines, which might lead to the optimization of vaccine designs for individuals with poor vaccine responses. FUNDING German Center for Infection Research, German Center for Lung Research, German Research Foundation, Excellence Strategy EXC 2155 "RESIST" and European Regional Development Fund.
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Affiliation(s)
- Ivan Odak
- Institute of Immunology, Hannover Medical School, Germany
| | - Lennart Riemann
- Institute of Immunology, Hannover Medical School, Germany; Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Germany; Clinician Scientist Program TITUS, Else-Kröner-Fresenius Foundation, Hannover Medical School, Germany
| | - Inga Sandrock
- Institute of Immunology, Hannover Medical School, Germany
| | - Anne Cossmann
- Department for Rheumatology and Immunology, Hannover Medical School, Germany
| | - Gema Morillas Ramos
- Department for Rheumatology and Immunology, Hannover Medical School, Germany
| | | | | | | | - Ahmed Hassan
- Institute of Immunology, Hannover Medical School, Germany
| | - Alexandra Dopfer-Jablonka
- Department for Rheumatology and Immunology, Hannover Medical School, Germany; German Center for Infection Research (DZIF), Partner Sites Hannover-Braunschweig, Germany
| | - Metodi V Stankov
- Department for Rheumatology and Immunology, Hannover Medical School, Germany
| | - Leonie M Weskamm
- Institute for Infection Research and Vaccine Development (IIRVD), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Marylyn M Addo
- Institute for Infection Research and Vaccine Development (IIRVD), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany; First Department of Medicine, Division of Infectious Diseases, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Inga Ravens
- Institute of Immunology, Hannover Medical School, Germany
| | | | - Anja Schimrock
- Institute of Immunology, Hannover Medical School, Germany
| | | | - Anika Janssen
- Institute of Immunology, Hannover Medical School, Germany
| | | | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Germany; Clinician Scientist Program TITUS, Else-Kröner-Fresenius Foundation, Hannover Medical School, Germany; German Center of Lung Research (DZL), BREATH, Hannover, Germany; Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Germany
| | - Christine Falk
- Institute for Transplantation Immunology, Hannover Medical School, Hannover, Germany
| | - Georg M N Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Germany; German Center for Infection Research (DZIF), Partner Sites Hannover-Braunschweig, Germany; Centre for Individualized Infection Medicine (CiiM), Hannover, Germany
| | - Reinhold Förster
- Institute of Immunology, Hannover Medical School, Germany; Clinician Scientist Program TITUS, Else-Kröner-Fresenius Foundation, Hannover Medical School, Germany; German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany; German Center of Lung Research (DZL), BREATH, Hannover, Germany; Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Germany.
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Mughal TA, Ali S, Hassan A, Kazmi SAR, Saleem MZ, Shakir HA, Nazer S, Farooq MA, Awan MZ, Khan MA, Andleeb S, Mumtaz S, Mumtaz S, Tahir HM, Gulzar N. Phytochemical screening, antimicrobial activity, in vitro and in vivo antioxidant activity of Berberis lycium Royle root bark extract. BRAZ J BIOL 2024; 84:e249742. [DOI: 10.1590/1519-6984.249742] [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: 03/12/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract Antioxidants are materials that scavenge or remove free radicals from living systems. The oxidation process ends in the production of free radicals. These free radicals are the chief birthplace of cancerous cells. Antioxidizing agents remove free radical intermediates by terminating oxidation processes by being oxidized themselves. On the other hand, infectious diseases affect the world on a large scale. To fight these diseases several synthetic compounds have been used. Plant based medications play important role in this regard. So, the current research aimed to investigate the antibacterial and antioxidant effect of Berberis lycium Royle root bark (BLR) extract. Berberis lycium Royle was used for phytochemical analysis and also as antimicrobial and antioxidant agents. The antimicrobial activity was evaluated by the agar well diffusion method. Current study revealed that BLR was rich in phytochemicals and toxic against tested pathogenic bacteria. BLR showed the highest activity against S. pyogenes (13.3±0.8 mm). The lowest antibacterial activity was reported against E. coli (0±0 mm). In case of minimum inhibitory concentration, it was observed that BLR with 10 μg/mL concentration showed the highest activity while 2.5 μg/mL of BLR showed the least inhibitory activity. The highest In vitro antioxidant activity was recorded as 65% at 100 µg/mL. In case of in vivo antioxidant activity level of CAT, GSH and SOD were decreased while that of MDA was enhanced in groups treated with CCl4 as compared to the control group. BLR extract treatment reversed all these changes significantly. Current results indicate that BLR is effective against bacterial pathogens and also has antioxidant potential.
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Affiliation(s)
- T. A. Mughal
- Women University of Azad Jammu & Kashmir, Pakistan; Government College University, Pakistan
| | - S. Ali
- Government College University, Pakistan
| | - A. Hassan
- Government College University, Pakistan
| | | | | | | | - S. Nazer
- Women University of Azad Jammu & Kashmir, Pakistan; University of the Punjab, Pakistan
| | | | - M. Z. Awan
- University of Azad Jammu and Kashmir, Pakistan
| | - M. A. Khan
- Green Hills Science College Muzaffarabad, Pakistan
| | - S. Andleeb
- University of Azad Jammu and Kashmir, Pakistan
| | - S. Mumtaz
- Government College University, Pakistan
| | - S. Mumtaz
- Government College University, Pakistan
| | | | - N. Gulzar
- University of Azad Jammu and Kashmir, Pakistan
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Abdelrahman MA, Zaki A, Salem SAM, Salem HF, Ibrahim ARN, Hassan A, Elgendy MO. The Impact of Cefepime and Ampicillin/Sulbactam on Preventing Post-Cesarean Surgical Site Infections, Randomized Controlled Trail. Antibiotics (Basel) 2023; 12:1666. [PMID: 38136700 PMCID: PMC10740998 DOI: 10.3390/antibiotics12121666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/09/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Over the previous three decades, the rate of caesarean sections performed worldwide has grown exponentially. In comparison to a vaginal birth, the risk of all postpartum infections is higher with a cesarean section. One of the key factors contributing to maternal morbidity is the development of infectious complications in the surgical site after a caesarean section. The primary goal of the research was to compare the efficiency of using ampicillin/sulbactam (AMS) and cefepime (CEF) to reduce the incidence of surgical site infections (SSI) following caesarean delivery. This prospective randomized study was conducted among 200 pregnant women scheduled for elective cesarean section. They were collected from the Obstetrics and Gynecology department of Beni-Suef University Hospital, and then they were randomly assigned into two groups. Group (A) received cefepime 30 min before and 12 h after cesarean delivery, while group (B) received ampicillin/sulbactam 30 min before and 12 h after cesarean delivery. The groups were matched regarding the baseline women characteristics. Comparing the cefepime to the ampicillin/sulbactam revealed that the cefepime significantly decreased superficial SSI from 27% to 14% (0.023). A significant decrease was observed in deep SSI with cefepime compared to ampicillin/sulbactam from 24% to 13% (p-value 0.045). Interestingly, when the cefepime was compared to the ampicillin/sulbactam, we noted that the incidence of endometritis significantly decreased from 13% to 5% (p = 0.048). A noted decrease in post-operative fever in cefepime as compared to ampicillin/sulbactam from 18% to 13% (p-value = 0.329). Receiving prophylactic cefepime pre- and post-cesarean delivery significantly decreases post-operative wound infection and endometritis.
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Affiliation(s)
- Mona A. Abdelrahman
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt
| | - Asmaa Zaki
- Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62764, Egypt; (A.Z.); (M.O.E.)
| | - Sara A. M. Salem
- Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt;
| | - Heba F. Salem
- Department of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt;
- Department of Pharmaceutics and Industrial Pharmacy, 6 October Technological University, Giza 12585, Egypt
| | - Ahmed R. N. Ibrahim
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia;
| | - Ahmed Hassan
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Sadat City, Sadat City 32897, Egypt;
| | - Marwa O. Elgendy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62764, Egypt; (A.Z.); (M.O.E.)
- Department of Clinical Pharmacy, Beni-Suef University Hospitals, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt
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Mumtaz S, Abbas Y, Ahmad I, Hassan A, Saeed MF, Yun S, Almarhoon ZM, Shelkh M, Hassan AM, Rosaiah P, Suneetha M, Ahmad A. Sugarcane-bagasse-ash in enhanced mesophilic Co-digestion for biogas and nutrient recovery: A concept of developing rural circular bioeconomy. Environ Res 2023; 237:116691. [PMID: 37574097 DOI: 10.1016/j.envres.2023.116691] [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] [Received: 05/26/2023] [Revised: 07/06/2023] [Accepted: 07/15/2023] [Indexed: 08/15/2023]
Abstract
Conductive agro-industrial wastes as accelerants in the anaerobic digestion (AD) of organic waste is a good technique for developing a rural circular economy, such as producing bioenergy and biofertilizer. This study disclosed the a role of sugar cane bagasse ash (SCBA) in enhancing the bioenergy (biogas) yield and digestate fertility via anaerobic co-digestion (AcoD) of buffalo dung (BD) and vegetable residue (VR) under mesophilic conditions (37 ᴼC). Firstly, an optimal BD/VR ratio (1:3) was determined based on biogas yield by introducing five different BD/VR ratios (1:0, 3:1, 1:1, 1:3, and 0:1) into AcoD systems. Secondly, the biogas yield was increased further by adding SCBA at five different concentrations (0, 0.5, 1, 1.5, and 2 wt%). Experimental results disclosed that the 1.5 wt% of SCBA gave the highest cumulative biogas yield (153.67 mL/g VS), COD removal rate (31.18%), and fertility (5.08%). Moreover, a framework is suggested to understand the role of SCBA in the enhanced DIET mechanism. This work documents an environmentally friendly and economical technique for developing a rural circular bioeconomy via the AD of organic agro-waste.
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Affiliation(s)
- Shahid Mumtaz
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Punjab, 61100, Pakistan
| | - Yasir Abbas
- Functional Materials Laboratory (FML), School of Materials Science and Engineering, Xi'an University of Architecture and Technology, Xi'an, Shaanxi, 710055, China
| | - Iftikhar Ahmad
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Punjab, 61100, Pakistan.
| | - Ahmed Hassan
- Department of Architectural Engineering, College of Engineering, UAE University, United Arab Emirates
| | - Muhammad Farhan Saeed
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Punjab, 61100, Pakistan
| | - Sining Yun
- Functional Materials Laboratory (FML), School of Materials Science and Engineering, Xi'an University of Architecture and Technology, Xi'an, Shaanxi, 710055, China
| | - Zainab M Almarhoon
- Department of Chemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Mohamed Shelkh
- Department of Chemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Ahmed M Hassan
- Faculty of Engineering and Technology, Future University in Egypt, New Cairo, 11835, Egypt
| | - P Rosaiah
- Department of Physics, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai, 602 105, India
| | - Maduru Suneetha
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk, 38541, South Korea.
| | - Awais Ahmad
- Department of Organic Chemistry, University of Cordoba, Spain
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11
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Strati P, Jallouk A, Deng Q, Li X, Feng L, Sun R, Adkins S, Johncy S, Cain T, Steiner RE, Ahmed S, Chihara D, Fayad LE, Iyer SP, Horowitz S, Nastoupil LJ, Nair R, Hassan A, Daoud TE, Hawkins M, Rodriguez MA, Shpall EJ, Ramdial JL, Kebriaei P, Hong DS, Westin JR, Neelapu SS, Green MR. A phase 1 study of prophylactic anakinra to mitigate ICANS in patients with large B-cell lymphoma. Blood Adv 2023; 7:6785-6789. [PMID: 37389847 PMCID: PMC10692290 DOI: 10.1182/bloodadvances.2023010653] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023] Open
Affiliation(s)
- Paolo Strati
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Andrew Jallouk
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Qing Deng
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Xubin Li
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lei Feng
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ryan Sun
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sherry Adkins
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Swapna Johncy
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Taylor Cain
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Raphael E. Steiner
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dai Chihara
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Luis E. Fayad
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Swaminathan P. Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sandra Horowitz
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Loretta J. Nastoupil
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ranjit Nair
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ahmed Hassan
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Taher E. Daoud
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Misha Hawkins
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maria A. Rodriguez
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth J. Shpall
- Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeremy L. Ramdial
- Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David S. Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jason R. Westin
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sattva S. Neelapu
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael R. Green
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
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12
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Doghish AS, Ali MA, Elrebehy MA, Mohamed HH, Mansour R, Ghanem A, Hassan A, Elballal MS, Elazazy O, Elesawy AE, Abdel Mageed SS, Nassar YA, Mohammed OA, Abulsoud AI. The interplay between toxoplasmosis and host miRNAs: Mechanisms and consequences. Pathol Res Pract 2023; 250:154790. [PMID: 37683390 DOI: 10.1016/j.prp.2023.154790] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
Toxoplasmosis is one of the highly prevalent zoonotic diseases worldwide caused by the parasite Toxoplasma gondii (T. gondii). The infection with T. gondii could pass unidentified in immunocompetent individuals; however, latent cysts remain dormant in their digestive tract, but they could be shed and excreted with feces infesting the environment. However, active toxoplasmosis can create serious consequences, particularly in newborns and infected persons with compromised immunity. These complications include ocular toxoplasmosis, in which most cases cannot be treated. Additionally, it caused many stillbirths and miscarriages. Circulating miRNAs are important regulatory molecules ensuring that the normal physiological role of various organs is harmonious. Upon infection with T. gondii, the tightly regulated miRNA profile is disrupted to favor the parasite's survival and further participate in the disease pathogenesis. Interestingly, this dysregulated profile could be useful in acute and chronic disease discrimination and in providing insights into the pathomechanisms of the disease. Thus, this review sheds light on the various roles of miRNAs in signaling pathways regulation involved in the pathogenesis of T. gondii and provides insights into the application of miRNAs clinically for its diagnosis and prognosis.
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Affiliation(s)
- Ahmed S Doghish
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt; Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt.
| | - Mohamed A Ali
- School of Biotechnology, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Mahmoud A Elrebehy
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt.
| | - Hend H Mohamed
- School of Biotechnology, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt; Biochemistry Department, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Reda Mansour
- Zoology and Entomology Department, Faculty of Science, Helwan University, Helwan 11795, Egypt; Biology Department, School of Biotechnology, Badr University in Cairo, Badr City, Cairo 11829, Egypt
| | - Aml Ghanem
- School of Biotechnology, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Ahmed Hassan
- School of Biotechnology, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt; Botany and Microbiology Department, Faculty of Science, Helwan University, Helwan 11795, Egypt
| | - Mohammed S Elballal
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Ola Elazazy
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Ahmed E Elesawy
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Sherif S Abdel Mageed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Yara A Nassar
- Biology Department, School of Biotechnology, Badr University in Cairo, Badr City, Cairo 11829, Egypt
| | - Osama A Mohammed
- Department of Clinical Pharmacology, College of Medicine, University of Bisha, Bisha 61922, Saudi Arabia
| | - Ahmed I Abulsoud
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt; Biochemistry Department, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
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13
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Hassan A, Macedo A, Bouchard-Fortier G, L'heureux S, Magnati M, Yu CCCC, Han K, Li M, Croke JM. Patient-Reported Distress and Acute Care Utilization for Cervical Cancer Patients Undergoing Concurrent Chemoradiation. Int J Radiat Oncol Biol Phys 2023; 117:e516. [PMID: 37785610 DOI: 10.1016/j.ijrobp.2023.06.1778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Although concurrent chemo-radiation (CRT) and brachytherapy (BT) is curative for locally advanced cervical cancer (LACC), it requires complex coordination of care and is associated with treatment-related toxicity. Our objective was to evaluate patient-reported symptoms and social distress in LACC patients undergoing concurrent CRT and BT to determine whether they are predictive of unplanned acute care utilization. MATERIALS/METHODS Patients with LACC treated with concurrent CRT and BT between 2013-2020 completed the Edmonton Symptom Assessment Scale-revised (ESAS-r; 9 cancer-related symptoms ranked 0-10) and the Social Difficulties Inventory-21 (SDI-21; 21 social issues ranked 0-3) at every visit as part of routine distress screening. Acute care utilization was defined as any unplanned visit to the radiation nursing clinic, urgent care clinic, emergency department or hospitalization within 1 year from starting treatment. A logistic regression model will be used to evaluate associations between ESAS-r and SDI-21 scores and acute care utilization. RESULTS Among 151 LACC patients, a total of 354 ESAS-r and SDI questionnaires were completed longitudinally. Mean age at diagnosis was 49.9 years (30-90), 44% were FIGO 2B and overall treatment time was 53.6 days (32-135). At baseline, the most prevalent moderate to severe symptoms (ESAS-r score ≥4) were well-being (50%), anxiety (44%), tiredness (43%) and pain (36%). Post-treatment, these persisted in 42%, 27%, 38%, and 26%, respectively. The most common social distress at baseline was financial (33%). Financial distress post-treatment was significantly predictive of worse well-being (OR = 5.80, p<0.06), anxiety (OR = 3.33, p<0.04) and depression (OR = 4.76, p<0.01). Use of acute care within 1 year after starting treatment occurred in 103 patients (68%) for a total of 617 visits: radiation nursing clinic 71.3%, urgent care clinic 4.4%, emergency department 8.3%, hospitalization 16%. On average there were 6.6 visits/patient (0-31), with the average number of days between treatment start and first acute care visit being 17.9 (0-74). CONCLUSION Cervical cancer patients undergoing concurrent CRT report prevalent financial distress and moderate to severe symptoms that persist post-treatment. Acute care utilization commonly occurred during treatment, highlighting a time when additional support is needed. Predictive modelling for distress factors resulting in acute care utilization is now underway.
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Affiliation(s)
- A Hassan
- Cancer Quality Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - A Macedo
- Cancer Quality Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - G Bouchard-Fortier
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - S L'heureux
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - M Magnati
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - C C C C Yu
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - K Han
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - M Li
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - J M Croke
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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14
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Nosrati JD, Bloom BF, Ma DC, Sidiqi BU, Hassan A, Adair N, Joseph S, Tchelebi L, Herman JM, Potters L, Chen W. Treatment Terminations during Radiation Therapy: A Ten-Year Experience. Int J Radiat Oncol Biol Phys 2023; 117:S96. [PMID: 37784613 DOI: 10.1016/j.ijrobp.2023.06.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Disruptionsin cancer care adversely affect clinical outcomes, particularly when a patient does not complete the prescribed course of treatment. The impact of treatment termination (TT) during radiation therapy has not been well studied. This study addresses TT in a large multi-center department of radiation oncology over a 10-year time period. MATERIALS/METHODS TTs of patients undergoing radiation treatment between January 2013 and December 2022 were prospectively tracked as part of departmentalquality and safety monitoring. A TT was defined as the discontinuation of therapy at any point following consent and simulation. Causes of TTs were categorized as: hospice/death, physician choice related to toxicity, physician choice unrelated to toxicity, patient choice related to toxicity, patient choice unrelated to toxicity, progression of disease, non-cancer illness, or other. The rate of TT was calculated as a percentage of all new patients who start radiation treatments. As part of our ongoing department quality and safety program, incremental changes were made to pre-treatment evaluation and scheduling processes, collectively referred to as the "No-Fly" policy. TT rates during three iterations of this policy were compared. RESULTS Outof 28,707 planned treatment courses, a total of 1,467 TTs were identified (5.1%). 688 (46.9%) involved patients treated with curative intent, 770 (52.5%) with palliative intent, and 9 (0.6%) for benign disease. The rate of TT decreased from 9.3% in 2013 to 3.3% in 2022. Relative to evolutions of our No-Fly policy, the overall TT rate decreased from 8.8% under No-Fly 1 (2013-2014), to 5.2% during No-Fly 2 (2015-2018), and 4.0% with No-Fly 3 (2019-2022) (ANOVA, p<0.001). The most common sites for TT were H&N (19.3%), CNS (17.9%), and Bone Metastases (17.9%). The most common cause of TT was hospice and/or death (36.5%), 69.1% of which were in patients receiving palliative treatments. Other common causes included patient choice unrelated to toxicity (35%), physician choice unrelated to toxicity (8.8%), and progression of disease (7.6%). There were 473 TTs without radiation dose given (1.6% of planned treatments, 32.3% of TTs). CONCLUSION Radiation TTs reflect major deviations from the original care plan. This large cohort study highlights the value of open departmental discourse about TTs, which prompted quality improvement changes that reduced TTs over time. Future studies addressing clinical outcomes can direct treatment decision-making and improve care for our patients.
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Affiliation(s)
- J D Nosrati
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, NY
| | - B F Bloom
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | - D C Ma
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | - B U Sidiqi
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, NY
| | - A Hassan
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | - N Adair
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | - S Joseph
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | - L Tchelebi
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | - J M Herman
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, NY
| | - L Potters
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | - W Chen
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY
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15
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Nadeem K, Shahzad S, Hassan A, Usman Younus M, Asad Ali Gillani S, Farhan K. Municipal solid waste generation and its compositional assessment for efficient and sustainable infrastructure planning in an intermediate city of Pakistan. Environ Technol 2023; 44:3196-3214. [PMID: 35302920 DOI: 10.1080/09593330.2022.2054370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
It is imperative to design and operate sustainable solid waste management (SWM) systems in cities based on the results of waste amount and characterization study (WACS). In this work, WACS was conducted and results were used to design an SWM system for an intermediate city of Pakistan. The study revealed that about 110 tons of solid waste per day is generated with a per capita rate of 0.337 kg/day. Around 51.2% of mixed municipal solid waste (MSW) is organic in nature and its non-scientific disposal is resulting in higher greenhouse gas (GHG) emissions. It was also found that more than 80% of valuables are taken away by the informal sector during the transfer of MSW from the generation source to the dumping site. Ultimate analyses showed that the moisture content (MC) and carbon to nitrogen (C:N) ratio were 64.23% and 51.14%, respectively. Proximate analysis revealed that moisture and calorific values were 57 % and 3505 BTU/lb., respectively. Based on these results, a material sorting facility (MSF) was proposed, with an estimated investment cost of US $3.64 million. However, the efficiency of the existing collection system is limited to 32 % only. In order to improve the collection efficiency (>90 %), an additional investment of US $1.638 million was estimated with an operations and maintenance (O&M) cost of US $19.25 per ton. Existing non-scientific MSW disposal practices contribute 32,079.61 CO2e tons/year of GHG emissions. The proposed MSF followed by composting is estimated to reduce GHG emissions by 38% to 19,722.38 CO2e tons/year.
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Affiliation(s)
- K Nadeem
- Laboratoire de Génie Chimique, CNRS, INPT, UPS, Université de Toulouse, Toulouse, France
| | - S Shahzad
- LMDC, INSA, UPS Génie Civil, Université de Toulouse, Toulouse Cedex, France
| | - A Hassan
- Chemical Engineering Department, MNS University of Engineering and Technology, Multan, Pakistan
| | - M Usman Younus
- Ecole Mathématiques, Informatique, Télécommunications de Toulouse, Université de Toulouse, Toulouse, France
- Department of Computer Science & IT, University of Jhang, Pakistan
| | - S Asad Ali Gillani
- Civil Engineering Department, University of Engineering and Technology, Lahore, Pakistan
| | - K Farhan
- The Urban Unit, Planning & Development Department, Government of the Punjab, Lahore, Pakistan
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16
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Shirah B, Algahtani H, Algahtani R, Alfares A, Hassan A. Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL): A challenging diagnosis and a rare multiple sclerosis mimic. J Stroke Cerebrovasc Dis 2023; 32:107225. [PMID: 37348440 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107225] [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: 01/04/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023] Open
Abstract
Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is an extremely rare hereditary cerebral small vessel disease caused by homozygous or compound heterozygous mutations in the gene coding for high-temperature requirement A serine peptidase 1 (HtrA1). Given the rare nature of the disease, delays in diagnosis and misdiagnosis are not uncommon. In this article, we reported the first case of CARASIL from Saudi Arabia with a novel homozygous variant c.1156C>T in exon 7 of the HTRA1 gene. The patient was initially misdiagnosed with primary progressive multiple sclerosis and treated with rituximab. CARASIL should be considered in the differential diagnosis of patients with suspected atypical progressive multiple sclerosis who have additional signs such as premature scalp alopecia and low back pain with diffuse white matter lesions in brain MRI. Genetic testing is important to confirm the diagnosis.
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Affiliation(s)
- Bader Shirah
- Department of Neuroscience, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia.
| | | | - Raghad Algahtani
- Department of Medicine, Aseer Central Hospital, Abha, Saudi Arabia
| | - Ahmed Alfares
- Centre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
| | - Ahmed Hassan
- Department of Neuroscience, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia.
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17
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Abdulghaffar HK, Alqarni AA, Altwirgi S, Shirah B, Badawi M, Hassan A. Cerebral Radiation-Induced Vasculopathy Mimicking Primary Central Nervous System Vasculitis. Cureus 2023; 15:e43659. [PMID: 37719541 PMCID: PMC10505072 DOI: 10.7759/cureus.43659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Cranial irradiation is one of the main treatment modalities for tumors of the CNS. However, it can lead to significant damage to the treated region. Among the late complications of radiation therapy to the brain is vasculopathy of the small and/or large arteries. In this article, we report a case of CNS radiation-induced vasculopathy presenting 30 years after cranial irradiation and mimicking primary CNS vasculitis. The present case illustrates the importance of monitoring and carefully evaluating delayed side effects of radiotherapy as well as emphasizes the importance of obtaining a detailed history of any patient presenting with sudden unexplained symptoms. If a complete proper history of the patient's past medical diagnoses and procedures was taken, medical professionals would not have needed to conduct extensive investigations and implement treatment plans for a less likely diagnosis, in this case, aggressive treatment of a possible primary CNS vasculitis with high-dose steroids. Therefore, it is imperative to raise the possibility of radiation-induced vasculopathy after excluding all possible causes of deterioration in patients with a history of cranial radiation therapy.
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Affiliation(s)
- Haifa K Abdulghaffar
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdulaziz A Alqarni
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Samaher Altwirgi
- College of Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Bader Shirah
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU
| | - Manal Badawi
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU
| | - Ahmed Hassan
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU
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18
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Mousa A, Hassan A, Oudah B, Arslan KI, Parang P. Acute Spontaneous Subdural Hematoma in a Patient With an End-Stage Renal Disease After Starting Dual Antiplatelet Therapy Post Drug-Eluting Stent Insertion: A Case Report. Cureus 2023; 15:e41761. [PMID: 37575833 PMCID: PMC10416268 DOI: 10.7759/cureus.41761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Dual antiplatelet therapy (DAPT) has been widely utilized for secondary prevention in patients with cardiovascular diseases, such as post-drug eluting stent insertion, stroke, and peripheral vascular disease. The occurrence of bleeding complications, including intracranial hemorrhage, has been extensively studied in relation to DAPT. However, the occurrence of acute spontaneous subdural hematomas in this context is relatively rare. These hematomas can manifest through various symptoms, including altered mental status (AMS) and confusion. The risk of intracranial hemorrhage is particularly higher in patients receiving aspirin with ticagrelor, especially in those with reduced estimated glomerular filtration rate (eGFR) and liver disease. In this case report, we present the case of a patient with end-stage renal disease undergoing peritoneal hemodialysis and a remote history of liver transplant. The patient presented to the hospital with chest pain, subsequently underwent drug-eluting stent placement, and was initiated on DAPT. Following the initiation of DAPT, the patient developed confusion and was diagnosed with an acute spontaneous subdural hematoma. The patient underwent middle meningeal artery embolization to manage the hematoma.
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Affiliation(s)
- Aliaa Mousa
- Internal Medicine, Capital Health Regional Medical Center, Trenton, USA
| | - Ahmed Hassan
- Internal Medicine, Capital Health Regional Medical Center, Trenton, USA
| | - Bashar Oudah
- Internal Medicine, Eisenhower Medical Center, Rancho Mirage, USA
| | | | - Pirouz Parang
- Cardiology, Capital Health Regional Medical Center, Trenton, USA
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19
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Imbabi T, Hassan A, Ahmed-Farid O, El-Garhy O, Sabeq I, Moustafa M, Mohammadein A, Hassan N, Osman A, Sitohy M. Corrigendum to "Supplementing rabbit diets with butylated hydroxyanisole affects oxidative stress, growth performance, and meat quality" [Animal 15(9) (2021) 100339]. Animal 2023; 17:100859. [PMID: 37451744 DOI: 10.1016/j.animal.2023.100859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Affiliation(s)
- T Imbabi
- Animal Production Department, Faculty of Agriculture, Benha University, Moshtohor 13736, Egypt
| | - A Hassan
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - O Ahmed-Farid
- Department of Physiology, National Organization for Drug Control and Research, Giza 12553, Egypt
| | - O El-Garhy
- Animal Production Department, Faculty of Agriculture, Benha University, Moshtohor 13736, Egypt
| | - I Sabeq
- Department of Food Hygiene, Faculty of Veterinary Medicine, Benha University, Moshtohor 13736, Egypt
| | - M Moustafa
- Genetics and Genetic Engineering Department, Faculty of Agriculture, Benha University, Moshtohor 13736, Egypt(1)
| | - A Mohammadein
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - N Hassan
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - A Osman
- Biochemistry Department, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt.
| | - M Sitohy
- Biochemistry Department, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt.
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20
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Saeed U, Uppal MR, Uppal MS, Uppal R, Khan AA, Hassan A, Piracha ZZ. Hepatitis C virus associated ALT, AST, GGT, Bili T, HB, HBA1C, CREAT, PT, aPPT, AFP, CEA, CA 125, CA 19-9, iPTH biomarkers, computed tomography and HCV burden of disease during pre COVID-19 era (2018-2019) and post COVID-19 era (2020-2022) in Pakistan. BRAZ J BIOL 2023; 84:e271451. [PMID: 37341223 DOI: 10.1590/1519-6984.271451] [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: 01/25/2023] [Accepted: 03/30/2023] [Indexed: 06/22/2023] Open
Abstract
The national burden of HCV has significantly mounted over the period of last few decades placing Pakistan at the worst placement of second largest burden of HCV globally. Herein for the first time from Pakistan, we examined clinical correlation of potential biomarkers with HCV. Nation-wide study was conducted on 13,348 suspected HCV patients during 2018-2022. During pre-COVID-19 era of 2018-2019, prevalence of HCV remained 30%. During 2018, among HCV positive patients, 91% of ALT, 63% of AST, 67% of GGT, 28% of Bili T, 62% of HB, 15% of HBA1C, 25% of CREAT, 15% of PT, 15% of aPTT and 64% of AFP were abnormal. During 2019, among HCV infected 74.47% of ALT, 63.54% of AST, 70.24% of GGT, 24.71% of Bili T, 8.77% of HB and 75% of AFP were raised. CT/CAT scan revealed 4.65% liver complications (mild 13.04%, moderate 30.43% and severe 56.52%). During 2020, HCV prevalence remained 25%. 65.17% of ALT, 64.20% of AST, 68.75% of GGT, 31.25% of Bili T, 20.97% of HB, 4.65% of CREAT and 73.68% of AFP levels were raised. CAT analysis revealed liver complications among 4.41% (14.81% mild, 40.74% moderate, and 44.44% sever). 85.71% of participants diabetes was out of control. During 2021, HCV prevalence remained 27.1%. ALT (73.86%), AST (50.6%), GGT (67.95%), Bili T (28.21%), HB (20%), CREAT (5.8%) and AFP (82.14%) levels were abnormal. During 2022, the levels of ALT (56.06%), AST (56.36%), GGT (56.6%), Bili T (19.23%), HB (43.48%), HBA1C (14.81), CREAT (18.92%), AFP (93.75%) were abnormal. CAT analysis revealed 7.46% liver complications (25% mild, 30.36% moderate, and 42.86% sever). During 2021-2022, 83.33% of subject's diabetes was not controlled.
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Affiliation(s)
- U Saeed
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
- Foundation University Islamabad, Foundation University School of Health Sciences, Clinical and Biomedical Research Center, Islamabad, Pakistan
| | - M R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - M S Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - A A Khan
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - A Hassan
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - Z Z Piracha
- International Center of Medical Sciences Research - ICMSR, Islamabad, Pakistan
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Abd Elhakem M, Botras W, Hassan A, Adly E. Effect of Drought Stress on Growth and Productivity of Some Mentha Species. Scientific Journal of Agricultural Sciences 2023; 5:0-0. [DOI: 10.21608/sjas.2023.211303.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Hassan A, Elhoseny M, Kayed M. A novel and accurate deep learning-based Covid-19 diagnostic model for heart patients. Signal Image Video Process 2023; 17:1-8. [PMID: 37362230 PMCID: PMC10197036 DOI: 10.1007/s11760-023-02561-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 06/28/2023]
Abstract
Using radiographic changes of COVID-19 in the medical images, artificial intelligence techniques such as deep learning are used to extract some graphical features of COVID-19 and present a Covid-19 diagnostic tool. Differently from previous works that focus on using deep learning to analyze CT scans or X-ray images, this paper uses deep learning to scan electro diagram (ECG) images to diagnose Covid-19. Covid-19 patients with heart disease are the most people exposed to violent symptoms of Covid-19 and death. This shows that there is a special, unclear relation (until now) and parameters between covid-19 and heart disease. So, as previous works, using a general diagnostic model to detect covid-19 from all patients, based on the same rules, is not accurate as we prove later in the practical section of our paper because the model faces dispersion in the data during the training process. So, this paper aims to propose a novel model that focuses on diagnosing accurately Covid-19 for heart patients only to increase the accuracy and to reduce the waiting time of a heart patient to perform a covid-19 diagnosis. Also, we handle the only one existed dataset that contains ECGs of Covid-19 patients and produce a new version, with the help of a heart diseases expert, which consists of two classes: ECGs of heart patients with positive Covid-19 and ECGs of heart patients with negative Covid-19 cases. This dataset will help medical experts and data scientists to study the relation between Covid-19 and heart patients. We achieve overall accuracy, sensitivity and specificity 99.1%, 99% and 100%, respectively. Supplementary Information The online version contains supplementary material available at 10.1007/s11760-023-02561-8.
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Affiliation(s)
- Ahmed Hassan
- Faculty of Science, Beni-Suef University, Beni-Suef, 62511 Egypt
| | - Mohamed Elhoseny
- Faculty of Computers and Information, Mansoura University, Mansoura, 35516 Egypt
| | - Mohammed Kayed
- Faculty of Computers and Artificial Intelligence, Beni-Suef University, Beni-Suef, 62511 Egypt
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Papadogianni G, Ravens I, Hassan A, Flatley A, Feederle R, Bernhardt G, Georgiev H. Establishment and Functional Characterization of Murine Monoclonal Antibodies Recognizing Neuritin. Antibodies (Basel) 2023; 12:antib12020028. [PMID: 37092449 PMCID: PMC10123642 DOI: 10.3390/antib12020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/17/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Neuritin represents a neurotrophic factor that is not only important in neuronal development and plasticity but also impacts endothelial angiogenesis, cell migration, tumor growth and the production of antibodies by B cells. We established monoclonal mouse anti-mouse neuritin antibodies by immunizing knock-out mice with two different neuritin-derived peptides. Because neuritin is well conserved between species, these new monoclonal antibodies recognize the neuritin of a wide variety of species, including human. Moreover, they not only recognize specifically surface-bound neuritin expressed by murine follicular regulatory T cells but also the block binding of recombinant neuritin to germinal center B cells. This suggests that these newly generated tools will be of great use in studying neuritin expression and function.
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Affiliation(s)
| | - Inga Ravens
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Ahmed Hassan
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Andrew Flatley
- Monoclonal Antibody Core Facility, Helmholtz Center Munich, Research Center for Environmental Health (GmbH), 85764 Neuherberg, Germany
| | - Regina Feederle
- Monoclonal Antibody Core Facility, Helmholtz Center Munich, Research Center for Environmental Health (GmbH), 85764 Neuherberg, Germany
| | - Günter Bernhardt
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Hristo Georgiev
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
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Khater A, Hassan A, Farouk O, Sinbel A, Saleh S, Abdelaziz M, Eldamshety O. Evaluation of Topical Sclerosant Agents for Minimization of Postmastectomy Seroma: A Placebo-Controlled, Double-Blind, Randomized Trial. Eur J Breast Health 2023; 19:134-139. [PMID: 37025572 PMCID: PMC10071883 DOI: 10.4274/ejbh.galenos.2023.2022-11-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/09/2023] [Indexed: 04/05/2023]
Abstract
Objective: Seroma after mastectomy is a bothersome problem. Topical sclerosants are one method used to reduce seroma. The aim of this study was to evaluate if spraying flaps before closure with doxycycline or bleomycin after total mastectomy can prevent seroma. Materials and Methods: After institutional review board approval, using a computer-based randomization program, a prospective, double-blind, placebo-controlled randomized, superiority study was conducted during the period from the first of August 2017 to the first of August 2018. IRB proposal code was MS/17.08.66 and the trial was approved at 15/8/2017. The trial is available publicly at http://www.eulc.edu.eg/eulc_v5/Libraries/Thesis/BrowseThesisPages.aspx?fn=PublicDrawThesis&BibID=12553049. The primary outcome of the study was to assess the incidence of seroma following total mastectomy after intervention comprising spraying of skin flaps with doxycycline or bleomycin versus placebo. Patients who were candidates for total mastectomy were randomized into control, doxycycline, and bleomycin groups. The postoperative data included length of the hospital stay, pain score among the three groups, post-operative drained fluid volume, post-operative day of drain removal, complication rates including infection, flap necrosis and hematoma, the incidence of seroma and aspirated seroma volume, and total number of postoperative visits. Results: Of 125 patients, 90 were candidates for total mastectomy. Analysis of these 90 showed that the incidence of seroma was similar; 43.4%, 40% and 40% in the control, doxycycline, and bleomycin groups, respectively (p = 0.99). Furthermore, wound complication rates were similar among all groups. Conclusion: Despite improved recognition and management of risk factors, seromas remain a common clinical concern in the postoperative setting of total mastectomy. These results suggest that sclerosant agents, specifically bleomycin and doxycycline, have no utility for prevention of post mastectomy seroma.
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Affiliation(s)
- Ashraf Khater
- Department of Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- * Address for Correspondence: E-mail:
| | - Ahmed Hassan
- Department of Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Omar Farouk
- Department of Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Sinbel
- Department of Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Saleh Saleh
- Department of Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mahmoud Abdelaziz
- Department of Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Osama Eldamshety
- Department of Surgery, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Alqarni AA, Shirah B, Algahtani H, Almohiy H, Hassan A. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: Atypical clinical presentation with isolated frontotemporal dementia. J Neurosci Rural Pract 2023; 14:371-373. [PMID: 37181160 PMCID: PMC10174151 DOI: 10.25259/jnrp_88_2023] [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: 02/23/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary syndrome caused by heterozygous mutations in the NOTCH3 gene that manifests in adulthood and is characterized by recurrent transient ischemic attacks and strokes, migraine-like headaches, psychiatric disturbance, and progressive dementia. The current study reports an interesting case of CADASIL in a Saudi patient with a heterozygous mutation in exon 18 of the NOTCH3 gene presenting only with cognitive decline without migraine or stroke. The diagnosis was suspected mainly because of the typical brain magnetic resonance imaging (MRI) features that led to performing genetic testing to confirm the diagnosis. This illustrates the importance of brain MRI in the diagnosis of CADASIL. Increased awareness of neurologists and neuroradiologists about the typical MRI features of CADASIL is of paramount importance to reach the diagnosis in a timely manner. Awareness of the atypical presentations of CADASIL will lead to identifying more CADASIL cases.
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Affiliation(s)
- Abdulaziz A. Alqarni
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Bader Shirah
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | | | - Hussain Almohiy
- Department of Radiological Science, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Hassan
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
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Hassan A, Elhoseny M, Kayed M. Hierarchical cloud architecture for identifying the bite of "Egyptian cobra" based on deep learning and quantum particle swarm optimization. Sci Rep 2023; 13:5250. [PMID: 37002322 PMCID: PMC10066290 DOI: 10.1038/s41598-023-32414-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
One of the most dangerous snake species is the "Egyptian cobra" which can kill a man in only 15 min. This paper uses deep learning techniques to identify the Egyptian cobra bite in an accurate manner based on an image of the marks of the bites. We build a dataset consisting of 500 images of cobra bites marks and 600 images of marks of other species of snakes that exist in Egypt. We utilize techniques such as multi-task learning, transfer learning and data augmentation to boost the generalization and accuracy of our model. We have achieved 90.9% of accuracy. We must keep the availability and accuracy of our model as much as possible. So, we utilize cloud and edge computing techniques to enhance the availability of our model. We have achieved 90.9% of accuracy, which is considered as an efficient result, not 100%, so it is normal for the system to perform sometimes wrong classifications. So, we suggest to re-train our model with the wrong predictions, whereas the edge computing units, where the classifier task is positioned, resend the wrong predictions to the cloud model, where the training process occurs, to retrain the model. This enhances the accuracy to the best level after a small period and increases the dataset size. We use the quantum particle swarm optimization technique to determine the optimal required number of edge nodes.
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Affiliation(s)
- Ahmed Hassan
- Faculty of Science, Beni-Suef University, Beni-Suef, 62511, Egypt.
| | - Mohamed Elhoseny
- Faculty of Computers and Information, Mansoura University, Mansoura, 35516, Egypt
| | - Mohammed Kayed
- Faculty of Computers and Artificial Intelligence, Beni-Suef University, Beni-Suef, 62511, Egypt
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Saleem A, Almutairi M, Hassan A, Al-Shadidi N, Alshammari K. Cholecysto-hepatic fistula in type III gallbladder perforation: A rare etiology of liver abscess; case report. Int J Surg Case Rep 2023; 105:108002. [PMID: 36965442 PMCID: PMC10073879 DOI: 10.1016/j.ijscr.2023.108002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Gallbladder perforation (GBP) with cholecystohepatic fistula is an extremely rare complication of acute and/or chronic gallbladder diseases. Niemeier classified GBP into three types each characterized by specific signs and symptoms. Radiological investigations such as abdominal ultrasonography (USG) and computed tomography (CT) are crucial to evaluate and diagnosing GBP, while fistulae are usually identified intraoperatively. CASE PRESENTATION A 77-year-old female patient, with a background medical history of multiple comorbidities, presented to our hospital with a one-week history of abdominal pain. Laboratory investigations showed abnormal values. The abdominal CT scan revealed a mildly enlarged liver, distended gallbladder, and liver abscess. Then, ultrasound-guided aspiration was done, and the clinical picture was consistent with calcular cholecystitis complicated with liver abscess. So, laparoscopic cholecystectomy was decided and the intraoperatively detected fistula was excised. The resected perforated gallbladder was sent for histopathological studies. The postoperative period was uneventful. CLINICAL DISCUSSION GBP is an unusual entity that is categorized into three types. It is considered a gallbladder complication and surgical emergency. The clinical features of GBP are non-specific and radiological tools aid in diagnosis demonstration. In the presented case of type III GBP, cholecystohepatic fistula was detected and excised intraoperatively. CONCLUSION Due to the rare entity of type III GBP in association with liver abscess, we report the case of a 77-year-old female with right lower quadrant pain, found to be caused by type III GBP with cholecystohepatic fistula and liver abscess.
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Affiliation(s)
- Athary Saleem
- Department of General Surgery, Al-Adan Hospital, Kuwait.
| | | | - Ahmed Hassan
- Department of General Surgery, Al-Adan Hospital, Kuwait
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Hassan A, Moustafa E, Mohamed S. Impact of welding processing parameters on the microstructure grain refinement and hardness behavior of the aluminum AA1050 joints. Egypt J Chem 2023. [DOI: 10.21608/ejchem.2023.187195.7448] [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: 03/29/2023]
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Hassan A, Galal S, Hassan A, Salman A. Correction: Utilization of carbon nanotubes and steel fibers to improve the mechanical properties of concrete pavement. Beni-Suef Univ J Basic Appl Sci 2023. [DOI: 10.1186/s43088-023-00368-7] [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: 03/28/2023] Open
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Mahdy MS, Azmy AF, Dishisha T, Mohamed WR, Ahmed KA, Hassan A, Aidy SE, El-Gendy AO. Irinotecan-gut microbiota interactions and the capability of probiotics to mitigate Irinotecan-associated toxicity. BMC Microbiol 2023; 23:53. [PMID: 36864380 PMCID: PMC9979425 DOI: 10.1186/s12866-023-02791-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 02/10/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Irinotecan is a chemotherapeutic agent used to treat a variety of tumors, including colorectal cancer (CRC). In the intestine, it is transformed into SN-38 by gut microbial enzymes, which is responsible for its toxicity during excretion. OBJECTIVE Our study highlights the impact of Irinotecan on gut microbiota composition and the role of probiotics in limiting Irinotecan-associated diarrhea and suppressing gut bacterial β-glucuronidase enzymes. MATERIAL AND METHODS To investigate the effect of Irinotecan on the gut microbiota composition, we applied 16S rRNA gene sequencing in three groups of stool samples from healthy individuals, colon cancer, and Irinotecan treated patients (n = 5/group). Furthermore, three Lactobacillus spp.; Lactiplantibacillus plantarum (L. plantarum), Lactobacillus acidophilus (L. acidophilus), Lacticaseibacillus rhamnosus (L. rhamnosus) were used in a single and mixed form to in-vitro explore the effect of probiotics on the expression of β-glucuronidase gene from E. coli. Also, probiotics were introduced in single and mixed forms in groups of mice before the administration of Irinotecan, and their protective effects were explored by assessing the level of reactive oxidative species (ROS) as well as studying the concomitant intestinal inflammation and apoptosis. RESULTS The gut microbiota was disturbed in individuals with colon cancer and after Irinotecan treatment. In the healthy group, Firmicutes were more abundant than Bacteriodetes, which was the opposite in the case of colon-cancer or Irinotecan treated groups. Actinobacteria and Verrucomicrobia were markedly present within the healthy group, while Cyanobacteria were noted in colon-cancer and the Irinotecan-treated groups. Enterobacteriaceae and genus Dialister were more abundant in the colon-cancer group than in other groups. The abundance of Veillonella, Clostridium, Butryicicoccus, and Prevotella were increased in Irinotecan-treated groups compared to other groups. Using Lactobacillus spp. mixture in mice models significantly relieved Irinotecan-induced diarrhea through the reduction of both β-glucuronidase expression and ROS, in addition to guarding gut epithelium against microbial dysbiosis and proliferative crypt injury. CONCLUSIONS Irinotecan-based chemotherapy altered intestinal microbiota. The gut microbiota participates greatly in determining both the efficacy and toxicity of chemotherapies, of which the toxicity of Irinotecan is caused by the bacterial ß-glucuronidase enzymes. The gut microbiota can now be aimed and modulated to promote efficacy and decrease the toxicity of chemotherapeutics. The used probiotic regimen in this study lowered mucositis, oxidative stress, cellular inflammation, and apoptotic cascade induction of Irinotecan.
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Affiliation(s)
- Marwa S Mahdy
- Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Salah Salem Street, Beni-Suef, 62511, Egypt
| | - Ahmed F Azmy
- Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Salah Salem Street, Beni-Suef, 62511, Egypt
| | - Tarek Dishisha
- Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Salah Salem Street, Beni-Suef, 62511, Egypt
| | - Wafaa R Mohamed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Kawkab A Ahmed
- Pathology Department, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Ahmed Hassan
- Department of Clinical Oncology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Sahar El Aidy
- Host-Microbe Interactions, Groningen Biomolecular Sciences and Biotechnology Institute (GBB), University of Groningen, Groningen, The Netherlands
| | - Ahmed O El-Gendy
- Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Salah Salem Street, Beni-Suef, 62511, Egypt.
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Abu-Abaa M, Al-Qaysi G, Hassan A, Kananeh S. Subarachnoid Hemorrhage With Multifocal Cerebral Aneurysms in a Patient With Crohn’s Disease and Sjögren's Syndrome: A Case Report and Literature Review. Cureus 2023; 15:e35585. [PMID: 37007320 PMCID: PMC10063248 DOI: 10.7759/cureus.35585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/04/2023] Open
Abstract
Only a few reports of the association between Crohn's disease (CD) and Sjögren's syndrome (SS) have been documented in the medical literature. Herein, we are presenting a 61-year-old female patient who presented with subarachnoid hemorrhage (SAH). She has a past medical history of primary SS on no active treatment, and CD in remission while on maintenance immunotherapy. She also tested positive for COVID-19. Computed tomography angiography (CTA) brain as well as cerebral angiogram revealed multifocal cerebral aneurysms. Successful coiling was achieved with a cerebral angiogram. This case serves to add to a limited body of reported cases and remind clinicians of the association between SS/CD and cerebral aneurysms. Herein, we review the literature regarding this association and also the effect of immunotherapy and COVID-19 on the progression of cerebral aneurysms.
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Abdelfattah OM, Martinez M, Sayed A, ElRefaei M, Abushouk A, Hassan A, Masri A, Winters SL, Kapadia S, Maron B, Rowin EJ, Maron M. Abstract P556: Temporal and Global Trends of the Incidence of Sudden Cardiac Death in Hypertrophic Cardiomyopathy: A Meta-Analysis. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p556] [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: 03/18/2023]
Abstract
Introduction:
Since hypertrophic cardiomyopathy(HCM) initial description, sudden cardiac death (SCD) has been the most feared complication of HCM.
Hypothesis:
Temporal, geographical, and age-related trends of SCD rates in HCM have drastically decreased over time.
Methods:
Databases were systematically searched to Nov 2021 for studies reporting on SCD event rates in HCM. Patients with SCD equivalents (appropriate ICD shocks and non-fatal SCD) were excluded. Random-e!ects model was utilized to pool study estimates calculating the overall incidence rates(IR) for each time-era, geographical region, and age-group. We analyzed 2 eras (before vs. after 2000, following implementation of ICD in HCM). Following 2000, 5-year intervals were used to reflect the temporal change in SCD.
Results:
98 studies(N=70,510patients and 431,407patient-years) met inclusion criteria. Overall rate of HCM SCD was 0.43%/year (95% CI: 0.37-0.50%; I2=75%; SCD events:1,938; person-years of follow-up: 408,715), with young patients(<18 years) demonstrating a>2-fold-risk for SCD vs. adults(18- 60years) (IR:1.09%; 95% CI: 0.69-1.73% vs. IR: 0.43%; 95% CI: 0.37-0.50%)(P-value for subgroup di!erences:<0.01). Contemporary SCD rates from 2015-present were 0.32%/year; significantly lower compared to 2000 or earlier (IR: 0.32%; 95% CI:0.20-0.52%, vs. IR: 0.73%; 95% CI:0.53-1.02%,respectively). Reported HCM-SCD rates were lowest in North America (IR: 0.28%;95% CI:0.18-0.43%) and highest in Asia(IR: 0.67%; 95% CI:0.54-0.84%).
Conclusions:
Contemporary HCM-related SCD are low (0.32%/year) representing a 2-fold decrease compared to prior treatment eras, with young HCM patients at the highest risk. SCD risk stratification maturation and primary prevention ICD application are likely responsible for the notable decline in SCD trends. Moreover, worldwide geographical disparities in SCD was evident, underscoring the need to increase access to SCD prevention for all HCM patients.
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ghanim I, Hassan A, Abdel Aleem AA, Tantawy I. Synthesis and Biological Evaluation of New Dithiocarbamate Derivatives and New α-aminophosphonate Conjugates Containing 1,3,5 Triazine Nucleus. Egypt J Chem 2023. [DOI: 10.21608/ejchem.2023.178096.7253] [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: 03/06/2023]
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Romeih S, Elkafrawy F, Shaaban M, Hassan A, Samual I, Gergis M, El mozy W, Yacoub M. Validation of cardiac index measured by four‐dimensional cardiac magnetic resonance flow against the invasively measured cardiac index in patients with pulmonary hypertension. Pulm Circ 2023. [DOI: 10.1002/pul2.12203] [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: 02/15/2023] Open
Affiliation(s)
- Soha Romeih
- Radiology Department, Aswan Heart Centre Aswan Egypt
- Cardiology Department Tanta University Egypt
| | - Fatma Elkafrawy
- Radiology Department, Aswan Heart Centre Aswan Egypt
- Radiology Department Alexandria University Egypt
| | - Mahmoud Shaaban
- Radiology Department, Aswan Heart Centre Aswan Egypt
- Cardiology Department Tanta University Egypt
| | - Ahmed Hassan
- Cardiology Department Cairo University Egypt
- Cardiology Department, Aswan Heart Centre Egypt
| | - Irini Samual
- Cardiology Department Cairo University Egypt
- Cardiology Department, Aswan Heart Centre Egypt
| | | | - Wesam El mozy
- Radiology Department, Aswan Heart Centre Aswan Egypt
- Radiology Department Cairo University Egypt
| | - Magdi Yacoub
- Radiology Department, Aswan Heart Centre Aswan Egypt
- Imperial collage of London London UK
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Roaldsen MB, Eltoft A, Wilsgaard T, Christensen H, Engelter ST, Indredavik B, Jatužis D, Karelis G, Kõrv J, Lundström E, Petersson J, Putaala J, Søyland MH, Tveiten A, Bivard A, Johnsen SH, Mazya MV, Werring DJ, Wu TY, De Marchis GM, Robinson TG, Mathiesen EB, Valente M, Chen A, Sharobeam A, Edwards L, Blair C, Christensen L, Ægidius K, Pihl T, Fassel-Larsen C, Wassvik L, Folke M, Rosenbaum S, Gharehbagh SS, Hansen A, Preisler N, Antsov K, Mallene S, Lill M, Herodes M, Vibo R, Rakitin A, Saarinen J, Tiainen M, Tumpula O, Noppari T, Raty S, Sibolt G, Nieminen J, Niederhauser J, Haritoncenko I, Puustinen J, Haula TM, Sipilä J, Viesulaite B, Taroza S, Rastenyte D, Matijosaitis V, Vilionskis A, Masiliunas R, Ekkert A, Chmeliauskas P, Lukosaitis V, Reichenbach A, Moss TT, Nilsen HY, Hammer-Berntzen R, Nordby LM, Weiby TA, Nordengen K, Ihle-Hansen H, Stankiewiecz M, Grotle O, Nes M, Thiemann K, Særvold IM, Fraas M, Størdahl S, Horn JW, Hildrum H, Myrstad C, Tobro H, Tunvold JA, Jacobsen O, Aamodt N, Baisa H, Malmberg VN, Rohweder G, Ellekjær H, Ildstad F, Egstad E, Helleberg BH, Berg HH, Jørgensen J, Tronvik E, Shirzadi M, Solhoff R, Van Lessen R, Vatne A, Forselv K, Frøyshov H, Fjeldstad MS, Tangen L, Matapour S, Kindberg K, Johannessen C, Rist M, Mathisen I, Nyrnes T, Haavik A, Toverud G, Aakvik K, Larsson M, Ytrehus K, Ingebrigtsen S, Stokmo T, Helander C, Larsen IC, Solberg TO, Seljeseth YM, Maini S, Bersås I, Mathé J, Rooth E, Laska AC, Rudberg AS, Esbjörnsson M, Andler F, Ericsson A, Wickberg O, Karlsson JE, Redfors P, Jood K, Buchwald F, Mansson K, Gråhamn O, Sjölin K, Lindvall E, Cidh Å, Tolf A, Fasth O, Hedström B, Fladt J, Dittrich TD, Kriemler L, Hannon N, Amis E, Finlay S, Mitchell-Douglas J, McGee J, Davies R, Johnson V, Nair A, Robinson M, Greig J, Halse O, Wilding P, Mashate S, Chatterjee K, Martin M, Leason S, Roberts J, Dutta D, Ward D, Rayessa R, Clarkson E, Teo J, Ho C, Conway S, Aissa M, Papavasileiou V, Fry S, Waugh D, Britton J, Hassan A, Manning L, Khan S, Asaipillai A, Fornolles C, Tate ML, Chenna S, Anjum T, Karunatilake D, Foot J, VanPelt L, Shetty A, Wilkes G, Buck A, Jackson B, Fleming L, Carpenter M, Jackson L, Needle A, Zahoor T, Duraisami T, Northcott K, Kubie J, Bowring A, Keenan S, Mackle D, England T, Rushton B, Hedstrom A, Amlani S, Evans R, Muddegowda G, Remegoso A, Ferdinand P, Varquez R, Davis M, Elkin E, Seal R, Fawcett M, Gradwell C, Travers C, Atkinson B, Woodward S, Giraldo L, Byers J, Cheripelli B, Lee S, Marigold R, Smith S, Zhang L, Ghatala R, Sim CH, Ghani U, Yates K, Obarey S, Willmot M, Ahlquist K, Bates M, Rashed K, Board S, Andsberg G, Sundayi S, Garside M, Macleod MJ, Manoj A, Hopper O, Cederin B, Toomsoo T, Gross-Paju K, Tapiola T, Kestutis J, Amthor KF, Heermann B, Ottesen V, Melum TA, Kurz M, Parsons M, Valente M, Chen A, Sharobeam A, Edwards L, Blair C. Safety and efficacy of tenecteplase in patients with wake-up stroke assessed by non-contrast CT (TWIST): a multicentre, open-label, randomised controlled trial. Lancet Neurol 2023; 22:117-126. [PMID: 36549308 DOI: 10.1016/s1474-4422(22)00484-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Current evidence supports the use of intravenous thrombolysis with alteplase in patients with wake-up stroke selected with MRI or perfusion imaging and is recommended in clinical guidelines. However, access to advanced imaging techniques is often scarce. We aimed to determine whether thrombolytic treatment with intravenous tenecteplase given within 4·5 h of awakening improves functional outcome in patients with ischaemic wake-up stroke selected using non-contrast CT. METHODS TWIST was an investigator-initiated, multicentre, open-label, randomised controlled trial with blinded endpoint assessment, conducted at 77 hospitals in ten countries. We included patients aged 18 years or older with acute ischaemic stroke symptoms upon awakening, limb weakness, a National Institutes of Health Stroke Scale (NIHSS) score of 3 or higher or aphasia, a non-contrast CT examination of the head, and the ability to receive tenecteplase within 4·5 h of awakening. Patients were randomly assigned (1:1) to either a single intravenous bolus of tenecteplase 0·25 mg per kg of bodyweight (maximum 25 mg) or control (no thrombolysis) using a central, web-based, computer-generated randomisation schedule. Trained research personnel, who conducted telephone interviews at 90 days (follow-up), were masked to treatment allocation. Clinical assessments were performed on day 1 (at baseline) and day 7 of hospital admission (or at discharge, whichever occurred first). The primary outcome was functional outcome assessed by the modified Rankin Scale (mRS) at 90 days and analysed using ordinal logistic regression in the intention-to-treat population. This trial is registered with EudraCT (2014-000096-80), ClinicalTrials.gov (NCT03181360), and ISRCTN (10601890). FINDINGS From June 12, 2017, to Sept 30, 2021, 578 of the required 600 patients were enrolled (288 randomly assigned to the tenecteplase group and 290 to the control group [intention-to-treat population]). The median age of participants was 73·7 years (IQR 65·9-81·1). 332 (57%) of 578 participants were male and 246 (43%) were female. Treatment with tenecteplase was not associated with better functional outcome, according to mRS score at 90 days (adjusted OR 1·18, 95% CI 0·88-1·58; p=0·27). Mortality at 90 days did not significantly differ between treatment groups (28 [10%] patients in the tenecteplase group and 23 [8%] in the control group; adjusted HR 1·29, 95% CI 0·74-2·26; p=0·37). Symptomatic intracranial haemorrhage occurred in six (2%) patients in the tenecteplase group versus three (1%) in the control group (adjusted OR 2·17, 95% CI 0·53-8·87; p=0·28), whereas any intracranial haemorrhage occurred in 33 (11%) versus 30 (10%) patients (adjusted OR 1·14, 0·67-1·94; p=0·64). INTERPRETATION In patients with wake-up stroke selected with non-contrast CT, treatment with tenecteplase was not associated with better functional outcome at 90 days. The number of symptomatic haemorrhages and any intracranial haemorrhages in both treatment groups was similar to findings from previous trials of wake-up stroke patients selected using advanced imaging. Current evidence does not support treatment with tenecteplase in patients selected with non-contrast CT. FUNDING Norwegian Clinical Research Therapy in the Specialist Health Services Programme, the Swiss Heart Foundation, the British Heart Foundation, and the Norwegian National Association for Public Health.
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Affiliation(s)
- Melinda B Roaldsen
- Department of Clinical Research, University Hospital of North Norway, Tromsø, Norway
| | - Agnethe Eltoft
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Hanne Christensen
- Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Stefan T Engelter
- Department of Neurology, University Hospital Basel, Basel, Switzerland; Department of Neurology and Neurorehabilitation, University of Basel, Basel, Switzerland; University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Bent Indredavik
- Department of Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway; Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dalius Jatužis
- Faculty of Medicine, Vilnius University, Center of Neurology, Vilnius, Lithuania
| | - Guntis Karelis
- Department of Neurology and Neurosurgery, Riga East University Hospital, Riga, Latvia; Rīga Stradiņš University, Riga, Latvia
| | - Janika Kõrv
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
| | - Erik Lundström
- Department of Medicine and Neurology, Uppsala University, Uppsala, Sweden
| | - Jesper Petersson
- Department of Neurology, Lund University, Institute for Clinical Sciences Lund, Lund, Sweden
| | - Jukka Putaala
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mary-Helen Søyland
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway; Department of Neurology, Hospital of Southern Norway, Kristiansand, Norway
| | - Arnstein Tveiten
- Department of Neurology, Hospital of Southern Norway, Kristiansand, Norway
| | - Andrew Bivard
- Department of Medicine, Royal Melbourne Hospital, Melbourne Brain Centre, Melbourne, VIC, Australia
| | - Stein Harald Johnsen
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Michael V Mazya
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - David J Werring
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Teddy Y Wu
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - Gian Marco De Marchis
- Department of Neurology, University Hospital Basel, Basel, Switzerland; Department of Neurology, University of Basel, Basel, Switzerland
| | - Thompson G Robinson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Ellisiv B Mathiesen
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
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Lasheen O, Yehia M, Salah A, Mikhail S, Hassan A. Towards cost saving in surgery without compromising safety: stapleless laparoscopic splenectomy in a developing country-a prospective cohort study. BMJ Open Qual 2023; 12:bmjoq-2022-002068. [PMID: 36707124 PMCID: PMC9884886 DOI: 10.1136/bmjoq-2022-002068] [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: 07/26/2022] [Accepted: 01/06/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Minimally invasive surgery has been steadily growing in popularity. Control of splenic hilar vessels is the most delicate step during laparoscopic splenectomy (LS). In the earlier eras of LS, hilar vessels were controlled using clips and/or ligation. Laparoscopic staples were later introduced and have arguably led to an increase in popularity of LS. They do not abolish potential complications of splenectomy and theoretically represent an added operative cost.In this study, we aimed to assess the safety and efficacy of stapleless LS (using knots, haemostatic devices and clips) compared with the now more conventional stapled LS. METHODS A pilot randomised prospective study was conducted in a university hospital between September 2018 and April 2020. It included 40 patients randomly assigned to two equal groups: (1) 20 patients: stapleless LS and (2) 20 patients: LS using laparoscopic staples.We compared operative time, intra and postoperative complications and postoperative recovery. RESULTS There was no statistically significant difference between both groups across all comparative outcomes. CONCLUSION Both techniques are comparable in terms of safety and operative time. In terms of cost efficiency, we recommend more comprehensive analyses of hospital costs.
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Affiliation(s)
- Omar Lasheen
- General Surgery, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Mohamed Yehia
- General Surgery, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Ayman Salah
- General Surgery, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Sameh Mikhail
- General Surgery, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Ahmed Hassan
- General Surgery, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
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Abdallah MS, Mosalam EM, Hassan A, Ramadan AN, Omara‐Reda H, Zidan AA, Samman WA, El‐berri EI. Pentoxifylline as an adjunctive in treatment of negative symptoms in chronic schizophrenia: A double-blind, randomized, placebo-controlled trial. CNS Neurosci Ther 2023; 29:354-364. [PMID: 36341700 PMCID: PMC9804082 DOI: 10.1111/cns.14010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
AIM The aim of this study was to explore the effectiveness and safety of pentoxifylline as an adjuvant to risperidone in mitigating the negative symptoms in patients with chronic schizophrenia. METHODS In this randomized, placebo-controlled study, eighty outpatients with chronic schizophrenia were given risperidone for 8 weeks along with either pentoxifylline or a placebo. The positive and negative syndrome scale (PANSS) was used to assess patients at the start of the trial, as well as at 2, 4, 6, and 8 weeks. Pre- and posttreatment serum levels of cAMP, TNF-α-, and IL-6 were measured. RESULTS The pentoxifylline group revealed a significant effect for time-treatment interaction on PANSS-negative subscale scores (p < 0.001), PANSS general psychopathology subscale scores (p < 0.001), and PANSS total scores (p < 0.001), but not on PANSS-positive subscale scores (p = 0.169). Additionally, when compared to the placebo group, the pentoxifylline group demonstrated a statistically significant increase in cAMP serum level and a statistically significant decrease in TNF-α and IL-6 serum levels. CONCLUSION Pentoxifylline adjunctive therapy with risperidone for 8 weeks was found to be promising in mitigating the negative symptoms in patients with chronic schizophrenia. TRIAL REGISTRATION NUMBER NCT04094207.
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Affiliation(s)
- Mahmoud S. Abdallah
- Department of Clinical Pharmacy, Faculty of PharmacyUniversity of Sadat CitySadat CityEgypt
| | - Esraa M. Mosalam
- Department of Biochemistry, Faculty of PharmacyMenoufia UniversityShebeen El‐KomEgypt
| | - Ahmed Hassan
- Department of Clinical Pharmacy, Faculty of PharmacyUniversity of Sadat CitySadat CityEgypt
| | - Ahmed N. Ramadan
- Department of Neuropsychiatry, Faculty of MedicineMenoufia UniversityShebeen El‐KomEgypt
| | - Hend Omara‐Reda
- Department of Neuropsychiatry, Faculty of MedicineMenoufia UniversityShebeen El‐KomEgypt
| | | | - Waad A. Samman
- Department of Pharmacology and Toxicology, College of PharmacyTaibah UniversityMedinaSaudi Arabia
| | - Eman I. El‐berri
- Clinical Pharmacy Department, Faculty of PharmacyTanta UniversityTantaEgypt
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Basely AM, Hassan A, Helmy FM, Abdel-Messih M, Ahmed M. Construction of Bi2S3/g-C3N4 step S-scheme heterojunctions for photothermal decomposition of rhodamine B dye under natural sunlight radiations. INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2022.110300] [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: 12/23/2022]
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Kamal M, Shoeib AEK, Megied MAA, Hassan A. Experimental Investigation of Actively Confined RC Columns Using Iron-Based Shape Memory Alloy Spiral Stirrups. cea 2022; 10:2953-2986. [DOI: 10.13189/cea.2022.100714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Pluer WT, Plach JM, Hassan A, Price D, Macrae ML. Retention of phosphorus in soils receiving bunker silo effluent. J Environ Manage 2022; 323:116147. [PMID: 36103790 DOI: 10.1016/j.jenvman.2022.116147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
The eutrophication of freshwater systems is a pervasive issue in North America and elsewhere, which has been linked to elevated phosphorus (P) loading from watersheds. Most excess P is thought to originate from non-point agricultural sources, and less attention has been given to small rural point sources, such as bunker silos on livestock farms. Sophisticated management practices are rarely used to attenuate nutrients from bunker silo effluent, leaving simple vegetated buffer strips or riparian zones to protect surface water; however, the efficacy of these systems or larger constructed treatment systems is unclear. This study compared two systems receiving bunker silo effluent, one a natural riparian system with a vegetated buffer strip that is the most common practice and the other a constructed treatment system with a forebay, slag filter, and swale. The study quantified P retention within various subsections of each system and characterized the forms of stored P to infer the potential for remobilization. Results indicate that soils receiving bunker silo effluent represent considerable stores of legacy P in the landscape (750 and 3400 kg ha-1), the majority of which is stored in labile forms that may be vulnerable to remobilization under the waterlogged conditions that often occur in management practices and riparian zones. Some areas of the systems were able to store considerably more P than others, with the slag filter showing the greatest treatment efficacy. Spatial variability in stored P was apparent, where sections of the systems that directly received effluent retained more P than sections located farther away from bunker silos (indirect inputs). Results indicate that passive treatment systems become P saturated over time, limiting their longterm P removal efficacy. The efficacy of these systems may be improved with the inclusion of sorptive materials as a slag filter within the constructed treatment system significantly increased the life expectancy of that system. Greater understanding of both quantity and forms of P retained in systems and soils receiving bunker silo effluent will help develop management strategies that are more effective and longer-lasting for reducing excess P losses to surface water bodies.
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Affiliation(s)
- W T Pluer
- Dept. of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
| | - J M Plach
- Dept. of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - A Hassan
- Dept. of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - D Price
- Dept. of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - M L Macrae
- Dept. of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
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Loche N, Chatron C, Hassan A, Bouraima F, Bernard L, Sautou V. Utilisation du Remdésivir et impact potentiel sur divers paramètres biologiques. Le Pharmacien Clinicien 2022. [PMCID: PMC9748208 DOI: 10.1016/j.phacli.2022.10.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Oliveira RKF, Nyasulu PS, Iqbal AA, Hamdan Gul M, Ferreira EVM, Leclair JW, Htun ZM, Howard LS, Mocumbi AO, Bryant AJ, Tamuzi JL, Avdeev S, Petrosillo N, Hassan A, Butrous G, de Jesus Perez V. Cardiopulmonary disease as sequelae of long-term COVID-19: Current perspectives and challenges. Front Med (Lausanne) 2022; 9:1041236. [PMID: 36530872 PMCID: PMC9748443 DOI: 10.3389/fmed.2022.1041236] [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: 09/10/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
COVID-19 infection primarily targets the lungs, which in severe cases progresses to cytokine storm, acute respiratory distress syndrome, multiorgan dysfunction, and shock. Survivors are now presenting evidence of cardiopulmonary sequelae such as persistent right ventricular dysfunction, chronic thrombosis, lung fibrosis, and pulmonary hypertension. This review will summarize the current knowledge on long-term cardiopulmonary sequelae of COVID-19 and provide a framework for approaching the diagnosis and management of these entities. We will also identify research priorities to address areas of uncertainty and improve the quality of care provided to these patients.
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Affiliation(s)
- Rudolf K. F. Oliveira
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- *Correspondence: Rudolf K. F. Oliveira,
| | - Peter S. Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Adeel Ahmed Iqbal
- National Health System (NHS), Global Clinical Network, London, United Kingdom
| | - Muhammad Hamdan Gul
- Department of Internal Medicine, University of Kentucky, Lexington, KY, United States
| | - Eloara V. M. Ferreira
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Zin Mar Htun
- Division of Pulmonary and Critical Care, National Institute of Health, University of Maryland, College Park, College Park, MD, United States
| | - Luke S. Howard
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ana O. Mocumbi
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
- Non-communicable Diseases Division, Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Andrew J. Bryant
- College of Medicine, University of Florida, Gainesville, FL, United States
| | - Jacques L. Tamuzi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Sergey Avdeev
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nicola Petrosillo
- Infection Prevention and Control-Infectious Disease Service, Foundation University Hospital Campus Bio-Medico, Rome, Italy
| | - Ahmed Hassan
- Department of Cardiology, Cairo University, Cairo, Egypt
| | - Ghazwan Butrous
- Medway School of Pharmacy, University of Kent at Canterbury, Canterbury, United Kingdom
| | - Vinicio de Jesus Perez
- Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University Medical Center, Stanford, CA, United States
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Abdelfattah OM, Martinez M, Sayed A, ElRefaei M, Abushouk AI, Hassan A, Masri A, Winters SL, Kapadia SR, Maron BJ, Rowin E, Maron MS. Temporal and Global Trends of the Incidence of Sudden Cardiac Death in Hypertrophic Cardiomyopathy. JACC Clin Electrophysiol 2022; 8:1417-1427. [PMID: 36424010 DOI: 10.1016/j.jacep.2022.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Since the initial clinical description of hypertrophic cardiomyopathy (HCM) over 60 years ago, sudden cardiac death (SCD) has been the most visible and feared complication of HCM. OBJECTIVES This study sought to characterize the temporal, geographic, and age-related trends of reported SCD rates in adult HCM patients. METHODS Electronic databases were systematically searched up to November 2021 for studies reporting on SCD event rates in HCM patients. Patients with SCD equivalents (appropriate implantable cardioverter-defibrillator [ICD] shocks and nonfatal cardiac arrests) were not included. A random-effects model was used to pool study estimates calculating the overall incidence rates (IR) for each time-era, geographic region, and age group. We analyzed 2 periods (before vs after 2000, following clinical implementation of ICD in HCM). Following 2000, 5-year intervals were used to demonstrate the temporal change in SCD rates. RESULTS A total of 98 studies (N = 70,510 patients and 431,407 patient-years) met our inclusion criteria. The overall rate of HCM SCD was 0.43%/y (95% CI: 0.37-0.50%/y; I2 = 75%; SCD events: 1,938; person-years of follow-up: 408,715), with young patients (<18 years of age) demonstrating a >2-fold-risk for sudden death vs adult patients 18-60 years of age (IR: 1.09%; 95% CI: 0.69%-1.73% vs IR: 0.43%; 95% CI: 0.37%-0.50%) (P value for subgroup differences <0.01). Contemporary SCD rates from 2015 to present were 0.32%/y and significantly lower compared with 2000 or earlier (IR: 0.32%; 95% CI: 0.20%-0.52% vs IR: 0.73%; 95% CI: 0.53%-1.02%, respectively). Reported SCD rates for HCM were lowest in North America (IR: 0.28%; 95% CI: 0.18%-0.43%,) and highest in Asia (IR: 0.67%; 95% CI: 0.54%-0.84%). CONCLUSIONS Contemporary HCM-related SCD rates are low (0.32%/y) representing a 2-fold decrease compared with prior treatment eras. Young HCM patients are at the highest risk. The maturation of SCD risk stratification strategies and the application of primary prevention ICD to HCM are likely responsible for the notable decline over time in SCD events. In addition, worldwide geographic disparities in SCD rates were evident, underscoring the need to increase access to SCD prevention treatment for all HCM patients.
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Affiliation(s)
- Omar M Abdelfattah
- Department of Internal Medicine, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey, USA
| | - Matthew Martinez
- Shannon T. Mast Center for Hypertrophic Cardiomyopathy, Department of Cardiovascular Medicine, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey, USA
| | - Ahmed Sayed
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Abdelrahman I Abushouk
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ahmed Hassan
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Ahmad Masri
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Stephen L Winters
- Section of Electrophysiology, Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey, USA
| | - Samir R Kapadia
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Barry J Maron
- Hypertrophic Cardiomyopathy Center, Department of Cardiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Ethan Rowin
- Hypertrophic Cardiomyopathy Center, Department of Cardiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Martin S Maron
- Hypertrophic Cardiomyopathy Center, Department of Cardiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA.
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Muacevic A, Adler JR, Kananeh S, Hassan A, Jumaah O. Lymphoplasmacytic Lymphoma/Waldenstrom Macroglobulinemia Masquerading as IgM Warm Antibody Autoimmune Hemolytic Anemia in Association With Mycoplasma pneumoniae Infection: A Case Report. Cureus 2022; 14:e31693. [PMID: 36561576 PMCID: PMC9765329 DOI: 10.7759/cureus.31693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 11/21/2022] Open
Abstract
Warm antibody autoimmune hemolytic anemia (AIHA) is mostly of IgG subtype. IgM subtype is extremely rare and has not been reported in association with lymphoplasmacytic lymphoma (LPL)/Waldenström macroglobulinemia (WM). We are reporting the case of a 75-year-old female patient who presented with severe hemolytic anemia and Mycoplasma pneumoniae pneumonia (MPP). Cold agglutinin and serum protein electrophoresis (SPEP) were negative but immunofixation was positive for IgM. Ultimately, hemolytic anemia was labeled warm antibody AIHA in association with MPP. She presented again one year later with more severe hemolytic anemia. Persistently elevated IgM was seen in immunofixation and triggered bone marrow biopsy that confirmed LPL/WM. This case highlights the clinical pearl that warm antibody AIHA in association with MPP is a rare entity and more intensive investigation to rule out other etiologies is mandated. Also, this case is rare as it is of IgM subtype warm AIHA and observed in the context of LPL/WM.
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Hassan A, Elfarouq A, Katheria V, Subar D. DD-07 INCISIONAL HERNIA FOLLOWING LAPAROSCOPIC COLORECTAL LIVER METASTASIS RESECTION. FIRST COMPARATIVE STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Since first laparoscopic liver surgery (LLR) in 1991, no literature to compare Incisional hernia (IH) incidence between LLR and open Resection (OLR). This is the first comparative study
Material and methods
Single centre retrospective review of Colorectal Liver Metastasis resections between 2011 till 2018. The primary end point is developing IH related to liver resection. Incidence of IH was compared between LLR and OLR. Factors including Age, Gender, Diabetes Mellitus, Steroid intake, Pre-op Creatinine and Albumin, Previous Liver resection ASA score were compared between both groups. Subcutaneous and peri-renal fat thickness measured as indicative of fat distribution. Numeric results presented in Mean±SD. SPSS 20 (IBM, Armonk, USA) used for statistical analysis. p ≤ 0.05 was considered statistically significant
Results
247 procedures with follow-up 41 ± 29 Months. IH was observed in 48 case (19.4%). Incidence was 10%, 19% at 1, 3 years respectively (Kaplan-Meier). 87 case (35%) had LLR and 160 (65%) OLR. OLR had lower pre-op Albumin (32±9 Vs 35±8 g/L, p 0.01, Mann-Whitney U), longer hospital stay (10±7 Vs 6±4 days, p 0.00, Mann-Whitney U) and more major liver resections i.e. Resection of 3 or more segments (58% Vs 29% in LLR, p 0.00, Chi2). No difference in IH Incidence in LLR (8%, 19% Vs 10%, 19%) and OLR at 1, 3 years respectively. Similarly, no difference in hernia size (53±37 mm in LLR Vs 50 ± 33 in OLR, p 0.96, Mann-Whitney U)
Conclusion
No difference in IH incidence or size between LLR and OLR.
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Affiliation(s)
- A Hassan
- General and HPB Surgery Department, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust , Blackburn , United Kingdom
| | - A Elfarouq
- General and HPB Surgery Department, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust , Blackburn , United Kingdom
| | - V Katheria
- General and HPB Surgery Department, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust , Blackburn , United Kingdom
| | - D Subar
- General and HPB Surgery Department, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust , Blackburn , United Kingdom
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Samuel I, Locas J, Mostafa S, Khaled A, El Mozy W, Gergis M, Hassan A. Behavior of right atrial strain in patients with advanced idiopathic pulmonary arterial hypertension after initiation of specific combined therapy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1921] [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: 11/12/2022] Open
Abstract
Abstract
Background
Right atrial (RA) function has emerged as an important determinant of outcome in pulmonary arterial hypertension (PAH). However, studies exploring RA function and assessing its behavior in response to specific PAH combination therapy, independent of RA size in patients with PAH is not adequately investigated.
Purpose
Assess the behavior of strain based measures of RA in response to combined PAH therapy, independent of RA size in patients with PAH.
Methods
RA peak longitudinal strain (PLS) and peak active contraction strain (PACS) were retrospectively assessed in 38 patients with advanced idiopathic pulmonary arterial hypertension (IPAH) who were referred to Aswan heart Centre and not receiving proper GDMT; at baseline and during follow-up after initiation of specific PAH combination therapy in the form of either Sildenafil/Bosentan or Sildenafil/Macitentan.
Results
Most of the patients were females with median (IR) age 34 (27–39) years. All patients presented with dyspnea WHO-FC III. At baseline, all patients were receiving only monotherapy in the form of sildenafil. Median (IR) time to echocardiographic follow-up was 11 (8–18) months. Patients presented with markedly right ventricle (RV) and RA enlargement, depressed RV systolic function, and reduced RA strain parameters compared with values previously reported in healthy controls. Among various baseline associations of the RA PLS, the strongest were with baseline RA area (rho: −0.659; p<0.001) and RVEF by CMR (rho: 0.570; p<0.001). At follow up; RA PLS and PACS significantly increased (16.6 vs 24 and 7.06 vs 11.42, respectively: p<0.001); however, RA area did not show significant decrease. Only RV TDI & FAC showed significant improvement among different RV function parameters measured by echocardiography. During the follow up period, 11 out of 38 patients (28.9%) were hospitalized. RA PLS change was significantly lower in the hospitalized group than the non-hospitalized group (4.40 vs 10.2; p=0.014). RA PLS change was independently associated with hospitalization in the multivariate regression analysis (95% CI: −0.061 to −0.010; p=0.008).
Conclusion
Initiation of specific PAH combination therapy in undertreated patients with IPAH showed improvement in RA strain parameters despite no change in RA area during follow up.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- I Samuel
- Faculty of Medicine, Cairo University , Cairo , Egypt
| | - J Locas
- Aswan Heart Centre - Magdi Yacoub Foundation , Aswan , Egypt
| | - S Mostafa
- Aswan Heart Centre - Magdi Yacoub Foundation , Aswan , Egypt
| | - A Khaled
- Aswan Heart Centre - Magdi Yacoub Foundation , Aswan , Egypt
| | - W El Mozy
- Aswan Heart Centre - Magdi Yacoub Foundation , Aswan , Egypt
| | - M Gergis
- Aswan Heart Centre - Magdi Yacoub Foundation , Aswan , Egypt
| | - A Hassan
- Faculty of Medicine, Cairo University , Cairo , Egypt
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Hu MK, Yuan M, James S, Lee HP, Abdul F, Yousif A, Hassan A, Khan J, Connolly D, Sharma V. Positive remodelling of coronary arteries on computed tomography coronary angiogram: an observational study. AsiaIntervention 2022; 8:110-115. [PMID: 36483287 PMCID: PMC9706778 DOI: 10.4244/aij-d-21-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) due to atherosclerosis is projected to be the leading cause of morbidity and mortality worldwide until 2040. CAD affects approximately 2.6 million people in the United Kingdom (UK), and 1 in 4 of them do not experience any symptoms. AIMS The aim of this study was to assess the characteristics and outcomes of patients with plaque features of positive remodelling (PR) on their computed tomography coronary angiogram (CTCA) images. METHODS Patients who were referred for CTCA from June 2018 to January 2020 were retrospectively identified. Patients underwent prospective, gated 128-slice dual-source CTCA. Patients with PR were compared to those without PR for demographics and outcomes. RESULTS A total of 861 patients were included in our study; 241 (28%) had PR, and 620 (72%) had no PR. Patients with PR were older (PR: 63.9±11.0 years vs no PR: 62.1±11.2 years; p=0.04), more likely to be male (PR: 65.6% vs no PR: 55.8%; p=0.01) and underwent coronary angiography more frequently (PR: 25.7% vs no PR: 14.4%; p<0.01). There were also significant increases in subsequent acute coronary syndrome (ACS) events (PR: 2.5% vs no PR: 0.0%; p<0.01) and the need for revascularisation therapy (PR: 15.4% vs no PR: 7.8%; p<0.01) in patients with PR despite being on statins (not a high dose). There was no difference in all-cause mortality. CONCLUSIONS Detection of PR on CTCA is a reliable prognostic indicator of future cardiovascular events and presents a valuable opportunity for initiation of aggressive primary prevention therapy.
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Affiliation(s)
- May Khei Hu
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Mengshi Yuan
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Sunil James
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Hui Ping Lee
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Fairoz Abdul
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Abdel Yousif
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Ahmed Hassan
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Jawad Khan
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
| | - Derek Connolly
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Vinoda Sharma
- Department of Cardiology, Birmingham City Hospital, Birmingham, United Kingdom
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Socias ME, Wood E, Le Foll B, Lim R, Choi JC, Mok WY, Bruneau J, Rehm J, Wild TC, Bozinoff N, Hassan A, Jutras-Aswad D. Impact of fentanyl use on initiation and discontinuation of methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: secondary analysis of a Canadian treatment trial. Addiction 2022; 117:2662-2672. [PMID: 35712892 PMCID: PMC9969999 DOI: 10.1111/add.15954] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Fentanyl is primarily responsible for the current phase of the overdose epidemic in North America. Despite the benefits of treatment with medications for opioid use disorder (MOUD), there are limited data on the association between fentanyl, MOUD type and treatment engagement. The objectives of this analysis were to measure the impact of baseline fentanyl exposure on initiation and discontinuation of MOUD among individuals with prescription-type opioid use disorder (POUD). DESIGN, SETTING AND PARTICIPANTS Secondary analysis of a Canadian multi-site randomized pragmatic trial conducted between 2017 and 2020. Of the 269 randomized participants, 65.4% were male, 67.3% self-identified as white and 55.4% had a positive fentanyl urine drug test (UDT) at baseline. Fentanyl-exposed participants were more likely to be younger, to self-identify as non-white, to be unemployed or homeless and to be currently using stimulants than non-fentanyl-exposed participants. INTERVENTIONS Flexible take-home dosing buprenorphine/naloxone or supervised methadone models of care for 24 weeks. MEASUREMENTS Outcomes were (1) MOUD initiation and (2) time to (a) assigned and (b) overall MOUD discontinuation. Independent variables were baseline fentanyl UDT (predictor) and assigned MOUD (effect modifier). FINDINGS Overall, 209 participants (77.7%) initiated MOUD. In unadjusted analyses, fentanyl exposure was associated with reduced likelihood of treatment initiation [odds ratio (OR) = 0.18, 95% confidence interval (CI) = 0.08-0.36] and shorter median times in assigned [20 versus 168 days, hazard ratio (HR) = 3.61, 95% CI = 2.52-5.17] and any MOUD (27 versus 168 days, HR = 3.32, 95% CI = 2.30-4.80). The negative effects were no longer statistically significant in adjusted models, and no interaction between fentanyl and MOUD was observed for any of the outcomes (all P > 0.05). CONCLUSIONS Both buprenorphine/naloxone and methadone may be appropriate treatment options for people with prescription-type opioid use disorder regardless of fentanyl exposure. Other characteristics of fentanyl-exposed individuals appear to be driving the association with poorer treatment outcomes.
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Affiliation(s)
- M Eugenia Socias
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Evan Wood
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Acute Care Programme, CAMH, Toronto, ON, Canada
| | - Ron Lim
- Department of Family Medicine and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jin Cheol Choi
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
| | - Wing Yin Mok
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
| | - Julie Bruneau
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Jürgen Rehm
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, CAMH, Toronto, ON, Canada
- Institute of Clinical Psychology and Psychotherapy Centre and Centre for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - T Cameron Wild
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Nikki Bozinoff
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Ahmed Hassan
- Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Didier Jutras-Aswad
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
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Hassan A, Galal S, Hassan A, Salman A. Utilization of carbon nanotubes and steel fibers to improve the mechanical properties of concrete pavement. Beni-Suef Univ J Basic Appl Sci 2022. [DOI: 10.1186/s43088-022-00300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Rigid pavements have become an urgent demand in recent years, as these pavements need less maintenance and renovation than other types. However, traditional rigid pavement faces various challenges and difficulties over its lifetime. It has a much higher initial erection cost than asphalt pavements, a greater sensitivity to dynamic stresses, and a highly susceptible to temperature variations causing cracking. Previous works dealt with these drawbacks by using effective materials as alternatives to cement and/or aggregates in pavements mixtures. In the last few years, much interest has been carried out in nanomaterial applications to improve the mechanical performance of construction materials, which can also be used for rigid pavement constructions. This improvement is due to nanomaterials' role in concrete as nanoreinforcements and nanofillers. On the other hand, various types of fibers have been used to improve the performance of concrete constructions. This study investigates the effect of adding carbon nanotubes (CNTs) and steel fibers (SFs) to concrete mixtures. A series of experiments on concrete mixes with various weight percentages of CNTs (0%, 0.025%, 0.050%, and 0.075%) were added to the mixtures to determine the best cost and amount of CNTs to add to a concrete mix. Compressive, tensile, and flexure strength characteristics are investigated. In the second experimental stage of this work, the effect of adding steel fibers to the mixture was investigated.
Results
According to the results, the optimal carbon nanotube content in concrete is 0.05%. Compared to other concrete combinations with varying proportions of CNTs, this quantity offers the maximum compressive, tensile, and flexural strength. Additionally, SFs can improve the mechanical properties of the mix as well as enhance its post-cracking and fatigue behavior. Adding both CNTs with SFs increased compressive, tensile, and flexural strength by 22.7%, 29.3%, and 70.8%, respectively, more than the traditional pavement.
Conclusion
This work found that combining SFs with CNTs improves the mechanical properties of the concrete mortar, resulting in a stronger mortar that can withstand more loads than the traditional one.
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Abdel-Wahab N, Montazari E, Spillson C, Amaria R, Glitza I, Patel S, Awiwi M, Hassan A, Tahon N, Elsayes K, Altan M, Wong M, Mcquade J, Tawbi H, Davies M, Yee C, Sharma P, Allison J, Johnson D, Diab A. 822P Phase II clinical trial: Safety and efficacy study of tocilizumab (Toci) in combination with ipilimumab (Ipi) 3mg/kg plus nivolumab (Nivo) 1mg/kg in patients (pts) with metastatic melanoma (MM). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.948] [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: 11/28/2022] Open
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