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Patel M, Shiwlani S, Kachhadia MP, Abdalla M, Samreen I, Mohamed AS, Nasir H. Neurosarcoidosis and Transverse Myelitis: Life-Threatening Manifestations of Sarcoidosis. Cureus 2024; 16:e52629. [PMID: 38374863 PMCID: PMC10876160 DOI: 10.7759/cureus.52629] [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: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Sarcoidosis, a systemic granulomatous disorder, typically involves the lungs, skin, and lymph nodes. Neurological manifestations are diverse and may include longitudinally extensive transverse myelitis (LETM), an uncommon inflammatory disorder of the spinal cord. We present a case of a 62-year-old female with LETM as the initial manifestation of sarcoidosis. The patient exhibited progressive bilateral lower extremity weakness, urinary retention, and sensory disturbances. Diagnostic workup revealed characteristic findings on spinal magnetic resonance imaging (MRI), cerebrospinal fluid analysis, and thoracic biopsy. Treatment with high-dose corticosteroids and subsequent immunomodulatory therapy resulted in significant improvement. Our case highlights the importance of including sarcoidosis in the differentials of LETM, particularly in patients with no respiratory manifestations.
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Affiliation(s)
- Mitwa Patel
- Internal Medicine, David Tvildiani Medical University, Tbilisi, GEO
| | | | | | | | - Iqra Samreen
- Internal Medicine, Augusta University, Augusta, USA
| | | | - Hira Nasir
- Internal Medicine, Mayo Hospital, Lahore, PAK
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Khamis Y, Mohamed AS, Abobakr M, He R, Wahid KA, Ahmed SM, Salzillo T, Dede C, Naser M, Ding Y, Wang J, Preston K, El-Habashy D, Fadel S, Ismail AA, Fuller CD. Dynamic Contrast Enhanced MRI as a Biomarker of Tumor Response and Oncologic Outcomes in Head and Neck Cancer: Results of a Single Institution Prospective Imaging Study. Int J Radiat Oncol Biol Phys 2023; 117:e677-e678. [PMID: 37785995 DOI: 10.1016/j.ijrobp.2023.06.2134] [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) We aim to determine the correlation between vascular parameters of Dynamic contrast enhanced (DCE) MRIs and tumor response and outcomes in head and neck (HNC) patients treated with definitive radiation therapy (RT). MATERIALS/METHODS Eighty-two HNC patients are included in this prospective study in one institute. All patients had malignant head and neck neoplasm indicative of curative- intent treatment. Patients were imaged using MRIs pre-, mid-, and post-RT completion at 8-12 weeks. T2-weighted sequences were used for tumor contouring then it was co-registered to respective DCE images. The response to treatment was checked at mid-radiotherapy (mid-RT) and at the end of RT. Mid-RT MRI was co-registered to baseline images and the manually segmented baseline primary tumor regions of interest were propagated to mid-RT images. Quantitative maps (Ktrans, Kep, Ve and Vp) were generated with the extended Tofts pharmacokinetic models and were used for analysis. These vascular parameters were presented as a mean value and percentile using histogram analysis and the following parameters were extracted using an in-house programming environment script: mean, 5th, 10th, 20th, 30th, 40th, 50th (i.e., median), 60th, 70th, 80th, 90th, 95th percentile. The non-parametric Wilcoxon signed-rank test was used to assess the changes of mid-RT DCE parameters compared to baseline. Recursive partitioning analysis (RPA) was used to identify the delta DCE threshold associated with relapse. We assessed the identified thresholds' correlation with oncological and survival endpoints using Cox regression with and without standard clinical variables. RESULTS The median age for patients is 61 years old (33-78 range). Never smokers are 39 (47%), 35 (43%) are former smoker and 8 (10%) are current smoker with a mean value of 14 pack per year and 26 standard deviations. Using AJCC 8th edition, 39 (47%) are stage I and 19 (23%) are stage II and stage III and IV are 15 (18%) and 9 (10%) respectively. HPV positive are 72 (88%). For patients with GTV-P at baseline (n = 60), 11 (18%) had mid-RT CR at the primary site which increased to 50 (83%) post-RT. The LC and RFS for the entire cohort were 91.4%, and 79.2% respectively. In GTV-P, none of the pre-radiotherapy DCE parameters were correlated with LC or RFS. Wilcoxon signed rank test was statistically significant in 80, 90 and 95 percentiles with (p<0.05). RPA analysis identified different thresholds for each DCE parameter, and its inclusions to the multivariate model improved its performance. In GTV-P, RPA analysis identified ΔKtrans 40 percentiles >15.6% at mid-RT as the most significant point. When this value of ΔKtrans added to the multivariate analysis it was associated with a significantly better model performance in RFS (p = 0.00001). CONCLUSION DCE parameters are a very promising tool to correlate with response and outcomes in H&N cancer patients. Future work is warranted for external validation of our findings.
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Affiliation(s)
- Y Khamis
- MD Anderson Cancer Center, Houston, TX; Department of clinical oncology and nuclear medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - A S Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Abobakr
- MD Anderson Cancer Center, Houston, TX
| | - R He
- MD Anderson Cancer Center, Houston, TX
| | - K A Wahid
- MD Anderson Cancer Center, Houston, TX
| | - S M Ahmed
- MD Anderson Cancer Center, Houston, TX
| | | | - C Dede
- MD Anderson Cancer Center, Houston, TX
| | - M Naser
- MD Anderson Cancer Center, Houston, TX
| | - Y Ding
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K Preston
- MD Anderson Cancer Center, Houston, TX
| | | | - S Fadel
- Department of clinical oncology and nuclear medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - A A Ismail
- Department of clinical oncology and nuclear medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - C D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Mohamed AS, Abobakr M, Tehami S, van Dijk LV, Lai SY, Fuller CD. Natural History and Clinical/Dosimetric Determinants of Osteoradionecrosis in a Large Cohort of Head and Neck Cancer Following Curative Radiotherapy: Debunking the Myth of Decreased Rates of Osteoradionecrosis in the Modern Radiotherapy Era. Int J Radiat Oncol Biol Phys 2023; 117:S123. [PMID: 37784318 DOI: 10.1016/j.ijrobp.2023.06.463] [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) Osteoradionecrosis (ORN) of the mandible is the most devastating toxicity following head and neck cancer (HNC) radiotherapy (RT). The rate of ORN occurrence has been debatable in the modern era of advanced RT. We aim to determine the natural history and time to ORN development in a large cohort of HNC. MATERIALS/METHODS After IRB approval, we identified HNC patients treated with curative-intent RT between 2005 and 2020 at MD Anderson Cancer Center. Dental oncology notes were reviewed and all dental procedures were recorded. Available dose volume histograms (DVHs) for the segmented mandibular volumes were extracted. Based on our previously published ORN normal tissue complication probability (NTCP) model, any dental procedure pre-RT is a clinical high-risk factor and, therefore, data were coded as (high vs. low clinical risk) accordingly. We also coded the dosimetric risk factors to (high vs. low dosimetric risk) according to our published DVH thresholds (high dosimetric risk if any applies: V45≥40%, V55≥25%, and/or D30 ≥40 Gy). Finally, patients were classified to four groups according to combined clinical and dosimetric risk factors (No, clinical, dosimetric, and both). We used the Kaplan-Meier method to calculate time to ORN development and ORN-free survival. For time to ORN development, any grade ORN occurrence was coded as event and all others were censored. For ORN-free survival, death and ORN were coded as events and all others were censored. Log-rank test was used to compared curves of different risk groups. RESULTS One thousand eight hundred sixty-six patients were included. Median follow-up was 38 months (range 4-162). ORN was reported in 252 patients (13.5%). The median time to ORN development was 18.5 months (range 4-145). 95 patients (37.7%) developed ORN after 2-years post-RT. The 1-, 3-, and 5-year ORN rates were 4.7%, 12.7%, and 17.8%, respectively. The 1-, 3-, and 5-year ORN-free survival were 94.3%, 85.5%, and 80.3%, respectively. There were statistically significant differences (P < 0.0001) between ORN-free survival in different clinical/dosimetric risk factors. The patients with no, clinical-only, dosimetric-only, and both clinical and dosimetric risk factors were 35%, 19%, 22%, and 24%, respectively. The 5-year ORN-free survival was 94.3%, 89.8%, 76.3%, and 69.6% for patients with no, clinical-only, dosimetric-only, and both clinical and dosimetric risk factors, respectively. The hazard-ratio (HR) of ORN development in clinical-only, dosimetric-only, and both clinical and dosimetric risk groups was 2.1, 5.4, and 7.5 compared to the no risk group (P<0.05 for all). CONCLUSION Our findings indicate that ORN remains a remarkable toxicity hazard for HNC survivors. A prolonged surveillance time is required for the majority of HNC survivor since more than one-third of the ORN events occurred after 2-year follow-up. Patients with combined clinical and dosimetric risk factors have a staggering ORN risk profile and are proper candidates for future prophylactic pharmacotherapy clinical studies.
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Affiliation(s)
- A S Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Abobakr
- MD Anderson Cancer Center, Houston, TX
| | - S Tehami
- MD Anderson Cancer Center, Houston, TX
| | - L V van Dijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - S Y Lai
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - C D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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El-Habashy D, Wahid KA, He R, Ding Y, Wang J, Preston K, Salzillo T, Naser M, McDonald B, Abobakr M, Shehata MA, Elkhouly E, Alagizy H, Hegazy AH, Fuller CD, Mohamed AS. Longitudinal Monitoring of Quantitative Imaging Kinetics of Primary Tumor and Nodal Volumes Using the MR-Linac Device in Head and Neck Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e663-e664. [PMID: 37785964 DOI: 10.1016/j.ijrobp.2023.06.2102] [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) We aim to characterize the serial quantitative apparent diffusion coefficient (ADC) changes of the target disease volume using diffusion-weighted imaging (DWI) acquired weekly during radiation therapy (RT) on a 1.5T MR-Linac and correlate these changes with tumor response and oncologic outcomes for head and neck squamous cell carcinoma (HNSCC) patients. MATERIALS/METHODS Thirty patients with pathologically confirmed HNSCC and received curative-intent RT at the University of Texas MD Anderson Cancer Center, were included in this prospective study. Baseline and weekly MRIs (weeks 1-6) were obtained, and various ADC parameters (mean, 5th, 10th, 20th, 30th, 40th, 50th, 60th, 70th, 80th, 90th and 95th percentile) were extracted from the target regions of interest (ROIs). Pre-RT and weekly ADC parameters were correlated with response during RT, loco-regional control, and the development of relapse using the Mann-Whitney U test. The Wilcoxon signed-rank test was used to compare the weekly ADC versus baseline values. Weekly volumetric changes (Δvolume) for each ROI were correlated with ΔADC using Spearman's Rho test. Recursive partitioning analysis (RPA) was performed to identify the optimal ΔADC threshold associated with different oncologic outcomes. RESULTS There was an overall significant rise in all ADC parameters during different time points of RT compared to baseline values for both GTV-P & GTV-N. The increased ADC values for GTV-P were statistically significant only for primary tumors achieving CR during RT. RPA identified GTV-P ΔADC 5th percentile >13% at the 3rd week of RT as the most significant parameter associated with CR for GTV-P during RT (p <0.001). Baseline ADC parameters didn't significantly correlate with response to RT or other oncologic outcomes. There was a significant decrease in residual volume of both GTV-P & GTV-N throughout the course of RT. Additionally, a significant negative correlation between mean ΔADC and Δvolume for GTV-P at the 3rd and 4th week of RT was detected (r = -0.39, p = 0.044 & r = -0.45, p = 0.019, respectively). CONCLUSION Assessment of ADC kinetics at regular intervals throughout RT is potentially able to predict the response to RT and oncologic outcome. Further studies with larger cohorts and multi-institutional data are needed for validation of our results.
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Affiliation(s)
- D El-Habashy
- MD Anderson Cancer Center, Houston, TX; Faculty of medicine, Menoufia university, Egypt, Shebin Elkom, Egypt
| | - K A Wahid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R He
- MD Anderson Cancer Center, Houston, TX
| | - Y Ding
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K Preston
- MD Anderson Cancer Center, Houston, TX
| | | | - M Naser
- MD Anderson Cancer Center, Houston, TX
| | | | - M Abobakr
- MD Anderson Cancer Center, Houston, TX
| | - M A Shehata
- Faculty of medicine, Menoufia university, Egypt, Shebin Elkom, Egypt
| | - E Elkhouly
- Menoufia University, Shebin Elkom, Al Minufiy, Egypt
| | - H Alagizy
- Faculty of medicine, Menoufia university, Egypt, Shebin Elkom, Egypt
| | - A H Hegazy
- Faculty of medicine, Menoufia university, Egypt, Shebin Elkom, Egypt
| | - C D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A S Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Wahid KA, Khriguian J, Dede C, Khamis Y, El-Habashy D, Restrepo N, Tehami S, Sahin O, Mohamed AS, Fuller CD, Naser M. Deep Learning Based Prognostic Prediction in Oropharyngeal Cancer Patients Using Multiparametric MRI Inputs. Int J Radiat Oncol Biol Phys 2023; 117:e631. [PMID: 37785885 DOI: 10.1016/j.ijrobp.2023.06.2027] [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) While prognostic outcomes for oropharyngeal cancer (OPC) patients have improved in recent years, patients still face a non-negligible risk of disease recurrence or death. Accurately predicting post-therapy prognosis would be highly valuable for risk stratification and treatment guidance for OPC patients. Recent studies using PET/CT data have demonstrated the effectiveness of large-scale, end-to-end image-based deep learning (DL) models for predicting progression-free survival (PFS) in OPC patients. Multiparametric MRI (mpMRI), which combines anatomical and functional MRI sequences, has the potential to offer similar results, and has the added advantage of high-frequency longitudinal imaging capabilities, such as through MR-Linac devices. Therefore, this study aimed to develop a DL model using mpMRI data to predict PFS, and to evaluate the impact of anatomical and functional input channels on model performance. MATERIALS/METHODS From a large-scale head and neck cancer database at MD Anderson Cancer Center, treatment-naïve OPC patients with available pre-radiotherapy mpMRI imaging were selected for this study. mpMRI images used for this study included T2-weighted images (T2) and apparent diffusion coefficient (ADC) maps. PFS event status was defined as having either a local, regional, or distant failure, and/or death; data were right censored if an event had not occurred. Images were resampled to the T2 resolution, normalized to a [-1,1] scale, and cropped to the field of view of the ADC image for use in DL models. A DL convolutional neural network model based on the DenseNet121 architecture from the Medical Open Network for AI (MONAI) Python package using a negative log-likelihood loss function was implemented. The model used mpMRI images as input channels and 20 output channels representing the different time intervals of the predicted PFS conditional probabilities of surviving that time interval; final PFS in days was obtained by summing the cumulative probability of surviving each interval times the interval duration. A 5-fold cross validation approach was used for model training and evaluation. Separate models using only T2, only ADC, and T2 + ADC channel inputs were compared. Model performance was measured using the C-index. RESULTS Out of 1154 patients, 404 met inclusion criteria. The overall PFS event rate was 16%. Median C-index values from the 5-fold cross validation were 0.62, 0.67, and 0.69 for the ADC, T2, and T2+ADC models, respectively. CONCLUSION Using large-scale datasets and open-source DL implementations, we find that OPC PFS prediction models using mpMRI data yield modest but comparable performance to existing models (i.e., state-of-the-art reference performance using PET/CT). Moreover, combining mpMRI channels may increase the performance of models for OPC prognostic prediction. Future work will involve integration of additional timepoints, additional mpMRI images, clinical variables, and saliency maps.
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Affiliation(s)
- K A Wahid
- MD Anderson Cancer Center, Houston, TX
| | - J Khriguian
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C Dede
- MD Anderson Cancer Center, Houston, TX
| | - Y Khamis
- MD Anderson Cancer Center, Houston, TX
| | | | | | - S Tehami
- MD Anderson Cancer Center, Houston, TX
| | - O Sahin
- MD Anderson Cancer Center, Houston, TX
| | - A S Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Naser
- MD Anderson Cancer Center, Houston, TX
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Abobakr M, He R, Wahid KA, Salzillo T, Ahmed SM, El-Habashy D, Khamis Y, Dede C, Ding Y, Wang J, Lai SY, Fuller CD, Mohamed AS. Assessment of Dynamic Contrast Enhanced (DCE) MRI for Detection of Radiotherapy Induced Alteration in Mandibular Vasculature. Int J Radiat Oncol Biol Phys 2023; 117:S31-S32. [PMID: 37784475 DOI: 10.1016/j.ijrobp.2023.06.295] [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) We aim to determine the kinetics of DCE-MRI changes in various mandibular risk volumes based on radiation (RT) dose received. MATERIALS/METHODS Eighty-eight head and neck cancer (HNC) patients (Pts) who underwent definitive RT were enrolled in this prospective study after IRB approval and informed consent. Images were acquired at pre-RT (Baseline), 3 weeks after RT start date (Mid-RT), 3 mos post-RT (PostRT1), and 6 mos post-RT (PostRT2). Manually segmented mandibular volumes on T2-weighted images were propagated to co-registered DCE-MRIs. Planning CTs and dose grids were also co-registered to corresponding baseline T2 images to create 3-D dose subvolumes. These were used to create 3 risk subvolumes; <30 Gy, 30-50 Gy, and >50 Gy ROIs. DCE images of different timepoints (TPs) were deformably co-registered and the dose subvolumes were propagated to each TP. We used the extended-Tofts model to generate the vascular quantitative maps (Ktrans and Ve). Each subvolume histogram parameters were extracted at each TP. Wilcoxon Signed Rank test was used to compare the changes at different TPs compared to baseline. We classified Pts' delta parameters at different TPs -based on our prior extensive QA assessment- into Pts with stable vascular profile (±25% change), Pts with significant increase (>25% change) and Pts with significant decrease (<-25%). Chi-square test was used to assess the change at different TPs. RESULTS For <30 Gy subvolumes, there were no significant changes (p > 0.05) in the studied DCE parameters at all TPs except a significant decrease (p < 0.001) in median Ktrans at PostRT2. For 30-50 Gy subvolumes, there was a significant increase in median Ktrans that started at MidRT (p = 0.006) and continued at PostRT1 (p = 0.04) but recovered to baseline values at PostRT2. Median Ve on the other hand only showed significant increase at PostRT1 (p = 0.001), but other TPs were not significantly different compared to baseline. Similarly, subvolumes >50 Gy showed same kinetics as in 30-50 Gy with significant increase of Ktrans at MidRT and PostRT1 and significant increase in Ve in only PostRT1 (P <0.05). For <30 Gy, there was significant increase in the number of Pts with stable or decrease in Ktrans at PostRT2 compared to earlier TPs (70% vs. 60% at PostRT1 and 54% at MidRT p = 0.003). 30-50 Gy subvolumes showed similar profile like <30 Gy with significant increase in the percentage of Pts with recovery at PostRT2. However, for >50 Gy, there was no significant increase in the number of Pts who recovered at PostRT2 (p = 0.3). Ve showed no significant increase in the percentage of Pts with recovery at different TPs (p > 0.05). CONCLUSION Results showed that for all dose mandibular subvolumes, there is an acute vascular insult that tends to recover at +6 months post-RT except for a selective group of patients who continue to have persistence of the vascular insult at high dose subvolumes. These findings are of importance for future selection of high risk population for prophylactic intervention against osteoradionecrosis.
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Affiliation(s)
- M Abobakr
- MD Anderson Cancer Center, Houston, TX
| | - R He
- MD Anderson Cancer Center, Houston, TX
| | - K A Wahid
- MD Anderson Cancer Center, Houston, TX
| | | | - S M Ahmed
- MD Anderson Cancer Center, Houston, TX
| | | | - Y Khamis
- MD Anderson Cancer Center, Houston, TX
| | - C Dede
- MD Anderson Cancer Center, Houston, TX
| | - Y Ding
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Y Lai
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - C D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A S Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Khriguian J, Mohamed AS, Beddar S, Lee A, Frank SJ, Gunn GB, Morrison WH. Disease Control and Toxicity Outcomes after Intraoperative HDR Brachytherapy for Neck Recurrences in Patients Previously Irradiated Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e592-e593. [PMID: 37785790 DOI: 10.1016/j.ijrobp.2023.06.1944] [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) Despite recent advances in local and systemic therapies for head and neck squamous cell carcinomas (HNSCC), the most common types of treatment failure remain local and regional. Patients with HNSCC also have a higher risk of developing secondary head and neck tumors due to a field cancerization phenomenon. Treatment of these recurrences poses a challenge, particularly in patients having previously received full dose external beam radiotherapy (EBRT) to the head and neck region. This study evaluates the clinical outcomes of intraoperative Harrison-Anderson-Mick applicator (HAM) HDR brachytherapy (BT) after salvage neck dissection for neck recurrences in patients previously irradiated for HNSCC. MATERIALS/METHODS All patients having received HAM BT for HNSCC neck recurrences at a single institution were identified. Demographic, treatment, disease control and toxicity data were collected retrospectively. Toxicity was graded as per Common Terminology Criteria for Adverse events version 5. The Kaplan Meier method was used to assess overall survival (OS) and ipsilateral regional control (IRC) from the time of HAM BT. RESULTS Nineteen patients with regional recurrence of HNSCC were treated with HAM BT Ir-192 between July 2006 and June 2022, with a median follow-up for survival of 51.4 months (range: 2.5-186.7). The median BT dose was 12.5 Gy delivered intraoperatively at 5 mm tissue depth/1 cm from source. Fifteen patients (78.9%) also received postoperative EBRT to a median dose of 46 Gy in 23 fractions and 13 (68.4%) received systemic therapy. Six patients (31.6%) developed ipsilateral neck recurrences (4 who had adjuvant EBRT and 2 who did not), 2 patients had primary site recurrences and 5 patients developed distant metastases. In terms of acute toxicity, 4 patients had grade 3 dysphagia requiring feeding tube (FT) placement and one patient required surgical intervention for wound necrosis. In terms of late toxicity, 2 additional patients required FT placement and 1 was able to have it removed. No grade 4+ late toxicities were noted. The IRC at the site of HAM BT at 1 year was 71.5% and 63.6% at 5 years. The 1-year OS was 81.3% and 5-year OS was 40.9%. CONCLUSION Intraoperative HAM BT resulted in favorable rates of IRC with acceptable toxicity in the reirradiation setting for HNSCC.
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Affiliation(s)
- J Khriguian
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A S Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Lee
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G B Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W H Morrison
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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8
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Sahin O, Wahid KA, Taku N, He R, Naser M, Mohamed AS, Fuller CD. Multi-Specialty Physician Performance in Predicting Radiographic Extranodal Extension in Nodal Metastases of Oropharyngeal Squamous Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e621. [PMID: 37785862 DOI: 10.1016/j.ijrobp.2023.06.2005] [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) The presence of extranodal extension (ENE) in oropharyngeal (OPC) cancer patients is an important prognostic factor and can be used to determine the optimal course of treatment; however, currently, the gold standard method for ENE assessment is performed pathologically, which can only be done in a post-hoc fashion after surgical treatment has already been performed. Anatomic imaging features are being explored as a possible method for the pre-therapeutic determination of ENE, but there is currently no objective standard for the assessment of ENE from radiographic images. In this study we recruited expert clinicians, including surgeons, radiation oncologists, and radiologists, across multiple institutions to individually evaluate the presence of ENE from CT scans in order to assess the performance of radiographic ENE evaluation in human experts across different specialties. MATERIALS/METHODS Pre-therapy contrast-enhanced CT scans were collected from 25 OPC patients with lymph node metastasis that were pathologically evaluated for ENE after surgical resection. 5 scans were randomly chosen to be duplicated and left/right inverted, resulting in a total of 30 scans of which 21 had pathologically-confirmed ENE. To hide the inversion, all images were cropped to only show the oropharynx region. 34 expert head and neck cancer physicians, comprised of 12 surgeons, 11 radiation oncologists, and 11 radiologists, then separately evaluated the 30 CT scans using 3D Slicer for ENE presence or absence with their prediction confidence. For each physician, discriminative performance metrics were measured by calculating the accuracy, sensitivity, specificity, area under the receiver-operating characteristic curve (AUC), and Brier score, a measure of the probabilistic prediction accuracy calculated from their confidence where a lower Brier score is better. Statistical tests were performed using the Mann Whitney U test. RESULTS The median (interquartile) study results are shown in Table 1. There was no statistically significant difference among groups for accuracy or AUC, but significant differences among groups for Brier score, sensitivity, and specificity. CONCLUSION In this study we provide evidence that expert physicians, regardless of specialty, show poor performance in assessing the presence of ENE from CT scans in OPC patients. These results agree with conclusions from previous literature, and suggest the need for further research in the automated analysis of radiographic ENE.
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Affiliation(s)
- O Sahin
- McGovern Medical School, Houston, TX
| | - K A Wahid
- MD Anderson Cancer Center, Houston, TX
| | - N Taku
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R He
- MD Anderson Cancer Center, Houston, TX
| | - M Naser
- MD Anderson Cancer Center, Houston, TX
| | - A S Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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9
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Mohamed AS, Elsebaie EM, Abdelrhman WM, Abdulmaguid NYM, Bahnasy RM, Elgendy MSA, Elashry AMMM, El-Hassanin MF, El-Wakeil NHM, Khalil AMM, Amin HF. Evaluation of In Vitro Antioxidant, Anti-Obesity, and Anti-Diabetic Activities of Opuntia ficus Cladodes Gel and Its Application as a Preservative Coating for Shrimp during Refrigerated Storage. Gels 2023; 9:716. [PMID: 37754397 PMCID: PMC10530947 DOI: 10.3390/gels9090716] [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: 07/29/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
Opuntia ficus cladodes (OFC) are considered one of the wastes that result from opuntia cultivation, and their disposal by traditional methods results in many environmental problems. Therefore, this study was conducted with two aims. The first was the production of OFC gel, and the evaluation of its in vitro antioxidant (by two methods, DPPH and ABTS), anti-obesity, and anti-diabetic activities. The second was an investigation of the effects of different concentrations of this gel (0, 50, and 100%) as an edible coating on the quality of shrimp during 8 days of refrigerated storage. The results showed that this gel was characterised by a high content of ash (10.42%), total carbohydrates (75.17%), and total phenols (19.79 mg GAE/g). OFC gel contained six types of sugars: arabinose, xylose, galactose, rhamnose, glucose, and uronic acid, and the most abundant was xylose (36.72%). It is also clear from the results that the OFC gel had high antioxidant properties, which were higher against DPPH than ABTS at the same concentration. OFC gel showed a high inhibition activity against lipase, α-glycosidase, and α-amylase enzymes, and their IC50 values were 1.43 mg/mL, 0.78 mg/mL, and 0.57 mg/mL, respectively. The results also stated that shrimp coated with OFC gel had lower pH, drip loss, TVB-N, and TBA values through the days of refrigerated storage. Moreover, the shrimp coated with 100% OFC gel were better than those coated with 50% OFC gel. In conclusion, OFC gel showed high potency as active antioxidant, for its enzyme anti-activities, and as an edible coating for shrimp.
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Affiliation(s)
- Alaa S. Mohamed
- Food Science Department, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt
| | - Essam Mohamed Elsebaie
- Food Technology Department, Faculty of Agriculture, Kafrelsheikh University, Kafr El-Shaikh 33516, Egypt
| | - Wesam Mohammed Abdelrhman
- Nutrition & Food Science Department, Faculty of Home Economics, Al-Azhar University, Tanta 31512, Egypt
| | - Nabila Yahia Mahmoud Abdulmaguid
- Nutrition & Food Science Department, Faculty of Home Economics, Al-Azhar University, Tanta 31512, Egypt
- Food Science and Nutrition Department, Science Collage, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Rasha M. Bahnasy
- Nutrition & Food Science Department, Faculty of Home Economics, Al-Azhar University, Tanta 31512, Egypt
| | - Manal Salah Abbas Elgendy
- Nutrition & Food Science Department, Faculty of Home Economics, Al-Azhar University, Tanta 31512, Egypt
| | | | - Marwa Fawzy El-Hassanin
- Nutrition & Food Science Department, Faculty of Home Economics, Al-Azhar University, Tanta 31512, Egypt
| | | | | | - Hesham F. Amin
- Department of Fish Processing and Technology, Faculty of Fish Resources, Suez University, Suez 43511, Egypt
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10
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Wentzel A, Floricel C, Canahuate G, Naser MA, Mohamed AS, Fuller CD, van Dijk L, Marai GE. DASS Good: Explainable Data Mining of Spatial Cohort Data. Comput Graph Forum 2023; 42:283-295. [PMID: 37854026 PMCID: PMC10583718 DOI: 10.1111/cgf.14830] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Developing applicable clinical machine learning models is a difficult task when the data includes spatial information, for example, radiation dose distributions across adjacent organs at risk. We describe the co-design of a modeling system, DASS, to support the hybrid human-machine development and validation of predictive models for estimating long-term toxicities related to radiotherapy doses in head and neck cancer patients. Developed in collaboration with domain experts in oncology and data mining, DASS incorporates human-in-the-loop visual steering, spatial data, and explainable AI to augment domain knowledge with automatic data mining. We demonstrate DASS with the development of two practical clinical stratification models and report feedback from domain experts. Finally, we describe the design lessons learned from this collaborative experience.
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Affiliation(s)
- A Wentzel
- University of Illinois Chicago, Electronic Visualization Lab
| | - C Floricel
- University of Illinois Chicago, Electronic Visualization Lab
| | | | - M A Naser
- University of Texas MD Anderson Cancer Center
| | - A S Mohamed
- University of Texas MD Anderson Cancer Center
| | - C D Fuller
- University of Texas MD Anderson Cancer Center
| | - L van Dijk
- University of Texas MD Anderson Cancer Center
| | - G E Marai
- University of Illinois Chicago, Electronic Visualization Lab
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11
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Sadia H, Oshikoya AF, Sachdev P, Fasoranti-Sowemimo OF, Shawl SH, Kumar K, Mohamed AS, Haseeb M, Nasir H. Atrial Myxoma: An Unusual Etiology of Ischemic Stroke in an Adult Patient. Cureus 2023; 15:e40599. [PMID: 37469821 PMCID: PMC10353846 DOI: 10.7759/cureus.40599] [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: 06/18/2023] [Indexed: 07/21/2023] Open
Abstract
Atrial myxoma is the most frequent primary cardiac tumor; however, it is a rare, substantial cause of cardiogenic emboli causing a stroke, especially in young adults. A cardiac myxoma has no specific clinical presentation, ranging from constitutional symptoms to non-cardiac symptoms and emboli, which leads to a diagnostic challenge in the clinical process. We report a case of a left atrial myxoma in an adult female who presented with sudden onset of right-sided weakness, headache, and numbness. Imaging confirmed cardiogenic emboli from the cardiac myxoma, which was reflected in an ischemic stroke.
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Affiliation(s)
- Haleema Sadia
- Internal Medicine, Khyber Teaching Hospital Peshawar, Peshawar, PAK
| | - Adetola F Oshikoya
- Internal Medicine, Near East University, Nicosia, CYP
- Internal Medicine, General Hospital Odan, Lagos, NGA
| | - Priyanka Sachdev
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | | | - Saima H Shawl
- Internal Medicine, Midwest Sleep and Wellness Clinic, Chicago, USA
- Medicine, Chattogram Medical College Hospital (CMCH), Chittagong, BGD
| | - Kapil Kumar
- Medicine and Surgery, Liaquat National Hospital and Medical College, Karachi, PAK
| | | | - Muhammad Haseeb
- Medicine, Allama Iqbal Medical College, Lahore, PAK
- Internal Medicine, Mount Sinai Hospital, Brooklyn, USA
| | - Hira Nasir
- Internal Medicine, Mayo Hospital, Lahore, PAK
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12
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Mohamed KH, Oshikoya AF, Kumar K, Anigbo CL, Sri Satya Sai Prashanth P, Mohamed AS, Haseeb M, Nasir H. Takotsubo Cardiomyopathy: A Possible Rare Complication of Guillain-Barré Syndrome. Cureus 2023; 15:e40083. [PMID: 37425556 PMCID: PMC10327529 DOI: 10.7759/cureus.40083] [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: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Dysautonomia is a common and severe complication of Guillain-Barré syndrome (GBS), which may manifest as cardiac arrhythmias, labile blood pressure, diaphoresis, and changes in gastrointestinal motility. Takotsubo cardiomyopathy (TCM) is a life-threatening manifestation of dysautonomia in patients with GBS, which is not widely underlined in the literature. The association between GBS and TCM has been well-documented in previous studies; however, there are few reported cases with GBS who developed TCM following their diagnosis with GBS. In this case report, we will discuss our experience treating a 59-year-old female patient who became hemodynamically unstable while recovering from an acute GBS infection. She was diagnosed with TCM after undergoing an echocardiogram and coronary angiogram ruling out thrombotic or obstructive coronary disease and myocarditis.
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Affiliation(s)
- Khalid H Mohamed
- Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR
| | - Adetola F Oshikoya
- Internal Medicine, Near East University, Nicosia, CYP
- Internal Medicine, General Hospital Odan Lagos, Lagos, NGA
| | - Kapil Kumar
- Medicine and Surgery, Liaquat National Hospital and Medical College, Karachi, PAK
| | | | | | | | - Muhammad Haseeb
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
- Internal Medicine, Mount Sinai Hospital, Brooklyn, USA
| | - Hira Nasir
- Internal Medicine, Mayo Hospital, Lahore, PAK
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13
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Shiza ST, Parajuli A, Samreen I, Padullaparthi T, Mohamed AS, Haseeb M, Sadia H, Mohamed KH, Nasir H. Acute Pancreatitis Simulating Myocardial Infarction: A Challenging Case. Cureus 2023; 15:e37769. [PMID: 37214020 PMCID: PMC10194184 DOI: 10.7759/cureus.37769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/23/2023] Open
Abstract
Acute pancreatitis is an inflammatory condition with varying local and systemic complications and variable severity. Although rare, cardiovascular complications induced by acute pancreatitis are rarely described in the literature. Epigastric pain with acute pancreatitis often simulates electrocardiographic changes in the absence of coronary artery abnormalities, resulting in a diagnostic dilemma for optimal treatment and management. We underline a case of acute pancreatitis complicated by acute coronary syndrome in a patient who presented with chest heaviness, dyspnea, nausea, and worsening epigastric pain associated with vomiting. Clinical and laboratory evaluations and using imaging modalities were suggestive of acute pancreatitis mimicking myocardial infarction (MI) in the absence of coronary artery abnormalities.
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Affiliation(s)
- Saher T Shiza
- Internal Medicine, New York City Health and Hospitals - Lincoln Hospital, New York, USA
| | - Aalok Parajuli
- Internal Medicine, Jalalabad Ragib Rabeya Medical College & Hospital, Jalalabad, BGD
| | - Iqra Samreen
- Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND
| | | | | | - Muhammad Haseeb
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Haleema Sadia
- Internal Medicine, Khyber Teaching Hospital Peshawar, Peshawar, PAK
| | - Khalid H Mohamed
- Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR
| | - Hira Nasir
- Internal Medicine, Mayo Hospital, Lahore, PAK
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14
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Mohamed KH, Shiza ST, Samreen I, Agboola AA, Mohamed AS, Kalluru PKR, Haseeb M, Munawar RZ, Nasir H. Non-ST-Segment Elevation Myocardial Infarction As Initial Thrombotic Event of Thrombotic Thrombocytopenic Purpura: A Rare Challenging Case. Cureus 2023; 15:e36363. [PMID: 37082484 PMCID: PMC10112854 DOI: 10.7759/cureus.36363] [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] [Accepted: 03/18/2023] [Indexed: 04/22/2023] Open
Abstract
Thrombotic thrombocytopenic purpura (TTP) is a rare autoimmune and devastating blood disorder that results in micro-clots throughout the body, leading to tissue damage and organ dysfunction resulting in widespread microangiopathic hemolytic anemia, thrombocytopenia, fever, and neurological symptoms. TTP patients commonly manifest renal and neurological symptoms; however, cardiovascular involvement is not widely reported in the literature. We report a case of non-ST-segment elevation myocardial infarction (NSTEMI) as an initial manifestation of TTP. Although rare, TTP complications must be considered among other possible causes of unexpected thrombocytopenia during acute phase treatment of acute coronary syndrome because of high morbidity and mortality.
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Affiliation(s)
- Khalid H Mohamed
- Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR
| | - Saher T Shiza
- Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND
| | - Iqra Samreen
- Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND
| | | | | | | | - Muhammad Haseeb
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
- Internal Medicine, Mount Sinai Hospital, Brooklyn, USA
| | | | - Hira Nasir
- Internal Medicine, Mayo Hospital, Lahore, PAK
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15
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Muacevic A, Adler JR, Agboola AA, Mohamed KH, Mohamed AS, Zahid N, Haseeb M, Nasir H. Immune Thrombocytopenia and Cerebral Venous Sinus Thrombosis Following COVID-19 Vaccination: A Case Report. Cureus 2023; 15:e34272. [PMID: 36855477 PMCID: PMC9968471 DOI: 10.7759/cureus.34272] [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: 01/26/2023] [Indexed: 01/28/2023] Open
Abstract
Mass vaccination against coronavirus disease 2019 (COVID-19) has been safe and effective. The ongoing emergence of vaccine-induced complications has challenged the public trust in vaccination programs and, though uncommon, can lead to significant morbidity and mortality. Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a rare and fatal complication of the COVID-19 vaccine. We present a rare case of VITT in a young female who presented with worsening headache, body rash with deteriorating neurological deficit after 12 days of the second dose of the ChAdOx1 COVID-19 vaccine. Initial blood tests showed thrombocytopenia with deranged clotting time and D-dimer levels. Her computed tomography venogram showed thrombosis in the left transverse sinus, and she was diagnosed with a provisional diagnosis of VITT. She initially managed with dexamethasone, intravenous immunoglobulins, and apixaban to reverse the autoimmune process. Our case highlights the clinical course, diagnosis, and management of VITT, which will assist physicians in the timely recognition and adequate management of VITT.
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16
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Uddin K, Mohamed KH, Agboola AA, Naqvi WA, Hussaini H, Mohamed AS, Haseeb M, Nasir H. Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Renal Vasculitis Following COVID-19 Vaccination: A Case Report and Literature Review. Cureus 2022; 14:e30206. [PMID: 36381730 PMCID: PMC9650918 DOI: 10.7759/cureus.30206] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an immune-mediated disorder of small and medium-sized vessels, characterized by the production of autoantibodies that target the neutrophilic antigens leading to mononuclear cell infiltration and destruction of blood vessels in lungs, skin, and kidneys. Although rare, the coronavirus disease 2019 (COVID-19) vaccine may trigger autoimmune vasculitis. We report a rare case of ANCA-associated renal vasculitis following COVID-19 vaccination in a 59-year-old male who presented with flu-like symptoms and deranged renal function tests. He received his second dose of the Pfizer COVID-19 vaccine 17 days ago. His clinical picture, serological testing, and radiological imaging were concerned with glomerular disease. His serum was positive for ANCAs, and the renal biopsy specimen revealed pauci-immune glomerulonephritis. He was diagnosed with AAV-associated renal vasculitis following COVID-19 vaccination because no other etiology was identified. His clinical improvement after starting rituximab and steroids reinforced the diagnosis.
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17
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Hussaini H, Rogers S, Kataria S, Uddin K, Mohamed KH, Mohamed AS, Tariq F, Ahmad S, Awais A, Ahmed Z, Chukwurah A, Khan A. COVID-19-Induced Seizures: A Meta-Analysis of Case Series and Retrospective Cohorts. Cureus 2022; 14:e28633. [PMID: 36196331 PMCID: PMC9524720 DOI: 10.7759/cureus.28633] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/30/2022] Open
Abstract
The adverse events and complications of coronavirus disease 2019 (COVID-19) continue to challenge the medical profession despite the worldwide vaccination against the severe acute respiratory coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. Other than typical respiratory manifestations, COVID-19 also presents a wide range of neurological manifestations. This article underlines the pooled incidence of COVID-19-induced seizures in patients with epilepsy and without epilepsy. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols, we conducted a bibliographical search, and an initial search revealed 1,375 articles. In total, 21 articles were included in the final analysis by following the inclusion criteria. A total of 11,526 patients from 21 published articles that met the predetermined search criteria were included. The median age of the patients was 61.9 years, of whom 51.5% were males. A total of 255 patients presented with seizures as the first manifestation of COVID-19 with a prevalence of 2.2% (95% confidence interval = 0.05-0.24, p < 0.01) (I2 = 97%), of which 71 patients had previously been diagnosed with epilepsy. Among patients with epilepsy, 49 patients had seizures as an initial presentation of SARA-CoV-2 with an incidence of 72% (0.54-0.85, p = 0.1) (I2 = 34). Although the incidence of COVID-19-induced seizures is not high compared to other neurological manifestations, seizure incidence in epileptic patients with COVID-19 is remarkably high. New-onset seizures in any patient should be considered a presentation of COVID-19 in the absence of other causative factors.
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18
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Abstract
Acute transverse myelitis (ATM) following coronavirus disease 19 (COVID-19) is rarely reported in the literature. We report a case of ATM after COVID-19 infection in a female who presented with sudden onset bilateral lower limb weakness, paresthesia, and urinary retention. She developed fever, cough, dyspnea two weeks ago, and her COVID-19 test was positive one week later. After a complete physical examination and detailed investigations, including cerebrospinal fluid analysis, autoimmune screening, and infectious workup, a diagnosis of ATM due to COVID-19 was made. Magnetic resonance imaging of the whole spine confirmed the diagnosis of ATM. She was managed with intravenous methylprednisolone, physical therapy, and bladder training and her condition improved gradually.
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Affiliation(s)
- Rija Qazi
- Neurology, Ziauddin College of Medicine, Karachi, PAK
| | - Ayesha Memon
- Neurology, Ziauddin College of Medicine, Karachi, PAK
| | | | - Muneeba Ali
- Internal Medicine, Foundation University Medical College, Islamabad, PAK
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19
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McGettigan S, Mohamed AS, Pillay I, Brassill MJ. 58 EVALUATION OF DIABETES MELLITUS IN A COHORT OF FRAIL OLDER ADULTS. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.58] [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: 02/25/2023] Open
Abstract
Abstract
Background
The aim of this study was to identify the prevalence of diabetes in a cohort of frail older adults who attended a model 3 hospital and explore the relationship between frailty and diabetes in this cohort. Prognosis and treatment of diabetes can vary greatly in the presence of frailty.
Methods
A multidisciplinary team provide liaison geriatric input to frail older adults in this hospital. Comprehensive geriatric assessments (CGAs) are carried out on patients identified using a VIP tool or via inpatient consults. These CGAs were reviewed regarding frailty scores, social/falls history, medications and diabetes complications including hypoglycaemia.
Results
CGAs were reviewed for 213 patients from September to November 2019. Fifty eight patients had a diagnosis of diabetes (27.2%), and all were type 2. The median age was 84. The average Clinical Frailty Scale score was 5.4 indicating mild to moderate frailty. Over two thirds of patients (n = 137) were on more than 5 medications. Seventy-six patients had a history of falls, and 24 (31.5%) of those had diabetes. Twenty-one patients were prescribed either sulphonylureas and/or insulin, and 7 of these were living alone. One patient had a sulphonylurea stopped on admission following CGA. Five patients had a documented history of hypoglycaemia, 2 of these patients were on insulin and 1 was on a sulphonylurea. The median HbA1c was 49 mmol/mol. Fifteen patients had diabetes complications, including 3 with retinopathy and 6 with neuropathy. The median duration of diabetes was 9.5 years. The majority of patients were managed at primary care level (n = 48, 82.75%).
Conclusion
The management of frail older adults with diabetes is complicated by multimorbidity and increased risk of adverse effects of treatment such as hypoglycaemia. Frailty assessment should be a routine component of a diabetes review for all older adults, and then glycaemic targets and medication choices should be adjusted accordingly.
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Affiliation(s)
- S McGettigan
- Tipperary University Hospital , Clonmel, Ireland
| | - A S Mohamed
- Tipperary University Hospital , Clonmel, Ireland
| | - I Pillay
- Tipperary University Hospital , Clonmel, Ireland
| | - M J Brassill
- Tipperary University Hospital , Clonmel, Ireland
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20
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Sarwar S, Mohamed AS, Rogers S, Sarmast ST, Kataria S, Mohamed KH, Khalid MZ, Saeeduddin MO, Shiza ST, Ahmad S, Awais A, Singh R. Neuropsychiatric Systemic Lupus Erythematosus: A 2021 Update on Diagnosis, Management, and Current Challenges. Cureus 2021; 13:e17969. [PMID: 34667659 PMCID: PMC8516357 DOI: 10.7759/cureus.17969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Accepted: 09/14/2021] [Indexed: 12/14/2022] Open
Abstract
Patients with systemic lupus erythematosus (SLE) experience neuropsychiatric symptoms. The term neuropsychiatric SLE (NPSLE) is a generic term that refers to a series of neurological and psychiatric symptoms directly related to SLE. In approximately 30% of patients with neuropsychiatric symptoms, SLE is the primary cause (NPSLE), and symptoms manifest more frequently around SLE onset. Neurovascular and psychotic conditions can also lead to NPSLE. Pathogenesis of NPSLE is implicated in both neuroinflammatory and ischemic mechanisms, and it is associated with high morbidity and mortality. After diagnosing and assigning causality, NPSLE treatment is individualized according to the type of neuropsychiatric manifestations, type of the predominant pathway, activity of SLE, and severity of the clinical manifestations. There are many problems to be addressed with regards to the diagnosis and management of NPSLE. Controlled clinical trials provide limited guidance for management, and observational cohort studies support symptomatic, antithrombotic, and immunosuppressive agents. The purpose of this review was to provide a detailed and critical review of the literature on the pathophysiology, diagnosis, and treatment of NPSLE. This study aimed to identify the shortcoming in diagnostic biomarkers, novel therapies against NPSLE, and additional research needs.
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Affiliation(s)
- Sobia Sarwar
- Neurology, Independent Medical College, Faisalabad, PAK
| | | | - Sylvette Rogers
- Family Medicine, Caribbean Medical University, Des Plaines, USA
| | - Shah T Sarmast
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Saurabh Kataria
- Neurology, Ochsner Louisiana State University Health Sciences Center - Shreveport, Shreveport, USA.,Neurology and Neurocritical Care, University of Missouri Health Care, Columbia, USA.,Neurology, West Virginia University, Morgantown, USA
| | - Khalid H Mohamed
- Anatomical Sciences, St. George's University - School of Medicine, St. George's, GRD
| | | | | | - Saher T Shiza
- Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND
| | - Sarfaraz Ahmad
- Internal Medicine, Saint James School of Medicine, Chicago, USA
| | - Anum Awais
- Internal Medicine, Fatima Jinnah Medical University, Lahore, PAK
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21
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Sarwar S, Rogers S, Mohamed AS, Ogula E, Ayantayo RA, Ahmed A, Shahzadi I, Kataria S, Singh R. Multiple Sclerosis Following SARS-CoV-2 Infection: A Case Report and Literature Review. Cureus 2021; 13:e19036. [PMID: 34858736 PMCID: PMC8612412 DOI: 10.7759/cureus.19036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 12/17/2022] Open
Abstract
Coronavirus disease 19 (COVID-19) is caused by severe acute respiratory coronavirus 2 (SARS-CoV-2). Apart from respiratory manifestations, COVID-19 can affect the nervous system due to its neurotropic features. Neurological manifestations and complications include headache, polyneuropathies, cerebrovascular accidents, seizures, encephalopathy, and demyelinating disease. We describe a case of multiple sclerosis, a demyelinating disease following COVID-19 infection, rarely reported in the literature. A 47-year-old female presented with fatigue, blurry vision, numbness, and signs of upper motor neuron lesions that had occurred three weeks after COVID-19 infection. Magnetic resonance imaging of the brain revealed demyelinating lesions in the periventricular area of both hemispheres, suggesting a demyelinating disease. A provisional diagnosis of multiple sclerosis was made. Her condition improved after the commencement of methylprednisolone.
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Affiliation(s)
- Sobia Sarwar
- Neurology, Independent Medical College, Faisalabad, PAK
| | - Sylvette Rogers
- Family Medicine, Caribbean Medical University, Des Plaines, USA
| | | | - Enitare Ogula
- Medicine, Saint James School of Medicine, Park Ridge, USA
| | | | | | - Iram Shahzadi
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Saurabh Kataria
- Neurology, Ochsner Louisiana State University Health Sciences Center, Shreveport, USA
- Clinical Observation and Research, Neurology and Neurocritical Care, University of Missouri Health Care, Columbia, USA
- Distant Research, Neurology, West Virginia University, Morgantown, USA
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22
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Abstract
Coronavirus disease 19 (COVID-19) is a respiratory disease, has a variable presentation, and neurological involvement in COVID-19 is not widely reported. We report a rare case of acute encephalitis in a COVID-19 patient presented with fever, dry cough, and dyspnea. She had a fever, tachypnea, and tachycardia. On auscultation, she had scattered wheezing in both lung fiends. Chest X-ray revealed small infiltrates in the lower lobe of both lungs. A nasopharyngeal swab for the COVID-19 polymerase chain reaction was positive. Later on, she developed sudden onset confusion accompanied by restlessness and visual hallucinations. Neurological examination revealed an altered level of consciousness, slight trembling of the limbs, psychomotor restlessness, and poor speech with no signs of meningeal irritation. Magnetic resonance imaging of the brain revealed diffuse hyperintense signals. A possible diagnosis of acute encephalitis was made due to concurrent COVID-19 infection and lack of other findings suggesting a diagnosis other than COVID-19. She was treated with azithromycin, tocilizumab, and methylprednisolone. Her condition started improving gradually.
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Affiliation(s)
- Shah T Sarmast
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | | | - Zain Amar
- Medicine, Isra University Hospital Hyderabad, Hyderabad, PAK
| | - Sobia Sarwar
- Neurology, Independent Medical College, Faisalabad, PAK
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Samaka RM, Mohamed AS, Abu-Zeid AY. Female Genital Tuberculosis, a Rare Lesion Mimicking Ovarian Carcinoma, with Granulosa Cell Tumor: A Case Report. Tumori 2021. [DOI: 10.1177/03008916211012332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Tuberculosis (TB) of the upper genital tract is a rare disease worldwide. TB should be always considered in the differential diagnosis of a pelvic or adnexal mass as it may diagnosed as ovarian carcinoma but both have completely different treatment. Therefore, recognition of TB is important for surgeons and histopathologists, in order to set a proper plan for management and avoid unnecessary extensive therapy. Granulosa cell tumor of the ovary is a rare type of ovarian cancer that accounts for approximately 2% of all ovarian tumors. This type of tumor is known as a sex cord-stromal tumor and usually occurs in adults. Thorough search in English literature revealed only 2 case reports showed combination between genital TB and granulosa cell tumor. Case summary: A 68 years old female patient complained of vaginal bleeding for four months. She had no personal or family history of TB. An ultrasound study showed a 2x1.5 cm mixed echogenic mass in the right adnexa. Based on her clinical and imaging findings which suggestive of ovarian cancer, the patient underwent panhystrectomy and bilateral salpingoophrectomy. The gross examination of the specimen revealed distended and coiled tubes with right adnexal mass measured 2x1.5 cm and dissection of the uterus revealed erythematous endometrium with yellowish secretions. The histopathologic assessment of right adnexal mass revealed malignant neoplasm *Granulosa cell tumor* formed of short polygonal cells arranged in diffuse sheets with patternless pattern. The malignant cells showed nuclear grooving. There was no necrosis or other ovarian neoplastic element. The histopathologic assessment of both tubes and endometrium revealed infiltration by multiple nodular granulomas. Each granuloma was formed of multinucleated giant cells and epithelioid cells rimmed by lymphocytes with occasional central caseation *genital tuberculosis*. Conclusion: The conclusion of this case report is to stress upon keeping genital TB in mind as a potential differential diagnosis for ovarian carcinoma.
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Affiliation(s)
- RM Samaka
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin Elkom city, Menoufia Governate, Egypt
| | - AS Mohamed
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin Elkom city, Menoufia Governate, Egypt
| | - AY Abu-Zeid
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin Elkom city, Menoufia Governate, Egypt
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Mohamed AS, Prusinski CC, Ritaccio AL, Tatum WO, Feyissa AM. Teaching Video NeuroImage: Unique Ipsilateral Manual Automatism in Temporal Lobe Epilepsy: Conducting the Orchestra. Neurology 2021; 97:e867-e868. [PMID: 33931533 DOI: 10.1212/wnl.0000000000012136] [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: 11/15/2022] Open
Affiliation(s)
- Alaa S Mohamed
- From the Department of Neurology, Mayo Clinic, Jacksonville, FL
| | | | | | - William O Tatum
- From the Department of Neurology, Mayo Clinic, Jacksonville, FL
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Muneer MS, Mohamed AS, Vizcaino MA, Raghunathan A, Naidich TP, Vibhute PG. Chordoid glioma: a rare old foe but a new pathological and radiological presentation. Clin Imaging 2021; 78:160-164. [PMID: 33836423 DOI: 10.1016/j.clinimag.2021.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/11/2021] [Accepted: 03/05/2021] [Indexed: 11/25/2022]
Abstract
Chordoid glioma (CG) is a rare WHO Grade II neoplasm of the anterior third ventricle. We report two cases of CG with new presentation in terms of histopathology and location: a case of CG with osseous metaplasia evident on imaging, and another CG, unusually located in the posterior portion of the third ventricle.
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Affiliation(s)
- Mohamed S Muneer
- Department of Radiology, Mayo Clinic, Jacksonville, FL, United States of America
| | - Alaa S Mohamed
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States of America
| | - M Adelita Vizcaino
- Department of Pathology, Mayo Clinic, Rochester, MN, United States of America
| | - Aditya Raghunathan
- Department of Pathology, Mayo Clinic, Rochester, MN, United States of America
| | - Thomas P Naidich
- Department of Radiology, Mount Sinai, New York, NY, United States of America
| | - Prasanna G Vibhute
- Department of Radiology, Mayo Clinic, Jacksonville, FL, United States of America.
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Saad AM, El‐Saadony MT, Mohamed AS, Ahmed AI, Sitohy MZ. Impact of cucumber pomace fortification on the nutritional, sensorial and technological quality of soft wheat flour‐based noodles. Int J Food Sci Technol 2021. [DOI: 10.1111/ijfs.14970] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ahmed M. Saad
- Biochemistry Department Faculty of Agriculture Zagazig University Zagazig44511Egypt
| | - Mohamed T. El‐Saadony
- Department of Agricultural Microbiology Faculty of Agriculture Zagazig University Zagazig44511Egypt
| | - Alaa S. Mohamed
- Food Science Department Faculty of Agriculture Zagazig University Zagazig44511Egypt
| | - Alshaymaa I. Ahmed
- Department of Agricultural Microbiology Faculty of Agriculture Beni‐Suef University Beni‐Suef18116Egypt
| | - Mahmoud Z. Sitohy
- Biochemistry Department Faculty of Agriculture Zagazig University Zagazig44511Egypt
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El-Saadony MT, Elsadek MF, Mohamed AS, Taha AE, Ahmed BM, Saad AM. Effects of Chemical and Natural Additives on Cucumber Juice's Quality, Shelf Life, and Safety. Foods 2020; 9:E639. [PMID: 32429212 PMCID: PMC7281498 DOI: 10.3390/foods9050639] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [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: 04/20/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 12/21/2022] Open
Abstract
Microbial contamination affects beverages' lifetime, quality, and safety. Cucumber crops are seasonally spoiled because of the overproduction. The current study aimed to maximize the importance of natural preservatives and reduce the usage of artificial ones to prolong the cucumber juice's storage life, enhance flavor, and control the microorganisms after protein isolate and organic acids supplementation. The additions included control (no addition), citric, benzoic acid, sodium salts, kidney bean pepsin hydrolysate (KPH), chicken egg protein isolate (CEPI), duck egg protein isolate (DEPI), and quail egg protein isolate (QEPI) as J-Control, J-Citric, J-Benzoic, J-sod. Citrate, J-sod. Benzoate, J-KPH, J-CEPI, J-DEPI, and J-QEPI, respectively. The antioxidant activity of these additives and juices was evaluated by DPPH radical scavenging activity. The antimicrobial activity, including antibacterial and antifungal activities, was evaluated by using disc assay and the radial growth of fungal mycelium, respectively. The phenolic compounds and flavonoids were estimated by a spectrophotometer as Gallic acid equivalent (GAE) and quercetin equivalent (QE), respectively. Moreover, chemical parameters such as pH, total soluble solids (TSS), Titratable acidity (TTA), and Vitamin C were evaluated by AOAC. Finally, the color properties were estimated by a spectrophotometer, using the Hunter method. KPH had higher significant (p ≤ 0.05) antioxidant activity (88%), along with antimicrobial activity. It significantly (p ≤ 0.05) reduced the growth of G+ and G- bacteria by 71%-97% and 58%-66% respectively. Furthermore, it significantly (p ≤ 0.05) inhibited the tested fungi growth by 70%-88% and the other additives less than that. During the storage of cucumber juice for an interval of zero, two, four, and six months, the phenolic compounds and flavonoids were significantly (p ≤ 0.05) decreased. Consequently, the potential activity of the juice was reduced; in addition, pH and vitamin C were significantly (p ≤ 0.05) decreased during the storage period. Meanwhile, the TSS and Titratable acidity were significantly raised. As for color and sensory properties, J-sod. Benzoate, J-KPH, J-CEPI, and J-DEPI had significantly (p ≤ 0.05) high scores in color, taste, and flavor against the control. Generally, the usage of natural additives extends the cucumber juice's lifetime and increased the manufacture of high-quality and valuable juice.
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Affiliation(s)
- Mohamed T. El-Saadony
- Department of Agricultural Microbiology, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt
| | - Mohamed F. Elsadek
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia
- Department of Nutrition and Food Science, Faculty of Home Economics, Helwan University, Helwan 11795, Egypt;
| | - Alaa S. Mohamed
- Food Science Department, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt;
| | - Ayman E. Taha
- Department of Animal Husbandry and Animal Wealth Development, Faculty of Veterinary Medicine, Alexandria University, Rasheed, Edfina 22758, Egypt;
| | - Badreldin M. Ahmed
- Department of Nutrition and Food Science, Faculty of Home Economics, Helwan University, Helwan 11795, Egypt;
| | - Ahmed M. Saad
- Biochemistry Department, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt;
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Hanafi NI, Mohamed AS, Md Noor J, Abdu N, Hasani H, Siran R, Osman NJ, Ab Rahim S, Sheikh Abdul Kadir SH. Ursodeoxycholic acid upregulates ERK and Akt in the protection of cardiomyocytes against CoCl2. Genet Mol Res 2016; 15:gmr8150. [PMID: 27323195 DOI: 10.4238/gmr.15028150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Ursodeoxycholic acid (UDCA) is used to treat liver diseases and demonstrates cardioprotective effects. Accumulation of the plasma membrane sphingolipid sphingomyelin in the heart can lead to atherosclerosis and coronary artery disease. Sphingomyelinases (SMases) break down sphingomyelin, producing ceramide, and inhibition of SMases activity can promote cell survival. We hypothesized that UDCA regulates activation of ERK and Akt survival signaling pathways and SMases in protecting cardiac cells against hypoxia. Neonatal cardiomyocytes were isolated from 0- to 2-day-old Sprague Dawley rats, and given 100 μM CoCl2, 150 μM H2O2, or placed in a hypoxia chamber for 24 h. The ameliorative effects of 100-μM UDCA treatment for 12 h were then assessed using MTS, QuantiGene Plex (for Smpd1 and Smpd2), and SMase assays, beating rate assessment, and western blotting (for ERK and Akt). Data were analyzed by the paired Student t-tests and one-way analyses of variance. Cell viability decreased significantly after H2O2 (85%), CoCl2 (50%), and hypoxia chamber (52%) treatments compared to the untreated control (100%). UDCA significantly counteracted the effects of chamber- and CoCl2- induced hypoxia on viability and beating rate. However, no significant differences were observed in acid SMase gene and protein expression between the untreated, CoCl2, and UDCA-CoCl2 groups. In contrast, neutral SMase gene and protein expression did significantly differ between the latter two groups. ERK and Akt phosphorylation was higher in hypoxic cardiomyocytes treated with UDCA than those given CoCl2 alone. In conclusion, UDCA regulates the activation of survival signaling proteins and SMases in neonatal rat cardiomyocytes during hypoxia.
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Affiliation(s)
- N I Hanafi
- Institute of Medical Molecular Biotechnology, Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - A S Mohamed
- Institute of Medical Molecular Biotechnology, Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - J Md Noor
- Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | | | - Hamid Hasani
- Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - R Siran
- Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - N J Osman
- Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - S Ab Rahim
- Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - S H Sheikh Abdul Kadir
- Institute of Medical Molecular Biotechnology, Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia.,Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
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Mikhail MW, Metwally AM, Allam KAM, Mohamed AS. Rodents as reservoir host of intestinal helminthes in different Egyptian agroecosystems. J Egypt Soc Parasitol 2009; 39:633-640. [PMID: 19795770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Hymenolepis diminuta were detected in rodents in all zones surveyed Governorates under studied (Suez, Menoufia, Giza, Damietta and Beni-Sewaf). The highest infestation recorded at Suez and Demiatta Governorates. On the other hand, rodents at Menoufia and Beni-Sewaf showed there is no convincing evidence that they infested with H. diminuta. The existence of one species of nematode namely, Streptopharagus kuntzi were recorded at Suez, Giza and Demiatta Governorates only. While Menoufia and Beni-Sewaf Governorates showed no convincing evidence that, they infested with nematode. Worms were recovered from Norway rats. Data indicated that Rattus norvegicus were the most vulnerable species at infection with H. diminuta and Streptopharagus kuntzi. Summer is highly infested with nematode in comparison with other seasonal study.
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Affiliation(s)
- Micheal W Mikhail
- Research Institute of Medical Entomology, Ministry of Health, Dokki, Giza, Egypt
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Al-Motabagani MA, Mohamed AS. Congenital malformations in mice induced by addiction to alcohol and cocaine. East Afr Med J 2005; 82:433-8. [PMID: 16261922 DOI: 10.4314/eamj.v82i8.9330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study the teratogenic effect of either alcohol alone, cocaine alone, or a combination of both alcohol and cocaine on mice foetuses. DESIGN Eighty pregnant mice were divided into four equal groups. In the first (alcohol) group, the pregnant females were given absolute ethanol at 2.5 gm/100 gm twice daily by oro-gastric incubation. In the second (cocaine) group, the pregnant females received cocaine hydrochloride at 20 mg/ 100 gm daily by intraperitoneal injection. In the third (combined) group, the pregnant females received alcohol at 2.5 gm/100 gm twice daily and cocaine hydrochloride at 20 mg/100 gm daily. In all groups the treatment started from the 6th day to the 15th day of gestation. The fourth group is the control. SETTINGS Department of Anatomy, College of Medicine, King Faisal University, Dammam, Saudi Arabia and Department of Anatomy, College of Medicine, Al-Azhar University, Cairo, Egypt. INTERVENTION The pregnant mice were sacrificed at the 20th day of gestation (one day before term). The uterine contents were evaluated and the number of dead and live foetuses was determined as well as the number of resorption. The living foetuses were examined for soft tissue anomalies. SUBJECTS Eighty pregnant mice. RESULTS This study revealed a significant increase in the number of dead foetuses and foetal growth parameters showed a significant decrease in the combined group. This group showed significant increase in anomalies of the head as hydrocephaly and complete cleft palate, of the kidney as bilateral secondary hydronephrosis and ectopic kidney, of the limbs, and of the tail as kinked tail. Both alcohol and cocaine groups alone showed significant increase in some of the anomalies of the head while in the alcohol group there was unilateral hydronephrosis. CONCLUSION This study indicates that the combined administration of alcohol and cocaine has a more teratogenic effect than either alcohol or cocaine alone.
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Affiliation(s)
- M A Al-Motabagani
- Department of Anatomy, College of Medicine, King Faisal University, Dammam, Saudi Arabia
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Mohamed AS, Thomson J, McDonald KJ, Hillyard DZ, Mark PB, Elliott HL, Jardine AG. Circulating Endothelial Cells in Renal Transplant Recipients. Transplant Proc 2005; 37:2387-90. [PMID: 15964423 DOI: 10.1016/j.transproceed.2005.03.126] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Indexed: 11/17/2022]
Abstract
Circulating endothelial cells (CECs) are a marker of endothelial injury and endothelial dysfunction. We measured CECs in 95 patients with functioning renal transplants at risk of premature cardiovascular (CV) disease and in normal control subjects. We were unable to demonstrate consistent relationships between CEC levels and conventional CV risk factors in transplant recipients. However, CEC levels were increased in patients with a history of rejection. We conclude that CECs are of little use as a marker of CV risk in this population but may be a useful marker to monitor allograft rejection.
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Affiliation(s)
- A S Mohamed
- Department of Cardiovascular and Medical Sciences, Gardiner Institute, Western Infirmary, University of Glasgow, Glasgow G11 6NT, Scotland, UK
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Mohamed AS, Rivas-Plata KA, Kraas JR, Saleh SM, Swope SL. Src-class kinases act within the agrin/MuSK pathway to regulate acetylcholine receptor phosphorylation, cytoskeletal anchoring, and clustering. J Neurosci 2001; 21:3806-18. [PMID: 11356869 PMCID: PMC6762727] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
Synaptogenesis at the neuromuscular junction requires agrin-induced stable localization of acetylcholine receptors (AChRs) at the endplate. The effects of agrin are transduced by the muscle-specific receptor tyrosine kinase (MuSK). This study provides evidence that Src-class protein tyrosine kinases mediate the effects of agrin-activated MuSK to regulate clustering and anchoring of AChRs in skeletal muscle. MuSK was complexed with both Src and Fyn in the C2 mouse muscle cell line. These associations were enhanced by agrin and by increasing protein tyrosine phosphorylation with pervanadate. Coupling between MuSK and the Src-class kinases in vivo appeared to be caused by a phosphotyrosine-SH2 domain interaction because binding of MuSK to the SH2 domains of Fyn and Src in vitro was specific, enhanced by phosphorylation, and dependent on MuSK autophosphorylation. In addition, Src and Fyn phosphorylated MuSK. AChR phosphorylation, stimulated by agrin or pervanadate, was inhibited by blocking Src-class kinases with PP1. Furthermore, agrin-induced clustering and cytoskeletal anchoring of AChRs was dependent on Src-family kinases. These data support the conclusion that Fyn and Src act downstream of MuSK to regulate the stable localization of AChRs at the neuromuscular endplate during agrin-induced synaptogenesis.
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Affiliation(s)
- A S Mohamed
- Department of Neuroscience, Georgetown University Medical Center, Washington DC 20007-2197, USA
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Piketty C, Weiss L, Thomas F, Mohamed AS, Belec L, Kazatchkine MD. Long-term clinical outcome of human immunodeficiency virus-infected patients with discordant immunologic and virologic responses to a protease inhibitor-containing regimen. J Infect Dis 2001; 183:1328-35. [PMID: 11294663 DOI: 10.1086/319861] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2000] [Revised: 01/30/2001] [Indexed: 11/03/2022] Open
Abstract
Within a prospective cohort of 150 human immunodeficiency virus (HIV)-infected patients who began first-line protease inhibitor therapy in 1996, the outcome of 42 patients with discrepant virologic and immunologic responses to antiretroviral treatment at 12 months was analyzed at 30 months of treatment. The incidence of AIDS-defining events and deaths (14%) in the group of patients with immunologic responses in the absence of a virologic response was higher than that in full-responder patients (2%); yet, the incidence in this group was lower than that in patients with no immunologic response, despite a virologic response (21%), and was lower than that in patients without an immunologic or virologic response (67%; P<.0001, log-rank test). Differences in outcome were significant (relative risk, 6.9; 95% confidence interval, 1.9-39.3) when factors for progression were compared with those of responder patients. The results support the relevance of the CD4 cell marker over plasma HIV load for predicting clinical outcome in patients who do not achieve full immunologic and virologic responses.
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Affiliation(s)
- C Piketty
- Department of Immunology, INSERM U430 and Université Pierre et Marie Curie, Paris, France.
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Abstract
Protein phosphorylation is a major molecular mechanism by which cellular function is regulated. In order to accomplish rapid and specific biochemical changes via phosphorylation, the activity of a protein kinase must be dynamically regulated. Historically, the activity of each protein kinase has been analyzed using a unique in vitro biochemical assay with a specific substrate and detection procedure. These assays require the use of radioactivity and are often labor intensive. Upon activation, most protein kinases autophosphorylate. Thus, a technical approach to detect changes in kinase activity is to measure autophosphorylation. The purpose of this protocol is to provide a detailed stepwise procedure for measuring the regulation of Src-class kinase activity using phosphorylation state-specific antibodies. Antibodies to a phosphorylated peptide derived from the autophosphorylation site of Src-family kinases are developed and affinity purified. The purified antibodies are used to analyze the regulation of Src and Fyn activity in a mouse muscle cell line. It is anticipated that the utility of these phosphorylation state-specific antibodies will ultimately result in the development of similar antibodies useful for analyzing the activity of many different kinases.
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Affiliation(s)
- A M Miermont
- EP08 Research Bld, Department of Neuroscience, Georgetown University Medical Center, 3970 Reservoir Rd NW, Washington, DC 20007-2197, USA
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Addous A, Mohamed AS, Ismail G, Al-Hashemy A. Post-Transplant Diabetes Mellitus in Kidney Transplant Recipients with Special Reference to Association with HLA Antigens. Saudi J Kidney Dis Transpl 2000; 11:559-562. [PMID: 18209345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
One hundred fifty three kidney transplant recipients whose grafts functioned for longer than one year were evaluated for evidence of post-transplant diabetes mellitus (PTDM). Twenty-six patients (17%) developed PTDM. Patients with PTDM were older than controls (mean age 49.4 vs 37.9 years). There was no demonstrable association between sex of patients and PTDM. The body mass index (BMI) was persistently higher in patients with PTDM compared to controls, although the difference did not amount to statistical significance. The association of PTDM with HLA-A28, A30 and B8 observed in other studies was not seen in our patients. Similarly, neither the positive association of HLA-DR3 and DR4, nor the negative association of HLA-B7 and DR2 seen in population-based studies of insulin dependent diabetes mellitus, were seen in our patients with PTDM. To our knowledge, this is the first report that has looked into the association of HLA antigens and PTDM in Saudi Arabia.
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Affiliation(s)
- A Addous
- Transplant Unit, Armed Forces Hospital, Southern Region, Khamis Mushayt, Saudi Arabia
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Abstract
The aim of the study was to determine the incidence of food and house dust mite (HDM) allergy in patients with nasal congestion and rhinorrhea attending the Otorhinolaryngology Clinic, National University of Malaysia, Kuala Lumpur. This was a prospective matched, controlled study of patients skin prick tested with commercial food and common aeroallergens. The participants were 148 Malaysian adults with symptoms of nasal congestion and rhinorrhea and 113 adult Malaysian control subjects without rhinitis symptoms. The skin prick test (SPT) was used to evaluate 11 foods common to the Malaysian diet and 3 HDM inhalants. Forty-eight percent of the patients with rhinitis had positive SPT results to foods, compared with 4.4% of control subjects (P < 0.05). The most commonly implicated foods were shrimp (48%) and rice (30%), which are common in the Malaysian diet. Seventy-two percent of rhinitis patients had positive SPT results to HDM, compared with 22.2% of control subjects (P < 0.05). Patients with rhinitis also had significantly more gastrointestinal problems than control subjects (P < 0.05). The incidences of HDM and food allergy are significantly greater in Malaysian adults with rhinitis symptoms than in control subjects without rhinitis. The effect of avoidance or immunotherapy awaits further study.
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Affiliation(s)
- B S Gendeh
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur
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Osman MY, Sharaf IA, Mohamed AS, Osman HM. Effect of the carbamate "aldicarb" on acetyl cholinesterase extracted from whole and different parts of rat brain (in vitro and in vivo studies). J Egypt Public Health Assoc 2000; 75:301-21. [PMID: 17216925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Aldicarb, a synthetic carbamate compound used as an insecticide and herbicide, is also employed as a pharmacological cholinergic agent in therapeutic forms. Inhibition of the enzyme AChE, which results in accumulation of ACh, is the basis for its use as an insecticide and it resulted in toxicity in a variety of animals including man. In this work, experiments were carried out in vitro and in vivo to study the effects of aldicarb on the activity of ChE enzyme extracted from whole and five different parts of rat brain, namely: basal ganglia, frontal cortex, medulla oblongata, pons and cerebellum. Kinetic measurements of Michaelis constants (Km), enzyme inhibitor dissociation constants (Ki) as well as the rate of carbamylation (k2c) and binding constants (Kl) for the inhibition of the enzyme obtained from the different parts were done. The carbamylation rate (degree of inhibition of AChE by carbamate) and binding constant for inhibition of whole and different parts of brain in vitro, indicated that the carbamylation rate constants of pons, medulla oblongata and cerebellum were higher than those of other parts. Inhibition of AChE in the different parts of the brain in vitro by aldicarb was of the competitive type, with different enzyme inhibitor dissociation constants (Ki). In vivo studies showed that the inhibition was marked in the enzyme obtained from pons, medulla oblongata and cerebellum; the parts responsible for vital centers and balance which coinsize with the in vitro results.
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Affiliation(s)
- M Y Osman
- Biochemistry Department, Medical Research Institute, Alexandria University, Egypt
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Kuo YH, Fabiani JN, Mohamed AS, Couetil JP, Lévy M, Gutmann L, Carpentier AF, Bélec L. Decreasing occupational risk related to blood-borne viruses in cardiovascular surgery in Paris, France. Ann Thorac Surg 1999; 68:2267-72. [PMID: 10617015 DOI: 10.1016/s0003-4975(99)01051-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Surgeons face the risk of patient-to-physician transmission of blood-borne viruses. This risk is related to the seroprevalence of the viruses in the patient population. METHODS The seroprevalence of the human immunodeficiency virus, hepatitis B virus, and hepatitis C virus were determined in cardiovascular patients at Hôpital Broussais in Paris, France, over a 5-year period (1994 to 1998). RESULTS Hepatitis C virus is the most prevalent virus in the patient population, whereas human immunodeficiency virus is the least frequent. The seroprevalence of hepatitis C virus and human immunodeficiency virus has decreased over time, whereas hepatitis B virus has remained constant. We apply the seroprevalence data to a mathematical model to estimate the occupational risk of seroconversion faced by surgeons over the length of their career. Our results show that the principal risk faced by the surgeon arises from hepatitis B virus and hepatitis C virus. The decreasing seroprevalence of the hepatitis C virus has resulted in a decrease in the occupational risk. CONCLUSIONS The probability of becoming infected with a blood-borne virus over the career of the surgeon is notable. The greatest occupational risk to the surgeon is from the hepatitis viruses and not HIV.
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Affiliation(s)
- Y H Kuo
- Laboratoire de Virologie, Service de Chirurgie Cardiovasculaire, Hôpital Broussais, Paris, France
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Affiliation(s)
- A S Mohamed
- Department of Medical Polyclinis, and Department of Biomedical Statistics and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Iacono RP, Carlson JD, Mohamed AS, Kuniyoshi SM. Reversal of levodopa failure syndrome by posteroventral-ansa pallidotomy. Adv Neurol 1999; 80:619-22. [PMID: 10410779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- R P Iacono
- Loma Linda University, Department of Neurosurgery, California, USA
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41
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Mohamed AS, Swope SL. Phosphorylation and cytoskeletal anchoring of the acetylcholine receptor by Src class protein-tyrosine kinases. Activation by rapsyn. J Biol Chem 1999; 274:20529-39. [PMID: 10400682 DOI: 10.1074/jbc.274.29.20529] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Src class protein-tyrosine kinases bind to and phosphorylate the nicotinic acetylcholine receptor of skeletal muscle. This study provided evidence for the functional importance of Src kinases in regulating the nicotinic acetylcholine receptor at the neuromuscular junction. Three Src class kinases, Fyn, Fyk, and Src, each formed a complex with the endplate-specific cytoskeletal protein rapsyn. In addition, cellular phosphorylation by each kinase was stimulated by rapsyn in heterologous transfected cells. Several lines of evidence supported rapsyn as a substrate for Src kinases. Most importantly, rapsyn regulation of Fyn, Fyk, and Src resulted in phosphorylation of the nicotinic acetylcholine receptor beta and delta subunits and anchoring of the receptor to the cytoskeleton. Both nicotinic acetylcholine receptor phosphorylation and cytoskeletal anchoring were blocked by the Src kinase-selective inhibitor herbimycin A. Rapsyn alone also induced a modest increase in nicotinic acetylcholine receptor phosphorylation and cytoskeletal translocation. However, inhibition by herbimycin A and a catalytically inactive dominant negative Src demonstrated that the effects of rapsyn were mediated by endogenous Src kinases. These data support the importance of Src class kinases for stabilization of the nicotinic acetylcholine receptor at the endplate during synaptic differentiation at the neuromuscular junction.
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Affiliation(s)
- A S Mohamed
- Department of Neurology, Division of Neuroscience, Georgetown Institute for Cognitive and Computational Sciences, Georgetown University Medical Center, Washington, D.C. 20007-2197, USA
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Bélec L, Mohamed AS, Authier FJ, Hallouin MC, Soe AM, Cotigny S, Gaulard P, Gherardi RK. Human herpesvirus 8 infection in patients with POEMS syndrome-associated multicentric Castleman's disease. Blood 1999; 93:3643-53. [PMID: 10339470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
The polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes (POEMS) syndrome is a rare multisystemic disorder associated with osteosclerotic myeloma and multicentric Castleman's disease (MCD). Human herpesvirus type 8 (HHV-8) DNA sequences have been detected in lymph nodes of about 40% of human immunodeficiency virus (HIV)-negative patients with MCD, and in bone marrow stromal cells of patients with multiple myeloma. Considering these data, we investigated the presence of HHV-8 in 18 patients with POEMS syndrome (9 with MCD), by nested polymerase chain reaction (N-PCR) to detect DNA sequenses in various cells and tissues obtained by biopsy or at autopsy (13 patients, of whom 7 had MCD), and by an immunofluorescence assay to detect anti-HHV-8 IgG antibodies in blood (18 patients, of whom 9 had MCD). Detection of HHV-8 DNA was performed using three different N-PCR, targeting nonoverlapping regions in open reading frame (ORF) 25 and ORF26. Seven of 13 (54%) POEMS patients had HHV-8 DNA sequences in their tissues, as assessed by all three N-PCR, and 9 of 18 (50%) had circulating anti-HHV-8 antibodies. HHV-8 was mainly detected in the subset of POEMS patients with MCD (6 of 7 [85%] for DNA sequences; 7 of 9 [78%] for antibodies). The percentage of positive N-PCR was higher in lymph nodes than in bone marrow samples (P <.02). Sequencing of amplicons showed a homogeneous restricted variability in the ORF26 region, characteristic of the minority subgroup B defined by Zong, and responsible for isoleucine and glycine substitutions at amino acid positions 134 and 167. These findings strongly suggest an association of HHV-8 infection with POEMS syndrome-associated MCD.
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Affiliation(s)
- L Bélec
- Groupe d'Etude et de Recherche sur le Nerf Et le Muscle (GERMEN, EA 2347), Faculté de Médecine de Créteil, Université Paris XII-Val de Marne, France
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Addous AO, Greening KA, Sjolander UA, Mohamed AS, Al Hashemy A. Nocardia asteroides in renal transplant recipients. Saudi Med J 1999; 20:319-322. [PMID: 27614493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Full text is available as a scanned copy of the original print version.
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Affiliation(s)
- A O Addous
- Renal Transplant Unit, Armed Forces Hospital, Khamis Mushayt, Kingdom of Saudi Arabia
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Mukari SZ, Vandort S, Ahmad K, Saim L, Mohamed AS. Parents' awareness and knowledge of the special needs of their hearing-impaired child. Med J Malaysia 1999; 54:87-95. [PMID: 10972010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
We surveyed parents of school-aged hearing impaired children to investigate their awareness and knowledge of the special needs of their child, especially in the area of the usage of hearing aids and methods of communication. Questionnaires were distributed to parents of hearing impaired children at 13 special schools for the deaf in Malaysia. Out of 1,267 questionnaires given out, 787 (62.1%) were completed and returned. Results of the survey indicated the majority of parents (68.6%) suspected hearing loss late, that is after their child's first birthday, and there was a significant time lag before the suspicion was confirmed. Over 82.8% of the children were diagnosed only after 1 year of age, with 41.3% being diagnosed after 3 years of age. Hearing aids were fitted late (mean = 5.32 years; SD = 2.66). Hearing aid ownership was influenced by the factors of socio-economic level and ethnic group (p < 0.01) whereas knowledge of use and proper care of the aids was influenced by socio-economic level (p < 0.01). Communication methods were generally inappropriate with 41.3% of the mothers and 48.5% of the fathers reporting ignorance of Bahasa Malaysia Kod Tangan, the sign language that is commonly used by their children. The parents' choice of communication method was not significantly influenced by socio-economic level or ethnic group. The study revealed the present inadequate state of services available for the rehabilitation of children with congenital hearing impairment.
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Affiliation(s)
- S Z Mukari
- Department of Audiology and Speech Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur
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Bélec L, Authier FJ, Mohamed AS, Soubrier M, Gherardi RK. Antibodies to human herpesvirus 8 in POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) syndrome with multicentric Castleman's disease. Clin Infect Dis 1999; 28:678-9. [PMID: 10194095 DOI: 10.1086/515169] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- L Bélec
- Laboratoire de Virologie, CHU Broussais-Hôtel Dieu, Paris, France.
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Mohamed AS, Dignam JD, Schlender KK. Cardiac myosin-binding protein C (MyBP-C): identification of protein kinase A and protein kinase C phosphorylation sites. Arch Biochem Biophys 1998; 358:313-9. [PMID: 9784245 DOI: 10.1006/abbi.1998.0857] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Myosin binding protein C (MyBP-C) is a major myofibril-associated protein in cardiac muscle which is subject to reversible phosphorylation. Cardiac MyBP-C is a substrate in vivo and in vitro for cAMP-dependent protein kinase (PKA) and calcium/phospholipid-dependent protein kinase (PKC). Chicken cardiac MyBP-C was phosphorylated by PKA to 3.0 mol phosphate/mol and by PKC to 2.0 mol phosphate/mol. Tryptic phosphopeptides from MyBP-C were purified by successive iron iminodiacetate column chromatography and reversed-phase high-performance liquid chromatography. Three phosphopeptides purified from PKA-phosphorylated MyBP-C contained phosphoserine [T1, (RTS[P]LAGGGR) and T2, (KRDS[P]FLR)] or phosphothreonine (CT3, MT[P]SAFL). PKC phosphorylated two of the same sites (T1 and T2) as PKA and an additional site [T2a (TGTTYKPPS[P]YK)]. PKA phosphorylation sites corresponding to peptides T1, T2, and T3 were identified in the N-terminus of the cDNA deduced amino acid sequence (S265, S300, and T274, respectively). The PKC-specific site in peptide T2a was at position S1169. cDNA clones encoding rat cardiac MyBP-C were isolated, and the segment corresponding to PKA and major PKC phosphorylation sites was sequenced. Chicken cardiac MyBP-C has a threonine at position 274 (CT3), whereas rat cardiac MyBP-C has a serine at the corresponding position. Only chicken cardiac MyBP-C had a phosphorylatable residue at the position corresponding to S1169. All of the cardiac MyBP-C phosphorylation sites are absent in known sequences of skeletal muscle MyBP-C isoforms.
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Affiliation(s)
- A S Mohamed
- Department of Pharmacology, Department of Biochemistry and Molecular Biology, Medical College of Ohio, 3035 Arlington Avenue, Toledo, Ohio, 43614-5804, USA
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Bélec L, Mohamed AS, Lechapt-Zalcman E, Authier FJ, Lange F, Gherardi RK. Lack of HHV-8 DNA sequences in sarcoid tissues of French patients. Chest 1998; 114:948-9. [PMID: 9743199 DOI: 10.1378/chest.114.3.948] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Bélec L, Authier J, Eliezer-Vanerot MC, Piédouillet C, Mohamed AS, Gherardi RK. Myoglobin as a polymerase chain reaction (PCR) inhibitor: a limitation for PCR from skeletal muscle tissue avoided by the use of Thermus thermophilus polymerase. Muscle Nerve 1998; 21:1064-7. [PMID: 9655125 DOI: 10.1002/(sici)1097-4598(199808)21:8<1064::aid-mus11>3.0.co;2-u] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Skeletal muscle tissue contains polymerase chain reaction (PCR) inhibitors that are coextracted by conventional nucleic acid extraction procedures. Myoglobin, a heme-containing molecule, was shown to act as a potent Thermus aquaticus DNA polymerase inhibitor and is likely to be involved in muscle tissue-associated PCR inhibition. The use of Thermus thermophilus DNA polymerase avoids muscle tissue-associated PCR inhibition, and should be used in case of small amounts or instability of the targeted nucleic acid.
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Affiliation(s)
- L Bélec
- Groupe d'Etude et de Recherche sur le Nerf et le Muscle (GERMEN), Faculté de Médecine de Créteil-Paris XII, Créteil, France
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Bélec L, Tevi-Benissan C, Mohamed AS, Carbonel N, Matta M, Grésenguet G. Enhanced detection of human herpesvirus-8 and cytomegalovirus in semen of HIV-seropositive asymptomatic heterosexual men living in Central Africa. AIDS 1998; 12:674-6. [PMID: 9583611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Mohamed AS, Becquart P, Hocini H, Métais P, Kazatchkine M, Bélec L. Dilution assessment of cervicovaginal secretions collected by vaginal washing to evaluate mucosal shedding of free human immunodeficiency virus. Clin Diagn Lab Immunol 1997; 4:624-6. [PMID: 9302218 PMCID: PMC170612 DOI: 10.1128/cdli.4.5.624-626.1997] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 10 mM concentration of lithium does not interfere with reverse transcription (RT) or PCR. Sampling of cervicovaginal fluid by vaginal washing, with lithium (10 mM) in the washing buffer as a marker of dilution, may be utilized to accurately determine in HIV-infected women, by quantitative RT-PCR, the genital shedding of acellular HIV RNA at the level of the mucosa itself.
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Affiliation(s)
- A S Mohamed
- Laboratoire de Virologie, Hôpital Broussais, Paris, France
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