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Hanim BS, Rahim RA, Mohd Salleh MF, Zakaria H, Abd Shukor N. CD47 and CD36 expressions in the placenta of mothers with chorioamnionitis. Malays J Pathol 2023; 45:463-471. [PMID: 38155387] [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: 12/30/2023]
Abstract
INTRODUCTION Chorioamnionitis is the inflammation of the placenta and is histologically defined as the presence of neutrophilic infiltration into the chorio-amnion membrane with and without involvement of the umbilical cord. Currently, the inflammatory mediators involved in the eliciting of inflammatory response is still largely under investigation. CD47 and CD36 are pro-inflammatory molecules that are still under investigation. The aim of this study was to determine the expressions of CD47 and CD36 in the placenta of mothers with chorioamnionitis. MATERIALS AND METHODS This was a cross-sectional study, involving a total of 100 cases that comprised of acute subchorionitis (stage I, n=20), acute chorioamnionitis (stage II, n=20), acute necrotising chorioamnionitis (stage III, n=20) and non-chorioamnionitis placenta as control (n=40). All tissue blocks were retrieved from the archived pathology record over a period of 4 years. CD36 and CD47 immunohistochemistry were performed on all cases and their expression in various cell types on the placenta were analysed. RESULTS CD36 was expressed only on the foetal vascular endothelial cells. Interestingly, CD47 showed positive staining on the neutrophils and its expression was significantly different between maternal inflammatory response stage II chorioamnionitis (n=13/20, p<0.001) with stage I and stage III chorioamnionitis. DISCUSSION Our study showed CD47 was expressed in the neutrophils and it was associated with poorer perinatal outcomes and it may have a role in the pathogenesis of chorioamnionitis.
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Affiliation(s)
- B S Hanim
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Pathology, Kuala Lumpur, Malaysia
| | - R A Rahim
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Pathology, Kuala Lumpur, Malaysia
| | - M F Mohd Salleh
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Pathology, Kuala Lumpur, Malaysia
| | - H Zakaria
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Pathology, Kuala Lumpur, Malaysia
| | - N Abd Shukor
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Pathology, Kuala Lumpur, Malaysia.
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Foula MS, Amer NM, Zakaria H, Ismail MH, Alshomimi SJ, Al Bisher HM, Alsaleem H, Almulhim K, Aldabaeab AE, Alratrout H, Alsadery HA, Alarfaj MA, Aljehani YM, El Damati AM. Surgical Management of Intra-gastric Balloon Complications, Single-Center Experience, and Literature Review. Obes Surg 2023; 33:2718-2724. [PMID: 37452985 DOI: 10.1007/s11695-023-06716-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION In Saudi Arabia, the prevalence of obesity has multiplied in the last decades leading to a surge in bariatric surgery and other endoscopic modalities. The intra-gastric balloon (IGB) is the most used endoscopic modality. Surgical management for IGB complications is required for gastrointestinal perforation and/or obstruction. However, the literature seems to underestimate these complications. MATERIALS AND METHODS A retrospective descriptive study was conducted in King Fahd University Hospital, Saudi Arabia, from Jan 2017 to Dec 2021, including all patients with complicated IGB who necessitated any surgical procedure. Exclusion criteria were patients with complicated IGBs that were only managed conservatively or endoscopically. RESULTS A total of 326 patients were admitted with different complications after bariatric procedures. Of them, six patients were referred due to IGB complications that necessitated operative intervention. All patients were young females. Three patients had gastric wall perforation, and were managed by endoscopic removal of the IGBs followed by exploratory laparotomy. One patient had an intestinal obstruction on top of a migrated IGB that was surgically removed. One patient had failed endoscopic retrieval of IGB and required a laparoscopic gastrostomy. Another patient had an esophageal rupture that required left thoracotomy, pleural flap, and insertion of an esophageal stent. All cases were discharged and followed up with no related complications. CONCLUSION IGB is an endoscopic alternative, within specific indications, for the management of obesity. However, surgical management may be necessary to manage its complications, including gastrointestinal perforation, IGB migration, and failure of endoscopic removal.
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Affiliation(s)
- Mohammed S Foula
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia.
| | - Nasser M Amer
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hazem Zakaria
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Mona H Ismail
- Division of Gastroenterology, Department of Internal Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Saeed J Alshomimi
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hassan M Al Bisher
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hassan Alsaleem
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Khalifa Almulhim
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Abdulaziz E Aldabaeab
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hefzi Alratrout
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Humood A Alsadery
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Mosab A Alarfaj
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Yasser M Aljehani
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Ahmed M El Damati
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Giglio MC, Zanfardino M, Franzese M, Zakaria H, Alobthani S, Zidan A, Ayoub II, Shoreem HA, Lee B, Han HS, Penna AD, Nadalin S, Troisi RI, Broering DC. Machine learning improves the accuracy of graft weight prediction in living donor liver transplantation. Liver Transpl 2023; 29:172-183. [PMID: 37160073 DOI: 10.1002/lt.26578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 07/29/2022] [Accepted: 09/06/2022] [Indexed: 01/28/2023]
Abstract
Precise graft weight (GW) estimation is essential for planning living donor liver transplantation to select grafts of adequate size for the recipient. This study aimed to investigate whether a machine-learning model can improve the accuracy of GW estimation. Data from 872 consecutive living donors of a left lateral sector, left lobe, or right lobe to adults or children for living-related liver transplantation were collected from January 2011 to December 2019. Supervised machine-learning models were trained (80% of observations) to predict GW using the following information: donor's age, sex, height, weight, and body mass index; graft type (left, right, or left lateral lobe); computed tomography estimated graft volume and total liver volume. Model performance was measured in a random independent set (20% of observations) and in an external validation cohort using the mean absolute error (MAE) and the mean absolute percentage error and compared with methods currently available for GW estimation. The best-performing machine-learning model showed an MAE value of 50 ± 62 g in predicting GW, with a mean error of 10.3%. These errors were significantly lower than those observed with alternative methods. In addition, 62% of predictions had errors <10%, whereas errors >15% were observed in only 18.4% of the cases compared with the 34.6% of the predictions obtained with the best alternative method ( p < 0.001). The machine-learning model is made available as a web application ( http://graftweight.shinyapps.io/prediction ). Machine learning can improve the precision of GW estimation compared with currently available methods by reducing the frequency of significant errors. The coupling of anthropometric variables to the preoperatively estimated graft volume seems necessary to improve the accuracy of GW estimation.
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Affiliation(s)
- Mariano Cesare Giglio
- Division of Hepato-biliary-pancreatic, Minimally Invasive and Robotic surgery, and Transplantation Service , Federico II University Hospital , Naples , Italy
| | | | | | - Hazem Zakaria
- Hepatopancreatobiliary and Liver Transplant Surgery , National Liver Institute, Menoufia University , Menoufia , Egypt.,Organ Transplant Center , King Faisal Specialist Hospital and Research Center , Riyadh , Saudi Arabia
| | - Salah Alobthani
- Organ Transplant Center , King Faisal Specialist Hospital and Research Center , Riyadh , Saudi Arabia
| | - Ahmed Zidan
- Organ Transplant Center , King Faisal Specialist Hospital and Research Center , Riyadh , Saudi Arabia.,Department of General Surgery , Assiut University , Assiut , Egypt
| | - Islam Ismail Ayoub
- Hepatopancreatobiliary and Liver Transplant Surgery , National Liver Institute, Menoufia University , Menoufia , Egypt
| | - Hany Abdelmeguid Shoreem
- Hepatopancreatobiliary and Liver Transplant Surgery , National Liver Institute, Menoufia University , Menoufia , Egypt
| | - Boram Lee
- Department of Surgery , Seoul National University Bundang Hospital , Seoul , Korea
| | - Ho-Seong Han
- Department of Surgery , Seoul National University Bundang Hospital , Seoul , Korea
| | - Andrea Della Penna
- Department of General, Visceral, and Transplant Surgery , University Hospital Tübingen , Tübingen , Germany
| | - Silvio Nadalin
- Department of General, Visceral, and Transplant Surgery , University Hospital Tübingen , Tübingen , Germany
| | - Roberto Ivan Troisi
- Division of Hepato-biliary-pancreatic, Minimally Invasive and Robotic surgery, and Transplantation Service , Federico II University Hospital , Naples , Italy
| | - Dieter Clemens Broering
- Organ Transplant Center , King Faisal Specialist Hospital and Research Center , Riyadh , Saudi Arabia
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Foula MS, Mirza Gari MK, Eldamati AM, Alshomimi SJ, Alarfaj MA, Alaqeel FO, Aldabaeab AE, Zakaria H. Anastomotic Site-Related Complications After Laparoscopic One-Anastomosis Gastric Bypass. Obes Surg 2022; 32:2799-2801. [PMID: 35676496 DOI: 10.1007/s11695-022-06139-0] [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] [Received: 05/21/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mohammed S Foula
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, 34445, Saudi Arabia.
| | - M Khalid Mirza Gari
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, 34445, Saudi Arabia
| | - Ahmed M Eldamati
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Saeed J Alshomimi
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, 34445, Saudi Arabia
| | - Mosab A Alarfaj
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, 34445, Saudi Arabia
| | - Faten O Alaqeel
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, 34445, Saudi Arabia
| | - Abdulaziz E Aldabaeab
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, 34445, Saudi Arabia
| | - Hazem Zakaria
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, 34445, Saudi Arabia
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Giglio MC, Zanfardino M, Franzese M, Zakaria H, Alobthani S, Zidan A, Troisi RI, Broering D. Machine learning improves the accuracy of graft weight prediction in living donor liver transplantation. Int J Surg 2022. [DOI: 10.1016/j.ijsu.2022.106437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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El-Gendy AEA, Hassan SHMET, Gertz B, Bernard B, Ahmed MM, Elzohry HA, El Tawab GA, El-Sayed MET, Kamel SY, Zakaria H, Mahros AM, Ahmed MH, Tahoon MA, Sakr MA, Gadallah AA, Ahmed FE, Elgazzar MF. Serotyping and Antibiotic Susceptibility of Invasive Streptococcus agalactiae in Egyptian Patients with or without Diabetes Mellitus. Am J Trop Med Hyg 2021; 105:1684-1689. [PMID: 34607308 DOI: 10.4269/ajtmh.21-0300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/08/2021] [Indexed: 11/07/2022] Open
Abstract
Streptococcus agalactiae serotype distribution and its antibiotic susceptibility affect disease prevention strategies, but the serotype distribution varies among patient groups. The objectives of this study were to establish the group B Streptococcus (GBS) serotype distribution in patients from Egypt and to assess antibiotic sensitivity of invasive GBS isolates. A total of 490 patients participated in this multicenter study; 160 had urinary tract infection, 115 complained of diabetic foot ulcers, 125 men had genital tract infections, and 30 women females had genital tract infections. Others had bronchopneumonia, otitis media, synovitis, or meningitis. Serotyping of the isolated GBS was performed at the CDC in the United States. Antibiotic sensitivity patterns were determined using the disk diffusion method. In men, the most common serotypes were II, III, and V, whereas types Ia, II, III, and V were isolated from women. Macrolides (erythromycin) resistance occurred in 4.1% of the isolates; 10.2% were resistant to both clindamycin and inducible resistance of macrolides, lincomycin, and streptogramin; 17.3% were resistant to quinolones; and 95.9% were resistant to tetracyclines. GBS primarily infected the urinary tract, skin, soft tissue, and genital tract in both genders. Isolates were sensitive to beta-lactam drugs, vancomycin, and linezolid; 14.0% were resistant to macrolides with or without clindamycin. Only 6.0% of the strains were sensitive to tetracyclines. Although GBS causes invasive infections in Egyptian adults, it rarely causes neonatal meningitis or sepsis. Future studies should determine whether GBS isolates are transmitted sexually, by performing a follow-up study of the partner of the infected patient.
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Affiliation(s)
| | | | - Bob Gertz
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Beal Bernard
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mohamed Meligy Ahmed
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt
| | - Hassan Ahmed Elzohry
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt
| | | | | | - Shimaa Y Kamel
- Department of Tropical Medicine, Faculty of Medicine, AinShams University, Cairo, Egypt
| | - Hazem Zakaria
- Hepatobiliary and Liver Transplant Surgery Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt
| | - Aya Mohammed Mahros
- Gastroenterology, Hepatology and Infectious Diseases Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohammed Hussien Ahmed
- Gastroenterology, Hepatology and Infectious Diseases Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Marwa Ali Tahoon
- Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt
| | | | | | - Fatma Eldesoky Ahmed
- Department of Clinical Pharmacology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
| | - Mohamed Fathey Elgazzar
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt
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Soliman MS, El-Deriny MM, Ibrahim DSS, Zakaria H, Ahmed Y. Suppression of root-knot nematode Meloidogyne incognita on tomato plants using the nematode trapping fungus Arthrobotrys oligospora Fresenius. J Appl Microbiol 2021; 131:2402-2415. [PMID: 33837626 DOI: 10.1111/jam.15101] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
AIM The aims of the study were to isolate and characterize the nematode trapping fungus, Arthrobotrys oligospora, to investigate the suppressive and predacious activities of the fungus against Meloidogyne incognita and to study the potentiality of A. oligospora in controlling root-knot caused by M. incognita on tomato plants. METHODS AND RESULTS Arthrobotrys oligospora (MRDS 300) was isolated from sandy soil samples collected from Al-Beheira, Egypt. In vitro experiments revealed a high efficiency of the fungus in capturing and suppressing M. incognita second juveniles (J2 ). Microscopic observations showed that the fungus develops adhesive traps consisting of loops of hyphae. Moreover, an in vitro experiment showed that the culture filtrate of A. oligospora had a high toxic effect on the nematode. Pot experiments carried out in two seasons (2018-2019) showed that A. oligospora significantly suppressed root knot on tomato plants caused by M. incognita. The number of females, galls and nematodes in different developing stages were reduced significantly. The treatment with A. oligospora had a prominent effect on enhancing plant growth. CONCLUSION Arthrobotrys oligospora had significant suppressive and predacious effects against root-knot nematode, M. incognita. The fungus developed different forms of trapping devices in addition to secreting toxic metabolites to M. incognita. The fungus had a plant-growth promoting effect. SIGNIFICANCE AND IMPACT OF THE STUDY Arthrobotrys oligospora (MRDS 300) is a potential biological control agent that can be utilized in controlling the root-knot diseases caused by M. incognita.
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Affiliation(s)
- M S Soliman
- Plant Quarantine Pathogens Laboratory, Mycology Research & Disease Survey Department, Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt
| | - M M El-Deriny
- Nematode Diseases Department, Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt
| | - D S S Ibrahim
- Nematode Diseases Department, Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt
| | - H Zakaria
- Plant Quarantine Pathogens Laboratory, Mycology Research & Disease Survey Department, Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt
| | - Y Ahmed
- Plant Quarantine Pathogens Laboratory, Mycology Research & Disease Survey Department, Plant Pathology Research Institute, Agricultural Research Center, Giza, Egypt
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Mohamed REED, Amin MA, Omar HM, Soliman HEM, Zakaria H. Hepatic magnetic resonance elastography: can it be an alternative to invasive biopsy preceding living donor liver transplantation? Egypt J Radiol Nucl Med 2020. [DOI: 10.1186/s43055-020-00324-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Recently, the living donor liver transplantation (LDLT) surgery is employed as the treatment of choice for end-stage chronic liver disease and hepatocellular carcinoma. The role of liver biopsy in donor’s selection protocol for adult living liver donors (LLDs) candidates is a point of controversy. Hepatic magnetic resonance elastography (MRE) is a promising technique particularly in grading of liver fibrosis that can be used for pre-transplantation evaluation of the LLDs candidates. The aim of the current study was to evaluate the diagnostic performance of hepatic MRE as a pre-transplantation imaging tool for LLDs candidates, prior to LDLT surgery.
Results
Thirty-seven eligible healthy LLDs candidates (28 males and 9 females; their ages ranged from 24 to 45 years) were the subject of the current study. A cut-off value ≥ 2.24 kilo Pascal (kPa) was assumed for discrimination between normal and abnormal hepatic tissues with high accuracy (99.24%). Also, a cut-off value ≥ 2.38 kPa for grading steatosis gave 98.44% accuracy, while a cut-off value ≥ 2.57 kPa for discriminating fibrosis stages yielded 98.80% accuracy.
Conclusion
MRE can be considered as a reliable non-invasive pre-transplant screening technique that has the potential to alternate the invasive liver biopsy technique in selection and validation of LLDs candidates for LDLT surgery.
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Zakaria H, Sallam AN, Ayoub II, Gad EH, Taha M, Roshdy MR, Sweed D, Gaballa NK, Yassein T. Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study. Ann Med Surg (Lond) 2020. [PMID: 32874564 DOI: 10.1016/j.amsu.2020.07.059.] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Periampullary adenocarcinoma (PAAC) had a poor prognosis, and pancreaticoduodenectomy (PD) remains the only potentially curative treatment. The study aimed to identify the impact of different clinicopathological factors on long-term survival following PD for PAAC. Patients and methods This study is a retrospective cohort study for the patients who underwent PD for pathologically proven PAAC from January 2010 to January 2019. Statistical analysis was done using Cox regression multivariate analyses for independent risk factors for survival. Result There were 137 patients with PAAC who underwent PD, 79 patients (57.7%) underwent pylorus-preserving PD. Pancreatico-jejunostomy was done in 108 patients (78.8%). The primary analysis showed that risk factors for poor long-term survival include patients with co-morbidities like hypertension or ischemic heart disease, Carbohydrate Antigen 19-9 > 400U/ml, tumor size > 3 cm, poor tumor differentiation, positive lymph nodes invasion, lymphovascular invasion, and Perineural invasion. Multivariate analysis demonstrated that large tumor size > 3 cm (HR: 0.177, 95%CI: 0.084-0.374, P = 0.002), poorly differentiated tumor (HR: 0.059, 95%CI: 0.020-0.0174, P = 0.016), and perineural invasion in the pathological study (HR: 0.101, 95%CI: 0.046-0.224, P = 0.006) were independent risk factors for poor 5-years survival. The prognosis was better in ampullary adenocarcinoma (5-year survival was 42.1%) than pancreatic adenocarcinoma (5-year survival was 24.3%). The 1, 3, 5 and 7-year overall survival rates were 84.5%, 57.4%, 35.9% and 20.1% respectively. Conclusion It seems from the current study that Tumor size > 3 cm, poor tumor differentiation, and Perineural invasion were independent predictors of poor survival in patients with PAAC.
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Key Words
- AC, (adenocarcinoma)
- CA, 19-9(Carbohydrate antigen 19-9)
- DM, (diabetes mellitus)
- HBV, (hepatitis B virus)
- HCV, (hepatitis C virus)
- HTN, (hypertension)
- ICU, (intensive care unit)
- IHD, (ischemic heart disease)
- LNs, (lymph nodes)
- PAAC, (periampullary adenocarcinoma)
- PD, (Pancreaticoduodenectomy)
- PDAC, (Pancreatic duct adenocarcinoma)
- PG, (pancreatico-gastrostomy)
- PJ, (pancreatico-jejunostomy)
- PPPD, (pylorus preserving pancreaticoduodenectomy)
- Pancreaticoduodenectomy
- Periampullary adenocarcinoma
- Perineural invasion
- SD, (standard deviation)
- Survival
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Affiliation(s)
- Hazem Zakaria
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Ahmed N Sallam
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Islam I Ayoub
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Emad H Gad
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Mohammad Taha
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Michael R Roshdy
- Department of General Surgery, Faculty of Medicine, Minia University, Egypt
| | - Dina Sweed
- Department of Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Nahla K Gaballa
- Department of Anesthesiology and Intensive Care, National Liver Institute, Menoufia University, Egypt
| | - Taha Yassein
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
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10
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Zakaria H, Sallam AN, Ayoub II, Gad EH, Taha M, Roshdy MR, Sweed D, Gaballa NK, Yassein T. Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study. Ann Med Surg (Lond) 2020; 57:321-327. [PMID: 32874564 PMCID: PMC7452109 DOI: 10.1016/j.amsu.2020.07.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/05/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background Periampullary adenocarcinoma (PAAC) had a poor prognosis, and pancreaticoduodenectomy (PD) remains the only potentially curative treatment. The study aimed to identify the impact of different clinicopathological factors on long-term survival following PD for PAAC. Patients and methods This study is a retrospective cohort study for the patients who underwent PD for pathologically proven PAAC from January 2010 to January 2019. Statistical analysis was done using Cox regression multivariate analyses for independent risk factors for survival. Result There were 137 patients with PAAC who underwent PD, 79 patients (57.7%) underwent pylorus-preserving PD. Pancreatico-jejunostomy was done in 108 patients (78.8%). The primary analysis showed that risk factors for poor long-term survival include patients with co-morbidities like hypertension or ischemic heart disease, Carbohydrate Antigen 19-9 > 400U/ml, tumor size > 3 cm, poor tumor differentiation, positive lymph nodes invasion, lymphovascular invasion, and Perineural invasion. Multivariate analysis demonstrated that large tumor size > 3 cm (HR: 0.177, 95%CI: 0.084–0.374, P = 0.002), poorly differentiated tumor (HR: 0.059, 95%CI: 0.020–0.0174, P = 0.016), and perineural invasion in the pathological study (HR: 0.101, 95%CI: 0.046–0.224, P = 0.006) were independent risk factors for poor 5-years survival. The prognosis was better in ampullary adenocarcinoma (5-year survival was 42.1%) than pancreatic adenocarcinoma (5-year survival was 24.3%). The 1, 3, 5 and 7-year overall survival rates were 84.5%, 57.4%, 35.9% and 20.1% respectively. Conclusion It seems from the current study that Tumor size > 3 cm, poor tumor differentiation, and Perineural invasion were independent predictors of poor survival in patients with PAAC. Periampullary adenocarcinoma (PAAC) is highly aggressive tumor. It has late diagnosis with poor prognosis. Pancreaticoduodenectomy (PD) is still the only curative treatment option. PD surgery is associated with high morbidity and mortality. It is important to determine which patients who can receive benefit from surgery.
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Key Words
- AC, (adenocarcinoma)
- CA, 19-9(Carbohydrate antigen 19-9)
- DM, (diabetes mellitus)
- HBV, (hepatitis B virus)
- HCV, (hepatitis C virus)
- HTN, (hypertension)
- ICU, (intensive care unit)
- IHD, (ischemic heart disease)
- LNs, (lymph nodes)
- PAAC, (periampullary adenocarcinoma)
- PD, (Pancreaticoduodenectomy)
- PDAC, (Pancreatic duct adenocarcinoma)
- PG, (pancreatico-gastrostomy)
- PJ, (pancreatico-jejunostomy)
- PPPD, (pylorus preserving pancreaticoduodenectomy)
- Pancreaticoduodenectomy
- Periampullary adenocarcinoma
- Perineural invasion
- SD, (standard deviation)
- Survival
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Affiliation(s)
- Hazem Zakaria
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Ahmed N Sallam
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Islam I Ayoub
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Emad H Gad
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Mohammad Taha
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Michael R Roshdy
- Department of General Surgery, Faculty of Medicine, Minia University, Egypt
| | - Dina Sweed
- Department of Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Nahla K Gaballa
- Department of Anesthesiology and Intensive Care, National Liver Institute, Menoufia University, Egypt
| | - Taha Yassein
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
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AlGhonaim M, AL-ATTAR B, Santiago D, Zakaria H, Kamal M. SUN-201 CHARACTERISTICS OF DIALYSIS AND RENAL TRANSPLANTATION IN THE KINGDOM OF SAUDI ARABIA. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Zakaria H, Saleh Y, Zidan A, Sturdevant M, Alabbad S, Elsheikh Y, Al-Hamoudi W, Albenmousa A, Troisi RI, Broering D. Is It Justified to Use Liver Grafts From Living Donors for Retransplant? A Single-Center Experience. EXP CLIN TRANSPLANT 2019; 18:188-195. [PMID: 31875463 DOI: 10.6002/ect.2019.0262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Liver retransplant is considered the only hope for patients with irreversible graft failure after primary transplant. In most Western centers, retransplantis done mainly from deceased donors; so far, only few published studies have reported on outcomes of liver retransplant with living donors. In this study, our aim was to analyze the outcomes of living-donor liver retransplant. MATERIALS AND METHODS Patients who underwent liver retransplant between February 2011 and February 2019 were included in the study. Preoperative, operative, and postoperative data were analyzed. Results from 2 patient groups were compared: liver retransplant with living donors and liver retransplant with deceased donors. RESULTS Thirty-two patients underwent liver retransplant (21 adult and 11 pediatric patients). The most common indications for liver retransplant were hepatic artery thrombosis (28.5%) and primary graft nonfunction (23.8%) in adults and hepatic artery thrombosis (45.5%) and chronic rejection (36.4%) in pediatric patients. Seventeen retransplant patients (53.1%) required early retransplant (within 1 mo), mainly due to hepatic artery thrombosis (52.9%) and primary graft nonfunction (35.3%). Late retransplant was mainly due to chronic rejection (40%) and recurrence of primary disease (26.7%). Seventeen patients (53.1%) underwent living-donor retransplant, and 5 donors underwent robotic right hepatectomy. Graft and patient survival rates at 1, 3, and 5 years were 81.3% for living-donor and 51.4% for deceased-donor liver retransplant recipients (P = .08). On multivariate analyses, we observed significant differences between both groups in pretransplant Model for End-Stage Liver Disease and Pediatric End-Stage Liver Disease scores (P = .05), preoperative international normalized ratio (P = .012), and cold ischemia time (P = .046). CONCLUSIONS The use of living donors for liver retransplant, despite its technical demand, was shown to be a safe and feasible option, especially when there is scarcity of deceased donors.
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Affiliation(s)
- Hazem Zakaria
- >From the Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt; and the Department of Liver and Small Bowel Transplantation & HPB Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Mirza Gari MK, Foula MS, Eldamati A, Alshomimi S, Zakaria H. Gastrocolic fistula after laparoscopic sleeve gastrectomy: Case report and literature review. Int J Surg Case Rep 2019; 66:201-203. [PMID: 31865232 PMCID: PMC6931086 DOI: 10.1016/j.ijscr.2019.11.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/09/2019] [Accepted: 11/17/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy is a popular bariatric procedure. Leakage after sleeve gastrectomy is the cornerstone for most of its related morbidity and mortality. Gastrocolic fistula is a rare complication resulting from chronic leak after laparoscopic sleeve gastrectomy. CASE PRESENTATION We report a case of 32-year-old male who underwent laparoscopic re-sleeve gastrectomy for weight regain after initial uneventful laparoscopic sleeve gastrectomy 3 years back. He presented to emergency department by septic shock secondary to leakage after sleeve gastrectomy. CT abdomen with IV contrast and oral gastrograffin confirmed post sleeve gastrectomy leak. Emergency diagnostic laparoscopy revealed a huge abscess cavity containing pus and dark fecal material and altered blood. A long leak was identified with eversion of gastric mucosa. Tubular structure connecting the upper part of the stomach and the colon was found which turned out to be a gastrocolic fistula. It was controlled by endoscopic linear stapler. After 6 weeks, a definitive open esophago-jeujonostomy with total gastrectomy was done successfully after difficult attempt of laparoscopic intervention. The patient was discharged home in a stable condition. CONCLUSION A high index of suspicion is important in detection of rare complications after laparoscopic sleeve gastrectomy including gastrocolic fistula. Complete laparoscopic resection of gastrocolic fistula is preferred. Gastrectomy might be the definitive surgery.
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Affiliation(s)
- M Khalid Mirza Gari
- Department of Surgery, King Fahad University Hopsital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Mohammed S Foula
- Department of Surgery, King Fahad University Hopsital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Ahmed Eldamati
- Department of Surgery, King Fahad University Hopsital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Saeed Alshomimi
- Department of Surgery, King Fahad University Hopsital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Hazem Zakaria
- Department of Surgery, King Fahad University Hopsital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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Woon LSC, Zakaria H. Adult Attention Deficit Hyperactivity Disorder in a Malaysian Forensic Mental Hospital: a Cross-sectional Study. East Asian Arch Psychiatry 2019; 29:118-123. [PMID: 31871308 DOI: 10.12809/eaap1851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine the prevalence of adult attention deficit hyperactivity disorder (ADHD) and comorbid mental disorders in a Malaysian forensic mental hospital. METHODS All adult patients admitted to the forensic wards who were able to understand Malay or English language and give written informed consent were included. Participants were assessed using the Conners Adult Attention-Deficit Diagnostic Interview for DSM-IV (for presence of adult ADHD and a history of childhood ADHD) and the Mini International Neuropsychiatric Interview (for psychiatric comorbidities). Sociodemographic and offence-related data were also collected. RESULTS Of 199 patients admitted, 120 were included for analysis. The mean age of participants was 36.3 years. 94.2% were men. 81.7% were single, divorced, or separated. 25% had a history of childhood ADHD. The prevalence of adult ADHD was 15.8%. The persistence rate was 63%. Among the 19 participants with adult ADHD, the most common psychiatric comorbidities were substance dependence (68.4%), lifetime depression (63.2%), and generalised anxiety disorder (47.4%). Compared with participants without ADHD, participants with adult ADHD were less likely to be married (0% vs 21.8%, p = 0.022) and more likely to have alcohol abuse (15.8% vs 2%, p = 0.028), lifetime manic/hypomanic episodes (42.1% vs 7.9%, p = 0.001), and generalised anxiety disorder (47.4% vs 19.8%, p = 0.017), and were of younger age at first offence (21.8 years vs 26.9 years, p = 0.021). CONCLUSIONS Adult ADHD is common in a Malaysian forensic mental hospital and is associated with unmarried status, alcohol abuse, lifetime manic/hypomanic episodes, generalised anxiety disorder, and younger age at first offence.
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Affiliation(s)
- L S C Woon
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - H Zakaria
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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15
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Gad EH, Zakaria H, Kamel Y, Alsebaey A, Zakareya T, Abbasy M, Mohamed A, Nada A, Abdelsamee MA, Housseni M. Surgical (Open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: A retrospective cohort study. Ann Med Surg (Lond) 2019. [DOI: https:/doi.org/10.1016/j.amsu.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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16
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Gad EH, Zakaria H, Kamel Y, Alsebaey A, Zakareya T, Abbasy M, Mohamed A, Nada A, Abdelsamee MA, Housseni M. Surgical (Open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: A retrospective cohort study. Ann Med Surg (Lond) 2019. [DOI: https://doi.org/10.1016/j.amsu.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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17
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Gad EH, Zakaria H, Kamel Y, Alsebaey A, Zakareya T, Abbasy M, Mohamed A, Nada A, Abdelsamee MA, Housseni M. Surgical (Open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: A retrospective cohort study. Ann Med Surg (Lond) 2019; 43:52-63. [PMID: 31198552 PMCID: PMC6556483 DOI: 10.1016/j.amsu.2019.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/18/2019] [Accepted: 05/23/2019] [Indexed: 02/06/2023] Open
Abstract
Objectives For complicated common bile duct stones (CBDS) that cannot be extracted by endoscopic retrograde cholangiopancreatography (ERCP), management can be safely by open or laparoscopic CBD exploration (CBDE). The study aimed to assess these surgical procedures after endoscopic failure. Methods We analyzed 85 patients underwent surgical management of difficult CBDS after ERCP failure, in the period from 2013 to 2018. Results Sixty-seven (78.8%) and 18(21.2%) of our patients underwent single and multiple ERCP sessions respectively. An impacted large stone was the most frequent cause of ERCP failure (60%). Laparoscopic CBDE(LCBDE), open CBDE(OCBDE) and the converted cases were 24.7% (n = 21), 70.6% (n = 60), and 4.7% (n = 4) respectively. Stone clearance rate post LCBDE and OCBDE reached 95.2% and 95% respectively, Eleven (12.9%) of our patients had postoperative complications without mortality. By comparing LCBDE and OCBDE; there was a significant association between the former and longer operative time. On comparing, T-tube and 1ry CBD closure in both OCBDE and LCBDE, there was significantly longer operative time, and post-operative hospital stays in the former. Furthermore, in OCBDE group, choledocoscopy had an independent direction to 1ry CBD repair and significant association with higher stone clearance rate, shorter operative time, and post-operative hospital stay. Conclusion Large difficult CBDS can be managed either by open surgery or laparoscopically with acceptable comparable outcomes with no need for multiple ERCP sessions due to their related morbidities; furthermore, Open choledocoscopy has a good impact on stone clearance rate with direction towards doing primary repair that is better than T-tube regarding operative time and post-operative hospital stay. Large difficult CBD stones can be managed either by open surgery or laparoscopically with acceptable comparable outcomes. No need for multiple ERCP sessions due to their related morbidities. Open choledocoscopy has a good impact on stone clearance rate with direction towards doing primary repair. Primary repair is better than T-tube regarding operative time and post-operative hospital stay.
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Affiliation(s)
- Emad Hamdy Gad
- Hepatobiliary Surgery, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Hazem Zakaria
- Hepatobiliary Surgery, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Yasmin Kamel
- Anaesthesia, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Ayman Alsebaey
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Talat Zakareya
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Mohamed Abbasy
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Anwar Mohamed
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Ali Nada
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | | | - Mohamed Housseni
- Intervention Radiology, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
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18
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Gad EH, Zakaria H, Kamel Y, Alsebaey A, Zakareya T, Abbasy M, Mohamed A, Nada A, Abdelsamee MA, Housseni M. Surgical (Open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: A retrospective cohort study. Ann Med Surg (Lond) 2019. [PMID: 31198552 DOI: 10.1016/j.amsu.2019.05.007.] [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] [Subscribe] [Scholar Register] [Indexed: 10/01/2022]
Abstract
Objectives For complicated common bile duct stones (CBDS) that cannot be extracted by endoscopic retrograde cholangiopancreatography (ERCP), management can be safely by open or laparoscopic CBD exploration (CBDE). The study aimed to assess these surgical procedures after endoscopic failure. Methods We analyzed 85 patients underwent surgical management of difficult CBDS after ERCP failure, in the period from 2013 to 2018. Results Sixty-seven (78.8%) and 18(21.2%) of our patients underwent single and multiple ERCP sessions respectively. An impacted large stone was the most frequent cause of ERCP failure (60%). Laparoscopic CBDE(LCBDE), open CBDE(OCBDE) and the converted cases were 24.7% (n = 21), 70.6% (n = 60), and 4.7% (n = 4) respectively. Stone clearance rate post LCBDE and OCBDE reached 95.2% and 95% respectively, Eleven (12.9%) of our patients had postoperative complications without mortality. By comparing LCBDE and OCBDE; there was a significant association between the former and longer operative time. On comparing, T-tube and 1ry CBD closure in both OCBDE and LCBDE, there was significantly longer operative time, and post-operative hospital stays in the former. Furthermore, in OCBDE group, choledocoscopy had an independent direction to 1ry CBD repair and significant association with higher stone clearance rate, shorter operative time, and post-operative hospital stay. Conclusion Large difficult CBDS can be managed either by open surgery or laparoscopically with acceptable comparable outcomes with no need for multiple ERCP sessions due to their related morbidities; furthermore, Open choledocoscopy has a good impact on stone clearance rate with direction towards doing primary repair that is better than T-tube regarding operative time and post-operative hospital stay.
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Affiliation(s)
- Emad Hamdy Gad
- Hepatobiliary Surgery, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Hazem Zakaria
- Hepatobiliary Surgery, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Yasmin Kamel
- Anaesthesia, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Ayman Alsebaey
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Talat Zakareya
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Mohamed Abbasy
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Anwar Mohamed
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | - Ali Nada
- Hepatology and Endoscopy, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
| | | | - Mohamed Housseni
- Intervention Radiology, National Liver Institute, Menoufia University, Shebein Elkoum, Egypt
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Abstract
The renal replacement therapy in Saudi Arabia has 3 main modalities: hemodialysis, peritoneal dialysis, and renal transplantation. Hemodialysis is one of the fastest growing industries of health care providers in Saudi Arabia. OBJECTIVE We aimed to review the health indicators of renal replacement therapy. MATERIALS AND METHODS We used the Saudi Center for Organ Transplantation Annual Report 2016. RESULTS Patients with end-stage renal disease on hemodialysis and peritoneal dialysis totaled 17,687. Saudi Arabia increased the numbers of dialysis centers and also added 2 more sectors. The Ministry of Health hospitals have 55% of the centers, government non-Ministry of Health has 9%, private and charitable hospitals have 21%, the King Abdullah Hemodialysis Project has 2%, and the outsourcing dialysis programs have 13%. There are 243 dialysis units in Saudi Arabia. Most dialysis centers are in the central region (30%); 27% are in the western region, 19% are in the southern region, 13% are in the eastern region, and 11% are in the northern region. The average net increase of dialysis patients is 6.2% annually and is projected to reach 22,000 by 2020. Causes of renal failure are mainly diabetic nephropathy (40%) and hypertensive nephropathy (38%). Hepatitis C virus positivity is at 12% and hepatitis B surface antigen positivity is at 4%. From the year 2000 renal transplantation from deceased and living donation has tripled in number, with a total of 798 kidneys transplanted. CONCLUSION Renal replacement therapy is increasing and dialysis center numbers are expected to increase. Renal transplantation numbers have improved both from living and deceased donors but further actions toward the promotion of the organ donation in Saudi Arabia is essential.
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Affiliation(s)
- F Shaheen
- Saudi Center for Organ Transplantation, Riyadh, Kingdom of Saudi Arabia.
| | - B Al-Attar
- Saudi Center for Organ Transplantation, Riyadh, Kingdom of Saudi Arabia
| | - D Santiago
- Saudi Center for Organ Transplantation, Riyadh, Kingdom of Saudi Arabia
| | - P Follero
- Saudi Center for Organ Transplantation, Riyadh, Kingdom of Saudi Arabia
| | - H Zakaria
- Saudi Center for Organ Transplantation, Riyadh, Kingdom of Saudi Arabia
| | - M Kamal
- Saudi Center for Organ Transplantation, Riyadh, Kingdom of Saudi Arabia
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Fouad A, MOUSA AHMED, Zakaria O, Zakaria H. MEDICOLEGAL AND CLINICAL ASPECTS OF PERIPHERAL VASCULAR INJURIES: A RETROSPECTIVE STUDY. The Egyptian Journal of Forensic Sciences and Applied Toxicology 2019. [DOI: 10.21608/ejfsat.2019.6483.1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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21
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Hayajneh FMF, Jalal M, Zakaria H, Abdelqader A, Abuajamieh M. Anticoccidial effect of apple cider vinegar on broiler chicken: an organic treatment to measure anti-oxidant effect. Pol J Vet Sci 2019; 21:361-369. [PMID: 30450876 DOI: 10.24425/122605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The objective of this study was to investigate the anticoccidial effect of apple cider vinegar added to drinking water with the anticoccidial effect of amprolium to feed broiler chicken. The study has adopted an observational approach to evaluate the anticoccidial effect of apple cider vinegar on broiler chicken. The antioxidative changes were measured adding natural apple cider vinegar to drinking water. Four hundred and fifty broiler chickens were purchased from the local market and distributed into three groups (T+vc: positive control, T-vc: negative control Tv: apple cider vinegar) with 150 chickens in each group. The three groups were further replicated into 3 blocks each containing 50 chickens. The groups were fed balanced diet, amprolium was added to the feed of positive control group, and apple cider vinegar was added to the water of Tv group. Measurements of the different variables were started from week 3, at the end of each week 3 birds were chosen randomly, blood samples were collected via the wing vein, and fecal oocysts were counted from intestinal contents of each individual bird using the McMaster technique. Broiler in the control groups T+ve and T-ve showed clinical signs of coccidiosis (blood in feces) and the number of coccidial oocytes in feces increased with time. In the vinegar group, no clinical signs of coccidiosis were observed. Concentrations of total antioxidants and catalase enzyme activity significantly increased (p≤0.05); while malondialdehyde concentration significantly decreased (p≤0.05).
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Affiliation(s)
- F M F Hayajneh
- School of Agriculture, Department of Animal Production, The Jordan University, Amman, Jordan, Jordan University, Amman 11942 Jordan
| | - M Jalal
- School of Agriculture, Department of Animal Production, The Jordan University, Amman, Jordan, Jordan University, Amman 11942 Jordan
| | - H Zakaria
- School of Agriculture, Department of Animal Production, The Jordan University, Amman, Jordan, Jordan University, Amman 11942 Jordan
| | - A Abdelqader
- School of Agriculture, Department of Animal Production, The Jordan University, Amman, Jordan, Jordan University, Amman 11942 Jordan
| | - M Abuajamieh
- School of Agriculture, Department of Animal Production, The Jordan University, Amman, Jordan, Jordan University, Amman 11942 Jordan
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Agatonovic-Kustrin S, Morton D, Adam A, Mizaton H, Zakaria H. High-performance thin-layer chromatographic methods in the evaluation of the antioxidant and anti-hyperglycemic activity of Myrmecodia platytyrea as a promising opportunity in diabetes treatment. J Chromatogr A 2017; 1530:192-196. [DOI: 10.1016/j.chroma.2017.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 01/05/2023]
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Shoreem H, Gad EH, Soliman H, Hegazy O, Saleh S, Zakaria H, Ayoub E, Kamel Y, Abouelella K, Ibrahim T, Marawan I. Small for size syndrome difficult dilemma: Lessons from 10 years single centre experience in living donor liver transplantation. World J Hepatol 2017; 9:930-944. [PMID: 28824744 PMCID: PMC5545138 DOI: 10.4254/wjh.v9.i21.930] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/19/2017] [Accepted: 06/20/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To analyze the incidence, risk factors, prevention, treatment and outcome of small for size syndrome (SFSS) after living donor liver transplantation (LDLT).
METHODS Through-out more than 10 years: During the period from April 2003 to the end of 2013, 174 adult-to-adults LDLT (A-ALDLT) had been performed at National Liver Institute, Menoufiya University, Shibin Elkoom, Egypt. We collected the data of those patients to do this cohort study that is a single-institution retrospective analysis of a prospectively collected database analyzing the incidence, risk factors, prevention, treatment and outcome of SFSS in a period started from the end of 2013 to the end of 2015. The median period of follow-up reached 40.50 m, range (0-144 m).
RESULTS SFSS was diagnosed in 20 (11.5%) of our recipients. While extra-small graft [small for size graft (SFSG)], portal hypertension, steatosis and left lobe graft were significant predictors of SFSS in univariate analysis (P = 0.00, 0.04, 0.03, and 0.00 respectively); graft size was the only independent predictor of SFSS on multivariate analysis (P = 0.03). On the other hand, there was lower incidence of SFSS in patients with SFSG who underwent splenectomy [4/10 (40%) SFSS vs 3/7 (42.9%) no SFSS] but without statistical significance, However, there was none significant lower incidence of the syndrome in patients with right lobe (RL) graft when drainage of the right anterior and/or posterior liver sectors by middle hepatic vein, V5, V8, and/or right inferior vein was done [4/10 (28.6%) SFSS vs 52/152 (34.2%) no SFSS]. The 6-mo, 1-, 3-, 5-, 7- and 10-year survival in patients with SFSS were 30%, 30%, 25%, 25%, 25% and 25% respectively, while, the 6-mo, 1-, 3-, 5-, 7- and 10-year survival in patients without SFSS were 70.1%, 65.6%, 61.7%, 61%, 59.7%, and 59.7% respectively, with statistical significant difference (P = 0.00).
CONCLUSION SFSG is the independent and main factor for occurrence of SFSS after A-ALDLT leading to poor outcome. However, the management of this catastrophe depends upon its prevention (i.e., selecting graft with proper size, splenectomy to decrease portal venous inflow, and improving hepatic vein outflow by reconstructing large draining veins of the graft).
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Kesrouani A, Hatoum I, Dabar G, Choucair J, Jabbour H, Zakaria H. Streptococcus G leading to septic abortion and multiple organ failure. CLIN EXP OBSTET GYN 2017. [DOI: 10.12891/ceog3552.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Kesrouani A, Hatoum I, Dabar G, Choucair J, Jabbour H, Zakaria H. Streptococcus G leading to septic abortion and multiple organ failure. CLIN EXP OBSTET GYN 2017; 44:317-318. [PMID: 29746050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The authors report a patient admitted at 12 weeks of pregnancy with an acute infectious syndrome, leading to abortion, sepsis, and multiple organ failure. Admission to intensive care unit (ICU) was needed after curettage for incomplete abortion complicated by uterine atony, hemorrhage, and septic shock. The patient had multiple organ failure and required non-invasive ventilation. Hemoculture showed streptococcus G bacteremia. She had no evidence of concurrent infection, mainly genital or urinary, except amygdalitis few days before. Hematogenous spread to the gestational sac could have possibly been the cause of her sepsis. Streptococcus G infection during pregnancy can lead to severe consequences.
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Zakaria H, Paterson-Brown S. Outcomes following cholecystostomy in patients with acute calcalous cholecystitis. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Al-Hwiesh AK, Shawarby MA, Abdul-Rahman IS, Al-Oudah N, Al-Dhofairy B, Divino-Filho JC, Abdelrahman A, Zakaria H, Nasr El-Din MA, Eldamati A, El-Salamony T, Al-Muhanna FA. Changes in peritoneal membrane with different peritoneal dialysis solutions: Is there a difference? Int J Organ Transplant Med 2016. [DOI: 10.1016/j.hkjn.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Aziz A, Zakaria H, Ayoub I, Soliman H, Osman M. The safety and adequacy of liver resection for large hepatocellular carcinoma: A retrospective single institute study. ACTA ACUST UNITED AC 2016. [DOI: 10.4103/2320-3846.181811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Aziz A, Yassein T, Taha M, Salem E, Zakaria H, Soliman ES, Abuelella K, Ibrahim T. Risk factors impacting mortality after living related liver transplantation for hepatocellular carcinoma: a retrospective cohort study. Egypt J Surg 2016. [DOI: 10.4103/1110-1121.189420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Aziz A, Saleh S, Soliman H, Shoreem H, Hegazy O, Taha M, Salem E, Zakaria H, Hamdy S, Abdeldayem H, Ibrahim T, Abuelella K. Evaluation of surgical complications in 204 live liver donors according to the modified clavien classification system. Egypt J Surg 2016. [DOI: 10.4103/1110-1121.194734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Eldamati A, Niaz R, Tanveer S, Zakaria H, AlJazzan N, El-Sharkawy T, AlDhafery B, Al-Mulhim AA. Sialolipoma of the Superficial Lobe of the Parotid Gland: A Case Report and Literature Review. Saudi J Med Med Sci 2015; 4:38-41. [PMID: 30787695 PMCID: PMC6298259 DOI: 10.4103/1658-631x.170893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Sialolipoma of the parotid gland is very rare. We report a case of a 38-year-old woman who presented with a painless, slowly growing, mobile lump of the parotid gland. Computed tomography revealed lipoma of the superficial lobe of the parotid gland. Superficial parotidectomy was performed with uneventful postoperative course. The histology showed sialolipoma. Review of the 25 reported cases (including our case) of parotid sialolipoma shows that this tumor is more common in the fifth decade of life, on the left side and the superficial lobe. It has a slight preference for men. Its clinical presentation mimics the standard (pure) parotid lipoma and other more common benign parotid tumors particularly pleomorphic adenoma and Warthin's tumor. Surgical excision is curative with minor complications and small recurrence rate. Histological examination is necessary to establish the diagnosis and to exclude malignancy.
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Affiliation(s)
- Ahmed Eldamati
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Rabia Niaz
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Shumaila Tanveer
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Hazem Zakaria
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Nasser AlJazzan
- Department of ENT, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Tarek El-Sharkawy
- Department of Pathology, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Bander AlDhafery
- Department of Radiology, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
| | - Abdulmohsen A Al-Mulhim
- Department of Surgery, King Fahd Hospital of the University, College of Medicine, University of Dammam, Saudi Arabia
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Abdeldayem H, Helmy A, Gad H, Salah E, Sadek A, Ibrahim T, Soliman E, Abuelella K, Osman M, Aziz A, Soliman H, Saleh S, Hegazy O, Shoreem H, Yasen T, Salem E, Taha M, Zakaria H, Ayoub I, Sherif A. Secondary Liver Tumors. Hepatic Surgery 2013. [DOI: 10.5772/51766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Biswal B, Sulaiman A, Ismail H, Zakaria H, Jalil Abdul M, Muhammad K. AOS14 Phase II clinical study of combination chemotherapy with herb Withania somnifera (ashwagandha) in breast cancer. Eur J Cancer 2012. [DOI: 10.1016/j.ejca.2012.02.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zakaria H, Abdul Rahman A. P-1332 - Motor neurological soft signs and verbal fluency among patients with schizophrenia: a significant correlation. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75499-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Titi H, Hasan Y, Al-Ismail K, Zakaria H, Tabbaa M, Abdullah A, Obeidat B. Response of Shami goats and kids to variable levels of soyabean or sunflower oils in diets. J Anim Feed Sci 2011. [DOI: 10.22358/jafs/66204/2011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tschechne B, Borghardt J, Wildfang I, Schroder D, Niebuhr H, Zakaria H, Fanaei S, Luft S, Jordan W. BENDAMUSTINE AND CETUXIMAB IN COMBINATION AS ALTERNATIVE THERAPEUTIC OPTION FOR RECURRENT HEAD AND NECK CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jordan W, Wildfang I, Welkoborsky H, Borghardt J, Zakaria H, Fanaei S, Niebuhr H, Luft S, Tschechne B. TPF induction-radioimmunochemotherapy for the treatment of advanced head and neck cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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38
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Wildfang I, Tschechne B, Borghardt J, Fanaei S, Zakaria H, Luft S, Jordan W. Oropharyngeal mucositis prophylaxis in combined radioimmunochemotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tschechne B, Wildfang I, Niebuhr H, Borghardt J, Zakaria H, Fanaei S, Luft S, Jordan W. Bendamustine and cetuximab as an alternative therapeutic option for recurrent head and neck squamous cell carcinoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e16029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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40
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Jordan W, Wildfang I, Welkoborsky H, Borghardt J, Zakaria H, Tschechne B. TPF induction therapy with radioimmunochemotherapy for the treatment of head and neck cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e17021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17021 Background: As of the good data for radiotherapy with cetuximab and the promising results of an induction chemotherapy containing docetaxel we developed a combination of these regimes. This retrospective analysis evaluates the safety and feasibility of a TPF induction therapy under pegfilgrastim protection with a subsequent concomitant RT immunochemotherapy using cetuximab. Methods: 64 patients (8 female/56 male) with advanced (mostly metastatic; T3/T4) head & neck cancer were treated. Patients were between 39 and 78 years old (median 61), ECOG between 1 and 3. Induction therapy consisted of three 21-day-cycles TPF (75 mg/m2 docetaxel d1; 35 mg/m2 cisplatin d1,2; 750 mg/m2 5-FU d1–5) and on d7 a protective dose of 6 mg pegfilgrastim. Before and after induction therapy PET-CT was used to evaluate response. PET-CT allowed best possible RT-planning with best adapted field margins. Subsequent radioimmunochemotherapy consisted of 400 mg/m2 cetuximab on day 1 (initial dose) and seven weekly cycles of 250 mg/m2 cetuximab and 40 mg/abs cisplatin on day 1. Radiotherapy on d1–5/; 1,8 Gy/day for a median dose 61,2 Gy (59,4 - 70,2 Gy). During the whole treatment CRP was monitored twice weekly and if necessary antibiotics were administered iv. Results: All 64 patients were evaluated after therapy completion. One death occured which was not treatment related (myocard infarct). Five patients decided not to complete the treatment. The response rates were: CR 56% (36), PR 31% (20), SD 11% (7), and PD 2% (1). 10 grade 3/4 toxicities had to be observed during radioimmunotherapy (skin rash, diarrhoe). All toxicities were reversible. In five patients therapy had to be interrupted for two weeks (skin rash). Karnofsky index could be kept stable and in some cases even improved. Conclusions: The new regimen is safe, shows great promise and deserves further development. PET-CT as a diagnostic tool, pegfilgrastim as a myeloprotective agent and docetaxel/cetuximab make a good combination. Especially during the induction therapy QoL is drastically improved. No significant financial relationships to disclose.
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Affiliation(s)
- W. Jordan
- Deister-Süntel-Klinik, Bad Münder, Germany; Praxis Radioonkologie und Strahlentherapie, Hannover, Germany; Krankenhaus Nordstadt, Hannover, Germany; Deister-Süntel- Klinik, Hannover, Germany; Praxis Tschechne/Luft/Jordan, Hannover, Germany
| | - I. Wildfang
- Deister-Süntel-Klinik, Bad Münder, Germany; Praxis Radioonkologie und Strahlentherapie, Hannover, Germany; Krankenhaus Nordstadt, Hannover, Germany; Deister-Süntel- Klinik, Hannover, Germany; Praxis Tschechne/Luft/Jordan, Hannover, Germany
| | - H. Welkoborsky
- Deister-Süntel-Klinik, Bad Münder, Germany; Praxis Radioonkologie und Strahlentherapie, Hannover, Germany; Krankenhaus Nordstadt, Hannover, Germany; Deister-Süntel- Klinik, Hannover, Germany; Praxis Tschechne/Luft/Jordan, Hannover, Germany
| | - J. Borghardt
- Deister-Süntel-Klinik, Bad Münder, Germany; Praxis Radioonkologie und Strahlentherapie, Hannover, Germany; Krankenhaus Nordstadt, Hannover, Germany; Deister-Süntel- Klinik, Hannover, Germany; Praxis Tschechne/Luft/Jordan, Hannover, Germany
| | - H. Zakaria
- Deister-Süntel-Klinik, Bad Münder, Germany; Praxis Radioonkologie und Strahlentherapie, Hannover, Germany; Krankenhaus Nordstadt, Hannover, Germany; Deister-Süntel- Klinik, Hannover, Germany; Praxis Tschechne/Luft/Jordan, Hannover, Germany
| | - B. Tschechne
- Deister-Süntel-Klinik, Bad Münder, Germany; Praxis Radioonkologie und Strahlentherapie, Hannover, Germany; Krankenhaus Nordstadt, Hannover, Germany; Deister-Süntel- Klinik, Hannover, Germany; Praxis Tschechne/Luft/Jordan, Hannover, Germany
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Zakaria H, Tabbaa M, Alshawabkeh K, Altaif K. The effect of dietary sodium bicarbonate on
performance and blood parameters of broiler
chickens and local Balady breed inoculated with
Salmonella gallinarum. J Anim Feed Sci 2009. [DOI: 10.22358/jafs/66398/2009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zakaria H, Kallmes D, Kadirvel R, Ding Y, Dai D, Lewis D, Robertson A. Similar hemodynamic features in elastase-induced rabbit saccular aneurysms compared to those of humans aneurysms. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)84469-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Basal stem rot of oil palm caused by Ganoderma boninense is of major economic importance. Observations of the low incidence of disease due to Ganoderma species in natural stands, suggest that the disease is kept under control by some biological means. Trichoderma spp. are saprophytic fungi with high antagonistic activities against soil-borne pathogens. However, their abundance and distribution are soil and crop specific. Trichoderma species have been found to be concentrated in the A1 (0-30 cm) and Be soil horizons (30-60 cm), although the abundance of Trichoderma was not significantly different between the oil palm and non-oil palm ecosystems. Characterisation of Trichoderma isolates based on cultural, morphological and DNA polymorphism showed that T. harzianum, T. virens, T. koningii and T. longibrachiatum made up 72, 14, 10 and 4% of the total Trichoderma isolates isolated. As Trichoderma species are present in the oil palm ecosystem, but at lower numbers and in locations different from those desired, soil augmentation with antagonistic Trichoderma spp. can be developed as a strategy towards integrated management of basal stem rot of oil palm.
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Affiliation(s)
- M Sariah
- Department of Plant Protection, Universiti Putra Malaysia, 43400UPM, Serdang, Selangor DE, Malaysia.
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Affiliation(s)
- Maha Abdel Hadi
- Department of Surgery, King Fahd Hospital, University of Alkhobar, Saudi Arabia.
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Souqiyyeh MZ, Al-Attar MB, Zakaria H, Shaheen FA. Dialysis centers in the kingdom of saudi arabia. Saudi J Kidney Dis Transpl 2001; 12:293-304. [PMID: 18209376] [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
To help future planning of the dialysis services in the different geographical regions and health sectors in Saudi Arabia, we surveyed its 130 active hemodialysis (HD) centers using a questionnaire about their manpower, hemodialysis equipment, as well as, peritoneal dialysis and transplant patients at the end of the year 2000. Almost all the dialysis centers were on hospital campus but of variable sizes with an average ratio of 14.8 dialysis machines per center (range 2-113 machines per center). The distribution of the dialysis centers according to the geographical regions of Saudi Arabia included 18(14%) in the northern, 25(19%) in the southern, 13(10%) in the eastern, 35(27%) in the western and 39(30%) in the central region. There was a total of 6,694 dialysis patients served on 1,918 hemodialysis machines. There were 1,793(93%) HD machines capable of performing bicarbonate dialysis. There was an average ratio of 3.5 patients per one HD machine. In addition to the hemodialysis, there were 28(22%) centers engaged in peritoneal dialysis (PD) and 56(43%) centers in the follow-up of post transplant patients. The total number of the nephrologists, regardless of their expertise was 212 of whom 180(84%) spoke Arabic; the average ratio was 32 patients per nephrologist (range of 14-58). There were 1320 hemodialysis nurses of whom only 465(35%) spoke Arabic. The average ratio of patients to nurses was five patients per nurse (range of 4-6). There were 72(55%) social workers and 70(54%)dietitians with average patients ratios to these supporting services of 1:93 patients (range of 1:58-137) and 1:96 patients (range of 1:53-137), respectively. The study HD patients had a mean age of 47.8 +/- 17.1 years (range: 2-92 years); of them, 52.5% were males and 12% had non-Saudi nationality. Of the hemodialysis patients, 1,815(27%) were diabetics. The calculated net increase of dialysis population was 988 patients per year (14.8%). There were 5,700(85%) patients on regular bicarbonate dialysate. Chronic viral infection were noted in more than half of all the dialysis population: thus 3,380(50%) were positive for hepatitis C viral (HCV) serology, 448(7%) had positive hepatitis B (HBV) antigenemia and six(0.1%) had the human acquired immunodeficiency syndrome. In conclusion, our findings demonstrated a satisfactory advancement achieved in many Saudi dialysis centers in terms of equipment, personnel and patients' care. However, there should be more emphasis in the future on quality care through better self-assessment of the performance of these centers.
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Affiliation(s)
- M Z Souqiyyeh
- Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia
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Razak IA, Fun HK, Yamin BM, Chinnakali K, Zakaria H, Ismail NB. Trichloro[methylenebis(diphenylphosphine oxide-O)]antimony(III). Acta Crystallogr C 1999. [DOI: 10.1107/s0108270198012335] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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47
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Waschütza G, Li V, Schäfer T, Schomburg D, Villmann C, Zakaria H, Otto B. Engineered disulfide bonds in recombinant human interferon-gamma: the impact of the N-terminal helix A and the AB-loop on protein stability. Protein Eng 1996; 9:905-12. [PMID: 8931130 DOI: 10.1093/protein/9.10.905] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Insertion sites for cysteines with optimal stereochemistry for the formation of unstrained disulfide bridges were identified in recombinant human interferon-gamma (rhu-IFN-gamma) by computer modelling. We have engineered two different disulfide cross-linked mutants, containing a pair of symmetry-related disulfide bonds, which stabilize the N-termini of both monomers of the homodimeric protein. Mutations E7C and S69C allow the formation of an intramonomer disulfide bond between helices A and D. In contrast, the A17C and H111C mutations lead to a covalent cross-link between both monomers. The AB-loop is linked to helix F. The fluorescence properties of native and disulfide cross-linked proteins were studied as a function of guanidine hydrochloride concentration. Melting temperatures (Tm) were calculated from the decrease in CD ellipticity at 220 nm. The induction of the antiviral effect was measured using A549 fibroblast cells infected with encephalomyocarditis virus. The ability to induce the expression of the HLA-DR antigen in Colo 205 cells was determined by fluorescence-activated cell scanning analysis. The stability of both mutants was strongly enhanced against temperature- and cosolvent-induced unfolding. The delta Tm of mutant IFN-gamma E7C/S69C was 15 degrees C. All measured biological activities of this mutant were equal to wild type. In the case of the other mutant IFN-gamma A17C/H111C, the delta Tm value was 25 degrees C. This mutation abolishes nearly the entire biological activity (< 1%) with no detectable changes of secondary structure in the CD spectrum. Our results illustrate the importance of the N-terminal helix A and the AB-loop for the unfolding pathway and thermodynamic stability of rhu-IFN-gamma.
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Affiliation(s)
- G Waschütza
- Fraunhofer Institut für Grenzflächen- und Bioverfahrenstechnik, Hannover, Germany
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Günther G, Fechteler T, Villmann C, Zakaria H, Schomburg D, Otto B. Computer-aided modeling of structure stabilizing disulfide bonds in recombinant human interferon-gamma. Pharm Acta Helv 1996; 71:37-44. [PMID: 8786998 DOI: 10.1016/0031-6865(95)00045-3] [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: 02/02/2023]
Abstract
We present a general search algorithm for possible insertion sites of disulfide bonds in proteins based on the coordinates of the solved X-ray or NMR structure, allowing the insertion of disulfide bonds with a minimum of conformational tension and backbone rearrangements. The FORTRAN 77 program "Ssuitable' was written for this purpose. This methodological approach was applied to recombinant human interferon-gamma (rhu-IFN-gamma), a cytokine of great pharmaceutical interest with a wide variety of biological activities including antiviral, antiproliferative and immunomodulatory effects. A model based on the C alpha-coordinates obtained from the Brookhaven data base was built. Four different insertion sites were selected in the model, connecting the two subunits of the homodimer. The thermodynamic stability of rhu-IFN-gamma is low, limiting its clinical application. We expect that the insertion of additional new disulfide bonds will enhance the thermodynamic stability as well as protect the protein against proteolytic degradation.
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Affiliation(s)
- G Günther
- Fraunhofer Institut für Toxikologie und Aerosolforschung, Hannover, Germany.
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