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El-Mokhtar SA, Afifi NA, Abdel-Malek MO, Hassan WA, Hetta H, El-Badawy O. Aberrant cytokine and VCAM-1 expression in patients with viral and non-viral related liver cirrhosis. Cytokine 2023; 171:156385. [PMID: 37788510 DOI: 10.1016/j.cyto.2023.156385] [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: 06/10/2023] [Revised: 08/26/2023] [Accepted: 09/27/2023] [Indexed: 10/05/2023]
Abstract
The study aim was to compare the alterations in the expression levels of proinflammatory and chemotactic cytokines as tumor necrosis factor-alpha (TNF-α), interleukin (IL)-17A and IL-8, the down regulatory cytokine IL-10, in addition to the vascular cell adhesion molecule-1 (VCAM-1) gene in different groups of patients with cirrhosis due to various etiologies. This case-control study included 84 patients suffering from cirrhosis of viral and non-viral etiologies and 20 sex and age-matched healthy controls. All patients were subjected to detailed history taking, clinical examination, and liver function assessment. The expression levels of TNF-α, IL-17A, IL-8, IL-10, and VCAM-1 were assessed in peripheral blood mononuclear cells by real-time PCR. Patients with cirrhosis showed marked changes in the tested gene expression levels relative to the control group. Higher expression levels of all genes except IL-10 were seen in patients of the viral than in the non-viral groups. Most of the significant correlations of liver function parameters were observed with TNF-α in both the viral and non-viral groups, followed by IL-17A. Increased TNF-α and IL-17A presented potential risk factors for disease progression to cirrhosis of Child class C.
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Affiliation(s)
- Sara A El-Mokhtar
- Microbiology & Immunology Department, Faculty of Pharmacy, Assiut University, Assiut, Egypt
| | - Noha A Afifi
- Medical Microbiology & Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed O Abdel-Malek
- Tropical Medicine & Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Waleed A Hassan
- Tropical Medicine & Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Helal Hetta
- Medical Microbiology & Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Omnia El-Badawy
- Medical Microbiology & Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
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Abd Almonaem ER, Shaheen AM, Abdelrahman AMN, Hassan WA, Daay El Khair NM, Abdel Haie OM. Association between Interleukin-17F 7488A/G and 7383A/G polymorphisms and susceptibility to juvenile idiopathic arthritis. Pediatr Res 2023; 94:1496-1502. [PMID: 36068342 PMCID: PMC10589088 DOI: 10.1038/s41390-022-02288-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/25/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Interleukin-17F (IL-17F), one of the cytokines, is crucial in the pathophysiology of juvenile idiopathic arthritis (JIA). Therefore, we aimed to determine the relation between IL17F 7488A/G and IL17F 7383A/G single-nucleotide polymorphisms and JIA susceptibility and to explain their impact on the disease activity. METHODS Genomic DNA of 70 patients with JIA and 70 age and sex-matched controls were extracted and typed for IL17F 7488A/G and IL17F 7383A/G single-nucleotide polymorphisms, using polymerase chain reaction with sequence-specific primers method, and compared between patients and controls. RESULTS When compared to AA participants, children with the AG genotype of the IL17F 7488A/G and IL17F 7383A/G polymorphisms showed a substantially greater risk of JIA. Furthermore, children with the G allele were 2.8 folds more likely to have JIA than the A allele for IL17F 7488A/G polymorphism and 3.72 folds for IL17F 7383A/G polymorphism. Children with AG genotype of IL17F 7383A/G polymorphism were far more likely to have high activity JIA. CONCLUSIONS The G allele of both IL17F 7488A/G and IL17F7383 A/G polymorphisms is associated with increased JIA susceptibility, and JIA at High Disease Activity was more likely to develop in AG subjects of the IL17F 7383 A/G polymorphism. IMPACT The relationship between Interleukin-17F 7488A/G and 7383A/G polymorphisms and risk for JIA has not been recognized before. Impact of Interleukin-17F 7488A/G and 7383A/G genotypes on JIA disease activity. The G allele of both IL17F 7488A/G and IL17F7383 A/G polymorphisms are associated with increased JIA susceptibility. AG genotype of Interleukin-17F 7383 A/G polymorphism compared to AA patients, had a higher probability of developing JIA at a High Disease Activity (HDA) level.
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Affiliation(s)
| | | | - Amira M N Abdelrahman
- Clinical and Chemical Pathology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Waleed A Hassan
- Rheumatology, Rehabilitation, and Physical Medicine Department, Benha University, Benha, Egypt
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Miedany YE, Abu-Zaid MH, Eissa M, Hassan WA, Mortada M, Tabra SAA, Mohamed SS, Maher SE, Gaafary ME, Medhat BM, Mosa DM, Fouad NA, Amer YA, Nasef SI, Shalaby RH, Adel Y, Elkhalek RA, Mahgoub MY, Lotfy HM. Consensus evidence-based recommendations for transition of care for adolescents with juvenile idiopathic arthritis: meeting patients’, parents’, and rheumatologists’ perspectives. Egypt Rheumatol Rehabil 2023; 50:39. [DOI: 10.1186/s43166-023-00195-9] [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] [Received: 03/31/2023] [Accepted: 05/26/2023] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
Transition of care means the process of educating and empowering adolescents and young adults to take an active role in their own healthcare, develop decision-making skills, and eventually transition from paediatric to adult healthcare providers. Most people do not switch doctors until they are young adults, but it can be beneficial to start preparing children earlier. We aimed to develop a specific toolkit tailored to paediatric and adult rheumatologists to assist them in transitioning of care of young people with juvenile onset rheumatic musculoskeletal diseases from the paediatric to adult rheumatology care.
Results
The expert panel was confined to an online survey (n = 18), all the experts completed the two rounds. At the conclusion of round 2, a total of 10 points were gathered. The range of respondents (ranks 7–9) who agreed with the recommendations was 88.9 to 100%. All 10 clinical standards identified by the scientific committee were written in the same way. Based on the answers to the structured key questions and the literature review, a structured template was developed presenting transition of care integrated pathway.
Conclusion
The developed rheumatology-specific guideline offers adolescents and young adults a focussed, multidisciplinary transition of care approach with equity of access, quality of care and flexibility and set up standards for transitional care for young adults with juvenile rheumatological diseases.
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Miedany YE, Abu-Zaid MH, Eissa M, Hassan WA, Mortada M, Tabra SAA, Mohamed SS, Maher SE, Gaafary ME, Medhat BM, Mosa DM, Fouad NA, Amer YA, Nasef SI, Shalaby RH, Adel Y, Elkhalek RA, Mahgoub MY, Lotfy HM. E07 Development of a coordinated transitional care program on adolescents with juvenile idiopathic arthritis: looking through the patient lens. Rheumatology (Oxford) 2023; 62. [DOI: 10.1093/rheumatology/kead323.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
Transition of care means the process of educating and empowering adolescents and young adults to take an active role in their own healthcare, develop decision-making skills, and eventually transition from paediatric to adult healthcare providers. Most people don't switch doctors until they are young adults, but it can be beneficial to start preparing children earlier.
Objectives
To provide a toolset specifically suited for adult and paediatric rheumatologists to help them transition the care of children with rheumatic diseases from adult to paediatric rheumatology care.
Methods
The preliminary scientific committee identified a total of ten major clinical questions in this study, which was conducted to obtain expert consensus. To reach consensus on the transition of care for young adults and adolescents with rheumatic diseases, the core leadership team sought out researchers and clinicians with expertise in both paediatric and adult rheumatic diseases management.
Results
The expert panel's participation was restricted to an online survey (n = 18); each expert completed both rounds. After round 2, a total of 10 points had been collected. 88.9% to100% of respondents (ranks 7–9) indicated they agreed with the recommendations. The scientific committee's 10 clinical standards were all prepared in the same style. A structured template describing the integrated pathway for transition of care was developed using the responses to the structured key questions and the results of the literature review.
Conclusion
The created rheumatology-specific guideline provides young adults with juvenile rheumatic diseases with a focused, multidisciplinary transition of care strategy with equity of access, quality of care, and flexibility and establishes standards for transitional care.
Ethics
This study was performed in accordance with the Helsinki Declaration. The ‘Clinical, Evidence-based, Guidelines’ (CEG) initiative protocol was approved the local ethical committee: ethical approval code: 34842/8/21, ethical board Tanta University.
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Affiliation(s)
- Yasser El Miedany
- Christ Church University , Kent, UK
- H. Senior Clinical Lecturer, King's College London , UK
| | | | | | - Waleed A Hassan
- Rheumatology and Rehabilitation, Benha University , Benha, Egypt
| | | | | | - Sally S Mohamed
- Rheumatology and Rehabilitation, Cairo University , Cairo, Egypt
| | | | - Maha El Gaafary
- Community Medicine and Public Health, Ain Shams University , Cairo, Egypt
| | - Basma M Medhat
- Rheumatology and Rehabilitation, Cairo University , Cairo, Egypt
| | - Doaa Mosad Mosa
- Rheumatology, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | | | | | - Samah Ismail Nasef
- Rheumatology and Rehabilitation, Suez Canal University , Ismailia, Egypt
| | - Radwa H Shalaby
- Rheumatology and Rehabilitation, Tanta University, Tanta , Egypt
| | - Yasmin Adel
- Rheumatology and Rehabilitation, Mansoura University , Egypt
| | | | | | - Hala M Lotfy
- Pediatric Rheumatology, Cairo University , Cairo, Egypt
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El Miedany Y, Salah S, Lotfy HM, Abu-Zaid MH, Mohamed SS, Maher SE, El Gaafary M, Abdulhady H, Farag Y, Eissa M, Radwan A, Medhat BM, El Mikkawy DME, Hassan WA, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Amer YA, Nasef SI, Abushady H, Galal S, El-Latif EA, Maria D, Shabana AH, Tabra SA. Egyptian evidence-based consensus on clinical practice recommendations for the management of Kawasaki disease. Egypt Rheumatol Rehabil 2023; 50:21. [PMCID: PMC10088797 DOI: 10.1186/s43166-023-00180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/10/2023] [Indexed: 09/02/2023] Open
Abstract
Background Kawasaki disease (KD) is an acute, self-limited febrile disease of unidentified cause that mostly affects children less than 5 years of age. This work aimed to provide an appropriate Egyptian evidence-based consensus on clinical practice recommendations for the management of Kawasaki disease. The main objective of this study, which employed the Delphi method, was to reach a consensus among experts on a treat-to-target management approach for KD. Results The expert panel was confined to an online survey (n =26), and all the expert completed the three rounds. At the conclusion of round 3, a total of 17 recommendation items were gathered, which were divided into two sections. The range of respondents (ranks 7–9) who agreed with the recommendations was 92.3 to 100%. All 17 clinical standards identified by the scientific committee were written in the same way. There have been algorithms proposed for managing various KD conditions. Conclusion The developed evidence-based consensus recommendations for the diagnosis and management of KD represent an up-to-date document that focuses on clinical management questions which are generally posed to health care professionals involved in the management of KD. This guideline was developed considering experience with and availability of treatment and diagnostic options in Egypt.
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Affiliation(s)
- Yasser El Miedany
- Canterbury Christ Church University, Kent, England
- King’s College London, London, England
| | - Samia Salah
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | - Hala M. Lotfy
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | | | | | | | - Maha El Gaafary
- Community Medicine and Public Health, Ain Shams University, Cairo, Egypt
| | - Hala Abdulhady
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | - Yomna Farag
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | - Mervat Eissa
- Rheumatology and Rehabilitation, Cairo University, Cairo, Egypt
| | - Ahmed Radwan
- Rheumatology and Rehabilitation, Sohag University, Sohag, Egypt
| | - Basma M. Medhat
- Rheumatology and Rehabilitation, Cairo University, Cairo, Egypt
| | | | | | - Doaa Mosad Mosa
- Rheumatology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Mohamed Mortada
- Rheumatology and Rehabilitation, Zagazig University, Zagazig, Egypt
| | | | | | | | | | - Hend Abushady
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | - Salwa Galal
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | | | - Dina Maria
- Cardiology, Tanta University, Tanta, Egypt
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Fotouh AA, Hamdy M, Ali F, Mohamed EF, Allam A, Hassan WA, Elsaman A, El-Najjar A, Amer MA, Mosad D, Tharwat S, El Bakry SA, Saleh H, Zaghloul A, Mahmoud M, Mohammed RHA, El-Saadany H, Fathi HM, Hammam N, Raafat HA, Moharram AN, Gheita TA. The Emerging Era of Interventional Imaging in Rheumatology: An Overview During the Coronavirus Disease-2019 (COVID-19) Pandemic. Open Access Rheumatol 2022; 14:43-56. [PMID: 35449707 PMCID: PMC9018128 DOI: 10.2147/oarrr.s355140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/25/2022] [Indexed: 11/29/2022] Open
Abstract
Imaging has long been taking its place in the diagnosis, monitor, and prognosis of rheumatic diseases. It plays a vital role in the appraisal of treatment. Key progress in the clinical practice of rheumatology is the innovation of advanced imaging modalities; such as musculoskeletal ultrasound (MSUS), computerized tomography (CT) and magnetic resonance imaging (MRI). These modalities introduced a promising noninvasive method for visualizing bone and soft tissues to enable an improved diagnosis. The use of MSUS in rheumatology is considered a landmark in the evolution of the specialty and its ease of use and many applications in rheumatic diseases make it a forerunner instrument in the practice. The use of MSUS among rheumatologists must parallel the development rate of the excellence revealed in the specialty. Moreover, innovative interventional imaging in rheumatology (III-R) is gaining fame and key roles in the near future for a comprehensive management of rheumatic diseases with precision. This review article throws light on the emergence of these robust innovations that may reshape the guidelines and practice in rheumatology, in particular, efforts to enhance best practice during the coronavirus disease 2019 (COVID-19) pandemic are endorsed.
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Affiliation(s)
| | - Mona Hamdy
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Fatma Ali
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, AlAzhar Girls, Cairo, Egypt
| | - Abdallah Allam
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Waleed A Hassan
- Rheumatology Department, Faculty of Medicine, Benha University, Banha, Egypt
| | - Ahmed Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amany El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Marwa A Amer
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa Mosad
- Rheumatology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samah A El Bakry
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hanan Saleh
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Zaghloul
- Interventional Pain Management and Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Mahmoud
- Orthopedic and Microsurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem H A Mohammed
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hala A Raafat
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf N Moharram
- Orthopedic and Microsurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer A Gheita
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Abdel-Monem SM, El-Brashy AWSE, Hassan WA, Abdullah OA, Almallah DH. Determination of estrogen receptor alpha gene (ESR1) polymorphism and its relation to systemic lupus erythematosus disease status. Egypt Rheumatol Rehabil 2022. [DOI: 10.1186/s43166-022-00119-z] [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
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with variable clinical manifestations that can affect various organs and tissues. Estrogen is an important element that performs a vital role in the pathology of SLE. It acts on target cells through binding to estrogen receptors (ERs). This study aimed to assess the effect of ER alpha gene polymorphism on SLE disease activity and clinical manifestations. This study included 30 SLE female patients and 20 healthy subjects as controls. ERα gene (pvull and xbal) polymorphisms were genotyped using the real-time polymerase chain reaction (RT-PCR) and correlated with clinical and laboratory manifestations of SLE as well as the activity and severity scores.
Results
Regarding ERα (rs1 2234693 Pvull) polymorphism, the TC and CC genotypes were mainly associated with SLE patients, with a high frequency of the mutant C allele. The TT genotype was found mainly in the control group. Concerning rs2 9340799 Xbal polymorphisms, the AG, AA, and GG genotypes frequencies were not significantly different between patient and controls. The TC/AA, CC/GG, and CC/GG genotypes were the most prevalent combinations among SLE patients, while the later combination is completely absent from the control group. There was a significant statistical association with the AA genotype with the neurological disorders and/or hematological affection in SLE patients. The TC genotype was more related to serositis, leucopenia and pyuria, while the AA polymorphism was associated only with leucopenia.
Conclusions
We conclude that the study offers a clue to the associations of ERα gene polymorphisms in SLE disease, and the combinations relevant to certain clinical manifestations. Estrogen level itself does not affect SLE susceptibility or activity but the mutations in its receptors are the main pathogenic factor.
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Medhat BM, Elmaghraby A, Farag Y, Marzouk H, Mostafa N, Khalifa I, Mohammed A, Elkhalifa M, ElSayed Hassan EH, Hassan WA. Assessment of Lupus Nephritis in a Multicenter Retrospective Egyptian Cohort: Initial Characteristics, Influence of Age and Gender, Outcome, and Potential Association with Disease Damage. Saudi J Kidney Dis Transpl 2022; 33:90-105. [PMID: 36647983 DOI: 10.4103/1319-2442.367830] [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: 01/18/2023] Open
Abstract
The study aimed to evaluate the association of demographic, clinical, and histopathologic characteristics with renal and disease outcomes. Persistent lack of partial or complete remission despite sequential induction therapy, chronic kidney disease (CKD) or endstage renal disease (ESRD), and/or mortality were determined as poor renal outcomes. Disease damage was investigated through the Systemic Lupus International Collaborating Clinics/ American College of Rheumatology Damage Index (SDI). Of 201 biopsy-proven lupus nephritis patients, a poor outcome was present in 56 (27.9%) patients, with nine (4.5%), 22 (10.9%), and 29 (14.4%) patients demonstrating lack of response, CKD, and ESRD, respectively, and the prevalence of mortality was 5.5% (11/201). The outcome was poor among males [29/201 (14.4%)] [P = 0.008; odds ratio (OR): 2.8; 95% confidence interval (CI): 1.2-6.4], yet comparable between adult- and juvenile-onset patients [80/201 (39.8%) (≤16 years)] (P = 0.6; OR: 0.8; 95% CI: 0.4-1.6). Hypertension (P <0.001; OR: 6.3; 95% CI: 2.6-14.9), elevated creatinine (P <0.001; OR: 5.2; 95% CI: 2.6-10.3), and hematuria (P <0.001; OR: 3.7; 95% CI: 1.9-7.5) at presentation, and fibrinoid necrosis [P <0.001; odds ratio (OR): 4.1; 95% confidence interval (CI): 2.1-8.1], wire loops (P = 0.006; OR: 2.4; 95% CI: 1.2-4.6), crescents (P <0.001; OR: 5.4 95% CI: 2.8-10.5), interstitial fibrosis (P = 0.001; OR: 2.7; 95% CI: 1.4-5.1), and acute vascular lesions (P = 0.004; OR: 3.6; 95% CI: 1.4-9.4) on biopsy were associated with a poor outcome. Chronic glomerular (P = 0.003) and acute vascular lesions (P <0.001), and a higher chronicity index (r = 0.1; P = 0.006) on biopsy, and frequent renal (r = 0.3; P <0.001) and extra-renal flares (r = 0.2; P <0.001) were associated with higher SDI scores. Among the studied renal and extra-renal parameters, independent predictors of higher disease damage solely included frequent renal flares (ᵝ= 1; P <0.001). To conclude, a poor renal outcome (27.9%) was associated with distinct features. Disease damage was associated with frequent renal flares.
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Affiliation(s)
- Basma M Medhat
- Rheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Elmaghraby
- Rheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yomna Farag
- Pediatric Rheumatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Huda Marzouk
- Pediatric Rheumatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Mostafa
- Pediatric Rheumatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Iman Khalifa
- Pediatric Department, Faculty of Medicine, Helwan University, Helwan, Egypt
| | - AbdelAal Mohammed
- Internal Medicine Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Elkhalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Eman Hassan ElSayed Hassan
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Waleed A Hassan
- Rheumatology, Rehabilitation, and Physical Medicine Department, Faculty of Medicine, Benha University, Benha, Egypt
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Abu-Zaid MH, Salah S, Lotfy HM, El Gaafary M, Abdulhady H, Tabra SAA, Salah H, Farag Y, Eissa M, Maher SE, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosad Mosa D, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, Mohamed SS, Hassan WA, Amer YA, Nasef SI, El Miedany Y. Consensus evidence-based recommendations for treat-to-target management of immunoglobulin A vasculitis. Ther Adv Musculoskelet Dis 2021; 13:1759720X211059610. [PMID: 34917176 PMCID: PMC8669874 DOI: 10.1177/1759720x211059610] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
IgA vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, is the most common cause of systemic vasculitis in childhood. Given its potential life-threatening systemic complications, early and accurate diagnosis as well as management of IgAV represent a major challenge for health care professionals. This study was carried out to attain an evidence-based expert consensus on a treat-to-target management approach for IgAV using Delphi technique. The preliminary scientific committee identified a total of 16 key clinical questions according to the patient, intervention, comparison, and outcomes (PICO) approach. An evidence-based, systematic, literature review was conducted to compile evidence for the IgAV management. The core leadership team identified researchers and clinicians with expertise in IgAV management in Egypt upon which experts were gathered from different governorates and health centers across Egypt. Delphi process was implemented (two rounds) to reach a consensus. An online questionnaire was sent to expert panel (n = 26) who participated in the two rounds. After completing round 2, a total of 20 recommendation items, categorized into two sections were obtained. Agreement with the recommendations (rank 7-9) ranged from 91.7-100%. Consensus was reached (i.e. ⩾75% of respondents strongly agreed or agreed) on the wording of all the 20 clinical standards identified by the scientific committee. Algorithms for the diagnosis and management have been suggested. This was an expert, consensus recommendations for the diagnosis and treatment of IgAV and IgA vasculitic nephritis, based on best available evidence and expert opinion. The guideline presented a strategy of care with a pathway to achieve a state of remission as early as possible. Plain Language Summary Given its potential life-threatening systemic complications, early and accurate diagnosis of immunoglobulin A vasculitis represents a major challenge for health care professionals. This work provided cornerstone principles for the management of the condition. Adopting PICO approach and implementing Delphi process a consensus was reached on evidence-based treat-to-target treatment recommendations. This will endorse enhancement and consistency of care of this cohort of patients in standard practice.
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Affiliation(s)
| | - Samia Salah
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | - Hala M Lotfy
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | - Maha El Gaafary
- Community Medicine and Public Health, Ain Shams University, Cairo, Egypt
| | - Hala Abdulhady
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | | | - Hala Salah
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | - Yomna Farag
- Pediatric Rheumatology, Cairo University, Cairo, Egypt
| | | | | | - Ahmed Radwan
- Rheumatology and Rehabilitation, Sohag University, Sohag, Egypt
| | | | - Basma M Medhat
- Rheumatology and Rehabilitation, Cairo University, Cairo, Egypt
| | - Dalia El Mikkawy
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | | | | | - Mohamed Mortada
- Rheumatology and Rehabilitation, Zagazig University, Zagazig, Egypt
| | | | | | | | - Sally S Mohamed
- Rheumatology and Rehabilitation, Cairo University, Cairo, Egypt
| | - Waleed A Hassan
- Rheumatology and Rehabilitation, Benha University, Benha, Egypt
| | - Youmna A Amer
- Rheumatology and Rehabilitation, Zagazig University, Zagazig, Egypt
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Abu-Zaid MH, Tabra SA, Salah S, Lotfy H, Abdulhady H, Salah H, El Gaafary M, Farag Y, Eissa M, Maher SE, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, Mohamed SS, Hassan WA, Amer Y, Nasef SI, El Miedany Y. P063 Consensus-based recommendations for treat to target management of immunoglobulin A vasculitis. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
IgAvasculitis (IgAV) is the commonest cause of vasculitis in childhood.
It is characterized by small vessel vasculitis of the skin, gastrointestinal tract, kidneys, joints, and, rarely, the lungs and the central nervous system. There is paucity of international guidelines for management of IgA V. the Objective is to develop guidelines specific for Egyptian children with IgA vasculitis.
Method
This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for IgA vasculitis using Delphi technique. The preliminary scientific committee identified a total of 16 key clinical questions according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) approach. Delphi process was implemented (2-rounds) to reach a consensus.
Results
An online questionnaire were sent to expert panel (n = 26) who participated in the two rounds. At the end of round 2, a total of 20 recommendation items, categorized into 2 sections were obtained. Agreement with the recommendations (rank 7–9) ranged from 91.7–100%. Consensus was reached (i.e. ≥75% of respondents strongly agreed or agreed) on the wording of all the 20 clinical standards identified by the scientific committee. Algorithms for the management have been suggested.
Conclusion
This was an expert, consensus recommendations for the diagnosis and treatment of IgA V and IgA V nephritis, based on best available evidence and expert opinion.
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Affiliation(s)
| | | | - S Salah
- Egyptian Academy of Bone Health
| | - H Lotfy
- Egyptian Academy of Bone Health
| | | | - H Salah
- Egyptian Academy of Bone Health
| | | | - Y Farag
- Egyptian Academy of Bone Health
| | - M Eissa
- Egyptian Academy of Bone Health
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Y Amer
- Egyptian Academy of Bone Health
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El Miedany Y, Hassan M, Salah S, Lotfy H, Abdulhady H, Salah H, El Gaafary M, Abd El-Latif E, Farag Y, Eissa M, Esam Maher S, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, SMohamed S, Tabra S, Hassan WA, Amer Y, Nasef SI. P016 Updated Clinical Practice Guidelines for JIA management adopting Treat to Target approach: the Egyptian College of Paediatric Rheumatology initiative. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is an unmet need from paediatric rheumatologists and rheumatologists, managing children with JIA, for a well formulated guidelines aiming at achieving better outcomes of their patients. To establish adequate and easily adopted guidelines in management of different variants of JIA in a relatively low resources country.
Method
This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for Juvenile Idiopathic Arthritis using Delphi technique. The preliminary scientific committee identified a total of 17 key clinical questions according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) approach. An evidence-based, systematic, literature review was conducted to compile evidence for the benefits and harms associated with JIA treatments. The core leadership team identified researchers and clinicians with expertise in JIA management in Egypt upon which Experts were gathered from different governorates and health centres across Egypt. Delphi process was implemented (2-rounds) to reacha consensus on the management recommendations of Egyptian JIA patients. Results: An online questionnaire were sent to expert panel (n = 27), of whom 26 participated in the two rounds. At the end of round 2, a total of eighteen (18) recommendation items, categorized into 4 sections to address the main 4 JIA categories, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.2–100% (average 86.8%). Consensus was reached (i.e. ≥75% of respondents strongly agreed or agreed) on the wording of all the 18 clinical standards identified by the scientific committee. Algorithms for the management of JIA polyarthritis, oligoarthritis and systemic JIA have been suggested.
Conclusion
A wide and representative panel of experts established a consensus regarding the management of JIA in Egypt. The developed guidelines provide a comprehensive approach to the management of JIA for ll Egyptian healthcare professionals who are involved in its management for follow up and frequent evaluation of these guidelines.
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Salah S, Lotfy H, Hassan M, Abdulhady H, Salah H, El Gaafary M, Abd El-Latif E, Farag Y, Eissa M, Esam Maher S, Radwan A, El-Shanawany AT, Medhat BM, El Mikkawy D, Mosa DM, El Deriny G, Mortada M, Osman NS, Fouad NA, Elkaraly NE, Mohamed SS, Tabra S, Hassan WA, Amer Y, Nasef SI, El Miedany Y. P050 Consensus based practice guidelines for the management and treatment of Juvenile familial Mediterranean fever: the Egyptian College of Paediatric Rheumatology initiative. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.042] [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: 11/12/2022] Open
Abstract
Abstract
Background
Familial Mediterranean fever (FMF) is the most common monogenic auto-inflammatory disease, with the highest prevalence amongst Mediterranean countries including Egypt (where there is high carrier rate of MEFV gene), characterized by recurrent attacks of fever and polyserositis. Mutations in the MEFV gene encoding pyrin has been associated with the disease, which causes exaggeration of the inflammatory response through uncontrolled interleukin production. Issuing updated treatment recommendations are vital for the treating healthcare professionals to get well acquainted with its diagnosis & treatment. To produce consensus-based recommendations to guide the early diagnosis, management and follow-up of patients with FMF.
Methods
The Patient/Population, Intervention, Comparison, and Outcomes (PICO) questions were developed and refined by the core team.
A qualitative synthesis of scientific evidence based on systematic review and clinical experience was conducted to compile evidence for the diagnosis and management of FMF.
A consensus process was conducted among the expert panel to generate the final recommendations and grade their strength.
3 rounds of Delphi process were carried out.
Results
Following 3 Delphi rounds, recommendations were developed for: early diagnosis, who to treat, treatment targets, genetic testing and its interpretation in association with clinical presentation, treatment of FMF and dealing with acute attacks, monitoring of management, identify treatment response, systemic affection, persistent attacks or inflammation, resistant cases, protracted symptoms, as well as remission status.
Algorithm for patients’ diagnosis and management is provided.
The final document comprises 12 recommendations, each presented with its degree of agreement (0–10), Level of agreement, grade of recommendation and rationale. The degree of agreement was >7/10 in all instances.
Conclusion
This guideline provides comprehensive approach to the accurate diagnosis and effective management/monitoring of FMF. It also represents a model for the incorporation of medical genetics practice into the more traditional domains of general medicine.
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Tibaldi J, Pistorio A, Aldera E, Puzone L, El Miedany Y, Pal P, Giri PP, De H, Khubchandani R, Chavan PP, Vilaiyuk S, Lerkvaleekul B, Yamsuwan J, Sabui TK, Datta P, Pardeo M, Bracaglia C, Sawhney S, Mittal S, Hassan WA, Elderiny GF, Abu-Zaid MH, Eissa M, Sztajnbok F, das Neves Sztajnbok FC, Russo R, Katsicas MM, Cimaz R, Marrani E, Alexeeva E, Dvoryakovskaya TM, Alsuweiti MO, Alzyoud RM, Kostik M, Chikova I, Minoia F, Filocamo G, Farag Y, Lotfy H, Nasef SI, Al-Mayouf SM, Maggio MC, Magalhaes CS, Gallizzi R, Conti G, Shimizu M, Civino A, Felici E, Giancane G, Ruperto N, Consolaro A, Ravelli A. Development and initial validation of a composite disease activity score for systemic juvenile idiopathic arthritis. Rheumatology (Oxford) 2021; 59:3505-3514. [PMID: 32829413 DOI: 10.1093/rheumatology/keaa240] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 12/31/2019] [Revised: 04/06/2020] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To develop a composite disease activity score for systemic JIA (sJIA) and to provide preliminary evidence of its validity. METHODS The systemic Juvenile Arthritis Disease Activity Score (sJADAS) was constructed by adding to the four items of the original JADAS a fifth item that aimed to quantify the activity of systemic features. Validation analyses were conducted on patients with definite or probable/possible sJIA enrolled at first visit or at the time of a flare, who had active systemic manifestations, which should include fever. Patients were reassessed 2 weeks to 3 months after baseline. Three versions were examined, including ESR, CRP or no acute-phase reactant. RESULTS A total of 163 patients were included at 30 centres in 10 countries. The sJADAS was found to be feasible and to possess face and content validity, good construct validity, satisfactory internal consistency (Cronbach's alpha 0.64-0.65), fair ability to discriminate between patients with different disease activity states and between those whose parents were satisfied or not satisfied with illness outcome (P < 0.0001 for both), and strong responsiveness to change over time (standardized response mean 2.04-2.58). Overall, these properties were found to be better than those of the original JADAS and of DAS for RA and of Puchot score for adult-onset Still's disease. CONCLUSION The sJADAS showed good measurement properties and is therefore a valid instrument for the assessment of disease activity in children with sJIA. The performance of the new tool should be further examined in other patient cohorts that are evaluated prospectively.
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Affiliation(s)
- Jessica Tibaldi
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Angela Pistorio
- Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Elena Aldera
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Laura Puzone
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | | | - Priyankar Pal
- Pediatric Rheumatology Division, Institute of Child Health, Kolkata, India
| | | | - Hriday De
- Pediatric Rheumatology Division, Institute of Child Health, Kolkata, India
| | - Raju Khubchandani
- Section of Pediatric Rheumatology, SRCC Children's Hospital, Mumbai, India
| | | | - Soamarat Vilaiyuk
- Rheumatology Division, Pediatric Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Butsabong Lerkvaleekul
- Rheumatology Division, Pediatric Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jutamas Yamsuwan
- Rheumatology Division, Pediatric Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tapas K Sabui
- Pediatric Rheumatology Clinic, R G Kar Medical College, Kolkata, India
| | - Pragati Datta
- Pediatric Rheumatology Clinic, R G Kar Medical College, Kolkata, India
| | - Manuela Pardeo
- Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Claudia Bracaglia
- Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Sujata Sawhney
- Division of Pediatric Rheumatology, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India
| | - Sumidha Mittal
- Division of Pediatric Rheumatology, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India
| | | | | | | | - Mervat Eissa
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Flavio Sztajnbok
- Pediatric Rheumatology Division, Adolescent Health Care Unit, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ricardo Russo
- Servicio de Inmunología y Reumatología, Hospital de Pediatría Garrahan, Buenos Aires, Argentina
| | - María Martha Katsicas
- Servicio de Inmunología y Reumatología, Hospital de Pediatría Garrahan, Buenos Aires, Argentina
| | - Rolando Cimaz
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Edoardo Marrani
- Division of Rheumatology, University Hospital Meyer, Florence, Italy
| | - Ekaterina Alexeeva
- Rheumatology Division, National Medical Research Center of Children's Health, Moscow, Russian Federation.,Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Tatyana M Dvoryakovskaya
- Rheumatology Division, National Medical Research Center of Children's Health, Moscow, Russian Federation.,Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Motasem O Alsuweiti
- Department of Immunology, Rheumatology and Allergy, Queen Rania Children's Hospital, Amman, Jordan
| | - Ra'ed M Alzyoud
- Department of Immunology, Rheumatology and Allergy, Queen Rania Children's Hospital, Amman, Jordan
| | - Mikhail Kostik
- Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Irina Chikova
- Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Francesca Minoia
- UOC Pediatria a Media Intensità di Cure, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Filocamo
- UOC Pediatria a Media Intensità di Cure, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Yomna Farag
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala Lotfy
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samah Ismail Nasef
- Rheumatology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Sulaiman M Al-Mayouf
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Maria Cristina Maggio
- Dipartimento Promise G. D'Alessandro, Università degli Studi di Palermo, Palermo, Italy
| | - Claudia Saad Magalhaes
- Pediatric Department, Hospital das Clínicas - Botucatu Medicine University, UNESP, Botucatu, Brazil
| | - Romina Gallizzi
- UOC Pediatria, Servizio di Immuno-Reumatologia Pediatrica, Azienda Ospedaliera Universitaria Gaetano Martino Messina, Messina, Italy
| | - Giovanni Conti
- UO Nefrologia e Reumatologia Pediatrica, Azienda Ospedaliera Universitaria Gaetano Martino, Messina, Italy
| | - Masaki Shimizu
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Adele Civino
- Pediatric Unit, Ospedale Vito Fazzi, Lecce, Italy
| | - Enrico Felici
- Pediatric Unit, AON SS Antonio e Biagio e Cesare Arrigo Children's Hospital, Alessandria, Italy
| | - Gabriella Giancane
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Nicolino Ruperto
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Alessandro Consolaro
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Angelo Ravelli
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy.,Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Behiry EG, Kamal HM, Rahman AA, Eissa HA, Hassan WA, Hassan ZG, Shafeek MM, El-Fallah AA. Association of genetic variants of interleukin-1β gene -511T/C (rs16944) and +3954C/T (rs1143634) and serum levels of pentaxin (PTX3) and interleukin -1β (IL-1β) with disease activity of systemic lupus erythematosus patients. Gene Reports 2020. [DOI: 10.1016/j.genrep.2020.100960] [Citation(s) in RCA: 1] [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: 12/30/2022]
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15
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Hassan WA, Medhat BM, Youssef MM, Farag Y, Mostafa N, Alnaggar AR, Behiry ME, Abdel Noor RA, Allam RSHM. Characteristics, evolution, and outcome of patients with non-infectious uveitis referred for rheumatologic assessment and management: an Egyptian multicenter retrospective study. Clin Rheumatol 2020; 40:1599-1610. [PMID: 32876781 DOI: 10.1007/s10067-020-05362-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/29/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the characteristics, evolution, and visual outcome of non-infectious uveitis. METHODOLOGY Records of 201 patients with non-infectious uveitis (136 (67.7%) males and 84 (41.8%) juvenile-onset (≤ 16 years)) were retrospectively reviewed. Data were analyzed through Kruskal-Wallis and Mann-Whitney, chi-square (χ2) tests, and logistic regression. RESULTS The median disease and follow-up durations were 36 (interquartile range (IQR) 24-70) and 24 (IQR 10-36) months, respectively. Fifty-eight (28.9%) patients had persistently idiopathic uveitis, and 143 (71.1%) were associated with rheumatic diseases, of whom uveitis heralded, coincided with, and succeeded the rheumatic manifestation(s) in 62/143 (43.4%), 37/143 (25.9%), and 44/143 (30.7%) patients, respectively. Established rheumatic diseases were Behçet's disease (103/201 (51.2%)), juvenile idiopathic arthritis (13/201 (6.5%)), sarcoidosis (8/201 (4%)), seronegative spondyloarthropathy (7/201 (3.5%)), and Vogt-Koyanagi-Harada (7/201 (3.5%)), and other diagnoses were present in 5/201 (2.5%) patients. Patients with idiopathic uveitis were characterized by a juvenile-onset (p < 0.001), lower male predominance (p = 0.01), prevalent granulomatous (p < 0.001), and anterior (p = 0.001) uveitis. The median visual acuity at last visit was 0.3 (IQR 0.05-0.6). Visual loss was present in 45/201 (22.3%) patients (36/201 (17.9%) unilateral and 9/201 (4.4%) bilateral). Apart from a longer disease duration (p = 0.002), lower educational level (p = 0.03), and prevalent panuveitis (p < 0.001), visual loss was not associated with any other studied ocular or extra-ocular characteristics. CONCLUSION Behçet's disease (51.2%) and idiopathic uveitis (28.9%) were the most prevalent causes of non-infectious uveitis in our study. Visual loss (22.3%) was associated with a longer disease duration, lower education level, and prevalent panuveitis. Key Points • Most common causes of uveitis referred to rheumatologists were Behçet's disease and idiopathic uveitis. • Several rheumatic diseases initially presented only with uveitis, more commonly in adult and male patients. • Panuveitis was more frequent among patients with an established rheumatic disease, whereas granulomatous uveitis was uncommon. • Longer disease duration and presence of panuveitis were independently associated with visual loss.
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Affiliation(s)
- Waleed A Hassan
- Rheumatology, Rehabilitation, and Physical Medicine Department, Faculty of Medicine, Benha University, Farid Nada St, Benha, 13518, Egypt.
| | - Basma M Medhat
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha M Youssef
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yomna Farag
- Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Mostafa
- Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alshaimaa R Alnaggar
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mervat E Behiry
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.,Armed Forces College of Medicine (AFCM), Cairo, Egypt
| | - Rasha A Abdel Noor
- Internal Medicine-Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Riham S H M Allam
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Noor-eldeen E, Hassan WA, Behiry EG, El-monem AEHA. Serum, synovial and mRNA expression of interleukin-33 in juvenile idiopathic arthritis patients: Potential role as a marker of disease activity and relation to musculoskeletal ultrasound. The Egyptian Rheumatologist 2020; 42:225-230. [DOI: 10.1016/j.ejr.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Hassan WA, Behiry EG, Abdelshafy S, Salem T, Baraka EA. Assessment of Endocan Serum Level in Patients with Behçet Disease: Relation to Disease Activity and Carotid Intima Media Thickness. Egypt J Immunol 2020; 27:129-139. [PMID: 33180395] [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: 06/11/2023]
Abstract
Behçet disease (BD) is a form of vasculopathy that can influence blood vessels of variable diameters. Endocan is a biomarker of endothelial activation and it is secreted from endothelial cells as a soluble proteoglycan. The aim of the work was to assess endocan serum level in patients with BD and to examine its relationship with disease activity parameters and carotid intima media thickness (IMT). The study encompassed 42 patients with BD (25 males and 17 females) diagnosed according to the International Study Group Criteria of BD and 42 age and sex matched apparently healthy volunteers as controls. Human Endothelial cell-specific Molecule-1 (Endocan) was assessed using ELISA. Carotid mean IMT was calculated by Color Doppler ultrasonography. Thickness measurement more than 1 mm was considered abnormal:BD patients had significantly increased endocan serum levels (median, 249.5; IQR, 174 - 445 ng/l) compared to healthy controls (median, 190.5; IQR, 128 - 235 ng/l, P=0.002), endocan serum level was increased in BD patients with active disease (median, 434; IQR, 246 - 617.5 ng/l) compared to those with inactive disease (median, 195.5; IQR, 145 - 235 ng/l, P < 0.001) and healthy controls (P < 0.001). Endocan serum levels showed significant positive correlations with erythrocyte sedimentation rate (P=0.04), C-reactive protein (P < 0.001), BD Current Activity form (P < 0.001) and carotid IMT (P=0.008). In conclusion, Endocan can be used to monitor disease activity and endothelial dysfunction in BD.
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Affiliation(s)
- Waleed A Hassan
- Department of Rheumatology, Rehabilitation & Physical Medicine, Faculty of Medicine, Benha University, Benha, Egypt
| | - Eman G Behiry
- Department of Clinical & Chemical Pathology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Shorouk Abdelshafy
- Department of Diagnostic Radiology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Tamer Salem
- Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Eman A Baraka
- Department of Rheumatology, Rehabilitation & Physical Medicine, Faculty of Medicine, Benha University, Benha, Egypt
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Yakubu A, Bamidele O, Hassan WA, Ajayi FO, Ogundu UE, Alabi O, Sonaiya EB, Adebambo OA. Farmers' choice of genotypes and trait preferences in tropically adapted chickens in five agro-ecological zones in Nigeria. Trop Anim Health Prod 2019; 52:95-107. [PMID: 31313015 PMCID: PMC6969870 DOI: 10.1007/s11250-019-01993-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 03/26/2019] [Accepted: 06/21/2019] [Indexed: 11/24/2022]
Abstract
This study aimed at determining chicken genotypes of choice and traits preference in chicken by smallholder farmers in Nigeria. Data were obtained from a total of 2063 farmers using structured questionnaires in five agro-ecological zones in Nigeria. Chi square (χ2) statistics was used to explore relationships between categorical variables. The mean ranks of the six genotypes and twelve traits of preference were compared using the non-parametric Kruskal-Wallis H (with Mann-Whitney U test for post hoc separation of mean ranks), Friedman, and Wilcoxon signed-rank (with Bonferroni's adjustments) tests. Categorical principal component analysis (CATPCA) was used to assign farmers into groups. Gender distribution of farmers was found to be statistically significant (χ2 = 16.599; P ≤ 0.002) across the zones. With the exception of Shika Brown, preferences for chicken genotypes were significantly (P ≤ 0.01) influenced by agro-ecological zone. However, gender differentiated response was only significant (P ≤ 0.01) in Sasso chicken with more preference by male farmers. Overall, FUNAAB Alpha, Sasso, and Noiler chicken were ranked 1st, followed by Kuroiler (4th), Shika Brown (5th), and Fulani birds (6th), respectively. Within genotypes, within and across zones and gender, preferences for traits varied significantly (P ≤ 0.005 and P ≤ 0.01). Traits of preference for selection of chicken breeding stock tended towards body size, egg number, egg size, and meat taste. Spearman's rank order correlation coefficients of traits of preference were significant (P ≤ 0.01) and ranged from 0.22 to 0.90. The two PCs extracted, which explained 65.3% of the variability in the dataset, were able to assign the farmers into two groups based on preference for body size of cock and hen and the other ten traits combined. The present findings may guide the choice of appropriate chicken genotypes while the traits of economic importance may be incorporated into future genetic improvement and conservation programs in Nigeria.
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Affiliation(s)
- A Yakubu
- Department of Animal Science, Faculty of Agriculture, Nasarawa State University, Keffi, Shabu-Lafia Campus, Lafia, Nasarawa, Nigeria.
| | - O Bamidele
- African Chicken Genetic Gains (ACGG) Project National Secretariat, Department of Animal Science, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
| | - W A Hassan
- Department of Animal Science, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
| | - F O Ajayi
- Department of Animal Science, University of Port-Harcourt, Rivers State, Nigeria
| | - U E Ogundu
- Department of Animal Science, Federal University of Technology, Owerri, Imo, Nigeria
| | - O Alabi
- Department of Animal Science, Landmark University, Omu-Aran, Kwara, Nigeria
| | - E B Sonaiya
- African Chicken Genetic Gains (ACGG) Project National Secretariat, Department of Animal Science, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
| | - O A Adebambo
- Department of Animal Breeding and Genetics, Federal University of Agriculture, Abeokuta, Ogun, Nigeria
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Hassan WA, Hamaad GA, Sayed EA, El Behisy MM, Gomaa MK. Clinical significance of interleukin 27 serum concentration in patients with systemic sclerosis: relation to clinical, laboratory and radiological parameters. Egypt Rheumatol Rehabil 2019. [DOI: 10.4103/err.err_63_18] [Citation(s) in RCA: 2] [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: 12/30/2022] Open
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Frusca T, Parolini S, Dall'Asta A, Hassan WA, Vitulo A, Gillett A, Pasupathy D, Lees CC. Fetal size and growth velocity in chronic hypertension. Pregnancy Hypertens 2017; 10:101-106. [PMID: 29153660 DOI: 10.1016/j.preghy.2017.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate longitudinal fetal growth and growth velocity for commonly measured biometric parameters in women with chronic hypertension. METHODS Two centre retrospective European study of women with chronic hypertension ascertained at pregnancy booking. Ultrasound measurements of head circumference (HC), abdominal circumference (AC) and femur length (FL) were used to derive longitudinal fetal growth charts derived using functional linear discriminant analysis (FLDA). These were compared to existing cross sectional and longitudinal charts, as was birthweight. RESULTS 282 women with a median of 3 third trimester ultrasound examinations were included. Gestation at delivery was 37.5weeks (SD 2.68), birthweight 3049g (SD 785). Birthweight <10th percentile found in 15.6% deliveries, >90th percentile 20.2%. Fetal size curves derived from women with chronic hypertension were no different to cross sectional and longitudinal charts for a normal population. Compared to a standard longitudinal biometry chart, growth velocity (mm/day) in chronic hypertension was higher for AC and FL at 30-32weeks (AC 1.447vs 1.357 p<0.05; FL 0.296vs 0.269 p<0.01) and 34-36weeks (AC 1.325vs 1.140 p<0.01; FL 0.248vs 0.198 p<0.01). CONCLUSIONS In women with chronic hypertension there is an excess of both SGA and LGA babies compared to population standards. Growth velocity of the AC and FL was greater after 30weeks compared to a normal population.
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Affiliation(s)
- T Frusca
- Obstetrics and Gynecology Unit, University of Parma, Italy
| | | | - A Dall'Asta
- Obstetrics and Gynecology Unit, University of Parma, Italy; Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital/Imperial College, Imperial College Healthcare NHS Trust, Hammersmith Campus, Du Cane Road, London W12 0HS, United Kingdom
| | - W A Hassan
- Addenbrooke's Hospital, Cambridge CB2 2QQ, United Kingdom; Colchester Hospital University Foundation Trust, United Kingdom
| | | | - A Gillett
- Institute of Psychiatry, King's College London, United Kingdom
| | - D Pasupathy
- Division of Women's Health, Women's Health Academic Centre KHP, King's College London, United Kingdom
| | - C C Lees
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital/Imperial College, Imperial College Healthcare NHS Trust, Hammersmith Campus, Du Cane Road, London W12 0HS, United Kingdom; Addenbrooke's Hospital, Cambridge CB2 2QQ, United Kingdom; Department of Development and Regeneration, University Hospitals Leuven, Campus Gasthuisberg, KU Leuven, B-3000 Leuven, Belgium.
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Soliman AF, El-Olemy GG, Hassan WA, Shaker RHM, Abdullah OA. Impact of an intensive dynamic exercise program on oxidative stress and on the outcome in patients with fibromyalgia. Egypt Rheumatol Rehabil 2016. [DOI: 10.4103/1110-161x.189642] [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: 01/24/2023] Open
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El-Brashy AEWS, El-Tanawy RM, Hassan WA, Shaban HM, Bhnasawy MMI. Potential role of vitamin K in radiological progression of early knee osteoarthritis patients. The Egyptian Rheumatologist 2016. [DOI: 10.1016/j.ejr.2016.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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El Tanawy RM, Belal KM, Hassan WA, Said EA, Hafez SM. Erratum: Assessment of serum antimutated citrullinated vimentin antibodies in rheumatoid arthritis. Egypt Rheumatol Rehabil 2016. [DOI: 10.4103/1110-161x.181882] [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: 11/04/2022] Open
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Baraka EA, Hassan WA. Musculoskeletal ultrasonographic evaluation of lower limb enthesopathy in ankylosing spondylitis and Behçet’s disease: Relation to clinical status and disease activity. Egypt Rheumatol Rehabil 2016. [DOI: 10.4103/1110-161x.189828] [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: 11/04/2022] Open
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Eggebø TM, Hassan WA, Salvesen KÅ, Torkildsen EA, Østborg TB, Lees CC. Prediction of delivery mode by ultrasound-assessed fetal position in nulliparous women with prolonged first stage of labor. Ultrasound Obstet Gynecol 2015; 46:606-610. [PMID: 25536955 DOI: 10.1002/uog.14773] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 09/22/2014] [Accepted: 12/16/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To ascertain if fetal head position on transabdominal ultrasound is associated with delivery by Cesarean section in nulliparous women with a prolonged first stage of labor. METHODS This was a prospective observational study performed at Stavanger University Hospital, Norway, and Addenbrooke's Hospital, Cambridge, UK, between January 2012 and April 2013. Nulliparous pregnant women with a singleton cephalic presentation at term and prolonged labor had fetal head position assessed by ultrasound. The main outcome was Cesarean section vs vaginal delivery, and secondary outcomes were association of fetal head position with operative vaginal delivery and duration of remaining time in labor. RESULTS Fetal head position was assessed successfully by ultrasound examination in 142/150 (95%) women. In total, 19/50 (38%) women with a fetus in the occiput posterior (OP) position were delivered by Cesarean section compared with 16/92 (17%) women with a fetus in a non-OP position (P = 0.01). On multivariable logistic regression analysis, the OP position predicted delivery by Cesarean section with an odds ratio (OR) of 2.9 (95% CI, 1.3-6.7; P = 0.01) and induction of labor with an OR of 2.4 (95% CI, 1.0-5.6; P = 0.05). Fetal head position was not associated with operative vaginal delivery or with remaining time in labor. The agreement between a digital and an ultrasound assessment of OP position was poor (Cohen's kappa = 0.19; P = 0.18). CONCLUSION OP fetal head position assessed by transabdominal ultrasound was significantly associated with delivery by Cesarean section.
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Affiliation(s)
- T M Eggebø
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
- National Center for Fetal Medicine, Trondheim University Hospital (St Olavs Hospital), Trondheim, Norway
| | - W A Hassan
- Fetal Medicine Department, Rosie Maternity Hospital, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - K Å Salvesen
- Department of Obstetrics and Gynaecology, Clinical Sciences, Lund University, Lund, Sweden
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - E A Torkildsen
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
| | - T B Østborg
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
| | - C C Lees
- Fetal Medicine Department, Rosie Maternity Hospital, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
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Hassan WA, Baraka EA, Fouad NA. Clinical significance of soluble programmed death-1(sPD-1) in rheumatoid arthritis patients: Relation to disease activity and functional status. The Egyptian Rheumatologist 2015. [DOI: 10.1016/j.ejr.2014.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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El Tanawy RM, Belal KM, Hassan WA, Said EA, Hafez SM. Assessment of serum antimutated citrullinated vimentin antibodies in rheumatoid arthritis. Egypt Rheumatol Rehabil 2015. [DOI: 10.4103/1110-161x.157862] [Citation(s) in RCA: 2] [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: 01/12/2023] Open
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Hassan WA, Bjerre M, Hjortebjerg R, Magnusson NE, Ramshanker N, Frystyk J. Letter to the editor concerning 'Elevated serum antibodies against insulin-like growth factor-binding protein-2 allow detecting early-stage cancers: evidences from glioma and colorectal carcinoma studies'. Ann Oncol 2014; 26:252-253. [PMID: 25355718 DOI: 10.1093/annonc/mdu491] [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: 11/13/2022] Open
Affiliation(s)
- W A Hassan
- Department of Clinical Medicine, Faculty of Health, Medical Research Laboratory, Aarhus University, Aarhus C
| | - M Bjerre
- Department of Clinical Medicine, Faculty of Health, Medical Research Laboratory, Aarhus University, Aarhus C
| | - R Hjortebjerg
- Department of Clinical Medicine, Faculty of Health, Medical Research Laboratory, Aarhus University, Aarhus C
| | - N E Magnusson
- Department of Clinical Medicine, Faculty of Health, Medical Research Laboratory, Aarhus University, Aarhus C
| | - N Ramshanker
- Department of Clinical Medicine, Faculty of Health, Medical Research Laboratory, Aarhus University, Aarhus C
| | - J Frystyk
- Department of Clinical Medicine, Faculty of Health, Medical Research Laboratory, Aarhus University, Aarhus C;; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark.
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Asker ME, Hassan WA, El-Kashlan AM. Experimentally induced hyperthyroidism influences oxidant and antioxidant status and impairs male gonadal functions in adult rats. Andrologia 2014; 47:644-54. [PMID: 25220112 DOI: 10.1111/and.12312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 05/26/2014] [Indexed: 01/06/2023] Open
Abstract
The objective of the present experiment was to study the effect of hyperthyroidism on male gonadal functions and oxidant/antioxidant biomarkers in testis of adult rats. Induction of hyperthyroidism by L-thyroxine (L-T4, 300 μg kg(-1) body weight) treatment once daily for 3 or 8 weeks caused a decrease in body weight gain as well as in absolute genital sex organs weight. The epididymal sperm counts and their motility were significantly decreased in a time-dependent manner following L-T4 treatment. Significant decline in serum levels of luteinising hormone, follicle stimulating hormone and testosterone along with significant increase in serum estradiol level was observed in hyperthyroid rats compared with euthyroid ones. Significant increase in malondialdehyde and nitric oxide concentration associated with significant decrease in superoxide dismutase and catalase activity was also noticed following hyperthyroidism induction. Both reduced glutathione content and glutathione peroxidase activity were increased in hyperthyroid rats compared with control rats. Marked histopathological alterations were observed in testicular section of hyperthyroid rats. These results provide evidence that hypermetabolic state induced by excess level of thyroid hormones may be a causative factor for the impairment of testicular physiology as a consequence of oxidative stress.
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Affiliation(s)
- M E Asker
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - W A Hassan
- Hormone Evaluation Department, National Organization for Drug Control and Research, Giza, Egypt
| | - A M El-Kashlan
- Hormone Evaluation Department, National Organization for Drug Control and Research, Giza, Egypt
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Eggebø TM, Hassan WA, Salvesen KÅ, Lindtjørn E, Lees CC. Sonographic prediction of vaginal delivery in prolonged labor: a two-center study. Ultrasound Obstet Gynecol 2014; 43:195-201. [PMID: 24105705 DOI: 10.1002/uog.13210] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/03/2013] [Accepted: 09/06/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To investigate whether head-perineum distance (HPD) measured by transperineal ultrasound is predictive of vaginal delivery and time remaining in labor in nulliparous women with prolonged first stage of labor and to compare the predictive value with that of angle of progression (AoP). METHODS This was a prospective observational study at Stavanger University Hospital, Norway and Addenbrooke's Hospital, Cambridge, UK from January 2012 to April 2013, of nulliparous women with singleton pregnancies with cephalic presentation at term with prolonged first stage of labor. We used transperineal ultrasound to measure HPD (shortest distance between the outer bony limit of the fetal skull and the perineum) and AoP (angle between a line through the long axis of the symphysis and the tangent to the fetal head) and transabdominal ultrasound to classify fetal head position. The main outcomes were vaginal delivery and time remaining in labor. RESULTS Of 150 women enrolled, 39 underwent delivery by Cesarean section. The area under the receiver-operating characteristics curve for the prediction of vaginal delivery was 81% (95% CI, 73-89%) using HPD as the test variable and 72% (95% CI, 63-82%) using AoP. HPD was ≤ 40 mm in 84 (56%) women, of whom 77 (92%; 95% CI, 84-96%) delivered vaginally. HPD was > 40 mm in the other 66 (44%) women, of whom 34 (52%; 95% CI, 40-63%) delivered vaginally. AoP was ≥ 110° in 84 of the 145 (58%) in whom this was available and, of these, 74 (88%; 95% CI, 79-93%) delivered vaginally. AoP was < 110° in the other 61 (42%) women, of whom 35 (57%; 95% CI, 45-69%) delivered vaginally. Multivariable logistic regression analysis showed that HPD ≤ 40 mm (odds ratio (OR), 4.92; 95% CI, 1.54-15.80), AoP ≥ 110° (OR, 3.11; 95% CI, 1.01-9.56), non-occiput posterior position (OR, 3.36; 95% CI, 1.24-9.12) and spontaneous onset of labor (OR, 4.44; 95% CI, 1.42-13.89) were independent predictors for vaginal delivery. Both ultrasound methods were predictive for the time remaining in labor. CONCLUSION Transperineal ultrasound measurement of HPD and AoP provide important information about the likelihood of vaginal delivery and the time remaining in labor in nulliparous women with prolonged labor.
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Affiliation(s)
- T M Eggebø
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway; National Center for Fetal Medicine, Trondheim University Hospital (St Olavs Hospital), Trondheim, Norway
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Hassan WA, Eggebø T, Ferguson M, Gillett A, Studd J, Pasupathy D, Lees CC. The sonopartogram: a novel method for recording progress of labor by ultrasound. Ultrasound Obstet Gynecol 2014; 43:189-194. [PMID: 24105734 DOI: 10.1002/uog.13212] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/05/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Progress of labor has hitherto been assessed by digital vaginal examination (VE). We introduce the concept of a non-intrusive ultrasound (US)-based assessment of labor progress (the 'sonopartogram') and investigate its feasibility for assessing cervical dilatation and fetal head descent and rotation. METHODS This was a prospective study performed in 20 women in the first stage of labor in two European maternity units. Almost simultaneous assessment of cervical dilatation and fetal head descent and rotation were made by US and digital VE. RESULTS The total number of paired US and digital VE assessments was 52, with a median of three per woman. Overall, 5% of sonopartogram parameters were not obtained compared with 18% of conventional digital VE parameters (P < 0.001). Assessment of cervical dilatation was possible in 86.5% of US examinations and 100% of digital VEs (P = 0.02), and dilatation was assessed as being greater by digital VE than by US (mean difference, 1.16 (95% limits of agreement, -0.76, 3.08) cm, r(2) = 0.68, P = 0.01). Fetal head descent was measured in all 52 cases by both methods (r(2) = 0.33, P < 0.001), but correlation between the two was only moderate. Head rotation was obtainable in 98% of US examinations and 46% of digital VEs (P < 0.001), with a mean difference of -3.9° (95% limits of agreement, -144.1°, 136.3°). CONCLUSION In this proof-of-concept study, the acquisition of data regarding progress of labor was more successful for the sonopartogram than the conventional partogram. The agreement between digital VE and US was good for cervical dilatation and head rotation but less so for head descent. US assessment of the progress of labor is feasible in most cases.
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Affiliation(s)
- W A Hassan
- Fetal Medicine Department, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Alberry M, Hassan WA, Goodburn S, Brockelsby J, Wladimiroff J, Nash R, Lees C. The impact of national guidance for anomaly screening and invasive testing: unintended consequences. Arch Dis Child Fetal Neonatal Ed 2014; 99:F83-6. [PMID: 23833074 DOI: 10.1136/archdischild-2013-303914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Recent guidance from the UK National Screening Committee (NSC) and the Fetal Anomaly Screening Programme (FASP) has led to important changes in prenatal ultrasound diagnosis and invasive testing. These relate to prenatal ultrasound investigation of what were previously known as 'soft markers' for Down's syndrome at the time of the detailed anomaly scan and as to whether full karyotype or FISH (fluorescent in situ hybridisation)/QFPCR (quantitative fluorescence PCR) testing for trisomies should be carried out when an invasive test is performed. Neither recommendation is directly related to the other but both in combination could have profound implications for the detection of chromosomal abnormalities other than trisomy 21 (Down's syndrome). In the light of two cases recently managed in one regional fetal medicine unit, we retrospectively reviewed cases where, with correct application of the NSC and FASP recommendations, non-lethal and clinically important chromosomal abnormalities would most likely not have been detected.
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Affiliation(s)
- M Alberry
- Department of Fetal Medicine, Rosie Hospital, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, , Cambridge, UK
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Fouad NA, Baraka EA, Hassan WA. Interleukin-18 gene polymorphisms in systemic lupus erythematosus: relation to disease status. Egypt J Immunol 2014; 21:1-12. [PMID: 25204040] [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: 06/03/2023]
Abstract
Systemic lupus erythematosus (SLE) is a multisystem autoimmune connective tissue disorder characterized by loss of self-tolerance causing immune-mediated tissue destruction and various clinical presentations Interleukin-18 (IL-18) is a proinflammatory cytokine that plays an important role in chronic inflammation and autoimmune disorders. This study investigates polymorphisms of the IL-18 gene in SLE patients at positions -607 and -137 of the promoter to elucidate their possible roles in the activity and severity of this disease. Fifty SLE patients and fifty unrelated healthy control group were included. AII SLE patients underwent thorough clinical examination and SLE disease activity assessment using SLEDAI. Genomic DNA was extracted from peripheral venous blood. Sequence-specific primer PCR analysis were used to genotype the DNA samples for SNP-607and SNP-137, while plasma IL-18 concentrations of patients and control subjects were measured by enzyme-linked immunosorbent assay. The frequency of SNP-607/CC genotype showed significant increase (P < 0.05), while genotype SNP-607/CA showed significant decrease (P < 0.05) in SLE patients as compared to the control group. Significantly elevated levels of plasma IL-18 were found in patients compared to controls (P < 0.001) and those with genotype CC at -607 demonstrated the highest IL-18 level (331.74 +/- 36.48 pg/mL). Serum IL-18 levels showed significant positive correlations with the ESR 1st hr. (r = 0.89), protein/creatinine ratios (r = 0.88), anti-dsDNA titers (r = 0.44) and SLEDAI scores (r = 0.91). In contrast, significant negative correlations were found with HB% r = -0.68, creatinine clearance (r = -0.87) and C3 (r = -0.81). In addition, a statistically significant association was found between IL-18 of CC -607 genotype and lupus nephritis, arthritis and immunological disorders. In conclusion, IL-18 promoter gene polymorphisms at position -607 may contribute to SLE activity and accelerate SLE development by enhancing production of IL-18 protein in SLE patients.
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Hassan WA, Eggebø TM, Ferguson M, Lees C. Simple two-dimensional ultrasound technique to assess intrapartum cervical dilatation: a pilot study. Ultrasound Obstet Gynecol 2013; 41:413-418. [PMID: 23024020 DOI: 10.1002/uog.12316] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To describe a two-dimensional (2D) ultrasound technique to measure cervical dilatation in labor, and to compare ultrasound with digital measurements. METHODS 2D transperineal ultrasound was performed in 21 nulliparous women in labor with a singleton fetus in cephalic presentation and cervical dilatation measured before or after a digital vaginal examination. The absolute difference was calculated and Bland-Altman analysis was used to assess the mean difference between digital vaginal examination and ultrasound examination of cervical dilatation. Pearson analysis was used to determine the correlation between digital and ultrasound measurements. Intraclass correlation coefficients (ICCs) with 95% CI were used to evaluate the reliability of the two methods. RESULTS Satisfactory quality images of the cervix were obtained in 19 of 21 cases. There was positive correlation between 2D ultrasound measurement of cervical dilatation and digital vaginal examination (Pearson coefficient r = 0.821, n = 19, P < 0.001). Bland-Altman analysis showed a mean difference between digital and ultrasound measurements of 0.08 cm (95% limits of agreement: -1.83 to 2.00) and the mean absolute difference was 1.24 cm. The ICC between the two methods was 0.81 (95% CI, 0.58-0.92). CONCLUSIONS Assessment and measurement of cervical dilatation by 2D transperineal ultrasound is feasible, with close agreement shown between the technique and digital vaginal examination. The technique that we describe could represent an important component of a 'sonopartogram' for ultrasound assessment of labor progress.
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Affiliation(s)
- W A Hassan
- Fetal Medicine Department, Rosie Maternity Hospital, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Abstract
The aim of this investigation was to study the epidemiologic and genetic aspects of mental subnormality (MS) in Assiut Governorate, representing the Egyptian population. The sample comprised 3000 randomly selected subjects from three localities: one urban (Assiut City) and two adjacent rural villages. Age-matched controls were chosen for comparison. The Stanford-Binet test was administered to each individual. During history-taking special attention was paid to consanguinity and categorization on a genetic basis. The results revealed 116 cases with MS, showing an overall prevalence of 3.9%, which varied in the three locations: 3.4% in Assiut City, and 3.8% and 4.4% in the two rural locations. Clinico-genetic classification revealed the following: idiopathic MS 27.6%, MCA/MR syndromes 24.1%, primary CNS defect 12.9%, Martin-Bell syndrome 10.3%, inborn errors of metabolism 9.5%, tetratogenic and environmental causes 5.2%, MS and epilepsy 4.3%, chromosomal disorders 3.4% and MS associated with psychiatric disorder 2.6%. Parental consanguinity was found in 65% of the total sample, which emphasizes the role played by that factor in the etiology of mental subnormality in Egypt.
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Affiliation(s)
- S A Temtamy
- Department of Human Genetics, National Research Center, Cairo, Egypt
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