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Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第7期30卷 742-758页

作者： Eyad Gadour abeer awad Zeinab Hassan Khalid Jebril Shrwani Bogdan Miutescu Hussein Hassan Okasha Department of Gastroenterology and Hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia Department of Internal Medicine Faculty of MedicineZamzam University CollegeKhartoum 11113Sudan Department of Hepatogastroenterology Kasar Alainy HospitalFaculty of MedicineCairo UniversityCairo 11451Egypt Department of Internal Medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom Public Health Authority Saudi Center for Disease Prevention and ControlJazan 45142Saudi Arabia Department of Clinical Infection Microbiology and ImmunologyInstitute of Infection and Global HealthSchool of Medicine and Life SciencesUniversity of LiverpoolLiverpoolUnited Kingdom Department of Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 300041Romania Advanced Regional Research Center in Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 30041Romania Department of Internal Medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt

BACKGROUND In hepatology,the clinical use of endoscopic ultrasound(EUS)has experienced a notable increase in recent *** applications range from the diagnosis to the treatment of various liver ***,this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver *** To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and *** PubMed,Medline,Cochrane Library,Web of Science,and Google Scholar databases were extensively searched until October *** methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias *** addition,statistical analyses were performed using the Comprehensive Meta-Analysis *** Overall,45 articles on EUS were included(28 on diagnostic role and 17 on therapeutic role).Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4%for focal liver lesions(FLL)and 96.6%for parenchymal liver ***-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases(3.1%and 8.7%,respectively).Analysis of data from four studies showed that EUS-guided liver abscess had high clinical(90.7%)and technical success(90.7%)without significant ***,EUS-guided interventions for the treatment of gastric varices(GV)have high technical success(98%)and GV obliteration rate(84%)with few complications(15%)and rebleeding events(17%).CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.

关键词： Focal liver lesion Liver abscess drainage Fine needle aspiration Gastric varices Endoscopic ultrasound

Cystic pancreatic lesions,the endless dilemma

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World Journal of Gastroenterology 2021年第21期27卷 2664-2680页

作者： Hussein Hassan Okasha abeer awad Ahmed El-meligui Reem Ezzat Ashraf Aboubakr Sameh AbouElenin Ramy El-Husseiny Ahmed Alzamzamy Department of Internal Medicine and Gastroenterology Hepatology UnitKasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Internal Medicine and Gastroenterology Hepatology UnitAssuit UniversityAssuit 71515Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11441Egypt Department of Gastroenterology and Hepatology Military Medical AcademyCairo 11441Egypt Department of Hepatology and Tropical Medicine National Hepatology and Tropical Medicine Research Institute(NHTMRI)Cairo 11441Egypt

Cystic pancreatic lesions involve a wide variety of pathological entities that include neoplastic and non-neoplastic *** proper diagnosis,differentiation,and staging of these cystic lesions are considered a crucial issue in planning further *** are great challenges for their diagnostic *** our time,new emerging methods for this diagnosis have been *** ultrasonography-guided fine-needle aspiration cytology with chemical and molecular analysis of cyst fluid and EUS-guided fine needlebased confocal laser endomicroscopy,through the needle microforceps biopsy,and single-operator cho-langioscopy/pancreatoscopy are promising methods that have been used in the diagnosis of cystic pancreatic *** we discuss the diagnosis of cystic pancreatic lesions and the benefits of various diagnostic models.

关键词： Pancreatic cystic lesion Endoscopic diagnosis Endoscopic ultrasonography Cyst fluid markers Endoscopic ultrasonography-guided fine needle-based confocal laser endomicroscopy Through the needle microforceps biopsy Single operator cholangioscopy/pancreatoscopy

Low Serum Free Triiodothyronine Is Associated with Increased Risk of Decompensation and Hepatocellular Carcinoma Development in Patients with Liver Cirrhosis

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Open Journal of Gastroenterology 2016年第6期6卷 166-174页

作者： Ula M. Al-Jarhi abeer awad Mona Mohsen Department of Medicine Cairo University Cairo Egypt Department of Chemical Pathology Cairo University Cairo Egypt

Background: FT3 levels in plasma may provide a marker for liver status in cirrhosis. Aim: The aim is to correlate thyroid functions with hepatic status in compensated and decompensated cirrhosis, and to study their effect on development of HCC. Settings and Design: Prospective controlled cohort study. A total of 58 patients with liver cirrhosis were recruited from Kasr AlAiny ER and outpatient clinics. Patients were categorised into compensated (11), decompensated (39) and patients with hepatocellular carcinoma (8). The study also included 12 healthy controls. Methods and Material: Liver function tests, TSH, FT4 and FT3 and abdominal ultrasound and triphasic computed tomography abdominal scans were done. Statistical Analysis Used: Chi-square and unpaired t-tests were used for comparison. One way ANOVA and Kruskal Wallis tests were used to compare more than two groups. Spearman Correlation followed by logistic regression analysis of significant variables was used to find predictors of dependent variables. Results: The frequency of patients with low FT3 was significantly higher in patients with liver cirrhosis (48%), and HCC (50%) than control subjects (12%) (p-value < 0.001). Mean serum FT3 was lowest among decompensated patients (2 pg/ml ± 0.7), followed by patients with HCC (2.5 pg/ml ± 0.7) and highest among compensated patients (3.7 pg/ml ± 0.4), p-value < 0.001. Logistic regression analysis showed that low FT3, male gender, ulcer bleeding and encephalopathy were independently associated with the development of HCC (OR, 95% CI: 1.1, 0.3 - 8). Conclusions: Low FT3 is common among patients with decompensated liver cirrhosis and HCC. FT3 shows a significant negative correlation with severity of liver disease and deterioration of liver function. Low FT3 shows a significant independent association with HCC.

关键词： Liver Cirrhosis Thyroid Functions HCC

Tangled web: Animal-human interaction and the rise of antibiotic resistance

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Infectious Diseases Research 2024年第1期5卷 1-2页

作者： Adel Khalil Ibrahim abeer Abdelnaser awad Doaa Mohammad Ghaith Faculty of Veterinary Medicine Cairo UniversityGiza square 12211Egypt Faculty of Medicine Cairo UniversityAl-Manial 11559CairoEgypt.

Introduction Egypt is a Low-Middle Income Country(LMIC)with a population of 106,472,382 people in August 2022(Worldometers&Department of Economic and Social Affairs,2022).Available evidence suggests that there are misuse/overuse of antibiotic in Egypt[1].On recognizing the global threat of antibiotic resistance(AMR),Egypt launched the National Action Plan(NAP)in *** comprehensive plan,inspired by the Global Action Plan(GAP),united diverse stakeholders like ministries,universities,and international *** NAP tackled AMR through four key strategies:boosting public understanding of antibiotics,optimizing their use across humans and animals,embracing a“One Health”approach,and implementing effective infection prevention practices[2].

关键词： Action boosting resistance

Non-pulmonary involvement in COVID-19:A systemic disease rather than a pure respiratory infection

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World Journal of Clinical Cases 2023年第3期11卷 493-505页

作者： Mohamed El-Kassas Mohamed Alboraie Mohamed Elbadry Reem El Sheemy Mohamed Abdellah Shimaa Afify Ahmad Madkour Mariam Zaghloul abeer awad Mohamed-Naguib Wifi Amira Al Balakosy Mohamed Eltabbakh Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11731Egypt Department of Internal Medicine Al-Azhar UniversityCairo 11884Egypt Department of Tropical Medicine Minia Faculty of MedicineMinia UniversityMinia 61511Egypt Department of Gastroenterology National Hepatology and Tropical Medicine Research InstituteCairo 11451Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineKafrelsheikh UniversityKafrelsheikh 33511Egypt Department of Internal Medicine Hepatogastroenterology UnitKasr Al-Ainy School of MedicineCairo 11451Egypt Department of Tropical Medicine Ain Shams UniversityCairo 11451Egypt

During the early phase of the coronavirus disease 2019(COVID-19)pandemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),diagnosis was difficult due to the diversity in symptoms and imaging findings and the variability of disease *** manifestations are reportedly the main clinical presentations of COVID-19 *** are working hard on a myriad of clinical,epidemiological,and biological aspects to better understand SARS-CoV-2 infection,aiming to mitigate the ongoing *** reports have documented the involvement of various body systems and organs apart from the respiratory tract including the gastrointestinal,liver,immune system,renal,and neurological *** involvement will result in diverse presentations related to effects on these *** presentations such as coagulation defects and cutaneous manifestation may also *** with specific comorbidities including obesity,diabetes,and hypertension have increased morbidity and mortality risks with COVID-19.

关键词： COVID-19 Non-pulmonary Extrapulmonary Clinical manifestations Systemic disease

Barriers for resuming endoscopy service in the context of COVID-19 pandemic:A multicenter survey from Egypt

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World Journal of Gastroenterology 2020年第43期26卷 6880-6890页

作者： Omar Elshaarawy Sameh Aldesoky Lashen Nahed A Makhlouf Doaa Abdeltawab Mariam Salah Zaghloul Rasha M Ahmed Hayam Fathy Shimaa Afifi Muhammad Abdel-Gawad Eman Abdelsameea Sherief Abd-Elsalam Salem Youssef Mohamed Mohammed Tag-Adeen Mina Tharwat Ahmed Alzamzamy Ahmed Nasr Bekhit Alshaimaa M Eid abeer awad Mohamed-Naguib Wifi Mohammad Aamr Waleed A Abd El Dayem Mohamed Alboraie Department of Hepatology Gastroenterology and Liver TransplantationNational Liver InstituteMenoufia UniversityShebine Elkom 32511Egypt Department of Internal Medicine and Center of Alcohol Research and Liver Diseases Salem Medical CenterHeidelberg UniversityHeidelberg 69121Germany Department of Internal Medicine Faculty of MedicineUniversity of AlexandriaAlexandria 21521Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Hepatology Gastroentrology and Infectious DiseasesKafrelsheikh UniversityFaculty of MedicineKafrelsheikh 33565Egypt Department of Internal Medicine Faculty of MedicineAssiut UniversityAssiut 71515Egypt National Hepatology and Tropical Medicine Research Institute Cairo 11638Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineAl-Azhar UniversityAssiut 71524Egypt Department of Tropical Medicine and Infectious Diseases Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Internal Medicine Gastroenterology and Hepatology UnitFaculty of MedicineZagazig UniversityZagazig 44519Egypt Department of Internal Medicine Gastroenterology UnitQena Faculty of MedicineSouth Valley UniversityQena 83523Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAswan UniversityAswan 81528Egypt Department of Gastroenterology and Hepatology Military Medical AcademyCairo 11771Egypt Department of Tropical Medicine Zagazig General HospitalZagazig 42511Egypt Department of Hepatology and Gastroenterology and Infectious Disease Faculty of MedicineAlAzhar UniversityCairo 11562Egypt Department of Internal Medicine Faculty of MedicineCairo UniversityCairo 11759Egypt Department of Hepatology and Gastroentorolgy Shebin Elkom Teaching HospitalShebine Elkom 3521Egypt Department of Tropical Medicine Faculty of MedicineZagazig UniversityZagazig 44519Egypt Department of Internal Medicine Al-Azhar UniversityCairo 11651Egypt

BACKGROUND The current coronavirus disease 2019(COVID-19)pandemic has affected routine endoscopy service across the gastroenterology *** led to the suspension of service provision for elective *** To assess the potential barriers for resuming the endoscopy service in *** A national online survey,four domains,was disseminated over a period of 4 wk in August *** primary outcome of the survey was to determine the impact of the COVID-19 pandemic on the endoscopy service and barriers to the full resumption of a disabled center(s).RESULTS A hundred and thirteen Egyptian endoscopy centers participated in the *** waiting list was increased by≥50% in 44.9% of areas with clusters of COVID-19 cases(n=49)and in 35.5% of areas with sporadic cases(n=62).Thirty nine(34.8%)centers suffered from staff shortage,which was considered a barrier against service resumption by 86.4% of centers in per-protocol *** multivariate analysis,the burden of cases in the unit locality,staff shortage/recovery and the availability of separate designated rooms for COVID-19 cases could markedly affect the resumption of endoscopy practice(P=0.029,<0.001 and 0.02,respectively)and Odd’s ratio(0.15,1.8 and 0.16,respectively).CONCLUSION The COVID-19 pandemic has led to restrictions in endoscopic *** staff shortage/recovery and the availability of COVID-19 designed rooms are the most important barriers against *** working hours and dividing endoscopy staff into teams may help to overcome the current situation.

关键词： COVID-19 Endoscopy Practice Pandemic Egypt Barriers