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In Frail Elderly Patients, Low-Dose Gemcitabine over 6-Hour Infusion Is Equally Effective and Less Toxic Than the Standard Gemcitabine Protocol for Advanced Pancreatic Adenocarcinoma: A Randomized Phase II Trial

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Journal of Cancer Therapy 2020年第3期11卷 124-141页

作者： Salah mabrouk Khallaf Elsayed mostafa Ali Ahmed mmaklad mohamed medhat Samir Anwar Tawfik Amin muhammad Abbas El-masry mona mSayed dalia Osama medical Oncology Department South Egypt Cancer InstituteAssiut UniversityAssiutEgypt Clinical Oncology and Nuclear medicine Department Sohag UniversitySohagEgypt Surgical Oncology Department South Egypt Cancer InstituteAssiut UniversityAssiutEgypt Division of gastroenterology-Department of internal medicine Assiut UniversityAssiutEgypt Radiation Oncology Department South Egypt Cancer InstituteAssiut UniversityAssiutEgypt

Background:?Treatment of frail elderly patients with pancreatic cancer is still a major problem due to intolerance to standard chemotherapy doses. Aim:?This study aims to compare the low-dose gemcitabine over 6 hours (LD6H) to the standard gemcitabine protocol in terms of clinical benefit, survival, and safety in the frail elderly patients with advanced pancreatic adenocarcinoma. methods:?Patients enrolled in this trial were randomly assigned by in a 1:1 fashion via closed envelope method to either receive gemcitabine of 1000 mg/m2?over 30-minute infusion on days 1, 8, and 15 of every 4-week cycle (standard protocol arm) or gemcitabine as a weekly low-dose (250 mg/m2) over 6-hour infusion (LD6H arm). Results:?We enrolled eighty-two eligible frail elderly patients with advanced pancreatic cancer. The patients were randomly assigned to receive either standard gemcitabine protocol (40 patients) or low-dose (250 mg/m2) gemcitabine over 6-hour infusion, given weekly (42 patients). There was no significant difference between the standard group and low-dose group as regard of the overall response rate (p = 0.654), the disease control rate (DCR) (p = 0.845), the median progression-free survival (PFS) (p = 0.908) and the overall survival (OS) (p = 0.331). The low-dose regimen had a significantly lower incidence of adverse effects grades 3 or 4 when compared to the standard regimen: (p = 0.024 for fatigue, p = 0.027 for hypotension, p = 0.012 for each anemia as well as thrombocytopenia, and p = 0.006 for neutropenia). Conclusion:?Low-dose gemcitabine over 6-hour infusion is equally effective and less toxic when compared to standard gemcitabine protocol in frail elderly patients with advanced pancreatic adenocarcinoma. So, we recommend the low-dose gemcitabine for frail elderly patients with advanced pancreatic cancer.

关键词： Continuous Infusion Elderly Frail Low Dose Gemcitabine Pancreatic Cancer

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Assessment of Endometrial Carcinoma markers and Hormone Receptors Profile before and after Bariatric Surgery: A Clinico-Pathological-Immunohistochemical Study

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Open Journal of Obstetrics and Gynecology 2019年第7期9卷 1019-1031页

作者： Walid mohamed Elnagar Samah Said Elbasateeny mai mohamed Abdelwahab mahmoud Abdou Yassin Taha Abdelwahab Baiomy maha Abdelhamid Fathy Amin dalia Abdallah El-Shafei Department of Obstetrics and Gynecology Faculty of Medicine Zagazig University Zagazig Egypt Department of Pathology Faculty of Medicine (Rabigh Branch) King Abdul Aziz University Jeddah KSA Department of Pathology Faculty of Medicine Zagazig University Zagazig Egypt Department of General Surgery Faculty of Medicine Zagazig University Zagazig Egypt Department of Physiology Faculty of Medicine Zagazig University Zagazig Egypt Department of Community Environmental & Occupational Medicine Faculty of Medicine Zagazig University Zagazig Egypt

Background: Obesity is a major risk factor for endometrial carcinoma, and we aim to assess markers of carcinogenesis including PTEN and Ki-67 and hormone receptors profile including ER, PR and AR before and after bariatric surgery to find out its effects in reducing endometrial carcinoma risk in morbid obese females. Patients and methods: The study included 80 females with morbid obesity (BmI > 40 Kg/m2) who underwent bariatric surgery. All were sampled by Pipelle biopsy at baseline and 12 months after operation and examined histopathologically and immunohistochemically for Ki-67, PTEN, ER, PR and AR. Results: Sixty two out of 80 (62/80) females showed no pathological abnormalities;4 had polyps;7 had simple endometrial hyperplasia;4 had atypical endometrial hyperplasia and 3 had endometrial carcinoma. In total, 34 females underwent gastric bypass operation (42.5%) and 46 underwent a sleeve gastrectomy operation (57.5%). There was a statistically significant difference between baseline weight and BmI before and after surgery (p men with simple hyperplasia, resolution occurred in 5 within 7 months of surgery. Three of 4 females with atypical hyperplasia (AH) showed resolution after 9 months. mean Ki-67 score was lower at 12 months (p men with baseline endometrial abnormalities, of whom 5/15 regained glandular PTEN expression as their endometrial abnormalities resolved. There was a significant reduction in ER score after surgery (p males with morbid obesity have a higher risk of harboring endometrial abnormalities even if asymptomatic. However, the endometrial pathology and the high ER and PR expression can be normalized within one year without me

关键词： Bariatric Surgery Obesity Endometrial Cancer Hormone Receptors

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Lasertherapy as A Strategy for Treatment Healing under Caloric Restriction – Study in Rats

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Journal of Pharmacy and Pharmacology 2018年第7期6卷 647-658页

作者： Leandro C. moscardi Talita P. Espíndola Amanda A. Ferreira Naiara Alves maria Esméria C. Amaral Andréa A. Aro Rodrigo A. dalia marcelo A. m. Esquisatto Fernanda A. S. mendonca Gláucia m. T. Santos Thiago A. m. Andrade Graduate Program in Biomedical Sciences of the Hermínio Ometto University Center UNIARARAS Araras So Paulo 13607-339 Brazilc

Complications in the healing process are challenging, especially in clinical situations of caloric restriction （CR）. The lasertherapy becomes an important strategy that aids the repair, especially in CR. Thus, it is important to investigate the InGaAlP-660 nm laser as an strategy to repair cutaneous wounds in rats submitted to 30% of CR and to understand the tissue repair in clinical situations of CR. Thirty-six male Wistar rats were used, of which half were fed with 30% less ration, and half with ad libitum diet, for 21 days. Then, punch lesions of 1.5 cm in diameter were made on the animals backs, which were divided into： NR （no-restricted）, R （restricted）-both before lesion; C （control）, RC （restricted-control）, L （laser）, RL （restricted-laser）-after lesion. Samples of the skin/lesion/scar were collected on the 2nd, 7th and 14th days post-injury for histological, biochemical and molecular analyses. The R group showed reduction of body mass, epidermal/dermal thickness, inflammation, angiogenesis, fibroplasia and collagenesis. The RL group showed control of inflammation, oxidative damage and increase of antioxidants than RC, which probably favored angiogenesis, collagenesis and reepithelialization, similar to C and L. Thus, 30% of CR impaired the skin （before lesion）. In the lesion, lasertherapy has shown to be effective in tissue repair mainly in CR status, being thus, the laser clinically important strategy to tissue repair in critical situations of caloric restriction.

关键词： Wound healing skin caloric restriction wound treatment therapeutic strategy lasertherapy

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Incidence of Haematoma in Post Bariatric Abdominoplasty Cases

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modern Plastic Surgery 2023年第3期13卷 74-84页

作者： Anoud Al Qaydi Dalal Al mansoori medhat Emil Shamsa Alameri Aysha Al Naqbi Ibrahim Al marzooqi Abdulla Tareq Al Hassani muhammad Tariq Ayub dalia medhat Habib Omar Alameri Department of Plastic and Reconstructive Surgery Zayed Military Hospital Abu Dhabi United Arab Emirates

Objective: This study aims at assessing the incidence of haematoma formation in abdominoplasty cases who had previous bariatric surgery and in those who did not have bariatric surgery before. Patients and methods: This is a 4 years retrospective study involving patients who underwent abdominoplasty surgery between the period of July 2015 and June 2019. The incidence of haematoma formation was assessed in relation to history of previous bariatric surgery in these patients. Results: 164 patients met the inclusion criteria of the study;46 of them were males and 118 were females. The mean age of the patients included in the study was 38.6 (21 - 60 years). The mean BmI was 27 kg/m2 (21.4 - 34.7 Kg/m2). The mean hospital stay was 6.6 days (4 - 19 days). 107 patients had history of previous bariatric surgery performed and 57 had not. 21 patients developed haematoma (12.8%). 16 of the patients who had haematoma had previous bariatric surgery done (15% of post bariatric surgery cases) while 5 patients developed haematoma with no history of previous bariatric surgery (8.8%). Sixteen male patients out of the 46 male patients in the study developed postoperative haematoma (34.8% of the male patients) while only 5 of the 118 female patients developed postoperative haematoma (4.2% of the female patients) which shows a significant difference in haematoma formation when comparing males to females in general (p Conclusion: Our study shows that the incidence of post abdominoplasty haematoma formation is significantly higher in male patients who had bariatric surgery before when compared to those who had not (p males when compared to females (p males with previous history of bariatric surgery have the highest chance of developing haematoma formation. Combining liposuction of the lower flanks, plication of the recti muscles or both to the abdominoplasty procedure did not result significantly in an incre

关键词： Haematoma Abdominoplasty Surgery Postbariatric Surgery Liposuction Plication Recti muscles

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Role of endoscopic ultrasound in the characterization of solid pseudopapillary neoplasm of the pancreas

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World Journal of Gastrointestinal Endoscopy 2023年第4期15卷 273-284页

作者： Katarzyna m Pawlak Nadeem Tehami Ben maher Shujaath Asif Krishn Kant Rawal Daniel Vasile Balaban mohammed Tag-Adeen Fahd Ghalim Wael A Abbas Elsayed Ghoneem Khaled Ragab mahmoud El-Ansary Shanil Kadir Sunil Amin Keith Siau Anna Wiechowska-Kozlowska Klaus mönkemüller dalia Abdelfatah Abeer Abdellatef Sundeep Lakhtakia Hussein Hassan Okasha Endoscopy Unit Department of GastroenterologyHospital of The Ministry of Interior and AdministrationSzczecin 01-218Poland Interventional Endoscopy Unit University Hospital Southampton NHS Foundation Trust3AX POUnited Kingdom Consultant Gastroenterologist AIG HospitalsHyderabad 500032India Department of Gastroenterology Prime Institute of Digestive SciencesRajkot 360001India Department of Gastroenterology Central Military Emergency University HospitalCarol Davila University of Medicine and PharmacyBucharest 010011Romania Division of Gastroenterology and Hepatology Department of Internal MedicineQena Faculty of MedicineSouth Valley UniversityQena 83511Egypt Department of Endoscopy Shefa Al-Orman HospitalLuxor 85951Egypt Interventional Endoscopy Unit Sainte Marie HospitalOSNY 95520France Department of Internal medicine Gastroenterology UnitFaculty of MedicineAssuit UniversityAssuit 71511Egypt Department of Gastroenterology and Hepatology Faculty of MedicineMansoura UniversityMansoura 35511Egypt Department of Hepatology and Gastroenterology Theodor Bilharz Research InstituteGiza 12511Egypt Department of Hepatology&Gastroenterology Theodor Bilharz Research InstituteGiza 12511Egypt Department of Gastroenterology Liaquat National Hospital&Medical CollegeKarachi 75900Pakistan

BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant *** ultrasound(EUS)assessment plays a vital role in lesion characterization and confirmation of the tissue ***,there is a paucity of data regarding the imaging assessment of these *** To determine the characteristic EUS features of SPN and define its role in preoperative *** This was an international,multicenter,retrospective,observational study of prospective cohorts from 7 large hepatopancreaticobiliary *** cases with postoperative histology of SPN were included in the *** collected included clinical,biochemical,histological and EUS *** One hundred and six patients with the diagnosis of SPN were *** mean age was 26 years(range 9 to 70 years),with female predominance(89.6%).The most frequent clinical presentation was abdominal pain(80/106;75.5%).The mean diameter of the lesion was 53.7 mm(range 15 to 130 mm),with the slight predominant location in the head of the pancreas(44/106;41.5%).The majority of lesions presented with solid imaging features(59/106;55.7%)although 33.0%(35/106)had mixed solid/cystic characteristics and 11.3%(12/106)had cystic *** was observed in only 4(3.8%)*** pancreatic duct dilation was uncommon,evident in only 2 cases(1.9%),whilst common bile duct dilation was observed in 5(11.3%)*** patient demonstrated a double duct sign at *** and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable *** guided biopsy was performed using three different types of needles:Fine needle aspiration(67/106;63.2%),fine needle biopsy(37/106;34.9%),and Sonar Trucut(2/106;1.9%).The diagnosis was conclusive in 103(97.2%)***-seven patients were treated surgically(91.5%)and the post-surgical SPN diagnosis was confirmed in all *** the 2-year

关键词： Solid pseudopapillary neoplasm SPN Frantz tumor Endoscopic ultrasound features EUSguided biopsy Fine needle aspiration/biopsy

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Digital Intubation without Stylet: myth or Reality? Case Report

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Open Journal of Anesthesiology 2021年第5期11卷 156-163页

作者： maya Christiam mauricio Jesús Alberto melendez Ordoñez Ismael Bernardo Viveros Peralta Villanueva Verónica Juan José Dosta Herrera Andrea Carolina Jimenez Palacios Jimmy Andersson Delgado Criollo monserrat Escalante Rodríguez dalia Fernanda Farrera Rámirez maribel méndez Suarez Pedro Sánchez mata Residente de Anestesiología Hospital Juárez de México Ciudad de México México médico adjunto al Servicio de Anestesiología Unidad Médica de Alta Especialidad (UMAE) Hospital General Doctor Gaudencio Jefe del Servicio de Anestesiología Unidad Médica de Alta Especialidad (UMAE) Hospital General Doctor Gaudencio González Garza (LA RAZA) Ciudad de México México

Digital intubation was discovered as one of the first methods to face a difficult airway without direct laryngoscopy. From the very beginning, this technique has been surrounded by much controversy, mainly because it required to be performed by an expert. Nowadays, it remains a useful technique when treating patients with difficult airways, so it is of utmost importance all personnel involved with airway management must know and perfect this technique when scenarios where conventional laryngoscopy or rescue devices for difficult airway are not available or contraindicated. The present work’s main objective is to suggest digital intubation as a safe and effective technique for the management of patients with difficult airways when there are no other devices available. The authors present a successful case of digital intubation on a patient with a difficult airway, demonstrating this technique is useful when performed by expert practitioners and when there is no other equipment available.

关键词： Intubation Intratracheal Oxygenation Anesthesia Airway management

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A model for the Risk of microcephaly Induced by the Zika Virus (ZIKV)

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Open Journal of modelling and Simulation 2016年第3期4卷 109-117页

作者： dalia m. muñoz Pizza Anibal muñoz Loaiza John F. Arredondo montoya Oscar A. manrique Vanessa Abello Sossa Carlos A. Abello muñoz Steven Raigosa Hans meyer Contreras Irma Pérez Contreras maria E. Cardenas Perea miguel A. Enríquez Grupo de modelación matemática en Epidemiología (GmmE) Facultad de Educación Universidad del Quindío Quindío Colombia Facultad de medicina Benemérita Universidad Autónoma de Puebla Puebla México

It has been introduced and analyzed a mathematical model based on integral equations, which turns into a dynamical system of non-linear differential equations to account for the risk of microcephaly incidence caused by the Zika virus. A specific pregnant women susceptible group has been accounted for. The epidemic threshold (basic reproduction number) has been obtained by implementing the next generation matrix method. A sensitivity analysis with respect to each parameter has been applied to that threshold. Finally, the incidence to the exposure is obtained by performing several system simulations.

关键词： model microcephaly Zika Virus Basic Reproduction Number Sensitivity Analysis

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Creatine supplementation in exercised rats: Effects on the aerobic capacity

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Open Journal of Animal Sciences 2013年第1期3卷 21-26页

作者： michel Barbosa de Araújo Roberto C. Vieira Junior Leandro P. moura marcelo Costa Junior Rodrigo A. dalia Amanda Christine da Silva Sponton Carla Ribeiro maria Alice R. mello Biosciences Institute Department of Physical Education Universidade Estadual Paulista Júlio de Mesquita Filho Rio Claro Brazil Biosciences Institute Department of Physical Education Universidade Estadual Paulista Júlio de Mesquita Filho Rio Claro Brazil Faculty of Nutrition Universidade Federal de Mato Grosso Cuiabá Brazil

This study aimed to analyze the possible metabolic disturbances caused by creatine supplementation on aerobic capacity of rats, inferred by the maximal lactate steady state. Forty male Wistar rats (90 days old) were distributed into two groups for eight weeks: trained group (T): rats that were submitted to a training protocol, and supplemented-trained group (TCr): rats that were submitted to a training protocol and received balanced diet supplemented with 2% creatine. The blood lactate concentrations equivalent to maximal lactate steady state during treadmill running were analyzed at the beginning and also at the end of the experiment. At the end of the experiment were done comparing the test results mLSS between the two groups. At the beginning of the experiment, prior to groups division, the majority of animals obtained mLSS at a speed of26 m/min, blood lactate concentration of 3.79 ± 0.76 mmol/L. At the end of the experiment, most of trained rats in T presented mLSS at the speed of28 m/min, blood lactate concentration of 3.37 ± 0.68 mmol/L. most TCr had mLSS at the speed of28 m/min, blood lactate concentration of 3.52 ± 0.69 mmol/L. We conclude that creatine supplementation was not the cause of the improvement in the aerobic capacity of rats in the tread-mill exercise.

关键词： Diet Lactate maximal Lactate Steady State Treadmill Running

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A Simulation model for the Risk of Fetal Exposure Originated by the Zika Virus (VIZK)

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Health 2016年第12期8卷 1178-1186页

作者： dalia m. muñoz Pizza Anibal muñoz Loaiza Oscar A. manrique Arias Vanessa Abello Sossa Carlos A. Abello muñoz Steven Raigosa Osorio Hans meyer Contreras John F. Arredondo montoya Gonzaga Ospina Patiño Irma Pérez Contreras maria E. Cardenas Perea miguel A. Enríquez Guerra Jesús A. Valdez García Grupo de modelación matemática en Epidemiología (GmmE) Facultad de Educación Universidad del Quindío Quindío Colombia Facultad de medicina Benemérita Universidad Autónoma de Puebla Puebla México

It is set and analyzed a simulation model based on non-linear ordinary differential equations to interpret the dynamics of the microcephaly incidence caused by the Zika virus in a risk group of pregnant women. This one is induced by a population of men in a reproductive age. Also, some parameters of the model were estimated for an average temperature of 23℃ and by using the adjusted functions from references [1] [2]. All system simulations were done with the maple software and parameters values obtained from several sources (estimated, hypothetic, and form literature). It has been found that the application of contraceptive measures impacts the population of sexually active women. As result, the exposure to congenital abnormalities increases, particularly, microcephaly.

关键词： model microcephaly Zika Virus Basic Reproduction Number Risk Group Incidence

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Role of macroscopic on-site evaluation of endoscopic ultrasoundguided fine-needle aspiration/biopsy:Results of a multicentric prospective study

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World Journal of Gastrointestinal Endoscopy 2024年第11期16卷 595-606页

作者： Hussein H Okasha Hiwa A Hussein Khaled m Ragab Omar Abdallah Fedoua Rouibaa Borahma mohamed Fahd Ghalim mahmoud Farouk mohamed Lasheen mohamed A Elbasiony Ahmed E Alzamzamy Ahmed El Deeb Hassan Atalla mahmoud El-Ansary Sahar mohamed moaz Elshair Wafaa Khannoussi mohamed Z Abu-Amer Amine Elmekkaoui mohammed S Naguib Adil Ait Errami Ahmed El-meligui Ahmed H El-Habashi mahmoud G Ameen dalia Abdelfatah mona Kaddah Hanane Delsa Division of Gastroenterology and Hepatology Department of Internal MedicineKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt Sulaimani Center for Advanced Gastrointestinal Endoscopy Sulaimani College of MedicineSulaymaniyah 46001Iraq Department of Hepatology and Gastroenterology Theodor Bilharz Research InstituteCairo 11211Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineMansoura UniversityFaculty of MedicineMansoura 35516Egypt Gastrointestinal Endoscopy Center Military Hospital Mohamed VFaculty of Medicine of RabatRabat 10100Rabat-Salé-KénitraMorocco Department of Gastroenterology“C” Ibn Sina HospitalMohammed V University in RabatRabat 10000Rabat-Salé-KénitraMorocco Digestive Endoscopy Unit Mekka ClinicCasablanca 20000Casablanca-SettatMorocco Department of Tropical medicine and Gastroenterology Luxor UniversityLuxor 85951Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineFaculty of MedicineMansoura UniversityMansoura 35516Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11841Egypt Department of Gastroenterology National Hepatology and Tropical Medicine Research InstituteCairo 12556Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineAl-Azhar UniversityCairo 11651Egypt Department of Gastroenterology and Endoscopy Center Cheikh Khalifa International University HospitalMohammed VI University of Sciences and HealthCasablanca 82403Casablanca-SettatMorocco Research Unit Mohammed VI Center for Research and InnovationRabat 10100Rabat-Salé-KénitraMorocco Department of Hepato-Gastroenterology Hassan II University Hospital of FezFaculty of MedicinePharmacy and Dentistry of FezSidi Mohamed Ben Abdellah UniversityFes 30003Fès-MeknèsMorocco Department of Gastroenterology Ahmed Maher Teaching HospitalCairo 11451Egypt Department of Gastroenterology Cadi Ayyad UniversityMohammed VIth University HospitalMarrakech

BACKGROUND The concept of macroscopic on-site evaluation(mOSE)was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on mOSE was superior to 4 *** studies suggest that mOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation,and some classi-fications have been *** studies have assessed the adequacy of histologic cores in mOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy(EUS-FNA/FNB).AIm To evaluate the performance of mOSE during EUS-FNA/*** This multicentric prospective study was conducted in 16 centers in 3 countries(Egypt,Iraq,and morocco)and included 1108 patients with pancreatic,biliary,or gastrointestinal pathology who were referred for EUS *** prospectively analyzed the mOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core *** management and analysis were performed using a Statistical Package for Social Sciences(SPSS)version *** A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological *** age was 59 years,and 509 patients(50.5%)were *** mean lesion size was 38 *** most frequently utilized needles were FNB-Franseen(74.5%)and 22 G(93.4%),with a median of 2 *** to 2 classifications,618 non-bloody cores(61.3%)and 964 good samples(95.6%)were adequate for histological *** overall diagnostic yield of cytopathology was 95.5%.The cytological examination confirmed the diagnosis of malignancy in 861 patients(85.4%),while 45 samples(4.5%)were ***-procedural adverse events occurred in 33 patients(3.3%).Statistical analysis showed a difference between needle types(P=0.035)with a high sensitivity of FNB(97%).The analysis of the relationship between the mOSE-score and the final diagnosis showed a significant difference between the different

关键词： macroscopic on-site evaluation Fine-needle aspiration Fine-needle biopsy Endoscopic ultrasound Specimen

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