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The combination of endoglin and FIB-4 increases the accuracy of detection of hepatic fibrosis in chronic hepatitis C patients

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Open Journal of Gastroenterology 2012年第2期2卷 62-67页

作者： dawlat salem Magdy El-Serafy Eman Obeida Wafaa Al-Akel Maissa El-Raziki Dina Attia Mostafa Hassan Biochemistry Department Faculty of Medicine Cairo University Cairo Egypt Endemic Medicine Department Faculty of Medicine Beni-Suef University Beni-Suef Egypt Endemic Medicine Department Faculty of Medicine Cairo University Cairo Egypt

Background and aim: In patients infected with chronic hepatitis C virus, liver biopsy is the gold standard method of staging fibrosis. Different combinations of serum markers attempted to correlate with hepatic fibrosis in place of liver biopsy and have shown encouraging results. The aim of our study is to evaluate the diagnostic value of endoglin and FIB-4 as non-invasive markers of hepatic fibrosis in HCV patients. Methods: We estimated serum endoglin & FIB-4 index in 40 infected chronic hepatitis C patients. Histological staging of hepatic fibrosis was done according to the METAVIR scoring system. Results: Both endoglin and FIB-4 index showed positive correlation with age and aspartate transaminase and inverse correlation with albumin. The diagnostic performance determined by AUROCs for early fibrosis (≤F2), was 0.868 for endoglin and 0.887 for FIB-4, at cut off va- lues of 5.5 & 0.98 with sensitivity of 64.3% & 82.1%, and specificity of 100% & 85% respectively. For ad-vanced fibrosis (>F2), the AUROC was 0.98 for endoglin and 0.967 for FIB-4, obtained at cut off values of 6.29 & 1.6, with sensitivity of 100% & 91.7%, and specificity of 89.3% & 92.9%, respectively. Conclusion: Both serum endoglin and FIB-4 index are fairly accurate in differentiating stages of hepatic fibrosis;their combination in a single equation enhanced the accuracy of fibrosis detection in chronic HCV patients.

关键词： Hepatitis C Virus Hepatic Fibrosis Liver Biopsy Non-Invasive Marker Endoglin FIB-4

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Infertility,pregnancy and breastfeeding in kidney transplantation recipients:Key issues

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World Journal of Meta-Analysis 2023年第3期11卷 55-67页

作者： Mohamad Habli dawlat Belal Ajay Sharma Ahmed Halawa Department of Internal Medicine Division of NephrologyKingdom HospitalRiyadh 11564Saudi Arabia Kasr El-Ainy School of Medicine Cairo UniversityCairo 11562Egypt Royal Liverpool University Hospital Royal Liverpool University HospitalLiverpool L78YEUnited Kingdom Department of Transplantation Sheffield Teaching HospitalsSheffield S102JFUnited Kingdom

Chronic kidney disease(CKD),especially in advanced stages,is an important cause of *** CKD patients,infertility has been linked to multiple *** pathophysiology of infertility related to CKD is complex and *** of modifiable factors can improve fertility in both *** males as well as females,successful kidney transplantation offers good chances of restoration of reproductive *** female renal allograft recipients,recovery of reproductive functions in the post-transplant period will manifest as restoration of normal menses and *** to this improvement,there is a significant risk of unplanned pregnancy,hence the need to discuss methods of contraception before *** kidney transplant recipients,different contraceptive options for pregnancy planning,have been *** selection of one contraception over another is based on preference and ***,in renal transplanted females,is associated with physiologic changes that occur in pregnant women with native *** medications during pregnancy,in a recipient with a single functioning kidney,expose the mother and fetus to unwanted *** immunosuppressive drugs are contraindicated during *** medications should be discussed with renal transplant recipients who are planning to breastfeed their *** addition to antirejection drugs,other medications should be managed accordingly,whenever pregnancy is planned.

关键词： Infertility Chronic kidney disease Pregnancy Kidney transplantation Immunosuppression Breastfeeding

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Post-transplant malignancy:Focusing on virus-associated etiologies,pathogenesis,evidence-based management algorithms,present status of adoptive immunotherapy and future directions

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World Journal of Meta-Analysis 2023年第7期11卷 317-339页

作者： Rahul Yadav Mohsen El Kossi dawlat Belal Ajay Sharma Ahmed Halawa Department of Urology Kidney Transplant and Robotic Uro-oncologyTender Palm Super Speciality HospitalLucknow 226010Uttar PradeshIndia Department of Urology and Kidney Transplant Charak Hospital and Research CentreLucknow 226003Uttar PradeshIndia Department of Nephrology Doncaster Royal InfirmaryDoncaster DN25LTUnited Kingdom Department of Nephrology and Medicine Kasr El-Ainy School of MedicineCairo UniversityCairo 11562Egypt Department of Transplant Surgery Royal Liverpool University HospitalsLiverpool L78XPUnited Kingdom Department of Transplantation Sheffield Teaching HospitalsSheffield S57AUUnited Kingdom

Modern immunosuppression has led to a decrease in rejection rates and improved survival rates after solid organ *** the potency of immunosuppression promotes post-transplant viral infections and associated cancers by impairing immune response against viruses and cancer *** review reflects the magnitude,etiology and immunological characteristics of various virus-related post-transplant malignancies,emphasizing the need for future research.A multidisciplinary and strategic approach may serve best but overall literature evidence targeting it is ***,the authors attempted to provide a more detailed update of the literature consensus for the prevention,diagnosis,management and surveillance of post-transplant viral infections and associated malignancies,with a focus on the current role of adoptive immunotherapy and the way *** order to achieve long-term patient and graft survival as well as superior post-transplant outcomes,collaborative research on holistic care of organ recipients is imperative.

关键词： Post-transplant malignancy management Post-transplant virus-associated malignancy Cancer Kidney transplantation Solid organ transplantation Virus

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