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Tumor characteristics of hepatocellular carcinoma after direct-acting antiviral treatment for hepatitis C: Comparative analysis with antiviral therapy-naive patients

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World Journal of Hepatology 2021年第11期13卷 1743-1752页

作者： Magdy Fouad mohamed el kassas elham Ahmed Reem el Sheemy Department of Tropical Medicine and Gastroenterology Minia UniversityMinia 61519Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Internal Medicine Minia UniversityMinia 61519Egypt Department of Tropical Medicine Minia UniversityMinia 61111Egypt

BACKGROUND Insufficient and contradictory data are available about the relation between directacting antivirals(DAAs)and hepatocellular carcinoma(HCC)development in patients with hepatitis C virus(HCV).AIM To analyze differences in basic clinical,radiological,and laboratory characteristics in addition to tumor behavior upon HCC diagnosis between patients with and without a previous history of DAAs *** This multicenter case-control study included 497 patients with chronic HCVrelated HCC,allocated into one of two groups according to their history of antiviral treatment for their *** Group I included 151 HCC patients with a history of DAAs,while 346 patients who had never been treated with DAAs were assigned to group II.A significant difference was observed between both groups regarding basic assessment scores(Child,MelD,and BCLC),which tended to have more advanced liver disease and HCC stage upon diagnosis in group ***,serum albumin was significantly affected,and serumα-fetoprotein was significantly higher in group II(P<0.001).In addition,group I showed significant HCC multicentricity than group II,while the incidence of portal vein thrombosis was significantly higher in group I(P<0.001).CONCLUSION The basic clinical scores and laboratory characteristics of HCC patients are advanced in patients who are naïve to DAAs treatment;however,HCC behavior is more aggressive in DAA-treated patients.

关键词： Hepatocellular carcinoma Direct-acting antiviral treatment Hepatitis C Tumor behavior Occurrence

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Evaluation of GALAD Score in Diagnosis and Follow-up of Hepatocellular Carcinoma after Local Ablative Therapy

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Journal of Clinical and Translational Hepatology 2023年第2期11卷 334-340页

作者： Rasha eletreby Marwa elsharkawy Alaa Awad Taha mohamed Hassany Amr Abdelazeem mohamed el-kassas Ahmed Soliman Endemic Medicine Department Faculty of MedicineCairo UniversityCairoEgypt Clinical and Chemical Pathology Department Faculty of MedicineCairo UniversityCairoEgypt Hepatogastroenterology Department Theodore Bilharz Research InstituteGizaEgypt Hepatogastroenterology Department National Hepatology and Tropical Medicine Research InstituteCairoEgypt Endemic Medicine Department Faculty of MedicineHelwan UniversityCairoEgypt

Background and Aims:Strategies for detection of early hepatocellular carcinoma(HCC)are still *** GALAD score is a serum biomarker-based model designed to predict the probability of having *** aimed to assess the ability of GALAD score to diagnose early HCC and its validity to follow patients after local ablation ***:This multicenter prospective study included 108 patients in two groups,58 HCC patients(67 focal lesions)with local ablative therapy(study group),and a control group of 50 patients with liver *** GALAD scores of the study and control groups,and of the HCC patients before and after ablative therapy were ***:Most patients were men(74.1%in study group and 76%in controls)with hepatitis C virus infection(98.30%in the study group,and 94%in controls).GALAD scores were significantly higher in HCC patients than in those with benign cirrhosis(2.65 vs.−0.37,p=0.001).Ablative therapy was successful in 94.4%of focal lesionsell-ablated tumors(2.19 vs.0.98,p=0.001).The best cutoff values of GALAD score for diagnosis of early HCC,and for prediction of well ablation of HCC were 0.74 and≤3.31(areas under the curve of 0.92 and 0.75,sensitivities of 84.48%and 76.19%,specificities of 89.13%and 83.33%,positive predictive values of 90.74%and 94.1%,and negative predictive values of 82%and 35.7%respectively).Conclusion:The GALAD score was effective for the diagnosis of early HCC and for followup after ablative therapy.

关键词： GALAD score HCC Ablative therapy Liver cirrhosis Egypt

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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

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Effect of treating chronic hepatitis C with direct-acting antivirals on extrahepatic cutaneous manifestations

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World Journal of Hepatology 2020年第10期12卷 841-849页

作者： mohamed el kassas Osama MO Hegazy Eman M Salah Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Dermatology Venereology and AndrologyFaculty of MedicineHelwan UniversityCairo 11795Egypt

BACKGROUND Hepatitis C virus(HCV)is a disease with a significant global impact,affecting approximately 2%-2.5%of the world’s *** direct-acting antivirals(DAAs)have been introduced over the past few years with great success in viral *** association of chronic HCV infection with a wide spectrum of cutaneous manifestations has been widely reported in the *** To assess the effect of treating HCV with DAAs on the extrahepatic cutaneous manifestations of *** This prospective observational study included 1039 HCV positive Egyptian patients who were eligible to receive DAAs.A total of 30 patients were diagnosed with extrahepatic cutaneous manifestations and fulfilled the inclusion criteria of the *** these patients,6 had classic lichen planus,8 were diagnosed with psoriasis vulgaris and 16 had *** patients received DAAs from October 2018 to July 2019 in the form of a three-month course of sofosbuvir/daclatasvir *** with lichen planus or psoriasis were dermoscopically evaluated before treatment and 6 mo after treatment,while patients with hepatic pruritus were assessed using the 12-Item Pruritus Severity Scale over the same *** All patients with psoriasis showed significant improvement in all psoriatic plaques,and all patients with hepatic pruritus scored 0 on the 12-Item Pruritus Severity Scale indicating total improvement of *** addition,four of six patients with lichen planus showed complete *** Treatment of HCV with DAAs was significantly effective in improving virusrelated extrahepatic cutaneous manifestations.

关键词： Directly acting antivirals Extrahepatic manifestations Hepatitis C virus Lichen planus Pruritus Cutaneous manifestations

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Towards hepatitis C virus elimination:Egyptian experience,achievements and limitations

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World Journal of Gastroenterology 2018年第38期24卷 4330-4340页

作者： Dalia Omran mohamed Alboraie Rania A Zayed mohamed-Naguib Wifi Mervat Naguib mohamed eltabbakh mohamed Abdellah Ahmed Fouad Sherief Sahar Maklad Heba Hamdy eldemellawy Omar Khalid Saad Doaa mohamed Khamiss mohamed el kassas Department of Endemic Medicine and Hepatology Faculty of MedicineCairo UniversityCairo 11651Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11599Egypt Department of Internal Medicine Al-Azhar UniversityCairo 11651Egypt Department of Clinical and Chemical Pathology Faculty of MedicineCairo UniversityCairo 11651Egypt Department of Internal Medicine Faculty of MedicineCairo UniversityCairo 11599Egypt Department of Tropical Medicine Faculty of MedicineAin Shams UniversityCairo 11566Egypt National Hepatology and Tropical Medicine Research Institute Cairo 11599Egypt Department of Internal Medicine Faculty of MedicineBeni-Suef UniversityBeni-Suef 62511Egypt Faculty of Medicine Ain Shams UniversityCairo 11566Egypt Department of Clinical and Chemical Pathology El-monera hospitalMinistry of HealthCairo 11562Egypt

Worldwide, more than one million people die each year from hepatitis C virus(HCV) related diseases, and over 300 million people are chronically infected with hepatitis B or C. Egypt used to be on the top of the countries with heavy HCV burden. Some countries are making advances in elimination of HCV, yet multiple factors preventing progress; remain for the majority. These factors include lack of global funding sources for treatment, late diagnosis, poor data, and inadequate screening. Treatment of HCV in Egypt has become one of the top national priorities since 2007. Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Mass HCV treatment program had started using Pegylated interferon and ribavirin between 2007 and 2014. Yet, with the development of highly-effective direct acting antivirals(DAAs) for HCV, elimination of viral hepatitis has become a real possibility. The Egyptian National Committee for the Control of Viral Hepatitis did its best to provide Egyptian HCV patients with DAAs. Egypt adopted a strategy that represents a model of care that could help other countries with high HCV prevalence rate in their battle against HCV. This review covers the effects of HCV management in Egyptian real life settings and the outcome of different treatment protocols. Also, it deals with the current and future strategies for HCV prevention and screening as well as the challenges facing HCV elimination and the prospect of future eradication of HCV.

关键词： Hepatitis C virus Egypt Direct acting antivirals screening elimination Limitations

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Circulating microRNA 9-3p and serum endocan as potential biomarkers for hepatitis C virus-related hepatocellular carcinoma

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World Journal of Hepatology 2021年第11期13卷 1753-1765页

作者： Amany mohamed Salah eldin Wahb mohamed el kassas Ahmed Kamal Khamis Mostafa elhelbawy Nesreen elhelbawy Mona Salah eldin Habieb Department of Medical Biochemistry and Molecular Biology Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Hepatology and Gastroenterology National Liver InstituteMenoufia UniversityShebin Elkom 32512MenoufiaEgypt Department of Medical Biochemistry and Molecular Biology Faculty of MedicineMenoufia UniversityShebin Elkoum 3511Egypt

BACKGROUND The high mortality rate of hepatocellular carcinoma(HCC)in Egypt is due mainly to the increasing prevalence of hepatitis C virus infection(HCV)and late diagnosis of the ***(miRNA),which regulate tumor proliferation and metastasis in HCC,may serve as a useful diagnostic approach for the early detection of HCC,thus decreasing its ***,endocan is a protein with angiogenic and inflammatory properties that are associated with tumor progression and poor *** To analyze the levels of miRNA 9-3p and endocan in HCV-infected HCC patients and correlate them with clinicopathological *** We compared levels of endocan and circulating miRNA 9-3p from 35 HCVrelated HCC patients to 33 patients with HCV-induced chronic liver disease and 32 age and gender matched healthy controls recruited from inpatient and outpatient clinics of the National Liver Institute,Menoufia University,Egypt in the period from January to March 2021 in a case-control *** samples from all groups were analyzed for *** was measured by enzymelinked immunosorbent assays,and the expression levels of circulating miRNA 9-3p were measured by real-time quantitative reverse transcriptase *** The levels of circulating miRNA 9-3p were significantly lower in the HCC group compared to the chronic liver disease(Pels in the chronic liver disease were significantly lower than those in the control group(Pels of serum endocan were significantly higher in the HCC group compared to the chronic liver disease(Pels of miRNA 9-3p were significantly inversely correlated to vascular invasion(P=0.002),stage of advancement of Barcelona Clinical Liver Cancer(P<0.001)and the metastatic site(P<0.001)of the HCC ***

关键词： MicroRNA 9-3p Hepatocellular carcinoma Endocan Diagnostic Biomarker Egypt

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Management of Hepatocellular Carcinoma: Updated Review

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Journal of Cancer Therapy 2013年第2期4卷 536-545页

作者： Tamer elbaz mohamed el kassas Gamal Esmat Endemic Medicine and Hepatogastroenterology Department Faculty of Medicine Cairo University Cairo Egypt Hepatology Department National Hepatology and Tropical Medicine Research Institute Cairo Egypt.

Hepatocellular carcinoma (HCC) represents one of the most challenging potentially curable tumors with high incidence, prevalence and mortality rates. For proper assessment, prognosis estimation and treatment decisions, at least seven important guidelines and staging systems were designated. Proper treatment needs the interaction of multidisciplinary HCC clinic to choose the most appropriate line of treatment. The different modalities of management include resection (surgery or transplantation), local ablation, chemoembolization, radioembolization and molecular targeted therapies with a wide range of investigational drugs that developed after the FDA approved sorafenib. Downstaging and bridging are two important strategies to manage HCC patients who will undergo liver transplantation to improve their postoperative survival. Finally, survival and prognosis depends on several prognostic factors that are either patient related or tumor related. In our study, we aim to provide an updated comprehensive review of the different aspects of liver cancer management starting from staging systems to the different applied treatment modalities.

关键词： Hepatocellular Carcinoma Staging Molecular Targeted Therapies

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Incidental radiological findings suggestive of COVID-19 in asymptomatic patients

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World Journal of Radiology 2022年第1期14卷 1-12页

作者： Marwa Romeih Mary R Mahrous mohamed el kassas Department of Radiodiagnosis Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Radiodiagnosis National Heart instituteCairo 11795Egypt

Despite routine screening of patients for coronavirus disease 2019(COVID-19)symptoms and signs at hospital entrances,patients may slip between the cracks and be incidentally discovered to have lung findings that could indicate COVID-19 infection on imaging obtained for other *** case reports and case series have been published to identify the pattern of this highly infectious *** article addresses the radiographic findings in different imaging modalities that may be incidentally seen in asymptomatic patients who carry *** general,findings of COVID-19 infection may appear in computed tomography(CT),magnetic resonance imaging,positron emission tomography-CT,ultrasound,or plain X-rays that show lung or only apical or basal *** identification of these characteristics by radiologists and clinicians is crucial because this would help in the early recognition of cases so that a rapid treatment protocol can be established,the immediate isolation to reduce community transmission,and the organization of close ***,it is important to both the patient and the physician that these findings are highlighted and reported.

关键词： Incidental Asymptomatic COVID-19 Chest computed tomography Positron emission tomography-computed tomography Magnetic resonance imaging Ultrasound Oncology patients

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Hepatic and gastrointestinal disturbances in Egyptian patients infected with coronavirus disease 2019: A multicentre cohort study

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World Journal of Gastroenterology 2021年第40期27卷 6951-6966页

作者： Hend Ibrahim Shousha Shimaa Afify Rabab Maher Noha Asem Eman Fouad Ehab F Mostafa Mohammed A Medhat Amr Abdalazeem Hazem elmorsy Miriam M Aziz Rateba S Mohammed mohamed Ibrahem Hassan elgarem Dalia Omran mohamed Hassany Bassem elsayed Ahmed Y Abdelaziz mohamed el kassas Endemic Medicine Faculty of MedicineCairo UniversityCairo 11562Egypt Gastroenterology Department National Hepatology&Tropical Medicine Research InstituteCairo 11563Egypt Hepatology Department Students HospitalCairo UniversityGiza 12566Egypt The Public Health Department Faculty of MedicineCairo UniversityCairo 11562Egypt Egyptian Ministry of Health and PopulationCairo 11567Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 15655Egypt Endemic Medicine Department Faculty of MedicineHelwan UniversityCairo 13544Egypt Internal Medicine 15 Mayo Smart HospitalMinistry of Health and PopulationCairo 13488Egypt Pediatrics Department Faculty of MedicineCairo UniversityCairo 11562Egypt Occupational and Environmental Medicine Department Faculty of MedicineCairo UniversityCairo 11562Egypt Clinical Biochemistry Department Faculty of medicineCairo UniversityCairo 11562Egypt Endemic Medicine Department Faculty of MedicineCairo UniversityCairo 11562Egypt Urology Department Cairo UniversityCairo 11562Egypt

BACKGROUND Various liver and gastrointestinal involvements occur in patients with coronavirus disease 2019(COVID-19)at variable *** studies report mild liver function disturbances correlated with COVID-19 severity,though liver failure is *** To study liver and gastrointestinal dysfunctions in Egyptian patients with COVID-19 and their relation to disease outcomes METHODS This multicentre cohort study was conducted on 547 Egyptian patients from April 15,2020 to July 29,*** polymerase chain reaction-confirmed COVID-19 cases were included from four quarantine hospitals affiliated to the Egyptian ministry of *** information,laboratory characteristics,treatments,fibrosis-4(FIB-4)index,COVID-19 severity,and outcomes were recorded and compared according to the degree of liver enzyme elevation and the presence of gastrointestinal ***-ups were conducted until discharge or *** analyses were performed to determine the independent factors affecting *** This study included 547 patients,of whom 53(9.68%)died during hospitalization and 1 was discharged upon his ***’mean age was 45.04±17.61 years,and 21.98%had severe or critical *** aminotransferase(ALT)and aspartate aminotransferase(AST)were available for 430 and 428 patients,*** total,26%and 32%of patients had elevated ALT and AST,*** liver injury with ALT or AST elevation exceeding 3-fold was recorded in 21(4.91%)and 16(3.73%)patients,*** gender,smoking,hypertension,chronic hepatitis C,and lung involvement were associated with elevated AST or *** was elevated in 50%of patients over ***-4 was significantly higher in patients admitted to the intensive care unit(ICU),those with more severe COVID-19,and *** independent variables affecting outcome were supplementary vitamin C intake(1 g daily capsules)[odds ratio(OR):0.05,95%confidence interval(CI

关键词： COVID-19 Egypt Liver injury Gastrointestinal symptoms Fibrosis-4 Liver enzymes

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Comparison between seismic analysis of twisting and regular 52-story towers considering soil-structure interaction

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Earthquake Engineering and Engineering Vibration 2024年第3期23卷 663-675页

作者： mohamed Naguib Abouelsaad Mohammed Shaaban Salah el Bagalaty mohamed E.el Madawy Structural Engineering Department Faculty of EngineeringMansura UniversityMansoura 35511Egypt Faculty of Engineering Delta University for Science and TechnologyGamasa 35712Egypt

A dynamic analysis of both twisting and regular towers is carried out to determine the results of considering soil-structure interaction(SSI)on high-rise *** addition,the difference between the seismic performance of using twisting towers over regular ones is *** twisting tower is a simulation of the Evolution Tower(Moscow).The towers’skeletons consist of RC elements and rest on a reinforced concrete piled-raft *** soil model is considered as multi-layered with the same soil properties as the zone chosen for the analysis(New Mansoura City,Egypt).The only difference between both towers is their shape in *** whole system is modelled and analyzed in a single step as one full 3D model,which is known as the direct approach in *** analyses are carried out using finite-element software(Midas GTS NX).Dynamic output responses due to three records of seismic loads are proposed and presented in some *** on the results,it is concluded that SSI has a considerable effect on the dynamic response of tall buildings mainly because of the foundation flexibility,as it leads to lengthening the vibration period,increasing the story drift and the base shear for both cases.

关键词： soil-structure interaction seismic analysis twisting towers base shear story drift finite element method Midas GTS NX

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