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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.k.allaf elsayed Mostafa Ali Ahmed MMak.ad 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

Back.round:?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 week.y 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 week.y (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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The Prevalence of Irritable Bowel Syndrome among Medical and Non-Medical Suez Canal University Students

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Open Journal of Gastroenterology 2015年第5期5卷 42-48页

作者： Mariam M. Darweesh Mennat Allah M. Abd el Hameed Yomna M. Hassan k.adiga A. Abd el Rheem Shaza A. mohamed Marwa A. Mahdy Ahmed A. Slwawy mona M. Abo el Ftooh Faculty of Medicine Suez Canal University Ismailia Egypt

Back.round: Irritable bowel syndrome (IBS) is one of the most frequently diagnosed gastrointestinal (GI) disorders in primary care and gastroenterology practices, despite the fact that many suffer symptoms without k.owing their diagnosis or seek.for medical consult, so this study aims to explore the prevalence of irritable bowel syndrome (IBS) among Suez Canal university students. Methods: A cross section. With multistage cluster probability sample. Using Rome criteria III IBS module, the questionnaire was administrated to Suez Canal university students;a population consisting of (86) students of the faculty of medicine & non-medical (84) students of the faculty of commerce English section with total (170) students of the third batch from both faculties (whose mean age is 20 ± 0.82) years old with total (109) females and (61) males. Results: The prevalence of IBS according to Rome III criteria in Suez Canal University was 22.9%. 23.8% were diseased in the faculty of commerce while 22.1% in faculty of medicine. Females in this study represent 64.1% of the sample, 30.3% of them were diseased, while males represent 35.9% about 9.8% of them were diseased. IBS constipation predominant type was 28.2%, diarrhea predominant type was 15.4%, mixed type was 46.2%, the unsubtyped cases represent 10.3%. Conclusion: Irritable bowel syndrome is a common disease among Suez Canal university students, more common in non medical students than medical ones, can be considered as a female predominant disease. And this requires a real medical concern.

关键词： Prevalence Irritable Bowel Syndrome IBS Gastrointestinal Diseases Rome III Criteria

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An Observational Study on the Management of COVID-19 Patients in Limited-Resource Hospitals

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Journal of Clinical and Nursing Research 2022年第3期6卷 43-53页

作者： Marwa O elgendy Ahmed M k.alaf Ahmed O el-Gendy mona A Abdelrahman Sara O el Gendy Ahmed M Abdel Hamied Omar Essam k.rim Al Amir Esraa M Yousry mohamed EA Abdelrahim Department of Clinical Pharmacy Teaching Hospital of Faculty of MedicineFaculty of MedicineBeni-Suef UniversityBeni-Suet Egypt Department of Clinical Pharmacy Faculty of PharmacyNahda University(NUB)Egypt Internal Medicine Department Faculty of MedicineBeni-Suef UniversityBeni-Suef Egypt Department of Microbiology and Immunology Faculty of PharmacyBeni-Suef UniversityBeni-Suef Egypt Department of Clinical and Chemical Pathology Faculty of MedicineBeni-Suef UniversityBeni-SuefEgypt Department of Pediatric Medicine Ministry of HealthBeni-Sueft Egypt Ministry of Health Beni-SuefEgypt Department of General Surgery Ministry of HealthBeni-Suefi Egypt Faculty of Agriculture Fayoum University Egypt Clinical Pharmacy Department Faculty of Pharmacy Beni-Suef UniversityBeni-Suef Egypt

Back.round:The purpose of this study was to evaluate the effectiveness of limited-resource hospitals in managing mild and moderate hospitalized cases of COVID-19 with comorbidities and in preventing their progression to severe ***:Data were obtained from 88 moderate COVID-19 patients with comorbidities who were admitted to limitedresource *** data were classified into several parts:comorbidities,chronic medication before hospital admission,symptoms of COVID-19 before and during hospitalization,clinical features,laboratory findings on hospital admission,complications during hospitalization,as well as worst laboratory values during hospitalization,hospital stay,and *** clinical features,laboratory results,type of oxygen therapy used,and the final treatment outcome were all evaluated to assess for any potential ***:All patients were alive upon *** admission,the majority of patients(60.2%)received COVID-19 treatment,and the average hospital stay was 12 *** most common symptoms were fever(88.7%),cough(95.5%),shortness of breath(90.9%),myalgia(84.1%),confusion(63.6%),headache(62.5%),sore throat(88.7%),rhinorrhea(17%),chest pain(58%),diarrhea(19.3%),nausea and vomiting(38.6%),anosmia(62.5%),as well as dysgeusia(64.8%).Based on chest radiograph or computed tomography(CT)scan,9.1%of the patients had unilateral pneumonia,90.9% had bilateral pneumonia,and 96.6% had multiple mottling and ground-glass *** was found associated with a significant increase in headache(p=0.005),rhinorrhea(p=0.013),chest pain(p=0.007),and the need for positive airway pressure(p=0.008).Between pre-and post-hospital admissions,there was a significant increase in lactate dehydrogenase and ferritin but a decrease in platelet,D-dimer,hemoglobin,lymphocytes,neutrophils,and total leucocyte count(pel(p=0.05).Conclusion:Limited-resource hospitals in Egypt w

关键词： COVID-19 Limited-resource hospitals COVID-19 laboratory tests Comorbidities

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Role of endoscopic ultrasound and cyst fluid tumor mark.rs in diagnosis of pancreatic cystic lesions

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World Journal of Gastrointestinal Endoscopy 2022年第6期14卷 402-415页

作者： Hussein Hassan Ok.sha Abeer Abdellatef Shaimaa elk.oly Mohamad-Sherif Mogawer Ayman Yosry Magdy elserafy Eman Medhat Hanaa k.alaf Magdy Fouad Tamer elbaz Ahmed Ramadan Mervat E Behiry k.rolis Y William Ghada Habib mona k.ddah Haitham Abdel-Hamid Amr Abou-elmagd Ahmed Galal Wael A Abbas Ahmed Youssef Altonbary Mahmoud el-Ansary Aml E Abdou Hani Haggag Tarek.Ali Abdellah mohamed A elfek. Heba Ahmed Faheem Hani M k.attab Mervat el-Ansary Safia Beshir mohamed el-Nady Department of Internal Medicine and Hepatogastroenterology Kasr Al-Aini HospitalsCairo UniversityKasr Al-Aini HospitalsCairo UniversityCairo 11451Egypt Department of Endemic Diseases Cairo UniversityCairo 11451Egypt Department of Tropical Medicine and Gastroenterology Minia UniversityMinia 61511Egypt Department of Internal Medicine Kasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Gastroenterology Armed forces College of MedicineCairo 11451Egypt Endoscopy and Internal Medicine Consultant at Dr/Ahmed Galal Endoscopy Center Alexandria 35516Egypt Department of Internal Medicine Faculty of MedicineAssuit UniversityAssuit 71111Egypt Department of Gastroenterology and Hepatology Mansoura UniversityMansoura 35511Egypt Department of Gastroenterology and Hepatology Theodor Bilharz Research InstituteCairo 11451Egypt Department of Microbiology and Immunology Faculty of Medicine for girls Al-Azhar UniversityCairo 11451Egypt Department of Internal Medicine Faculty of MedicineAin shams UniversityCairo 11451Egypt Department of Internal Medicine Bani-suef UniversityBani-suefBani-suef 62511Egypt Department of Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Clinical Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Environmental Medicine&Clinical Pathology National Research CentreCairo 11451Egypt

BACk.ROUND Pancreatic cystic lesions(PCLs) are common in clinical practice. The accurate classification and diagnosis of these lesions are crucial to avoid unnecessary treatment of benign lesions and missed opportunities for early treatment of potentially malignant *** To evaluate the role of cyst fluid analysis of different tumor mark.rs such as cancer antigens [e.g., cancer antigen(CA)19-9, CA72-4], carcinoembryonic antigen(CEA), serine protease inhibitor k.zal-type 1(SPINk.), interleuk.n 1 beta(IL1-β), vascular endothelial growth factor A(VEGF-A), and prostaglandin E2(PGE2)], amylase, and mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign *** This study included 76 patients diagnosed with PCLs using different imaging modalities. All patients underwent endoscopic ultrasound(EUS) and EUS-fine needle aspiration(EUS-FNA) for characterization and sampling of different *** The mean age of studied patients was 47.4 ± 11.4 years, with a slight female predominance(59.2%). Mucin stain showed high statistical significance in predicting malignancy with a sensitivity of 87.1% and specificity of 95.56%. It also showed a positive predictive value and negative predictive value of 93.1% and 91.49%, respectively(P k., amylase, and CEA levels had high statistical significance(P elation with mural nodules, lymph nodes, cyst diameter, mucin stain, and cyst fluid CEA. Meanwhile, logistic multivariable regression analysis proved that mural nodules, mucin stain, and SPINk. were independent predictors of malignancy in cystic pancreatic *** EUS examination of cyst morphology with cytopathological analysis and cyst fluid ana

关键词： Pancreatic cystic neoplasm Mucinous cystic neoplasm Intraductal papillary mucinous neoplasm Mucin stain Amylase

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