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HCV Therapy Follow-up Fractionation (CTF2) by Intra-PBMC Nested RNA PCR Recognizes Early Virologic Response and Relapse

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Journal of Clinical and Translational Hepatology 2018年第2期6卷 147-154页

作者： Mohamed Darwish ahmed Abd Alla Saleh ahmed Elibiary ramy Hassan Elshaboury George Y.Wu Reham M.Dawood Mostafa Kamel El Awady Tropical Medicine Department Faculty of MedicineAl-Azhar UniversityCairoEgypt Department of Pharmacy Massachusetts General HospitalBostonMAUSA Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterHartfordCTUSA Department of Microbial Biotechnology National Research CenterCairoEgypt

Background and Aims:Sustained virologic response is evaluated by single-step reverse transcription(SRT)PCR as-say,which assesses hepatitis C virus(HCV)clearance from plasma but not from tissues such as peripheral blood mono-nuclear cells(PBMCs).Persistence of HCV RNA in PBMCs beyond end of treatment(EOT)is associated with *** goal was to measure intra-PBMC HCV RNA levels during oral antiviral therapy according to the HCV therapy follow-up fractionation(CTF2)***:Compen-sated chronic HCV patients(n=278 SRT-PCR positive)were scheduled to receive oral antiviral *** were followed-up by SRT and intra-PBMCs HCV RNA PCR at the end of the 2nd,6th,10th,14th,18th and 24th weeks to evaluate virus clearance from plasma and PBMCs,*** CTF2 protocol evaluated SRT and PBMC PCR status at each follow-up point for determining therapy continuation or inter-ruption to address cost ***:All patients tested negative by SRT PCR after therapy for 2 ***-cation of the CTF2 protocol revealed:a)increasing HCV clear-ance rate from 75.9%at the end of 10th week to 90.3%at the end of 24th week(p<0.00001);b)faster clearance of HCV from plasma compared to PBMCs at each point of follow-up until the 18th week(p<0.05);c)higher viral elimination rates diagnosed by PBMC HCV RNA PCR(?)compared to PBMC HCV RNA PCR(+)from the 6th to 24th week of treatment(p<0.0001);d)higher over-time increase curve of combined plasma and PBMC HCV RNA determined negativity compared to the decline in positivity curves by PBMC PCR at the 6th-18th week compared to the 24th week(p<0.01)—these results validated treatment continuation;and e)solitary evaluation of EOT sustained HCV infection and relapses by PBMC HCV RNA(p<0.001).Conclusions:Early elimination of serum and tissue(PBMC)HCV infection by oral antiviral therapy can be achieved and evaluated during a cost-effective CTF2 pro-tocol application.

关键词： CTF2 protocol HCV PBMCs PCR Cost-effectiveness

Mid-term results of sub-trochanteric valgus osteotomy for symptomatic late stages Legg-Calvé-Perthes disease

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World Journal of Orthopedics 2023年第5期14卷 328-339页

作者： Khaled M Emara ramy ahmed Diab ahmed K Emara Mohamed Eissa Mostafa Gemeah Shady Abdelghaffar Mahmoud Department of Orthopedic Surgery Ain Shams UniversityCairo 11591Egypt Department of Orthopedic Surgery Cleveland Clinic FoundationClevelandOH 9500United States Health Care Innovation Program Arizona State UniversityTempeAZ 85287United States

BACKGROUND The treatment of late stages of Legg-Calvé-Perthes disease(LCPD)is *** the concept of femoral head containment is a well-established technique of treatment,its use remains debatable in the late stages of the disease,as it does not improve symptoms in terms of limb length discrepancy and *** To assess the results of subtrochanteric valgus osteotomy in symptomatic patients with late-stage Perthes *** From 2000 to 2007,36 symptomatic patients with late stage of Perthes disease were surgically treated with subtrochanteric valgus osteotomy and followed-up for 8 to 11 years using the IOWA score and range of motion(ROM)*** Mose classification was also assessed at the last follow-up to reflect possible *** patients were 8 years old or older at the time of surgery,in the post-fragmentation stage,and complaining of pain,limited ROM,Trendelenburg gait,and/or abductor *** The preoperative IOWA score(average:53.3)markedly improved at the 1-year post follow-up period(average:85.41)and then slightly improved at the last follow-up(average:89.4)(P value<0.05).ROM improved,with internal rotation increased on average by 22°(from 10°preoperatively to 32°postoperatively)and abduction increased on average by 15.9°(from 25°preoperatively to 41°postoperatively).The mean Mose deviation of femoral heads was 4.1 mm at the end of the follow-up *** tests used were the paired t-test and Pearson correlation test,where the level of significance was a P value less than *** Subtrochanteric valgus osteotomy can be a good option for symptomatic relief in patients with late-stage of LCPD.

关键词： Legg-Calvé-Perthes disease Femoral head avascular necrosis Valgus osteotomy Deformity correction Post fragmentation stage Late stage Perthes

STW 5 is effective against nonsteroidal anti-inflammatory drugs induced gastro-duodenal lesions in rats

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World Journal of Gastroenterology 2019年第39期25卷 5926-5935页

作者： Mohamed T Khayyal Walaa Wadie Enas A Abd El-Haleim Kawkab A ahmed Olaf Kelber ramy M Ammar Heba Abdel-Aziz Department of Pharmacology Faculty of PharmacyCairo UniversityCairo 11562Egypt Department of Pathology Faculty of Veterinary MedicineCairo UniversityCairo 12211Egypt Steigerwald Arzneimittelwerk GmbH Bayer Consumer HealthDarmstadt 64295Germany Department of Pharmacology Faculty of PharmacyKafrelsheikh UniversityKafrelsheikh 33511Egypt

BACKGROUND Proton pump inhibitors are often used to prevent gastro-intestinal lesions induced by nonsteroidal anti-inflammatory ***,they are not always effective against both gastric and duodenal lesions and their use is not devoid of side *** To explore the mechanisms mediating the clinical efficacy of STW 5 in gastroduodenal lesions induced by nonsteroidal anti-inflammatory drugs(NSAIDs),exemplified here by diclofenac,in a comparison to *** Gastro-duodenal lesions were induced in rats by oral administration of diclofenac(5 mg/kg)for 6 successive *** group was given concurrently STW 5(5 mL/kg)while another was given omeprazole(20 mg/kg).A day later,animals were sacrificed,stomach and duodenum excised and divided into 2 segments:One for histological examination and one for measuring inflammatory mediators(tumor necrosis factorα,interleukins-1βand 10),oxidative stress enzyme(heme oxygenase-1)and apoptosis regulator(B-cell lymphoma 2).RESULTS Diclofenac caused overt histological damage in both tissues,associated with parallel changes in all parameters *** 5 and omeprazole effectively prevented these changes,but STW 5 superseded omeprazole in protecting against histological damage,particularly in the *** The findings support the therapeutic usefulness of STW 5 and its superiority over omeprazole as adjuvant therapy to NSAIDs to protect against their possible gastro-duodenal side effects.

关键词： Diclofenac STW 5 Omeprazole Gastro-intestinal lesions Inflammation

La^3+ doped LiCo0.25Zn0.25Fe2O4 spinel ferrite nanocrystals:Insights on structural,optical and magnetic properties

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Journal of Rare Earths 2021年第1期39卷 75-82,I0003页

作者： M.I.A.Abdel Maksoud ahmed El-Ghandour A.H.Ashour M.M.Atta Soraya Abdelhaleem ahmed H.El-Hanbaly ramy Amer Fahim Said M.Kassem M.S.Shalaby A.S.Awed Materials Science Lab. Radiation Physics DepartmentNational Center for Radiation Research and Technology(NCRRT)Atomic Energy AuthorityCairoEgypt Center Photonics and Smart Materials(CPSM) Zewail City of Science and TechnologyOctober Gardens6th of October CityGizaEgypt Polymers Physics Lab. Radiation Physics DepartmentNational Center for Radiation Research and Technology(NCRRT)Atomic Energy AuthorityCairoEgypt Egyptian Nuclear and Radiological Regulatory Authority CairoEgypt Radiation Protection and Dosimetry Department National Center for Radiation Research and Technology(NCRRT)Atomic Energy AuthorityCairoEgypt Magnetic and Thermal Lab Solid State&Accelerators DepartmentNational Center for Radiation Research and TechnologyAtomic Energy AuthorityNasr CityCairoEgypt Higher Institute for Engineering and Technology ManzalaDakahliaEgypt

This paper addresses the manipulation of structural,morphology,optical and magnetic properties of LiCo0.25Zn0.25Fe2 O4 ferrite via incorporation of different proportions of La^3+at the expense of iron ions using a sol-gel *** samples were characterized using the X-ray diffraction technique(XRD),Fourier transform infrared(FT-IR)spectroscopy,the energy dispersive X-ray spectra(EDX),inductively coupled plasma optical emission spectroscopy(ICP-OES),high resolution scanning electron microscopy(SEM),Brunauer-Emmett-Teller(BET)surface area analysis,ultraviolet-diffuse reflectance spectroscopy(UV-DRS),and vibrating sample magnetometer(VSM)*** Rietveld refinements of the samples indicate that at higher concentrations of La^3+,nanostructures with dual phase,*** spinel and orthorhombic LaFeO3 perovskite with space group(Pbnm)*** studies show that the energy band gap(Eg)of the bare LiCo0.25Zn0.25Fe2 O4 ferrite sample(2.18 eV)reaches up to 2.47 eV at x=0.06 and above this concentration,it drops sharply to 2.00 *** the saturation magnetization and the coercivity of LiCo0.25Zn0.25LaxFe2-xO4 are lower than that of LiCo0.25Zn0.25Fe2 O4 ***,the superparamagnetic nature and low values of saturation magnetization and coercivity of LiCo0.25Zn0.25LaxFe2-xO4 NPs are suitable to be applied in transformers core.

关键词： Li-Co-Zn ferrite Superparamagnetic nature Optical properties Magnetic behavior Transformers core Rare earths

Disease control and failure patterns of unresectable hepatocellular carcinoma following transarterial radioembolization with yttrium-90 microspheres and with/without sorafenib

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World Journal of Gastroenterology 2021年第47期27卷 8166-8181页

作者： Ajalaya Teyateeti Armeen Mahvash James Long Mohamed abdelsalam Rony Avritscher ahmed Kaseb Bruno Odisio Gregory Ravizzini Devaki Surasi Achiraya Teyateeti Homer Macapinlac Srinivas Cheenu Kappadath Department of Nuclear Medicine The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Division of Nuclear Medicine Department of RadiologyFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Department of Interventional Radiology The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Biostatistics The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Division of Radiation Oncology Department of RadiologyFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Department of Imaging Physics The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States

BACKGROUND Impressive survival outcome of our previous study in unresectable hepatocellular carcinoma(HCC)patients undergoing yttrium-90 glass microspheres transarterial radioembolization(TARE)with/without sorafenib according to individuals’disease burden,i.e.,intrahepatic tumor load(IHT)and adverse disease features(ADFs)might partly be confounded by other treatments and underlying hepatic ***,a dedicated study focusing on treatment response and assessment of failure patterns might be a way to improve treatment outcome in addition to patient selection based on the disease *** To assess the tumor response,disease control and patterns of disease progression following TARE with/without sorafenib in unresectable HCC *** This retrospective study was conducted in successful TARE procedures with available pre-and post-treatment imaging studies(n=169).Three treatment subgroups were(1)TARE only(TARE_alone)for IHT≤50%without ADFs,i.e.,macrovascular invasion,extrahepatic disease(EHD)and infiltrative/ill-defined HCC(n=63);(2)TARE with sorafenib(TARE_sorafenib)for IHT>50%and/or presence of ADFs(n=81);and(3)TARE only for patients who could not receive sorafenib due to contraindication or intolerance(TARE_no_sorafenib)(n=25).Objective response rate(ORR;consisted of complete response(CR)and partial response(PR)),disease control rate(DCR;consisted of CR,PR and stable disease)and failure patterns of treated,intrahepatic and extrahepatic sites were assessed using the modified response evaluation criteria in solid *** to progression(TTP)was calculated from TARE to the first radiologic progression at any site using Kaplan-Meier *** of prognostic factors for TTP using the univariate Kaplan-Meier method and multivariate Cox proportional hazard model were performed in major population subgroups,TARE_alone and TARE_*** The median radiologic follow-up time was 4.4 mo(range 0.5-48.8).In treated area,ORR was highest in

关键词： Radioembolization Selective internal radiotherapy Tumor response Pattern of progression Time to progression Sorafenib

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

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World Journal of Gastroenterology 2017年第32期23卷 5962-5968页

作者： Hussein Okasha Shaimaa Elkholy ramy El-Sayed Mohamed-Naguib Wifi Mohamed El-Nady Walid El-Nabawi Waleed A El-Dayem Mohamed I Radwan Ali Farag Yahya El-sherif Emad Al-Gemeie ahmed Salman Mohamed El-Sherbiny ahmed El-Mazny Reem E Mahdy Internal Medicine Department Cairo University Department of Tropical Medicine Zagazig University Internal Medicine Department Beni Suef University Tropical Medicine Department El Manial Specialized Hospital Pathology Department National Cancer InstituteCairo University Internal Medicine Department Assiut University

AIM To evaluate the accuracy of the elastography score combined to the strain ratio in the diagnosis of solid pancreatic lesions(SPL). METHODS A total of 172 patients with SPL identified by endoscopic ultrasound were enrolled in the study to evaluate the efficacy of elastography and strain ratio in differentiating malignant from benign lesions. The semi quantitative score of elastography was represented by the strain ratio method. Two areas were selected, area(A) representing the region of interest and area(B) representing the normal area. Area(B) was then divided by area(A). Sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), and accuracy were calculated by comparing diagnoses made by elastography, strain ratio and final *** SPL were shown to be benign in 49 patients and malignant in 123 patients. Elastography alone had a sensitivity of 99%, a specificity of 63%, and an accuracy of 88%, a PPV of 87% and an NPV of 96%. The best cut-off level of strain ratio to obtain the maximal area under the curve was 7.8 with a sensitivity of 92%, specificity of 77%, PPV of 91%, NPV of 80% and an accuracy of 88%. Another estimated cut off strain ratio level of 3.8 had a higher sensitivity of 99% and NPV of 96%, but with less specificity, PPV and accuracy 53%, 84% and 86%, respectively. Adding both elastography to strain ratio resulted in a sensitivity of 98%, specificity of 77%, PPV of 91%, NPV of 95% and accuracy of 92% for the diagnosis of SPL. CONCLUSION Combining elastography to strain ratio increases the accuracy of the differentiation of benign from malignant SPL.

关键词： Endoscopic Ultrasound Elastography Strain Ratio Real Time Pancreatic lesions

The Diagnostic Accuracy of Automated Fetal Heart Echocardiography by Five Dimensional Compared to Two-Dimensional Ultrasound in the Second Trimester of Pregnancy

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Open Journal of Obstetrics and Gynecology 2018年第5期8卷 513-520页

作者： Rehab M. Abdelrahman ahmed R. M. ramy Amr M. Abdelhady Department of Obstetrics and Gynecology Maternity Hospital Ain Shams University Cairo Egypt Fetal Care Unit Ain Shams University Cairo Egypt

Objective: To compare the diagnostic accuracy of Fetal Intelligent Navigation Echocardiography (FINE) method by Five-Dimensional Ultrasound in automated fetal heart examination to conventional fetal heart examination by Two-Dimensional ultrasound in second trimester pregnancy. Methods: 90 normal singleton pregnancies at the second trimester were enrolled in this prospective study. Fetal heart was examined by Two-Dimensional Ultrasound (2D US) and Five-Dimensional Ultrasound (FINE). Paired numerical data were compared using the paired samples t test. Inter-method agreement for the rating of the quality of cardiac views by 2D US or 5D US was assessed by calculation of the prevalence-adjusted and bias-adjusted kappa coefficient (PABAK). Results: There was no statistical significant difference between fetal heart echocardiography assessment using 2DUS or 5DUS(FINE) (p-value > 0.05). The overall inter-method agreement between 2D US and 5D US was 0.92. The difference in % of satisfactory views between 2D and 5D US was 1.73%, (95% CI - 0.5% to 3.33%) (P-value = 0.144). Conclusion: Our findings indicate the accuracy of 5DUS (FINE) echocardiography in evaluation of normal heart in the second trimester of pregnancy.

关键词： Fetal Heart Echocardiography Fetal Intelligent Navigation Echocardiography 5DUS

Brand versus Generic Rosuvastatin in Egyptian Patients with Hyperlipidemia;Cost-Minimization Analysis

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International Journal of Clinical Medicine 2019年第12期10卷 631-638页

作者： Sameh Shaheen ahmed S. H. Elserafy Mohamed Amin ramy Hassan Emad R. Issak Cardiology Department Ain Shams University Cairo Egypt AstraZeneca Cairo Egypt ClinAmygate Cairo Egypt

Background: Serum level of cholesterol is one of the most vital risk factors for cardiovascular diseases (CVD). Statins are highly effective drugs for reducing serum cholesterol;hence, preventing coronary heart disease (CHD). Rosuvastatin (Crestor) is one of the most potent and widely prescribed statins. Even though generic statins have been approved based on their bioequivalence with brand-name drugs, there remains considerable concern as regards their effectiveness and safety. Most clinicians and patients welcome the generic drug decreased costs;however, it is indispensable for them that effectiveness and safety are not compromised. Thus, the rationale intended for this study is to compare brand rosuvastatin and generic rosuvastatin as regard their economic impact using a cost-minimization analysis. Methods: This cost-minimization model estimates potential impact of rosuvastatin brand versus generic on the healthcare resource utilization for one-year frame from the payer perspective. The model conforms to real practice of management of hyperlipidemia in Egypt and was validated by experts. Results: The drug costs in the rosuvastatin brand group were 3,155,250 EGP while in the generic group were 2,299,030 EGP. The costs of CVD events in the rosuvastatin brand group were 5,863,558 EGP, while in the generic group were 6,810,180 EGP. The total costs in the rosuvastatin brand group were 9,018,808 EGP, while in the generic group were 9,109,210 EGP with a difference of −100,047 EGP. Conclusions: In conclusion, the real cost of generic treatment is more than that of the brand statin when taking into consideration the cardiovascular events.

关键词： Rosuvastatin Generics Cardiovascular Events Cost-Minimization

Cost of external fixation vs external fixation then nailing in bone infection

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World Journal of Orthopedics 2015年第1期6卷 145-149页

作者： Khaled Mohamed Emara ramy ahmed Diab Khaled Abd EL Ghafar Orthopaedic Surgery Ain Shams University

AIM: To study the cost benefit of external fixation vs external fixation then nailing in treatment of bone infection by segment ***: Out of 71 patients with infected nonunion tibia treated between 2003 and 2006, 50 patients fitted the inclusion criteria(26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence fromschool or work were calculated and compared between both ***: The cost of hospital stay and surgery in the group of external fixation only was 22.6 ± 3.3 while the cost of hospital stay and surgery in the group of early external fixation removal and replacement by intramedullary nail was 26.0 ± 3.2. The difference was statistically significant regarding the cost of hospital stay and surgery in favor of the group of external fixation only. The total cost of medical care(surgery, hospital stay, treatment outside the hospital including medications, dressing, physical therapy, outpatient laboratory work, etc.) in group of external fixation only was 63.3 ± 15.1, and total absence from work was 38.6 ± 6.6 wk. While the group of early removal of external fixation and replacement by IM nail, total cost of medical care was 38.3 ± 6.4 and total absence from work or school was 22.7 ± 4.1. The difference was statistically significant regarding the total cost and absence from work in favor of the group of early removal and replacement by IM ***: Early removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance, and health authorities.

关键词： Cost Fixator Nailing Infection