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Cystic pancreatic lesions,the endless dilemma

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World Journal of Gastroenterology 2021年第21期27卷 2664-2680页

作者： hussein Hassan Okasha Abeer Awad Ahmed El-meligui Reem Ezzat Ashraf Aboubakr Sameh AbouElenin ramy El-husseiny Ahmed Alzamzamy Department of Internal Medicine and Gastroenterology Hepatology UnitKasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Internal Medicine and Gastroenterology Hepatology UnitAssuit UniversityAssuit 71515Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11441Egypt Department of Gastroenterology and Hepatology Military Medical AcademyCairo 11441Egypt Department of Hepatology and Tropical Medicine National Hepatology and Tropical Medicine Research Institute(NHTMRI)Cairo 11441Egypt

Cystic pancreatic lesions involve a wide variety of pathological entities that include neoplastic and non-neoplastic *** proper diagnosis,differentiation,and staging of these cystic lesions are considered a crucial issue in planning further *** are great challenges for their diagnostic *** our time,new emerging methods for this diagnosis have been *** ultrasonography-guided fine-needle aspiration cytology with chemical and molecular analysis of cyst fluid and EUS-guided fine needlebased confocal laser endomicroscopy,through the needle microforceps biopsy,and single-operator cho-langioscopy/pancreatoscopy are promising methods that have been used in the diagnosis of cystic pancreatic *** we discuss the diagnosis of cystic pancreatic lesions and the benefits of various diagnostic models.

关键词： Pancreatic cystic lesion Endoscopic diagnosis Endoscopic ultrasonography Cyst fluid markers Endoscopic ultrasonography-guided fine needle-based confocal laser endomicroscopy Through the needle microforceps biopsy Single operator cholangioscopy/pancreatoscopy

Determinants of Schistosoma mansoni transmission in hotspots at the late stage of elimination in Egypt

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Infectious Diseases of Poverty 2022年第5期11卷 95-96页

作者： ramy Mohamed Ghazy Walid Ismail Ellakany Mai M.Badr Nehad E.M.Taktak Heba Elhadad Sarah MAbdo Ayat Hagag Abdel Rahman hussein Mohamed Mostafa Tahoun 不详 Department of Tropical Medicine Faculty of MedicineAlexandria UniversityAlexandriaEgypt

Background In certain settings,the prevalence and severity of schistosoma infection do not lessen despite repeated rounds of preventative chemotherapy;these areas are known as *** study aimed to investigate the role of human practices,besides environmental and malacological factors,in the maintenance of the Schistosoma mansoni infection transmission chain in hotspot areas in *** This cross-sectional study was conducted between July and November 2019 in Kafr El-Sheikh Governorate,Egypt.A pre-designed structured interviewing questionnaire was used to collect humanitarian *** samples were collected from children aged 6–15 years on three successive days and examined using the Kato-Katz ***,water and snail samples were taken from watercourses surrounding *** were identified based on their shell morphology and structure and tested for cercaria *** samples were analyzed for their physicochemical and biological *** A total of 2259 fecal samples(1113 in summer and 1146 in fall)were collected from 861 *** 46.9%of the participants were males,and 31.8%were aged 6–10 *** prevalence of *** infection was higher during the summer than during the fall(19.1%vs 7.2%,respectively,P<0.01).The intensity of infection(light,moderate,and heavy)during summer versus fall was(93.55 vs 89.38%,6.45 vs 8.85%,and 0.00%vs 1.77%),respectively(P<0.05).A higher prevalence of human infection was observed among males than females[OR=1.63,95%confidence interval(CI):1.10–2.40,P=0.015],children aged 11–15 years than among their counterparts aged 6–10 years(OR=2.96,95%CI:1.72–5.06,P<0.001),and mothers with a low level of education(OR=3.33,95%CI:1.70–6.52,P<0.001).The main identified risk factors were contacting the main body of water-canal for washing clothes(OR=1.81,95%CI:1.12–2.49,P=0.015),land irrigation(OR=2.56,95%CI:1.32–4.96,P=0.004),water collection(OR=2.94,95%CI:1.82–4.73,P<0.001),bathing(

关键词： Schistosoma mansoni Praziquantel Biomphalaria alexandrina Community engagement Transmission cycle Neglected tropical diseases

Gemcitabine combined with cisplatin in the treatment of advanced malignant pleural mesothelioma (MPM): Institutional experience

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The Chinese-German Journal of Clinical Oncology 2013年第5期12卷 213-218页

作者： ramy R. Ghali Sherif Abdelwahab Mohamed E. L. Bassiuony Ayman I. Kamel hussein Shalaby Dina N. K. Boulos Clinical Oncology Department Ain Shams University Radiodiagnosis Department Cairo University Chest Department Abbassia Chest Hospital Community Environmental and Occupational Medicine DepartmentAin Shams University

Objective： The aim of our study was to evaluate the efficacy and safety of gemcitabine and cisplatin in patients with previously untreated advanced malignant pleural mesothelioma （MPM）. Methods： Thirty-three eligible patients with histologically proven advanced MPM with ECOG PS of 〈 2 and had adequate liver and kidney functions received gemcitabine （1000 mg/m2） on days 1 and 8 combined with cisplatin （80 mg/m^2） on day 1. Results： The majority of the study group were males and constituted 87.9% （n = 29）, while females constituted 12.1% （n = 4）. The median age was 52 years and ranged from 37 to 69 years. Regarding SWOG performance status, 5 patients were PS 0, 21 patients were PS 1 and 7 patients were PS 2. Regarding pathological subtypes, epithelial histology represented 84.8% of the study （n = 28） while sarcomatoid type represented 6% （n = 2） and biphasic type accounted for 9% （n = 3）. Regarding staging according to IMIG staging system, 12.1% of patients were stage Ⅱ, 54.5% were stage Ⅲand 33.3% were stage Ⅳ. Only one patient （3%） had attained a complete response, 18 patients （54.5%） showed partial response, 12 patients （36.4%） showed stationary disease, while 2 patients （6.1%） showed progressive disease. The correlation between response rate obtained and PS was statistically significant （P = 0.029）. After a median follow-up of 14.4 months, the median survival time was 20.3 months （95% Cl： 14.58-26.01 months） and the progression free survival time was 11.8 months （95% CI： 10.76-12.83 months） Conclusion： The combination of gemcitabine and cisplatin is an active and safe treatment in patients with MPM. Further larger comparative studies are warranted to document this finding.

关键词： cisplatin mesothelioma gemcitbine

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