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World Journal of Gastroenterology 2024年第23期30卷 2947-2953页

作者： Ahmed Tawheed Ibrahim Halil Bahcecioglu Mehmet Yalniz mohamed el-kassas Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Gastroenterology Faculty of MedicineFirat UniversityElazig 23119Türkiye Liver Disease Research Center College of MedicineKing Saud UniversityRiyadh 7805Saudi Arabia

In this editorial,we respond to a review article by Nabi et al,in which the authors discussed gastroesophageal reflux(GER)following peroral endoscopic myotomy(POEM).POEM is presently the primary therapeutic option for achalasia,which is both safe and effective.A few adverse effects were documented after POEM,including *** diagnostic criteria were not clear enough because approximately 60%of patients have a long acid exposure time,while only 10%experience reflux *** predictors of high disease incidence have been identified,including old age,female sex,obesity,and a baseline lower esophageal sphincter pressure of less than 45 *** technical steps during the procedure,such as a lengthy or full-thickness myotomy,may further enhance the *** pump inhibitors are currently the first line of *** voices are increasingly advocating for the routine combining of POEM with an endoscopic fundoplication method,such as peroral endoscopic fundoplication or transoral incisionless ***,more research is necessary to determine the safety and effectiveness of these procedures in the long term for patients who have undergone them.

关键词： Achalasia Per-oral endoscopic myotomy Gastroesophageal reflux disease Transoral incisionless fundoplication Peroral endoscopic fundoplication

Metabolic aspects of hepatitis C virus

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World Journal of Gastroenterology 2022年第22期28卷 2429-2436页

作者： mohamed el-kassas Abeer Awad Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Internal Medicine Faculty of MedicineCairo UniversityCairo 11566Egypt

Many metabolic factors are associated with chronic hepatitis C virus(HCV)infection and can influence the course of the illness and impact the progression of liver and non-liver-related diseases through complex *** of these factors impact the course of chronic HCV(CHC)and result in the conceptual translation of CHC from a localized to systemic *** the traditional liver manifestations associated with CHC infection,such as cirrhosis and hepatocellular carcinoma,various extrahepatic disorders are associated with HCV infection,including atherosclerosis,glucose and lipid metabolic disturbances,alterations in the iron metabolic pathways,and lymphoproliferative *** coexistence of metabolic disorders and CHC is known to influence the chronicity and virulence of HCV and accelerates the progression to liver fibrosis and hepatocellular *** resistance is one of the key factors that have a tremendous metabolic impact on ***,there is a great need to properly evaluate patients with CHC infection and correct the modifiable metabolic risk ***,patients with HCV who achieved a sustained virological response showed an overall improvement in glucose metabolism,but the exact evidence still requires further studies with long-term *** review delineates the most recent evidence on the main metabolic factors associated with CHC and the possible influence of chronic HCV infection on metabolic features.

关键词： Hepatitis C virus Metabolic factors Steatosis Insulin resistance

Fibrolamellar hepatocellular carcinoma:A rare but unpleasant event

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World Journal of Gastrointestinal Oncology 2022年第6期14卷 1103-1114页

作者： Walaa Abdelhamed mohamed el-kassas Department of Endemic Medicine Sohag UniversitySohag 14322Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

Fibrolamellar carcinoma(FLC)is a rare variant of hepatocellular carcinoma(HCC),comprising 1%–9%of all *** is a poorly understood malignancy,which seems to be more prevalent in young patients with no underlying liver *** term“fibrolamellar”is derived from thick fibrous collagen bands surrounding the tumor *** HCC,cirrhosis and viral hepatitis infection are not predisposing to FLC,and it is not associated with elevations in serum *** patients often present with vague abdominal pain,nausea,malaise,and weight *** cases present are at an advanced stage at the time of initial ***,curative treatment options can still be offered to up to 70%of ***(resection/liver transplantation)is the mainstay of treatment and the only potentially curative *** have been less chemoresponsive than the conventional HCC,however,in advanced cases,multimodality treatments can be *** advances in molecular studies of FLC have found a unique DNAJB1–PRKACA fusion transcript in most of the cases *** review aims to describe clinical characteristics,diagnostic methods,and therapeutic modalities for this rare tumor to raise awareness among clinicians and surgeons.

关键词： Fibrolamellar carcinoma Hepatocellular carcinoma Hepatitis Cirrhosis Viral hepatitis infection

Hepatocellular carcinoma recurrence:Predictors and management

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Liver Research 2023年第4期7卷 321-332页

作者： Walaa Abdelhamed mohamed el-kassas Endemic Medicine Department Sohag UniversitySohagEgypt Endemic Medicine Department Faculty of MedicineHelwan UniversityCairoEgypt

Hepatocellular carcinoma(HCC),the sixth most common cancer globally,is associated with high mortality rates and more than 830,000 annual *** advances in the available management options including surgical resection and local ablative therapies,recurrence rates after the initial treatment exceed 50%,even among patients who have undergone curative-intent ***,postsurgical HCC recurrence occurs in about 70%of cases five years *** management of recurrent HCC remains *** review discusses different predictors for HCC recurrence after each treatment modality and different approaches available to stratify these *** specific guidelines for managing HCC recurrence and strict surveillance protocols for such recurrence after initial HCC management are needed.

关键词： Hepatocellular carcinoma(HCC) Recurrence Ablation Liver resection Liver transplantation

Barrett’s esophagus in a patient with bulimia nervosa:A case report

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World Journal of Clinical Cases 2022年第17期10卷 5841-5845页

作者： Ahmed Gouda mohamed el-kassas Department of Gastroenterology NMC Ruwais HospitalAbu Dhabi 14638United Arab Emirates Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

BACKGROUND Barrett’s esophagus is a known complication of long-standing gastroesophageal reflux disease,and it is a potential risk factor of developing esophageal *** SUMMARY Here,we present a case of a 47-year-old male patient referred to the gastroenterology clinic for upper endoscopy because he has a long-standing history of heartburn and vomiting after *** examination,he had characteristic findings of self-induced vomiting as abrasions and callosities on the dorsum of the right hand and dental erosions.A detailed history revealed that he had 17 years of binge eating with self-induced *** upper endoscopy showed gastroesophageal reflux grade D with salmon-red mucosal projections,and the biopsy revealed intestinal mucosal *** This case emphasized the importance of considering upper endoscopy screening for Barrett’s esophagus in patients with eating disorders,especially those with self-induced vomiting,as in bulimia nervosa.

关键词： Barrett’s esophagus Bulimia nervosa Gastroesophageal reflux disease Case report

Diagnosis,treatment protocols,and outcomes of liver transplant recipients infected with COVID-19

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World Journal of Clinical Cases 2023年第10期11卷 2140-2159页

作者： Mai Hashem mohamed el-kassas Tropical Medicine and Gastroenterology Assiut University HospitalAssiut 71515Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

Several cases of fatal pneumonia during November 2019 were linked initially to severe acute respiratory syndrome coronavirus 2,which the World Health Organization later designated as coronavirus disease 2019(COVID-19).The World Health Organization declared COVID-19 as a pandemic on March 11,*** the general population,COVID-19 severity can range from asymptomatic/mild symptoms to seriously *** mortality rate could be as high as 49%.The Centers for Disease Control and Prevention have acknowledged that people with specific underlying medical conditions,among those who need immunosuppression after solid organ transplantation(SOT),are at an increased risk of developing severe illness from *** transplantation is the second most prevalent SOT *** to their immunosuppressed state,liver transplant(LT)recipients are more susceptible to serious ***,comorbidities and prolonged immunosuppression among SOT recipients enhance the likelihood of severe *** is crucial to comprehend the clinical picture,immunosuppressive management,prognosis,and prophylaxis of COVID-19 infection because it may pose a danger to transplant *** review described the clinical and laboratory findings of COVID-19 in LT recipients and the risk factors for severe disease in this population *** the following sections,we discussed current COVID-19 therapy choices,reviewed standard practice in modifying immunosuppressant regimens,and outlined the safety and efficacy of currently licensed drugs for inpatient and outpatient ***,we explored the clinical outcomes of COVID-19 in LT recipients and mentioned the efficacy and safety of vaccination use.

关键词： COVID-19 Liver transplantation Recipient Protocols Outcomes

Patterns of liver profile disturbance in patients with COVID-19

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World Journal of Clinical Cases 2022年第7期10卷 2063-2071页

作者： Hend Ibrahim Shousha Ahmed Ramadan Rania Lithy mohamed el-kassas Department of Endemic Medicine Faculty of MedicineCairo UniversityCairo 12556Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional ***-19 may be a new cause of liver disease,as liver profile disturbance is one of the most common findings among *** molecular mechanism underlying this phenomenon,however,is still *** this paper,we review the most current research on the patterns of change in liver profile among patients with COVID-19,the possible explanation for these findings,and the relation to pre-existing liver disease in these patients.

关键词： Liver functions COVID-19 Liver profile Alanine transaminase aspartate transaminase Bilirubin

Fibrosis regression following hepatitis C antiviral therapy

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World Journal of Hepatology 2022年第6期14卷 1120-1130页

作者： Aisha elsharkawy Reham Samir mohamed el-kassas Department of Endemic Medicine and Hepatogastroenterology Faculty of MedicineCairo UniversityCairo 11566Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

Hepatitis C virus(HCV)infection is one of the most common causes of liver *** is a major etiological factor of continuous liver injury by triggering an uncontrolled inflammatory response,causing liver fibrosis and *** fibrosis is a dynamic process that can be reversible upon timely cessation of the injurious agent,which in cases of HCV is represented by the sustained virological response(SVR)following antiviral ***-acting antiviral therapy has recently revolutionized HCV therapy and minimized *** fibrosis can be assessed with variable invasive and non-invasive methods,with certain *** the broad validation of the diagnostic and prognostic value of non-invasive modalities of assessment of liver fibrosis in patients with HCV,the proper interpretation of liver stiffness measurement in patients after SVR remains *** is also still a debate whether this regression is caused by the resolution of liver injury following treatment of HCV,rather than true fibrosis *** of liver fibrosis can possess a positive impact on patient's quality of life reducing the incidence of ***,fibrosis regression does not abolish the risk of developing hepatocellular carcinoma,which mandates regular screening of patients with advanced fibrosis.

关键词： Fibrosis regression Hepatitis C virus Direct-acting antivirals Hepatocellular carcinoma Liver fibrosis Cirrhosis

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