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Liver stiffness as a predictor of hepatocellular carcinoma behavior in patients with hepatitis C related liver cirrhosis

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 22-28页

作者： sameh a lashen Mohamed M Elshafei Fahmy H Hablass Eman A Alsayed Asmaa A Hassan Department of Internal Medicine Faculty of MedicineUniversity of AlexandriaAlexandriaEgypt Department of Radiology Faculty of MedicineUniversity of AlexandriaAlexandriaEgypt Department of Biomedical Informatics and Medical Statistics Medical Research InstituteUniversity of AlexandriaAlexandriaEgypt

Background: Risk strati cation and prognostication of hepatocellular carcinoma (HCC) help to improve patient outcome. Herein we investigated the role of liver stiffness measurement (LSM) in the prediction of HCC behavior. Methods: Totally 121 na ve patients with HCC were included. HCC radiological evaluation and staging were done. LSM was measured using virtual touch quanti cation. Patients were divided into early to intermediate HCC (BCLC-0, A and B) and late HCC (BCLCC and D). HCC was treated according to the BCLC stage. HCC recurrence-free interval was estimated. Results: The mean LSM inside the tumor was signi cantly lower than the peri-tumoral area and the cirrhotic non-cancerous liver parts (P<0.001). In late HCCs stage, the mean LSM inside the tumor and in the peri-tumoral tissue was lower than the corresponding values in the early to intermediate HCCs stage (P<0.001). LSM inside the tumor and in the peri-tumoral tissue negatively correlated with serum AFP, tumor vascular invasion, and stage (P<0.05). The recurrence-free interval was directly correlated to LSM inside the tumor and inversely to LSM in cirrhotic non tumorous liver part. Kaplan-Meier analysis showed that the recurrence-free interval was signi cantly longer in patients with LSM inside the tumor of ≥1.25m/s compared to those with LSM inside the tumor of<1.25m/s. Conclusions: LSM can serve as a potential non-invasive predictor for HCC clinical behavior and the recurrence-free interval following loco-regional treatments.

关键词： Fibrosis Hepatitis C Hepatocellular carcinoma Point shear wave Liver cirrhosis

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β-arrestin-2 predicts the clinical response to β-blockers in cirrhotic portal hypertension patients: A prospective study

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World Journal of Hepatology 2022年第2期14卷 429-441页

作者： sameh a lashen Mohammed M Shamseya Marwa A Madkour Radwa M Abdel Salam Sanaa S Mostafa Division of Hepatology and Gastroenterology Faculty of MedicineAlexandria UniversityAlexandria 21521Egypt Department of Experimental and Clinical Internal Medicine Medical Research InstituteAlexandria 21561Egypt Department of Pathology Medical Research InstituteAlexandria UniversityAlexandria 21561Egypt

BACKGROUND Portal hypertension,a common complication associated with liver cirrhosis,can result in variceal bleeding,which greatly impacts patient ***,β-arrestin-2 has been shown to predict the acute hemodynamic response to nonselectiveβ-blocker therapy for cirrhotic portal ***,more data is needed on the long-term effects of and changes inβ-arrestin-2 following nonselectiveβ-blocker *** To investigate the expression and role ofβ-Arrestin-2 in predicting the long-term response to nonselectiveβ-blockers in cirrhotic portal hypertensive *** We prospectively enrolled 91 treatment-naïve patients with cirrhotic portal *** clinical and laboratory data were *** was performed for grading and treating varices and obtaining gastric antral *** measured the serum and antral expression ofβ-arrestin-2 and obtained Doppler measurement of the portal vein congestion *** with nonselectiveβ-blockers was then *** patients were followed up for 18 mo,after which they have undergone a repeat antral biopsy and re-evaluation of the portal vein congestion *** A higher serum level and antral expression ofβ-arrestin-2 was associated with longer bleedingfree intervals,greater reduction in the portal vein congestion index,and improved grade of *** patients with a lowβ-arrestin-2 expression,17.6%were nonselectiveβ-blocker responders,whereas,among those with high expression,95.1%were responders(P<0.001).A serumβ-arrestin-2 value≥2.23 ng/mL was associated with a lower likelihood of variceal bleeding(90%sensitivity and 71%specificity).β-arrestin-2 expression significantly decreased after nonselectiveβ-blocker ***β-arrestin-2 expression in cirrhotic portal hypertension predicts the clinical response to long-term nonselectiveβ-blocker ***β-arrestin-2 is a potential noninvasive biomarker for selecting the candidate patients for nonselectiveβ-bl

关键词： β-arrestin-2 Portal hypertension Variceal bleeding Nonselective beta-blockers Portal congestion index Variceal ligation

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Colorectal cancer in Arab world:A systematic review

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World Journal of Gastrointestinal Oncology 2021年第11期13卷 1791-1798页

作者： Nahed A Makhlouf Muhammad Abdel-Gawad Aya M Mahros sameh a lashen Mariam Zaghloul Ahmed Eliwa Eman E Elshemy Zainab Ali-Eldin Doaa Abdeltawab Fathiya El-Raey Dalia Omran Marwa Khalaf Nancy Fanous Ahmed Shawkat Abdelmohsen Ahmed Abu-Elfatth Mohamed Abdelghani Mahmoud Farouk Mohamed Abdelaziz Mohamed Alboraie Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Hepatology Gastroenterologyand Infectious DiseasesAl-Azhar UniversityAssiut 71631Egypt Department of Hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversityKafrelsheikh 33656Egypt Department of Internal Medicine Alexandria UniversityAlexandria 21521Egypt Department of Internal Medicine Al-Azhar UniversityCairo 11884Egypt Department of Hepatogastroenterology and Infectious Diseases Al-Azhar UniversityCairo 11651Egypt Department of Internal Medicine Ain Shams UniversityCairo 11646Egypt Department of Hepatogastroenterology and Infectious diseases Faculty of MedicineAl-Azhar UniversityDamietta 34511CairoEgypt Department of Endemic Medicine Cairo UniversityCairo 12613Egypt Department of Tropical Medicine and Gastroenterology Assiut Liver CenterAssiut 71511Egypt Department of Gastroenterology Hepatology and EndoscopyPolice Authority HospitalCairo 12654Egypt Department of Clinical Oncology and Nuclear Medicine Al-Azhar UniversityCairo 11824Egypt

BACKGROUND The incidence of colorectal cancer(CRC)is increasing among young individuals in the Arab world as well as in other regions of the *** To explore the incidence and prevalence of CRC in the Arab *** The PubMed,Scopus,Web of Science,EBSCO and Wiley databases were searched to retrieve relevant articles irrespective of the language or the publication *** search terms were("colon OR rectum OR sigmoid OR rectal OR colonic OR colorectal")AND("cancer OR malignancy OR malignant OR neoplasm")AND("Jordan"OR"United Arab Emirates"OR"Bahrain"OR"Tunisia"OR"Algeria"OR"Djibouti"OR"Saudi Arabia"OR"Sudan"OR"Syria"OR"Somalia"OR"Iraq"OR"Oman"OR"Palestine"OR"Qatar"OR"Comoros"OR"Kuwait"OR"Lebanon"OR"Libya"OR"Egypt"OR"Morocco"OR"Mauritania"OR"Yemen").Reviews,metaanalyses,and articles containing nonoriginal data were *** articles were screened,and relevant data were *** statistics were used for data *** Nine studies were *** of the studies provided information regarding the prevalence of *** prevalence of CRC was 0.72% in Saudi Arabia and 0.78% in the United Arab Emirate,while in Egypt,it ranged from 0.4% to 14%.Four studies showed information regarding the *** annual incidence rate of CRC in Qatar was 7.5/100000/*** Egypt,the crude incidence rate(CIR)in males was 3.1 for colon cancer and 1 for rectal cancer,while in females,it was 2.3 for colon cancer and 0.8 for rectal *** age-standardized rate for CRC incidence in 2003 was 36.90 for males,26.50 for females,and 30.49 for both sexes in Saudi *** 2016,the CIRs in Saudi Arabia were 3.6 and 2.1 in females for colon cancer and rectal cancer,respectively,while in males,it was 3.3 and 2.8 for colon cancer and rectal cancer,*** study in Egypt revealed that 25% of CRC cases occurred among individuals younger than 40 years *** There is a considerable prevalence of CRC in some Arab *** studies are n

关键词： Colorectal cancer Incidence Prevalence Arab world

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Barriers for resuming endoscopy service in the context of COVID-19 pandemic:A multicenter survey from Egypt

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World Journal of Gastroenterology 2020年第43期26卷 6880-6890页

作者： Omar Elshaarawy sameh Aldesoky lashen Nahed A Makhlouf Doaa Abdeltawab Mariam Salah Zaghloul Rasha M Ahmed Hayam Fathy Shimaa Afifi Muhammad Abdel-Gawad Eman Abdelsameea Sherief Abd-Elsalam Salem Youssef Mohamed Mohammed Tag-Adeen Mina Tharwat Ahmed Alzamzamy Ahmed Nasr Bekhit Alshaimaa M Eid Abeer Awad Mohamed-Naguib Wifi Mohammad Aamr Waleed A Abd El Dayem Mohamed Alboraie Department of Hepatology Gastroenterology and Liver TransplantationNational Liver InstituteMenoufia UniversityShebine Elkom 32511Egypt Department of Internal Medicine and Center of Alcohol Research and Liver Diseases Salem Medical CenterHeidelberg UniversityHeidelberg 69121Germany Department of Internal Medicine Faculty of MedicineUniversity of AlexandriaAlexandria 21521Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Hepatology Gastroentrology and Infectious DiseasesKafrelsheikh UniversityFaculty of MedicineKafrelsheikh 33565Egypt Department of Internal Medicine Faculty of MedicineAssiut UniversityAssiut 71515Egypt National Hepatology and Tropical Medicine Research Institute Cairo 11638Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineAl-Azhar UniversityAssiut 71524Egypt Department of Tropical Medicine and Infectious Diseases Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Internal Medicine Gastroenterology and Hepatology UnitFaculty of MedicineZagazig UniversityZagazig 44519Egypt Department of Internal Medicine Gastroenterology UnitQena Faculty of MedicineSouth Valley UniversityQena 83523Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAswan UniversityAswan 81528Egypt Department of Gastroenterology and Hepatology Military Medical AcademyCairo 11771Egypt Department of Tropical Medicine Zagazig General HospitalZagazig 42511Egypt Department of Hepatology and Gastroenterology and Infectious Disease Faculty of MedicineAlAzhar UniversityCairo 11562Egypt Department of Internal Medicine Faculty of MedicineCairo UniversityCairo 11759Egypt Department of Hepatology and Gastroentorolgy Shebin Elkom Teaching HospitalShebine Elkom 3521Egypt Department of Tropical Medicine Faculty of MedicineZagazig UniversityZagazig 44519Egypt Department of Internal Medicine Al-Azhar UniversityCairo 11651Egypt

BACKGROUND The current coronavirus disease 2019(COVID-19)pandemic has affected routine endoscopy service across the gastroenterology *** led to the suspension of service provision for elective *** To assess the potential barriers for resuming the endoscopy service in *** A national online survey,four domains,was disseminated over a period of 4 wk in August *** primary outcome of the survey was to determine the impact of the COVID-19 pandemic on the endoscopy service and barriers to the full resumption of a disabled center(s).RESULTS A hundred and thirteen Egyptian endoscopy centers participated in the *** waiting list was increased by≥50% in 44.9% of areas with clusters of COVID-19 cases(n=49)and in 35.5% of areas with sporadic cases(n=62).Thirty nine(34.8%)centers suffered from staff shortage,which was considered a barrier against service resumption by 86.4% of centers in per-protocol *** multivariate analysis,the burden of cases in the unit locality,staff shortage/recovery and the availability of separate designated rooms for COVID-19 cases could markedly affect the resumption of endoscopy practice(P=0.029,<0.001 and 0.02,respectively)and Odd’s ratio(0.15,1.8 and 0.16,respectively).CONCLUSION The COVID-19 pandemic has led to restrictions in endoscopic *** staff shortage/recovery and the availability of COVID-19 designed rooms are the most important barriers against *** working hours and dividing endoscopy staff into teams may help to overcome the current situation.

关键词： COVID-19 Endoscopy Practice Pandemic Egypt Barriers

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