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1. Predictors of Treatment Failure with Sofosbuvir/Daclatasvir Regimen for 12 Weeks in Patients with Chronic HCV in Egypt

Author

Gamal Esmat, Amr El Fouly, Mohamed El Kassas, and Ahmed Tawheed

Subjects
General Medicine
Abstract

Background: Hepatitis C virus HCV infection is one of the main causes of chronic liver disease worldwide, Egypt has the highest national-level HCV prevalence in the world, Sofosbuvir/ Daclatasvir (SOF/DAC) regimen widely used to treat HCV infection in Egypt. Aims: to identify the predictors of treatment failure with Sofosbuvir/Daclatasvir regimen for 12 weeks in HCV Egyptian patients. Methodology: A retrospective cohort, we investigated the predictors of treatment failure in 2300 HCV patients received the SOF/DAC regimen in Egypt. Results: Patients who completed the treatment and follow up visits were 2079 patients,4 patients stopped treatment due to side effects, 35 due to incompliance and 182 patients missed their follow up visits after treatment, out of the 2079 patients 2043 (98.3%) patients responded to treatment with SVR12 and just 36 (1.7%) patients had treatment failure, presence of Hypertension (p=0.001), Diabetes Miletus (p=0.001), ALT level >51 (p=0.013) , AST level >60 (p=0.002), AFP > 6 (p=0.000) and abnormal liver echo-pattern all were found to have an impact on SVR12 rates, some other factors were found to be insignificant as age, sex, BMI, special habits, liver function tests, haemoglobin, total leucocytic count and serum creatinine, by multivariate analysis AFP was found to be the strongest predictor of treatment failure with cut off value >6 with sensitivity 66.67% and specificity 77.31%. Conclusion: This study shows that ALT, AST, AFP, Abnormal Liver Echo-pattern and the Presence of Diabetes Miletus or Hypertension were found to affect SVR rates, but the strongest predictor was AFP level with a cutoff value of >6.

Published
2023

3. Establishing a research production line in real-life settings: the case of Hepatitis C management in a viral hepatitis specialized Egyptian center

Author

Mohamed El Kassas, Mohamed Eltabbakh, Mohamed Elbadry, Ahmed Tawheed, and Tamer Elbaz

Subjects
Treatment Outcome, Genotype, Humans, Drug Therapy, Combination, Egypt, Hepacivirus, General Medicine, Hepatitis C, Chronic, Antiviral Agents, Hepatitis C
Abstract

Efforts toward eradicating the Hepatitis C virus (HCV) have advanced rapidly, due to the development of direct-acting antivirals (DAAs), especially with the appearance of pan-genotypic combinations. Real-world studies, in particular, have verified the efficacy and safety of DAA combinations documented in registration trials. This review documents the results of using DAA combinations in real-life settings in everyday clinical practice in Egypt, the country with the highest prevalence of HCV. The significant number of treated patients in Egypt, which exceeded four million allowed tremendous data about the results of HCV management in real-life settings for different treatment regimens and disease conditions. DAA combinations have resulted in high sustained virologic response rates (SVR12) and few adverse reactions in real-life settings. SVR12 rates ranged from 90% to 100%, depending on the combination of drugs used, the HCV genotype, and the stage of liver disease. Most adverse reactions reported in real-world settings were mild and resulted in treatment discontinuation in only a minority of cases. Data from real-life studies covered most aspects of HCV management that were lacking after initial approval studies. More research is needed to tailor treatment and produce generic HCV combinations to overcome the residual limitations of the currently available DAAs.

Published
2022

4. Changes in presentation, treatment, and survival of patients with hepatocellular carcinoma in Damietta, Egypt, 2007-2019: a retrospective monocentric cohort study

Author

Kévin Jean, Ahmed Tawheed, Liem Binh Luong Nguyen, Tarek Heikal, Usama Eldaly, Neveen Elhadidy, Ahmed Elghaieb, Ahmed Aboudonia, Laura Tondeur, Amélie Dublineau, Arnaud Fontanet, Mohamed El-Kassas, Laboratoire Modélisation, épidémiologie et surveillance des risques sanitaires (MESuRS), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité), Endemic Medicine Department, Faculty of Medicine, Helwan University [Caire], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Université Paris Cité (UPCité)-Pasteur-Cnam Risques infectieux et émergents (PACRI), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Medical Oncology Department, Damietta Oncology Center, Damietta, Egypt., Pharmaceutical Services Department, Damietta Oncology Center, Damietta, Egypt., and Radiology Department, Damietta Oncology Center, Damietta, Egypt.

Subjects
liver cancer, [SDV]Life Sciences [q-bio], staging system, Egypt, epidemiology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, hepatocellular carcinoma, survival, Journal of Hepatocellular Carcinoma
Abstract

Kévin Jean,1,2 Ahmed Tawheed,3 Liem Binh Luong Nguyen,4 Tarek Heikal,5 Usama Eldaly,5 Neveen Elhadidy,6 Ahmed Elghaieb,7 Ahmed Aboudonia,7 Laura Tondeur,1 Amélie Dublineau,4 Arnaud Fontanet,2,4 Mohamed El-Kassas3 1Laboratoire MESuRS, Conservatoire national des arts et métiers, Paris, France; 2Unité PACRI, Institut Pasteur, Conservatoire national des arts et métiers, Paris, France; 3Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; 4Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris-Cité, Paris, France; 5Medical Oncology Department, Damietta Oncology Center, Damietta, Egypt; 6Pharmaceutical Services Department, Damietta Oncology Center, Damietta, Egypt; 7Radiology Department, Damietta Oncology Center, Damietta, EgyptCorrespondence: Kévin Jean, Laboratoire MESuRS, Conservatoire national des arts et métiers, 292 rue Saint Martin, Paris, 75003, France, Email kevin.jean@lecnam.netIntroduction: We aimed to assess temporal changes in the presentation and survival of patients with hepatocellular carcinoma (HCC) in the northern Egypt region, one of the regions reporting the highest incidence of the disease globally.Methods: We conducted a monocentric retrospective study. Patients presenting at the Damietta Oncology referral center between 2007 and 2019 with a diagnosed HCC were eligible. Individual, clinical and tumor characteristics at HCC diagnosis, including the Barcelona Clinic Liver Cancer (BCLC) staging, were retrieved from medical files and patients’ final vital status was ascertained by combining various data sources. Patients were divided into 2 groups based on diagnosis period: pre- and post-2014. Survival was analysed based on Kaplan–Meier curves and differences in restricted mean survival time (RMST).Results: Data from 5097 patients (among 5210 eligible, 97.8%) were analyzed. We observed a significant trend toward HCC diagnosed at earlier stage in the post- vs pre-2014 period (BCLC stage 0/A or B: 37.2% vs 27.1%, p< 10− 3). Overall patient’s survival after the HCC diagnosis was poor, with a median of 8.1 months. The BCLC staging system performed well in predicting survival. Despite a trend toward HCC diagnosed at earlier stages, we did not observe a significant improvement in survival over time. Overall, treatments offered in this medical center were in line with international guidelines, and 16.1% of the patients who received a curative treatment had an improved survival (30.7 months in median). However, HCC recurrence was frequent among patients cured for HCC, with a median time to recurrence of 22 months.Discussion: Overall survival after HCC diagnosis in Egypt remains poor but is significantly improved by curative therapy. Despite a trend toward earlier diagnosis of HCC, we did not observe a general improvement in survival over time, which remains to be clearly understood.Keywords: hepatocellular carcinoma, liver cancer, Egypt, staging system, survival, epidemiology

Published
2022

5. Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

Author

Global Health Research Group on Children’s Non-Communicable Diseases Collaborative: Soham Bandyopadhyay, Noel, Peter, Kokila, Lakhoo, Simone de Campos Vieira Abib, Hafeez, Abdelhafeez, Shaun, Wilson, Max, Pachl, Benjamin, Martin, Sonal, Nagras, Mihir, Sheth, Catherine, Dominic, Suraj, Gandhi, Divya, Parwani, Rhea, Raj, Diella, Munezero, Rohini, Dutta, Nsimire Mulanga Roseline, Kellie, Mcclafferty, Armin, Nazari, Smrithi, Sriram, Sai, Pillarisetti, Kingdavid, Nweze, Aishwarya, Ashwinee, Gul, Kalra, Poorvaprabha, Patil, Priyansh, Nathani, Khushman Kaur Bhullar, Muhammed, Elhadi, Maryam, Khan, Nehal, Rahim, Shweta, Madhusudanan, Joshua, Erhabor, Manasi, Shirke, Aishah, Mughal, Darica, Au, Mahan, Salehi, Sravani, Royyuru, Mohamed, Ahmed, Syeda Namayah Fatima Hussain, Daniel, Robinson, Anna, Casey, Mehdi, Khan, Alexandre, Dukundane, Kwizera, Festus, Vaishnavi, Govind, Rohan, Pancharatnam, Lorraine, Ochieng, Elliott, H Taylor, Hritik, Nautiyal, Marta de Andres Crespo, Somy, Charuvila, Alexandra, Valetopoulou, Krithi, Ravi, Fatumata, Jalloh, Nermin, Badwi, Shahnur, Shah, Rohini, Rajpal, Masooma, Rana, Muskaan Abdul Qadir, Emmanuel, Uwiringiyimana, Abdelrahman, Azzam, Mayara, Fanelli, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Isadora Schwaab Guerini, Anfel, Bouderbala, Sarah, Alfurais, Mohamed, Gamal, Yara, Hijazi, Shatha, Tailakh, Hamza, Alnaggar, Zain, Douba, Sewar, Elejla, Abdullah, Eldaly, Ekram, Sharashi, Ahmad, Mansour, Tamara, Elyan, Aouabed, Nesrine, Ammar, Ayman, Aya, Zazo, Mohamed, Bonna, Safia, Lorabi, Hassan, Alalami, Rawan Yasser Emam, Soham, Bandyopadhyay, Muath, Alser, Mohamad, K Abou Chaar, Dennis, Mazingi, Hira, Zuberi, Iyad, Sultan, Dhruv Nath Ghosh, Nitin James Peters, Reto, M Baertschiger, Augusto, Zani, Lucy, Davies, Kefas John Bwala, M Umar, A, Abdurahaman, Aremu, Dauda, E Suleiman, Tybat, Aliyu, Ayesha, Saleem, Muhammad, Arshad, Kashaf, Turk, Sadaf, Altaf, Oluseyi Oyebode Ogunsua, Tunde Talib Sholadoye, Musliu Adetola Tolani, Yakubu, Alfa, Keffi Mubarak Musa, Mwangi, Irungu, Ken, Muma, Sarah, Muma, Mitchelle, Obat, Youssef Sameh Badran, Abdulrahman Ghassan Qasem, Faris, Ayasra, Reema, Alnajjar, Mohamed, Abdel-Maboud, Abdelrahman, Bahaa, Ayat, M Saadeldin, Mohamed, Adwi, Mahmoud, Adly, Abdallah, Elshenawy, Amer, Harky, Leanne, Gentle, Kirstie, Wright, Jessica, Luyt, Olivia, White, Charlotte, Smith, Nathan, Thompson, Thomas, Smith, Imogen, Harrison, Ashrarur Rahman Mitul, Sabbir, Karim, Nazmul, Islam, Sara Kader Alsaeiti, Fatma Saleh Benkhial, Mohammed Miftah Faraj Almihashhish, Eman Salem Muftah Burzeiza, Raja Mari Mohammed Nasef, Hend Mohammed Masoud, Mabroukah Saeid Alshamikh, Fatma Mohammed Masoud, William, B Lo, Nyararai, Togarepi, Elaine, Carrolan, Benjamin, J, Mohamed Hassanin O'Sullivan, Ahmed, Saleh, Mahmoud, Bassiony, Mostafa, Qatora, Mohamed, Bahaaeldin, Shady, Fadel, Yasmine El Chazli, Kamel, Hamizi, Mehdi Anouar Zekkour, Rima, Rahmoun, Boutheyna, Drid, Salma Naje Abu Teir, Mohamed Yazid Kadir, Yassine, Zerizer, Nacer, Khernane, Brahim, Saada, Imane, Ammouze, Yahya, Elkaoune, Hajar, Moujtahid, Ghita, Chaoui, Hajar, Benaouda, Meryem, Gounni, Narjiss, Aji, Laila, Hessissen, Joana Mafalda Monteiro, Susana, Nunes, Maria do Bom-Sucesso, Dave, R Lal, Brian, T Craig, Kerri, Becktell, Tahmina, Banu, Md Afruzul Alam, Orindom Shing Pulock, Tasmiah Tahera Aziz, Rosanda, Ilic, Danica, Grujicic, Tijana, Nastasovic, Igor, Lazic, Mihailo, Milicevic, Vladimir, Bascarevic, Radovan, Mijalcic, Vuk, Scepanovic, Aleksandar, Stanimirovic, Aleksandra, Paunovic, Ivan, Bogdanovic, Shahnoor, Islam, Akm Amirul Morshed, A K, M Khairul Basher, Mehnaz, Akter, M Rezanur Rahman, S, Zannat, Ara, Mohammed Tanvir Ahammed, Tania, Akter, Kamrun, Nahar, Fatema, Sayed, Ashfaque, Nabi, Md Asif Iqbal, Md Masud Rana, Asaduzzaman, Md, Hasanuzzaman, Md, Kemal Tolga Saracoglu, Elif, Akova, Evren, Aydogmus, Bekir Can Kendirlioglu, Tufan, Hicdonmez, Arshiya, Adhnon, Asim Noor Rana, Hani, Humad, Anjan, Madasu, Ahmed, Y Azzam, Mohammed, A Azab, Sherief, Ghozy, Alzhraa Salah Abbas, Olanrewaju, Moses, Ibiyeye Taiye Taibat, Taiwo, Jones, Kalu, Ukoha, Olagundoye, Goke, Okorie, Ikechukwu, Abiodun Idowu Okunlola, Milind, Chitnis, Helga, Nauhaus, Danelle, Erwee, Robyn, Brown, Agata, Chylinska, Robin, Simpson, Prasanna, Gomes, Marco Aurelio Ciriaco Padilha, Elvercio Pereira de Oliveira Junior, Lucas Garschagen de Carvalho, Fabiola Leonelli Diz, Mohamed El Kassas, Usama, Eldaly, Ahmed, Tawheed, Mohamed, Abdelwahab, Oudrhiri Mohammed Yassaad, Bechri, Hajar, El Ouahabi Abdessamad, Arkha, Yasser, Hessissen, Laila, Farah Sameer Yahya, Yasir, Al-Agele, Maria Teresa Peña Gallardo, Jacqueline Elizabeth Montoya Vásquez, Juan Luis García León, Sebastián Shu Yip, Mariam, Lami, Matthew H, V Byrne, Duha, Jasim, Harmit, Ghattaura, Eric, W Etchill, Daniel, Rhee, Stacy, Cooper, Kevin, Crow, Morgan, Drucker, Megan, Murphy, Benjamin, Shou, Alan, Siegel, Yasin, Kara, Gül Nihal Özdemir, Mahmoud, Elfiky, Ehab El Refaee, John George Massoud, Ayah Bassam Ibrahim, Ruaa Bassam Ibrahim, Faris Abu Za'nouneh, Ranya, M Baddourah, Toqa, Fahmawee, Ayah Al Shraideh, Ghazwani, Salman, Ehab, Alameer, Al-Mudeer, Ali, Ghazwani, Yahia, Khozairi, Waleed, Khalil, Ghandour, Shaima', Al-Dabaibeh, Ammar, Al-Basiti, Hazim, Ababneh, Omaima, El-Qurneh, Yousef, Alalawi, Ahmad Al Ayed, Ehab, Hanafy, Naif Al Bolowi, Amos Hp Loh, Anette, S Jacobsen, Heidi, Barola, Aubrey, L Pagaduan, Jingdan, Fan, Olumide Abiodun Elebute, Adesoji, O Ademuyiwa, Christopher, O Bode, Justina, O Seyi-Olajide, Oluwaseun, Ladipo-Ajayi, Felix, M Alakaloko, George, C Ihediwa, Kareem, O Musa, Edamisan, O Temiye, Olufemi, Oni, Adeseye, M Akinsete, Janita, Zarrish, Ramsha, Saleem, Soha, Zahid, Atiqa, Amirali, Ahsan, Nadeem, Sameer Saleem Tebha, Zonaira, Qayyum, Sana, Tahir, Anneqa, Tahir, Rabbey Raza Khan, Ayesha, Mehmood, Taimur Iftikhar Qureshi, Pooja, Kumari, Victor, Calvagna, Nathalie, Galea, Ariana, Axiaq, Matthew, R Schuelke, Jake, A Kloebe, Robert, L Owen, Alexander, S Roth, Catherine, Yang, J Hudson Barnett, Lucien, P Jay, Kirk David Wyatt, Paul, J Galardy, Agnes, Vojcek, Mahmoud Maher Abdelnaby Alrahawy, Seham, M Ragab, Abdallah, R Allam, Eman Ibrahim Hager, Kıvılcım Karadeniz Cerit, Adnan, Dağçınar, Tümay, Umuroğlu, Ayten, Saraçoğlu, Mustafa, Sakar, Can, Kıvrak, Gül, Çakmak, Ibrahim, Sallam, Gamal, Amira, Mohamed, Sherief, Ahmed, Sherif, Simone de Oliveira Coelho, Arissa, Ikeda, Licia, Portela, Marianne Monteiro Garrigo, Ricardo Vianna de Carvalho, Fernanda, Lobo, Sima Ester Ferman, Fernanda Ferreira da Silva Lima, Moawia Mohammed Ali Elhassan, Nada Osman Yousif Elhaj, Hytham K, S Hamid, Emmanuel, A Ameh, Vincent, E Nwatah, Adewumi, B Oyesakin, Andrew Nwankwo Osuigwe, Okechukwu Hyginus Ekwunife, Chisom Adaobi Nri-Ezedi, Eric Okechukwu Umeh, Nellie, Patiala, Ibukunolu Olufemi Ogundele, Abiodun Folashade Adekanmbi, Olubunmi Motunrayo Fatungase, Olubunmi Obafemi Obadaini, Sarah, Al-Furais, Humaida, Hemlae, Sreylis, Nay, John, Mathew, M Jeffri Ismail, R, Simonede Campos Vieira Abib, Fabianne Altruda de Moraes Costa Carlesse, Mayara Caroline Amorim Fanelli, Fernanda Kelly Marques de Souza, Pierfrancesco, Lapolla, Andrea, Mingoli, Denis, Cozzi, Anna Maria Testi, Paolo, Musiu, Paolo, Sapienza, Gioia, Brachini, Martina, Zambon, Simona, Meneghini, Pierfranco, Cicerchia, Bruno, Cirillo, Abdulrahman Omar Taha, Bouaoud, Souad, Mebarki, Malika, Bioud, Belkacem, Ayman, Meelad, Hajier Salim Alrashed, Fayza, Haider, Fatema Naser Al Fayez, Fakher, Rahim, Alhassan, Abdul-Mumin, Halwani Yaninga Fuseini, Peter Gyamfi Kwarteng, Abubakari Bawa Abdulai, Sheba Mary Pognaa Kunfah, Gilbert, B Bonsaana, Stephanie, Ajinkpang, Edmund, M Der, Francis, A Abantanga, Mary Joan Kpiniong, Kingsley Aseye Hattor, Kingsley Appiah Bimpong, Mohamed, Elbahnasawy, Sherief, Abdelsalam, Ahmed, Samir, Amanpreet, Brar, Andreea, C Matei, Lubna, Samad, Hira Khalid Zuberi, Kishwer, Nadeem, Naema, Khayyam, Fatima Ambreen Imran, Nida, Zia, Sadia, Muhammad, Muhammad Rafie Raza, Muhammad Rahil Khan, Alaa, Hamdan, Abdeljawad, Mazloum, Ali, Abodest, Nisreen, Ali, Bardisan, Gawarieh, Ammar, Omran, Almed, Moussa, Alaa, Ahmed, Munawar, Hraib, Victor, Khoury, Abdulrahman, Almjersah, Mohammad Ali Deeb, Almahmod, Alkhalil, Akram, Ahmed, Mohammad, Ahmad, Ali, Alelayan, Ali, Hammed, Wassem, Shater, Ahmad, Bouhuwaish, Alqasim, Abdulkarim, Eman, Abdulwahed, Marwa, Biala, Reem, Ghamgh, Amani, Alamre, Marwa, Shelft, Asmaa A, M Albanna, Hoda, Tawel, Emmanuel, Hatzipantelis, Athanasios, Tragiannidis, Eleni, Tsotridou, Assimina, Galli-Tsinopoulou, Dayang Anita Abdul Aziz, Zarina Abdul Latiff, Hamidah, Alias, C-Khai, Loh, Doris, Lau, Azrina Syarizad Khutubul, Raphael, N Vuille-Dit-Bille, Stefan, G Holland-Cunz, Nima, Allafi, Taiwo Akeem Lawal, Kelvin Ifeanyichukwu Egbuchulem, Olakayode Olaolu Ogundoyin, Isaac Dare Olulana, Biobele, J Brown, Oluwasegun Joshua Afolaranmi, Abdulbasit, Fehintola, Annika, Heuer, Christine, Nitschke, Michael, Boettcher, Matthias, Priemel, Lennart, Viezens, Martin, Stangenberg, Marc, Dreimann, Alonja, Reiter, Jasmin, Meyer, Leon, Köpke, Karl-Heinz, Frosch, Samson, Olori, Uduak, Offiong, Philip Mari Mshelbwala, Fashie Andrew Patrick, Aminu Muhammed Umar, N Otene ThankGod, Abdulrasheed, A Nasir, Kazeem O, O Ibrahim, Dupe, S Ademola-Popoola, Olayinka, T Sayomi, Alege, Abdurrzzaq, Ademola, A Adeyeye, Khadijah, O Omokanye, Lukman, O Abdur-Rahman, Olubisi Olutosin Bamidele, Shakirullah, Abdulazeez, Aminat, Akinoso, Michael, O Adegboye, Shireen Anne Nah, Yuki Julius Ng, Syukri Ahmad Zubaidi, Murad, Almasri, Sara, Ali, Rasaq, Olaosebikan, Akila, Muthukumar, Patricia, Shinondo, Amon, Ngongola, Bruce, Bvulani, Azad, Patel, Abdullahi, Nuhu-Koko, Baba, Jibrin, Ajiboye, L Olalekan, Christopher, S Lukong, Ezekiel, I Ajayi, Gabriela, Guillén, Sergio, López, José Andrés Molino, Pablo, Velasco, Omar, Elmandouh, Omar, Hamam, Rim, Elmandouh, Nensi Melissa Ruzgar, Rachel, Levinson, Shashwat, Kala, Sarah, Ullrich, Emily, Christison-Lagay, Aya Sabry Mortada, Mahmoud Ahmed Ebada, Eman Seif Alnaser Solimam, Khaled, Abualkher, Amr Mohammed Elsayed Yousf, Mohamed Mohamed Holail, Reem Mohamed Almowafy, Salah Eddine Oussama Kacimi, Janice Hui Ling Wong, Reto, Baertschiger, Essam, Elhalaby, Mahmoud, M Saad, Guido, Seitz, Judith, Lindbert, Francis Abantanga Georgios Tsoulfas, Asimina, Galli-Tsinopoulou, Maryam Ghavami Adel, Virgone, Calogero, Francesco, Pata, Gaetano, Gallo, Mohammad, K Abou Chaar, Eric Mwangi Irungu, Outani, Oumaima, Zineb, Bentounsi, Adesoji, Ademuyiwa, Lily, Saldana, Jan, Godzinsky, Abdelbasit, Ali, Dragana, Janic, Mohamed Bella Jalloh, Nellie, Bell, Annette, Jacobsen, Chan Hon Chui, Israel Fernandez Pineda, Lucas, Krauel, Maricarmen, Olivos, Waha, Rahama, Hazim, Elfatih, Arda, Isik, Kate, Cross, Andrea, Hayes-Jordan, Roshni, Dasgupta, Mohamedraed, Elshami, and Bandyopadhyay S., Peter N., Lakhoo K., Vieira Abib S. d. C. , Abdelhafeez H., Wilson S., Pachl M., Martin B., Nagras S., Sheth M., et al.

Subjects
Adolescent, Retinal Neoplasms, Temel Tıp Bilimleri, Medicine (miscellaneous), Assessment and Diagnosis, global surgery, Sağlık Bilimleri, Temel Bilgi ve Beceriler, Genel Tıp, Fundamental Medical Sciences, Pathophysiology, Clinical Medicine (MED), paediatrics, Cohort Studies, TIP, GENEL & DAHİLİ, Health Sciences, Internal Medicine, EPIDEMIOLOGY, Humans, Klinik Tıp (MED), Aile Sağlığı, Child, MEDICINE, GENERAL & INTERNAL, Developing Countries, Pandemics, Dahiliye, Patofizyoloji, paediatric oncology, public health, Developed Countries, COVID-19, Hodgkin Disease, Klinik Tıp, CHILDHOOD-CANCER, Fundamentals and Skills, General Medicine, CLINICAL MEDICINE, CARE, Değerlendirme ve Teşhis, Tıp, General Health Professions, Medicine, Tıp (çeşitli), Family Practice, Genel Sağlık Meslekleri
Abstract

ObjectivesPaediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs.DesignA multicentre, international, collaborative cohort study.Setting91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020.ParticipantsPatients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer.Main outcome measureAll-cause mortality at 30 days and 90 days.Results1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (pConclusionsThe COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.

Published
2022

6. Hepatitis C Antiviral Therapy In Patients With Successfully Treated Hepatocellular Carcinoma: Dancing With Wolves

Author

Ahmed Tawheed, Mohamed Eltabbakh, Mohamed El Kassas, and Ahmed Kaseb

Subjects
medicine.medical_specialty, Cirrhosis, business.industry, Hepatitis C virus, Antiviral therapy, Hepatitis C, medicine.disease_cause, medicine.disease, Gastroenterology, digestive system diseases, Virological response, 03 medical and health sciences, 0302 clinical medicine, Interferon, 030220 oncology & carcinogenesis, Internal medicine, Hepatocellular carcinoma, medicine, 030211 gastroenterology & hepatology, In patient, business, neoplasms, medicine.drug
Abstract

Hepatitis C virus (HCV) infection is known to be one of the leading causes of hepatocellular carcinoma (HCC) all over the world. Previously, multiple studies have confirmed a decreased rate of HCC occurrence or recurrence in the cases of hepatitis C associated cirrhosis after treatment with interferon, in comparison to the untreated cases, even in the absence of clearance of HCV. Treatment programs with direct-acting antivirals (DAAs) as a new method for HCV treatment and cure in 2014, with higher safety and efficacy, were considered as an important step in the treatment of patients with history of HCC, improving their overall prognosis. Recently, reports coming from various European centers claimed that the risk of HCC increased following DAAs therapy, especially in cases with previous HCC. Moreover, other studies revealed that the recurrence of HCC after DAAs treatment was more aggressive. Even though others were not able to conclude the same results, the role of DAA therapy in recurrence of HCC in patients with previous HCC after sustained virological response (SVR) achievement remains questionable. This review explored the existing literature and discussed opinions on the possibility of increasing recurrence of HCC following DAA therapy, possible mechanisms, predictors of HCC recurrence post DAAs, and whether those patients should be treated or not.

Published
2019

7. Effect of disease stage and treatment outcomes on the dynamics of liver functions during and after treatment of hepatitis C with directly acting antivirals

Author

Adel El Tahan, Mohamed Youssef, Inas Moaz, Mohamed Hassany, Basem Eysa, Sherif Elbehiry, Ahmed F Sherief, Mohamed El Kassas, Ahmed Tawheed, Nermeen Abdeen, Ayman A. Aziz, Mohamed Alboraie, Mohammad El-Sayed, and Sameera Ezzat

Subjects
Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Sustained Virologic Response, Serum albumin, Disease, Hepacivirus, Gastroenterology, Antiviral Agents, Virus, Internal medicine, medicine, Humans, Stage (cooking), Hepatology, biology, business.industry, Hepatitis C, Hepatitis C, Chronic, medicine.disease, Treatment Outcome, Viral replication, biology.protein, Liver function, business
Abstract

BACKGROUND Virus C infection is recently treated successfully with plenty of direct antiviral agents (DAAs). We aimed to evaluate the effect of disease stage and treatment outcome on the dynamics of liver functions during treatment of hepatitis C with DAAs. METHODS We reported the liver function in 2354 subjects diagnosed as chronic hepatitis C before, during and after treatment with different DAAs regimens. Patients were classified into two groups according to treatment response with further subclassification according to the presence or absence of cirrhosis, and changes in liver functions were compared in each group and subgroup. RESULTS Totally 2213 (94%) achieved sustained virological response (SVR) to DAAs therapy with significant improvement in all liver biochemistry. Also, there was an improvement in the non-SVR group's liver enzymes in relapsers during and after treatment; however, there was no improvement in serum albumin. We noticed a slight increase in serum bilirubin at weeks 4 and 8 for both groups. CONCLUSION DAAs therapy is associated with improvement of the liver biochemical profile and improved outcome in the majority of chronic hepatitis C virus patients due to suppression of viral replication. However, the long-term impact of DAAs therapy needs to be further evaluated.

Published
2021

8. Clinical features and laboratory characteristics of patients hospitalized with COVID-19: single centre report from Egypt

Author

Mohamed Badr, Hassan Elsayed, Amr El Fouly, Dalia Omran, Mohamed El Kassas, Ahmed Tawheed, Mohamed Hassany, Mahmoud Gamal, Noha Asem, Ahmad Madkour, Ahmed Al Shafie, Hamdy Sayed, and Amr Abdelazeem

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Neutrophils, Population, Disease, 01 natural sciences, Microbiology, Asymptomatic, Severity of Illness Index, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Virology, Internal medicine, Severity of illness, Medicine, Humans, 030212 general & internal medicine, Lymphocytes, 0101 mathematics, Young adult, education, Child, Asymptomatic Infections, Retrospective Studies, education.field_of_study, business.industry, Incidence (epidemiology), 010102 general mathematics, Age Factors, COVID-19, Retrospective cohort study, General Medicine, Middle Aged, Middle age, Hospitalization, Infectious Diseases, Parasitology, Egypt, Female, medicine.symptom, business, Tomography, X-Ray Computed
Abstract

Introduction: The recently discovered novel coronavirus disease (COVID-19) has emerged in Wuhan, China, since January 2020. Egypt reported a low incidence of infection when compared with other countries. The aim of the study was to assess the characterization of COVID-19 infection among the Egyptian population. Methodology: Data were collected from a single COVID-19 quarantine hospital in Cairo. A total number of 195 cases were included with their clinical, laboratory, and radiological data. Results: Three different age groups behaved differently for COVD-19 infection. The pediatric age group was asymptomatic entirely, the middle age group (18-50 years) were asymptomatic in 53.3% of cases, while 77.9% of those above 50 years were symptomatic (p ≤ 0.001). The latter group had a high incidence of COVID-pneumonia in (83.1%), and moderate to critical presentations were encountered in 66.3% of them. Neutrophil to lymphocyte (N/L) ratio correlated directly with the age and case severity. C-reactive protein (CRP) and computed tomography scan chest (CT-chest) had added value on COVID-19 diagnosis in suspected cases. Conclusions: In Egypt, patients above 50 years are at a higher risk for symptomatic COVID-19 infection and leaner for moderate to critical COVID-19 presentation. The triad of CT-chest, CRP, and N/L ratio could be an integrated panel for assessing disease severity.

Published
2020

9. Variation in Use of Repurposed Medications Among Patients With Coronavirus Disease 2019. From The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 Registry Investigator Group

Author

Michael A. Garcia, MD, Shelsey W. Johnson, MD, Nicholas A. Bosch, MD, MSc, Emily K. Sisson, MA, Christopher R. Sheldrick, PhD, Vishakha K. Kumar, MD, MBA, Karen Boman, BS, Scott Bolesta, PharmD, Vikas Bansal, MBBS, MPH, Neha Deo, BS, J. P. Domecq, MD, Amos Lal, MD, Amy B. Christie, MD, Valerie M. Banner-Goodspeed, MPH, Devang Sanghavi, MD, MHA, Girish Vadgaonkar, MBBS, Ognjen Gajic, MD, MSc, Rahul Kashyap, MBBS, MBA, Allan J. Walkey, MD, MSc, for the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study Investigators, Jean-Baptiste Mesland, Pierre Henin, Hélène Petre, Isabelle Buelens, Anne-Catherine Gerard, Philippe Clevenbergh, Dragana Markotić, Ivana Bošnjak, Ruben Garza, Eric Chu, Victoria Chan, Oscar Y Gavidia, Felipe Pachon, Yeimy A Sanchez, Mohamed El Kassas, Mohamed Badr, Ahmed Tawheed, Hend Yahia, Jose Luis Ramos Coello, Guillermo Perez, Ana Karen Vallecillo Lizardo, Gabina María Reyes Guillen, Helin Archaga Soto, Smitha S. Segu, Tuhin Chakraborty, Epcebha Joyce, Girish Vadgaonkar, Rekha Ediga, Shilpa Basety, Shwetha Dammareddy, Phani Sreeharsha Kasumalla, Umamaheswara Raju, Janaki Manduva, Naresh Kolakani, Shreeja Sripathi, Sheetal Chaitanya, Mradul Kumar Daga, Munisha Agarwal, Ishan Rohtagi, Sridhar Papani, Mahesh Kamuram, Kamlesh Kumar Agrawal, Vijendra Baghel, Kirti Kumar Patel, Surapaneni Krishna Mohan, Ekambaram Jyothisree, Wataru Matsuda, Reina Suzuki, Michihito Kyo, Yuki Itagaki, Akira Kodate, Yuki Takahashi, Koyo Moriki, Fatimah Hassan-Hanga, Hadiza Galadanci, Abubakar Shehu Gezawa, Halima M. S. Kabara, Taiwo Gboluwaga Amole, Halima Kabir, Dalha Gwarzo Haliru, Abdullahi S Ibrahim, Muhammad Sohaib Asghar, Mashaal Syed, Syed Anosh Ali Naqvi, Igor Borisovich Zabolotskikh, Konstantin Dmitrievich Zybin, Sergey Vasilevich Sinkov, Tatiana Sergeevna Musaeva, Mohammed A Almazyad, Mohammed I Alarifi, Jara M Macarambon, Ahmad Abdullah Bukhari, Hussain A. Albahrani, Kazi N Asfina, Kaltham M Aldossary, Marija Zdravkovic, Zoran Todorovic, Viseslav Popadic, Slobodan Klasnja, Bojan Kovacevic, Jovana Bojicic, Predrag D Stevanovic, Dejan S Stojakov, Duska K Ignjatovic, Suzana C Bojic, Marina M Bobos, Irina B Nenadic, Milica S Zaric, Marko D Djuric, Vladimir R Djukic, Santiago Y. Teruel, Belen C. Martin, Uluhan Sili, Huseyin Bilgin, Pinar Ay, Abhijit A Raval, Andrea Franks, Anmol Kharbanda, Sunil Jhajhria, Zachary Fyffe, Stephen Capizzi, Bethany Alicie, Martha Green, Lori Crockarell, Amelia Drennan, Kathleen Dubuque, Tonya Fambrough, Nikole Gasaway, Briana Krantz, Peiman Nebi, Jan Orga, Margaret Serfass, Alina Simion, Kimberly Warren, Cassie Wheeler, CJ Woolman, Amy B. Christie, Dennis W. Ashley, Rajani Adiga, Andrew S. Moyer, George M. Verghese, Andrea Sikora Newsome, Christy C. Forehand, Rebecca Bruning, Timothy W. Jones, Moldovan Sabov, Fatema Zaidi, Fiona Tissavirasingham, Dhatri Malipeddi, Donna Lee Armaignac, Don Parris, Maria Pilar Zuniga, Ilea Vargas, Viviana Boronat, Anneka Hutton, Navneet Kaur, Prashank Neupane, Nohemi Sadule-Rios, Lourdes M. Rojas, Aashish Neupane, Priscilla Rivera, Carlos Valle Carlos, Gregory Vincent, Valerie M. Banner-Goodspeed, Somnath Bose, Lauren E. Kelly, Melisa Joseph, Marie McGourty, Krystal Capers, Benjamin Hoenig, Maria C. Karamourtopoulos, Anica C. Law, Elias N. Baedorf Kassis, Allan J. Walkey, Sushrut S. Waikar, Michael A. Garcia, Mia Colona, Zoe Kibbelaar, Michael Leong, Daniel Wallman, Kanupriya Soni, Jennifer Maccarone, Joshua Gilman, Ycar Devis, Joseph Chung, Munizay Paracha, David N. Lumelsky, Madeline DiLorenzo, Najla Abdurrahman, Shelsey Johnson, Kimberly Zammit, Patrick, J McGrath, William Loeffler, Maya, R Chilbert, Raghavendra Tirupathi, Alymer Tang, Arshad Safi, Cindy Green, Jackie Newell, Katja M. Gist, Imran A Sayed, John Brinton, Larisa Strom, Steven K. Daugherty, Sam Atkinson, Kelly Shrimpton, David P. Yamane, Ivy Benjenk, Nivedita Prasanna, Norma Smalls, Michael Smith, William Snow, Riley Liptak, Hannah Durant, Valerie Pendleton, Alay Nanavati, Risa Mrozowsk, Yuk Ming Liu, Sarah Zavala, Esther Shim, Ronald A. Reilkoff, Julia A. Heneghan, Sarah Eichen, Lexie Goertzen, Scott Rajala, Ghislaine Feussom, Ben Tang, Christine C. Junia, Robert Lichtenberg, Hasrat Sidhu, Diana Espinoza, Shelden Rodrigues, Maria Jose Zabala, Daniela Goyes, Ammu Susheela, Buddhi Hatharaliyadda, Naveen Rameshkumar, Amulya Kasireddy, Genessis Maldonado, Lisseth Beltran, Akshata Chaugule, Hassan Khan, Rodrigo Cartin-Ceba, Ayan Sen, Amanda Palacios, Giyth M. Mahdi, Rahul Kashyap, Ognjen Gajic, Vikas Bansal, Aysun Tekin, Amos Lal, John C. O’Horo, Neha N. Deo, Mayank Sharma, Shahraz Qamar, Juan Pablo Domecq, Romil Singh, Alex Niven, Abigail La Nou, Marija Bogojevic, Barbara Mullen, Devang Sanghavi, Pablo Moreno Franco, Pramod Guru, Karthik Gnanapandithan, Hollie Saunders, Zachary Fleissner, Juan Garcia, Alejandra Yu, Lee Mateus, Siva Naga Yarrarapu, Nirmaljot Kaur, Abhisekh Giri, Syed Anjum Khan, Nitesh Kumar Jain, Thoyaja Koritala, Jessica Timmer, Kimberly Welker, Chakradhar Venkata, Miriam Engemann, Annamarie Mantese, Anna Eschler, Mary Hejna, Emily Lewandowski, Kristen Kusmierski, Clare Martin, Bhagat S. Aulakh, Sandeep Tripathi, Jennifer A. Bandy, Lisa M. Kreps, Dawn R. Bollinger, Roger Scott Stienecker, Andre G. Melendez, Tressa A. Brunner, Sue M Budzon, Jessica L. Heffernan, Janelle M. Souder, Tracy L. Miller, Andrea G. Maisonneuve, Brian L. Delmonaco, Anthony Franklin, Mitchell Heath, Antonia L. Vilella, Sara B. Kutner, Kacie Clark, Danielle Moore, Harry L. Anderson, III, Dixy Rajkumar, Ali Abunayla, Jerrilyn Heiter, Howard A. Zaren, Stephanie J. Smith, Grant C. Lewis, Lauren Seames, Cheryl Farlow, Judy Miller, Gloria Broadstreet, Anthony Martinez, Micheal Allison, Aniket Mittal, Rafael Ruiz, Aleta Skaanland, Robert Ross, Paul K Mohabir, Connor G O’Brien, Komal Dasani, Neha Gupta, Tracy L Jones, Shonda C Ayers, Amy B Harrell, Brent R Brown, Megan Edwards, Caleb Darby, Kristy Page, Amanda Brown, Jessie McAbee, Katherine A. Belden, Michael Baram, Devin M. Weber, Rosalie DePaola, Yuwei Xia, Hudson Carter, Aaron Tolley, Mary Barletta, Mary Ferranti, Benjamin J Sines, Thomas J Bice, Patrick W. McGonagill, Colette Galet, Janice Hubbard, David Wang, Lauren Allan, Aditya Badheka, Madhuradhar Chegondi, Usman Nazir, Garrett Rampon, Jake Riggle, Nathan Dismang, Roger A. Alvarez, Amarilys Alarcon-Calderon, Marie Anne Sosa, Sunita K. Mahabir, Mausam J. Patel, Dima Dandachi, Hariharan Regunath, Maraya N. Camazine, Grant. E. Geiger, Abdoulie O. Njai, Baraa M. Saad, Renee D. Stapleton, Anne E. Dixon, Olivia Johnson, Sara S. Ardren, Stephanie Burns, Anna Raymond, Erika Gonyaw, Kevin Hodgdon, Chloe Housenger, Benjamin Lin, Karen McQuesten, Heidi Pecott-Grimm, Julie Sweet, Sebastian Ventrone, Ashish K. Khanna, Lynne Harris, Bruce Cusson, Jacob Fowler, David Vaneenenaam, Glen McKinney, Imoh Udoh, Kathleen Johnson, Vishwanath Pattan, Jessica Papke, Ismail Jimada, Nida Mhid, Samuel Chakola, Kevin Sheth, Abdalla Ammar, Mahmoud Ammar, Victor Torres Lopez, Charles Dela Cruz, Akhil Khosla, and Samir Gautam

Subjects
medicine.medical_specialty, hydroxychloroquine, Observational Study, dexamethasone, Viral Infection and Respiratory Illness Universal Study, Logistic regression, law.invention, coronavirus disease 2019, Therapeutic index, Randomized controlled trial, law, antiviral agents, Pandemic, medicine, Intensive care medicine, RC86-88.9, business.industry, Medical emergencies. Critical care. Intensive care. First aid, Hydroxychloroquine, General Medicine, Odds ratio, Clinical trial, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, business, Cohort study, medicine.drug
Abstract

Supplemental Digital Content is available in the text., IMPORTANCE: At the start of the coronavirus disease 2019 pandemic, medications repurposed for management of coronavirus disease 2019 were used in the absence of clinical trial evidence. OBJECTIVES: To describe the variation and evolution in use of repurposed medications for coronavirus disease 2019. DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study of adults hospitalized with coronavirus disease 2019 between February 15, 2020, and April 12, 2021, across 76 United States and international hospitals within the Society of Critical Care Medicine’s Discovery Viral Infection and Respiratory Illness Universal Study coronavirus disease 2019 registry. MAIN OUTCOMES AND MEASURES: Hospital variation was quantified using multivariable adjusted random effects logistic regression models and unsupervised clustering. Repurposed medications included antivirals, corticosteroids, hydroxychloroquine, immunomodulators, and therapeutic dose anticoagulants. RESULTS: Among 7,069 adults hospitalized with coronavirus disease 2019, 1,979 (28%) received antivirals, 2,876 (41%) received corticosteroids, 1,779 (25%) received hydroxychloroquine, 620 (9%) received immunomodulators, and 2,154 (31%) received therapeutic dose anticoagulants. Contribution of hospital site to risk-adjusted variation was 46% for antivirals, 30% for corticosteroids, 48% for hydroxychloroquine, 46% for immunomodulators, and 52% for therapeutic dose anticoagulants. Compared with the early pandemic, the later pandemic practice phenotypes converged with increased use of antivirals (odds ratio, 3.14; 95% CI, 2.40–4.10) and corticosteroids (odds ratio, 5.43; 95% CI, 4.23–6.97), with decreased use of hydroxychloroquine (odds ratio, 0.02; 95% CI, 0.01–0.04) and immunomodulators (odds ratio, 0.49; 95% CI, 0.34–0.70). There was no clinically significant change in the use of therapeutic dose anticoagulants (odds ratio, 1.01; 95% CI, 1.01–1.02). There were no differences in risk-adjusted mortality between hospitals with high rates of repurposed medication use compared with hospitals with low rates of use. CONCLUSIONS AND RELEVANCE: Hospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials. Platforms developed for rapid activation and enrollment in clinical trials of repurposed medications are needed prior to the next pandemic to expedite effective, evidence-based practice.

Published
2021

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