89 results on '"Nasr L"'
Search Results
2. Crohn's disease: A retrospective analysis between computed tomography enterography, colonoscopy, and histopathology
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Saade, C., Nasr, L., Sharara, A., Barada, K., Soweid, A., Murad, F., Tawil, A., Ghieh, D., Asmar, K., Tamim, H., and Khoury, N.J.
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- 2019
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3. Students’ resolutions of some paradoxes of infinity in the lens of the grossone methodology
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Nasr, L., primary
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- 2023
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4. P10.13 Real World Outcomes for Non Small Cell Lung Cancer Treated With Checkpoint Inhibitors in Lebanon, A Multicenter Observational Study
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Nasr, F., primary, Diab, S., additional, Al Ghauche, A., additional, Hallit, S., additional, and Nasr, L., additional
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- 2021
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5. P02.20 Does Response at 1st Scan Imaging After Any Line Correlate With PFS?
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Nasr, F., primary, Nasr, L., additional, Alghoche, A., additional, Diab, S., additional, and Hallit, S., additional
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- 2021
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6. Activation energy and hall-coefficient measurements in lightly dopedn-InP in the thermal freeze-out region
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Abboudy, S., Abou-el-nasr, L., Kassem, M., and El-wahidy, E.
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- 1993
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7. Stoichiometric ratio and doping effects on the thermal properties of sodium potassium sulphate crystals
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Abboudy, S., Hamed, A. E., Kassem, M. E., and Abou-El-Nasr, L. I.
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- 1993
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8. BONE MARROW VOLUME IRRADIATED AND RISK OF CYTOPENIAS IN AGGRESSIVE B‐CELL LYMPHOMA PATIENTS BRIDGED WITH RADIATION THERAPY FOR CART CELL THERAPY.
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Manzar, G. S., Dabaja, B. S., Wu, S. Y., Nasr, L. F., Dudzinski, S. O., Yoder, A. K., Corrigan, K. L., Gunther, J. R., Ahmed, S., Spiotto, M., Shpall, E. J., Nieto, Y., Daher, M., Rafei, H., Sainai, N., Srour, S. A., Nair, R., Westin, J., Neelapu, S. S., and Steiner, R. E.
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RADIOTHERAPY ,BONE marrow ,CELLULAR therapy ,LYMPHOMAS - Published
- 2023
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9. Transformative Service Organizations: Moving to Mutualism
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Sebastiani, Roberta, Fisk, Nasr, L, Gallan, A, Ng, S, Rayburn, Sw, and Roy, S.
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TSO ,Settore SECS-P/08 - ECONOMIA E GESTIONE DELLE IMPRESE ,TSR - Published
- 2016
10. The effect of vanadium on rat hypercholesterolemia in the presence and absence of statins
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Nasr, L. R., primary, Saber, M. E., additional, Hussam, B., additional, Salma, A. R., additional, and Muzaffar, I., additional
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- 2017
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11. Transformative Service Organizations: Moving to Mutualism
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SERVSIG, Sebastiani, Roberta, Fisk, Nasr, L, Gallan, A, Ng, S, Rayburn, Sw, Roy, S., SEBASTIANI R (ORCID:0000-0001-5004-3859), SERVSIG, Sebastiani, Roberta, Fisk, Nasr, L, Gallan, A, Ng, S, Rayburn, Sw, Roy, S., and SEBASTIANI R (ORCID:0000-0001-5004-3859)
- Abstract
Transformative Service Research (TSR) emphasizes the role of services and service systems in affecting the individual and collective well-being (Ostrom et al. 2015). TSR has focused primarily on the micro-level, meaning the interactions among and between customers, service providers, partners, and other customers. To extend TSR further, we propose the concept of a Transformative Service Organization (TSO) to provide a theoretically-driven assessment of what is required for service organizations to truly transform the lives and well-being of their customers, employees, stakeholders, and society.
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- 2016
12. Effect of optical-phonon scattering on the energy distribution of hot electrons in semiconductors at low temperature
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El-Wahidy, E. F. and Abou El-Nasr, L.
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- 1983
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13. La dexmédétomidine est-elle une alternative anesthésique au propofol dans l’anesthésie pour hystéroscopie diagnostique ?
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Ben Marzouk, S., primary, Abassi, E., additional, Ben Nasr, L., additional, Marzougui, Y., additional, Jabri, H., additional, and Maghrebi, H., additional
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- 2014
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14. Open heart operation in patients suffering from hereditary spherocytosis
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Nasr L. Gayyed, Mike P. Holden, and Nick Bouboulis
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Pulmonary and Respiratory Medicine ,Aortic valve ,Hemolytic anemia ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Splenectomy ,Spherocytosis, Hereditary ,law.invention ,Hereditary spherocytosis ,law ,Risk Factors ,Mitral valve ,medicine ,Cardiopulmonary bypass ,Open heart operation ,Humans ,Aged ,Heart Rupture, Post-Infarction ,Cardiopulmonary Bypass ,Intraoperative Care ,business.industry ,Middle Aged ,medicine.disease ,Surgery ,Red blood cell ,medicine.anatomical_structure ,Aortic Valve ,Heart Valve Prosthesis ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Hereditary spherocytosis is a clinically heterogeneous, genetically determined red blood cell membrane disorder resulting in hemolytic anemia. Structural or functional disorders of the cytoskeletal proteins result in the formation of spherocytes, which lack the strength, durability, and flexibility to withstand the stresses of the circulation. This problem can be accentuated by the deleterious effects of the heart-lung machine. Three patients with hereditary spherocytosis underwent open heart operation with no deaths and no serious complications resulting from the hematologic defect. Splenectomy is recommended, although not essential, before a cardiac operation, and mechanical valves should perhaps be avoided.
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- 1993
15. Liver microsomal membrane fluidity and microsomal desaturase activities in adult spontaneously hypertensive rats.
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Foucher C, Narce M, Nasr L, Delachambre MC, Poisson JP, Foucher, C, Narce, M, Nasr, L, Delachambre, M C, and Poisson, J P
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- 1997
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16. Urodynamic changes following intrathecal administration of morphine and fentanyl to dogs
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El Bindary, E. M., primary and Abu El Nasr, L. M., additional
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- 2001
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17. Open heart operation in patients suffering from hereditary spherocytosis
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Gayyed, Nasr L., primary, Bouboulis, Nick, additional, and Holden, Mike P., additional
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- 1993
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18. Activation energy and hall-coefficient measurements in lightly doped n-InP in the thermal freeze-out region.
- Author
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Abboudy, S., Abou-el-nasr, L., Kassem, M., and El-wahidy, E.
- Abstract
The direct-current resistivity, β, and Hall coefficient, R , of lightly doped n-type InP samples were measured at temperatures ( T) down to 12K and magnetic fields up to 4.8 kG. A sharp exponential increase in β, as T was decreased, was observed for temperatures below 80 K. The Hall coefficient showed a similar trend, i.e. R increased sharply as T was reduced below 80 K. This is attributed to the freeze-out of conduction electrons onto their donor sites. The donor activation energy, E , calculated from the temperature dependence of the resistivity, was less than the theoretical prediction. An enhanced dielectric constant would be a possible candidate for such behaviour. The initial decrease in β (as T is reduced) recorded in the higher-temperature region is due to impurity scattering probably combined with lattice scattering. [ABSTRACT FROM AUTHOR]
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- 1993
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19. Exploring customer feedback from a transformative service research perspective
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Nasr, L., Thorsten Gruber, and Jamie Burton
20. Vitamin D3 and glucose-6-phosphate dehydrogenase in rat duodenal epithelial cells
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Nasr, L. B., primary, Monet, J. D., additional, Lucas, P., additional, and Bader, C. A., additional
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- 1989
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21. In situ biochemical studies of intestinal alkaline phosphatase in normal and phosphate-depleted rats by microdensitometry.
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Bader, C A, primary, Ben Nasr, L, additional, Monet, J D, additional, Bachelet, M, additional, Assailly, J, additional, and Ulmann, A, additional
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- 1984
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22. Immersive virtual reality for chronic neuropathic pain after spinal cord injury: a pilot, randomized, controlled trial.
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Tabacof L, Salazar SI, Breyman E, Nasr L, Dewill S, Aitken A, Canori A, Kypros M, Cortes M, Fry A, Wood J, and Putrino D
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Introduction: Neuropathic pain (NP) poses significant challenges for individuals with spinal cord injury (SCI), often inadequately managed by current interventions. Immersive virtual reality (IVR) has emerged as a promising approach for pain modulation, yet robust evidence is lacking., Objectives: This pilot study investigated the analgesic effects of different IVR environments (scenic, somatic) compared with a control environment, and explored psychomotor properties influencing pain attenuation., Methods: Twenty-two participants with NP caused by SCI were randomized into 3 IVR environments: somatic (n = 8), scenic (n = 7), and control (n = 8), undergoing 3 weekly sessions over 4 weeks with baseline, postintervention, and one-month follow-ups., Results: There was a significant interaction effect between VR environment and time point on Neuropathic Pain Symptom Inventory scores (F(4,37.0) = 2.80, P = 0.04). Scenic VR participants exhibited reduced scores postintervention and at follow-up, with no significant changes in somatic VR or control environments. Similar trends were observed in secondary measures, such as Neuropathic Pain Scale and pain numeric rating scale. Enjoyment and presence were associated with decreased pain-change scores (F(1, 252) = 4.68, P = 0.03 for enjoyment; F(1, 223.342) = 7.92, P = 0.005 for presence), although not significantly influenced by VR environment or time point., Conclusion: Both environments showed reduced pain outcomes, underscoring the need for personalized IVR pain therapies and informing further technology development for NP management., Competing Interests: The authors have no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.)
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- 2024
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23. Results of ponatinib as frontline therapy for chronic myeloid leukemia in chronic phase.
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Haddad FG, Sasaki K, Nasr L, Short NJ, Kadia T, Dellasala S, Cortes J, Nicolini FE, Issa GC, Jabbour E, and Kantarjian H
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- Humans, Middle Aged, Adult, Male, Female, Aged, Young Adult, Follow-Up Studies, Leukemia, Myeloid, Chronic-Phase drug therapy, Fusion Proteins, bcr-abl genetics, Fusion Proteins, bcr-abl antagonists & inhibitors, Treatment Outcome, Dasatinib adverse effects, Dasatinib therapeutic use, Dasatinib administration & dosage, Antineoplastic Agents therapeutic use, Antineoplastic Agents adverse effects, Pyridazines adverse effects, Pyridazines therapeutic use, Pyridazines administration & dosage, Imidazoles adverse effects, Imidazoles therapeutic use, Imidazoles administration & dosage, Protein Kinase Inhibitors adverse effects, Protein Kinase Inhibitors therapeutic use, Protein Kinase Inhibitors administration & dosage, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality
- Abstract
Background: Ponatinib is a third-generation BCR::ABL1 tyrosine kinase inhibitor (TKI) with robust activity in Philadelphia chromosome-positive leukemias. Herein, we report the long-term follow-up of the phase 2 trial of ponatinib in chronic myeloid leukemia in chronic phase., Methods: Patients received ponatinib 30 to 45 mg/day. The primary end point was the rate of 6-month complete cytogenetic response (CCyR). The study was held in June 2014 because of the risk of cardiovascular toxicity, requiring patients to change TKI., Results: Fifty-one patients were treated with ponatinib (median dose, 45 mg/day). Median age was 48 years (range, 21-75); 30 (59%) had baseline cardiovascular comorbidities. Median treatment duration was 13 months (range, 2-25). Fourteen patients (28%) discontinued ponatinib because of toxicities, 36 (71%) after the Food and Drug Administration warning/study closure, and one for noncompliance. Dasatinib was the most frequently chosen second-line TKI (n = 34; 66%). Among 46 patients evaluable at 6 months, 44 (96%) achieved CCyR, 37 (80%) major molecular response, 28 (61%) MR4, and 21 (46%) MR4.5. The cumulative 6-month rates of CCyR, major molecular response, MR4, and MR4.5 were 96%, 78%, 50%, and 36%, respectively. Durable MR4 ≥24 or ≥60 months was observed in 67% and 51% of patients, respectively. The 24-month event-free survival rate was 97%. After a median follow-up of 128 months, the 10-year overall survival rate was 90%. Eight patients (16%) had serious grade 2 to 3 cardiovascular adverse events, leading to permanent discontinuation in five (10%)., Conclusion: Ponatinib yielded high cytogenetic and molecular responses in newly diagnosed chronic myeloid leukemia in chronic phase. Its use in the frontline setting is hindered by arterio-/vaso-occlusive and other severe toxicities., (© 2024 American Cancer Society.)
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- 2024
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24. Na-caprate-induced increase in MDCK II epithelial cell leak pathway permeability and opening number is associated with disruption of basal F-actin organization.
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Rana S, Nasr L, Chang D, Axis J, and Amsler K
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- Dogs, Animals, Madin Darby Canine Kidney Cells, Cell Membrane Permeability drug effects, Zonula Occludens-1 Protein metabolism, Zonula Occludens-1 Protein genetics, Heterocyclic Compounds, 4 or More Rings pharmacology, Actin Cytoskeleton metabolism, Actins metabolism, Epithelial Cells metabolism, Epithelial Cells drug effects, Tight Junctions metabolism, Tight Junctions drug effects
- Abstract
Confluent populations of the epithelial cell line, MDCK II, develop circumferential tight junctions joining adjacent cells to create a barrier to the paracellular movement of solutes and water. Treatment of MDCK II cell populations from the apical surface with 1 mM Na-caprate increased permeability to macromolecules (Leak Pathway) without increasing monolayer disruption or cell death. Graphical analysis of the apparent permeability versus solute Stokes radius for a size range of fluorescein-dextran species indicates apical 1 mM Na-caprate enhances Leak Pathway permeability by increasing the number of Leak Pathway openings without significantly affecting opening size. Na-caprate treatment did not alter the content of any tight junction protein examined. Treatment of MDCK II cell populations with apical 1 mM Na-caprate disrupted basal F-actin stress fibers and decreased the tortuosity of the tight junctions. Treatment of MDCK II cell populations with blebbistatin, a myosin ATPase inhibitor, alone had little effect on Leak Pathway permeability but synergistically increased Leak Pathway permeability when added with 1 mM Na-caprate. Na-caprate exhibited a similar ability to increase Leak Pathway permeability in wild-type MDCK II cell monolayers and ZO-1 knockdown MDCK II cell monolayers but an enhanced ability to increase Leak Pathway permeability in monolayers of TOCA-1 knockout MDCK II cells. These results demonstrate that Na-caprate increases MDCK II cell population Leak Pathway permeability by increasing the number of Leak Pathway openings. This action is likely mediated by alterations in F-actin organization, primarily involving disruption of basal F-actin stress fibers. NEW & NOTEWORTHY This study determines the underlying change in the openings in the epithelial tight junction permeability barrier structure that leads to a change in the paracellular permeability to macromolecules (the Leak Pathway) and connects this to disruption of specific F-actin structures within the cells. It provides important and novel insights into how tight junction permeability to macromolecules is modulated by specific changes to cellular and tight junction composition/organization.
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- 2024
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25. Liquid biopsy as a tool for KRAS/NRAS/BRAF baseline testing in metastatic colorectal cancer.
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Kourie HR, Zouein J, Zalaquett Z, Chebly A, Nasr L, Karak FE, Sadek M, Safar O, Fouani M, Bitar N, Kachmar K, Nasr F, Farhat F, Makarem J, Kattan J, and Taieb J
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- Humans, Liquid Biopsy, Mutation, Male, Female, Middle Aged, Aged, Neoplasm Metastasis, Adult, Colorectal Neoplasms genetics, Colorectal Neoplasms pathology, Proto-Oncogene Proteins B-raf genetics, GTP Phosphohydrolases genetics, Proto-Oncogene Proteins p21(ras) genetics, Membrane Proteins genetics
- Abstract
Background: The absence of KRAS and NRAS gene mutations (RAS wild type) in metastatic colorectal cancer (mCRC), is associated with a good response to targeted therapy with anti-EGFR receptor antibodies. The current gold standard for RAS mutational status identification is genetic testing on tissue biopsy samples., Objective: This study aimed to assess the relevance of liquid biopsy as a less invasive alternative to tissue biopsy for detecting KRAS/NRAS and BRAF mutations in patients with metastatic colorectal cancer (mCRC). The study also aimed to determine the concordance between liquid biopsy and tissue biopsy., Methods: This is a phase IV, observational, uncontrolled, non-comparative, non-randomized, open label study. RAS/BRAF status will be tested at baseline using tissue and liquid biopsy using the Idylla/Biocartis PCR-based device. The primary endpoint is the comparison of the RAS status based on liquid biopsy with the RAS status based on tissue biopsy., Results: 100 patients with mCRC were included in the study. 75 % of patients showed concordant results between liquid biopsy and tissue biopsy, while 25 % had discordant results. Liquid biopsy demonstrated a sensitivity of 62 % and a specificity of 93 %. The accuracy of liquid biopsy was 75 %, with a moderate agreement between the two tests. The most frequent mutations in concordant cases were in KRAS (41 %), followed by NRAS (4 %) and BRAF (3 %). Mutations were not detected in 42 % of tissue biopsy samples and 60 % of liquid biopsy samples. The presence of hepatic metastases did not significantly affect the concordance between the biopsy methods., Conclusion: Liquid biopsy using the Idylla™ system showed a relatively low sensitivity but high specificity for detecting KRAS/NRAS and BRAF mutations in mCRC patients. Despite some discordant cases, liquid biopsy remains a promising alternative to tissue biopsy due to its non-invasiveness, ability to provide multiple samples, and better representation of tumor heterogeneity., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Hampig Raphael Kourie reports financial support was provided by Merck KGaA, Darmstadt, Germany. Hampig Raphael Kourie reports financial support was provided by Biocartis. Hampig Raphael Kourie reports financial support was provided by Saint-Joseph University of Beirut Research Council. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Masson SAS.)
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- 2024
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26. Mesenchymal stem cells biological and biotechnological advances: Implications for clinical applications.
- Author
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Pharoun J, Berro J, Sobh J, Abou-Younes MM, Nasr L, Majed A, Khalil A, Joseph, Stephan, and Faour WH
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- Humans, Animals, Biotechnology methods, COVID-19, Mesenchymal Stem Cells cytology, Mesenchymal Stem Cell Transplantation methods
- Abstract
Background: Mesenchymal stem cells (MSCs) are multipotent stem cells that are able to differentiate into multiple lineages including bone, cartilage, muscle and fat. They hold immunomodulatory properties and therapeutic ability to treat multiple diseases, including autoimmune and chronic degenerative diseases. In this article, we reviewed the different biological properties, applications and clinical trials of MSCs. Also, we discussed the basics of manufacturing conditions, quality control, and challenges facing MSCs in the clinical setting., Methods: Extensive review of the literature was conducted through the databases PubMed, Google Scholar, and Cochrane. Papers published since 2015 and covering the clinical applications and research of MSC therapy were considered. Furthermore, older papers were considered when referring to pioneering studies in the field., Results: The most widely studied stem cells in cell therapy and tissue repair are bone marrow-derived mesenchymal stem cells. Adipose tissue-derived stem cells became more common and to a lesser extent other stem cell sources e.g., foreskin derived MSCs. MSCs therapy were also studied in the setting of COVID-19 infections, ischemic strokes, autoimmune diseases, tumor development and graft rejection. Multiple obstacles, still face the standardization and optimization of MSC therapy such as the survival and the immunophenotype and the efficiency of transplanted cells. MSCs used in clinical settings displayed heterogeneity in their function despite their extraction from healthy donors and expression of similar surface markers., Conclusion: Mesenchymal stem cells offer a rising therapeutic promise in various diseases. However, their potential use in clinical applications requires further investigation., Competing Interests: Declaration of competing interest The authors declare that they have no financial nor competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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27. Combination of dasatinib and venetoclax in newly diagnosed chronic phase chronic myeloid leukemia.
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Jabbour E, Haddad FG, Sasaki K, Carter BZ, Alvarado Y, Nasnas C, Nasr L, Masarova L, Daver N, Pemmaraju N, Short NJ, Skinner J, Kadia T, Borthakur G, Garcia-Manero G, Ravandi F, Issa GC, Andreeff M, and Kantarjian H
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- Humans, Middle Aged, Adult, Female, Aged, Male, Young Adult, Leukemia, Myeloid, Chronic-Phase drug therapy, Leukemia, Myeloid, Chronic-Phase genetics, Dasatinib administration & dosage, Dasatinib therapeutic use, Dasatinib adverse effects, Bridged Bicyclo Compounds, Heterocyclic administration & dosage, Bridged Bicyclo Compounds, Heterocyclic therapeutic use, Bridged Bicyclo Compounds, Heterocyclic adverse effects, Sulfonamides administration & dosage, Sulfonamides therapeutic use, Sulfonamides adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use
- Abstract
Background: The dual inhibition of the BCR::ABL1 tyrosine kinase and BCL-2 could potentially deepen the response rates of chronic myeloid leukemia in chronic phase (CML-CP). This study evaluated the safety and efficacy of the combination of dasatinib and venetoclax., Methods: In this phase 2 trial, patients with CML-CP or accelerated phase (clonal evolution) received dasatinib 50 mg/day for three courses; venetoclax was added in course 4 for 3 years. The initial venetoclax dose was 200 mg/day continuously but reduced later to 200 mg/day for 14 days, and to 100 mg/day for 7 days per course once a molecular response (MR)4.5 was achieved. After 3 years of combination, patients were maintained on single-agent dasatinib. The primary end point was the rate of major molecular response (MMR) by 12 months of combination., Results: Sixty-five patients were treated. Their median age was 46 years (range, 23-73). By 12 months of combination, the MMR, MR4, and MR4.5 rates were 86%, 53%, and 45%, respectively. After a median follow-up of 42 months, the 4-year event-free and overall survival rates were 96% and 100%, respectively. Outcomes with the combination were comparable to historical outcomes with single-agent dasatinib (cumulative 12-months MMR rate of 79% with both strategies). The incidence of grade 3-4 neutropenia was 22% with the combination and 11% with single-agent dasatinib (p < .001)., Conclusions: Treatment with dasatinib and venetoclax was safe and effective in CML-CP. The cumulative response rates with the combination were similar to those with single-agent dasatinib. Further follow-up is needed to evaluate the rates of durable deep molecular response and treatment-free remission., (© 2024 American Cancer Society.)
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- 2024
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28. Fracture strength of preformed zirconia crown and CAD-CAM zirconia, ceramic, and hybrid composite crowns for the restoration of primary molars: An in vitro study.
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El Hayek JE, Tohme H, Nasr L, El Hachem R, Kabbani N, and Mchayleh NF
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- Humans, In Vitro Techniques, Dental Stress Analysis, Dental Prosthesis Design, Dental Restoration Failure, Materials Testing, Dental Materials chemistry, Zirconium chemistry, Crowns, Computer-Aided Design, Molar, Tooth, Deciduous, Ceramics chemistry
- Abstract
Background: Paediatric-preformed zirconia crowns have been associated with several issues, primarily their inability to be crimped and the need for extensive tooth preparation. Additionally, the capacity to adjust the size, shape, and fit of these crowns is very limited., Aim: To evaluate and compare the fracture strength of four different types of dental crowns intended for paediatric patients., Design: The fracture resistance of four types of paediatric crowns was evaluated using the universal testing machine; freshly extracted primary molars received one of the following: preformed zirconia crowns, custom-made computer-aided design and computer-aided manufacturing (CAD-CAM) zirconia crowns, custom-made CAD-CAM ceramic crowns, and custom-made CAD-CAM hybrid composite crowns. Data were statistically compared using the Kruskal-Wallis test followed by the Bonferroni test, and the level of significance was set at 5%., Results: Results showed that there was a statistically significant difference among the four groups (p < .001). The highest value of fracture force was observed for the milled zirconia crown and the lowest for the prefabricated zirconia., Conclusion: The implementation of the CAD-CAM digital crown fabrication technique has the potential to address issues associated with preformed crowns in paediatric patients, particularly in terms of fracture resistance., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)
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- 2024
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29. Results of the Simultaneous Combination of Ponatinib and Blinatumomab in Philadelphia Chromosome-Positive ALL.
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Kantarjian H, Short NJ, Haddad FG, Jain N, Huang X, Montalban-Bravo G, Kanagal-Shamanna R, Kadia TM, Daver N, Chien K, Alvarado Y, Garcia-Manero G, Issa GC, Garris R, Nasnas C, Nasr L, Ravandi F, and Jabbour E
- Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. In this analysis, we update our experience with the chemotherapy-free regimen of blinatumomab and ponatinib in 60 patients with newly diagnosed Philadelphia chromosome (Ph)-positive ALL. At a median follow-up of 24 months, the complete molecular response rate by reverse transcriptase-polymerase chain reaction was 83% (67% at the end of course one), and the rate of measurable residual disease negativity by next-generation clono-sequencing was 98% (45% at the end of course one). Only two patients underwent hematopoietic stem cell transplantation (HSCT). Seven patients relapsed: two with systemic disease, four with isolated CNS relapse, and one with extramedullary Ph-negative, CRLF2-positive pre-B ALL. The estimated 3-year overall survival rate was 91% and event-free survival rate was 77%. Three patients discontinued blinatumomab because of adverse events (related, n = 1; unrelated, n = 2) and nine discontinued ponatinib because of cerebrovascular ischemia, coronary artery stenosis, persistent rash, elevated liver function tests with drug-induced fatty liver, atrial thrombus, severe arterial occlusive disease of lower extremities, pleuro-pericardial effusion, and debilitation. In conclusion, the simultaneous combination of ponatinib and blinatumomab is a highly effective and relatively safe nonchemotherapy regimen. This regimen also reduces the need for intensive chemotherapy and HSCT in first remission in the majority of patients.
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- 2024
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30. A phase 1/2 study of mini-hyper-CVD plus venetoclax in patients with relapsed/refractory acute lymphoblastic leukemia.
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Short NJ, Jabbour E, Jain N, Senapati J, Nasr L, Haddad FG, Li Z, Hsiao YC, Yang JJ, Pemmaraju N, Ohanian M, Wierda WG, Montalban-Bravo G, Borthakur G, Han L, Xiao L, Huang X, Abramova R, Zhao M, Garris R, Konopleva M, Ravandi F, and Kantarjian H
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- Adult, Humans, Inotuzumab Ozogamicin therapeutic use, Bridged Bicyclo Compounds, Heterocyclic adverse effects, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy, Cardiovascular Diseases chemically induced, Sulfonamides
- Abstract
Abstract: Preclinical studies suggest that Bcl-2 inhibition with venetoclax has antileukemic activity in acute lymphoblastic leukemia (ALL) and may synergize with conventional chemotherapy. We designed a phase 1/2 clinical trial to evaluate the safety and efficacy of low-intensity chemotherapy in combination with venetoclax in adults with relapsed or refractory ALL. Patients received the mini-hyper-CVD regimen (dose-attenuated hyperfractionated cyclophosphamide, vincristine, and dexamethasone alternating with methotrexate and cytarabine) in combination with venetoclax (200 mg or 400 mg daily) on days 1 to 14 in cycle 1 and on days 1 to 7 in consolidation cycles. Twenty-two patients were treated. The median number of prior therapies was 2 (range, 1-6). Thirteen patients (59%) had undergone prior allogeneic stem cell transplant (allo-SCT), and 7 of 18 patients (39%) with B-cell ALL had previously received both inotuzumab ozogamicin and blinatumomab. The recommended phase 2 dose of venetoclax in the combination regimen was 400 mg daily. The composite complete remission (CR) and CR with incomplete hematologic recovery (CRi) rate was 57% (CR, 43%; CRi, 14%), and 45% of responders achieved measurable residual disease negativity by multiparameter flow cytometry. Four patients proceeded to allo-SCT. The median duration of response was 6.3 months. The median overall survival was 7.1 months, and the 1-year overall survival rate was 29%. The most common grade ≥3 nonhematologic adverse events were infection in 17 patients (77%) and febrile neutropenia in 4 patients (18%). Overall, the combination of mini-hyper-CVD plus venetoclax was active in heavily pretreated relapsed/refractory ALL. Further development of venetoclax-based combinations in ALL is warranted. This trial is registered at www.clinicaltrials.gov as #NCT03808610., (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
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- 2024
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31. An Overlooked Disease: Minimal Autonomous Cortisol Secretion (MACS). A Narrative Review.
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Farah S, Nasr L, and Eid Fares J
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- Humans, Cushing Syndrome diagnosis, Cushing Syndrome metabolism, Cushing Syndrome epidemiology, Prevalence, Hydrocortisone metabolism, Hydrocortisone blood
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Background: A far more common disease than Cushing's syndrome is subclinical hypercortisolism or mild autonomous cortisol secretion (MACS), with an overall prevalence of 0.2-2%., Objective: This review aims to shed light on the prevalence, screening and diagnostic criteria, comorbidities, and management of Mild Autonomous Cortisol Secretion (MACS)., Methods: Studies eligible targeted MACS regarding prevalence, screening, comorbidities, management, and clinical outcome. This is a narrative-review. IRB approval was not needed., Results: The 1 mg Dexamethasone suppression test (DST) remains the first screening test. MACS is associated with adverse cardiometabolic and renal outcomes, osteoporosis and osteopenia, immunodeficiency, depression, coagulopathy, and sarcopenia. Surgery is the gold standard treatment. Medical therapy is recommended when surgery is contraindicated or not feasible. Clinically silent hypercortisolism is a frequent entity that necessitates early detection and treatment. The production of cortisol should be looked at as a spectrum where subtle, undetectable levels can still be produced. They know its association with adverse health outcomes., Conclusion: MACS is no longer considered an asymptomatic disorder; repeated hormonal and functional tests are crucial to prevent multiorgan damage., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2024
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32. Addendum: Systemic AL amyloidosis: current approach and future direction.
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Bou Zerdan M, Nasr L, Khalid F, Allam S, Bouferraa Y, Batool S, Tayyeb M, Adroja S, Mammadii M, Anwer F, Raza S, and Chaulagain CP
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- 2023
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33. A phase 1/2 study of azacitidine, venetoclax and pevonedistat in newly diagnosed secondary AML and in MDS or CMML after failure of hypomethylating agents.
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Short NJ, Muftuoglu M, Ong F, Nasr L, Macaron W, Montalban-Bravo G, Alvarado Y, Basyal M, Daver N, Dinardo CD, Borthakur G, Jain N, Ohanian M, Jabbour E, Issa GC, Qiao W, Huang X, Kanagal-Shamanna R, Patel KP, Bose P, Ravandi F, Delumpa R, Abramova R, Garcia-Manero G, Andreeff M, Cortes J, and Kantarjian H
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- Humans, Aged, Middle Aged, Aged, 80 and over, Azacitidine adverse effects, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols adverse effects, Leukemia, Myelomonocytic, Chronic drug therapy, Myelodysplastic Syndromes drug therapy, Leukemia, Myeloid, Acute diagnosis
- Abstract
Background: Pevonedistat is a first-in-class, small molecular inhibitor of NEDD8-activating enzyme that has clinical activity in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Preclinical data suggest synergy of pevonedistat with azacitidine and venetoclax., Methods: This single-center, phase 1/2 study evaluated the combination of azacitidine, venetoclax and pevonedistat in older adults with newly diagnosed secondary AML or with MDS or chronic myelomonocytic leukemia (CMML) after failure of hypomethylating agents. Patients received azacitidine 75 mg/m
2 IV on days 1-7, venetoclax at maximum dose of 200-400 mg orally on days 1-21 (AML cohort) or days 1-14 (MDS/CMML cohort) and pevonedistat 20 mg/m2 IV on days 1, 3 and 5 for up to 24 cycles. The primary endpoints for the phase 2 portion of the study were the CR/CRi rate in the AML cohort and the overall response rate (CR + mCR + PR + HI) in the MDS/CMML cohort., Findings: Forty patients were enrolled (32 with AML and 8 with MDS/CMML). In the AML cohort, the median age was 74 years (range 61-86 years), and 27 patients (84%) had at least one adverse risk cyto-molecular feature, including 15 (47%) with a TP53 mutation or MECOM rearrangement; seventeen patients (53%) had received prior therapy for a preceding myeloid disorder. The CR/CRi rate was 66% (CR 50%; CRi 16%), and the median overall survival (OS) was 8.1 months. In the MDS/CMML cohort, 7 patients (87%) were high or very high risk by the IPSS-R. The overall response rate was 75% (CR 13%; mCR with or without HI 50%; HI 13%). The most common grade 3-4 adverse events were infection in 16 patients (35%), febrile neutropenia in 10 patients (25%) and hypophosphatemia in 9 patients (23%). In an exploratory analysis, early upregulation of NOXA expression was observed, with subsequent decrease in MCL-1 and FLIP, findings consistent with preclinical mechanistic studies of pevonedistat. Upregulation of CD36 was observed, which may have contributed to therapeutic resistance., Conclusions: The triplet combination of azacitidine, venetoclax and pevonedistat shows encouraging activity in this very poor-risk population of patients with AML, MDS or CMML. Trial registration ClinicalTrials.gov (NCT03862157)., (© 2023. The Author(s).)- Published
- 2023
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34. AI-based online chat and the future of oncology care: a promising technology or a solution in search of a problem?
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Kassab J, Nasr L, Gebrael G, Chedid El Helou M, Saba L, Haroun E, Dahdah JE, and Nasr F
- Abstract
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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- 2023
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35. Cholera Infection Risks and Cholera Vaccine Safety in Pregnancy.
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El Hayek P, Boueri M, Nasr L, Aoun C, Sayad E, and Jallad K
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- Infant, Newborn, Pregnancy, Female, Humans, Stillbirth, Cholera Vaccines adverse effects, Cholera epidemiology, Cholera prevention & control, Cholera complications, Perinatal Death, Abortion, Spontaneous
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Introduction: Discuss the impact of cholera infection on pregnant women, fetus, and neonates and review the safety of cholera vaccines in pregnancy., Methods: This study was carried out as a narrative review during November 2022. A thorough literature review was conducted on the following databases: PubMed, Scopus, SciELO, CINAHL, Web of Science, and ScienceDirect. The following parameters were assessed from the included studies: type of cholera vaccine, cholera symptoms, cholera treatment, effect of cholera on pregnancy, effect of cholera treatment on pregnancy, effect of cholera vaccine on pregnancy, risk factors for fetuses and neonates, and prevention of cholera. The authors independently extracted data from the 24 included studies., Results: Cholera infection is a serious threat on pregnancy as it could lead to increased stillbirths and neonatal death. Fetal death was shown to occur mainly in the third trimester as most of the pregnant women infected with cholera had spontaneous abortions even after controlling for other confounding variables such as maternal age, dehydration level, and vomiting. Neonatal death was attributed mainly to congenital malformations and low Apgar scores with no improvements. Besides, cholera vaccines have shown to be safe in pregnancy and have proven to lower fetal and neonatal malformations among vaccinated compared to nonvaccinated pregnant women., Conclusion: This narrative summarizes the different complications due to cholera infection in pregnancy. It also reviews the safety of cholera vaccine administration in pregnant women., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Pamela El Hayek et al.)
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- 2023
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36. Liquid biopsies and minimal residual disease in lymphoid malignancies.
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Bou Zerdan M, Kassab J, Saba L, Haroun E, Bou Zerdan M, Allam S, Nasr L, Macaron W, Mammadli M, Abou Moussa S, and Chaulagain CP
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Minimal residual disease (MRD) assessment using peripheral blood instead of bone marrow aspirate/biopsy specimen or the biopsy of the cancerous infiltrated by lymphoid malignancies is an emerging technique with enormous interest of research and technological innovation at the current time. In some lymphoid malignancies (particularly ALL), Studies have shown that MRD monitoring of the peripheral blood may be an adequate alternative to frequent BM aspirations. However, additional studies investigating the biology of liquid biopsies in ALL and its potential as an MRD marker in larger patient cohorts in treatment protocols are warranted. Despite the promising data, there are still limitations in liquid biopsies in lymphoid malignancies, such as standardization of the sample collection and processing, determination of timing and duration for liquid biopsy analysis, and definition of the biological characteristics and specificity of the techniques evaluated such as flow cytometry, molecular techniques, and next generation sequencies. The use of liquid biopsy for detection of minimal residual disease in T-cell lymphoma is still experimental but it has made significant progress in multiple myeloma for example. Recent attempt to use artificial intelligence may help simplify the algorithm for testing and may help avoid inter-observer variation and operator dependency in these highly technically demanding testing process., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bou Zerdan, Kassab, Saba, Haroun, Bou Zerdan, Allam, Nasr, Macaron, Mammadli, Abou Moussa and Chaulagain.)
- Published
- 2023
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37. Systemic AL amyloidosis: current approach and future direction.
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Bou Zerdan M, Nasr L, Khalid F, Allam S, Bouferraa Y, Batool S, Tayyeb M, Adroja S, Mammadii M, Anwer F, Raza S, and Chaulagain CP
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- Humans, Congo Red therapeutic use, Melphalan, Immunoglobulin Light-chain Amyloidosis therapy, Immunoglobulin Light-chain Amyloidosis drug therapy, Amyloidosis drug therapy, Frailty, Hematopoietic Stem Cell Transplantation adverse effects, Paraproteinemias
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Systemic Light chain (AL) amyloidosis is a monoclonal plasma cell proliferative disorder characterized by deposition of amyloidogenic monoclonal light chain fragments causing organ dysfunction. It is a fatal disease and if not diagnosed and treated early can lead to organ failure and potentially death. The renal system along with the cardiovascular system are the most common organs involved but other organs such as gut and liver can be involved as well. The initial evaluation of patients requires confirming the diagnosis with tissue biopsy and staining with Congo red followed by confirmatory typing with mass spectrometry of the Congo red positive tissue. Then establishing the extent of the organs involvement by various staging and biomarkers testing. The treatment options and the tolerability of therapy depend on the disease staging, frailty, and co-morbidities. The autologous hematopoietic cell transplantation (HCT) after high dose melphalan therapy is an effective strategy which is usually done after initial bortezomib induction therapy. Unfortunately, most systemic AL amyloidosis patients are not candidate for HCT due to frailty, old age, multi-organ involvement, renal and heart failure at the time of diagnosis. While it is widely accepted that the patients need to be treated until they achieve complete hematologic response, the maintenance therapy after HCT is not well established in AL amyloidosis. In this review, we report the literature on the latest treatment updates of AL amyloidosis and the ongoing clinical trials highlighting the future treatments.
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- 2023
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38. Association between the Timing of Pre-Workout Macronutrient Intake and Rated Appetite among Resistance-Trained Adults in Jbeil, Lebanon.
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Nasr L, Sacre Y, Attieh R, and Mannan H
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- Humans, Adult, Young Adult, Lebanon, Cross-Sectional Studies, Eating, Cross-Over Studies, Appetite physiology, Energy Intake physiology
- Abstract
Macronutrients play an important role in appetite regulation. In addition, adequate nutrient and energy intake, which may be altered by exercise-induced appetite fluctuations, is required to ensure important training outcomes. However, findings regarding appetite responses to macronutrient consumption before training and to different resistance training intensities remain inconclusive. This study investigated the association of three types of macronutrient intake before different intensities of resistance training with appetite. A purposive cross-sectional design was used to collect data from 280 resistance-trained individuals (mean age 26.4 ± 5.8 years) representing five gyms located in Jbeil, Lebanon, and who completed an online questionnaire. Data collected included socio-demographics, nutritional strategies followed by each respondent, training characteristics, and appetite rating before, during and after exercise using a validated visual analogue scale (VAS). A short-term suppression of appetite was reported during resistance-training, with no significant difference in exercise intensities ( p > 0.05). In addition, low-fiber carbohydrate and protein food/beverage content consumed 30-60 min before training had an advantage in appetite suppression. In summary, these findings suggest that resistance training combined with pre-workout consumption of a whole meal was associated with appetite suppression, at least during the short period of exercise. From the perspective of appetite control and energy balance, the critical factor is the quantity and quality of macronutrient food sources, in addition to the timing surrounding training of nutrients ingested.
- Published
- 2023
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39. Hemidiaphragm Paralysis Caused by Phrenic Nerve Neurofibroma.
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Kumar A, Nasr L, Barker A, Pienta M, and O'Dwyer D
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- Humans, Phrenic Nerve physiology, Paralysis, Diaphragm diagnostic imaging, Neurofibroma diagnosis, Neurofibroma diagnostic imaging, Respiratory Paralysis diagnosis, Respiratory Paralysis etiology
- Published
- 2023
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40. Central Nervous System Prophylaxis and Treatment in Acute Leukemias.
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Wu SY, Short NJ, Nasr L, Dabaja BS, and Fang PQ
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- Humans, Cytarabine therapeutic use, Methotrexate therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Central Nervous System, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy, Leukemia, Myeloid, Acute drug therapy, Central Nervous System Neoplasms etiology, Central Nervous System Neoplasms prevention & control
- Abstract
Opinion Statement: Improvements in systemic therapy in the treatment of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) have improved patient outcomes and reduced the incidence of CNS relapse. However, management of patients with CNS disease remains challenging, and relapses in the CNS can be difficult to salvage. In addition to treatment with CNS-penetrant systemic therapy (high-dose methotrexate and cytarabine), intrathecal prophylaxis is indicated in all patients with ALL, however is not uniformly administered in patients with AML without high-risk features. There is a limited role for radiation treatment in CNS prophylaxis; however, radiation should be considered for consolidative treatment in patients with CNS disease, or as an option for palliation of symptoms. Re-examining the role of established treatment paradigms and investigating the role of radiation as bridging therapy in the era of cellular therapy, particularly in chemotherapy refractory patients, is warranted., (© 2022. The Author(s).)
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- 2022
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41. The Prevalence and Predicting Factors of Temporomandibular Disorders in COVID-19 Infection: A Cross-Sectional Study.
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Haddad C, Sayegh SM, El Zoghbi A, Lawand G, and Nasr L
- Abstract
Introduction During the pandemic of coronavirus disease 2019 (COVID-19), an increase in temporomandibular disorders (TMDs) was noticed in infected patients. In the present study, we aimed to assess the prevalence of TMDs during COVID-19 infection and to evaluate associated factors. Methods An observational cross-sectional online survey was conducted in April and May 2021 in order to estimate the prevalence of TMDs in participants who were previously infected with COVID-19. A multivariable logistic regression model was carried out to explore predicting factors of TMDs during COVID-19 infection. Results In total, the prevalence of TMDs during the COVID-19 infection period among participants was 41.9%. High fever episodes (adjusted odds ratio {aOR}: 3.25), gastro-esophageal reflux (aOR: 2.56), and toothache (aOR: 3.83) during COVID-19 illness were found to be positive predictors of TMDs, while vitamin D deficiency was found to be a negative predictor (aOR: 0.28). Conclusion Our study has highlighted a relatively high prevalence of TMDs in COVID-19-infected patients that may conclude TMDs as a possible COVID-19 symptom. Further studies are warranted to confirm the association between TMDs and COVID-19 infection and thereupon include TMDs among the known symptoms of COVID-19., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Haddad et al.)
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- 2022
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42. Remote Patient Monitoring of Blood Pressure Is Feasible Poststroke and Can Facilitate Triage of Care.
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Tosto-Mancuso JM, Putrino D, Wood J, Tabacof L, Breyman E, Nasr L, Mohammadi N, Dangayach NS, and Kellner CP
- Abstract
Background and Purpose: Strict blood pressure (BP) control is a universally accepted therapeutic intervention in the prevention of secondary stroke, yet this remains difficult when patients return home postinjury. This study aimed to investigate the application of the remote patient monitoring (RPM) of BP in patients after stroke, or who were at immediate risk of stroke, and the subsequent outcomes relating to triage and escalation of care., Methods: This was a single-center proof-of-concept study. Participants were patients aged 18 years and older with a diagnosis of stroke or who were at immediate risk of stroke. Patients were enrolled into the precision recovery program (PRP) and asked to assess their BP and heart rate daily and enter values into a MyCap application for the RPM program. These data were reviewed daily by an assigned PRP clinician, and weekly Zoom meetings were held with the patient. Care was triaged and escalated to a physician as indicated., Results: Twelve patients (5 [42%] female, aged mean [range] 63 [43-84] years) met the inclusion criteria and continued in the program for median (range) 136 (8-227) days. The median (range) number of excursions of BP above limits per participant was 19 (0-79) for systolic and 36 (0-104) for diastolic. A total of 16 triage events (median [range] 1 [0-3]) were initiated for escalation of care., Conclusions: This study demonstrated that RPM is feasible in patients poststroke or at immediate risk of stroke, and facilitates the triage of care when BP is elevated above recommended limits., Competing Interests: Dr. Kellner has received research grant support from Cerebrotech, Siemens, Penumbra, Medtronic, Minnetronix, Viz. AI, Integra, Longeviti, Irras, ICE Neurosystems, and StemPharm; and has ownership interest in Precision Recovery Inc, Borealis andMetis Innovative.Metis Innovative is an investment group that has coordinated investments in Synchron, Proprio, Fluid Biotech, and Precision Recovery Inc. Dr. David Putrino has ownership interest in Precision Recovery Inc.Dr. Jenna Tosto-Mancuso has ownership interest in Precision Recovery Inc., (© Jenna M. Tosto-Mancuso et al., 2022; Published by Mary Ann Liebert, Inc.)
- Published
- 2022
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43. A Synopsis Clonal Hematopoiesis of Indeterminate Potential in Hematology.
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Bou Zerdan M, Nasr L, Saba L, Meouchy P, Safi N, Allam S, Bhandari J, and Chaulagain CP
- Abstract
Clonal hematopoiesis of indeterminate potential can be defined as genetic mutations that correlate in hematologic neoplasia such as myelodysplastic syndrome. Patients with cytopenia increasingly undergo molecular genetic tests of peripheral blood or bone marrow for diagnostic purposes. Recently, a new entity has been demarcated to lessen the risk of incorrect diagnoses of hematologic malignancies. This new entity is a potential precursor of myeloid diseases, analogous to monoclonal gammopathy of undetermined significance as a potential precursor of multiple myeloma.
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- 2022
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44. Prevalence of recurrent oral ulcers and association with ABO/Rh group systems in a Lebanese sample.
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Noujeim Z, Nasr L, Hajj R, and El-Outa A
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- Humans, Phenotype, Prevalence, White People, Oral Ulcer
- Published
- 2022
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45. Adhesion molecules in multiple myeloma oncogenesis and targeted therapy.
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Bou Zerdan M, Nasr L, Kassab J, Saba L, Ghossein M, Yaghi M, Dominguez B, and Chaulagain CP
- Abstract
Every day we march closer to finding the cure for multiple myeloma. The myeloma cells inflict their damage through specialized cellular meshwork and cytokines system. Implicit in these interactions are cellular adhesion molecules and their regulators which include but are not limited to integrins and syndecan-1/CD138, immunoglobulin superfamily cell adhesion molecules, such as CD44, cadherins such as N-cadherin, and selectins, such as E-selectin. Several adhesion molecules are respectively involved in myelomagenesis such as in the transition from the precursor disorder monoclonal gammopathy of undetermined significance to indolent asymptomatic multiple myeloma (smoldering myeloma) then to active multiple myeloma or primary plasma cell leukemia, and in the pathological manifestations of multiple myeloma., Competing Interests: Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript., (© 2022 The Authors.)
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- 2022
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46. Remote Patient Monitoring Identifies the Need for Triage in Patients with Acute COVID-19 Infection.
- Author
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Tabacof L, Wood J, Mohammadi N, Link KE, Tosto-Mancuso J, Dewil S, Breyman E, Nasr L, Kellner C, and Putrino D
- Subjects
- Humans, Monitoring, Physiologic, Pandemics, Retrospective Studies, SARS-CoV-2, Triage, COVID-19 epidemiology
- Abstract
Introduction: Telehealth was frequently used in the provision of care and remote patient monitoring (RPM) during the COVID-19 pandemic. The Precision Recovery Program (PRP) remotely monitored and supported patients with COVID-19 in their home environment. Materials and Methods: This was a single-center retrospective cohort study reviewing data acquired from the PRP clinical initiative. Results: Of the 679 patients enrolled in the PRP, 156 patients were screened by a clinician following a deterioration in symptoms and vital signs on a total of 240 occasions, and included in the analyses. Of these 240 occasions, 162 (67%) were escalated to the PRP physician. Thirty-six patients were referred to emergency department, with 12 (7%) admitted to the hospital. The most common risk factors coinciding with hospital admissions were cardiac (67%), age >65 (42%), obesity (25%), and pulmonary (17%). The most common symptoms reported that triggered a screening event were dyspnea/tachypnea (27%), chest pain (14%), and gastrointestinal issues (8%). Vital signs that commonly triggered a screening event were pulse oximetry (15%), heart rate (11%), and temperature (9%). Discussion: Common factors (risk factors, vital signs, and symptoms) among patients requiring screening, triage, and hospitalization were identified, providing clinicians with further information to support decision making when utilizing RPM in this cohort. Conclusion: A clinician-led RPM program for patients with acute COVID-19 infection provided supportive care and screening for deterioration. Similar models should be considered for implementation in COVID-19 cohorts and other conditions at risk of rapid clinical deterioration in the home setting.
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- 2022
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47. Impact of ABO and Rhesus blood groups on COVID-19 susceptibility and severity: A case-control study.
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Kerbage A, Haddad SF, Nasr L, Riachy A, Mekhael E, Nassim N, Hoyek K, Sleilaty G, Nasr F, and Riachy M
- Subjects
- ABO Blood-Group System, Case-Control Studies, Humans, Retrospective Studies, SARS-CoV-2, COVID-19
- Abstract
Early evidence from China suggested that blood groups may be involved in susceptibility to COVID-19. Several subsequent studies reported controversial results. We conducted a retrospective matched case-control study that aims to investigate the association between blood groups and the risk and/or severity of COVID-19. We compared the blood groups distribution of 474 patients admitted to the hospital for COVID-19 between March 2020 and March 2021, to that of a positive control group of outpatients infected with COVID-19 and matched them for sex and age, as well as to the distribution in the general population. Three hundred and eighteen HC+ pairs with available blood group information were matched. The proportion of group A Rh+ in hospitalized patients (HC+) was 39.9% (CI 35.2%-44.7%), compared to 44.8% (CI 39.8%-49.9%) and 32.3% in the positive outpatient controls (C+) and the general population (C-), respectively. Both COVID-19-positive groups (HC+ and C+) had significantly higher proportions of group A Rh+ compared to the general population (p = 0.0019 and p < 0.001, respectively), indicating that group A Rh+ increases susceptibility to COVID-19. Although blood group A Rh+ was more frequent in the outpatients C+ compared to the hospitalized group HC+, the association did not reach statistical significance, indicating that blood group A Rh+ is not associated with severity. There was no significant relationship between COVID-19 and other blood groups. Our findings indicate that blood group A Rh+ increases the susceptibility for COVID-19 but is not associated with higher disease severity., (© 2021 Wiley Periodicals LLC.)
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- 2022
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48. Post-acute COVID-19 Syndrome Negatively Impacts Physical Function, Cognitive Function, Health-Related Quality of Life, and Participation.
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Tabacof L, Tosto-Mancuso J, Wood J, Cortes M, Kontorovich A, McCarthy D, Rizk D, Rozanski G, Breyman E, Nasr L, Kellner C, Herrera JE, and Putrino D
- Subjects
- COVID-19 physiopathology, Cross-Sectional Studies, Humans, Retrospective Studies, Surveys and Questionnaires, Post-Acute COVID-19 Syndrome, COVID-19 complications, Cognition Disorders virology, Physical Functional Performance, Quality of Life, Social Participation
- Abstract
Objective: This report describes persistent symptoms associated with post-acute COVID-19 syndrome (PACS) and the impact of these symptoms on physical function, cognitive function, health-related quality of life, and participation., Design: This study used a cross-sectional observational study design. Patients attending Mount Sinai's post-acute COVID-19 syndrome clinic completed surveys containing patient-reported outcomes., Results: A total of 156 patients completed the survey, at a median (range) time of 351 days (82-457 days) after COVID-19 infection. All patients were prevaccination. The most common persistent symptoms reported were fatigue (n = 128, 82%), brain fog (n = 105, 67%), and headache (n = 94, 60%). The most common triggers of symptom exacerbation were physical exertion (n = 134, 86%), stress (n = 107, 69%), and dehydration (n = 77, 49%). Increased levels of fatigue (Fatigue Severity Scale) and dyspnea (Medical Research Council) were reported, alongside reductions in levels of regularly completed physical activity. Ninety-eight patients (63%) scored for at least mild cognitive impairment (Neuro-Qol), and the domain of the EuroQol: 5 dimension, 5 level most impacted was Self-care, Anxiety/Depression and Usual Activities., Conclusions: Persistent symptoms associated with post-acute COVID-19 syndrome seem to impact physical and cognitive function, health-related quality of life, and participation in society. More research is needed to further clarify the relationship between COVID-19 infection and post-acute COVID-19 syndrome symptoms, the underlying mechanisms, and treatment options., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2022
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49. Acceptance of COVID-19 vaccination and its determinants among Lebanese dentists: a cross-sectional study.
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Nasr L, Saleh N, Hleyhel M, El-Outa A, and Noujeim Z
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- Cross-Sectional Studies, Dentists, Humans, Pandemics, SARS-CoV-2, Vaccination, COVID-19, COVID-19 Vaccines
- Abstract
Background: Dentists are at high risk of exposure to occupational Coronavirus Disease 2019 (COVID-19). Since vaccination is crucial to control COVID-19 pandemic, we aimed to assess COVID-19 vaccination acceptance and its determinants among Lebanese practicing dentists., Methods: A cross-sectional online study was conducted between February 15 and 22, 2021, among dentists practicing in Lebanon. Prevalence of COVID-19 vaccine acceptance was estimated. A multivariable modified Poisson regression model was used to explore determinants of COVID-19 vaccine acceptance., Results: In total, 86% of participants were willing to receive or have already received a COVID-19 vaccine. Having received the influenza vaccine during the COVID-19 pandemic was linked to a 12% increase in the COVID-19 vaccination acceptance rate. In addition, participants having moderate and high COVID-19 vaccination knowledge levels were more likely to accept receiving the vaccine, and participants whose fear of COVID-19 level was high were more likely to accept receiving the vaccine compared to those having a low fear level. Contrarily, those who visit the medical doctor only when needed and once a year were less likely to accept COVID-19 vaccine compared to participants who routinely visit the medical doctor., Conclusions: Our study showed a high level of acceptance of COVID-19 vaccination among Lebanese practicing dentists. And since knowledge about COVID-19 vaccination was associated with the vaccine acceptance, it should be improved and updated to further increase the acceptance rate. High acceptability of COVID-19 vaccination among dentists is expected to have a positive impact among the population in terms of increasing awareness and vaccine uptake., (© 2021. The Author(s).)
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- 2021
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50. The prevalence, distribution, and radiological evaluation of dentigerous cysts in a Lebanese sample.
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Noujeim Z and Nasr L
- Abstract
Purpose: This study was performed to evaluate the prevalence, distribution, and radiological features (as per the Shear classification) of dentigerous cysts in a Lebanese sample., Materials and Methods: It was an epidemiological, cross-sectional, 5-year retrospective study of 137 dentigerous cysts treated at Lebanese Army Dental Departments. The collected data comprised demographic and radiological information corresponding to patients from July 2015 to July 2020. Syndromic cases were excluded. Demographic data and the radiological features of cases were studied and analyzed., Results: Dentigerous cysts were treated in 109 patients (58.7% males and 41.3% females; mean age: 28.3±16.3 years) out of 6,013 patients (52% males and 48% females), with a prevalence of 1.8%. Dentigerous cysts were more commonly found in patients in their second and third decades of life than in older age groups. Of the 109 patients, 22.9% had multiple dentigerous cysts. Of the 137 cysts, 71.5% were mandibular. The most prevalent anatomical location was the posterior mandible, followed by the posterior maxilla. The most commonly involved tooth was the mandibular third molar. Regarding radiological types, the central type was the most common (60.6%), followed by the lateral type (29.2%), and the circumferential type (10.2%)., Conclusion: The results of this study were similar to studies of other populations in terms of distribution and features. Multiple non-syndromic dentigerous cysts were more common than reported in other studies, which warrants further clinical studies to reveal previously undetected factors., Competing Interests: Conflicts of Interest: None., (Copyright © 2021 by Korean Academy of Oral and Maxillofacial Radiology.)
- Published
- 2021
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