|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Hepatocellular injury and the mortality risk among patients with COVID-19: A retrospective cohort study显示文摘BACKGROUND Clearly,infection with severe acute respiratory syndrome coronavirus 2 is not limited to the lung but also affects other organs.We need predictive models to determine patients’prognoses and to improve health care resource allocation during the coronavirus disease 2019(COVID-19)pandemic.While treating COVID-19,we observed differential outcome prediction weights for markers of hepatocellular injury among hospitalized patients.AIM To investigate the association between hepatocellular injury and all-cause inhospital mortality among patients with COVID-19.METHODS This multicentre study employed a retrospective cohort design.All adult patients admitted to Al-Azhar University Hospital,Assiut,Egypt and Abo Teeg General Hospital,Assiut,Egypt with confirmed COVID-19 from June 1,2020,to July 30,2020 were eligible.We categorized our cohort into three groups of(1)patients with COVID-19 presenting normal aminotransferase levels;(2)patients with COVID-19 presenting one-fold higher aminotransferase levels;and(3)patients with COVID-19 presenting two-fold higher aminotransferase levels.We analysed the association between elevated aminotransferase levels and all-cause in-hospital mortality.The survival analysis was performed using the Kaplan–Meier method and tested by log-rank analysis.RESULTS In total,376 of 419 patients met the inclusion criteria,while 29(8%)patients in our cohort died during the hospital stay.The median age was 40 years(range:28-56 years),and 51%were males(n=194).At admission,54%of the study cohort had liver injury.The pattern of liver injury was hepatocellular injury with an aspartate aminotransferase(AST)predominance.Admission AST levels were independently associated with all-cause in-hospital mortality in the logistic regression analysis.A one-fold increase in serum AST levels among patients with COVID-19 led to an eleven-fold increase in in-hospital mortality(P<0.001).Admission AST levels correlated with C-reactive protein(r=0.2;P<0.003)and serum ferritin(r=0.2;P<0.0002)levels.Admission alanine aminotransferase levels correlated with serum ferritin levels(r=0.1;P<0.04).Serum total bilirubin levels were independently associated with in-hospital mortality in the binary logistic regression analysis after adjusting for age and sex but lost its statistical significance in the fully adjusted model.Serum ferritin levels were significantly associated with in-hospital mortality(P<0.01).The probability of survival was significantly different between the AST groups and showed the following order:a two-fold increase in AST levels>a one-fold increase in in AST levels>normal AST levels(P<0.0001).CONCLUSION Liver injury with an AST-dominant pattern predicts the severity of COVID-19.Elevated serum ferritin levels are associated with fatal outcomes. | Ali Madian Ahmed Eliwa Hytham Abdalla Haitham A Azeem Aly | 2021 | World Journal of Hepatology2021，13，8： | 3 |
| 2 | 胸腔镜内乳淋巴结清扫:一种针对乳腺癌内乳淋巴结的分期技术(英文)显示文摘Objective: The aim of our study was to investigate the feasibility and safety of thoracoscopic internal mammary lymphadenectomy as a method to refine and thereby improve nodal staging in breast cancer. Methods: During the period from June 2004 to May 2007, 50 patients with operable breast cancer underwent modified radical mastectomy (MRM) or breast conserving surgery (BCS), followed by thoracoscopic internal mammary lymphadenectomy, using 3 ports through the skin incision of the MRM or the BCS. Metal clips were used to mark precise site of lymphadenectomy. Results: of total number of 50 patients, the mean age of patients was 44 years (range, 27-60 years). 40 (80%) had medio-central tumor, 10 (20%) had lateral tumor. 35 (70%) had clinically involved axillary nodes. 16 out of 50 patients received neo-adjuvant CTH. 44 patients underwent MRM and 6 patients underwent BCS. No intra-operative complications occurred. Atelectasis was the only postoperative complication that was encountered, which occurred in 12 cases, and was treated conservatively. The average chest drainage period was 1.2 day (range, 1-2 days). The total number of IMN metastasis was 18 patients (36%). The risk of IMN metastasis was higher; in younger patients (P = 0.03), in medio-central tumors (P = 0.03), in bigger tumors (P = 0.05), with heavier metastasis of axillary LNs (P = 0.001). But a correlation with the histological pattern of the 1ry tumor didn't exist (P = 1). Knowing the IMN status helped in proper staging of patients, 7 patients showed evident stage migration after adding the IMN analysis to that of primary tumor and axillary LN. During the follow up period (the median, 22 months; range, 7 to 42 months), no patient had pleural dissemination or port-site metastasis. Conclusion: Thoracoscopic IMN lymphadenectomy is a safe procedure, which can be done serious additional complications or cosmetic compromise. And allow proper nodal staging, which allow proper treatment planning. | Waheed Yousry Garee Hesham Elsebaie Haytham Gareer Hytham Ahmed Mohamed Wafa Hussein Soliman | 2011 | The Chinese-German Journal of Clinical Oncology2011，10，10： | 1 |
| 3 | Aspartate transferase-to-platelet ratio index-plus: A new simplified model for predicting the risk of mortality among patients with COVID-19显示文摘BACKGROUND Coronavirus disease 2019(COVID-19)has a spectrum of clinical syndromes with serious involvement of the lung and frequent effection of the liver and hemostatic system.Blood biomarkers are affordable,rapid,objective,and useful in the evaluation and prognostication of COVID-19 patients.AIM To investigate the association between aspartate transferase-to-platelet ratio index(APRI)and in-hospital mortality to develop a COVID-19 mortality prediction model.METHODS A multicenter cohort study with a retrospective design was conducted.Medical records of all consecutive adult patients admitted to Al-Azhar University Hospital(Assiut,Egypt)and Chest Hospital(Assiut,Egypt)with confirmed COVID-19 from July 1,2020 to October 1,2020,were retrieved and analyzed.The patient cohort was classified into the following two categories based on the APRI:(1)COVID-19 presenting with APRI≤0.5;and(2)COVID-19 presenting with APRI(>0.5 and≤1.5).The association between APRI and all-cause in-hospital mortality was analyzed,and the new model was developed through logistic regression analyses.RESULTS Of the 353 patients who satisfied the inclusion criteria,10%were admitted to the intensive care unit(n=36)and 7%died during the hospital stay(n=25).The median age was 40 years and 50.7%were male.On admission,49%had aspartate transferase-dominant liver injury.On admission,APRI(>0.5 and≤1.5)was independently associated with all-cause in-hospital mortality in unadjusted regression analysis and after adjustment for age and sex;after stepwise adjustment for several clinically relevant confounders,APRI was still significantly associated with all-cause inhospital mortality.On admission,APRI(>0.5 and≤1.5)increased the odds of mortality by fivetimes(P<0.006).From these results,we developed a new predictive model,the APRI-plus,which includes the four predictors of age,aspartate transferase,platelets,and serum ferritin.Performance for mortality was very good,with an area under the receiver operating curve of 0.90.CONCLUSION APRI-plus is an accurate and simplified prediction model for mortality among patients with COVID-19 and is associated with in-hospital mortality,independent of other relevant predictors. | Ali Madian Ahmed Eliwa Hytham Abdalla Haitham A Azeem Aly | 2022 | World Journal of Gastroenterology2022，28，16： | 1 |
| 4 | 肾脏肿瘤保留肾单位手术的评价: 单一机构的经验(英文)显示文摘Objective:The aim of the study was to report the experience of National Cancer Institute(NCI),Cairo University,Egypt,in managing various benign and malignant renal tumors with nephron sparing surgery(NSS),and to assess its safety and feasibility.Methods:Reviewing the literature for NSS,and records of patients who underwent NSS in the period from January 2000 to December 2009 at National Cancer Institute,Cairo University regarding the patient and tumor related characteristics,the indication for NSS,operative technique,postoperative complications,full histopathological data,and follow up results.Results:The total number of patients was 17.Mean age at surgery was 30.7 years(range 1.5-65 years).Five patients had bilateral tumors during surgery.The mean tumor size was 4.5 cm(range 1-9 cm).All patients had normal preoperative kidney functions.Seven patients had an absolute indication for NSS,6 patients had a relative indication,and 4 patients had an elective indication.All the 5 patients with bilateral tumors underwent bilateral simultaneous surgery.Cold ischemia was used in 8 patients,1 patient was exposed to warm ischemia,manual compression was used in 2 patients,and no vascular control was applied in 6 patients.Complications were encountered in 2 patients,one of them had urinary leakage which needed reoperation,and the other had subcutaneous hematoma which was treated conservatively.Histopathological analysis revealed Wilm's tumor(8 patients),angiomyolipoma(4 patients),renal cell carcinoma(4 patients),and hydatid cyst(1 patient).All patients had negative surgical margin.For patients with Wilm's tumor,the mean follow up was 21.4 months(range 0-94 months),2 patients had local recurrence,and 1 patient had distant metastasis.For patients with RCC,the mean follow up was 15.3 months(5-33 months),no patients had local recurrence or distant metastasis.All patients had normal kidney functions during postoperative and follow up periods.Conclusion:NSS is a feasible safe procedure that can be done with acceptable complications rate and it provides a good solution for patients with bilateral tumors,early localized renal cell carcinoma,and benign tumors. | Hytham Abd-elkareem Ahmed Abdelhamid Hussein Ezzat Ismael Mourad | 2011 | The Chinese-German Journal of Clinical Oncology2011，10，9： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员