BACKGROUND De novo malignancies are a major reason of long-term mortalities after liver transplan... more BACKGROUND De novo malignancies are a major reason of long-term mortalities after liver transplantation. However, they usually receive minimal attention from most health care specialists. The current study aims to evaluate our experience of de novo malignancies after living-donor liver transplantation (LDLT). METHODS We reviewed the data of patients who underwent LDLT at our center during the period between May 2004 and December 2018. RESULTS During the study period, 640 patients underwent LDLT. After a mean follow-up period of 41.2 ± 25.8 months, 15 patients (2.3%) with de novo malignancies were diagnosed. The most common de novo malignancies were cutaneous cancers (40%), post-transplantation lymphoproliferative disorders (13.3%), colon cancers (13.3%), and breast cancers (13.3%). Acute cellular rejection (ACR) episodes occurred in 10 patients (66.7%). Mild ACR occurred in 8 patients (53.3%), and moderate ACR occurred in 2 patients (13.3%). All patients were managed with aggressive cancer treatment. The mean survival after therapy was 40.8 ± 26.4 months. The mean overall survival after LDLT was 83.9 ± 52.9 months. Twelve patients (80%) were still alive, and 3 mortalities (20%) occurred. The 1-, 5-, and 10-year overall survival rates after LDLT were 91.7%, 91.7%, and 61.1%, respectively. On multivariate regression analysis, smoking history, operation time, and development of ACR episodes were significant predictors of de novo malignancy development. CONCLUSIONS Liver transplant recipients are at high risk for the development of de novo malignancies. Early detection and aggressive management strategies are essential to improving the recipients' survival.
Living liver donors represent a special group of patients. They are healthy individuals who are e... more Living liver donors represent a special group of patients. They are healthy individuals who are exposed to a major surgery, in which the dominant liver proportion is extracted as a graft. Of all potential donor-related morbidities, posthepatectomy liver dysfunction (PHLD) is the most significant as it may be directly related to donor mortality. We aimed to review our data of adult living donor liver transplantation (LDLT) utilizing the right hemiliver grafts to determine the incidence and potential predictors for the development of PHLD, defined according to the International Study Group of Liver Surgery. We reviewed the data of all adult living donors who underwent right hemihepatectomy during the period between May 2004 and 2016. During the study period, 434 cases underwent right hemihepatectomy for adult LDLT. We divided our cases into 2 groups according to the occurrence of PHLD. A significant lower residual liver volume and percentage were noted in PHLD group. Longer intensive ...
With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting... more With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting to patient quality of life (QOL), and employment is an important factor in aiding the social reintegration of LT patients. This study aims to evaluate the current employment status of liver graft recipients and various factors that may hinder reemployment. Fifty patients above age 18 who underwent either living or deceased donor LT at a single center from March 2009 to July 2016 were interviewed during their visit to the outpatient clinic. The internally developed questionnaire consisted of 10 items. The Karnofsky Performance Scale and EQ-5D were used to evaluate patient function and QOL. A total of 25 (50%) patients returned to work after transplantation (the working group), and 21 (84%) patients in the working group returned to work within the first year after transplantation. In the non-working group (n=25), 17 (68%) answered that their health was the reason for unemployment. Fatigue...
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, Sep 26, 2016
The aim of this study was to analyze the prognostic factors related to the recurrence rate and ov... more The aim of this study was to analyze the prognostic factors related to the recurrence rate and overall survival of vulval melanoma patients by means of a subgroup analysis of the VULvar CANcer study. The international multicenter VULvar CANcer study involved 100 international centers, which contributed 2453 vulvar cancer cases. Of the 1727 patients finally included in the study, 42 were suffering from vulvar melanoma (2.4%). The mean follow-up for vulval melanoma patients was 44.1±35.7 months. Recurrence rate was 50%, and the mean recurrence-free survival was 43.5±6.6 months. For local recurrences, the mean recurrence-free interval was 63.3±8.6 months; for metastasis, 33.5±3.5 months. The 5-year recurrence-free survival rate was 28.6%. The mean overall survival for vulvar melanomas was 45.9±4 months and the 5-year overall survival rate was 78.6%. The only factor with prognostic significance regarding local recurrence of vulvar melanoma was tumor size (P = 0.003). American Joint Comm...
SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...
SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...
Beni-Suef University Journal of Basic and Applied Sciences
Background This study aimed to assess the clinical and hemato-biochemical changes associated with... more Background This study aimed to assess the clinical and hemato-biochemical changes associated with diarrhea in E. coli and Salmonella pathogens in Friesian bovine calves less than one month old as well as to examine the relationship between Vit D3 and cardiac biomarkers. Results The study was carried out on 43 Friesian calves from a private farm in Ash Sharqia Governorate, 33 diarrheic calves aged 1–14 days with an average body weight 43.7 ± 1.2 kg, and 10 apparently healthy calves were kept as a control group to investigate the clinical and hemato-biochemical profiles. E. coli and Salmonella pathogens were isolated from the diarrheic calves where 76% were E. coli and 24% were Salmonella. Diarrheic calves showed signs of anorexia, weakness, dullness, staggering gait, pale mucous membranes with sunken eyes and dehydration. Analysis of clinical and hemato-biochemical profile of the diarrheic calves revealed significant increase in body temperature, respiratory rate, heart rate, white b...
Nearly 113 non outbreak raw and processed chicken meat products were collected from grocery store... more Nearly 113 non outbreak raw and processed chicken meat products were collected from grocery stores and supermarkets namely chicken quarter, chicken fillet, drum stick, chicken panee, and luncheon and nagets. C.perfringens were isolated in percentage of 2 7.43, t yping of C.perfringens isolates b y I/D injection i n gui nea pig reveal ad types A,D and non-toxigenic st rains. The i ncidence of toxigenic st rains were 83. 9% while 16. 1% were n on-toxigenic s trains. 70.8% of the toxigenic isolates classified as C.perfringens type A while 1 2.9% of the isolates classified as C.perfringens type D. Studying t he enterotoxigenicity of C.perfringens type A by using s uckling m ouse bioassay revealed that 45.5% of the isolates were enterotoxigenic (produce enterotoxin). U sing PCR for c onfirmation the presence of a and enterotoxin g ene in e nterotoxigenic t ype A isolates yielded cpa and enterotoxin genes in t he predicted 1167bp and 233bp fragments re spectively.
BACKGROUND De novo malignancies are a major reason of long-term mortalities after liver transplan... more BACKGROUND De novo malignancies are a major reason of long-term mortalities after liver transplantation. However, they usually receive minimal attention from most health care specialists. The current study aims to evaluate our experience of de novo malignancies after living-donor liver transplantation (LDLT). METHODS We reviewed the data of patients who underwent LDLT at our center during the period between May 2004 and December 2018. RESULTS During the study period, 640 patients underwent LDLT. After a mean follow-up period of 41.2 ± 25.8 months, 15 patients (2.3%) with de novo malignancies were diagnosed. The most common de novo malignancies were cutaneous cancers (40%), post-transplantation lymphoproliferative disorders (13.3%), colon cancers (13.3%), and breast cancers (13.3%). Acute cellular rejection (ACR) episodes occurred in 10 patients (66.7%). Mild ACR occurred in 8 patients (53.3%), and moderate ACR occurred in 2 patients (13.3%). All patients were managed with aggressive cancer treatment. The mean survival after therapy was 40.8 ± 26.4 months. The mean overall survival after LDLT was 83.9 ± 52.9 months. Twelve patients (80%) were still alive, and 3 mortalities (20%) occurred. The 1-, 5-, and 10-year overall survival rates after LDLT were 91.7%, 91.7%, and 61.1%, respectively. On multivariate regression analysis, smoking history, operation time, and development of ACR episodes were significant predictors of de novo malignancy development. CONCLUSIONS Liver transplant recipients are at high risk for the development of de novo malignancies. Early detection and aggressive management strategies are essential to improving the recipients' survival.
Living liver donors represent a special group of patients. They are healthy individuals who are e... more Living liver donors represent a special group of patients. They are healthy individuals who are exposed to a major surgery, in which the dominant liver proportion is extracted as a graft. Of all potential donor-related morbidities, posthepatectomy liver dysfunction (PHLD) is the most significant as it may be directly related to donor mortality. We aimed to review our data of adult living donor liver transplantation (LDLT) utilizing the right hemiliver grafts to determine the incidence and potential predictors for the development of PHLD, defined according to the International Study Group of Liver Surgery. We reviewed the data of all adult living donors who underwent right hemihepatectomy during the period between May 2004 and 2016. During the study period, 434 cases underwent right hemihepatectomy for adult LDLT. We divided our cases into 2 groups according to the occurrence of PHLD. A significant lower residual liver volume and percentage were noted in PHLD group. Longer intensive ...
With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting... more With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting to patient quality of life (QOL), and employment is an important factor in aiding the social reintegration of LT patients. This study aims to evaluate the current employment status of liver graft recipients and various factors that may hinder reemployment. Fifty patients above age 18 who underwent either living or deceased donor LT at a single center from March 2009 to July 2016 were interviewed during their visit to the outpatient clinic. The internally developed questionnaire consisted of 10 items. The Karnofsky Performance Scale and EQ-5D were used to evaluate patient function and QOL. A total of 25 (50%) patients returned to work after transplantation (the working group), and 21 (84%) patients in the working group returned to work within the first year after transplantation. In the non-working group (n=25), 17 (68%) answered that their health was the reason for unemployment. Fatigue...
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, Sep 26, 2016
The aim of this study was to analyze the prognostic factors related to the recurrence rate and ov... more The aim of this study was to analyze the prognostic factors related to the recurrence rate and overall survival of vulval melanoma patients by means of a subgroup analysis of the VULvar CANcer study. The international multicenter VULvar CANcer study involved 100 international centers, which contributed 2453 vulvar cancer cases. Of the 1727 patients finally included in the study, 42 were suffering from vulvar melanoma (2.4%). The mean follow-up for vulval melanoma patients was 44.1±35.7 months. Recurrence rate was 50%, and the mean recurrence-free survival was 43.5±6.6 months. For local recurrences, the mean recurrence-free interval was 63.3±8.6 months; for metastasis, 33.5±3.5 months. The 5-year recurrence-free survival rate was 28.6%. The mean overall survival for vulvar melanomas was 45.9±4 months and the 5-year overall survival rate was 78.6%. The only factor with prognostic significance regarding local recurrence of vulvar melanoma was tumor size (P = 0.003). American Joint Comm...
SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...
SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...
Beni-Suef University Journal of Basic and Applied Sciences
Background This study aimed to assess the clinical and hemato-biochemical changes associated with... more Background This study aimed to assess the clinical and hemato-biochemical changes associated with diarrhea in E. coli and Salmonella pathogens in Friesian bovine calves less than one month old as well as to examine the relationship between Vit D3 and cardiac biomarkers. Results The study was carried out on 43 Friesian calves from a private farm in Ash Sharqia Governorate, 33 diarrheic calves aged 1–14 days with an average body weight 43.7 ± 1.2 kg, and 10 apparently healthy calves were kept as a control group to investigate the clinical and hemato-biochemical profiles. E. coli and Salmonella pathogens were isolated from the diarrheic calves where 76% were E. coli and 24% were Salmonella. Diarrheic calves showed signs of anorexia, weakness, dullness, staggering gait, pale mucous membranes with sunken eyes and dehydration. Analysis of clinical and hemato-biochemical profile of the diarrheic calves revealed significant increase in body temperature, respiratory rate, heart rate, white b...
Nearly 113 non outbreak raw and processed chicken meat products were collected from grocery store... more Nearly 113 non outbreak raw and processed chicken meat products were collected from grocery stores and supermarkets namely chicken quarter, chicken fillet, drum stick, chicken panee, and luncheon and nagets. C.perfringens were isolated in percentage of 2 7.43, t yping of C.perfringens isolates b y I/D injection i n gui nea pig reveal ad types A,D and non-toxigenic st rains. The i ncidence of toxigenic st rains were 83. 9% while 16. 1% were n on-toxigenic s trains. 70.8% of the toxigenic isolates classified as C.perfringens type A while 1 2.9% of the isolates classified as C.perfringens type D. Studying t he enterotoxigenicity of C.perfringens type A by using s uckling m ouse bioassay revealed that 45.5% of the isolates were enterotoxigenic (produce enterotoxin). U sing PCR for c onfirmation the presence of a and enterotoxin g ene in e nterotoxigenic t ype A isolates yielded cpa and enterotoxin genes in t he predicted 1167bp and 233bp fragments re spectively.
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Papers by Ahmed Shehta