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8篇 您的检索式:作者名="Imam Waked"
    题名 作者 年代 出处 被引量
1Hepatocellular carcinoma: Epidemiology, risk factors and pathogenesis显示文摘Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Given that the burden of chronic liver disease is expected to rise owing to increasing rates of alcoholism, hepatitis B and C prevalence and obesity-related fatty liver disease, it is expected that the incidence of HCC will also increase in the foreseeable future. This article summarizes the international epidemiology, the risk factors and the pathogenesis of HCC, including the roles of viral hepatitis, toxins, such as alcohol and aflatoxin, and insulin resistance.Asmaa Ibrahim Gomaa Shahid A Khan Mireille B Toledano Imam Waked Simon D Taylor- Robinson 2008World Journal of Gastroenterology2008,14,27:78
2Diagnosis of hepatocellular carcinoma显示文摘Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the diagnosis of HCC, including serum markers, radiological techniques and histological evaluation, and summarises international guidelines for the diagnostic approach to HCC.Asmaa I Gomaa Shahid A Khan Edward LS Leen Imam Waked Simon D Taylor-Robinson 2009World Journal of Gastroenterology2009,15,11:44
3Recent advances in multidisciplinary management of hepatocellular carcinoma显示文摘The incidence of hepatocellular carcinoma(HCC) is increasing, and it is currently the second leading cause of cancer-related death worldwide. Potentially curative treatment options for HCC include resection, transplantation, and percutaneous ablation, whereas palliative treatments include trans-arterial chemoembolization(TACE), radioembolization, and systemic treatments. Due to the diversity of available treatment options and patients' presentations, a multidisciplinaryteam should decide clinical management of HCC, according to tumor characteristics and stage of liver disease. Potentially curative treatments are suitable for very-early- and early-stage HCC. However, the vast majority of HCC patients are diagnosed in later stages, where the tumor characteristics or progress of liver disease prevent curative interventions. For patients with intermediate-stage HCC, TACE and radioembolization improve survival and are being evaluated in addition to potentially curative therapies or with systemic targeted therapy. There is currently no effective systemic chemotherapy, immunologic, or hormonal therapy for HCC, and sorafenib is the only approved moleculartargeted treatment for advanced HCC. Other targeted agents are under investigation; trials comparing new agents in combination with sorafenib are ongoing. Combinations of systemic targeted therapies with local treatments are being evaluated for further improvements in HCC patient outcomes. This article provides an updated and comprehensive overview of the current standards and trends in the treatment of HCC.Asmaa I Gomaa Imam Waked 2015World Journal of Hepatology2015,7,4:15
4Platelet-albumin-bilirubin score - a predictor of outcome of acute variceal bleeding in patients with cirrhosis显示文摘BACKGROUND The albumin-bilirubin(ALBI)score was validated as a prognostic indicator in patients with liver disease and hepatocellular carcinoma.Incorporating platelet count in the platelet-albumin-bilirubin(PALBI)score improved validity in predicting outcome of patients undergoing resection and ablation.AIM To evaluate the PALBI score in predicting outcome of acute variceal bleeding in patients with cirrhosis.METHODS The data of 1517 patients with cirrhosis presenting with variceal bleeding were analyzed.Child Turcotte Pugh(CTP)class,Model of End-stage Liver Disease(MELD),ALBI and PALBI scores were calculated on admission,and were correlated to the outcome of variceal bleeding.Areas under the receivingoperator characteristic curve(AUROC)were calculated for survival and rebleeding.RESULTS Mean age was 52.6 years;1176 were male(77.5%),69 CTP-A(4.5%),434 CTP-B(29.2%),1014 CTP-C(66.8%);306 PALBI-1(20.2%),285 PALBI-2(18.8%),and 926 PALBI-3(61.1%).Three hundred and thirty-two patients died during hospitalization(21.9%).Bleeding-related mortality occurred in 11%of CTP-B,28%of CTP-C,in 21.8%of PALBI-2 and 34.4%of PALBI-3 patients.The AUROC for predicting survival of acute variceal bleeding was 0.668,0.689,0.803 and 0.871 for CTP,MELD,ALBI and PALBI scores,respectively.For predicting rebleeding the AUROC was 0.681,0.74,0.766 and 0.794 for CTP,MELD,ALBI and PALBI scores,respectively.CONCLUSION PALBI score on admission is a good prognostic indicator for patients with acute variceal bleeding and predicts early mortality and rebleeding.Omar Elshaarawy Naglaa Allam Eman Abdelsameea Asmaa Gomaa Imam Waked 2020World Journal of Hepatology2020,12,3:13
5Validation of modified albumin-bilirubin-TNM score as a prognostic model to evaluate patients with hepatocellular carcinoma显示文摘BACKGROUND An ideal staging system for hepatocellular carcinoma(HCC)should rely on the hepatic reserve function and tumor burden.With the improvement in diagnostic and treatment strategies for HCC,in addition to recent treatment of viral hepatitis,finding a suitable assessment tool for hepatic reserve has become mandatory.AIM To validate a recently proposed modified albumin-bilirubin-TNM(mALBI-T)grade as a prognostic model for patients with HCC in Egypt.METHODS For patients diagnosed with HCC,Child-Turcotte-Pugh(CTP)score,Barcelona Clinic Liver Cancer(BCLC)stage,albumin-bilirubin(ALBI),plateltetalbumin– bilirubin(PALBI),ALBI-based BCLC,ALBI-T and mALBI-T grades were estimated.Patients were followed from time of diagnosis to date of death or date of data collection if they remained alive.Overall survival and received treatments were determined.Survival data were analyzed.RESULTS A total of 1910 patients were included(mean age,57 years;1575 males).At presentation,50.6%had CTP A,36.1%had CTP B and 13.4%had CTP C;12%had ALBI grade 1,62.3%had ALBI grade 2 and 24.7%had ALBI grade 3.Overall median survival was 13 mo;survival was better in patients with ALBI 1 than in those with ALBI 2 and 3(28.6 vs 14 and 5.8 mo,respectively,P<0.001).Patients with ALBI-T grades 0 and 1 had better survival than those with ALBI-T grades 2,3,4 and 5(P<0.001).The modified ALBI-T showed better stratification and significant improvement in prediction of survival.CONCLUSION ALBI-T grade is a superior prognostic tool that selects patients with HCC who have better liver reservoir and tumor stage.mALBI-T is a better prognostic model in patients with HCC.Omar Elshaarawy Alzhraa Alkhatib Mostafa Elhelbawy Asmaa Gomaa Naglaa Allam Ayman Alsebaey Eman Rewisha Imam Waked 2019World Journal of Hepatology2019,11,6:7
6Normal liver stiffness: a study in living donors with normal liver histology显示文摘AIM: To define the normal range of liver stiffness(LS) values using transient elastography in living-related liver transplantation candidate donors with normal liver histology. METHODS: LS was measured using Fibroscan in 50(16 women, 34 men) healthy potential donors(mean age 28.4 ± 5.9 years) who were being evaluated for liver donation for their relatives at the National Liver Institute, Menoufeya University, Egypt. All potential donors had normal liver tests and were negative for hepatitis B or C virus infection. Abdominal ultrasounds showed normal findings. None of the subjects had diabetes, hypertension, renal impairment, heart disease, or body mass index > 30 kg/m2. All subjects had normal liver histology upon liver biopsy. They all donated the right lobe of their liver with successful outcomes.RESULTS: The mean LS was 4.3 ± 1.2 k Pa(range: 1.8-7.1 k Pa). The 5th and 95 th percentiles of normal LS were 2.6 k Pa and 6.8 k Pa, respectively, with a median of 4 k Pa; the interquartile range was 0.6 ± 0.4. LS measurements were not significantly different between men and women(4.4 ± 1.1 k Pa vs 3.9 ± 1.3 k Pa) and did not correlate with age. However, stiffness values were significantly lower in subjects with a body mass index < 26 kg/m2 compared to those with an index ≥ 26 kg/m2(4.0 ± 1.1 k Pa vs 4.6 ± 1.2 k Pa; P <0.05). There were no differences in hospital stay or postoperative bilirubin, albumin,alanine and aspartate transaminases, or creatinine levels(at discharge) between donors with livers stiffness ≤ 4 k Pa and those with stiffness > 4 k Pa. CONCLUSION: Healthy donors with normal liver histology have a median LS of 4 k Pa. Stiffness values are elevated relative to increase in body mass index.Ayman Alsebaey Naglaa Allam Khalid Alswat Imam Waked 2015World Journal of Hepatology2015,7,8:3
7Ascites and alpha-fetoprotein improve prognostic performance of Barcelona Clinic Liver Cancer staging显示文摘AIM: To assess how ascites and alpha-fetoprotein(AFP) added to the Barcelona Clinic Liver Cancer(BCLC) staging predict hepatocellular carcinoma survival.METHODS: The presence of underlying cirrhosis, ascites and encephalopathy, Child-Turcotte-Pugh(CTP) score, the number of nodules, and the maximum diameter of the largest nodule were determined at diagnosis for 1060 patients with hepatocellular carcinoma at a tertiary referral center for liver disease in Egypt. Demographic information, etiology of liver disease, and biochemical data(including serum bilirubin, albumin, international normalized ratio, alanine and aspartate aminotransferases, and AFP) were evaluated. Staging of the tumor was determined at the time of diagnosis using the BCLC staging system; 496 patients were stage A and 564 patients were stage B. Patients with mild ascites on initial ultrasound, computed tomography, or clinical examination, and who had a CTP score ≤ 9 were included in this analysis. All patients received therapy according to the recommended treatment based on the BCLC stage, and were monitored from the time of diagnosis to the date of death or date of data collection. The effect of the presence of ascites and AFP level on survival was analyzed.RESULTS:At the time the data were censored,123/496(24.8%)and 218/564(38.6%)patients with BCLC stages A and B,respectively,had died.Overall mean survival of the BCLC A and B patients during a three-year follow-up period was 31 mo[95%confidence interval(95%CI):29.7-32.3]and 22.7mo(95%CI:20.7-24.8),respectively.The presenceof ascites,multiple focal lesions,large tumor size,AFP level and CTP score were independent predictors of survival for the included patients on multivariate analysis(P<0.001).Among stage A patients,18%had ascites,33%had AFP≥200 ng/m L,and 8%had both.Their median survival in the presence of ascites was shorter if AFP was≥200 ng/m L(19 mo vs 24 mo),and in the absence of ascites,patients with AFP≥200 ng/m L had a shorter survival(28mo vs 39 mo).For stage B patients,survival for the corresponding groups was 12,18,19 and 22 mo.The one-,two-,and three-year survival rates for stage A patients without ascites and AFP<200 ng/m L were94%,77%,and 71%,respectively,and for patients with ascites and AFP≥200 ng/m L were 83%,24%,and 22%,respectively(P<0.001).Adding ascites and AFP≥200 ng/m L improved the discriminatory ability for predicting prognosis(area under the curve,0.618vs 0.579 for BCLC,P<0.001).CONCLUSION:Adding AFP and ascites to the BCLC staging classification can improve prognosis prediction for early and intermediate stages of hepatocellular carcinoma.Asmaa I Gomaa Alzhraa Al-Khatib Wael Abdel-Razek Mohammed Saad Hashim Imam Waked 2015World Journal of Gastroenterology2015,21,18:3
8Optimal therapy in genotype 4 chronic hepatitis C: finally cured?显示文摘Wael Abdel‐Razek Imam Waked 2015Liver Int2015,,:1
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