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Article ; Online: Renal arterial resistive index versus novel biomarkers for the early prediction of sepsis-associated acute kidney injury.

Zaitoun, Taysser / Megahed, Mohamed / Elghoneimy, Hesham / Emara, Doaa M / Elsayed, Ibrahim / Ahmed, Islam

2024

Abstract: Acute kidney injury (AKI) is a critical complication of sepsis. There is a continuous need to identify and validate biomarkers for early detection. Serum and urinary biomarkers have been investigated, such as neutrophil gelatinase associated lipocalin ( ... ...

Abstract	Acute kidney injury (AKI) is a critical complication of sepsis. There is a continuous need to identify and validate biomarkers for early detection. Serum and urinary biomarkers have been investigated, such as neutrophil gelatinase associated lipocalin (NGAL) and cystatin C (Cys C), but their reliability in the intensive care unit (ICU) remains unknown. Renal hemodynamics can be investigated by measuring the renal resistive index (RRI). This study aimed to compare the performance of RRI, serum NGAL (sNGAL), urinary NGAL (uNGAL), and serum Cys C levels as early predictors of the diagnosis and persistence of sepsis-associated AKI. A total of 166 adult patients with sepsis syndrome were enrolled immediately after ICU admission. Biomarkers were measured directly (T1) and on day 3 (T3). RRI was measured directly (T1) and 24 h later (T2). Patients were categorized (according to the occurrence and persistence of AKI within the first 7 days) into three groups: no AKI, transient AKI, and persistent AKI. The incidence rate of sepsis-associated AKI was 60.2%. Sixty-six patients were categorized as in the no AKI group, while another 61 were in transient AKI and only 39 were in persistent AKI. The RRI value (T1 ≥ 0.72) was the best tool for predicting AKI diagnosis (area under the receiver operating characteristic curve, AUROC = 0.905). Cys C (T1 ≥ 15.1 mg/l) was the best tool to predict the persistence of AKI (AUROC = 0.977). RRI (T1) was the best predictive tool for sepsis-associated AKI, while Cys C was the best predictor of its persistence and 28-day mortality.
Language	English
Publishing date	2024-03-06
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-024-03558-y
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Article ; Online: The efficacy of TACE; how can automated feeder software help?

Hassan Abdelsalam / Doaa M. Emara / Ehab M. Hassouna

The Egyptian Journal of Radiology and Nuclear Medicine, Vol 53, Iss 1, Pp 1-

2022 Volume 8

Abstract: Abstract Background This is a prospective study of 44 patients having 57 hepatocellular carcinoma (HCC) lesions indicated for transarterial chemoembolization (TACE) and a control group of 41 patients having 55 HCC lesions. TACE in the study group was ... ...

Abstract	Abstract Background This is a prospective study of 44 patients having 57 hepatocellular carcinoma (HCC) lesions indicated for transarterial chemoembolization (TACE) and a control group of 41 patients having 55 HCC lesions. TACE in the study group was performed on an angiography machine with an installed automated feeder detection (AFD) software (EmboGuide; Philips Healthcare, Best, The Netherlands) and in the control group was performed on a similar angiography machine (ALLURA XPER FD 20, Philips, Holland), but lacking the AFD software. The aim is to evaluate the clinical utilization of cone-beam CT (CBCT) and (AFD) software in accurate detection of (HCC) arterial feeders, the effect of (AFD) software utilization on the outcome of (TACE) and its utilization effect on fluoroscopy time and radiation dose to the patient during the (TACE) procedure. Results The highest percentage of agreement was between the number of arterial feeders detected by EmboGuide and the actual number of feeders detect during embolization reaching 91.2% with p value < 0.001. The residual non-intended non-embolized areas among the study group at 1-month follow-up were found in 2 out of 57 lesions compared to 9 out of 55 lesions in the control group. The average dose-area product (DAP) among the study group was less than that of the control group. Conclusion CBCT using AFD software provides more information about tumor feeders with consequent more efficient targeted embolization, higher success rate of TACE and less patient exposure to radiation.
Keywords	TACE ; EmboGuide ; HCC feeders ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Subject code	616
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Satellite-based estimates of groundwater storage depletion over Egypt.

Shalby, Ahmed / Emara, Sobhy R / Metwally, Mohammed I / Armanuos, Asaad M / El-Agha, Doaa E / Negm, Abdelazim M / Gado, Tamer A

Environmental monitoring and assessment

2023 Volume 195, Issue 5, Page(s) 594

Abstract: An arid climate accompanied by a freshwater shortage plagued Egypt. It has resorted to groundwater reserves to meet the increasing water demands. Fossil aquifers were lately adopted as the sole water source to provide the irrigation water requirements of ...

Abstract	An arid climate accompanied by a freshwater shortage plagued Egypt. It has resorted to groundwater reserves to meet the increasing water demands. Fossil aquifers were lately adopted as the sole water source to provide the irrigation water requirements of the ongoing reclamation activities in barren areas. Yet, the scarcity of measurements regarding the changes in the aquifers' storage poses a great challenge to such sustainable resource management. In this context, the Gravity Recovery and Climate Experiment (GRACE) mission enables a novel consistent approach to deriving aquifers' storage changes. In this study, the GRACE monthly solutions during the period 2003-2021 were utilized to estimate alterations in terrestrial water storage (TWS) throughout Egypt. Changes in groundwater storage (GWS) were inferred by subtracting soil water content, derived from the GLDAS-NOAH hydrological model, from the retrieved TWS. The secular trends in TWS and GWS were obtained using the linear least square method, while the non-parametric technique (Mann-Kendall's tau) was applied to check the trend significance. The derived changes in GWS showed that all aquifers are undergoing a significant loss rate in their storage. The average depletion rate over the Sinai Peninsula was estimated at 0.64 ± 0.03 cm/year, while the depletion rate over the Nile delta aquifer was 0.32 ± 0.03 cm/year. During the investigated period (2003-2021), the extracted groundwater quantity from the Nubian aquifer in the Western Desert is estimated at nearly 7.25 km
MeSH term(s)	Egypt ; Environmental Monitoring/methods ; Groundwater ; Water ; Desert Climate
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2023-04-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	782621-7
ISSN	1573-2959 ; 0167-6369
ISSN (online)	1573-2959
ISSN	0167-6369
DOI	10.1007/s10661-023-11171-3
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Article ; Online: Shear wave elastography versus strain elastography to identify benign superficial lymph nodes

Amr A. Abdel Kerim / Amr M. El Abd / Nagy N. Naguib / Maha Guimei / Doaa M. Emara

The Egyptian Journal of Radiology and Nuclear Medicine, Vol 54, Iss 1, Pp 1-

sonographic assessment with histopathological confirmation

2023 Volume 11

Abstract: ... analysis of SWV measurement using ARFI revealed a cut-off value of ≥ 2.70 m/sec to recognize malignant LNs ... imaging modality to identify benign lymph nodes. ARFI at a cut-off value of < 2.7 m/sec was superior to SE ...

Abstract	Abstract Background Differentiation between benign and malignant superficial lymph nodes (LNs) presents clinical dilemma. No specific criteria are established with conventional ultrasound to make a distinction. We aimed to study the added value of shear wave velocity (SWV) measurement with acoustic radiation force impulse (ARFI) and strain elastography (SE) to identify benign superficial LNs. The study included 115 superficial LNs subjected to conventional ultrasonography, 4-scale strain elastography and shear wave velocity measurement using ARFI. Histopathological analysis was obtained for all examined nodes. Results SE correctly diagnosed 89.3% of the reactive and 92.2% of the metastatic LNs and erroneously diagnosed 72.7% of the lymphoma LNs as being benign. Overall sensitivity, specificity, PPV, NPV and accuracy were 74.4%, 73%, 85.3%, 57.4% and 73.9%, respectively. The receiver operating curve analysis of SWV measurement using ARFI revealed a cut-off value of ≥ 2.70 m/sec to recognize malignant LNs and to obtain best sensitivity (88.5%) and specificity (89.2%) (Area under the curve: 0.819, 95% confidence interval (CI): 0.744 and 0.894). The PPV, NPV and accuracy were 94.5%, 78.6% and 88.7%, respectively. As compared to SE, ARFI boosted the diagnostic accuracy of lymphoma LNs from 27.3 to 68.2% and showed better specificity and NPV to identify benign LN as contrasted to SE. Conclusions SE could be adequate to differentiate reactive from metastatic LN but not from Lymphomas. Shear wave elastography is a reasonable imaging modality to identify benign lymph nodes. ARFI at a cut-off value of < 2.7 m/sec was superior to SE and the best B-mode features.
Keywords	Lymph node ; Strain elastography ; Shear wave velocity ; ARFI ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Can magnetic resonance imaging predict preoperative consistency and vascularity of intracranial meningioma?

Ahmed A. ElBeheiry / Ahmed A. Fayed / Ahmed H. Alkassas / Doaa M. Emara

The Egyptian Journal of Radiology and Nuclear Medicine, Vol 53, Iss 1, Pp 1-

2022 Volume 15

Abstract: Abstract Background Meningiomas are considered the most common primary intracranial neoplasms. The surgical resection is the main curative therapy. Evaluation of meningioma consistency and vascularity is important before surgery to be aware about the ... ...

Abstract	Abstract Background Meningiomas are considered the most common primary intracranial neoplasms. The surgical resection is the main curative therapy. Evaluation of meningioma consistency and vascularity is important before surgery to be aware about the difficulties that neurosurgeon will face during resection, the possibility of total resection and to determine which equipment will be suitable for surgery. The purpose of this study was to identify the relationship between the MRI predictors of meningioma consistency [utilizing tumor/cerebellar peduncle T2-weighted imaging intensity (TCTI) ratios] as well as tumor vascularity (utilizing arterial spin labeling perfusion) in correlation with intraoperative findings. The study was carried out on 40 patients with MRI features of intracranial meningiomas. Non-contrast conventional MRI followed by arterial spin labeling MR perfusion and post contrast sequences were done for all cases. Final diagnosis of the cases was established by histopathological data while consistency and vascularity was confirmed by operative findings. Results According to surgical data, the studied cases of intracranial meningiomas were classified according to tumor consistency into 19 cases (47.5%) showing soft consistency, 14 cases (35%) showing intermediate consistency and 7 cases (17.5%) showing firm/hard consistency. TCTI ratio was the most significant MRI parameter in correlation with operative consistency of meningiomas, with soft lesions showing TCTI ranging from 1.75 to 2.87, intermediate consistency lesions TCTI ranging from 1.3 to 1.6, and firm lesions TCTI ranging from 0.9 to 1.2. According to intraoperative vascularity, cases were classified into 27 cases (67.5%) showing hypervascularity, 6 cases (15%) showing intermediate vascularity and 7 cases (17.5%) showing hypovascularity. Arterial spin labeling (ASL) was the most significant MRI parameter in correlation with operative vascularity of meningiomas, with hypervascular lesions showing normalized cerebral blood flow (n-CBF) ranging ...
Keywords	Meningiomas ; Tumor/cerebellar peduncle T2-weighted imaging intensity (TCTI) ratio ; Arterial Spin Labeling ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Utility of diffusion weighted imaging (DWI) in assessment of liver fibrosis

Doaa M. Emara / Marwa M. Reda / Doaa A. Elwazzan

Alexandria Journal of Medicine, Vol 54, Iss 4, Pp 347-

2018 Volume 352

Abstract: Objectives: hepatic fibrosis occurs due to chronic liver injury. Early fibrosis can be reversed by treatment with specific antifibrotic therapy in addition to removal of the cause if possible, that is why, identification of the early liver fibrosis is ... ...

Abstract	Objectives: hepatic fibrosis occurs due to chronic liver injury. Early fibrosis can be reversed by treatment with specific antifibrotic therapy in addition to removal of the cause if possible, that is why, identification of the early liver fibrosis is important. MRI DWI is a non-invasive non-contrast imaging technique which help in diagnosis of different stages of hepatic fibrosis. Aim of the work: was to study the predictive value of diffusion weighted MRI for assessing liver fibrosis in comparison to liver biopsy in chronic hepatitis C virus patients. Methods: all the studied cases were subjected to the followings: (1) History and laboratory examination (PCR for HCV and liver function tests). (2) MRI DWI and post processing ADC map. (3) Percutaneous liver biopsy in cases with HCV for histopathological examination to assess the stage of fibrosis. Results: this study was carried out on 75 subjects, divided into two group, 50 cases and 25 controls, the mean age in the two studied groups was 36.5 ± 9.32 and 35.8 ± 6.75 respectively in patients and control. ADC of both liver and spleen showed a highly significant increase in the control than in the cases with mean liver ADC in the control group = 2.3 ± 0.25. There was a significant negative correlation between the mean ADC of the liver, spleen and the stage of liver fibrosis.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2018-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Multidetector computed tomography

Doaa M. Emara / Khaled M. Moghazy / Galal M. Abouelnagah / Ahmed H. Amer

The Egyptian Journal of Radiology and Nuclear Medicine, Vol 52, Iss 1, Pp 1-

a corner stone imaging modality in evaluation of acute small bowel diseases

2021 Volume 12

Abstract: Abstract Background The diagnosis of acute small bowel diseases is one of the challenging issues that confronted by the radiologists so accurate diagnosis is essential to determine the appropriate way of management. CT has become the preferred imaging ... ...

Abstract	Abstract Background The diagnosis of acute small bowel diseases is one of the challenging issues that confronted by the radiologists so accurate diagnosis is essential to determine the appropriate way of management. CT has become the preferred imaging tool to evaluate acute small bowel diseases. Our study aimed to assess the role of MDCT in evaluation of acute abdomen secondary to small bowel origin by identification and differentiation between different acute small bowel pathologies. Results Thirty-eight patients presented with acute abdomen of small bowel origin from June 2019 to September 2019. The mean age of incidence was 48 ± 19 years ranged from 4 to 88 years. Males represented by 23 patients (60.5%). Acute exacerbation of inflammatory bowel diseases (Crohn’s disease) represented by (34.2%), small bowel obstruction (31.6%), ischemic bowel diseases (21.1%), small bowel perforation (10.5%) and infectious (TB enteritis) small bowel disease (2.6%). MDCT had an overall high sensitivity (97.3%) in assessment of acute small bowel diseases in correlation with post-operative data and follow-up response to management. Conclusions MDCT is a reliable diagnostic imaging tool for assessment of patients with acute abdomen secondary to small bowel origin with high-efficiency in differentiation between different pathological entities that causing acute abdomen.
Keywords	Multidetector computed tomography (MDCT) ; Acute abdomen ; Acute small bowel diseases ; Crohn’s disease ; Small bowel obstruction ; Ischemic bowel diseases ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Subject code	610
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The added value of multidetector CT in the diagnosis of gastrointestinal causes of acute abdomen in geriatrics

Doaa M. Emara / Adel M. Rizk / Abeer M. Ahmed / Amr Magdi El Abd

The Egyptian Journal of Radiology and Nuclear Medicine, Vol 52, Iss 1, Pp 1-

2021 Volume 16

Abstract: Abstract Background Due to changes in the gastrointestinal system in geriatric people, there are higher rates of atypical presentations of common disorders. In order to decrease the mortality rate, an efficient and correct diagnosis should be given for ... ...

Abstract	Abstract Background Due to changes in the gastrointestinal system in geriatric people, there are higher rates of atypical presentations of common disorders. In order to decrease the mortality rate, an efficient and correct diagnosis should be given for these patients. The aim of this study was to assess the role of MDCT in evaluating gastrointestinal tract-related acute abdominal pain in geriatric patients. Results Among fifty geriatric patients presented clinically with acute abdominal pain of gastrointestinal origin from November 2019 to September 2020, mean age was 70.2 ± 5.6 years ranging from 65 to 86 years. Majority were female, (thirty patients, 60%). Gastric causes (16%): obstruction (62.5%) and perforation (37.5%); and intestinal causes (84%): obstruction (71.4%), inflammatory (28.6%), perforation (23.8%), vascular (11.9%), and others (2.4%) were the frequent causes of acute abdominal pain in the studied patients. MDCT had a very high sensitivity of 98% (95% CI) as well as its PPV (95% CI) was 100% in the evaluation of gastrointestinal-related acute abdominal pain. Conclusion MDCT is a reliable diagnostic imaging modality for geriatric patients presented with acute abdominal pain suggested to be of gastrointestinal origin with a very high sensitivity in diagnosing the causative pathological conditions. MDCT can efficiently differentiate between obstructive, inflammatory, perforated, and ischemic bowel disorders.
Keywords	Multidetector computed tomography (MDCT) ; Geriatric patients ; The elderly ; Acute abdominal pain ; Gastrointestinal ; Intestinal ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Subject code	610
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dual gradient echo in-phase and out of phase sequences in assessment of hepatic iron overload in patients with beta-thalassemia, would be better?

Ali Mohamed Aboughonaim, Ahmed / Naguib Ettaby, Ashraf / Ibrahim El-Noueum, Khaled / Hassab, Hoda / Emara, Doaa M

European journal of radiology

2022 Volume 154, Page(s) 110412

Abstract: Purpose: To evaluate the diagnostic accuracy of the dual gradient-echo (GRE) in- and out-of-phase sequences as a quantitative tool for hepatic iron overload in comparison with MRI R2* relaxometry in paediatric patients with beta-thalassemia.: Method: ...

Abstract	Purpose: To evaluate the diagnostic accuracy of the dual gradient-echo (GRE) in- and out-of-phase sequences as a quantitative tool for hepatic iron overload in comparison with MRI R2* relaxometry in paediatric patients with beta-thalassemia. Method: Sixty-three patients with beta-thalassemia major (transfusion-dependent) or beta-thalassemia intermedia (transfusion- and non-transfusion-dependent) were referred from the paediatric department (haematology unit) to the radiology department at a university hospital. The paediatrician conducted a clinical examination for the studied group, assessed their laboratory data, conducted R2* relaxometry and dual gradient echo sequences to calculate R2* and relative signal intensity index at the axial mid-section of the liver, and studied their correlation. A 1.5 Tesla MR scanner was used (Achieva; Philips Medical Systems, the Netherlands). Data were fed to the computer and analysed using the IBM SPSS software package version 20.0 (Armonk, NY: IBM Corp). The Kolmogorov-Smirnov test was used to verify the normality of distribution. The significance of the results was determined at the 5% level. The Chi-square, Fisher's exact correction, Pearson coefficient, and Bland-Altman tests were used. Results: Dual gradient-echo in- and out-of-phase sequences using visual assessment accurately assessed 93.65% of our patient group with hepatic iron overload. A significant correlation was found between the relative signal intensity index and hepatic MRI R2* relaxometry (p < 0.001, r = 0.861). Conclusions: Dual gradient-echo in and out-of-phase sequences are good imaging tools for hepatic iron detection and quantification. These sequences showed good correlation with R2* relaxometry (r = 0.861, p < 0.001).
MeSH term(s)	Child ; Humans ; Iron/analysis ; Iron Overload/diagnostic imaging ; Liver/diagnostic imaging ; Magnetic Resonance Imaging/methods ; beta-Thalassemia/complications ; beta-Thalassemia/diagnostic imaging
Chemical Substances	Iron (E1UOL152H7)
Language	English
Publishing date	2022-06-15
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	138815-0
ISSN	1872-7727 ; 0720-048X
ISSN (online)	1872-7727
ISSN	0720-048X
DOI	10.1016/j.ejrad.2022.110412
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Article ; Online: Ultrasound elastography in characterization of prostatic lesions: correlation with histopathological findings.

Emara, Doaa M / Naguib, Nagy N / Yehia, Mohamed / El Shafei, Mohamed M

The British journal of radiology

2020 Volume 93, Issue 1110, Page(s) 20200035

Abstract: Objective: Ultrasound elastography is increasingly used in the diagnosis of prostate cancer, however results are heterogeneous. We correlate in a large sample-size prospective study the accuracy of elastography, aiming to settle an accurate cut-off ... ...

Abstract	Objective: Ultrasound elastography is increasingly used in the diagnosis of prostate cancer, however results are heterogeneous. We correlate in a large sample-size prospective study the accuracy of elastography, aiming to settle an accurate cut-off point for diagnosis and possibility of use as a screening tool. Methods: Prospective study that included 120 patients with mean age 59.5 ± 9.8 years, showing enlarged prostate by clinical examination with prostate-specific antigen >4 ng ml Results: There was statistically significant difference ( Conclusion: Strain ratio improves the detection of prostatic cancer with high sensitivity (100%) and high negative predictive value (100%). Advances in knowledge: Different prostatic lesions are mostly similar in grayscale ultrasound.Imaging plays an important role in differentiation of prostatic nodules.Ultrasound elastography may play an important role in distinguishing benign from malignant nodules.
MeSH term(s)	Aged ; Echocardiography, Doppler, Color ; Elasticity Imaging Techniques/methods ; Humans ; Image-Guided Biopsy/methods ; Male ; Middle Aged ; Neoplasm Grading ; Predictive Value of Tests ; Prospective Studies ; Prostate/diagnostic imaging ; Prostate/pathology ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Sample Size ; Sensitivity and Specificity
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2020-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2982-8
ISSN	1748-880X ; 0007-1285
ISSN (online)	1748-880X
ISSN	0007-1285
DOI	10.1259/bjr.20200035
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