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  1. AU="Muhanna, Adel"
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  1. Article: Hospitalizations for alcoholic liver disease during the COVID-19 pandemic increased more for women, especially young women, compared to men.

    Campbell, John Patterson / Jahagirdar, Vinay / Muhanna, Adel / Kennedy, Kevin F / Helzberg, John H

    World journal of hepatology

    2023  Volume 15, Issue 2, Page(s) 282–288

    Abstract: Background: Alcoholic liver disease (ALD) remains one of the major indications for liver transplantation in the United States and continues to place a burden on the national healthcare system. There is evidence of increased alcohol consumption during ... ...

    Abstract Background: Alcoholic liver disease (ALD) remains one of the major indications for liver transplantation in the United States and continues to place a burden on the national healthcare system. There is evidence of increased alcohol consumption during the coronavirus disease 2019 (COVID-19) pandemic, and the effect of this on the already burdened health systems remains unknown.
    Aim: To assess the trends for ALD admissions during the COVID-19 pandemic, and compare it to a similar pre-pandemic period.
    Methods: This retrospective study analyzed all admissions at a tertiary health care system, which includes four regional hospitals. ALD admissions were identified by querying a multi-hospital health system's electronic database using ICD-10 codes. ALD admissions were compared for two one-year periods; pre-COVID-19 from April 2019 to March 2020, and during-COVID-19 from April 2020 to March 2021. Data were analyzed using a Poisson regression model and admission rates were compared using the annual quarterly average for the two time periods, with stratification by age and gender. Percent increase or decrease in admissions from the Poisson regression model were reported as incident rate ratios.
    Results: One thousand three hundred and seventy-eight admissions for ALD were included. 80.7% were Caucasian, and 34.3% were female. An increase in the number of admissions for ALD during the COVID-19 pandemic was detected. Among women, a sharp rise (33%) was noted in those below the age of 50 years, and an increase of 22% in those above 50 years. Among men, an increase of 24% was seen for those below 50 years, and a 24% decrease in those above 50 years.
    Conclusion: The COVID-19 pandemic has had widespread implications, and an increase in ALD admissions is just one of them. However, given that women are often prone to rapid progression of ALD, this finding has important preventive health implications.
    Language English
    Publishing date 2023-03-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2573703-X
    ISSN 1948-5182
    ISSN 1948-5182
    DOI 10.4254/wjh.v15.i2.282
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Lymph node ratio is a more robust predictor of overall survival than N stage in stage III colorectal adenocarcinoma.

    Beirat, Amir F / Amarin, Justin Z / Suradi, Haya H / Qwaider, Yasmeen Z / Muhanna, Adel / Maraqa, Bayan / Al-Ani, Abdallah / Al-Hussaini, Maysa

    Diagnostic pathology

    2024  Volume 19, Issue 1, Page(s) 44

    Abstract: Background: Lymph node ratio (LNR) may offer superior prognostic stratification in colorectal adenocarcinoma compared with N stage. However, candidate cutoff ratios require validation. We aimed to study the prognostic significance of LNR and its optimal ...

    Abstract Background: Lymph node ratio (LNR) may offer superior prognostic stratification in colorectal adenocarcinoma compared with N stage. However, candidate cutoff ratios require validation. We aimed to study the prognostic significance of LNR and its optimal cutoff ratio.
    Methods: We reviewed the pathology records of all patients with stage III colorectal adenocarcinoma who were managed at the King Hussein Cancer Center between January 2014 and December 2019. We then studied the clinical characteristics of the patients, correlates of lymph node count, prognostic significance of positive lymph nodes, and value of sampling additional lymph nodes.
    Results: Among 226 included patients, 94.2% had ≥ 12 lymph nodes sampled, while 5.8% had < 12 sampled lymph nodes. The median number of lymph nodes sampled varied according to tumor site, neoadjuvant therapy, and the grossing pathologist's level of training. According to the TNM system, 142 cases were N1 (62.8%) and 84 were N2 (37.2%). Survival distributions differed according to LNR at 10% (p = 0.022), and 16% (p < 0.001), but not the N stage (p = 0.065). Adjusted Cox-regression analyses demonstrated that both N stage and LNR at 10% and 16% predicted overall survival (p = 0.044, p = 0.010, and p = 0.001, respectively).
    Conclusions: LNR is a robust predictor of overall survival in patients with stage III colorectal adenocarcinoma. At a cutoff ratio of 0.10 and 0.16, LNR offers better prognostic stratification in comparison with N stage and is less susceptible to variation introduced by the number of lymph nodes sampled, which is influenced both by clinical variables and grossing technique.
    MeSH term(s) Humans ; Neoplasm Staging ; Lymph Node Ratio ; Lymphatic Metastasis/pathology ; Colorectal Neoplasms/pathology ; Lymph Nodes/pathology ; Prognosis ; Adenocarcinoma/pathology ; Retrospective Studies
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2210518-9
    ISSN 1746-1596 ; 1746-1596
    ISSN (online) 1746-1596
    ISSN 1746-1596
    DOI 10.1186/s13000-024-01449-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Sarcoidosis Manifesting as Liver Granuloma With Asteroid Bodies.

    Muhanna, Adel / Al Momani, Laith / Likhitsup, Alisa

    Cureus

    2021  Volume 13, Issue 9, Page(s) e17915

    Abstract: Sarcoidosis is an autoimmune disease, which most commonly affects the lungs and lymph nodes and is characterized with non-caseating granulomas. Hepatic involvement in sarcoidosis occurs in less than 1% of patients. Most patients with hepatic sarcoidosis ... ...

    Abstract Sarcoidosis is an autoimmune disease, which most commonly affects the lungs and lymph nodes and is characterized with non-caseating granulomas. Hepatic involvement in sarcoidosis occurs in less than 1% of patients. Most patients with hepatic sarcoidosis remain asymptomatic with only laboratory abnormalities. We present the case of a 59-year-old man with sarcoidosis who was evaluated for an elevation of alkaline phosphatase. Laboratory test results revealed an alkaline phosphatase level of 230 U/L, with normal alanine aminotransferase, aspartate aminotransferase, bilirubin, and albumin. Computed tomography of the abdomen and pelvis with intravenous contrast of the liver showed a mildly enlarged liver. Liver biopsy sections showed steatosis, active steatohepatitis, and focal portal granuloma formation with asteroid body. The patient was scheduled regular liver function tests and clinical monitoring. Most patients with hepatic sarcoidosis remain asymptomatic with only laboratory abnormalities such as elevation of liver enzymes and alkaline phosphatase. Although liver involvement is common in gastrointestinal sarcoidosis, progression to liver cirrhosis is rare in such patients. While symptomatic patients may be managed with systematic prednisone, asymptomatic patients may require only laboratory and clinical monitoring.
    Language English
    Publishing date 2021-09-12
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.17915
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Granulomatous Hepatitis Secondary to Histoplasmosis in an Immunocompetent Patient.

    Muhanna, Adel / Nimri, Faisal M / Almomani, Zaid A / Al Momani, Laith / Likhitsup, Alisa

    Cureus

    2021  Volume 13, Issue 9, Page(s) e17631

    Abstract: Histoplasma ... ...

    Abstract Histoplasma capsulatum
    Language English
    Publishing date 2021-09-01
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.17631
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Small Bowel Metastasis as a Presentation of Testicular Seminoma.

    Muhanna, Adel / Nimri, Faisal / Almomani, Zaid A / Al Momani, Laith / Likhitsup, Alisa / Hamid, Fadi

    Cureus

    2021  Volume 13, Issue 9, Page(s) e17962

    Abstract: Testicular germ cell tumors account for 95% of testicular cancers in men with approximately 71,000 patients being diagnosed with testicular cancer every year. The overall survival of testicular germ cell tumors is approximately 95%. However, the ... ...

    Abstract Testicular germ cell tumors account for 95% of testicular cancers in men with approximately 71,000 patients being diagnosed with testicular cancer every year. The overall survival of testicular germ cell tumors is approximately 95%. However, the prognosis becomes less favorable when distant metastasis is present. Gastrointestinal (GI) tract metastasis occurs in less than 5% of patients with non-seminomatous tumors, and in less than 1% in patients with pure seminomas. GI metastasis usually involves the colon, esophagus, and stomach with the most common symptoms of GI metastasis being diarrhea, nausea, vomiting, and obstruction. We discuss the case of a 42-year-old male patient with GI manifestations as the first presentation of testicular seminoma with metastasis to the small bowel. Computed tomography of the abdomen and pelvis revealed a small bowel mass, and the diagnosis was confirmed with histopathologic examination of endoscopic biopsy samples. The patient subsequently underwent chemotherapy treatment with close surveillance. Clinicians should maintain a high index of suspicion in the differential diagnosis of abdominal pain in young male patients, especially when associated with symptoms like unexplained weight loss, constitutional symptoms, and testicular pain or swelling. Metastasis to the GI tract from the testis should be promptly diagnosed and managed, as the overall survival rates can significantly decrease with the delay of diagnosis.
    Language English
    Publishing date 2021-09-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.17962
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: The association between microscopic colitis and celiac disease: a systematic review and meta-analysis.

    Nimri, Faisal M / Muhanna, Adel / Almomani, Zain / Khazaaleh, Shrouq / Alomari, Mohammad / Almomani, Laith / Likhitsup, Alisa

    Annals of gastroenterology

    2022  Volume 35, Issue 3, Page(s) 281–289

    Abstract: Background: Multiple studies suggested that celiac disease (CD) may be associated with microscopic colitis (MC); however, most were limited by a small sample size or the main scope of interest. We aimed to analyze previously published literature on this ...

    Abstract Background: Multiple studies suggested that celiac disease (CD) may be associated with microscopic colitis (MC); however, most were limited by a small sample size or the main scope of interest. We aimed to analyze previously published literature on this association to determine its extent and significance.
    Methods: A systematic review was conducted in PubMed, Embase, PubMed Central, Cochrane, and ScienceDirect databases from inception through January 2022. The PRISMA guideline was followed for data extraction. Effect estimates were extracted and combined using random effect, the generic inverse variance method of DerSimonian and Laird and pooled odds ratio (OR), and event rates (ER) were calculated. The Newcastle-Ottawa scale was used to evaluate the risk of bias. Forest plots were generated and publication bias assessed via conventional techniques.
    Results: Twenty-six studies with a total of 22,802 patients with MC were included in this analysis. CD was significantly associated with MC (odds ratio [OR] 8.276, 95% confidence interval [CI] 5.888-11.632; P<0.001). The ER for MC in CD patients was 6.2% (95%CI 4.1-9.2%; P<0.001), while the ER for CD in MC patients was 6.1% (95%CI 3.9-9.5%; P<0.001). CD was prevalent in both types of MC: 5.2% (95%CI 2.2-12.1%; P<0.001) in collagenous colitis and 6.3% (95%CI 3.4-11.5%; P<0.001) in lymphocytic colitis. We found no publication bias, according to funnel plots and Egger's regression asymmetry testing.
    Conclusions: Our meta-analysis confirms a statistically significant association between CD and MC, with a high prevalence of CD in both types of MC. Gastroenterologists should be wary of this association when evaluating patients with either disease, particularly patients with a suboptimal response to first-line therapy.
    Language English
    Publishing date 2022-04-08
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2032850-3
    ISSN 1108-7471
    ISSN 1108-7471
    DOI 10.20524/aog.2022.0714
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Safety and Effectiveness of Long-Term Anticoagulation for Atrial Fibrillation Among Nonagenarians: A Real-World Analysis.

    Elkaryoni, Ahmed / Barssoum, Kirolos / Barakat, Amr F / Elgendy, Islam Y / Elsayed, Mahmoud / Muhanna, Adel / Arnason, Anne / Shatla, Islam / Darki, Amir / Wimmer, Alan P

    The American journal of cardiology

    2020  Volume 140, Page(s) 151–152

    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Blood Coagulation/drug effects ; Female ; Humans ; Male ; Middle Aged ; Stroke/blood ; Stroke/etiology ; Stroke/prevention & control ; Treatment Outcome ; Young Adult
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2020-11-11
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2020.11.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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