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Article ; Online: Clomiphene Citrate in the Management of Infertility in Oligospermic Obese Men with Hypogonadism: Retrospective Pilot Study.

Panner Selvam, Manesh Kumar / Baskaran, Saradha / Tannenbaum, Jacob / Greenberg, Jacob / Shalaby, Hosam Y / Hellstrom, Wayne J G / Sikka, Suresh C

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 11

Abstract: Background and Objectives: ...

Abstract	Background and Objectives:
MeSH term(s)	Humans ; Male ; Retrospective Studies ; Pilot Projects ; Semen Analysis ; Semen ; Clomiphene/therapeutic use ; Hypogonadism/complications ; Hypogonadism/drug therapy ; Testosterone/therapeutic use ; Infertility, Male/drug therapy ; Infertility, Male/etiology ; Obesity/complications
Chemical Substances	Clomiphene (1HRS458QU2) ; Testosterone (3XMK78S47O)
Language	English
Publishing date	2023-10-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59111902
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Article: Mechanisms of Melanoma Progression and Treatment Resistance: Role of Cancer Stem-like Cells.

Al Hmada, Youssef / Brodell, Robert T / Kharouf, Naji / Flanagan, Thomas W / Alamodi, Abdulhadi A / Hassan, Sofie-Yasmin / Shalaby, Hosam / Hassan, Sarah-Lilly / Haikel, Youssef / Megahed, Mosaad / Santourlidis, Simeon / Hassan, Mohamed

Cancers

2024 Volume 16, Issue 2

Abstract: Melanoma is the third most common type of skin cancer, characterized by its heterogeneity and propensity to metastasize to distant organs. Melanoma is a heterogeneous tumor, composed of genetically divergent subpopulations, including a small fraction of ... ...

Abstract	Melanoma is the third most common type of skin cancer, characterized by its heterogeneity and propensity to metastasize to distant organs. Melanoma is a heterogeneous tumor, composed of genetically divergent subpopulations, including a small fraction of melanoma-initiating cancer stem-like cells (CSCs) and many non-cancer stem cells (non-CSCs). CSCs are characterized by their unique surface proteins associated with aberrant signaling pathways with a causal or consequential relationship with tumor progression, drug resistance, and recurrence. Melanomas also harbor significant alterations in functional genes (BRAF, CDKN2A, NRAS, TP53, and NF1). Of these, the most common are the BRAF and NRAS oncogenes, with 50% of melanomas demonstrating the BRAF mutation (BRAF
Language	English
Publishing date	2024-01-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16020470
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Article ; Online: CD133-Dependent Activation of Phosphoinositide 3-Kinase /AKT/Mammalian Target of Rapamycin Signaling in Melanoma Progression and Drug Resistance.

Kharouf, Naji / Flanagan, Thomas W / Alamodi, Abdulhadi A / Al Hmada, Youssef / Hassan, Sofie-Yasmin / Shalaby, Hosam / Santourlidis, Simeon / Hassan, Sarah-Lilly / Haikel, Youssef / Megahed, Mossad / Brodell, Robert T / Hassan, Mohamed

Cells

2024 Volume 13, Issue 3

Abstract: Melanoma frequently harbors genetic alterations in key molecules leading to the aberrant activation of PI3K and its downstream pathways. Although the role of PI3K/AKT/mTOR in melanoma progression and drug resistance is well documented, targeting the PI3K/ ...

Abstract	Melanoma frequently harbors genetic alterations in key molecules leading to the aberrant activation of PI3K and its downstream pathways. Although the role of PI3K/AKT/mTOR in melanoma progression and drug resistance is well documented, targeting the PI3K/AKT/mTOR pathway showed less efficiency in clinical trials than might have been expected, since the suppression of the PI3K/mTOR signaling pathway-induced feedback loops is mostly associated with the activation of compensatory pathways such as MAPK/MEK/ERK. Consequently, the development of intrinsic and acquired resistance can occur. As a solid tumor, melanoma is notorious for its heterogeneity. This can be expressed in the form of genetically divergent subpopulations including a small fraction of cancer stem-like cells (CSCs) and non-cancer stem cells (non-CSCs) that make the most of the tumor mass. Like other CSCs, melanoma stem-like cells (MSCs) are characterized by their unique cell surface proteins/stemness markers and aberrant signaling pathways. In addition to its function as a robust marker for stemness properties, CD133 is crucial for the maintenance of stemness properties and drug resistance. Herein, the role of CD133-dependent activation of PI3K/mTOR in the regulation of melanoma progression, drug resistance, and recurrence is reviewed.
MeSH term(s)	Humans ; Sirolimus/pharmacology ; Phosphatidylinositol 3-Kinases/metabolism ; Phosphatidylinositol 3-Kinase/metabolism ; Proto-Oncogene Proteins c-akt/metabolism ; Melanoma/pathology ; Signal Transduction ; TOR Serine-Threonine Kinases/metabolism ; Drug Resistance, Neoplasm
Chemical Substances	Sirolimus (W36ZG6FT64) ; Phosphatidylinositol 3-Kinases (EC 2.7.1.-) ; Phosphatidylinositol 3-Kinase (EC 2.7.1.137) ; Proto-Oncogene Proteins c-akt (EC 2.7.11.1) ; TOR Serine-Threonine Kinases (EC 2.7.11.1)
Language	English
Publishing date	2024-01-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells13030240
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Article ; Online: Ultrasound Elastography Predicts Thyroid Nodule Volume Reduction Rate After Percutaneous Ethanol Ablation.

Abdelgawad, Mohamed / Shalaby, Hosam / Akkera, Mounika / Rashad, Yasmine / Grace, Lee / Ibraheem, Kareem / Kandil, Emad

The American surgeon

2020 Volume 87, Issue 4, Page(s) 581–587

Abstract: Objectives: To evaluate the safety and efficacy of percutaneous ethanol ablation (PEA) on indeterminate thyroid nodules (Bethesda III and IV) based on ultrasound (US) elastography by assessing the volume reduction rate (VRR), relative reduction in size, ...

Abstract	Objectives: To evaluate the safety and efficacy of percutaneous ethanol ablation (PEA) on indeterminate thyroid nodules (Bethesda III and IV) based on ultrasound (US) elastography by assessing the volume reduction rate (VRR), relative reduction in size, resolution of compressive symptoms, and post-procedural complications. Materials and methods: This is a retrospective cohort study of all thyroid nodules treated with PEA by a single surgeon at a North American tertiary referral center. Study variables included demographics, nodule characteristics, Bethesda classification, US elastography, presence of compressive symptoms, thyroid function, and post-procedural complications. Relative volume reductions and VRR were calculated at 3- and 6-month follow-ups. Results: Thirty-four thyroid nodules were evaluated in 22 patients. All thyroid nodules underwent a fine needle aspiration prior to PEA. After 6 months, 45% of all thyroid nodules exhibited a VRR of ≥50%. A significant VRR was achieved in the soft thyroid nodules at 6 months (42.15% ± 31), compared to the stiff nodules with 30.92% ± 91.53, Discussion: To the best of our knowledge, this is the largest series of PEA for thyroid nodules in North America. Ultrasound elastography is a useful adjunct in predicting the success of PEA for nonmalignant thyroid nodules. Percutaneous ethanol ablation is both a safe and effective alternative to surgery for relief of compressive symptoms in select patients.
MeSH term(s)	Ablation Techniques ; Aged ; Cohort Studies ; Elasticity Imaging Techniques ; Ethanol/administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Thyroid Nodule/diagnostic imaging ; Thyroid Nodule/pathology ; Thyroid Nodule/surgery ; Treatment Outcome
Chemical Substances	Ethanol (3K9958V90M)
Language	English
Publishing date	2020-11-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/0003134820951491
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Article: Tumor Microenvironment as a Therapeutic Target in Melanoma Treatment.

Kharouf, Naji / Flanagan, Thomas W / Hassan, Sofie-Yasmin / Shalaby, Hosam / Khabaz, Marla / Hassan, Sarah-Lilly / Megahed, Mosaad / Haikel, Youssef / Santourlidis, Simeon / Hassan, Mohamed

Cancers

2023 Volume 15, Issue 12

Abstract: The role of the tumor microenvironment in tumor growth and therapy has recently attracted more attention in research and drug development. The ability of the microenvironment to trigger tumor maintenance, progression, and resistance is the main cause for ...

Abstract	The role of the tumor microenvironment in tumor growth and therapy has recently attracted more attention in research and drug development. The ability of the microenvironment to trigger tumor maintenance, progression, and resistance is the main cause for treatment failure and tumor relapse. Accumulated evidence indicates that the maintenance and progression of tumor cells is determined by components of the microenvironment, which include stromal cells (endothelial cells, fibroblasts, mesenchymal stem cells, and immune cells), extracellular matrix (ECM), and soluble molecules (chemokines, cytokines, growth factors, and extracellular vesicles). As a solid tumor, melanoma is not only a tumor mass of monolithic tumor cells, but it also contains supporting stroma, ECM, and soluble molecules. Melanoma cells are continuously in interaction with the components of the microenvironment. In the present review, we focus on the role of the tumor microenvironment components in the modulation of tumor progression and treatment resistance as well as the impact of the tumor microenvironment as a therapeutic target in melanoma.
Language	English
Publishing date	2023-06-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15123147
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Article ; Online: Effects of Parathyroidectomy on Normocalcemic Primary Hyperparathyroidism and the Role of Intraoperative PTH Measurement.

Alameer, Ehab / Omar, Mahmoud / Hoof, Marcus / Shalaby, Hosam / Abdelgawad, Mohamed / Zora, Ghassan / Shama, Mohamed / Kandil, Emad

The American surgeon

2021 Volume 88, Issue 5, Page(s) 873–879

Abstract: Background: Normocalcemic primary hyperparathyroidism (NCpHPT) and normohormonal primary hyperparathyroidism (NHpHPT) are recently recognized variants of primary hyperparathyroidism. Current guidelines for the management hyperparathyroidism recognize ... ...

Abstract	Background: Normocalcemic primary hyperparathyroidism (NCpHPT) and normohormonal primary hyperparathyroidism (NHpHPT) are recently recognized variants of primary hyperparathyroidism. Current guidelines for the management hyperparathyroidism recognize NCpHPT as one of the areas that are recommended for more research due to limited available data. Methods: A retrospective review of patients who had parathyroidectomy between 2014 and 2019. We excluded patients with multiple endocrine neoplasia syndromes and secondary and tertiary hyperparathyroidism. Included patients were classified based on the biochemical profile into classic or normocalcemic hyperparathyroidism group. Collected data included demographics, preoperative localizing imaging, intraoperative parathyroid hormone levels, and postoperative cure rates. Results: 261 patients were included: 160 patients in the classic and 101 patients in the normocalcemic group. Patients in the normocalcemic group had significantly more negative sestamibi scans (n = 58 [8.2%] vs 78 [51.3%], Conclusion: Normocalcemic hyperparathyroidism is a challenging disease. Surgeons should be aware of the lower cure rate in this group, interpret intraoperative parathyroid hormone with caution, and have a lower threshold for bilateral neck exploration and 4 glands visualization.
MeSH term(s)	Humans ; Hyperparathyroidism, Primary/diagnostic imaging ; Hyperparathyroidism, Primary/surgery ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroidectomy/methods ; Radionuclide Imaging ; Retrospective Studies
Chemical Substances	Parathyroid Hormone
Language	English
Publishing date	2021-11-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348211048844
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Article: Diagnostic Accuracy of Ultrasound in Predicting Extrathyroidal Extension and Its Relation to Body Mass Index in a North American Population.

Omar, Mahmoud / Attia, Abdallah S / Issa, Peter P / Christensen, Bryce R / Sugumar, Kavin / Alnahla, Ahmed / Hadedeya, Deena / Shalaby, Hosam / Gupta, Neel / Shama, Mohamed / Toraih, Eman / Kandil, Emad

Biomedicines

2022 Volume 10, Issue 10

Abstract: Detection of extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma (PTC) influences treatment plan and surgical aggressiveness. Ultrasound (US) is the long-standing preoperative imaging method of choice. Recent literature from Asia ... ...

Abstract	Detection of extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma (PTC) influences treatment plan and surgical aggressiveness. Ultrasound (US) is the long-standing preoperative imaging method of choice. Recent literature from Asia suggests US accuracy to be influenced by patient characteristics, such as body mass index (BMI). Here, we examine the effect of BMI on the accuracy of US at a North American tertiary referral center. A total of 204 PTC-confirmed patients were retrospectively read by a radiologist blinded to surgical pathology findings. The radiologist recorded multiple sonographic features, including ETE, loss of echogenic capsule, nodule vascularity, capsular abutment, and bulging of contour. When considering all patients, the ultrasonographic feature with the best overall performance was loss of echogenic capsule (diagnostic odds ratio (DOR) = 4.48, 95% confidence interval (CI) = 1.86-10.78). Sub-group analysis by patient BMI found that area under the curve (AUC) for sonographic features was greater in non-obese BMI patients (0.71 ± 0.06) when compared with obese patients (0.43 ± 0.05;
Language	English
Publishing date	2022-09-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines10102408
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Article ; Online: Impact of surgery versus medical management on cardiovascular manifestations in Graves disease.

Elnahla, Ahmed / Attia, Abdallah S / Khadra, Helmi S / Munshi, Ruhul / Shalaby, Hosam / Lee, Grace S / Kandil, Emad

Surgery

2020 Volume 169, Issue 1, Page(s) 82–86

Abstract: Background: Graves disease is well known to have multiple adverse effects on the cardiovascular system. We compared the cardiovascular outcomes after surgical intervention versus medical treatment in patients with Graves disease.: Methods: We ... ...

Abstract	Background: Graves disease is well known to have multiple adverse effects on the cardiovascular system. We compared the cardiovascular outcomes after surgical intervention versus medical treatment in patients with Graves disease. Methods: We performed a retrospective study of all Graves disease patients with a cardiovascular comorbidity who underwent either surgical or medical management (N = 151). Perioperative biochemical and cardiovascular outcomes from the surgical versus the medical groups were analyzed. Results: Of 151 patients, 69 (45.6%) patients underwent total thyroidectomy and 82 (54.3%) patients received medical treatment. Hypertension resolved in 44.7% of the patients from the surgical group vs 18% in the medical group (P = .03). Tachyarrhythmias, including atrial fibrillation and tachycardia, improved in 85.9% of patients in the surgical group vs 66% in the medical group (P = .01). All cardiovascular manifestations examined, hypertension, tachyarrhythmias, and heart failure, improved in 69% of patients in the surgical group and 42.6% of patients in the medical group during the follow-up period (P < .01). Conclusion: Surgical treatment offers a significant and rapid clinical improvement of cardiovascular manifestations in Graves disease patients, such as hypertension, tachyarrhythmias, and heart failure. Surgery should be considered and recommended in Graves disease patients with known cardiovascular manifestations.
MeSH term(s)	Adult ; Antithyroid Agents/therapeutic use ; Clinical Decision-Making ; Female ; Follow-Up Studies ; Graves Disease/complications ; Graves Disease/therapy ; Heart Failure/diagnosis ; Heart Failure/etiology ; Heart Failure/therapy ; Humans ; Hypertension/diagnosis ; Hypertension/etiology ; Hypertension/therapy ; Male ; Middle Aged ; Retrospective Studies ; Tachycardia/diagnosis ; Tachycardia/etiology ; Tachycardia/therapy ; Thyroidectomy ; Treatment Outcome
Chemical Substances	Antithyroid Agents
Language	English
Publishing date	2020-05-10
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2020.03.023
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Article ; Online: The Effect of Patient Positioning on Intraoperative Neuromonitoring During Thyroid and Parathyroid Surgery.

Munshi, Ruhul / Mankowski, Nicholas / Souza, Spenser / Shalaby, Hosam / Elnahla, Ahmed / Akkera, Mounika / Hussein, Mohammad / Cox, Katherine / Borchardt, Jeffrey / McClure, Brian / Shama, Mohamed / Toraih, Eman / Kandil, Emad

The American surgeon

2021 Volume 89, Issue 5, Page(s) 1461–1467

Abstract: Background: Intraoperative neuromonitoring (IONM) has been accepted as a routine adjunct among surgeons who perform thyroid and parathyroid surgeries. Thyroid and parathyroid surgeries use various patient positioning strategies that have poorly ... ...

Abstract	Background: Intraoperative neuromonitoring (IONM) has been accepted as a routine adjunct among surgeons who perform thyroid and parathyroid surgeries. Thyroid and parathyroid surgeries use various patient positioning strategies that have poorly understood effects on IONM. The aim of this study was to compare IONM signals between the transaxillary and transcervical approaches. Methods: In this retrospective cohort study, we evaluated 463 adult patients who underwent a total of 502 procedures. The procedures performed included total thyroidectomy, right or left hemithyroidectomy, and parathyroidectomy. Vagus nerve and recurrent laryngeal nerve (RLN) latency and amplitude measurements were analyzed intra-operatively. The distances between the vagus nerve and the trachea were measured via ultrasound during transaxillary procedures. Results: Compared to the transcervical approach, the right vagus nerve latency was significantly decreased in the transaxillary approach. Transaxillary surgery was not associated with increased latency or decreased amplitude on IONM. The distance between the vagus nerve and trachea was significantly decreased post-positioning during transaxillary approaches. Discussion: Despite differences in patient positioning, a transaxillary approach was not associated with increased stress on the vagus nerve or RLN, according to IONM data. The decreased right vagus nerve latency associated with a transaxillary approach highlights the importance of considering patient positioning and laterality while interpreting IONM data.
MeSH term(s)	Adult ; Humans ; Thyroid Gland/surgery ; Retrospective Studies ; Recurrent Laryngeal Nerve Injuries/etiology ; Recurrent Laryngeal Nerve Injuries/prevention & control ; Thyroidectomy/methods ; Patient Positioning
Language	English
Publishing date	2021-12-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348211061103
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Article ; Online: Efficacy of indocyanine green fluorescence in predicting parathyroid vascularization during thyroid surgery.

Razavi, Alexander C / Ibraheem, Kareem / Haddad, Antoine / Saparova, Lachin / Shalaby, Hosam / Abdelgawad, Mohamed / Kandil, Emad

Head & neck

2019 Volume 41, Issue 9, Page(s) 3276–3281

Abstract: Background: We examined the value of indocyanine green (ICG) fluorescence angiography in predicting parathyroid vascularization following thyroid and central compartment surgeries.: Methods: Data were prospectively collected on adult patients ... ...

Abstract	Background: We examined the value of indocyanine green (ICG) fluorescence angiography in predicting parathyroid vascularization following thyroid and central compartment surgeries. Methods: Data were prospectively collected on adult patients undergoing thyroid and/or central compartment surgeries. Outcomes were compared in surgeries performed with and without ICG use. ICG scoring was used to quantify the vascularity of parathyroid glands. Results: One hundred eleven patients were included; 43 (38.7%) patients underwent ICG injections. There was no significant difference in mean parathyroid hormone (PTH) changes at the end of surgery (29.24 vs 23.48 pg/mL, P = .38), symptomatic hypocalcemia (7.9% vs 3.9%, P = .37), or length of stay (1.095 ± 0.22 vs 0.912 ± 0.07 days, P = .51) between surgeries performed with and without ICG. The average vascularization score among individuals undergoing ICG angiography was 2.89 out of a maximum of 8 points. Conclusion: Low-flow ICG patterns are not associated with postoperative PTH changes or transient hypocalcemia and may lead to unnecessary parathyroid autotransplantation.
MeSH term(s)	Adult ; Angiography ; Female ; Fluorescence ; Fluorescent Dyes ; Humans ; Hypocalcemia/epidemiology ; Indocyanine Green ; Male ; Optical Imaging ; Parathyroid Glands/blood supply ; Parathyroid Glands/diagnostic imaging ; Parathyroid Hormone/blood ; Postoperative Complications/blood ; Postoperative Complications/epidemiology ; Predictive Value of Tests ; Retrospective Studies ; Thyroidectomy/adverse effects
Chemical Substances	Fluorescent Dyes ; Parathyroid Hormone ; Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2019-06-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.25837
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