Shahera el-etreby

, Al Manşūrah
Medicine,Biology and Education
M.D. Internal Medicine


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    ABSTRACT: Background Chronic hepatitis C (CHC) is associated with multiple extrahepatic manifestations, including the recently recognized effect on pulmonary function tests (PFTs) and lung parenchyma. Aim To evaluate changes in PFTs and lung parenchyma in asymptomatic Egyptian patients with a CHC infection. Patients and methods This cross-sectional study included 70 CHC patients. All patients were subjected to a liver biopsy. Fibrosis stage and activity grade were assessed according to the METAVIR scoring system using scale ranges from 0 to 4. All patients were subjected to PFTs, measurement of arterial blood gases, and high-resolution computed tomography (HRCT) of the chest. All smokers, obese (BMIZ30) patients, and patients with known pulmonary disease were excluded. Results An alteration in PFTs was observed in 29 (41.42%) patients out of 70. A restrictive pattern was found in 27 patients (38.57%), in whom forced vital capacity and the total lung capacity values were reduced to less than 80% of the predicted values. Forced expiratory volume in 1 s/forced vital capacity value was more than 70%. Also, HRCT of the chest showed interstitial pulmonary fibrosis (IPF) with either an interstitial or an alveolar pattern with a total score not exceeding 2. These findings correlated significantly with the PFTs results. Also, there was no significant correlation between the presence of a restrictive pattern in PFTs or IPF in HRCT with other parameters in terms of age, BMI, sex, liver fibrosis, activity score, level of viremia, and duration of disease. Conclusion Hepatitis C virus could be a trigger factor for alterations in PFTs and lung parenchyma in the studied asymptomatic Egyptian patients with a CHC genotype 4 infection. HRCT AQ2 could be a sensitive, noninvasive method for the early detection of IPF in these patients.
    07/2012; DOI:10.1097/01.ELX.0000415485.73087.c8
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    EASL; 04/2012
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    ABSTRACT: 1. HCV could be a trigger factor for alterations in PFTs and lung parenchyma in the studied asymptomatic Egyptian patients with CHC-genotype 4 infection. 2. HCRT and Alveolar–arterial O 2 gradient can be used as sensitive methods for early detection of IPF in those patients. 3. Pegylated interferon may induce worsening of chest disease irrespectively of the patient outcomes. 4. So, screening for pulmonary disease is suggested in CHC patients before starting antiviral therapy 100 patients with CHC genotype 4 78 patients continued the course of treatment till 48 weeks 30 with restrictive PFTs+ positive HRCT 14 patients improved PFTS and HRCT findings 12 SVR 2 NR 16 patients remains with restrictive PFTs+ positive HRCT 14 SVR 2 NR 48 patients with initial normal PFTs and HRCT 35 patients remain with normal PFTs and HRCT 29 SVR 6 NR 13 patients developed restrictive PFTs and positive HRCT findings 11 SVR 2 NR 22 patients were excluded; 18 not achieved EVR and 4 patients stopped at week 24 (1 due interstitial pneumonitis and 3 due to breakthrough) ntroduction I Chronic hepatitis C (CHC) triggers multiple extrahepatic immune-lymphoproliferative disorders which might include 'idiopathic' pulmonary fibrosis. This can be detected by effects on pulmonary function tests (PFTs) ± high resolution computed tomography (HRCT) of the chest. Moreover, interferon therapy alone or in combination with ribavirin has been associated with pulmonary complications. Aim of the work: to evaluate changes in PFTs and HRCT of the chest in asymptomatic Egyptian patients with CHC and the effects of interferon/ribavirin therapy Patients and methods: This prospective cohort included 100 patients with chronic HCV-genotype 4. All patients received on a fixed weekly dose of 180 μg of peginterferon α-2a in combination with ribavirin in dose adjusted to body weight. All patients subjected to PFTs, arterial blood gases (ABGs) and HRCT of the chest before and after treatment. HRCT showed lower lung lobes shows interlobular septal thickening of both sides and minimal ground glass opacity in left side. (before treatment). HRCT showed interlobular septal thickening of both sides and bilateral ground glass opacity and honeycomb appearance 24 weeks after treatment SVR sustained virological response, NR non responder
    APASL; 02/2012
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    ABSTRACT: To evaluate the role of 64 multidetector CT angiography in preoperative evaluation of hepatic artery in candidates who underwent hepatic resection.Materials and methodsSixty-seven patients underwent triphasic CT scan using 64 multidetector CT scanner. They were 33 with hepatocellular carcinoma, 21 with solitary metastases, seven potential donors for liver transplantation, five with gaint haemangiomas, and one with large primary Non-Hodgkin lymphoma. The images were analyzed for the depiction of hepatic artery. The frequencies of anatomical variants of the hepatic artery were evaluated based on the classification proposed by Michels’ in 1966. The findings was compared and correlated with operative data.ResultsType I variant was seen in 43 patients (64.2) and variants were seen in other 24 patients (35.8%). We found seven patients with type II variant, 11 patients with type III variant, two patients with type V variant, and two patients with VI variant. There were two patients with type variants did not fit Michels’ classification. In 55 patients, the surgical findings concurred with 64 MDCT angiography findings (100%).Conclusion64 MDCT angiography is an effective, high-resolution, noninvasive imaging technique that readily demonstrates the hepatic arterial map with direct impact on treatment decisions including patient selection for hepatic resection.
    06/2011; 42(2):133-137. DOI:10.1016/j.ejrnm.2011.06.004

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