khaled kamel - Academia.edu (original) (raw)
Papers by khaled kamel
The Egyptian Journal of Chest Diseases and Tuberculosis
© 2019 The Egyptian Journal of Chest Diseases and Tu Objective Pleural effusion is a common medic... more © 2019 The Egyptian Journal of Chest Diseases and Tu Objective Pleural effusion is a common medical problem occurring owing to various causes, and the diagnostic panel includes various diagnostic modalities. The rationale is to compare the accuracy of chest computed tomography (CT) versus transthoracic ultrasound (TTUS) in the detection of gross pathological pleural derangement through confirmatory thoracoscopic examination. Patients and methods A total of 50 patients with undiagnosed exudative pleural effusion were included, in whom the two radiological modalities were performed and compared with the results of thoracoscopy. Results A total of 18 (36%) female and 32 (64%) male patients were included, with a mean age of 50±14.95 years. TTUS showed superiority in the assessment of the pleura regarding thickening, nodulation, trabeculation, septation, encystation, and invasion of the chest wall in relation to the thoracoscopic findings, over the CT, which was statistically significant (P=0.0001). Moreover, it showed higher sensitivity and specificity than CT in all examined items. This is in addition to the known advantages of the TTUS being noninvasive, less expensive, and no exposure to radiation. Thus, it is recommended as a sole imaging procedure of choice in assessment of the pleura in adjunct to thoracoscope.
The Egyptian Journal of Chest Diseases and Tuberculosis
Background and objective Ultrasound can evaluate pleural thickening; however, medical thoracoscop... more Background and objective Ultrasound can evaluate pleural thickening; however, medical thoracoscopy permits direct inspection of the pleura, and biopsies are taken under direct vision. This study evaluated the degree of pleural thickening observed during medical thoracoscopy and compared it with the pleural thickness grades assessed and measured using transthoracic ultrasonography (TUS). Patients and methods A total of 118 cases with undiagnosed exudative pleural effusion were included. They were subjected to history taking, clinical examination, routine laboratory investigations, computed tomography chest, TUS to assess degree of parietal pleural thickening, and medical thoracoscopy to evaluate the observed degree of pleural thickening. Results There was a significant positive correlation between pleural thickening measured by US with thoracoscopic grades of thickness and significant positive correlation between pleural thickening grades measured by US and thoracoscopic grades of pleural thickness. Performance of thoracoscopy using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for assessment of pleural thickening in comparison with US as a standard tool for measurement was 36, 77, 52, 77, and 66%, respectively, whereas in assessing the shape of visceral pleura, this performance increased up to 89, 89, 85, 85, and 88%, respectively. Conclusion This study showed the superiority of TUS in assessment of parietal pleura thickening and chest wall invasion. In addition, TUS has other advantages as being noninvasive, less expensive, and no exposure to radiation. However, medical thoracoscopy can detect the visceral pleural shape better owing to the advantage of direct visualization of the lung surface.
Tuberculosis and Respiratory Diseases
Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can ... more Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cutoff value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cutoff value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. Conclusion: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.
The Egyptian Journal of Bronchology, 2021
Background The nature of opaque lesions such as effusions, atelectasis, masses, and consolidation... more Background The nature of opaque lesions such as effusions, atelectasis, masses, and consolidations can be clarified by sonography. This study investigated the sensitivity and accuracy of ultrasound-guided percutaneous core needle biopsy in different thoracic tumors (lung, pleural, chest wall, and mediastinal). Results Sixty patients underwent ultrasound-guided percutaneous transthoracic core biopsy of peripheral thoracic masses with a Tru-Cut needle with a big bore. Twenty masses were in the lung, seventeen lesions were in the pleura, ten masses were in the mediastinum, eleven were enlarged palpable lymph nodes, and two masses were in chest wall. The sensitivity, PPV, and accuracy for detection of chest tumors in the chest wall, mediastinum, lung, and pleura were 100% for all, and in LN 88.9, 100, and 90.9%, respectively. The overall diagnostic performance of sonar-guided Tru-Cut needle biopsy in diagnosis was 97.78% sensitivity, 98.18% accuracy, and 100% PPV. Conclusion Tru-Cut nee...
Egyptian Journal of Chest Diseases and Tuberculosis, 2013
Lung cancer is the most common cause of cancer-related deaths. Chest CT scan is frequently unreli... more Lung cancer is the most common cause of cancer-related deaths. Chest CT scan is frequently unreliable in staging mediastinal lymph node metastases of lung cancer, since interpretation relies on lesion size. EBUS offers a unique way of imaging and parabronchial structures. The procedure is safe, minimally invasive and does not require general anesthesia or hospitalization. The complication rate is extremely low. Subjects and methods: This study was conducted on eleven patients who were found without CT evidence of enlarged mediastinal lymph nodes. Bronchoscopy and EBUS were performed for the diagnosis of lung cancer. TBLB of detected mediastinal lymph nodes was performed. CT guided biopsies were done for non-diagnosed cases. Results: In this study bronchogenic carcinoma was diagnosed by bronchoscopic biopsy in 6 cases (54.5%), by EBUS-TBNA in 2 cases (18.2%), and by CT guided biopsy in 3 cases (27.3%). From the eleven patients with negative CT scan, EBUS of mediastinal L.N was positive in four cases (36.4%). The first case showed 2 small subcarinal L.N station (7) and 2 right hilar lymph node stations (10R). In the second case EBUS detected 2 subcarinal lymph node stations (7) and one left hilar station (10L). In the third case there was one subcarinal lymph node station (7). The fourth case showed a left hilar lymph node station (10L). Conclusions: EBUS is safe and minimally invasive technique in the detection of mediastinal lymph metastasis. EBUS in combination with conventional radiologic tools may contribute to improve diagnosis and staging of lung cancer.
Egyptian Journal of Bronchology, 2018
Objectives Pleural thickening is defined as the increase in thickness of the pleura of more than ... more Objectives Pleural thickening is defined as the increase in thickness of the pleura of more than 3 mm and can be caused by a wide range of diseases, either nonmalignant or malignant. Thoracic ultrasound has high sensitivity in assessing the pleura. Aim The aim of this study was to assess the role of thoracic ultrasound in differentiation of the causes of pleural thickening. Design A prospective study included 48 patients selected from the inpatient Chest Department, Kasr Al-Ainy Hospital, from January 2016 till October 2017. Patients diagnosed as having pleural thickening underwent thoracic ultrasound as well as ultrasound-guided pleural biopsy by Tru-cut needle. Descriptive data were obtained including age and sex of the patients. Thoracic ultrasound was done for the side of pleural thickening. The distribution of pleural thickness, either localized or diffuse; the surface; invasion of chest wall or diaphragm; the echogenicity and vascularity; and the presence of pleural effusion a...
Advances in Respiratory Medicine, 2020
Instroduction: Obstructive sleep apnea is a common disorder, characterized by recurrent narrowing... more Instroduction: Obstructive sleep apnea is a common disorder, characterized by recurrent narrowing and closure of the upper airway accompanied by intermittent oxyhemoglobin desaturation and sympathetic activation. Ultrasound imaging of the airways has advantages of being safe, quick, repeatable, portable and widely available. Airway ultrasound can visualize and assess the mouth and tongue, oropharynx, hypopharynx, epiglottis, larynx, vocal cords, cricothyroid membrane, cricoid cartilage, trachea, and cervical esophagus. Material and methods: This study assessed the role of ultrasonography in detecting the level and degree of obstruction of airway passages in patients with obstructive sleep apnea (OSA) and its relation to OSA severity. It included thirty-three patients diagnosed as OSA, and ten healthy subjects as a control group. All participants were ≥ 18 years and were subjected to full medical history, Epworth sleepiness score (ESS), thorough clinical examination, complete overnig...
The Egyptian Journal of Bronchology, 2020
Background Convex probe endobronchial ultrasound is a minimally invasive technique used for perfo... more Background Convex probe endobronchial ultrasound is a minimally invasive technique used for performing real-time transbronchial needle aspiration of enlarged hilar and mediastinal lymph nodes and could be used for diagnosing proximal peribronchial lesions. Although computed tomography, magnetic resonant imaging, and positron emission tomography/computed tomography have relatively high sensitivity for mediastinal evaluation, pathology is the gold standard. This study compared between Echo Tip Ultra HD-EBUS 22G needle and Echo Tip ProCore HD-EBUS 22G needle in diagnosis of mediastinal lesions using convex probe endobronchial ultrasound. Results Twenty-four patients with mediastinal lesions were included. Convex probe endobronchial ultrasound-guided transbronchial needle aspiration using both Echo Tip Ultra HD 22G and Echo Tip ProCore HD 22G needles was done to all patients with no peripheral lymph node enlargement. CP-EBUS TBNA had diagnostic accuracy 50%, sensitivity 47.6%, and speci...
The Egyptian Journal of Radiology and Nuclear Medicine, 2017
The Egyptian Journal of Radiology and Nuclear Medicine, 2018
Egyptian Journal of Bronchology, 2017
![Research paper thumbnail of Corrigendum to “Endobronchial ultrasonography for lung cancer staging in negative mediastinum on computed tomography” [Egypt. J. Chest Dis. Tuberc. 62 (3) (2013) 475–479]](https://attachments.academia-assets.com/112541282/thumbnails/1.jpg)
](Egyptian Journal of Chest Diseases and Tuberculosis, 2016
Egyptian Journal of Chest Diseases and Tuberculosis, 2014
Introduction: Lung cancer is one of the leading causes of cancer-related deaths in the world and ... more Introduction: Lung cancer is one of the leading causes of cancer-related deaths in the world and early detection and proper staging are highly important for planning of treatment strategy. Aim of the work: To study the possible added value of transthoracic ultrasound (TUS) in staging of lung cancer. Patients and methods: The study was carried out at Chest Department, Kasr El-Aini hospital in the period from April 2012 to December 2012. TUS was carried out on 50 cases with primary lung cancer after revision of CT chest images. Results: TUS was only able to detect pulmonary masses in 31 cases (they had an ultrasound (US) window to reach the tumor mass). The study found that TUS was more able to detect more cases with chest wall invasion than CT chest and it was able to differentiate between visceral and parietal pleural invasion. It was also not only more able to detect the presence of pleural fluid encystation than CT scan detection but also was more able to further characterize its type. Diaphragmatic mobility was also assessed by TUS. There was also a statistical significant difference between TUS and CT chest in detecting consolidation and/or collapse. Conclusion: TUS is complementary and adding a value to both clinical and computerized tomographic diagnoses of lung cancer. It can help in staging of lung cancer and aid chest physicians in determining the modality of treatment in each patient depending on his/her stage.
European Urology, 2003
Objectives: This study was undertaken to evaluate the diagnostic efficacy of telomerase in urine,... more Objectives: This study was undertaken to evaluate the diagnostic efficacy of telomerase in urine, and bladder wash and also the matrix metalloproteinase-9 (MMP-9) in urine, compared with voided urine cytology (VUC) and bladder wash cytology (BWC) for the detection of bladder cancer cells. Material and Methods: A total of 110 subjects provided a single preoperative voided morning urine sample for telomerase, matrix metalloproteinase-9 (MMP-9) and cytology. Bladder wash samples were obtained for telomerase and cytology. Cystoscopy was done for all patients as the reference standard for the identification of bladder cancer. Biopsy of any suspicious lesion was performed for histopathological examination. Of 110 cases 73 were histologically diagnosed as bladder cancer, whereas the remaining 16 had benign urological disorders. A group of 21 healthy volunteers were also enrolled in this study. Results: The optimal threshold values for telomerase activity in urine, bladder wash and MMP-9 were calculated by receiver-operator characteristics (ROC) curves as 0.05, 0.088 and 0.51 (ng/ml), respectively. The levels and the positivity rates of the 2 parameters were significantly higher in the malignant group compared to either the benign group or normal controls. Of the entire group, telomerase activity in urine, bladder wash, and MMP-9 were positive in 92%, 87% and 61%, respectively in bladder cancer patients with positive cytology. Moreover, these positive rates for them were significantly higher in bilharzial bladder cancer cases (88%, 89%, 69%, respectively) compared to non-bilharzial cases (50%, 62.5%, 50%). The overall sensitivity and specificity were 83% and 88.6%, 86.3% and 78.3% for telomerase activity in urine, and in bladder wash, respectively; 66.6% and 80% for MMP-9 and 58.5% and 100% for voided urine cytology and 64.4% and 100% for bladder wash cytology. Combined sensitivity of VUC with the 2 biomarkers together was higher than either combined sensitivity of VUC with one of the biomarkes or than that of the biomarker alone. Conclusions: Our data indicate that urinary telomerase and MMP-9 had superior sensitivities over VUC. The combined use of markers increased the sensitivity of cytology from 58.46% to 95%. The higher sensitivities of markers in bilharzial bladder cancer than non-bilharzial type highlight their clinical utility in screening patients with urinary bilharziasis.
The Egyptian Journal of Chest Diseases and Tuberculosis
© 2019 The Egyptian Journal of Chest Diseases and Tu Background Diaphragm ultrasound has lately b... more © 2019 The Egyptian Journal of Chest Diseases and Tu Background Diaphragm ultrasound has lately been used in the prediction of successful weaning from mechanical ventilation. Aim To assess diaphragm thickening fraction (DTF) and mobility measured by ultrasound as predictors of successful weaning. Patients and methods This prospective study included 30 patients who were planned for weaning from invasive mechanical ventilation. Rapid shallow breathing index was measured, and diaphragmatic ultrasound was carried out to assess diaphragmatic excursion (DE) and diaphragm thickening at the time of spontaneous breathing trial. Patients were classified into two groups: group I included patients with successful weaning and group II included patients with failed weaning. Results DTF was significantly higher in group I; however, there was no statistically significant difference between the two groups regarding DE. There was a statistically significant difference between the two groups regarding rapid shallow breathing index, as it was higher in group II. The sensitivity, specificity, positive predictive value, and negative predictive value for DTF at a cutoff value more than 0.33% in prediction of successful weaningwere 94, 100, 100, and 91.7%, respectively; the corresponding values for DE at a cutoff value more than 0.91 cm were 84, 37, 69.6, and 57.1%, respectively. Conclusion DTF may be useful to predict successful weaning during spontaneous breathing trial, and it has better performance than DE.
The Egyptian Journal of Chest Diseases and Tuberculosis
© 2019 The Egyptian Journal of Chest Diseases and Tu Objective Pleural effusion is a common medic... more © 2019 The Egyptian Journal of Chest Diseases and Tu Objective Pleural effusion is a common medical problem occurring owing to various causes, and the diagnostic panel includes various diagnostic modalities. The rationale is to compare the accuracy of chest computed tomography (CT) versus transthoracic ultrasound (TTUS) in the detection of gross pathological pleural derangement through confirmatory thoracoscopic examination. Patients and methods A total of 50 patients with undiagnosed exudative pleural effusion were included, in whom the two radiological modalities were performed and compared with the results of thoracoscopy. Results A total of 18 (36%) female and 32 (64%) male patients were included, with a mean age of 50±14.95 years. TTUS showed superiority in the assessment of the pleura regarding thickening, nodulation, trabeculation, septation, encystation, and invasion of the chest wall in relation to the thoracoscopic findings, over the CT, which was statistically significant (P=0.0001). Moreover, it showed higher sensitivity and specificity than CT in all examined items. This is in addition to the known advantages of the TTUS being noninvasive, less expensive, and no exposure to radiation. Thus, it is recommended as a sole imaging procedure of choice in assessment of the pleura in adjunct to thoracoscope.
The Egyptian Journal of Chest Diseases and Tuberculosis
Background and objective Ultrasound can evaluate pleural thickening; however, medical thoracoscop... more Background and objective Ultrasound can evaluate pleural thickening; however, medical thoracoscopy permits direct inspection of the pleura, and biopsies are taken under direct vision. This study evaluated the degree of pleural thickening observed during medical thoracoscopy and compared it with the pleural thickness grades assessed and measured using transthoracic ultrasonography (TUS). Patients and methods A total of 118 cases with undiagnosed exudative pleural effusion were included. They were subjected to history taking, clinical examination, routine laboratory investigations, computed tomography chest, TUS to assess degree of parietal pleural thickening, and medical thoracoscopy to evaluate the observed degree of pleural thickening. Results There was a significant positive correlation between pleural thickening measured by US with thoracoscopic grades of thickness and significant positive correlation between pleural thickening grades measured by US and thoracoscopic grades of pleural thickness. Performance of thoracoscopy using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for assessment of pleural thickening in comparison with US as a standard tool for measurement was 36, 77, 52, 77, and 66%, respectively, whereas in assessing the shape of visceral pleura, this performance increased up to 89, 89, 85, 85, and 88%, respectively. Conclusion This study showed the superiority of TUS in assessment of parietal pleura thickening and chest wall invasion. In addition, TUS has other advantages as being noninvasive, less expensive, and no exposure to radiation. However, medical thoracoscopy can detect the visceral pleural shape better owing to the advantage of direct visualization of the lung surface.
Tuberculosis and Respiratory Diseases
Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can ... more Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cutoff value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cutoff value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. Conclusion: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.
The Egyptian Journal of Bronchology, 2021
Background The nature of opaque lesions such as effusions, atelectasis, masses, and consolidation... more Background The nature of opaque lesions such as effusions, atelectasis, masses, and consolidations can be clarified by sonography. This study investigated the sensitivity and accuracy of ultrasound-guided percutaneous core needle biopsy in different thoracic tumors (lung, pleural, chest wall, and mediastinal). Results Sixty patients underwent ultrasound-guided percutaneous transthoracic core biopsy of peripheral thoracic masses with a Tru-Cut needle with a big bore. Twenty masses were in the lung, seventeen lesions were in the pleura, ten masses were in the mediastinum, eleven were enlarged palpable lymph nodes, and two masses were in chest wall. The sensitivity, PPV, and accuracy for detection of chest tumors in the chest wall, mediastinum, lung, and pleura were 100% for all, and in LN 88.9, 100, and 90.9%, respectively. The overall diagnostic performance of sonar-guided Tru-Cut needle biopsy in diagnosis was 97.78% sensitivity, 98.18% accuracy, and 100% PPV. Conclusion Tru-Cut nee...
Egyptian Journal of Chest Diseases and Tuberculosis, 2013
Lung cancer is the most common cause of cancer-related deaths. Chest CT scan is frequently unreli... more Lung cancer is the most common cause of cancer-related deaths. Chest CT scan is frequently unreliable in staging mediastinal lymph node metastases of lung cancer, since interpretation relies on lesion size. EBUS offers a unique way of imaging and parabronchial structures. The procedure is safe, minimally invasive and does not require general anesthesia or hospitalization. The complication rate is extremely low. Subjects and methods: This study was conducted on eleven patients who were found without CT evidence of enlarged mediastinal lymph nodes. Bronchoscopy and EBUS were performed for the diagnosis of lung cancer. TBLB of detected mediastinal lymph nodes was performed. CT guided biopsies were done for non-diagnosed cases. Results: In this study bronchogenic carcinoma was diagnosed by bronchoscopic biopsy in 6 cases (54.5%), by EBUS-TBNA in 2 cases (18.2%), and by CT guided biopsy in 3 cases (27.3%). From the eleven patients with negative CT scan, EBUS of mediastinal L.N was positive in four cases (36.4%). The first case showed 2 small subcarinal L.N station (7) and 2 right hilar lymph node stations (10R). In the second case EBUS detected 2 subcarinal lymph node stations (7) and one left hilar station (10L). In the third case there was one subcarinal lymph node station (7). The fourth case showed a left hilar lymph node station (10L). Conclusions: EBUS is safe and minimally invasive technique in the detection of mediastinal lymph metastasis. EBUS in combination with conventional radiologic tools may contribute to improve diagnosis and staging of lung cancer.
Egyptian Journal of Bronchology, 2018
Objectives Pleural thickening is defined as the increase in thickness of the pleura of more than ... more Objectives Pleural thickening is defined as the increase in thickness of the pleura of more than 3 mm and can be caused by a wide range of diseases, either nonmalignant or malignant. Thoracic ultrasound has high sensitivity in assessing the pleura. Aim The aim of this study was to assess the role of thoracic ultrasound in differentiation of the causes of pleural thickening. Design A prospective study included 48 patients selected from the inpatient Chest Department, Kasr Al-Ainy Hospital, from January 2016 till October 2017. Patients diagnosed as having pleural thickening underwent thoracic ultrasound as well as ultrasound-guided pleural biopsy by Tru-cut needle. Descriptive data were obtained including age and sex of the patients. Thoracic ultrasound was done for the side of pleural thickening. The distribution of pleural thickness, either localized or diffuse; the surface; invasion of chest wall or diaphragm; the echogenicity and vascularity; and the presence of pleural effusion a...
Advances in Respiratory Medicine, 2020
Instroduction: Obstructive sleep apnea is a common disorder, characterized by recurrent narrowing... more Instroduction: Obstructive sleep apnea is a common disorder, characterized by recurrent narrowing and closure of the upper airway accompanied by intermittent oxyhemoglobin desaturation and sympathetic activation. Ultrasound imaging of the airways has advantages of being safe, quick, repeatable, portable and widely available. Airway ultrasound can visualize and assess the mouth and tongue, oropharynx, hypopharynx, epiglottis, larynx, vocal cords, cricothyroid membrane, cricoid cartilage, trachea, and cervical esophagus. Material and methods: This study assessed the role of ultrasonography in detecting the level and degree of obstruction of airway passages in patients with obstructive sleep apnea (OSA) and its relation to OSA severity. It included thirty-three patients diagnosed as OSA, and ten healthy subjects as a control group. All participants were ≥ 18 years and were subjected to full medical history, Epworth sleepiness score (ESS), thorough clinical examination, complete overnig...
The Egyptian Journal of Bronchology, 2020
Background Convex probe endobronchial ultrasound is a minimally invasive technique used for perfo... more Background Convex probe endobronchial ultrasound is a minimally invasive technique used for performing real-time transbronchial needle aspiration of enlarged hilar and mediastinal lymph nodes and could be used for diagnosing proximal peribronchial lesions. Although computed tomography, magnetic resonant imaging, and positron emission tomography/computed tomography have relatively high sensitivity for mediastinal evaluation, pathology is the gold standard. This study compared between Echo Tip Ultra HD-EBUS 22G needle and Echo Tip ProCore HD-EBUS 22G needle in diagnosis of mediastinal lesions using convex probe endobronchial ultrasound. Results Twenty-four patients with mediastinal lesions were included. Convex probe endobronchial ultrasound-guided transbronchial needle aspiration using both Echo Tip Ultra HD 22G and Echo Tip ProCore HD 22G needles was done to all patients with no peripheral lymph node enlargement. CP-EBUS TBNA had diagnostic accuracy 50%, sensitivity 47.6%, and speci...
The Egyptian Journal of Radiology and Nuclear Medicine, 2017
The Egyptian Journal of Radiology and Nuclear Medicine, 2018
Egyptian Journal of Bronchology, 2017
Egyptian Journal of Chest Diseases and Tuberculosis, 2016
Egyptian Journal of Chest Diseases and Tuberculosis, 2014
Introduction: Lung cancer is one of the leading causes of cancer-related deaths in the world and ... more Introduction: Lung cancer is one of the leading causes of cancer-related deaths in the world and early detection and proper staging are highly important for planning of treatment strategy. Aim of the work: To study the possible added value of transthoracic ultrasound (TUS) in staging of lung cancer. Patients and methods: The study was carried out at Chest Department, Kasr El-Aini hospital in the period from April 2012 to December 2012. TUS was carried out on 50 cases with primary lung cancer after revision of CT chest images. Results: TUS was only able to detect pulmonary masses in 31 cases (they had an ultrasound (US) window to reach the tumor mass). The study found that TUS was more able to detect more cases with chest wall invasion than CT chest and it was able to differentiate between visceral and parietal pleural invasion. It was also not only more able to detect the presence of pleural fluid encystation than CT scan detection but also was more able to further characterize its type. Diaphragmatic mobility was also assessed by TUS. There was also a statistical significant difference between TUS and CT chest in detecting consolidation and/or collapse. Conclusion: TUS is complementary and adding a value to both clinical and computerized tomographic diagnoses of lung cancer. It can help in staging of lung cancer and aid chest physicians in determining the modality of treatment in each patient depending on his/her stage.
European Urology, 2003
Objectives: This study was undertaken to evaluate the diagnostic efficacy of telomerase in urine,... more Objectives: This study was undertaken to evaluate the diagnostic efficacy of telomerase in urine, and bladder wash and also the matrix metalloproteinase-9 (MMP-9) in urine, compared with voided urine cytology (VUC) and bladder wash cytology (BWC) for the detection of bladder cancer cells. Material and Methods: A total of 110 subjects provided a single preoperative voided morning urine sample for telomerase, matrix metalloproteinase-9 (MMP-9) and cytology. Bladder wash samples were obtained for telomerase and cytology. Cystoscopy was done for all patients as the reference standard for the identification of bladder cancer. Biopsy of any suspicious lesion was performed for histopathological examination. Of 110 cases 73 were histologically diagnosed as bladder cancer, whereas the remaining 16 had benign urological disorders. A group of 21 healthy volunteers were also enrolled in this study. Results: The optimal threshold values for telomerase activity in urine, bladder wash and MMP-9 were calculated by receiver-operator characteristics (ROC) curves as 0.05, 0.088 and 0.51 (ng/ml), respectively. The levels and the positivity rates of the 2 parameters were significantly higher in the malignant group compared to either the benign group or normal controls. Of the entire group, telomerase activity in urine, bladder wash, and MMP-9 were positive in 92%, 87% and 61%, respectively in bladder cancer patients with positive cytology. Moreover, these positive rates for them were significantly higher in bilharzial bladder cancer cases (88%, 89%, 69%, respectively) compared to non-bilharzial cases (50%, 62.5%, 50%). The overall sensitivity and specificity were 83% and 88.6%, 86.3% and 78.3% for telomerase activity in urine, and in bladder wash, respectively; 66.6% and 80% for MMP-9 and 58.5% and 100% for voided urine cytology and 64.4% and 100% for bladder wash cytology. Combined sensitivity of VUC with the 2 biomarkers together was higher than either combined sensitivity of VUC with one of the biomarkes or than that of the biomarker alone. Conclusions: Our data indicate that urinary telomerase and MMP-9 had superior sensitivities over VUC. The combined use of markers increased the sensitivity of cytology from 58.46% to 95%. The higher sensitivities of markers in bilharzial bladder cancer than non-bilharzial type highlight their clinical utility in screening patients with urinary bilharziasis.
The Egyptian Journal of Chest Diseases and Tuberculosis
© 2019 The Egyptian Journal of Chest Diseases and Tu Background Diaphragm ultrasound has lately b... more © 2019 The Egyptian Journal of Chest Diseases and Tu Background Diaphragm ultrasound has lately been used in the prediction of successful weaning from mechanical ventilation. Aim To assess diaphragm thickening fraction (DTF) and mobility measured by ultrasound as predictors of successful weaning. Patients and methods This prospective study included 30 patients who were planned for weaning from invasive mechanical ventilation. Rapid shallow breathing index was measured, and diaphragmatic ultrasound was carried out to assess diaphragmatic excursion (DE) and diaphragm thickening at the time of spontaneous breathing trial. Patients were classified into two groups: group I included patients with successful weaning and group II included patients with failed weaning. Results DTF was significantly higher in group I; however, there was no statistically significant difference between the two groups regarding DE. There was a statistically significant difference between the two groups regarding rapid shallow breathing index, as it was higher in group II. The sensitivity, specificity, positive predictive value, and negative predictive value for DTF at a cutoff value more than 0.33% in prediction of successful weaningwere 94, 100, 100, and 91.7%, respectively; the corresponding values for DE at a cutoff value more than 0.91 cm were 84, 37, 69.6, and 57.1%, respectively. Conclusion DTF may be useful to predict successful weaning during spontaneous breathing trial, and it has better performance than DE.