Ahmed Morsy

Bio: Ahmed Morsy is an academic researcher from Cairo University. The author has contributed to research in topics: Medicine & Surgery. The author has an hindex of 7, co-authored 24 publications receiving 337 citations.

Effect of sirolimus on malignancy and survival after kidney transplantation: systematic review and meta-analysis of individual patient data

Abstract: Objective To examine risk of malignancy and death in patients with Eligibility Randomized controlled trials comparing immunosuppressive regimens with and without sirolimus in recipients of kidney or combined pancreatic and renal transplant for which the author was willing to provide individual patient level data. Two reviewers independently screened titles/abstracts and full text reports of potentially eligible trials to identify studies for inclusion. All eligible trials reported data on malignancy or survival. Results The search yielded 2365 unique citations. Patient level data were available from 5876 patients from 21 randomized trials. Sirolimus was associated with a 40% reduction in the risk of malignancy (adjusted hazard ratio 0.60, 95% confidence interval 0.39 to 0.93) and a 56% reduction in the risk of non-melanoma skin cancer (0.44, 0.30 to 0.63) compared with controls. The most pronounced effect was seen in patients who converted to sirolimus from an established immunosuppressive regimen, resulting in a reduction in risk of malignancy (0.34, 0.28 to 0.41), non-melanoma skin cancer (0.32, 0.24 to 0.42), and other cancers (0.52, 0.38 to 0.69). Sirolimus was associated with an increased risk of death (1.43, 1.21 to 1.71) compared with controls. Conclusions Sirolimus was associated with a reduction in the risk of malignancy and non-melanoma skin cancer in transplant recipients. The

Circulating miRNAs 21 and 221 as biomarkers for early diagnosis of prostate cancer

Abstract: To compare the expression of two promising circulating micro-ribonucleic acids (miRNAs 21 and 221) in patients with prostate cancer to subjects without cancer and to evaluate their potential role as specific noninvasive molecular biomarkers for prostate cancer diagnosis, circulating miRNAs 21 and 221 expression profiles were analyzed in 20 men aged 50–75 years, presenting with lower urinary tract symptoms (LUTSs) and undergoing transrectal ultrasound (TRUS)-guided prostate biopsy based on either elevated serum prostate-specific antigen (PSA) (>4.0 ng/ml) or suspicious digital rectal examination (DRE). The performance of miRNAs 21 and 221 in differentiating prostate cancer from nonmalignant cases was evaluated and compared to DRE and elevated PSA. miRNA 21 was overexpressed in 90 % of group A vs. 10 % of group B, while miRNA 221 was overexpressed in 80 % of group A vs. 20 % of group B (p = 0.001). MiRNA 21 overexpression had the highest performance as a diagnostic test with a sensitivity of 90 % and a specificity 90 % (p = 0.02). No correlations were noted between Gleason score of prostate cancer cases and relative quantity (RQ) 21 (r = −0.355, p = 0.292) or RQ 221 (r = −0.044, p = 0.892). Our study showed that serum miRNAs 21 and 221 expression profiling tests may be used as specific noninvasive molecular biomarkers for prostate cancer diagnosis due to their higher sensitivity and specificity with a high negative predictive value leading to a decrease in the biopsies taken for patients with elevated serum PSA values.

Sleep Apnea Detection Using an Adaptive Fuzzy Logic Based Screening System

Abstract: We report an adaptive diagnostic system for the classification of breathing events for the purpose of detecting sleep apnea syndromes. The system employs two classification engines used in series. The first engine is fuzzy logic-based and generates one of three outcomes for each breathing event: normal, abnormal, and not-sure. The second classification engine is based on a center of gravity engine which is trained using the normal and abnormal events, generated by the first engine, and is specifically designed for sorting out the not-sure events. The fuzzy logic engine can be tuned very conservatively to reduce or eliminate the chance of error at the first stage. Since the second engine is trained adaptively using normal and abnormal data of the same patient, its accuracy is generally better than relying on multi-patient training approaches. The two-step, adaptive nature of the system allows for high accuracy and lends itself well for practical implementation

A new gradient-based algorithm for edge detection in ultrasonic carotid artery images

Abstract: In human clinical studies, digital B-Mode ultrasound images of carotid and femoral artery walls are used to measure Intima-Media Thickness (IMT). IMT represents the arterial intima-media complex and is a validated surrogate parameter for atherosclerosis and cardiovascular disease risk. Conventionally, IMT is obtained by tracing the ultrasound interfaces of the arterial far walls manually. The manual tracing, however, may be replaced by an automated approach in order to decrease image analysis variability and improve consistency and efficiency of the imaging laboratory. In this paper, we present and test a novel automated edge detection method which employs a multi-step gradient based algorithm. The new method principally uses intensity, intensity gradient, and interface continuity of pixels to determine the ultrasound interfaces. In our investigations, we used the far wall of the common carotid artery to test the proposed algorithm. As our results show, the novel algorithm greatly eliminates subjectivity associated with conventional manual tracing and semi-automated gradient methods that employ seed point selection. The new method can therefore have a great potential in atherosclerosis studies and clinical trials.

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients: A Guidance Report and Clinical Checklist by the Consensus on Managing Modifiable Risk in Transplantation (COMMIT) Group.

Abstract: Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes.COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant.The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting.

International Liver Transplantation Society Consensus Statement on Immunosuppression in Liver Transplant Recipients.

Abstract: Effective immunosupression management is central to achieving optimal outcomes in liver transplant recipients. Current immunosuppression regimens and agents are highly effective in minimizing graft loss due to acute and chronic rejection but can also produce a substantial array of toxicities. The utilization of immunosuppression varies widely, contributing to the wide disparities in posttransplant outcomes reported between transplant centers. The International Liver Transplantation Society (ILTS) convened a consensus conference, comprised of a global panel of expert hepatologists, transplant surgeons, nephrologists, and pharmacologists to review the literature and experience pertaining to immunosuppression management to develop guidelines on key aspects of immunosuppression. The consensus findings and recommendations of the ILTS Consensus guidelines on immunosuppression in liver transplant recipients are presented in this article.

Renal association clinical practice guideline in post-operative care in the kidney transplant recipient.

Abstract: These guidelines cover the care of patients from the period following kidney transplantation until the transplant is no longer working or the patient dies During the early phase prevention of acute rejection and infection are the priority After around 3–6 months, the priorities change to preservation of transplant function and avoiding the long-term complications of immunosuppressive medication (the medication used to suppress the immune system to prevent rejection) The topics discussed include organization of outpatient follow up, immunosuppressive medication, treatment of acute and chronic rejection, and prevention of complications The potential complications discussed include heart disease, infection, cancer, bone disease and blood disorders There is also a section on contraception and reproductive issues Immediately after the introduction there is a statement of all the recommendations These recommendations are written in a language that we think should be understandable by many patients, relatives, carers and other interested people Consequently we have not reworded or restated them in this lay summary They are graded 1 or 2 depending on the strength of the recommendation by the authors, and AD depending on the quality of the evidence that the recommendation is based on

Roles of mTOR complexes in the kidney: implications for renal disease and transplantation.

Abstract: The mTOR pathway has a role in the development of renal disease, kidney transplant rejection and malignancies. Here, the authors discuss the mechanisms by which mTOR complexes drive the pathogenesis of these diseases as well as the therapeutic potential of mTOR inhibitors.