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Salma Rezk

    Salma Rezk

    Submit Manuscript | http://medcraveonline.com several undesirable side effects associated with the treatment. Vanadium is known to have toxic effects, but believed to have a simultaneous therapeutic use as well [1]. Vanadium is one of the... more
    Submit Manuscript | http://medcraveonline.com several undesirable side effects associated with the treatment. Vanadium is known to have toxic effects, but believed to have a simultaneous therapeutic use as well [1]. Vanadium is one of the heavy metals that exist in our food and many other products that we use on a daily basis. It is believed that vanadium could be a therapy agent which can lower cholesterol levels in living organisms. In literature, several reports support this direction while others deviated from this prediction due to the high toxicity levels of vanadium.
    Patients with metastatic breast cancer (MBC) typically have short survival times and their successful treatment represents one of most challenging aspects of patient care. This poor prognostic behavior is in part due to molecular features... more
    Patients with metastatic breast cancer (MBC) typically have short survival times and their successful treatment represents one of most challenging aspects of patient care. This poor prognostic behavior is in part due to molecular features including increased tumor cell clonal heterogeneity, multiple drug resistance mechanisms, and alterations of the tumor microenvironment. The AURORA US Metastasis Project was established with the goal to identify molecular features specifically associated with metastasis. We therefore collected and molecularly characterized specimens from 55 metastatic breast cancer (BC) patients representing 51 primary cancers and 102 metastases. The 153 unique tumors were assayed using RNAseq, tumor/germline DNA exomes and low pass whole genome sequencing, and global DNA methylation microarrays. We found intrinsic molecular subtype differences between primary tumors and their matched metastases to be rare in triple negative breast cancer (TNBC)/Basal-like subtype ...
    Water bottles and cups composed of polystyrene also contain non-polymerized styrene. Styrene’s toxicological profile is associated with several health issues for humans. Mainly, the central and peripheral nervous systems are highly... more
    Water bottles and cups composed of polystyrene also contain non-polymerized styrene. Styrene’s toxicological profile is associated with several health issues for humans. Mainly, the central and peripheral nervous systems are highly disturbed by styrene ingestion. Styrene is also considered to be a carcinogenic agent and has been linked to cancer. The HPLC method was validated through prepared QC samples. The HPLC method validated over the range (0.2 - 50 ng) with good linearity r²=0.9998. The validation data proved on average 97.5% accuracy with this method. The analysis further depicted that both sources of water contained styrene; 2.2 and 3.2 ng/mL for fresh and stored water respectively. Styrene was released in larger quantities in boiled water than in cold water. In fresh water, the styrene level was raised by 50% and by 100% for the stored water. On the average, a person may be exposed up to 7 µg/day for cold water, and up to 13 µg/day for hot water. Consequently, we also studi...
    Background: It has become increasingly clear that effective treatment of metastatic breast cancer (MBC) requires an in-depth understanding of the molecular differences between primary tumors and metastases. The AURORA US Network was... more
    Background: It has become increasingly clear that effective treatment of metastatic breast cancer (MBC) requires an in-depth understanding of the molecular differences between primary tumors and metastases. The AURORA US Network was established to collect primary breast cancer-metastasis pairs for multi-platform genomic profiling in order to identify the molecular drivers of metastatic disease. AURORA US has both a retrospective and prospective phase. This is the first report of the retrospective phase. Methods: Archived tissue samples from the primary tumor and at least one distant metastasis were retrospectively collected from 83 MBC patients. Following internal quality assessment, samples from 55 pts, including 105 distinct metastatic lesions, were subject to DNA low pass whole genome and exome sequencing, DNA methylation arrays, and RNA sequencing. Early analyses of these multi-platform data include: DNA methylation, tumor gene expression and microenvironmental signatures, somatic and germline variants, DNA copy number changes, and structural variants between breast primaries and matched metastases. Results: Median age at diagnosis was 49 years (25-76); 32 (58%) were Stage I or II at presentation, 27 (49%) had a family history of breast cancer, and 20 (36%) had a second breast primary. Median disease-free interval before developing MBC was 2 years (range 0-36, 5 patients presented with Stage IV). Median overall survival from initial presentation was 4 years (range 0-37). Median survival after developing MBC was 1 year (range 0-13), with a median of three treatments. Primary tissue samples were banked from 1977-2017 and metastases were banked from 1999-2017. Clinical phenotypes of the primaries included 27 HR+ (49%), 15 triple negative (TNBC, 27%), and 11 HER2+ (20%, 12 missing HER2 status). Intrinsic subtype distribution of the primaries included 17 Basal-like (31%), 17 Luminal A (31%), 7 Normal-like (13%), 5 HER2-enriched (9%), and 1 Luminal B, with 8 pending. All metastases from the Basal-like cases remained Basal-like, while metastases from luminal primaries tended to gain HER2-Enriched subtype features (5/18, p = 0.01). Overall, we identified significant metastasis-enriched alterations in metabolism pathways, an increase in proliferation, and the loss of differentiation signatures and immune infiltrates with progression; the latter being the most pronounced in brain metastases. The most frequent somatic mutations in this cohort were in TP53, NCOR1, and RUNX1. Interestingly, ERBB2, EGFR, and ATM were also mutated in ≥10% of the tumors sequenced. In almost all cases, CpG island hypermethylation was clonally present in the primary tumor and persisted stably in the majority of metastatic lesions. Promoter CpG island hypermethylation was also identified in some metastatic lesions at JAM3, an important cellular adhesion molecule,and this was accompanied by reduced mRNA expression. CONCLUSIONS: Collection of banked primary and metastatic tissue pairs identified a young MBC cohort with a high frequency of breast cancer family history and second breast primaries. Molecular characterization of luminal tumor pairs highlighted acquisition of aggressive traits including increased proliferation and loss of differentiation in the metastases. In contrast, basal-like pairs remained relatively unchanged, except for the loss of immune activation. Ongoing analyses to be presented include clonal heterogeneity and phylogeny, novel metastasis signature discovery, gene fusion, and endogenous retrovirus detection. Citation Format: Tari A King, Minetta C Liu, Marni B McClure, Toshinori Hinoue, Benjamin J Kelly, Chad J Creighton, Jay Bowen, Kristen Leraas, Robyn T Burns, Sara Coppens, Salma Rezk, Amy L Garrett, Justin M Balko, Joel S Parker, Ben H Park, Ian Krop, Carey Anders, Katherine A Hoadley, Julie Gastier-Foster, Mothaffar F Rimawi, Rita Nanda, Nancy U Lin, Claudine Isaacs, P. Kelly Marcom, Anna Maria Storniolo, Fergus J Couch, Elaine R Mardis, Adrian V Lee, Uma Chandran, Peter W Laird, Susan G Hilsenbeck, Larry Norton, Andrea L Richardson, W. Fraser Symmans, Lisa A Carey, Antonio C Wolff, Nancy E Davidson, Charles M Perou, the AURORA US Network. Multiplatform analysis of matched primary and metastatic breast tumors from the AURORA US Network [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr GS3-08.
    Background: Egypt had high burden of HCV infection worldwide. The new direct-acting antivirals (DAAs) can target almost all steps of HCV life cycle. Objective: Study of the incidence of acute kidney injury (AKI) in HCV infected patients... more
    Background: Egypt had high burden of HCV infection worldwide. The new direct-acting antivirals (DAAs) can target almost all steps of HCV life cycle. Objective: Study of the incidence of acute kidney injury (AKI) in HCV infected patients receiving DAAs. Patients and methods: A prospective study that was conducted in the Virology Clinic in Kobry El-Koba Military Hospital on 63 male patients who were eligible to treatment by DAAs, who received treatment with sofosbuvir, daclatasvir and ribavirin combination. They were divided into Group A: 33 patients with eGFR > 90 ml/min and Group B: 30 patients with chronic kidney disease (CKD) stage II-III (eGFR 30 mL/min). The fluctuations in serum creatinine and eGFR were measured while on-therapy and for 3 months follow up after end of treatment. Results: total of 63 male patients, treatment-naive were included. Group A (33 patients) with eGFR > 90 mL/min. Group B (30 patients) with eGFR 90 ml/min in comparison with those with eGFR 45 ml/m...
    The goal of this qualitative study was to assess physicians’ perceptions around features of key screens within a prominent commercial EHR, and to solicit end-user recommendations for improved retrieval of high-priority clinical... more
    The goal of this qualitative study was to assess physicians’ perceptions around features of key screens within a prominent commercial EHR, and to solicit end-user recommendations for improved retrieval of high-priority clinical information. We conducted a qualitative, descriptive study of 25 physicians in a medical ICU setting. at a tertiary academic medical center. An in-depth, semi-structured interview guide was developed to elicit physician perceptions on information retrieval as well as favorable and unfavorable features of specific EHR screens. Transcripts were independently coded in a qualitative software management tool by at least two trained coders using a common code book. We successfully obtained vendor permission to map physicians perception’s on full Epic© screenshots. Among the 25 physician participants (13 female; 5 attending physicians, 9 fellows, 11 residents), the majority of participants reported experiencing challenges finding clinical information in the EHR. We ...