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PubMed | National Cancer Institute and Children Cancer Hospital, Children Cancer Hospital, Menoufiah University and Children Cancer Hospital and National Research Center of Egypt
Type: Journal Article | Journal: Journal of the Egyptian National Cancer Institute | Year: 2016

To evaluate the sensitivity (Se), specificity (Sp), and predictive values (PV) of PET scan during management of pediatric mature B cell non-Hodgkins lymphoma (NHL) in comparison with conventional computed tomography (CT) scan.A retrospective study enrolled on pediatric NHL patients at Children Cancer Hospital Egypt (CCHE) during the period from July 2007 to the end of June 2013.For 115 pediatric patients diagnosed with mature B cell NHL, 152 PET and 152 CT scans were done simultaneously. Median age was 5.7years. They were 85 males (74%) and 30 females (26%). One hundred twenty six scans (82.9%) were done for 100 (87%) Burkitt lymphoma (BL) patients, while 26 scans (17.1%) were done for 15 (13.0%) patients with diffuse large B cell NHL (DLBC). Nineteen examination (12.5%) were done before starting chemotherapy (group 1), 107 (70.3%) at time of evaluation (group 2), and 26 (17.1%) during follow up (group C). Overall sensitivity was 91.6% for PET and 70.0% for conventional CT (p=0.02). Specificity was 84.1% for PET and 58.9% for CT (p<0.001). Positive predictive value (PPV) for PET was 50%, while was 22% for CT scan (p<0.001). Negative predictive value (NPV) for PET was 98%, and 92% for CT (p=0.01).PET scan is significantly more sensitive than conventional CT in the management of aggressive pediatric mature B cell NHL. PET negativity is an excellent indicator of tumor response.


PubMed | Saint George Hospital University Medical Center, Tel Aviv Sourasky Medical Center, Jordan University of Science and Technology, Hospital for Sick Children and 11 more.
Type: Journal Article | Journal: The American journal of gastroenterology | Year: 2016

Hereditary biallelic mismatch repair deficiency (BMMRD) is caused by biallelic mutations in the mismatch repair (MMR) genes and manifests features of neurofibromatosis type 1, gastrointestinal (GI) polyposis, and GI, brain, and hematological cancers. This is the first study to characterize the GI phenotype in BMMRD using both retrospective and prospective surveillance data.The International BMMRD Consortium was created to collect information on BMMRD families referred from around the world. All patients had germline biallelic MMR mutations or lack of MMR protein staining in normal and tumor tissue. GI screening data were obtained through medical records with annual updates.Thirty-five individuals from seven countries were identified with BMMRD. GI data were available on 24 of 33 individuals (73%) of screening age, totaling 53 person-years. The youngest age of colonic adenomas was 7, and small bowel adenoma was 11. Eight patients had 19 colorectal adenocarcinomas (CRC; median age 16.7 years, range 8-25), and 11 of 18 (61%) CRC were distal to the splenic flexure. Eleven patients had 15 colorectal surgeries (median 14 years, range 9-25). Four patients had five small bowel adenocarcinomas (SBC; median 18 years, range 11-33). Two CRC and two SBC were detected during surveillance within 6-11 months and 9-16 months, respectively, of last consecutive endoscopy. No patient undergoing surveillance died of a GI malignancy. Familial clustering of GI cancer was observed.The prevalence and penetrance of GI neoplasia in children with BMMRD is high, with rapid development of carcinoma. Colorectal and small bowel surveillance should commence at ages 3-5 and 8 years, respectively.


Silbermann M.,Technion - Israel Institute of Technology | Pitsillides B.,Cyprus Association of Cancer Patients and Friends | Al-Alfi N.,Abu Dhabi University | Omran S.,Jordan University of Science and Technology | And 9 more authors.
Annals of Oncology | Year: 2013

This article introduces palliative care to cancer patients in Middle Eastern countries. It considers the importance of the multidisciplinary team in providing an adequate service to the patient and his/her family. It provides views of professionals from the various countries with regard to the role of the nurse in such teams; whereby the three elements of palliative care nursing entail: 1.Working directly with patients and families; 2.Working with other health and social care professionals to network and co-ordinate services; and 3. working at an organizational level to plan, develop and manage service provision in local, regional and national settings. This article also details the challenges that nurses face in the Middle East and outlines the preferable ways to overcome such challenges. The latter include more focused educational activities at the undergraduate and graduate levels and continuous clinical training throughout their work as palliative care nurse specialists. © The Author 2013. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.


El-Mahallawy H.A.,Cairo University | Khedr R.,Cairo University | Taha H.,Children Cancer Hospital | Shalaby L.,Cairo University | Mostafa A.,Children Cancer Hospital
Pediatric Blood and Cancer | Year: 2016

We describe an outbreak of mucormycosis in a pediatric oncology hospital during December 2010 and the measures taken to stop it. The outbreak began with two consecutive cases of laboratory-documented mucormycosis infections within 1 week. Investigations to track the source were conducted immediately. Air plate cultures from machines and ducts supplying patients' rooms revealed the growth of Rhizomucor. Of five affected patients, all had acute leukemia and three were histopathologically proven. All patients were treated with liposomal amphotericin B after mucormycosis was diagnosed. Posaconazole was used as a secondary prophylaxis in one case. Three patients died. Pediatr Blood Cancer. © 2015 Wiley Periodicals, Inc.


Abdel-Rahman M.H.,Ohio State University | Pilarski R.,Ohio State University | Ezzat S.,Menoufia University | Ezzat S.,Children Cancer Hospital | And 2 more authors.
Familial Cancer | Year: 2010

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. The extent of the contribution of familial/hereditary predisposition to the development of uveal melanoma is largely unknown. Thus we sought to ascertain the frequency of cancers in patients with UM and their family members to identify the prevalence of hereditary/familial predisposition to cancer in these patients. An unselected series of 121 patients with UM seen in a university-based tertiary referral program were consented to the study. Cancer histories (site and age of diagnosis) were obtained for all first-and second-degree relatives. Patients/families were classified as being potentially at high risk for hereditary predisposition if they met any of the following criteria: (1) Diagnosis of UM at age 30 or under, (2) Two or more cases of UM in the family, (3) UM plus at least one other primary cancer in the same patient (excluding non-melanoma skin and cervix cancers due to their strong environmental etiological link). (4) Family history meeting high risk criteria for a known hereditary cancer predisposition syndrome as defined by Hampel et al. (J Med Genet 41(2):81-91, 2004). One patient had a family history of UM (0.8%). Ten patients (8.3%) had a personal and/or family history consistent with predisposition to a known hereditary cancer syndrome including six with possible hereditary breast, two with hereditary colon and two with hereditary melanomas. Twenty three patients (19%) had a personal history of a second cancer after exclusion of non-melanoma skin and cervical cancers. The frequency of cutaneous melanomas was significantly higher in UM patients than the general population (RR: 2.97, 95% CI: 1.00-6.94). Patients with a family history suggestive of a high risk predisposition to a known cancer syndrome had a significantly higher risk for having a second cancer than the remaining UM patients (P = 0.02). Our results indicate that the frequency of UM patients with high risk for a hereditary cancer predisposition is much higher than earlier estimates (0.6%) and that it could be as high as 11.6%. Our results suggest that cancer phenotypes in these patients are diverse and include cancers other than UM. Thus, alerting ophthalmologists to the need for expanding their cancer family history intake to include other cancers is warranted. It also suggests that patients with a hereditary predisposition to UM have a higher risk for the development of other cancers and that characterization of the germline genetic alterations in these patients is highly warranted. © Springer Science+Business Media B.V. 2010.


Shad A.,Georgetown University | Ashraf M.S.,Children Cancer Hospital | Hafeez H.,Shaukat Khanum Memorial Cancer Hospital and Research Center
Journal of Pediatric Hematology/Oncology | Year: 2011

Palliative care services are poorly developed in most resource-poor countries. With the increase in the number of cancer cases being diagnosed in these countries, most of whom present in advanced stages, an urgent need for palliative care is emerging. Pakistan is an example of a resource-poor country where palliative care services are in the initial phase of development. Copyright © 2011 by Lippincott Williams & Wilkins.


Abou-Elenein H.S.,Children Cancer Hospital
Chinese-German Journal of Clinical Oncology | Year: 2013

Objective: The main purpose of this work was to present a Z-phantom manufactured in home (at National Cancer Institute Cairo University) and it's use in a simple way to check the accuracy of the computed-tomography (CT) table movement and CT gantry tilt, also the other general quality control (QC) tests of the CT simulator used at radiotherapy department. Methods: The laser phantom was used to check the external mobile laser position accuracy, for internal image indicator laser beam (light field) the coincidence between light field and radiation exposure at CT simulator was checked using X-Omat ready back film. The Z-phantom was used to check the slice thickness and the table movement and so the gantry tilts. The image quality testes were checked using the CT image quality phantom. TLDs were inserted to the Cicil phantom at the center of each scan volume to estimate the patient dose. Results: The results showed that the difference in the fixed distance between the external mobile laser and the internal image indicator laser beam was less than ± 1 mm; the orientation of the two mobile lateral lasers was coincident. The mechanical movement and the image quality of the CT simulator were within the tolerances and the results were 0.5 mm, 0.2% and 0.6% for the mechanical movement, noise and image uniformity respectively. Conclusion: A CT simulator with a good performance is important for the radiotherapy treatment planning specially with the extremely revolution in radiotherapy techniques, also a rotten quality assurance (QA) program is very important to be shore about the reproducibility of the CT performance. The use of Z-phantom to check the gantry tilt and the table movement is faster than the use of ready back films in these tests. © 2013 Springer-Verlag Berlin Heidelberg.


Elshami M.,Children Cancer Hospital
Journal of Pediatric Hematology/Oncology | Year: 2011

Palliative care is uprising in developing countries. The Children Cancer Hospital Egypt 57357 palliative care service put the main concepts in pediatric palliation in consideration while facing the challenges and needs for these children and their families. The palliative care program developed will be connected to other centers in Egypt as well as further branches of the hospital in other Egyptian cities. Copyright © 2011 by Lippincott Williams & Wilkins.


Attalla E.M.,Cairo University | Attalla E.M.,Children Cancer Hospital
Chinese-German Journal of Clinical Oncology | Year: 2013

Objective: The aim of this study was to measure the leakage by two methods with ion chamber and ready packs film, and to investigate the feasibility and the advantages of using two dosimetry methods for assessing leakage radiation around the head of the linear accelerators. Methods: Measurements were performed using a 30 cm3 ion chamber; the gantry at 0, the X-ray head at 0, the field size at between the central axis and a plane surface at a FSD of 100 as a reference, a series of concentric circles having radii of 50, 75, and 100 cm with their common centre at the reference point. The absorbed dose was measured at the reference point, and this would be used as the reference dose. With the diaphragm closed, the measurements were taken along the circumference of the three circles and at 45 intervals. Results: Leakage radiations while the treatment head was in the vertical position varied between 0.016%-0.04%. With the head lying horizontally, leakage radiation was the same order magnitude and varied between 0.02%-0.07%. In the second method, the verification was accomplished by closing the collimator jaws and covering the head of the treatment unit with the ready pack films. The films were marked to permit the determination of their positions on the machine after exposed and processed. With the diaphragm closed, and the ready packs films around the linear accelerator the beam turned on for 2500 cGy (2500 MU). The optical density of these films was measured and compared with this of the reference dose. Leakage radiation varied according to the film positions and the magnitude of leakage was between 0.005%-0.075%. Conclusion: The differences between the values of the leakage radiation levels observed at different measurement points do not only reflect differences in the effective shielding thickness of the head wall, but are also related to differences in the distances between the target and the measurement points. The experimental errors involved in dosimetric measurement also contribute to such differences. © 2013 Springer-Verlag Berlin Heidelberg.


Ashraf M.S.,Children Cancer Hospital
Journal of Pediatric Hematology/Oncology | Year: 2012

Pediatric oncology in Pakistan has developed over last decade with substantial increase in the facility for treatment and number of expertise. Though large numbers of children still do not reach treatment center more children have now access to quality cancer treatment. There has been gradual improvement in Pediatric oncology nursing and allied services. Pediatric Palliative care in Pakistan is in initial phase of development. Pediatric Oncology services are largely supported by philanthropists. Children Cancer Hospital a project of Children Cancer Foundation Pakistan Trust is not only providing quality treatment to every child regardless of paying ability but also playing a pivotal role in capacity building and creating awareness about childhood cancer in Pakistan. Copyright © 2012 by Lippincott Williams & Wilkins.

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