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Goubran, H., G. Ragab, and W. Sabry, "Metabolism-mediated thrombotic microangiopathy and B12", Vitamins and Hormones, vol. 119: Academic Press Inc., pp. 441 - 455, 2022. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis ScienceTransfusion and Apheresis Science, vol. 56, issue 3: Elsevier, pp. 330 - 335, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ

Our microbiota is determined by many variables including ABO blood groups. The microbiota is not only confined to the gut and skin but is also recoverable from blood of healthy donors.The microbiota shape our immune system through cross reactivity with antigens, the expression of direct molecular patterns, the release of cytokines, the effects on nutrients and micronutrients and even through an interplay with epigenetics. It is likely, therefore, that a donor's microbiota could alter the antigenicity of blood and its components and potentially contribute to transfusion-related immune modulation [TRIM]. It could also potentially transmit infections. The recipient's microbiome contributes, on the other hand, to the tolerance to transfused blood, or to the development of transfusion reactions. Cancer patients are a particularly vulnerable population, often immunosuppressed with a significantly altered microbiota. They are more at risk for transmission of ?dormant? bacteria via blood transfusion. Furthermore, chemotherapy and radiation induce mucositis that likely results in significant translocation of gut microbiota and abnormal immune reactions to transfused blood. It is therefore relevant to revisit transfusion thresholds and consider transfusion-saving strategies in cancer patients.Our microbiota is determined by many variables including ABO blood groups. The microbiota is not only confined to the gut and skin but is also recoverable from blood of healthy donors.The microbiota shape our immune system through cross reactivity with antigens, the expression of direct molecular patterns, the release of cytokines, the effects on nutrients and micronutrients and even through an interplay with epigenetics. It is likely, therefore, that a donor's microbiota could alter the antigenicity of blood and its components and potentially contribute to transfusion-related immune modulation [TRIM]. It could also potentially transmit infections. The recipient's microbiome contributes, on the other hand, to the tolerance to transfused blood, or to the development of transfusion reactions. Cancer patients are a particularly vulnerable population, often immunosuppressed with a significantly altered microbiota. They are more at risk for transmission of ?dormant? bacteria via blood transfusion. Furthermore, chemotherapy and radiation induce mucositis that likely results in significant translocation of gut microbiota and abnormal immune reactions to transfused blood. It is therefore relevant to revisit transfusion thresholds and consider transfusion-saving strategies in cancer patients.

Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis Science, vol. 56, issue 3: Pergamon, pp. 330-335, 2017. Abstract
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Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis Science, vol. 56, issue 3: Elsevier Ltd, pp. 330 - 335, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Ragab, G., P. T. Atkinson, and M. L. Stoll, The Microbiome in Rheumatic Diseases and Infection, : Springer, 2018. Abstract
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Ragab, G., T. P. Atkinson, and M. L. Stoll, "The microbiome in rheumatic diseases and infection", The Microbiome in Rheumatic Diseases and Infection: Springer International Publishing, pp. 1 - 490, 2018. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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REFAAT, M., A. M. Abdullatif, M. M. Hamza, T. A. Macky, M. - S. H. El-Agha, G. Ragab, and M. M. Soliman, "MONTHLY INTRAVITREAL INFLIXIMAB IN BEHÇET'S DISEASE ACTIVE POSTERIOR UVEITIS: A Long-Term Safety Study", Retina (Philadelphia, Pa.), vol. 41, issue 8: NLM (Medline), pp. 1739 - 1747, 2021. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Refaat, M., A. M. Abdullatif, M. M. Hamza, T. A. Macky, M. H. El-Agha, G. Ragab, and M. M. Soliman, "Monthly Intravitreal Infliximab in Behçet's Disease Active Posterior Uveitis: A Long-Term Safety Study.", Retina (Philadelphia, Pa.), 2020. Abstract
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El-Gendy, H., R. M. El-Gohary, S. Mahfouz, H. M. A. Ahmed, D. M. El Demerdash, and G. Ragab, "Multifocal avascular necrosis in a patient with refractory immune thrombocytopenia and antiphospholipid antibodies; case report and review of literature", Platelets, vol. 30, issue 5: Taylor & Francis, pp. 664-671, 2019. Abstract
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El-Gendy, H., R. M. El-Gohary, S. Mahfouz, H. M. A. Ahmed, D. M. El Demerdash, and G. Ragab, "Multifocal avascular necrosis in a patient with refractory immune thrombocytopenia and antiphospholipid antibodies; case report and review of literature", Platelets, vol. 30, issue 5: Taylor and Francis Ltd, pp. 664 - 671, 2019. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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El-Gendy, H., R. M. El-Gohary, S. Mahfouz, H. M. A. Ahmed, D. M. El Demerdash, and G. Ragab, "Multifocal avascular necrosis in a patient with refractory immune thrombocytopenia and antiphospholipid antibodies; case report and review of literature.", Platelets, pp. 1-8, 2018 Oct 29. Abstract

Avascular necrosis (AVN) is a devastating condition that is rarely reported in patients with immune thrombocytopenia (ITP). Treatment with steroids remains a major risk factor for developing AVN. However, the incidence of AVN in patients with ITP requiring corticosteroid therapy is much less than that observed with other clinical conditions requiring corticosteroids. ITP is a bleeding disorder but can be also be a pro-thrombotic state via different mechanisms and thus could result in AVN. Among the possible causes of this pro-thrombotic state is the presence of antiphospholipid antibodies (aPLs). In this case, we report a patient with refractory ITP who developed multifocal AVN around the time she acquired new aPLs. We also discuss different mechanisms by which risk of thrombosis is increased in ITP and the relationship between ITP, aPLs and antiphospholipid syndrome.

Ragab, G., H. El-Gendy, and R. M. El-Gohary, Musculoskeletal Disorders and Treatment, , 2017. Abstract
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