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Toukhy, A., S. Fayed, N. Sabry, and M. Shawki, "The Impact of an Established Pharmaceutical Care Pathway on Drug Related Problems in an Intensive Care Unit", American Journal of the Medical Sciences, vol. 362, issue 2, pp. 143 - 153, 2021. AbstractWebsite

Background: The incidence of drug related problems (DRPs) in intensive care units (ICU) is higher compared to any other wards in the hospital, requiring a structured pathway to ensure optimum detection of DRPs. The study aimed to evaluate the impact of implementing a pharmaceutical care pathway on the detection and management of DRPs in an ICU. Methods: The study was conducted in a general ICU and included three phases: tool preparation phase included the development of a core measures reference pathway and daily working scenario flow-charts, a control phase where the patient files and pharmacists' case assessment notes were retrospectively reviewed to detect the rate of DRPs before pathway implementation and a prospective phase similar to the control phase but with the implementation of the new pathway. The number and classification of DRPs and required core measures in the control and implementation phases were documented. Results: Using the new pathway, the detection of unmet core measures increased from 7.3% in the control phase to 99% in the implementation phase (p-value <0.001). The prevalence of unidentified DRPs/1000 patients' service days decreased from 98.1 in the control phase to 27.08 in the implementation phase (p-value <0.001). However, there was no significant difference between the phases regarding mortality rate and length of ICU stay. Conclusions: The implementation of a unified pharmaceutical care pathway improved the detection of DRPs in ICU patients. © 2021 Southern Society for Clinical Investigation

Toukhy, S. H. E. -, F. M. Kamel, I. El-Sayyed, and M. F. Haridy, "EFFECT OF STORAGE ON MICRO TENSILE BOND STRENGTH OF VARIOUS TYPES OF FLOWABLE COMPOSITE", EGYPTIAN DENTAL JOURNAL, vol. 60, issue 1, pp. 983-989, 2014. effect_of_storage.pdf
Toulany, M., M. Iida, S. Keinath, F. F. Iyi, K. Mueck, B. Fehrenbacher, W. Y. Mansour, M. Schaller, D. L. Wheeler, and P. H. Rodemann, "Dual targeting of PI3K and MEK enhances the radiation response of K-RAS mutated non-small cell lung cancer.", Oncotarget, vol. 7, issue 28, pp. 43746-43761, 2016 Jul 12. Abstract

Despite the significant contribution of radiotherapy to non-small lung cancer (NSCLC), radioresistance still occurs. One of the major radioresistance mechanisms is the hyperactivation of the PI3K/Akt pathway in which Akt facilitates the repair of DNA double-strand breaks (DSBs) through the stimulation of DNA-PKcs. We investigated if targeting PI3K would be a potential approach for enhancing the radiosensitivity of K-RAS mutated (K-RASmut) NSCLC cell lines A549 and H460. Short-term (1-2 h) pre-treatment of cells with the PI3K inhibitor PI-103 (1 μM) inhibited Akt/DNA-PKcs activity, blocked DSBs repair and induced radiosensitivity, while long-term (24 h) pre-treatment did not. Lack of an effect after 24 h of PI-103 pre-treatment was due to reactivation of K-Ras/MEK/ERK-dependent Akt. However, long-term treatment with the combination of PI-103 and MEK inhibitor PD98059 completely blocked reactivation of Akt and impaired DSBs repair through non-homologous end joining (NHEJ) leading to radiosensitization. The effect of PI3K inhibition on Akt signaling was also tested in A549 mouse xenografts. P-Akt and P-DNA-PKcs were inhibited 30 min post-irradiation in xenografts, which were pretreated by PI-103 30 min before irradiation. However, Akt was reactivated 30 min post-irradiation in tumors, which were pre-treated for 3 h with PI-103 before irradiation. After a 24 h pretreatment with PI-103, a significant reactivation of Akt was achieved 24 h after irradiation. Thus, due to MEK/ERK-dependent reactivation of Akt, targeting PI3K alone is not a suitable approach for radiosensitizing K-RASmut NSCLC cells, indicating that dual targeting of PI3K and MEK is an efficient approach to improve radiotherapy outcome.

Toulany, M., M. Iida, S. Keinath, F. F. Iyi, K. Mueck, B. Fehrenbacher, W. Y. Mansour, M. Schaller, D. L. Wheeler, and P. H. Rodemann, "Dual targeting of PI3K and MEK enhances the radiation response of K-RAS mutated non-small cell lung cancer.", Oncotarget, vol. 7, issue 28, pp. 43746-43761, 2016 Jul 12. Abstract

Despite the significant contribution of radiotherapy to non-small lung cancer (NSCLC), radioresistance still occurs. One of the major radioresistance mechanisms is the hyperactivation of the PI3K/Akt pathway in which Akt facilitates the repair of DNA double-strand breaks (DSBs) through the stimulation of DNA-PKcs. We investigated if targeting PI3K would be a potential approach for enhancing the radiosensitivity of K-RAS mutated (K-RASmut) NSCLC cell lines A549 and H460. Short-term (1-2 h) pre-treatment of cells with the PI3K inhibitor PI-103 (1 μM) inhibited Akt/DNA-PKcs activity, blocked DSBs repair and induced radiosensitivity, while long-term (24 h) pre-treatment did not. Lack of an effect after 24 h of PI-103 pre-treatment was due to reactivation of K-Ras/MEK/ERK-dependent Akt. However, long-term treatment with the combination of PI-103 and MEK inhibitor PD98059 completely blocked reactivation of Akt and impaired DSBs repair through non-homologous end joining (NHEJ) leading to radiosensitization. The effect of PI3K inhibition on Akt signaling was also tested in A549 mouse xenografts. P-Akt and P-DNA-PKcs were inhibited 30 min post-irradiation in xenografts, which were pretreated by PI-103 30 min before irradiation. However, Akt was reactivated 30 min post-irradiation in tumors, which were pre-treated for 3 h with PI-103 before irradiation. After a 24 h pretreatment with PI-103, a significant reactivation of Akt was achieved 24 h after irradiation. Thus, due to MEK/ERK-dependent reactivation of Akt, targeting PI3K alone is not a suitable approach for radiosensitizing K-RASmut NSCLC cells, indicating that dual targeting of PI3K and MEK is an efficient approach to improve radiotherapy outcome.

Touny, A., M. M. Saleh, and M. A. Al-Omair, "Metal Implants for Hard Tissue Restoration", Metal Implants for Hard Tissue Restoration, Germany, LAP Lambert Academic Publishing, ISBN: 978-3-659-96706-1 , 2016. chapter-_biomedical.pdf
Touny, A. H., R. H. Tammam, and M. M. Saleh, "Electrocatalytic oxidation of formaldehyde on nanoporous nickel phosphate modified electrode", Applied Catalysis B: Environmental, vol. 224, pp. 1017–1026, 2018. electrocatalytic_oxidation_of_formaldehyde_on_nanoporous_nickel_phosphate.pdf
Touray, B. J. B., M. Hanafy, Y. Phanse, R. Hildebrand, and A. M. Talaat, "Protective RNA nanovaccines against Mycobacterium avium subspecies hominissuis", Frontiers in Immunology, vol. 14, 2023. AbstractWebsite

The induction of an effective immune response is critical for the success of mRNA-based therapeutics. Here, we developed a nanoadjuvant system compromised of Quil-A and DOTAP (dioleoyl 3 trimethylammonium propane), hence named QTAP, for the efficient delivery of mRNA vaccine constructs into cells. Electron microscopy indicated that the complexation of mRNA with QTAP forms nanoparticles with an average size of 75 nm and which have  90% encapsulation efficiency. The incorporation of pseudouridine-modified mRNA resulted in higher transfection efficiency and protein translation with low cytotoxicity than unmodified mRNA. When QTAP-mRNA or QTAP alone transfected macrophages, pro-inflammatory pathways (e.g., NLRP3, NF-kb, and MyD88) were upregulated, an indication of macrophage activation. In C57Bl/6 mice, QTAP nanovaccines encoding Ag85B and Hsp70 transcripts (QTAP-85B+H70) were able to elicit robust IgG antibody and IFN- ɣ, TNF-α, IL-2, and IL-17 cytokines responses. Following aerosol challenge with a clinical isolate of M. avium ss. hominissuis (M.ah), a significant reduction of mycobacterial counts was observed in lungs and spleens of only immunized animals at both 4- and 8-weeks post-challenge. As expected, reduced levels of M. ah were associated with diminished histological lesions and robust cell-mediated immunity. Interestingly, polyfunctional T-cells expressing IFN- ɣ, IL-2, and TNF- α were detected at 8 but not 4 weeks post-challenge. Overall, our analysis indicated that QTAP is a highly efficient transfection agent and could improve the immunogenicity of mRNA vaccines against pulmonary M. ah, an infection of significant public health importance, especially to the elderly and to those who are immune compromised.

Tourky, M. S., A. A. A. Salman, M. A. Salman, M. M. Abdelfatah, A. E. Taha, H. Hagag, M. Y. S. Youssef, M. S. Arafa, S. A. Khattab, M. M. Borham, et al., "Intraoperative Factors Associated With Early Recipient Death After Adult-to-Adult Living Donor Liver Transplant.", Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, vol. 19, issue 8, pp. 817-825, 2021. Abstract

OBJECTIVES: Living donor liver transplant is the gold standard therapy for patients with terminal hepatic disorders for whom no alternative therapy is available. The primary aim was to assess different intraoperative factors that may predict early death after adult-to-adult living donor liver transplant. The secondary aim was to assess the effect of small-for-size syndrome on mortality.

MATERIALS AND METHODS: This retrospective multicenter cohort study was performed on records from 145 adults with cirrhosis who had received a right lobe living donor liver transplant. Patients were divided according to the occurrence of short-term mortality (death within the first month after transplant). The primary intraoperative parameters included graft weight, surgical duration, mean blood pressure, serum lactate and sodium bicarbonate, transfusions, durations of cold and warm ischemia and anhepatic phase, input and output during surgery, and portal venous pressures.

RESULTS: There were statistically significant variations between both cohorts for number of units of packed red blood cells, durations of cold and warm ischemia and anhepatic phase, preclamp and postreperfusion portal venous pressures, average urine output, mean serum lactate, mean blood pressure, and surgical duration (P ⟨ .001). Also, there were significant differences in the number of platelets, units of fresh frozen plasma, and mean sodium bicarbonate (P = .025, .003, and .035, respectively). Of the 25 patients who died within the early postoperative period, 20 had developed small-for-size syndrome (P ⟨ .001).

CONCLUSIONS: A variety of intraoperative risk factors may affect early posttransplant mortality, which suggests the high complexity of living donor liver transplants and the need for well-trained experienced teams to perform these surgeries.

Tourky, M., A. Youssef, M. Salman, T. Abouelregal, M. Tag El-Din, A. Moustafa, A. Taha, A. El-Mikkawy, A. Saadawy, and A. Salman, "Portal venous pressure in non-cirrhotic bilharzial patients undergoing elective splenectomy, can it affect mortality? A prospective study.", Acta gastro-enterologica Belgica, vol. 84, issue 4, pp. 549-556, 2021. Abstract

Background and study aims: To evaluate the impact of intraoperatively measured portal vein pressure (PVP) on mortality in non-cirrhotic bilharzial patients undergoing splenectomy.

Methods: The present study is a prospective study that was conducted in Egypt from April 2014 to April 2018. Adult patients with non-cirrhotic bilharziasis who were scheduled to undergo splenectomy were included. Studied cases were divided into a survival cohort and a non-survival cohort. The main objective was the correlation between the incidence of mortality and intraoperative PVP.

Results: The present work comprised 130 cases with a mean age of 51.8 ± 6.4 years old. The in-hospital mortality rate was 22.3%, with sepsis as a major cause of death (37.9%). In term of the association between preoperative variables and mortality, survivors had statistically significant lower portal vein diameter (13.6 ± 1.8 versus 15.2 ± 1.8mm; p<0.001) and higher portal vein velocity (14.2 ± 1.8 versus 10.4 ± 2.3 cm/sec; p<0.001) than nonsurvivors. The survived patients had significantly lower PVP (13.9 ± 1.1 versus 17.7 ± 2.7; p<0.001). A cut-off value of ≥14.5 mmHg, the PVP yielded a sensitivity of 86.2% and a specificity of 69% for the prediction of mortality. The association analysis showed a statistically significant association between mortality and postoperative liver function parameters.

Conclusions: High intraoperative PVP is linked to early postoperative death in non-cirrhotic cases undergoing splenectomy. Our study showed that PVP > 14.5mmHg was an independent predictor of death and showed good diagnostic performance for the detection of early postoperative mortality.

Toustrup, K., B. S. Sørensen, M. H. A. Metwally, T. Tramm, L. S. Mortensen, J. Overgaard, and J. Alsner, "Validation of a 15-gene hypoxia classifier in head and neck cancer for prospective use in clinical trials.", Acta oncologica (Stockholm, Sweden), vol. 55, issue 9-10, pp. 1091-1098, 2016 Sep - Oct. Abstract

BACKGROUND: In head and neck squamous cell carcinomas (HNSCC) hypoxic radioresistance can be reduced by use of the hypoxic modifier nimorazole, as shown in the DAHANCA 5 trial. Recently, a 15-gene hypoxia classifier has shown predictive impact for the effect of nimorazole by identifying 'more' and 'less' hypoxic tumors in the DAHANCA 5 cohort. A prospective multicentre EORTC-1219 study is initiated, where nimorazole and prospective use of the classifier as a predictor is tested in relation to the most recent accelerated chemoradiotherapy treatment. Validation of the gene expression classification procedures is described here.

MATERIAL AND METHODS: Formalin-fixed paraffin-embedded (FFPE) tumor material from three recent HNSCC cohorts [DAHANCA 18 (n = 96), 24 (n = 40), and IAEA Hypo (n = 55)] was used to establish and validate procedures for prospective classification of patients. Repeatability was tested for the different steps in the gene expression analysis, and reproducibility was tested with xenograft tumors (FaDuDD, UTSCC33), where gene expression in complementary sections was compared after fixation and embedding locally and at international institutions, respectively. Intra-tumor heterogeneity was addressed by classifying biopsy samples from HNSCC tumors, where 2-4 biopsies from each tumor was accessible.

RESULTS: Procedures were successfully established for individual classification of HNSCC patients in retrospective and prospective cohorts. Measurements of gene expression levels were reproducible between different international institutions.

CONCLUSION: Technical validation of the 15-gene hypoxia classifier demonstrated that it is suitable for implementation in prospective clinical trials.

Toustrup, K., B. S. Sørensen, M. H. A. Metwally, T. Tramm, L. S. Mortensen, J. Overgaard, and J. Alsner, "Validation of a 15-gene hypoxia classifier in head and neck cancer for prospective use in clinical trials.", Acta oncologica (Stockholm, Sweden), vol. 55, issue 9-10, pp. 1091-1098, 2016 Sep - Oct. Abstract

BACKGROUND: In head and neck squamous cell carcinomas (HNSCC) hypoxic radioresistance can be reduced by use of the hypoxic modifier nimorazole, as shown in the DAHANCA 5 trial. Recently, a 15-gene hypoxia classifier has shown predictive impact for the effect of nimorazole by identifying 'more' and 'less' hypoxic tumors in the DAHANCA 5 cohort. A prospective multicentre EORTC-1219 study is initiated, where nimorazole and prospective use of the classifier as a predictor is tested in relation to the most recent accelerated chemoradiotherapy treatment. Validation of the gene expression classification procedures is described here.

MATERIAL AND METHODS: Formalin-fixed paraffin-embedded (FFPE) tumor material from three recent HNSCC cohorts [DAHANCA 18 (n = 96), 24 (n = 40), and IAEA Hypo (n = 55)] was used to establish and validate procedures for prospective classification of patients. Repeatability was tested for the different steps in the gene expression analysis, and reproducibility was tested with xenograft tumors (FaDuDD, UTSCC33), where gene expression in complementary sections was compared after fixation and embedding locally and at international institutions, respectively. Intra-tumor heterogeneity was addressed by classifying biopsy samples from HNSCC tumors, where 2-4 biopsies from each tumor was accessible.

RESULTS: Procedures were successfully established for individual classification of HNSCC patients in retrospective and prospective cohorts. Measurements of gene expression levels were reproducible between different international institutions.

CONCLUSION: Technical validation of the 15-gene hypoxia classifier demonstrated that it is suitable for implementation in prospective clinical trials.

Towab, A. S. M. A., E. A. W. Khalil, Z. A. H. Osman, and Z. Mokhtar, "Age Differences in Physical and Emotional Reactivity to Daily Stressors among Psychiatric Nurses", . Journal of American Science, vol. 8, issue 12, pp. 1501-1507, 2012. Abstract

Stressors encountered in daily life aspects, such as home, and work may increase
physical and emotional reactivity to stress especially in persons working in the
nursing field. Characteristics of the individual as age may limit or increase his
reactivity to daily stressors. The aim of this study is to examine the age differences in
physical and emotional reactivity to daily stressors among nurses working in AlAbbassia
Mental Health Hospital. A descriptive correlational design was utilized for
the current study. Sample of convenience of 100 psychiatric nurses working in AlAbbassia
Mental Health Hospital were divided into two groups "middle age group"
and "young age group". Four tools were utilized in the current study including sociodemographic
Data Sheet, Daily Stressors Scale, Physical Symptoms of Stress Scale,
and Psychological Distress Scale. The results showed that: middle adult group of
nurses reported physical and emotional reactivity to daily stress less than younger
adult group of nurses. The study concludes that, age plays an important role in
controlling emotional and physical reactivity to stress amongnurses working in AlAbbassia
Mental Health Hospital. Further investigation is needed to examine age
groups' difference to stress, as well as, other factors that may be influential in stress
development.

Towab, A., A. S. M. Khalil, E. A. W. Osman, and Z. Mokhtar, "Age Differences in Reactivity to Daily Stressors: The Role of Personal Control", Journal of American Science, vol. 8, issue 12, 2012. cu_pdf.pdf
Towaij, S. J., M. A. K. Hamid, and A. Mohsen, "Diffraction by an infinite corner reflector transversely loaded by concentric dielectric slabs†", International Journal of Electronics, vol. 33, no. 3: Taylor & Francis, pp. 241–253, 1972. Abstract
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Towaij, S. J., M. A. K. Hamid, and A. Mohsen, "Diffraction by an infinite corner reflector transversely loaded by concentric dielectric slabs†", International Journal of Electronics, vol. 33, no. 3: Taylor & Francis, pp. 241–253, 1972. Abstract
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Towaij, S. J., M. A. K. Hamid, and A. Mohsen, "Diffraction by an infinite corner reflector transversely loaded by concentric dielectric slabs†", International Journal of Electronics, vol. 33, no. 3: Taylor & Francis, pp. 241–253, 1972. Abstract
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Townsend, G., N. Siddiqi, M. Youssef, and T. Graja, "Are we doing too many re-excisions? Review of practice in breast conserving surgery", European Journal of Surgical Oncology, vol. 40, issue 11, pp. S76, 2014.
Trad, F., A. E. Giba, X. Devaux, M. Stoffel, D. Zhigunov, A. Bouché, S. Geiskopf, R. Demoulin, P. Pareige, E. Talbot, et al., "Influence of phosphorus on the growth and the photoluminescence properties of Si-NCs formed in P-doped SiO/SiO2 multilayers", Nanoscale, vol. 13, issue 46: The Royal Society of Chemistry, pp. 19617 - 19625, 2021. AbstractWebsite

This work reports on the influence of phosphorous atoms on the phase separation process and optical properties of silicon nanocrystals (Si-NCs) embedded in phosphorus doped SiO/SiO2 multilayers. Doped SiO/SiO2 multilayers with different P contents have been prepared by co-evaporation and subsequently annealed at different temperatures up to 1100 °C. The sample structure and the localization of P atoms were both studied at the nanoscale by scanning transmission electron microscopy and atom probe tomography. It is found that P incorporation modifies the mechanism of Si-NC growth by promoting the phase separation during the post-growth-annealing step, leading to nanocrystal formation at lower annealing temperatures as compared to undoped Si-NCs. Hence, the maximum of Si-NC related photoluminescence (PL) intensity is achieved for annealing temperatures lower than 900 °C. It is also demonstrated that the Si-NCs mean size increases in the presence of P, which is accompanied by a redshift of the Si-NC related emission. The influence of the phosphorus content on the PL properties is studied using both room temperature and low temperature measurements. It is shown that for a P content lower than about 0.1 at%, P atoms contribute to significantly improve the PL intensity. This effect is attributed to the P-induced-reduction of the number of non-radiative defects at the interface between Si-NCs and SiO2 matrix, which is discussed in comparison with hydrogen passivation of Si-NCs. In contrast, for increasing P contents, the PL intensity strongly decreases, which is explained by the growth of Si-NCs reaching sizes that are too large to ensure quantum confinement and to the localization of P atoms inside Si-NCs.

Tran, J. Q., A. A. Othman, A. Mikulskis, P. Wolstencroft, and J. Elkins, "Pharmacokinetics of daclizumab high-yield process with repeated administration of the clinical subcutaneous regimen in patients with relapsing-remitting multiple sclerosis.", Clinical pharmacology : advances and applications, vol. 8, pp. 9-13, 2016. AbstractWebsite

BACKGROUND: Daclizumab high-yield process (DAC HYP), a humanized immunoglobulin G1 monoclonal antibody specific for the α subunit (CD25) of the high-affinity interleukin-2 receptor, has demonstrated efficacy for treatment of relapsing forms of multiple sclerosis in Phase II and III clinical trials.

OBJECTIVE: To characterize the pharmacokinetics (PK) of DAC HYP following repeated administration of the 150 mg subcutaneous (SC) dose every 4 weeks (q4wk), the proposed clinical regimen in patients with relapsing-remitting multiple sclerosis (RRMS).

METHODS: Twenty-six patients with RRMS received DAC HYP 150 mg SC q4wk for a total of six doses. Serial PK blood samples were collected over the first and last dosing intervals and trough PK samples were collected between these doses. Blood samples for immunogenicity assessment were collected throughout the study. Serum DAC HYP levels and anti-DAC HYP antibodies were characterized using validated immunoassays. PK parameters were estimated using noncompartmental analysis.

RESULTS: DAC HYP showed slow SC absorption with a median time to reach maximum observed concentration (Cmax) value of ~1 week. Steady state was reached by the fourth injection. At steady state, DAC HYP mean serum Cmax, minimum observed concentration (Cmin), and area under the concentration-time curve within a dosing interval (AUCtau) values were 29.1 µg/mL, 14.9 µg/mL, and 638 µg · day/mL, respectively, with intersubject variability of 35%-40%. The AUC accumulation ratio was ~2.5 at steady state. DAC HYP had a long elimination half-life of ~22 days and low apparent clearance (0.274 L/day). Nine patients tested positive for anti-DAC HYP antibodies, with no impact on DAC HYP clearance in this limited data set.

CONCLUSION: The PK of DAC HYP in patients with RRMS are consistent with those previously reported in healthy volunteers. The half-life of ~3 weeks and the low fluctuations in peak and trough concentrations of serum DAC HYP support the once-monthly SC dosing regimen.

Tran, J. Q., A. A. Othman, P. Wolstencroft, and J. Elkins, "Therapeutic protein-drug interaction assessment for daclizumab high-yield process in patients with multiple sclerosis using a cocktail approach.", British journal of clinical pharmacology, vol. 82, issue 1, pp. 160-7, 2016 Jul. AbstractWebsite

AIMS: To characterize the potential effect of daclizumab high-yield process (DAC HYP), a monoclonal antibody that blocks the high-affinity interleukin-2 receptors for treatment of multiple sclerosis, on activity of cytochrome P450 (CYP) enzymes.

METHODS: Twenty patients with multiple sclerosis received an oral cocktail of probe substrates of CYP1A2 (caffeine 200 mg), CYP2C9 (warfarin 10 mg/vitamin K 10 mg), CYP2C19 (omeprazole 40 mg), CYP2D6 (dextromethorphan 30 mg) and CYP3A (midazolam 5 mg) on two sequential occasions: 7 days before and 7 days after subcutaneous administration of DAC HYP 150 mg every 4 weeks for three doses. Serial pharmacokinetic blood samples up to 96 h post dose and 12-h urine samples were collected on both occasions. Area under the curve (AUC) for caffeine, S-warfarin, omeprazole and midazolam, and urine dextromethorphan to dextrorphan ratio were calculated. Statistical analyses were conducted on log-transformed parameters using a linear mixed-effects model.

RESULTS: The 90% confidence intervals (CIs) for the geometric mean ratio (probe substrate with DAC HYP/probe substrate alone) for caffeine AUC from 0-12 h (0.93-1.15), S-warfarin AUC from 0 to infinity (AUC[0-inf]) (0.95-1.06), omeprazole AUC(0-inf) (0.88-1.13) and midazolam AUC(0-inf) (0.89-1.15) were within the no-effect boundary of 0.80-1.25. The geometric mean ratio for urine dextromethorphan to dextrorphan ratio was 1.01, with the 90% CI (0.76-1.34) extending slightly outside the no-effect boundary, likely due to high variability with urine collections and CYP2D6 activity.

CONCLUSIONS: DAC HYP treatment in patients with multiple sclerosis had no effect on CYP 1A2, 2C9, 2C19, 2D6 and 3A activity.

Translator, L. Y., P. Elrefaei, O. Khalifa, and H. H. E. - Abbadi, Recontextualizing Resistance, , Newcastle, Cambridge Scholars Publishing, 2017.
Trebec, D. P., D. Chandra, A. Gramoun, K. Li, J. N. M. Heersche, and M. F. Manolson, "Increased expression of activating factors in large osteoclasts could explain their excessive activity in osteolytic diseases", Journal of cellular biochemistry, vol. 101, no. 1: Wiley Online Library, pp. 205–220, 2007. Abstract
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Trebec, D. P., D. Chandra, A. Gramoun, K. Li, J. N. M. Heersche, and M. F. Manolson, "Increased expression of activating factors in large osteoclasts could explain their excessive activity in osteolytic diseases", Journal of cellular biochemistry, vol. 101, no. 1: Wiley Online Library, pp. 205–220, 2007. Abstract
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Treister, A. D., P. L. Nesper, A. E. Fayed, M. K. Gill, R. G. Mirza, and A. A. Fawzi, "Prevalence of Subclinical CNV and Choriocapillaris Nonperfusion in Fellow Eyes of Unilateral Exudative AMD on OCT Angiography.", Translational vision science & technology, vol. 7, issue 5, pp. 19, 2018. Abstract

Purpose: To determine the prevalence of subclinical choroidal neovascularization (CNV) in fellow eyes of patients with unilateral exudative age-related macular degeneration (AMD) using optical coherence tomography angiography (OCTA) and to quantify choriocapillaris nonperfusion adjacent to CNV.

Methods: We retrospectively reviewed all patients with AMD who underwent OCTA and identified eyes with unilateral exudative AMD. We determined the presence of subclinical CNV on custom en face macular slabs of the outer retina and choriocapillaris and confirmed on cross-sectional scans. Two graders quantified the percent choriocapillaris area of nonperfusion (PCAN) in the entire choriocapillaris slab as well as in the "halo" zone (200 μm) surrounding subclinical and exudative CNV lesions.

Results: Of 140 AMD patients who underwent OCTA, 34 had unilateral exudative AMD, with five of the 34 fellow eyes (14.7%) having subclinical CNV. Compared with PCAN in the entire slab (10.333 ± 4.288%), we found that "halo" PCAN, surrounding CNV, was significantly higher (13.045 ± 5.809%; < 0.001). Further, there was a trend for higher PCAN in exudative CNV eyes (15.267 ± 7.230%) compared with their fellow subclinical CNV eyes (10.823 ± 3.365%, = 0.115).

Conclusions: There is a notable prevalence of subclinical CNV in fellow eyes with unilateral exudative CNV, and significantly greater choriocapillaris nonperfusion adjacent to all CNV lesions. We identified a trend for increased choriocapillaris nonperfusion in exudative AMD eyes as compared with their fellow subclinical CNV eyes, which deserves further study.

Translational Relevance: OCTA can be useful in clinical practice to detect subclinical CNV and study choriocapillaris dysfunction.

Treppo, E., L. Quartuccio, G. Ragab, and S. De Vita, "Rheumatologic manifestations of Hepatitis C Virus", Minerva Medica, vol. 112, issue 2: Edizioni Minerva Medica, pp. 201 - 214, 2021. AbstractWebsite
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