Papers by Georges P. Aftimos
Annals of Epidemiology, 2004
FOR THE LEBANESE CANCER EPIDEMIOLOGY GROUP* PURPOSE: Cancer incidence rates in Lebanon have been ... more FOR THE LEBANESE CANCER EPIDEMIOLOGY GROUP* PURPOSE: Cancer incidence rates in Lebanon have been lacking for over three decades. National data based on a total of 4388 cases diagnosed during the year 1998 were reviewed and analyzed. METHODS: Crude and age-standardized rates (ASRs) per 100,000 population were calculated and results were contrasted with estimates from developed and selected developing countries in the region. RESULTS: Among males, bladder (18.5%), prostate (14.2%), and lung cancer (14.1%) were the most frequently reported malignancies. Among females, breast cancer alone accounted for over a third of all cancers, followed by colon cancer (5.8%), and cancer of the corpus uteri (4.8%). Sex-differentials in incidence rates were highest for tobacco-related cancers (lung, larynx, and bladder). Compared with current estimates worldwide, ASRs for bladder cancer in Lebanon showed strikingly high rates. Whereas ASRs for breast and prostate cancer remained lower than those observed in developed countries, they were greater than those estimated from neighboring countries with a similar epidemiological transition as Lebanon. CONCLUSIONS: Findings of the comparative assessments most likely reflect differentials in prevalence of risk factors and lifestyle variables (e.g., lung and breast cancers) and can be partly explained by improvement in cancer detection rate in recent years (for prostate cancer). The implications of the results in light of primary prevention activities, screening practices, and research initiatives in Lebanon are discussed.
Transplantation Proceedings, 2001
The Annals of The Royal College of Surgeons of England, 2012
We report the case of a patient who presented with a painful breast lump that turned out to be an... more We report the case of a patient who presented with a painful breast lump that turned out to be an adenoid cystic carcinoma of the breast. The literature is reviewed, highlighting the good prognosis associated with this rare condition and the current preferred treatment modalities.
Molecular and Clinical Oncology, 2017
Late detection and lack of standard treatment strategies in larynx cancer patients result in high... more Late detection and lack of standard treatment strategies in larynx cancer patients result in high levels of mortality and poor prognosis. Prognostic stratification of larynx cancer patients based on molecular prognostic tumor biomarkers may lead to more efficient clinical management. Krüppel-like factor 4 (KLF4) and Heat Shock Protein 27 (HSP27) have an important role in tumorigenesis and are considered promising candidate biomarkers for various types of cancer. However, their role in larynx carcinoma remains to be elucidated. The present study aimed to determine KLF4 and HSP27 expression profiles in laryngeal tumors. The protein and mRNA expression levels of KLF4 and HSP27 were evaluated by immunohistochemical and reverse transcription-polymerase chain reaction analyses in 44 larynx carcinoma samples and 21 normal tissue samples, and then correlated with clinical characteristics. A differential expression of KLF4 and HSP27 was observed between normal and tumor tissues. The protein and mRNA expression levels of KLF4 were significantly decreased in larynx squamous cell carcinoma (LSCC) compared with normal tissue, whereas HSP27 was significantly overexpressed in tumor tissues compared with normal tissues, at the protein and mRNA levels. KLF4 expression decreased gradually with tumor progression whereas HSP27 expression increased. A significant difference was observed between stages I and IV. KLF4 and HSP27 exhibit opposite functions and roles in the carcinogenic process of LSCC. Their role in laryngeal cancer initiation and progression emphasizes their use as potential future targets for prognosis and treatment. KLF4 and HSP27 expression levels may act as potential biomarkers in patients with cancer of the larynx.
Molecular Immunology, 2003
Journal of Nephrology & Therapeutics, 2014
We report a case of a 45-year-old woman who presented for nephrotic syndrome and anemia. Her kidn... more We report a case of a 45-year-old woman who presented for nephrotic syndrome and anemia. Her kidney biopsy confirmed the diagnosis of class V membranous lupus nephritis. She had also criterias for antiphospholipid syndrome: miscarriages and antiphospholipid antibodies. She received as immunosuppression treatment corticosteroids and mycophenolate mofetil. Her kidney function deteriorated and three bolus of cyclophosphamide were given. She developed a severe pneumonia and became uremic. She underwent two sessions of acute hemodialysis and developed deep venous thrombosis in her leg. Anticoagulation was then started and her kidney function stabilized for a few months until she was put on chronic dialysis three years and a half after her initial presentation. We emphasize on the factors that worsen the renal prognosis in membranous lupus nephritis patients. We also highlight the importance of recognizing early the antiphospholipid syndrome in lupus nephritis in order to treat it and prevent eventually end-stage renal failure.
Journal of gastric cancer, 2017
Despite the decreasing incidence and mortality from gastric cancer, it remains a major health pro... more Despite the decreasing incidence and mortality from gastric cancer, it remains a major health problem worldwide. Ninety percent of cases are adenocarcinomas. Here, we report a case of gastric adenocarcinoma developed after successful treatment of prior primary gastric diffuse large B-cell lymphoma (DLBCL). Our patient was an elderly man with primary gastric DLBCL in whom complete remission was achieved after R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone plus rituximab) chemotherapy. Helicobacter pylori infection persisted despite adequate treatment leading to sustained chronic gastritis. The mean time to diagnose metachronous gastric carcinoma was seven years. We believe that a combination of many risk factors, of which chronic H. pylori infection the most important, led to the development of gastric carcinoma following primary gastric lymphoma. In summary, patients who have been successfully treated for primary gastric lymphoma should be followed up at regular sho...
Molecular and Clinical Oncology, 2016
Lung cancer is most prevalent human cancer worldwide. However, no molecular markers are currently... more Lung cancer is most prevalent human cancer worldwide. However, no molecular markers are currently available for predicting lung cancer prognosis. Therefore, identifying novel biomarkers may be useful for improving clinical diagnosis and patient stratification. Krüppel-like factor 4 (KLF4) is a transcription factor with opposing roles in different human cancers. Its overexpression in several cancers is correlated with a poor prognosis. However, the expression and role of KLF4 in lung cancer remains to be elucidated. The aim of this study was to determine the profile of KLF4 expression in different types of lung cancer. The KLF4 protein expression level was tested and evaluated by immunohistochemical analysis in 47 lung tumors and normal tissues, and then correlated with clinical characteristics. A differential expression of KLF4 was observed between normal tissue and each of the lung cancer types. A significant decrease in KLF4 expression was observed in non-small-cell lung cancer (NSCLC) compared with that in normal tissue, while significant overexpression was detected in small-cell lung cancer. Furthermore, a higher rate of expression was observed in stage II, III and IV disease compared with stage I disease in NSCLC tissues. KLF4 expression was not found to be associated with age or gender. Our results suggested that the KLF4 protein level may be a potential biomarker in patients with advanced lung cancer.
Revue Medicale Libanaise, 2002
Les tumeurs de la region pre-sacree sont rares et la plupart sont d'origine congenitale (epid... more Les tumeurs de la region pre-sacree sont rares et la plupart sont d'origine congenitale (epidermoide, teratome, chordome...). Le kyste epidermoide est le plus frequent. Nous presentons le cas d'une femme de 33 ans chez laquelle une masse asymptomatique a ete decouverte dans la region presacree lors de l'accouchement par voie basse et qui s'est revelee etre un kyste epldermoide. Le CT-Scan et l'echo-endoscopie retrouvent une masse kystique bien delimitee dans l'espace presacre. Une discussion des differentes modalites diagnostiques et therapeutiques est faite, et des recommandations generales sont proposees.
American Heart Journal, 1985
Pathology & Oncology Research, 2013
Incidence of various Hodgkin (HL) and non-Hodgkin lymphoma (NHL) subtypes and association with vi... more Incidence of various Hodgkin (HL) and non-Hodgkin lymphoma (NHL) subtypes and association with viruses in Lebanon are not known. We undertook a nationwide study of 272 patients diagnosed with lymphoma in 2007. HL comprised 32.7 % (n = 89) of cases while NHL represented 67.3 % (n = 183). Consistent with the literature, nodular sclerosis was the most predominant HL subtype (n = 57/89). Among NHL, B-cell NHL represented 88 % (n = 161/183), T-cell NHL 9 % (n = 17/183), whereas in 2.7 % it was not classifiable. The B-cell NHL comprised predominantly diffuse large B-cell lymphoma (46 %) and follicular lymphoma (23 %). 81 cases were reviewed by a panel of pathologists with 87.6 % concordance rate. Serology was negative for hepatitis C in 122 tested cases. HIV was positive in 2 cases. Two adult T-cell leukemia/lymphoma were HTLV-I positive. EBV IgG were positive in 88.5 % of cases. 38 EBV seropositive cases [27 NHL (24 B-cell, 3 T-cell) and 11 HL] were studied for EBV genome expression using EBV-encoded RNA (EBER)-in situ hybridization. EBER expression was positive in 8 (21 %) cases (6 HL, 2 T-cell NHL). The distribution of lymphoma subtypes in Lebanon appears similar to that of Western countries. The high rate of EBV positivity in HL and T-cell lymphoma by EBER deserves further investigation.
Le Journal médical libanais. The Lebanese medical journal
Methyl methacrylate (MMA), a widely used monomer in dentistry and medicine has been reported to c... more Methyl methacrylate (MMA), a widely used monomer in dentistry and medicine has been reported to cause abnormalities or lesions in several organs. Experimental and clinical studies have documented that monomers may cause a wide range of adverse health effects such as irritation to skin, eyes, and mucous membranes, allergic dermatitis, stomatitis, asthma, neuropathy, disturbances of the central nervous system, liver toxicity, and fertility disturbances. The purpose of this study was to determine whether MMA mixed with water at four different concentrations is able to affect the histological structure of testicular tissues and seminal vesicle on male rats. The target population consisted of 60 male Sprague-Dawley rats. They were housed in colony cages and divided into five groups: The first group (n=15) designated as the control group and four experimental groups (n=45). Experiments were conducted by exposing the four experimental groups to MMA administered per os mixed with water at d...
Le Journal médical libanais. The Lebanese medical journal
Methyl methacrylate (MMA) is commonly used in medicine and dentistry. The adverse effects of MMA ... more Methyl methacrylate (MMA) is commonly used in medicine and dentistry. The adverse effects of MMA are well described in the literature. Animal studies have largely confirmed the risks reported in clinical observations. There is no study indicating direct implication of MMA on male fertility mechanism. The purpose of this study was to determine whether MMA is able to modify the testosterone level. The target population consisted of 60 male Sprague-Dawley rats. They were closed in colony cages and divided into five groups: The first group (n=15) designated as the control group and four experimental groups (n=45). Experiments were conducted by exposing the four experimental groups to MMA with water at different concentrations (4% per hundred, 8% per hundred, 16% per hundred and 32% per hundred) administered per os. The exposure duration was eight months. Blood was obtained before and at the end of the exposure and the measurement of the testosterone level was made by EIA test. The expos...
Journal of the American Society of Nephrology : JASN, Jan 5, 2014
Transient receptor potential canonical (TRPC) Ca(2+)-permeant channels, especially TRPC3, are inc... more Transient receptor potential canonical (TRPC) Ca(2+)-permeant channels, especially TRPC3, are increasingly implicated in cardiorenal diseases. We studied the possible role of fibroblast TRPC3 in the development of renal fibrosis. In vitro, a macromolecular complex formed by TRPC1/TRPC3/TRPC6 existed in isolated cultured rat renal fibroblasts. However, specific blockade of TRPC3 with the pharmacologic inhibitor pyr3 was sufficient to inhibit both angiotensin II- and 1-oleoyl-2-acetyl-sn-glycerol-induced Ca(2+) entry in these cells, which was detected by fura-2 Ca(2+) imaging. TRPC3 blockade or Ca(2+) removal inhibited fibroblast proliferation and myofibroblast differentiation by suppressing the phosphorylation of extracellular signal-regulated kinase (ERK1/2). In addition, pyr3 inhibited fibrosis and inflammation-associated markers in a noncytotoxic manner. Furthermore, TRPC3 knockdown by siRNA confirmed these pharmacologic findings. In adult male Wistar rats or wild-type mice subjec...
Le Journal médical libanais. The Lebanese medical journal
Natriuretic peptides seem to be a potent regulator of cell Ca2+ signalling in their action on the... more Natriuretic peptides seem to be a potent regulator of cell Ca2+ signalling in their action on the cardiovascular system. It was therefore the aim of this study to investigate the effect(s) of B-type natriuretic peptide (BNP) on the action potential and the L-type calcium current (I(CaL)) in the rat left ventricular myocytes. Perforated and whole cell patch clamp technique was used to record action potential (AP) and I(CaL) in current and voltage clamp mode, respectively. At the concentration tested of 10(-7) M, BNP significantly increased the action potential duration at 50% and at 90% of repolarization by 16.85% and 1639% respectively, and the phase II slope of the AP by 52.5%; reduced the I(CaL) amplitude with a 16.17% decrease in the peak amplitude; reduced (16.51%) the inactivation time course of current decay; increased the V0.5 activation of the L-type calcium channel by 32.84% and decreased V0.5 inactivation by 34.39%. These data suggest that BNP modulates cardiomyocyte funct...
PLoS ONE, 2014
The cardiovascular effects of mild and overt thyroid disease include a vast array of pathological... more The cardiovascular effects of mild and overt thyroid disease include a vast array of pathological changes. As well, thyroid replacement therapy has been suggested for preserving cardiac function. However, the influence of thyroid hormones on cardiac remodeling has not been thoroughly investigated at the molecular and cellular levels. The purpose of this paper is to study the effect of hypothyroidism and thyroid replacement therapy on cardiac alterations. Thirty Wistar rats were divided into 2 groups: a control (n = 10) group and a group treated with 6-propyl-2-thiouracil (PTU) (n = 20) to induce hypothyroidism. Ten of the 20 rats in the PTU group were then treated with L-thyroxine to quickly re-establish euthyroidism. The serum levels of inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor alpha (TNF-a), interleukin 6 (IL6) and pro-fibrotic transforming growth factor beta 1 (TGF-b1), were significantly increased in hypothyroid rats; elevations in cardiac stress markers, brain natriuretic peptide (BNP) and cardiac troponin T (cTnT) were also noted. The expressions of cardiac remodeling genes were induced in hypothyroid rats in parallel with the development of fibrosis, and a decline in cardiac function with chamber dilation was measured by echocardiography. Rapidly reversing the hypothyroidism and restoring the euthyroid state improved cardiac function with a decrease in the levels of cardiac remodeling markers. However, this change further increased the levels of inflammatory and fibrotic markers in the plasma and heart and led to myocardial cellular infiltration. In conclusion, we showed that hypothyroidism is related to cardiac function decline, fibrosis and inflammation; most importantly, the rapid correction of hypothyroidism led to cardiac injuries. Our results might offer new insights for the management of hypothyroidism-induced heart disease.
Journal of medical case reports, 2014
Schistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps ass... more Schistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation. We describe the case of a 20-year-old Ethiopian woman living in Lebanon who presented with nonspecific abdominal symptoms. Her biochemical profile was normal in addition to the results of her stool and urine tests. A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon. Pathology revealed a hamartomatous polyp but it was full of partially calcified parasitic eggs of Schistosoma mansoni compatible with chronic schistosomiasis. She was treated with two doses of praziquantel and showed immediate marked clinical improvement. This unusual case will give us the opportunity to discuss schistosomiasis, its occurrence in colon polyps, clinical significance and the vari...
Le Journal médical libanais. The Lebanese medical journal
Evaluate the prognostic significance of EGFR, p53 and E-cadherin known, along with histopathologi... more Evaluate the prognostic significance of EGFR, p53 and E-cadherin known, along with histopathologic criteria, in mucoepidermoid cancer (MEC) of the salivary glands. Retrospective case series review between January 1994 and December 2002 of all patients with salivary glands mucoepidermoid cancer treated at one university hospital. Histopathology review and immunohistochemistry study for EGFR, p53 and E-cadherin was undertaken on formalin-fixed, paraffin embedded surgical specimens. Clinicopathological parameters were reviewed and survival analysis was conducted to study the prognostic significance of these factors. All patients were treated by the same multidisciplinary team which included three head and neck surgeons, one plastic surgeon, two medical oncologists and one radiation oncologist at Hôtel-Dieu de France, a tertiary care university hospital of Saint-Joseph University, Beirut-Lebanon. Thirteen patients were treated for MEC during this period. The parotid gland was the most c...
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Papers by Georges P. Aftimos