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Browsing by Author "Abdeljawad, Khaled"
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Item Real-world effectiveness of COVID-19 vaccination in liver cirrhosis: a systematic review with meta-analysis of 51,834 patients(Taylor & Francis, 2023-01-17) Beran, Azizullah; Mhanna, Asmaa; Mhanna, Mohammed; Hassouneh, Ramzi; Abuhelwa, Ziad; Mohamed, Mouhand F. H.; Sayeh, Wasef; Musallam, Rami; Assaly, Ragheb; Abdeljawad, Khaled; Medicine, School of MedicineSARS-CoV-2 vaccinations were found to be highly effective in phase 3 clinical trials. However, these trials have not reported data regarding the subgroup of liver disease or excluded patients with liver disease. The effectiveness of COVID-19 vaccines among liver cirrhosis (LC) patients is unclear. We conducted this meta-analysis to assess the effectiveness of SARS-CoV-2 vaccination in LC patients. A comprehensive literature search was conducted to include all the relevant studies that compared the outcomes of LC patients who received SARS-CoV-2 vaccines vs. unvaccinated patients. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated by the Mantel-Haenszel method within a random-effect model. Four studies with 51,834 LC patients (20,689 patients received at least one dose vs 31,145 were unvaccinated) were included. COVID-19–related complications, including hospitalization (RR 0.73, 95% CI 0.59–0.91, P = 0.004), mortality (RR 0.29, 95% CI 0.16–0.55, P = 0.0001), and need for invasive mechanical ventilation (RR 0.29, 95% CI 0.11–0.77, P = 0.01), were significantly lower in the vaccinated group compared to the unvaccinated group. SARS-CoV-2 vaccination in LC patients reduced COVID-19–related mortality, intubation, and hospitalization. SARS-CoV-2 vaccination is highly effective in LC. Further prospective studies, preferably randomized controlled trials, are necessary to validate our findings and determine which vaccine is superior in patients with LC.Item Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist(Elsevier, 2015-03) Abdeljawad, Khaled; Vemulapalli, Krishna C.; Kahi, Charles J.; Cummings, Oscar W.; Snover, Dale C.; Rex, Douglas K.; Department of Medicine, IU School of MedicineBackground The prevalence of sessile serrated adenomas and/or polyps (SSA/Ps) is uncertain. Objective To determine the prevalence of SSA/Ps and SSA/Ps with cytologic dysplasia (SSA/P-CD) by using a colonoscopist with a high lesion detection rate and an expert in serrated lesion pathology. Design Retrospective screening colonoscopy study. Setting Academic endoscopy unit. Patients A total of 1910 average risk, asymptomatic patients aged ≥50 years underwent screening colonoscopy between August 2005 and April 2012 by a single colonoscopist with a high lesion detection rate. Interventions Slides of all lesions in the serrated class proximal to the sigmoid colon and all rectal and sigmoid colon serrated lesions >5 mm in size were reviewed by an experienced GI pathologist. Main Outcome Measurements Prevalence of SSA/Ps, defined as the proportion of patients with ≥1 SSA/P. Results There were 1910 patients, of whom 389 had 656 lesions in the serrated class. Review by the experienced GI pathologist determined a prevalence of SSA/Ps without cytologic dysplasia of 7.4% and SSA/Ps-CD of 0.6% (total SSA/P prevalence 8.1%). SSA/Ps and SSA/Ps-CD comprised 5.6% and 0.3%, respectively, of all resected polyps. The mean size of SSA/Ps was 7.13 mm (standard deviation [SD] 4.66), and 51 of 77 (66.2%) polyps ≥10 mm in the serrated class were SSA/Ps. Limitations Retrospective design. Conclusion A colonoscopist with a high lesion detection rate and an experienced pathologist identified a high prevalence (8.1%) of SSA/Ps in a screening population. SSA/Ps are more common than previously believed.