Validation of the Arabic version of the SCOFF questionnaire for the screening of eating disorders.

The high prevalence of eating disorders in Arab countries indicates a need for an Arabic language screening tool. This study aimed to validate an Arabic version (A-SCOFF) of the British SCOFF questionnaire, a brief tool for the screening of eating disorders in primary health care. After translation and back-translation the A-SCOFF was given to 123 female patients [mean age 32 (SD 8.8) years] visiting primary health-care centres in Beirut. Each patient was evaluated by an eating disorders specialist blinded to A-SCOFF results. The validated Arabic version of the Mini International Neuropsychiatric Interview and the DSM-IV criteria for eating disorders were used as diagnostic references. The best diagnostic threshold for the A-SCOFF was found to be at 2 positive answers with a sensitivity of 80.0%, a specificity of 72.7% and an area under the curve of 80.0%. The A-SCOFF questionnaire is accurate and reliable for the early detection of eating disorders in this high-risk population.

[Anti-tetanus immunity among university students and health staff in North Lebanon and administration of anti-tetanus serums in two hospitals]. / Immunité antitétanique chez des étudiants universitaires et personnels de santé au Liban-Nord et administration de serum antitétanique dans deux hôpitaux.

Tetanus is a serious illness that kills about one million people a year globally. This study aimed to i) evaluate immunity against tetanus (by antibodies titres in blood) among health staff and students at the Public Health Faculty, Lebanese University, ii) explore the determinants of the anti-tetanus immunity by a questionnaire and iii) estimate anti-tetanic serum use in the emergency departments of two hospitals (1 private, 1 public) in Tripoli. Most of the participants (76.6%) had anti-tetanus antibody titres ≥ 0.1 UI/mL. There was no association between immune status and gender (P = 0.614) but more participants ≤ 25 years were immunized than those > 25 years (P < 0.001) and more students were immunized than employees (P = 0.032). There was an inverse association between anti-tetanus immunity and having visited a physician in the past year (P = 0.009). In 2011, 1037 people received anti-tetanus immunoglobulins at the hospitals, 73% at the private hospital. Vaccination campaigns targetting adults > 25 years may be warranted to assure good anti-tetanus protection and avoid administration of anti-tetanus immunoglobulins in emergency departments.

Prevalence of type b Haemophilus influenzae and antibiotic resistance in 52 clinical isolates in north Lebanon.

The aim of this study was to determine the capsular typing and type b prevalence of clinical Haemophilus influenzae strains in north Lebanon in both invasive and non-invasive disease and to determine the susceptibility pattern and the mechanism of resistance to ß-lactams [ß-lactamase-producing strains and ß-lactamase-negative ampicillin resistant (BLNAR) strains]. Fifty-two strains of clinical H. influenzae were isolated from 312 clinical specimens; the resistance pattern to ß-lactams of these strains was determined by using the disc diffusion and E-test methods followed by molecular methods such as PCR of blaTEM et blaROB genes. Nine (17.4%) of the 52 strains were resistant to ampicillin; all of them produced type TEM-1 ß-lactamase. In the susceptible strains 15.3% were not fully susceptible to ß-lactams or considered low BLNAR strains. Slide agglutination serotyping showed that 30.7% of the strains were type b.

[Prevalence of pathological gambling in Lebanese students]. / Prévalence du jeu pathologique chez les étudiants libanais.

INTRODUCTION: Pathological gambling is a behavioral dependency on hazard games that is classified, in the DSM-IV, among impulse control disorders. According to many studies, the international prevalence of pathological ranges between 2 and 6%. This disorder is often accompanied by a considerable impact on patients' life as well as on the life of people surrounding them. Adolescents and young adults are considered to be a population at risk to develop this kind of behavioral dependency. The problem of pathological gambling is one of the major problems from which the Lebanese population of university students in Lebanese society suffers. The prevalence of pathological gambling in the Lebanese population of university students is lacking from the contemporary medical literature. MATERIALS AND METHODS: In our study, five of the biggest private universities in Lebanon (Notre-Dame University of Louaizé [NDU], Lebanese American University [LAU], American University of Beirut [AUB], Saint-Joseph University [USJ] and Holy Spirit University of Kaslik [USEK]) were surveyed. Each questionnaire was based essentially on the South Oaks Gambling Screen (SOGS). RESULTS: Four hundred and seventy-seven questionnaires were completed in these universities. Among the 477 students that completed the questionnaire, 5.87% appeared to be suffering from pathological gambling; 25.15% of responding students presented some problems related to gambling while the rest of them, corresponding to 68.92%, had no problems related to gambling. CONCLUSION: This is the first study of its kind conducted in the Lebanon. Its interest lies in that it offers an important evaluation of the prevalence of pathological gambling in the Lebanese population of university students. According to this study, the prevalence of pathological gambling in Lebanese university students is high. Prevention programs and sensitization strategies are needed in order to prevent the occurrence of this disorder in the Lebanese young. More studies are needed in this domain in order to evaluate precisely the prevalence of pathological gambling in Lebanese university students.

[Preliminary study on the prevalence of Campylobacter in childhood diarrhoea in north Lebanon]. / Etude préliminaire sur la prévalence de Campylobacter dans les diarrhées infantiles au nord du Liban.

Campylobacter species are a major cause of human diarrhoeal disease worldwide. In Lebanon, the true prevalence of Campylobacter infections and the species distribution in childhood diarrhoea are not known. This study in 2010 investigated the prevalence of Campylobacter species and its possible etiologic role in childhood diarrhoea in north Lebanon. A total of 90 stool samples from children (aged 1 month to 10 years) presenting with diarrhoea were collected from 5 hospitals. A polymerase chain reaction technique (PCR) was used for each sample forthe amplification of all Campylobacter species followed by 5 PCR reactions for the amplification of C. jejuni, C. hyointestinalis, C. coli, C. fetus and C. upsaliensis. Of the 90 samples, 10 were positive for Campylobacterspecies (11.1%):1 for C.coli, 1 for C. jejuni, 2 for both C. jejuni and C. coli, and 6 could not be identified to the species level with the available primers. Campylobacter species is frequently associated with childhood diarrhoea in north Lebanon but Campylobacter infection may be significantly underdiagnosed because the search for Campylobacter is not part of the routine stool culture.

Health-care-seeking behaviour among university students in Lebanon.

This cross-sectional study assessed the health-care-seeking behaviour, barriers to accessing care and associated factors among a sample of 543 Lebanese students at Saint-Joseph University. Data were collected on health-care-seeking behaviour for health issues in the previous 12 months using an anonymous questionnaire. Health-care-seeking behaviour was categorized as: formal (professional help sought); informal relational (help sought from friends/family); informal personal (self-help). The health issues examined were: physical, psychological, social and relational, sexual, drug, alcohol and smoking. When facing health-related issues, the students tended to seek informal health care. Formal health-care-seeking behaviour was almost non-existent for psychological issues (3.3%), relational and social issues (1.8%), and issues related to substance use (5.1%). The barriers to seeking formal health care fell into 2 categories: accessibility and relational. To encourage young people to access formal health care, specific health services should be provided for them where they are assured of confidentiality and understanding.

Increased phosphorus content of preload suppresses ad libitum energy intake at subsequent meal.

Food intake is believed to be partially controlled by hepatic signals related to adenosine triphosphate (ATP) status. We hypothesized that increased phosphorus content of one meal can stimulate hepatic ATP synthesis of the next meal, which in turn contributes to satiation. This hypothesis was tested by measuring the energy intake after phosphorus addition to several preloads. The phosphorus content of the different preloads was found to be inversely related to the energy intake at a subsequent meal, although the exact mechanism behind such effects was not studied. Such findings point to a potential role for phosphorus in the control of food intake.

[Infections with respiratory syncytial virus in North Lebanon--prevalence during winter 2008]. / Les infections à virus respiratoire syncytial au Nord du Liban--prévalence au cours de l'hiver 2008.

Between 1 December 2007 and 31 May 2008, we analysed 120 nasopharyngeal swabs for the presence respiratory syncytial virus (RSV) infection in 120 children aged 15 days to 6 years, hospitalized in 2 hospitals in North Lebanon. Of the 120 samples, 32 were positive (26.7%) for RSV. There was a peak in January which progressively disappeared from February to May. Being positive for RSV was significantly associated with the presence of rhinorrhoea and dyspnoea as clinical symptoms and the absence of pneumonia signs on chest X-ray and the diagnosis of bronchitises or bronchiolitis. Testing for RSV is important in cases of respiratory infections in children as it may limit unnecessary prescription of antibiotics.

Research in action: mammography utilization following breast cancer awareness campaigns in Lebanon 2002-05.

Four consecutive annual surveys of 1200 women each were conducted in Lebanon in connection with the National Breast Cancer Awareness campaigns (2002-05) to measure the prevalence of mammography utilization and the impact of these campaigns, and to highlight regional and demographic differences. The utilization of mammography in the previous 12 months was low and increased only slightly over 4 years (from 11% to 18%). In the 2005 campaign, it was twice as high (25%) in greater Beirut than in mostly rural areas, and among women aged 40-59 years (about 21%) compared with younger (12%) or older (11%) women. In each wave, repeat mammograms were less common than first time screening.

Effect of phosphorus supplementation on weight gain and waist circumference of overweight/obese adults: a randomized clinical trial.

BACKGROUND: Phosphorus status is inversely correlated with body weight; however, the effect of phosphorus supplementation on body weight in a controlled design has not been studied. METHODS: This is a double-blind, randomized, placebo-controlled trial of 63 adults aged 18-45 years with a body mass index (BMI) of ⩾25 kg m(-2) and normal kidney function at the American University of Beirut. Participants were randomly assigned to the placebo or phosphorus group where daily placebo or phosphorus supplements were ingested with three main meals (breakfast, lunch and dinner) for a period of 12 weeks. Primary outcomes were changes in anthropometric measures, blood metabolites (including lipid profile, glucose and insulin) and subjective appetite scores. The trial is registered with Clinical Trial.gov, NCT02329990. RESULTS: Body weight was significantly lower in the phosphorus group when compared with the placebo group (-0.65 kg (95% confidence interval (CI) -1.69 to 0.40) vs 1.13 kg (95% CI 0.19 to 2.06), P=0.01). Similarly, BMI and waist circumference were significantly lower in the phosphorus group when compared with the placebo group (-0.24 kg m(-2) (95% CI -0.59 to 0.12) vs 0.42 kg m(-2) (95% CI 0.05 to 0.78), P=0.01; -3.62 cm (95% CI-4.90 to -2.33) vs 0.38 cm ( 95% CI-0.44 to 1.20), P<0.001; respectively). Several parameters of subjective appetite scores were decreased in the phosphorus-supplemented group. CONCLUSIONS: Phosphorus supplementation for 12 weeks significantly decreases body weight, BMI, waist circumference and subjective appetite scores. These findings support a promising role of the mineral phosphorus in the prevention and management of obesity, especially abdominal adiposity. The exact mechanisms of action and longer-term effects still need to be elucidated.

Epidemiology of hip fractures in Lebanon: a nationwide survey.

INTRODUCTION: Hip fractures are a reliable indicator of osteoporosis. Despite their importance, few studies have assessed their epidemiology in Lebanon and the Middle East. HYPOTHESES: Hip fracture incidence rates in Lebanon approximate those of Northern countries, and show the same characteristics, particularly the exponential increase with age, higher incidence in women, and a recent trend of rate leveling in women but not in men. MATERIALS AND METHODS: A national database of hip fracture cases admitted to hospitals in Lebanon in 2007 was created. Crude and age-adjusted incidence rates were calculated at 5-year intervals for individuals over age 50. These rates were also standardized to the 2000 United States population, and compared to those of other countries. Projected incidence rates in Lebanon in 2020 and 2050 were also calculated. RESULTS: A total of 1199 patients were included in the study. The crude annual incidence rate in individuals over 50 was 147 per 100,000 individuals, 132 per 100,000 males and 160 per 100,000 females, with a female-to-male ratio of 1.2. The age-standardized annual incidence rates (per 100,000) were 180 in males and 256 in females. Assuming unchanged healthcare parameters, the projected crude incidence rates for people over 50 are expected to reach 174 and 284 per 100,000 in 2020 and 2050 respectively. CONCLUSIONS: Lebanese hip fracture rates are lower than Northern countries, but show many similar characteristics such as an exponential increase with age, a higher incidence in women, and clues of a leveling of rates in women but not in men. Numbers are expected to increase substantially in the coming decades. LEVEL OF EVIDENCE: Level IV. Epidemiological study.

Modelos de predicción funcional en el accidente vascular cerebral / Functional prediction models in cerebrovascular accident

Objetivo. Analizar modelos de predicción del estado funcional tras un accidente cerebrovascular agudo. Estrategia de búsqueda. Se procede al análisis de los modelos publicados entre 1999 y 2005 obtenidos por Medline, comunicaciones y tesis doctorales a nivel nacional. Selección de estudios y de datos. Se han considerado como criterios de inclusión el que los modelos de accidente cerebrovascular isquémico o hemorrágico pronostiquen el resultado funcional. Se han excluido los modelos de accidente cerebrovascular transitorio, hemorragia subaracnoidea y los que predicen la mortalidad o supervivencia. Se han analizado los factores que forman parte de los modelos y el grado de predicción. Síntesis de resultados. Se obtuvieron 24 variables predictoras en los 28 modelos seleccionados. La capacidad funcional inicial está presente en todos ellos, siendo la medida de la independencia funcional la forma más frecuente de valorarla (32 %). Se puede dar un pronóstico entre la segunda y la cuarta semana en 13 modelos y se miden los resultados a los 6 meses en el 36 %. El método estadístico que más se emplea es el de regresión logística, y se obtiene un valor de predicción superior al 80 % en 11 modelos. Conclusiones. Múltiples factores son los que determinan el pronóstico funcional del accidente cerebrovascular agudo, sin encontrar mucha coincidencia en las variables que determinan el resultado. El grado de discapacidad previa, el déficit en la primera exploración o momento de realizar el pronóstico, unido a otros factores como la edad, el soporte social y vivir en pareja, influyen en el resultado funcional y en la institucionalización del paciente

Objective. Analyze prediction models of the functional state after acute cerebrovascular accident. Search strategy. Analysis of the models published between 1999 and 2005 obtained by Medline, communications and doctorate theses nationwide was done. Selection of studies and data. Inclusion criteria have been considered that the ischemic or hemorrhagic cerebrovascular accident models prognosticate the functional result. Transient cerebrovascular accident, subarachnoid hemorrhaging models and those that predict mortality or survival have been excluded. The factors that form a part of the models and prediction grade have been analyzed. Synthesis of results. A total of 24 predictor variables were obtained in the 28 models selected. The initial functional capacity is present in all of them, the Measure of Functional Independence being the most frequent way of evaluating it (32 %). Prognosis can be made between the second and fourth week in 13 models and the results measured at 6 months in 36 %. The statistical method used most is the logistic regression and a predictive value greater than 80 % is obtained in 11 models. Conclusions. Multiple factors are those that determine the functional prognosis of acute cerebrovascular accident, without finding much coincidence in the variables that determine the result. The grade of previous incapacity, deficit in the first examination or time of making the prognosis, together with other factors such as age, social support and living with a partner, influence the functional result and institutionalization of the patient