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1.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 28-29
in English, French | IMEMR | ID: emr-206745

ABSTRACT

Different cancer chemotherapeutics can work by inducing apoptosis in cancer cells. Moreover, various tumor suppressors and oncogenes play a role in regulating senescence and apoptosis [1]. Senescent cells, formed in response to chemotherapeutic drugs, facilitate protection from lymphogenesis and aid in tissue repair [2]. Yet, the accumulation and chronic persistence of these cells promote adverse effects including chemoresistance and cancer relapse [3]. This demonstrates the importance of cell fate decision, apoptosis versus senescence, in determining the efficacy of therapeutic treatment not only in tumor clearance but also its recurrence. Here we established an in vitro senescence model using SU-DHL-4 lymphoma cells [DLBCL]. Our results showed that the exposure to the chemotherapeutic drug doxorubicin induces features of cellular senescence including cell cycle arrest, regulation of the tumor suppressor p53, resistance to apoptosis, secretion of various senescence-associated factors and positive beta-galactosidase staining. In addition, those senescent cells showed resistance to the treatment with cell-permeable peptide [Bcl-2/IP3R disruptor-2 [BIRD-2]] that targets the BH4 domain of BCL-2 potentiating pro-apoptotic calcium signaling in normal lymphoma cells. This suggests a calcium-dependent mechanism by which senescent cells resist apoptosis. We also revealed using Western blot analysis that senescent cells upregulate the antiapoptotic protein BCL-2. Inhibition of this protein using the small molecule ABT-737 specifically induced apoptosis in senescent cells. Reaching the conclusion that senescent cells can be eliminated pharmacologically paves the way towards new strategies to encounter cancer relapse due to chemoresistance

2.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 30
in English | IMEMR | ID: emr-206746

ABSTRACT

Background:Estrogen [ER] and progesterone [PR] are important factors in prognosis and treatment of breast cancer patients. Many studies suggest that disease free survival [DFS] differs when one of these receptors is positive and the other is negative. We aim to study the impact of positivity of estrogen receptors comparing with progesterone receptors on DFS in early breast cancer


Patients and Methods: Asingle institute retrospective study was performed of 224 patients with early breast cancer, stage I, II, IIIa, between 2008 and 2010. The patients underwent mastectomy or lumpectomy and received adjuvant hormone therapy. This study has two arms: Group A [patients with ER positive, PR negative n = 127]. Group B [patients with PR positive, ER negative n = 97]. The endpoint was 3-year disease free survival in both arms


Results: The 3-year disease free survival in the group A was 75.8 percent, while it was 77.2 percent in group B [p = 0.31]


Conclusion: There is no difference between the impact of estrogen receptors positivity and progesterone receptors positivity on disease free survival in the treatment of early breast cancer

3.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 31
in English | IMEMR | ID: emr-206747

ABSTRACT

Background: Dietary habits are established in childhood and are often maintained into adulthood [Thompson RA et al., 2005]. Early childhood is the perfect time to teach children good eating habits, especially in nurseries where they spent most of their time [Dosso JA et al., 2017]. Currently, the nutrients intake of many children does not meet the dietary guidelines [Pem D et al., 2015]. Overweight/obesity is common, and increases rapidly in early childhood. Thus, nutrition education and interventions are key to improve children's health; nursery educators being the main target [Al Mohtadi RM and Al Zboon HS, 2017]


Objective: This study aims to determine the effectiveness of a nutrition education intervention on nutrition status of children aged one to three years old and nutritional knowledge of nursery educators in private and public Lebanese nurseries


Design: 137 children were assessed at baseline. Fifty-six of them were included in the study. Pre and post surveys were conducted including a demographic questionnaire addressed to nurseries' directors and a nutritional standardized questionnaire addressed to nurseries' educators. The intervention consisted of nutrition education trainings, anthropometric measurements for children and nutrition activities program during the six-month Period


Results: Results indicated an improvement in the full intervention nursery versus the minimal intervention nurseries. The prevalence of overweight children was 44.6 Percent and 36.6Percent after intervention with an improvement of 8Percent. Post intervention, the percentage of stunted children remained the same in all nurseries; children in healthy range increased from 55.3Percent to 62.5Percent and the percentage of children in excessive range decreased by 4 Percent. The intervention made a significant impact on the nutrition knowledge [p value = 0.064], with a 6.13Percent improvement between pre and post results. Results demonstrated also a lack of conformity between the offered nutrient intakes and the recommended corresponding references. This non-compliance is due to a deficiency of recommended energy [770.05 Kcal vs. 1100 Kcal] and carbohydrates intake [101.86g vs. 130g], whereas proteins [14.0Percent] and fat [33Percent] intake appears to be consistent. The dietary patterns of children revealed a carbohydrate-based diet with very few consuming a variety of fruit and vegetables. Some changes were made in the dietary choices of the children after the intervention, with the inclusion of more fruits and vegetables and decreased intake of carbohydrate-rich food


Conclusion o Results analysis indicated a need to enhance nurseries educators' nutrition knowledge and to improve the quality and quantity of food provided to children. A typical menu and directed children activities might be a good additional approach to enhance nutrition and behavioral outcomes. Parent's involvement seems a good axis for future research

4.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 32-33
in English, French | IMEMR | ID: emr-206748

ABSTRACT

Early childhood is the perfect time to teach the child good eating habits, especially in nurseries through their educators and the offered menu. These nurseries should therefore ensure that their menus are varied and balanced. This study aims to analyze nutritionally the menus offered to children, from one to three years old in Lebanese nurseries located in Metn. For this purpose, a survey was made including a demographic standardized questionnaire addressed to nurseries heads, with another nutritional standardized questionnaire addressed to nurseries teachers and a checklist also standardized to locate the current nutritional status of nurseries. Among fifty-three visited nurseries, a sampling of thirty menus acquired was used for this analysis and the results demonstrated the lack of conformity between the offered nutrient intakes and the recommended American corresponding reference. This non-compliance is due to an excess of 28.2Percent of recommended energy intake, 23.6Percent and 51Percent respectively of carbohydrates and proteins, whereas only fat intake appears consistent. The iron intake exceeded recommendations by 39.3Percent, while zinc exceeded by 65Percent; only vitamin A intake was 46.2Percent below the recommended intake. Nurseries educators' nutritional knowledge was found to be insufficient. Accordingly, these results indicate the need to improve the quality and quantity of food provided to children in nurseries and the necessity for nurseries educators training and education in early childhood nutrition

5.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 34
in English, French | IMEMR | ID: emr-206749

ABSTRACT

During infancy, children spend most of their time in child care. The aim of our study is to evaluate the nutritional knowledge level of educators and to show that nutritional education initiated in the preschool age [0 to 3 years] helps to improve children's eating habits. For this purpose, a pilot study was conducted between July 15, 2015 and October 15, 2015, covering one nursery and five educators, in which interventions have allowed educators to learn the basics of child nutrition and strategies to improve eating behaviors of children. After analyzing the results, desirable changes in eating habits of the children were noticeable, for instance an 80Percent improvement in fruit consumption and 55Percent in vegetable consumption; similarly there was a 21Percent increase in the knowledge of educators. However, despite this nutritional intervention, 80Percent of children persist to prefer sweets and treats. Thus continuous nutrition education might be the solution to this problem

6.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 36
in English | IMEMR | ID: emr-206750

ABSTRACT

Background: Human epidermal growth factor receptor 2 [HER2] is a significant predictive factor for benefit from adjuvant Trastuzumab [HER2-targeted therapy] which is considered the standard treatment for patients with HER2+ early breast cancer [EBC] after completion of adjuvant chemotherapy. We aimed to determine whether the high level of HER2 positivity would influence the outcome of adjuvant Trastuzumab and the prognosis at diagnosis


Patients and Methods: A total of 157 patients with EBC [HER2 positive, lymph nodepositive, hormonal receptors negative] who received adjuvant chemotherapy and Trastuzumab [8 mg/kg intravenously as a loading dose followed by 6 mg/kg every 3 weeks for 6 months] at Albairouni University Hospital. This is a single institute study with two arms based on HER2 positivity ratio. Group A [HER2 FISH ratio 4; n = 66 patients]. The primary endpoint was 3-year disease free survival [DFS] in relation to HER2 FISH ratio


Results: The 3-year DFS in the group A was 75.8Percent, while it was 77.2Percent in the group B [p = 0.31]. Stages II and III in the group A were 32Percent and 68Percent respectively, while in the group B they were 27.27Percent and 72.72Percent respectively. Grades [I-II] and [III-IV] in group A were 60.4Percent and 39.6Percent respectively, while in group B they were 68.18Percent and 31.81Percent respectively. Differences were not statistically significant


Conclusion: The high degree of HER2 amplification [FISH ratio > 4 vs.

7.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 37
in English | IMEMR | ID: emr-206751

ABSTRACT

Background: Pregnancy-associated breast cancer [PABC] is defined as breast cancer diagnosed during pregnancy and within one year after delivery. PABC is a challenging and complex case for patients and their physicians. Pregnancy and lactation produce anatomical and physiological changes in breast tissue which make diagnosis of breast masses more difficult. Many studies conclude that PABC have more adverse prognosis than non-PABC. Our study aims to determine the prognostic factors in PABC then compare them with non-PABC


Methods: A retrospective case-control study at Albaironi University Hospital in Damascus. The study included 50 patients identified with PABC between 2005 and 2015. Then we selected 100 patients [2:1] identified as non-PABC between 2010 and 2015. The differences in clinical features and prognostic factors were compared between cases and controls


Results: Of the 50 PABC cases, breast cancer was diagnosed during pregnancy in 22 patients, and within one year after delivery in 28 patients. PABC cases were more likely than controls to be negative for estrogen receptor [41 Percent vs 14 Percent, p = 0.03] and negative for progesterone receptor [50 Percent vs 21 Percent, p = 0.04] and they were more likely than controls to be triple negative [21 Percent vs 5 Percent, p = 0.02]. Cases were also more likely to have advanced stage [p = 0.03], and were more likely to have a metastasis [M1] at diagnosis [27 Percent vs 8 Percent; p = 0.01]


Conclusion: Pregnancy-associated breast cancer is a clinically and biologically distinct entity. PABC is associated with more adverse tumor features and prognostic factors than non-PABC matched for age

8.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 38
in English | IMEMR | ID: emr-206752

ABSTRACT

Aims: Klatskin tumors arise at the bile duct confluence, and constitute the most common type of cholangiocarcinomas. We retrospectively studied a series of 23 patients operated for Bismuth Type III Klatskin tumors and investigated the relations between clinicopathological features, postoperative bile leak and overall survival at 1, 3 and 5 years


Methods: The hospital records were searched from 2006 till 2016 for operated Type III Klatskin tumors. All patients underwent resection of the hepatic ducts and regional lymphadenectomy, with a right hepatectomy for Type IIIa in 12 patients and left hepatectomy for Type IIIb in 11 patients


Results and Conclusion: 63.6 percent of patients with Type IIIb cholangiocarcinoma developed bile leakage postoperatively versus 25 percent of those with Type IIIa, a correlation to be further investigated. R0 resection was achieved in 91.3 percent of the cases. Two patients were lost to follow-up after 1 year due to traveling. Two patients died in the hospital due to intraoperative complications. Overall 1-year survival was 90 percent, 3-year survival 47.6 percent and 5-year survival 19 percent. The studied population included 10 females and 13 males. Interestingly, during the first two years, 50 percent of female patients died, versus 20 percent of male patients. After five years, the difference in survival between genders was no longer significant. Regarding the pathological features, 7 patients had positive lymph nodes and 14 patients had negative lymph nodes. During the first two years, 85.7 percent of those who had positive nodes died, versus 50 percent of those with negative nodes. An elevated PT INR level is associated with worse prognosis with statistical significance [p < 0.05]. Although our data analysis is not yet complete, we are currently working on developing it further to understand the correlation among the studied variables. Our sample size reflects the work of a single surgeon, in the same institution during a 10-year follow-up. Few of the variables might be interesting to further analyze and might add to the literature additional questions on what affects both bile leak and survival in Bismuth Type III Klatskin tumors exclusively

9.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 39-42
in English, French | IMEMR | ID: emr-206753

ABSTRACT

Background: Loco-regional renal cell carcinoma [RCC] accounts for 15 to 20 percent of patients with RCC, with a risk of post-surgical relapse of 40 percent [1,2]. Following the adoption of tyrosine kinase inhibitors [TKIs] as the first-line treatment of metastatic RCC, multiple studies evaluated Sunitinib [3,4] and Pazopanib [5] in the adjuvant setting of high-risk resected RCC. However, these studies have yielded inconclusive results, and there are currently no meta-analyses combining the results of all trials evaluating TKIs in the adjuvant setting of high-risk RCC. The aim was to perform a meta-analysis to evaluate and compare the possible benefit of Sunitinib and Pazopanib on diseasefree survival [DFS] in the adjuvant setting of high-risk RCC


Methods: This meta-analysis included all the phase 3 randomized controlled trials [ASSURE 3, S-TRAC 4 and PROTECT 5] evaluating Sunitinib and Pazopanib in the adjuvant setting of high-risk RCC. A random-effects model was preferentially used to pool the data using the inverse variance method and a subgroup analysis including Sunitinib and Pazopanib subgroups was used in order to account for heterogeneity and allow comparison of the two subgroups. Two variations of the same analysis were undertaken as sensitivity analyses : first with a fixed-effects model, second while excluding the results of the ASSURE study. The primary outcome was the comparison of disease-free survival [DFS] between TKIs and placebo. Hazard ratios were reported along with their 95 percent confidence intervals [95 percentCI]


Results: A total of 3447 patients from the three trials were included in the analysis. There was a tendency for a significant overall effect of both TKIs on DFS; however, this tendency only reached the threshold for statistical significance in the fixed-effects model [HR = 0.91; 95 percentCI = 0.83-0.99; p = 0.03] but not in the random-effects model [HR = 0.85; 95 percentCI = 0.72-1.01; p = 0.06, Figure 1]. Significant between-study overall heterogeneity was observed [p = 0.07; I2 = 58 percent] and the subgroup analysis showed that this was largely due to the heterogeneity within the Sunitinib subgroup [p = 0.05; I2 = 73 percent, Figure 1]. Moreover, a sensitivity analysis excluding the ASSURE study led to results which were markedly more homogeneous [p = 0.48; I2 = 0 percent]. While the test for overall effect was found to be significant in the Pazopanib subgroup [HR = 0.80; 95 percentCI = 0.65-0.98; p = 0.03] but not in the Sunitinib subgroup [HR = 0.90; 95 percentCI = 0.67-1.19; p = 0.45], there was no significant difference between the subgroup effects [p = 0.51; I2 =0 percent; Figure 1]


Conclusion: Our analysis showed that Pazopanib and Sunitinib could still have a potential role in the armamentarium of adjuvant treatment in high-risk RCC. However, it failed to demonstrate a significant difference between these agents in this setting

11.
12.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 45-46
in English, French | IMEMR | ID: emr-206756

ABSTRACT

Introduction: Anti-PD1 immunotherapies are drastically changing the current standard of care of metastatic cutaneous melanoma. However, about 60 percent of the treated patients do not respond to anti-PD1, and atypical radiological responses delays the detection of primary resistances. The objective of this study was to determine whether the quantitative monitoring of circulating tumor DNA [ctDNA] could early predict the tumor response to anti-PD1


Material and Methods: Fifty-two patients treated with anti-PD1 at Nantes University Hospital for metastatic cutaneous melanoma were selected on their BRAF and NRAS mutational status. Plasmas were collected at the initiation of the treatment, at 2 and 4 weeks of treatment, and then every 4 weeks until the progression. Circulating DNA was extracted from 2ml of plasma. To evaluate specifically the concentration of tumor circulating DNA [ctDNA] fraction, the somatic alterations detected in tissue were quantified by digital PCR [dPCR]


Results: ctDNA was detectable at initiation of treatment for 22/52 patients [42 percent]. Absence of detectable ctDNA prior to the treatment was associated with a favorable prognosis in overall survival. During the follow-up, we defined a biological response [bR] as a significant decrease in the amount of ctDNA relative to the baseline level [considering the precision of dPCR measurement] and biological progression [bP] as a significant increase in the amount of ctDNA relative to its nadir. The absence of biological response after 2 weeks of treatment was associated with a lack of clinical benefit of anti-PD1, with a response rate of 0 percent and PFS all inferior to 120 days [n = 10]. In contrast the detection of a bR at week 2 was associated with a response rate of 50 percent [n = 12]. For these patients, detection of bP at 4, 8 or 16 weeks of treatment was 100 percent predictive of a subsequent progressive disease [n = 6], on average 75 days prior its radiological detection. All patients with a persistent bR beyond the 16th week [n = 6] did not experience any progressive disease and continued sustained responses, with PFS of at least 306 to 755 days [ongoing]


Conclusion: The quantitative monitoring of ctDNA, taking into account the measurement precision of dPCR, allows a specific, sensitive and early detection of non-responsive patients to anti-PD1. We propose a simple and non-invasive test to improve the management and follow-up of patients treated with anti-PD1, for whom predictive markers are still limited

13.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 47
in English | IMEMR | ID: emr-206757

ABSTRACT

Background: Lapatinib is a dual tyrosine kinase inhibitor blocking human epidermal growth factor receptors [HER1, HER2]. Lapatinib in combination with Capecitabine has showed efficacy in HER2+ metastatic breast cancer [MBC] previously treated with Anthracycline, Taxane and Trastuzumab. This study is the first to evaluate the clinical benefit and safety of the combination of Lapatinib and Capecitabine in HER2+ MBC previously treated with Anthracycline, Taxane and Trastuzumab, treated at Albairouni Cancer Center


Patients and Methods: Patients with HER2+, hormonal receptors negative, locally advanced or metastatic breast cancer that had failed Anthracycline, a Taxane, and Trastuzumab were enrolled. Patients received [Lapatinib 1250 mg per day continuously plus Capecitabine 2000 mg/m2 on days 1 through 14 of a 21-day cycle]. Treatment was given until progression. The primary endpoint was the clinical benefit [complete response, partial response or stability] for at least 3 months


Results: In the 60 evaluable patients, clinical benefit rate was documented in 76 percent and 58.32 percent of the study population for 3 and 6 months, respectively. Progression beyond one year was seen in 15 patients [25 percent]. Interestingly, one patient achieved time to progression [TTP] > 24 months. Median TTP was 8.1 months [95 percent CI: 6.5-11.2]. The most clinical side effects were mild: nausea [40 percent], vomiting [20 percent], diarrhea [35 percent], hand-foot syndrome [41.7 percent], rash [15 percent] and fatigue [11.66 percent]


Conclusion: The combination of Lapatinib and Capecitabine demonstrated a broad clinical benefit with acceptable safety profile in pretreated HER2+ metastatic breast cancer with either visceral or brain metastases

14.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 48-49
in English, French | IMEMR | ID: emr-206758

ABSTRACT

Aim: The administration of total parenteral nutrition [TPN] in terminally ill cancer patients is aggressive with a relatively high risk of complications. In this paper, we investigated the use of TPN in Lebanese cancer patients at end of life. To our knowledge, this is the first study describing TPN administration to Middle Eastern patients with advanced cancer


Methods: We conducted this observational study at Hotel-Dieu de France University Hospital, Lebanon. Eligible cases included all cancer patients that died at our institution between the 1st of January and the 31st of December 2014. The patients and tumors characteristics as well as the management plan were retrieved from the hospital records


Results: Our study enrolled 129 cancer patients at end of life among which 39 percent had received TPN: 28 percent during the last 6 weeks and 34 percent during the last 3 months. The mean duration of TPN administration was 33 days [range: 1 to 211]. The mean duration between the end of TPN administration and death was 37 days [range: 0 to 315]. TPN administration correlated negatively to hyperlipidemia [OR = 0.33; 95 percent CI [0.12 - 0.87]] and to the presence of three cardiovascular risk factors [OR = 0.28; 95 percent CI [0.10 - 0.80]]. On the other hand, it correlated positively to gastrointestinal tumors [OR = 3.9; 95 percent CI [1.3 - 11.7]] and to imaging studies during the last month of life [OR = 3.4; 95 percent CI [1.3 - 9.0]]. In the multivariate analysis, only hyperlipidemia was found to be a significant determinant of the TPN administration [p = 0.010; ORa= 0.29 [0.11 - 0.74]


Conclusion: The prevalent use of TPN at end of life underlines a difficulty in adopting a palliative care approach in our population. This is truly applicable in Middle Eastern populations that seem to refuse a patient-centered supportive care approach

15.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 50-51
in English, French | IMEMR | ID: emr-206759

ABSTRACT

Introduction: Localized form of gastric cancer is currently treated, independently of genetic profiles, by surgical resection with perioperative chemotherapy, radiotherapy and/or targeted therapy. Next-generation sequencing (NGS) recently provided new information regarding gene mutations related to gastric cancer pathogenesis. This information can determine new therapeutic pathways to successfully treat gastric cancer depending on its molecular profiling. Ramucirumab is a humanized monoclonal antibody directed against vascular endothelial growth factor receptor 2. Ramucirumab is approved in second-line therapy for advanced or metastatic gastric cancer as a single agent or combined with chemotherapy in molecularly unselected patients. Some studies determined prognostic value of plasma biomarkers and cytokines in patients treated with Ramucirumab (RAINBOW trial). Other studies have shown no relationship between Ramucirumab therapy and VEGFR-2 mutation (REGARD trial). However, no studies have shown significant survival benefit for certain genetic profiles in patients treated with Ramucirumab therapy. The aim of this study is to assess the value of certain molecular profiles in predicting response to Ramucirumab therapy in advanced or metastatic gastric cancer


Methods: This is a retrospective study to determine molecular profiles for gastric cancer that predict outcomes of treatment with Ramucirumab. Patients' molecular profiling will be studied using NGS. Included patients are those with advanced or metastatic gastric cancer treated with second-line Ramucirumab therapy combined with Paclitaxel. Patient characteristics are collected retrospectively from medical records including tumor localization, size, stage, type of surgery, definitive histological subtype, number of lymph nodes resected. Type and response to first line chemotherapy as well as overall survival (OS) and disease free survival (DFS) are acquired for all patients


Results o Kaplan-Meier curves for DFS and OS will be compared between subjects with different somatic mutations using log-rank test. Multivariate Cox regression models for DFS and OS with mutated somatic genes as independent variables were computed. Any predictive factor for response to Ramucirumab, especially molecular, will be reported


Conclusion o Molecular characteristics of advanced gastric cancer patients will be analyzed to define any predictive value for response to Ramucirumab in second-line based therapy

16.
LMJ-Lebanese Medical Journal. 2019; 67 (suppl.): 52
in English | IMEMR | ID: emr-206760

ABSTRACT

Objective: To estimate the frequency of patients in Lebanon who report an impact of chemotherapy-induced nausea and vomiting [CINV] on their daily life and to evaluate the determinants of such impact, considering not only the prognostic factors related to the patient, disease and treatment, but also the intrinsic characteristics of the CINV, namely, the distinction between acute and delayed phase, and the intensity of nausea and vomiting


Methods: This prospective cross-sectional study, performed between January 2016 and December 2016, included 328 patients. The Functional Living Index - Emesis [FLIE] score was used to evaluate the impact of CINV on patients' daily lives and day-to-day functioning


Results: The results of the backward logistic regression taking the two-category FLIE score as dependent variable showed that current alcohol drinking would increase the odds of having a high FLIE score . 108 by more than 8 times [p = 0.047; ORa = 8.114], while having an anticipatory feeling of nausea/vomiting, number of acute vomiting episodes and the intensity of late nausea would significantly increase the odds of having a FLIE score < 108 by 98.6 percent, 48.4 percent and 29.6 percent respectively [p < 0.0001, ORa = 0.014; p < 0.0001, ORa = 0.516 and p = 0.006, ORa = 0.704]


Conclusion: Chemotherapy-induced nausea and vomiting are still affecting the quality of life[QOL] of oncology patients despite all treatment novelties. Astrong association between the number of vomiting episodes, the intensity of late nausea and the anticipatory feeling of nausea/vomiting and a decrease in the patient's QOL and comfort was found. This research was able to shed the light on the importance of well-controlling CINV to preserve the patient's QOL

17.
Weekly Epidemiological Monitor. 2019; 12 (27): 1
in English | IMEMR | ID: emr-206767

ABSTRACT

In June 2019, a master facilitator training workshop on One Health Zoonotic Disease Prioritization [OHZDP] was organized by FAO and US-CDC at the One Health office in Rome. It aimed to provide FAO and WHO staff from different regions the necessary knowledge and skills for training of national-level partners on OHZDP process

18.
Weekly Epidemiological Monitor. 2019; 12 (28): 1
in English | IMEMR | ID: emr-206768

ABSTRACT

As a part of the cholera preparedness and response plan in Somalia, the Federal Ministry of Health (FMOH) of Somalia secured 1.3 million doses of the Oral Chol-era Vaccine (OCV) aiming to vaccinate about 650,000 people aged 1 year and above in 6 districts. With the support of EPI/Polio team, the first round of OCV campaign was conducted from 22 to 28 June 2019

19.
Weekly Epidemiological Monitor. 2019; 12 (30): 1
in English | IMEMR | ID: emr-206769

ABSTRACT

Between 22 and 25 of July 2019, WHO Eastern Mediterranean regional Office (EMRO), with support of the US-CDC and Japan Government, has conducted a sub-regional training for national Rapid Response Teams (RRTs) for seven countries in the region on outbreak investigation of MERS and other emerging disease epidemics and clusters using the multi-hazards risk approach

20.
Weekly Epidemiological Monitor. 2019; 12 (31): 1
in English | IMEMR | ID: emr-206770

ABSTRACT

Pakistan, Afghanistan and Nigeria, continue to be the last three polioendemic countries globally. Since late 2018, Pakistan has experienced significant upsurge in confirmed cases of polio. Since then, and as of epi week 30 of 2019, the country had reported a total of 59 cases of confirmed polio

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