Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.069
Filtrar
1.
Int J Gynaecol Obstet ; 148(1): 14-20, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31596955

RESUMEN

Lebanon invested in the prevention of maternal mortality after the civil war, which left a deficient vital registration system leading to unreliable estimates of maternal mortality ratio (MMR). Starting in 2004, the Ministry of Public Health integrated reproductive health into primary health care and established a national notification system of maternal and neonatal deaths. From 1990 to 2013, Lebanon achieved an annual change in MMR of -7.5%, which was the highest rate of reduction in the region and met the requirements of Millennium Development Goal 5. For the period 2010-2018, data collected through the national notification system indicate an MMR of 14.9, which is below the officially reported MMR of 23. Since the influx of Syrian refugees, Lebanon has experienced a rise in the number of live births with a slightly increasing trend in MMR, especially in regions with the highest concentration of refugees. Causes of maternal mortality in Lebanon align with the three-delays model, pointing to deficiencies in the quality of maternity care. More efforts are needed toward strengthening the national notification system to include cases that occur outside hospitals, identifying near-miss cases, reinforcing the emergency response system, and engaging with all stakeholders to improve quality of care.


Asunto(s)
Mortalidad Materna , Femenino , Humanos , Líbano/epidemiología , Nacimiento Vivo/epidemiología , Embarazo , Refugiados/estadística & datos numéricos
2.
Hum Genet ; 138(11-12): 1323-1330, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31677132

RESUMEN

Phenotypic heterogeneity is often observed in patients with telomeropathies caused by pathogenic variants in telomere biology genes. However, the roles of recessive variants in these different phenotypes are not fully characterized. Our goal is to describe the biological roles of a novel homozygous RTEL1 variant identified in a consanguineous Lebanese family with unusual presentation of telomeropathies. A proband was screened for germline variants in telomere biology genes by whole exome sequencing. Leukocytes' telomere length was measured in the proband and eight relatives. We identified a novel homozygous p.E665K RTEL1 variant in the proband, his mother, and seven siblings that associated with telomere shortening and a broad spectrum of clinical manifestations, ranging from mild unspecific findings to severe phenotypes. Consanguinity in at least three family generations led to increased frequency of the homozygous p.E665K variant in the youngest generation and progressive telomere shortening. The increased frequency of the homozygous RTEL1 variant due to consanguinity in this Lebanese family allowed us to infer novel behaviors of recessive RTEL1 variants, as the expressivity and penetrance of this gene are very heterogenous between inter- and intra-generations. Progressive telomere shortening was associated with disease anticipation, first reported in recessive autosomal telomeropathies. Both genetic testing and telomere length measurement were critical for the clinical diagnosis of this family with telomere diseases marked by phenotypic heterogeneity.


Asunto(s)
Consanguinidad , ADN Helicasas/genética , Enfermedades Genéticas Congénitas/epidemiología , Homocigoto , Mutación , Telómero/genética , Adolescente , Adulto , Femenino , Enfermedades Genéticas Congénitas/genética , Humanos , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Linaje , Fenotipo , Adulto Joven
3.
Psychiatr Danub ; 31(4): 429-439, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31698399

RESUMEN

BACKGROUND: To the best of our knowledge, no studies have been conducted in order to assess the correlation of these factors with the self-esteem in Lebanon. Therefore, this study aims to assess risk factors associated with self- esteem among a representative sample of the Lebanese population. SUBJECTS AND METHODS: A cross-sectional, conducted between November 2017 and March 2018, enrolled 789 participants. Self-esteem was measured using the Rosenberg scale. An exploratory factor analysis was executed to detect patterns of risk factors associated with self-esteem from our sample. A cluster analysis was then performed with the identified factor scores to identify the different profiles of the participants. RESULTS: Relationship management (Beta=0.117), emotional awareness (Beta=0.074) and personal accomplishment (Beta=0.064) were associated with a higher self-esteem, whereas high depression (Beta=-0.102), alexithymia (Beta=-0.077), burnout depersonalization (Beta=-0.078), suicidal ideation (Beta=-0.391) were associated with a lower self-esteem. Factor 1 (High emotional intelligence & low depersonalization) (Beta=1.819) was associated with increased self-esteem, whereas Factor 2 (High suicidal ideation, high alcohol dependence, high depression and anxiety) and Factor 3 (High burnout, high stress and high alexithymia) were associated with decreased self-esteem (Beta=-1.380 and Beta=-0.751) respectively. Being widowed (Beta=-2.332), belonging to cluster 1 (People with emotional dysregulation) (Beta=-2.850) and cluster 2 (People in distress) (Beta=-3.660) were significantly associated with decreased self-esteem. CONCLUSIONS: Depression, anxiety, burnout, stress, low emotional intelligence, alexithymia, suicide ideation, alcohol dependence and many other factors can be prevented, or reduced, by interventions that improve self-esteem.


Asunto(s)
Autoimagen , Síntomas Afectivos/epidemiología , Ansiedad/epidemiología , Análisis por Conglomerados , Estudios Transversales , Depresión/epidemiología , Inteligencia Emocional , Humanos , Líbano/epidemiología , Factores de Riesgo , Ideación Suicida
4.
Infect Dis Obstet Gynecol ; 2019: 5016810, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31467477

RESUMEN

Objective: Candida species colonize the vagina in at least 20% of women, with rates rising to 30% during pregnancy. This study aimed at determining the prevalence and risk factors of vulvovaginal candidiasis (VVC) in pregnant women at 35-37 weeks of gestation. It also aims at finding possible correlations between VVC and vaginal colonization by other agents, such as Group B Streptococcus (GBS) and bacterial vaginosis. Methodology: Over a one-year period, high vaginal swabs were collected from pregnant women during their regular antenatal checkup in different polyclinics in Beirut and South Lebanon. Swabs were examined microscopically, cultured on Sabouraud Dextrose Agar, and Candida isolates were identified using Chromatic Candida medium and Germ Tube Test. Results: VVC was detected in 44.8% of samples, with C. glabrata (44.4%) and C. albicans (43.4%) being the most isolated species. Approximately, half of pregnant women (57.7%) were coinfected with Candida and bacterial vaginosis, while 26% of them carried simultaneously Candida spp. and GBS. No significant correlation was found between the occurrence of VVC and demographic, clinical, medical, and reproductive health characteristics of pregnant women. In contrast, participants with previous miscarriages and those being hospitalized during the past 12 months were more susceptible to develop vaginal C. krusei infection in comparison to other Candida species (p=0.0316 and p=0.0042, respectively). Conclusion: The prevalence of VVC in pregnant women is an increasing trend in our community. Therefore, routine medical examination and regular screening for candidiasis in the antenatal care program is highly recommended to manage the disease and its complications.


Asunto(s)
Candida/patogenicidad , Candidiasis Vulvovaginal/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , Adulto , Candida/clasificación , Femenino , Humanos , Líbano/epidemiología , Embarazo , Prevalencia , Factores de Riesgo , Vagina/microbiología , Adulto Joven
5.
Comp Immunol Microbiol Infect Dis ; 64: 109-116, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31174685

RESUMEN

Coxiella burnetii causes diseases in humans (Q fever) and animals, domestic ruminants playing a major role in the epidemiology of the infection. Information on C. burnetii infection in Lebanon is scanty. In order to assess the prevalence of C. burnetii infection in ruminants, a cross-sectional study was undertaken in 2014. A total of 1633 sera from ruminants (865 cattle, 384 sheep and 384 goats) from 429 farms (173 cattle, 128 sheep and 128 goats), in seven provinces of Lebanon were randomly selected and assayed for the presence of antibodies. 39.86% of farms (95% CI: 35.23-44.56) resulted positive. The seroprevalence was 30.63% in Cattle-farms, 46.88% in sheep-farms and 45.31% in goat-farms. Milk samples collected from 282 seropositive animals (86 cows, 93 sheep and 103 goats) from 171 positive farms were tested by a high sensitive Real-Time PCR targeted to the IS1111 transposon of C. burnetii. The overall prevalence in farms was estimated to be 14.04%. Cattle-, sheep- and goat farm prevalence rates were 15.09%, 10% and 17.24%, respectively. The findings of the study show that C. burnetii prevalence in Lebanese domestic ruminants is related to animal species and farming practices. Indeed, the mixed herds with sheep (p < 0.01), the presence of common lambing/kidding areas (p < 0.001) in farms where the use of disinfectants was not a routine practice (p < 0.05) were identified as important risk factors. The results of the study provide baseline information for setting up herd management and public health measures for the prevention and control of Q fever in Lebanon.


Asunto(s)
Anticuerpos Antibacterianos/sangre , Coxiella burnetii/aislamiento & purificación , Leche/microbiología , Fiebre Q/veterinaria , Rumiantes/microbiología , Animales , Proteínas Bacterianas/genética , Bovinos , Enfermedades de los Bovinos/epidemiología , Coxiella burnetii/genética , Estudios Transversales , Granjas , Enfermedades de las Cabras/epidemiología , Cabras , Líbano/epidemiología , Prevalencia , Fiebre Q/epidemiología , Reacción en Cadena en Tiempo Real de la Polimerasa , Factores de Riesgo , Estudios Seroepidemiológicos , Ovinos , Enfermedades de las Ovejas/epidemiología
6.
Medicine (Baltimore) ; 98(25): e15993, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31232932

RESUMEN

Organizing interfacility transfers is an essential component of regionalized care to improve patient outcomes. This study examines transfer characteristics after establishing a transfer center in a tertiary care center in Beirut Lebanon, and identifies predictors of success in patient transfers.This retrospective observational chart review examined all transfer center requests to and from the tertiary care center over a 4-year period (2013-2017). Descriptive analysis was done, followed by a bivariate analysis comparing transfers based on final decision (accepted yes/no) and by a multivariate logistic regression to identify predictors of successful transfers.A total of 4100 transfer requests were analyzed. Incoming transfer requests were more common than outgoing requests (56.5% vs 43.4%) and were mainly for adult patients (71.0% incoming and 78.7% outgoing). Reasons of transfers were mostly medical (99.4%) for incoming transfers and financial (73.1%) and medical (17.9%) for outgoing transfers. Requested level of care was most commonly intensive care unit for incoming transfers (61.6%) and regular floor for outgoing transfers (48.6%). Outgoing transfers were more successful than incoming transfers (59.9% vs 39.6%). Predictors of success in patient transfers within the healthcare system were identified: These included specific types of financial coverage, diagnoses, levels of care, and medical services for incoming transfers in addition to age groups and receiving hospital location for outgoing transfers.Transfer centers can be implemented successfully in any healthcare system to improve patient care and safety. Identifying facilitators and barriers to successful transfers can help healthcare administrators and policymakers address gaps in the system and improve access to care.


Asunto(s)
Servicios Médicos de Urgencia/normas , Seguridad del Paciente , Transferencia de Pacientes/normas , Centros de Atención Terciaria , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Servicios Médicos de Urgencia/economía , Servicios Médicos de Urgencia/estadística & datos numéricos , Femenino , Humanos , Lactante , Recién Nacido , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Cultura Organizacional , Transferencia de Pacientes/economía , Transferencia de Pacientes/estadística & datos numéricos , Mejoramiento de la Calidad , Estudios Retrospectivos , Adulto Joven
7.
BMC Ophthalmol ; 19(1): 137, 2019 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-31248388

RESUMEN

BACKGROUND: Uveitis in the pediatric population is uncommon, accounting for 2 to 14% of all uveitis cases, yet resulting in significant ocular morbidity. A number of studies have focused on patterns and complications of uveitis in the pediatric age group (≤ 16 years). In this report, we studied children with uveitis syndromes focusing on demographics, anatomic distribution, etiologies, treatment, and complications. We additionally divided subjects into two age groups to look into any differential characteristics pertaining to the younger age group and the role of amblyopia as a cause of visual loss. METHODS: Retrospective chart review of 80 eyes of 49 uveitis patients aged ≤16 years. Subjects were categorized by age of onset into visually immature (≤8 years) and visually mature group (> 8 years). Data compared between the two age groups included demographics, disease characteristics, visual outcomes and complications. RESULTS: Idiopathic uveitis was the most common diagnosis (51%). Anterior uveitis complications (posterior synechiae and band keratopathy) were more common in the younger group (p = 0.002 and p = 0.03 respectively) while posterior uveitis manifestations (vitreous haze and vasculitis) were more common in the older age group (p = 0.04 and p < 0.001 respectively). Amblyopia was the most common cause of vision loss in the visually immature versus cataract in the visually mature. CONCLUSION: Anterior uveitis and its complications were more common in visually immature group in our cohort. Amblyopia was identified as the main cause of visual loss in the younger population.


Asunto(s)
Ambliopía/etiología , Catarata/etiología , Enfermedades de la Córnea/etiología , Medición de Riesgo/métodos , Centros de Atención Terciaria/estadística & datos numéricos , Uveítis/epidemiología , Agudeza Visual , Distribución por Edad , Factores de Edad , Ambliopía/epidemiología , Catarata/epidemiología , Niño , Preescolar , Enfermedades de la Córnea/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Líbano/epidemiología , Masculino , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Uveítis/complicaciones , Uveítis/fisiopatología
8.
BMC Public Health ; 19(1): 769, 2019 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-31208379

RESUMEN

BACKGROUND: Studies exploring the association between weight and asthma are not conclusive. Both obesity and asthma have been increasing in Lebanon, their association is not yet documented. The aim of this study is to explore the effect of weight on asthma control in adults. METHODS: This is a cross-sectional study, involving all consecutive asthma patients presenting to the outpatient allergy clinic at the Hotel-Dieu de France (HDF) University Hospital between January 1, 2014 and December 30, 2016. Patients included were those who consented to fill the Asthma Control Test (ACT) after 3 months of therapy. BMI was reported at the same time of the questionnaire. RESULTS: A total of 183 records of diagnosed asthma cases in adults were included. Sixty-three (34.4%) were males and 120 (65.6%) females, with a mean age of 38.5 (SD = 14.3). Ninety patients (49.2%) were of normal weight, 65 (35.5%) overweight and 28 (15.3%) obese. Seventy-one percent had an ACT score ≤ 19, which corresponds to poor asthma control. Patients who were overweight or obese were more likely to have poor asthma control compared to patients who had a normal weight at the time of evaluation. CONCLUSION: In conclusion, our study showed a significant association between asthma control as assessed by the ACT and high BMI defining overweight or obesity. This is the first national study exploring the association between asthma and overweight/obesity in Lebanon. A larger study with sampling from different specialists' sites is needed to draw more conclusions about this association.


Asunto(s)
Asma/prevención & control , Obesidad/epidemiología , Sobrepeso/epidemiología , Adolescente , Adulto , Asma/epidemiología , Índice de Masa Corporal , Comorbilidad , Estudios Transversales , Femenino , Humanos , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
9.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artículo en Inglés | IBECS | ID: ibc-184678

RESUMEN

Background: Continuing education (CE) is an internationally recommended approach as a lifelong learning model for pharmacists, enabling them to maintain the necessary knowledge, skills and ethical attitudes so as to remain current and competent in their practice. Objectives: The objective of this study is to 1) describe factors associated with taking different types of CE courses among pharmacists in Lebanon, and 2) assess the correlation between types of CE activity and the attitude of Lebanese pharmacists (motivation and value) and their computer literacy. Methods: This is a cross-sectional observational study conducted between February and May 2017, using a random sample of Lebanese pharmacists from all districts of Lebanon. All pharmacists were eligible to participate; the sample consisted of those who agreed to complete the questionnaire. The questionnaire includes questions about computer literacy, motivation and value about CE, in addition to sociodemographic characteristics of pharmacists. Results: Out of the 750 questionnaires distributed, 628 (83.73%) were filled out and returned to be analyzed. The mean age of the participants was 39.04 (SD 10.57) years, 66.9% of them were females, and 41.1% of them had a bachelor degree in pharmacy and worked in Mount Lebanon. Among the 628 respondents, 567 (90.3%) have earned at least one CE credit. Of those, 5.4% took mainly online courses, 15.4% took mainly live courses and the remaining took both types of CE. Higher motivation (aOR=1.05; CI 0.994-1.109) and higher value (aOR=1.076; CI 0.968-1.197) were associated with higher odds of taking live CE courses. Higher motivation (aOR=1.07; 95%CI 0.994-1.152) was associated with higher odds of taking online CE courses. Higher motivation (aOR=1.059; 95%CI 1.006-1.114) and higher general confidence with computer use (aOR=1.058; 95%CI 1.012-1.106) were significantly associated with higher odds of taking both types of CE courses. Conclusions: A high percentage of Lebanese pharmacists enrolled in the CE system, mainly driven by motivation and value of CE, in addition to a higher general confidence in computer use. Further efforts should be exerted by the Lebanese Order of Pharmacists to motivate pharmacists and help them improve their computer literacy, which is expected to improve not only enrollment in CE activities, but also the completion of their CE requirements


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Farmacéuticos/estadística & datos numéricos , Disponibilidad de Medicamentos Vía Internet/estadística & datos numéricos , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Educación del Paciente como Asunto/estadística & datos numéricos , Líbano/epidemiología , Continuidad de la Atención al Paciente/estadística & datos numéricos , Actitud hacia los Computadores , Estudios Transversales , Encuestas de Atención de la Salud/estadística & datos numéricos
10.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artículo en Inglés | IBECS | ID: ibc-184679

RESUMEN

Background: Due to aging, along with its associated physiological changes, older adults are extremely vulnerable to be afflicted with multiple chronic conditions (multimorbidity). Accordingly, prescribing a large number of drugs to older adults would be inevitable. Resulted complex drug regimens can lead to prescribing of Potentially Inappropriate Medications (PIMs) with subsequent negative health and economic outcomes. Objectives: The main objective of this study is to investigate the prevalence and predictors of PIMs prescribing among Jordanian elderly outpatients, using the last updated version of the American Geriatrics Society (AGS) Beers Criteria (2015 version). Methods: A Unicenter, cross-sectional study were data was assessed using medical records of included study subjects conducted over three months period from beginning of October to the end of December 2016 at King Abdullah University Hospital, Al Ramtha, Jordan. Our study included patients aged 65 years or above who visited the outpatient clinics at King Abdullah University hospital (KAUH) and were prescribed at least one oral medication during the study period. PIMs were identified for these patients and further classified according to the 2015 AGS Beers Criteria. We measured the prevalence of PIMs prescribed among elderly outpatients in Jordan. Results: A total of 4622 eligible older adults were evaluated in this study, of whom 62.5% (n=2891) were found to have at least one PIM prescribed during the three months study period. 69% of identified PIMs were medications to be used with caution in elderly, 22% were medications to avoid in many or most older adults, 6.3% were medications to be avoided or have their dosage adjusted based on kidney function in older adults, 2.04% medications were to avoid in older adults with specific diseases/syndromes, and 1.6% were potentially clinically important non-anti-infective drug-drug interactions to be avoided in older adults. Female gender and polypharmacy were found to be significant predictors of PIMs use among elderly. Conclusions: Potentially Inappropriate Medication prescribing is common among Jordanian elderly outpatients. Female gender and polypharmacy are associated with more PIMs prescribing and so need further attention


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Prescripción Inadecuada/estadística & datos numéricos , Lista de Medicamentos Potencialmente Inapropiados/estadística & datos numéricos , Enfermedad Crónica/tratamiento farmacológico , Líbano/epidemiología , Afecciones Crónicas Múltiples/tratamiento farmacológico , Polifarmacia , Factores de Riesgo , Salud del Anciano
11.
PLoS One ; 14(5): e0216740, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31116760

RESUMEN

OBJECTIVE: There is an increase in Emergency Department (ED) utilization globally. Understanding what patients present to EDs with is important for resource allocation, training and staffing purposes. There is paucity of data pertaining to ED visit presentations in Lebanon. This study aims at describing the spectrum of diseases among adult patients who present to a tertiary care center in Lebanon, an upper-middle income country (UMIC). METHODS: A retrospective chart review of adult patients (age ≥ 19) presenting to a tertiary care hospital ED during 2010-2011 was completed. Common diagnoses in three categories (all adult visits, treat and release, admitted visits) were assessed. Diagnoses were classified according to the Clinical Classifications Software. Descriptive statistics were presented in tables as frequencies and percentages. RESULTS: During the study period, 32787 adults presented to the ED with 18.7% resulting in hospital admission. The most common diagnoses in ED patients were injuries and conditions due to external causes, abdominal pain, non-specific chest pain and intestinal infections. In the treat and release group, intestinal infections emerged in the common list for ages 19-44. Coronary atherosclerosis was common in admitted patients aged ≥45 years. Summer was the busiest season, with abdominal pain and intestinal infection being prominent diagnoses during that season. CONCLUSIONS: This study is the first to assess adult ED visits in a Lebanese setting. Our study suggests that patients in our population suffer from the double burden of both communicable and non-communicable disease, with coronary atherosclerosis common in admitted patients (≥ 45 years) and intestinal infections common in treat and release adult patients (19-44years), the latter condition peaking in summer and driving seasonal surges in ED visits.


Asunto(s)
Servicios Médicos de Urgencia/estadística & datos numéricos , Servicio de Urgencia en Hospital , Centros de Atención Terciaria , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/epidemiología , Enfermedades Transmisibles/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Centros de Atención Terciaria/estadística & datos numéricos , Heridas y Traumatismos/epidemiología , Adulto Joven
12.
Medicina (Kaunas) ; 55(6)2019 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-31141934

RESUMEN

Background and Objectives: Lung cancer (LC) is the most common cancer in the world. Developing countries in the Middle East and North Africa (MENA) region, including Lebanon, have witnessed a great increase in the incidence rates of this disease. The aim of our study is to investigate the incidence rates of lung cancer in Lebanon from 2005 to 2015 and to compare these rates to other countries from the MENA region and other regions of the world. Material and Methods: Lung cancer data for the years 2005-2015 were collected from the National Cancer Registry of Lebanon and stratified by gender and age group. Age-specific and age-standardized incidence rates were calculated and analyzed using joinpoint regression. Age-standardized incidence rates to the world population (ASR(w)) for other countries were obtained from two online databases. Results: Lung cancer ranked as the second most common cancer in Lebanon and accounted for 9.2% of all newly diagnosed cancers. Lung cancer ASR(w) showed a significantly increasing trend over the period studied for males and females. Lung cancer ASR(w) among males in Lebanon came second after Malta when compared to other MENA countries, but it was among the lowest when compared to non-MENA countries. For females, Lebanon ranked first when compared to other MENA countries but was among the lowest when compared to countries in other regions of the world. The lung cancer incidence rate increased with age in both sexes and 89.2% of patients were 50 years of age or older. Conclusion: Lebanon has the highest incidence of LC in females and the second highest for males in the MENA region. The lung cancer incidence rate is on the rise and older age groups are much more burdened by this disease than the young ones. Several risk factors, particularly smoking, play a role in increased LC incidence among the Lebanese population.


Asunto(s)
Neoplasias Pulmonares/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios Epidemiológicos , Femenino , Humanos , Incidencia , Líbano/epidemiología , Neoplasias Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Sistema de Registros/estadística & datos numéricos
13.
Poult Sci ; 98(11): 5883-5891, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31134283

RESUMEN

Campylobacter jejuni is recognized as the most common foodborne pathogen associated with human gastroenteritis worldwide. Broilers are frequently infected by the bacteria and are considered the main source of exposure to humans. However, despite its public health impact, no recent data are currently available in Lebanon about Campylobacter spp. in poultry and human population. Therefore, this study aimed to determine the prevalence and genetic diversity of Campylobacter spp. in 227 ceca and on 227 carcasses of broiler chickens collected in Lebanese slaughterhouses. Overall, the prevalence of Campylobacter was shown to reach 67.0% in ceca and 17.2% on carcasses of Lebanese poultry. The only 2 Campylobacter species identified were C. jejuni and C. coli, with a slightly higher prevalence of C. coli in ceca and of C. jejuni on carcasses. A high level of genetic diversity was reported among the 51 C. jejuni isolates selected, since 25 distinct profiles were identified according to the comparative genomic fingerprinting typing method based on a subset of 40 genes using the 90% similarity threshold. Predominant clusters observed in Lebanese poultry isolates were also frequently found among French human clinical cases, highlighting that broiler chickens represent a potential reservoir for human campylobacteriosis. In addition, a significantly higher prevalence of Campylobacter spp. was found in slaughterhouse workers than in a cohort of hospitalized patients with no contact with poultry, confirming that contaminated broiler chickens in slaughterhouse appeared to be a non-negligible source of Campylobacter spp. transmission. Interestingly, a significant association between Campylobacter spp. and Blastocystis sp. has been observed. This correlation suggested that the presence of Campylobacter spp. would be favored when Blastocystis sp. is present and, similarly, the absence of one would favor the absence of the other. This is the first large-scale investigation focusing on the impact of Campylobacter spp. in broiler chickens in Lebanon and confirmed the need to implement prevention and control measures in the poultry production to reduce the burden of campylobacteriosis in the human population.


Asunto(s)
Infecciones por Blastocystis/veterinaria , Blastocystis/aislamiento & purificación , Infecciones por Campylobacter/veterinaria , Campylobacter/genética , Pollos , Variación Genética , Enfermedades de las Aves de Corral/epidemiología , Animales , Infecciones por Blastocystis/epidemiología , Infecciones por Blastocystis/parasitología , Campylobacter/aislamiento & purificación , Infecciones por Campylobacter/epidemiología , Infecciones por Campylobacter/microbiología , Líbano/epidemiología , Enfermedades de las Aves de Corral/microbiología , Enfermedades de las Aves de Corral/parasitología , Prevalencia
14.
Asian J Psychiatr ; 42: 42-47, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30951932

RESUMEN

Mental health problems are common in Lebanon, and so are psychiatric emergencies. In order to show the characteristics of psychiatric emergencies in Lebanon along with their dispositional determinants, we conducted this retrospective, single-center, chart-review study of patients who presented to the Emergency Department between July 1, 2016 until December 31, 2016 and required an official psychiatrist consultation. Our sample included 195 patients of all age groups. The most common diagnosis was depression (75 patients) followed by anxiety (61 patients). 107 patients (54.8%) required admission for adequate treatment; however only 72 (67.3%) of those were actually admitted, and the rest (32.7%) left the hospital against medical advice. Increased hospital admission was associated with being a female (OR = 3.042), having family history of psychiatric disease (OR = 2.040) and having suicidal ideations (OR = 12.949). In a country that has inadequate health coverage, financial coverage can also be a determining factor in whether or not patients get the admission they need.


Asunto(s)
Susceptibilidad a Enfermedades/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Trastornos Mentales , Admisión del Paciente/estadística & datos numéricos , Ideación Suicida , Adolescente , Adulto , Trastornos de Ansiedad/economía , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/terapia , Trastorno Depresivo/economía , Trastorno Depresivo/epidemiología , Trastorno Depresivo/terapia , Susceptibilidad a Enfermedades/terapia , Servicio de Urgencia en Hospital/economía , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Cobertura del Seguro/economía , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/economía , Seguro de Salud/estadística & datos numéricos , Líbano/epidemiología , Masculino , Trastornos Mentales/economía , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Persona de Mediana Edad , Admisión del Paciente/economía , Estudios Retrospectivos , Adulto Joven
15.
Medicine (Baltimore) ; 98(16): e14906, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31008922

RESUMEN

With increasing rates of device implantation, there is an increased recognition of device infection. We conducted a retrospective observational study in a tertiary care center in Lebanon, with data collected from medical records of patients presenting with cardiac implantable electronic device (CIED) infection from 2000 to 2017 with the purpose of identifying etiologies, risk factors and other parameters, and comparing them to available data from the rest of the world. We identified a total of 22 CIED infections. The most common microbial etiologies, including involvement in polymicrobial infection, were coagulase-negative staphylococci (45.5%) and Staphylococcus aureus (22.7%). Rare cases of Brucella melitensis, Sphingomonas paucimobilis, and Kytococcus schroeteri device infection were seen. Heart failure was seen in 77.3% of patients, hypertension in 68.2%, and chronic kidney disease in 50%. Skin changes were the most common presenting symptoms (86.4%). Antibiotics were given to all patients and all had their devices removed, with 36.4% undergoing new device implantation. This is the first study of CIED infections in Lebanon and the Middle East. Local epidemiology and occupational exposure must be considered while contemplating the microbial etiology of infection. Close monitoring after device implantation is important in preventing device infection that carries high risk of morbidity and mortality.


Asunto(s)
Desfibriladores Implantables , Marcapaso Artificial , Infecciones Relacionadas con Prótesis/epidemiología , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Líbano/epidemiología , Masculino , Registros Médicos , Persona de Mediana Edad , Infecciones Relacionadas con Prótesis/microbiología , Estudios Retrospectivos , Factores de Riesgo , Infecciones Estafilocócicas/microbiología , Adulto Joven
16.
Asian J Psychiatr ; 42: 85-86, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30978558

RESUMEN

Suicide rates have been suspected to increase in Lebanon during the last couple of years. While these rates might be increasing due to an increase in the probability of declaring suicide, it seems important to study why suicide, as a phenomenon, might be possibly increasing in the Lebanese society. One of the most important reasons behind this rise in suicide rates could be related to the economical crisis that has been striking the country for more than two years.


Asunto(s)
Economía , Factores Socioeconómicos , Estrés Psicológico/epidemiología , Suicidio/estadística & datos numéricos , Adulto , Humanos , Líbano/epidemiología , Suicidio/tendencias
17.
Int J Dermatol ; 58(7): 834-843, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30968403

RESUMEN

BACKGROUND: Cutaneous leishmaniasis (CL) remains a prioritized neglected tropical disease. CL novel presentations call for updating its features. METHODS: A multiregional cohort of 396 patients with confirmed CL was reviewed. Lesion's clinical stage and eruption type were assigned. Disease was considered as extensive if numerous (≥5), large (>3 cm), disfiguring, threatening vital sensory organs, and/or older than 12 months. Microscopically, Ackerman's inflammatory pattern, Ridley's pattern (RP), and parasitic index (PI) were recorded. Microscopic variables pertaining to the organisms, epidermis, and host's inflammatory response were also assessed. All cases were confirmed and speciated molecularly. RESULTS: In our region, 71.8% of cases showed extensive disease with 15.7% exceeding 12 months duration. Leishmania tropica accounted for 91.3% of cases while Leishmania major constituted 8.7% and presented solely as dry lesions. The dominant inflammatory composite consisted of plasma cells, lymphocytes, and histiocytes. Granulomatous inflammation was present in 55.5%. Most cases showed interface changes (72.7%), spongiosis (75.3%), and marked epidermal hyperplasia (63.9%). Transepidermal elimination of organisms was present in 29.2% of cases. None of traditional classification patterns (clinical stage, microscopic pattern, and RP) showed the predicted linear correlation with lesion age. High and low PI levels correlated with early and healing microscopic patterns, respectively, but did not correlate with the corresponding RPs. PI was bimodal with peaks at 3-6 and 9-12 months. CONCLUSION: Cutaneous leishmaniasis is an evolving disease defying the traditional prediction classifications. Our study sets the ground for adopting updated clinical courses, microscopic presentation, and species mapping.


Asunto(s)
Carga Global de Enfermedades/tendencias , Leishmania major/aislamiento & purificación , Leishmania tropica/aislamiento & purificación , Leishmaniasis Cutánea/epidemiología , Enfermedades Desatendidas/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Líbano/epidemiología , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/parasitología , Masculino , Persona de Mediana Edad , Enfermedades Desatendidas/diagnóstico , Enfermedades Desatendidas/parasitología , Pakistán/epidemiología , Estudios Retrospectivos , Arabia Saudita/epidemiología , Piel/citología , Piel/parasitología , Piel/patología , Siria/epidemiología , Adulto Joven
18.
Psychiatry Res ; 275: 338-344, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30954844

RESUMEN

Suicide and self-harm in young people is a global public health issue, although epidemiological evidence remains scant in many parts of the world. The aims of the present study are to describe the prevalence, comorbidity patterns, and the clinical and demographic correlates of suicidality among a representative sample of adolescents from Beirut, Lebanon. We recruited 510 adolescents aged 11-17 and one of their parents/legal guardians using a multistage random cluster design. The validated Arabic version of the Development and Well-Being Assessment (DAWBA) was administered independently to the parent/legal guardian, and adolescents, who also self-completed the Strengths and Difficulties Questionnaire (SDQ), and the Peer-Relations Questionnaire (PRQ). The parent/legal guardian also completed the SDQ and provided demographic and clinical information. A total of 22 adolescents (4.3%) have experienced suicidal ideation or attempt. Correlates of suicidality were female gender, alcohol use in the past 4 weeks, lifetime exposure to a stressful life event, suffering from a major depressive disorder and having bipolar disorder within the last 4 weeks. Only 1 suicidal participant reported ever seeking professional mental health help. Our findings highlight an alarming treatment gap in Lebanese adolescents experiencing suicidality. Future studies should aim at investigating barriers to care and at developing community-based interventions to improve access to care.


Asunto(s)
Trastorno Bipolar/epidemiología , Trastorno Depresivo Mayor/epidemiología , Utilización de Instalaciones y Servicios/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Adolescente , Trastorno Bipolar/psicología , Niño , Análisis por Conglomerados , Comorbilidad , Trastorno Depresivo Mayor/psicología , Femenino , Humanos , Líbano/epidemiología , Masculino , Prevalencia , Factores de Riesgo , Ideación Suicida , Suicidio/psicología , Encuestas y Cuestionarios
19.
BMC Urol ; 19(1): 16, 2019 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-30836962

RESUMEN

BACKGROUND: No accurate evaluation of smoking and water pollution on bladder cancer has been conducted in the Lebanese population. Our aim is to examine the significance of smoking and one of the main water pollutants Trihalomethanes (THM) on bladder cancer risk. METHODS: Population Attributable Fraction (PAF) was used to quantify the contribution of the risk factors smoking and THMs on bladder cancer in Lebanon. To calculate PAF for each risk factor, we used the proportion of the population exposed and the relative risk for each risk factor. Relative risks for each risk factor were obtained from published meta-analyses. The population at risk values were obtained from a report on chronic disease risk factor surveillance in Lebanon which was conducted by the World Health Organization between 2008 and 2009 and a national study by Semerjian et al. that conducted a multipathway exposure assessment of selected public drinking waters of Lebanon for the risk factors smoking and THMs, respectively. RESULTS: Bladder cancer cases that were the result of smoking in Lebanon among males and females are 33.4 and 18.6%, respectively. Cases attributed to mid-term exposure to THM contamination of drinking water is estimated at 8.6%. CONCLUSION: This paper further highlights the negative impact of smoking on bladder cancer risk and adds an overlooked and often underestimated risk that THMs have on this type of cancer. Thus, it is imperative that a national based study which assesses THM exposure by gender and smoking status be implemented to determine the real risk behind this byproduct.


Asunto(s)
Agua Potable/efectos adversos , Fumar/efectos adversos , Fumar/epidemiología , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/epidemiología , Contaminación Química del Agua/efectos adversos , Adulto , Femenino , Humanos , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Trihalometanos/efectos adversos , Neoplasias de la Vejiga Urinaria/etiología
20.
J Fr Ophtalmol ; 42(3): 288-294, 2019 Mar.
Artículo en Francés | MEDLINE | ID: mdl-30857804

RESUMEN

INTRODUCTION: Diabetic retinopathy (DR) is a leading cause of blindness worldwide. Non-mydriatic fundus photography (NMFP) has been adopted as a screening tool for this disease. We aim to determine the prevalence of DR through this method in Lebanese diabetic patients and to evaluate the impact of such screening in this population. MATERIALS AND METHODS: This study explores data from an awareness and screening campaign conducted in Lebanon. Diabetic patients from multiple regions were referred by their endocrinologists to undergo NMFP using the Optomed SmartScope® handheld fundus camera. Photographs were interpreted by a remote observer, and recommendations were given accordingly. The prevalence of DR was calculated, and statistical analyses were performed on the clinical characteristics, fundus findings and number of referrals to ophthalmologists. RESULTS: The campaign lasted 11 months, during which 2205 patients were examined in 37 screening locations. Out of the 97.41% of patients with type 2 diabetes mellitus, 12.56% had signs of DR, with no significant difference between the regions. 6.28% of the photos were uninterpretable. Positive results were associated with a longer duration of diabetes (P<0.01), treatment with insulin (P<0.01), as well as the presence and chronicity of systemic hypertension (P=0.01). 25% of patients with positive testing were retrospectively asked about their follow-up; only one third had an ophthalmologic examination as per the recommendation, among whom 68.18% underwent treatment for proliferative DR and/or diabetic macular edema. CONCLUSION: Tele-ophthalmology is useful in mass screening for DR. The importance of dilated fundus examinations still needs to be highlighted for diabetic patients, and better collaboration between endocrinologists and ophthalmologists is required to improve screening outcomes.


Asunto(s)
Retinopatía Diabética/diagnóstico , Técnicas de Diagnóstico Oftalmológico , Fondo de Ojo , Tamizaje Masivo/métodos , Fotograbar/métodos , Adulto , Anciano , Anciano de 80 o más Años , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/patología , Retinopatía Diabética/epidemiología , Femenino , Humanos , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud/normas , Examen Físico , Prevalencia , Evaluación de Programas y Proyectos de Salud , Estudios Retrospectivos , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA