Complicaciones de las prótesis de hombro: valor añadido de la imagen SPECT/TC / Complications of shoulder arthroplasty: added value of SPECT/CT imaging

El número de implantes protésicos de hombro se ha incrementado considerablemente en los últimos años, con el consiguiente aumento de las complicaciones derivadas de dicho procedimiento. El diagnóstico correcto de cada tipo de complicación es esencial para la toma de decisiones terapéuticas, y se basa actualmente en la información aportada tanto por las técnicas de radiodiagnóstico como de medicina nuclear. No obstante, ambos métodos diagnósticos presentan unas limitaciones intrínsecas que pueden ser superadas en gran medida con la incorporación de la imagen SPECT/TC, la cual está llamada a desempeñar un papel fundamental en la valoración de las prótesis de hombro

The incidence of prosthetic shoulder replacements has increased considerably in recent years, as well as the complications derived from the procedure. The correct diagnosis of each type of complication is essential for therapeutic decision making, which is currently based on the information provided by radiological and nuclear medicine imaging. Nevertheless, both techniques have intrinsic limitations that could be mostly overcome with the advent of the hybrid SPECT/CT imaging, which is set to play a fundamental role in the evaluation of shoulder prostheses

Complications of shoulder arthroplasty: added value of SPECT/CT imaging. / Complicaciones de las prótesis de hombro: valor añadido de la imagen SPECT/TC.

The incidence of prosthetic shoulder replacements has increased considerably in recent years, as well as the complications derived from the procedure. The correct diagnosis of each type of complication is essential for therapeutic decision making, which is currently based on the information provided by radiological and nuclear medicine imaging. Nevertheless, both techniques have intrinsic limitations that could be mostly overcome with the advent of the hybrid SPECT/CT imaging, which is set to play a fundamental role in the evaluation of shoulder prostheses.

First Lebanese Antibiotic Awareness Week campaign: knowledge, attitudes and practices towards antibiotics.

Antibiotic resistance (ABR) is a major global health threat that increases the risk of treatment failure and increases medical costs. One of the most common factors contributing to the spread of ABR is self-medication. The public, as well as workers in clinical and veterinary sectors, commit false practices towards appropriate antibiotic use, favouring the spread of resistance. As such, the first Lebanese Antibiotic Awareness Week campaign was initiated with a human-centred and interactive approach. The data showed a strikingly low level of antibiotic awareness. Cooperation between relevant stakeholders, policy-makers and health actors is crucial to control and overcome the problem of ABR.

ATTITUDES TOWARDS AND PRACTICE OF SEXUALITY AMONG UNIVERSITY STUDENTS IN LEBANON.

Sexuality is still a taboo in Middle Eastern countries, and Lebanon is no exception. This study's objective was to evaluate attitudes towards sexuality and its practice among university students in Lebanon and assess their respective correlates. The cross-sectional study was carried out among students selected from seventeen universities across Lebanon. The participants received a self-administered standardized questionnaire that assessed their attitudes towards sexuality. It included questions on socio-demographic factors, risk-taking, risky behaviours and sexuality-related questions. Among 3384 students, 2700 (79.8%) answered the questions on sexuality. Around 15% had engaged in sexual activity, while 20% were regularly sexually active. Among males, 34.8% had never had sexual activity, 29.9% had tried it and 35.3% were regularly sexually active. Among females the results were respectively 85.1%, 5.3% and 9.6% (p<0.001). Only 36% regularly used condoms during their relationships. A liberal attitude towards sex, male sex, motives for risky behaviours, current cigarette smoking and problematic alcohol consumption were associated with sexual activity. Realizing that risky behaviours are dangerous, health concerns related to sexual relationships and a liberal attitude towards sex were associated with regular condom use. However, being bothered by condoms and female sex were inversely associated with condom use. Finally, participants who had motives for, and those who felt excited about risky behaviours, and those reporting current cigarette and waterpipe smoking and problematic alcohol consumption (ß=0.600; p=0.002) embraced a more liberal attitude towards sex. Conversely, females (ß=-7.58; p<0.001) and individuals who considered risky behaviours as dangerous reported an unfavourable attitude towards sexuality. A substantial proportion of Lebanese university students have regular sexual activity, but a low percentage use condoms for protection. Interventions are required among males in particular in view of these attitude and behavioural changes towards sexuality.

Risk perception, motives and behaviours in university students.

Risky behaviours among young people are relatively frequent, with several motives and attitudes lying behind. Our objective was to evaluate the role of risk perception, attractiveness and motives for risk behaviour taking among university students in Lebanon. A cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in public and private universities. Items of risk intake and perception scale, attractiveness of risky behaviours, and motives for risky behaviours were assessed, in addition to cigarette and waterpipe smoking and dependence, alcohol problematic consumption and mental distress scale. After verifying the validity of scales and reliability in the university students' population, we found that risk perception was associated with lower risk intake, while risk attractiveness was a driver for it. Moreover, motives differed in their driving of risky behaviour, a particular point was that women indicated more goal achievement objectives, the latter concept was associated with lower risk taking. University students in Lebanon, women in particular, demonstrated wiser behaviour and may benefit from heath education programme to increase their awareness about risky behaviours. Identifying other personal, environmental, social and psychological predictors may also be important to improve effectiveness of these programmes.

Waterpipe dependence in university students and effect of normative beliefs: a cross-sectional study.

OBJECTIVES: The objective of this study was to measure the correlates, including normative beliefs, associated with waterpipe (WP) and cigarette smoking prevalence and dependence. SETTING: A cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in 17 public and private universities. PARTICIPANTS: Of the 4900 distributed questionnaires, 3384 (69.1%) were returned to the field worker. All available students during break times were approached, with no exclusion criteria. PRIMARY AND SECONDARY OUTCOME MEASURES: sociodemographic variables, detailed active and passive smoking, in addition to items of the tobacco dependence scales were all evaluated. RESULTS: Correlates to WP smoking were studying in a private university (adjusted OR, aOR=1.50 (1.26 to 1.79); p<0.001) and ever smoking cigarettes (aOR=1.80(1.44 to 2.26); p<0.001); friends' and societal influence were found on smoking behaviour and dependence. Although the role of parents was not visible in decreasing the risk of smoking WP, their protective influence seemed more important on WP dependence (ß=-1.09(-1.79 to -0.28); p<0.001), a behaviour that is considered more deleterious for health. Parents' and friends' disagreement with smoking had a protective effect on cigarette smoking and dependence (aOR<1; p<0.01), while thinking that idols and successful people smoke increased the risk of both cigarette smoking and dependence (aOR>1; p<0.01). CONCLUSIONS: In conclusion, WP smoking and dependence are influenced by parents' and friends' opinions, and idols' smoking status. Future research is necessary to further improve our understanding of motives for WP smoking and dependence.

[Light-induced amaurosis fugax]. / Amaurosis fugax inducida por la luz intensa.

INTRODUCTION: Internal carotid artery atherosclerotic disease may present with a wide variety of ipsilateral ocular symptoms and signs that can herald a devastating stroke. Asymptomatic retinal emboli, transient monocular visual loss (also known as amaurosis fugax) and central retinal artery occlusion are the most common. CLINICAL CASE: A 66-year-old man presented several spells of monocular light-induced amaurosis fugax related to a severe carotid occlusive disease. Ancillary tests showed an exhausted cerebrovascular reactivity and visual evoked potentials demonstrated an increased latency. Following a carotid endarterectomy the patient remained asymptomatic and ancillary tests normalized. DISCUSSION: Our report supports the theory that light-induced amaurosis fugax occurs on a hemodynamic basis. A prompt recognition of this symptom is critical since symptomatic severe carotid stenosis implies a high risk of ipsilateral stroke.

Amaurosis fugax inducida por la luz intensa / Light-induced amaurosis fugax

Introducción. La enfermedad arterioesclerótica de la arteria carótida interna puede dar lugar a una gran variedad de síntomas y signos oculares ipsolaterales que pueden preceder a un ictus devastador. La emolización retiniana asintomática, la amaurosis fugax y la oclusión de la arteria central de la retina son las manifestaciones oculares más frecuentes. Caso clínico. Un paciente de 66 años experimentó repetidos episodios de amaurosis fugax inducida por la luz intensa en el contexto de una estenosis carotídea ipsilateral severa. Las pruebas complementarias mostraron una agotamiento de la reserva hemodinámica cerebral y un retraso de los potenciales evocados visuales en ese ojo. Tras la endarterectomía carotídea el pacient no experimentó nuevos episodios de amaurosis y las pruebas complementarias se normalizaron. Conclusiones. Nuestro caso apoya la teoría de que el fenómeno de amaurosis fugax inducida por la luz intensa tiene un origen más hemodinámico que embólico. La identificación precoz de este síntoma es crucial dado el alto riesgo de ictus que supone la estenosis carotídea sintomática severa

Introduction. Internal carotid artery atherosclerotic disease may present with a wide variety of ipsilateral ocular symptoms and signs that can herald a devasting stroke. Asymptomatic retinal emboli, transient monocular visual loss (also known as amaurosis fugax) and central retinal artery occlusion are the most common. Clinical case. A 66-years-old man presented several spells of monocular carotid occlusive amaurosis fugax related to severe carotid occlusive disease. Ancillary tests showed an exhausted cerebrovascular reactivity and visual evoked potentials demonstrated an increased latency. Following a carotid endarterectomy the patient remained asymptomatic and ancillary tests normalized. Discussion. Our report supports the theory that light-induced amaurosis fugax occurs on a hemodynamic basis. A prompt recognition of this symptom is critical since symptomatic severe carotid stenosis implies a high risk of ipsilateral stroke

[Preoperative serum levels of the carcinoembryonic antigen (CEA) and prognosis in colorectal cancer]. / Niveles séricos preoperatorios del CEA y pronóstico en el cáncer colorrectal.

OBJECTIVE: To analyze the prognostic value of the preoperative serum levels of the carcinoembryonic antigen (CEA) in primary colorectal carcinoma. MATERIAL AND METHODS: Preoperative serum levels of CEA were analyzed in 275 colorectal cancer patients, who were followed up for a minimum of 5 years, or until death. RESULTS: The percentage of positivities for the preoperative serum levels of CEA (> 6 ng/ml) was positively and significantly associated with the tumoral stage (A: 10,5%; B: 38,8%; C: 32,2%; y D: 72%; p < 0,0001). In addition, the elevated serum values of the antigen were significantly associated, in the univariate analysis, with short survival in the overall group of patients (p < 0,0001). However, the multivariate analysis only showed an independent prognosis value of the CEA in the subgroup of patients with stage C tumors. CONCLUSIONS: Preoperative serum levels of CEA may be useful to predict tumoral extension, and also for the prognosis regarding stage C colorectal cancer patients.