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1.
East Mediterr Health J ; 26(2): 182-188, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32141596

RESUMO

Background: Diabetes mellitus in all its forms has been rapidly increasing worldwide, especially in the Eastern Mediterranean Region. Aims: This national study aimed to assess the prevalence and clinical aspects of diabetes mellitus in Lebanon with special focus on type 1 (T1DM). Methods: A national multistage, random household sample survey was conducted, using face-to-face interviews with 1 questionnaire per household. A total of 4500 households were selected from all areas based on a pre-existing sampling frame of the Lebanese population. Results: The prevalence of previously diagnosed diabetes mellitus in the surveyed population of 17 832 persons (mean age ~36 years) was 7.95%. The prevalence of T1DM in particular was estimated at 0.1%, or almost 1% of all detected cases of diabetes mellitus. Most persons with diabetes mellitus reported obtaining their usual care from endocrinologists rather than primary healthcare physicians. Delayed performance of haemoglobin A1c test was reported in 25% of 1418 patients. Hypoglycaemic episodes recently occurred in 30% of patients; of whom, at least one third required medical attention, including hospital admission. Diagnosed complications were reported in 22% of cases, with retinopathy being the most common. Conclusions: Prevalence of T1DM in this population was lower than international estimates. Diabetes mellitus management appears to be deficient, based on delays in standard control testing, hypoglycaemic episodes and diabetes mellitus-related complications. Coordination of diabetic care management should be devolved to primary healthcare physicians, who can keep track of the need for referral to various types of diabetes mellitus care.


Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus/epidemiologia , Gerenciamento Clínico , Adulto , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus/terapia , Diabetes Mellitus Tipo 1/terapia , Feminino , Humanos , Líbano/epidemiologia , Masculino , Prevalência , Inquéritos e Questionários
2.
Vasc Health Risk Manag ; 16: 53-56, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32021228

RESUMO

Introduction: Factor V Leiden (G1691A), prothrombin (G20210A) and MTHFR (C677T) gene mutations were investigated in many studies for their association with Deep Venous Thrombosis. Case Presentation: A North Lebanese family has been examined, from an index case, a 40-year-old woman, who had a history of venous thrombosis with unexplained recurrent miscarriage. The index case was found to be heterozygous for factor V Leiden G1691A, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T gene variants. Her family members were heterozygous for at least two of the three-point mutations, and multiple risk factors associated with thrombophilia were identified. Conclusion: Our findings emphasize the need for clarifying the utility and futility of thrombophilia testing in the era of molecular diagnostics.


Assuntos
Aborto Habitual/etiologia , Resistência à Proteína C Ativada/genética , Coagulação Sanguínea/genética , Fator V/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Mutação , Protrombina/genética , Trombofilia/genética , Trombose Venosa/etiologia , Aborto Habitual/sangue , Aborto Habitual/diagnóstico , Resistência à Proteína C Ativada/sangue , Resistência à Proteína C Ativada/complicações , Resistência à Proteína C Ativada/diagnóstico , Adulto , Feminino , Predisposição Genética para Doença , Hereditariedade , Humanos , Líbano , Linhagem , Fenótipo , Gravidez , Fatores de Risco , Trombofilia/sangue , Trombofilia/complicações , Trombofilia/diagnóstico , Trombose Venosa/sangue , Trombose Venosa/diagnóstico
3.
Medicine (Baltimore) ; 99(6): e19021, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028412

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has a significant impact on quality of life and is costly to the health care system. It has been demonstrated that a self-management program improves quality of life, but programs are not universally available and telehealth interventions can provide home-based support, but have mixed results. AIM: The aims of this study are to (1) assess the feasibility and acceptability of a 6 weeks' educational program related to self-management with remote monitoring for Lebanese COPD patients; (2) pre-test its impact on quality of life, emergency visits, and rate of rehospitalization, and (3) to make recommendations for a future randomized trial. METHODS: Validated questionnaires will be adapted to meet the context of our study in terms of acceptability, adoption, adequacy, fidelity, cost, and coverage. The impact of this program on quality of life will be measured with the COPD assessment test (CAT) and the COPD clinical questionnaire (CCQ), and the Hospital Anxiety and Depression (HAD) scale will be used to measure anxiety. All measures will be delivered pre- and post-intervention. To evaluate the impact of our program on the rate of hospitalization and emergency visits, the number of hospitalizations and emergency room visits during the year preceding the intervention will be collected from the hospital register of each participant. DISCUSSION: This study is the first to evaluate the application of telehealth to optimize COPD management in Lebanon. The results of this study will provide evidence regarding the efficacy and feasibility of this approach for Lebanese patients with moderate to severe COPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica/terapia , Autogestão , Telemedicina/métodos , Adulto , Protocolos Clínicos , Estudos de Viabilidade , Feminino , Humanos , Líbano , Masculino , Satisfação do Paciente , Qualidade de Vida , Autogestão/métodos , Inquéritos e Questionários
4.
Environ Monit Assess ; 192(3): 201, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32107647

RESUMO

Bacterial diversity is an important factor controlling the functioning of aquatic ecosystems. With the critical sensitivity of the microbial community towards chemical and/or physical factors, this study aims to identify for the first time the microbiota of the Lebanese coastal Ibrahim River. Water and sediment samples were collected at the outlet of the river, between May 2016 and April 2017, covering a hydrological year. The main microbiological parameters were tested: total germs, total coliforms, fecal coliforms, Escherichia coli, and Enterococcus. A DNA extraction followed by NGS analysis was applied on both water and sediment samples, in order to investigate the bacterial diversity and the habitat specificity. The link between this microbial composition and seasonal variations was then investigated. Results showed fourteen different bacterial phyla, among which were major microorganisms, including a wide variety of pathogenic and commensal ones, frequently available in the aquatic ecosystem. Most of the detected water microbiota were mostly correlated to other freshwater samples, with the main dominance of 5 common phyla: Proteobacteria, Actinobacteria, Firmicutes, Bacteroidetes, and Acidobacteria with the average of 43%, 13%, 16%, 10%, and 4% respectively. Despite this overall similarity, multiple patterns were visible, confirming the influence of the temporal variations and the discharge influence on taxonomic diversity. Sediment samples contained the highest relative abundance of Proteobacteria, Firmicutes, and Bacteroidetes: with an average of 31%, 44%, and 22% respectively. Our study showed that the Ibrahim River outlet has a specific habitat clustering. The among-compartment bacterial community variation, which responded to changing environmental factors, approved the existence of a meaningful temporal heterogeneity.


Assuntos
Microbiota , Rios , Microbiologia da Água , Monitoramento Ambiental , Líbano , RNA Ribossômico 16S , Água
6.
Geneva; World Health Organization; 2020-02-22.
em Inglês | WHO IRIS | ID: who-331219
7.
Int J Gynaecol Obstet ; 148(1): 14-20, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31596955

RESUMO

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.


Assuntos
Mortalidade Materna , Feminino , Humanos , Líbano/epidemiologia , Nascimento Vivo/epidemiologia , Gravidez , Refugiados/estatística & dados numéricos
8.
BMC Health Serv Res ; 19(1): 973, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852546

RESUMO

BACKGROUND: Cardiovascular diseases are the leading cause of death in Lebanon and Qatar. When lifestyle modifications prove insufficient, medication becomes a cornerstone in controlling such diseases and saving lives. Price, availability, and affordability hinder the equitable access to medicines. The study aimed to assess prices, availability, and affordability of essential cardiovascular disease medicines in relation to pricing strategies in Qatar and Lebanon. METHODS: A cross-sectional survey using a variant of the World Health Organization and Health Action International (WHO/HAI) methodology as outlined in "Measuring medicine prices, availability, affordability and price components" (2008), second edition, was adopted. Prices and availability of 27 cardiovascular medicines were collected from public and private dispensing outlets. For international comparison, prices were adjusted to purchasing power parity. Data was analyzed across multiple sectors, within and across countries. RESULTS: A total of 15 public and private outlets were surveyed in each country. Prices were more uniform in Qatar than in Lebanon. In the public sector, medicines were free-of-charge in Lebanon and priced lower than the international reference prices in Qatar. The ratio of medicine unit price to international reference price in the private sectors surveyed are significantly higher than the acceptable threshold of 4. This ratio of originator brands and lowest priced generics in Qatar were up to two and five times those in Lebanon, respectively, even after adjusting for purchasing power parity. However, prices of lowest priced generics in the private sector were at least 35% cheaper in Qatar and 65% cheaper in Lebanon than their comparative originator brands. Medicines were more available in the private sector in Lebanon than in Qatar, but only the originator brand availability in the public sector in Qatar exceeded the WHO target of more than 80%. While affordable in the public sector in Qatar, four out of thirteen medicines exceeded the threshold in all private sectors covered. Hence, only the public sector in Qatar had a satisfying level of availability and affordability. CONCLUSIONS: Except for the Qatari public sector, medicine prices, availability, and affordability are falling short from targets. Key policy decisions should be implemented to improve access to medicines.


Assuntos
Fármacos Cardiovasculares/economia , Fármacos Cardiovasculares/provisão & distribução , Doenças Cardiovasculares/tratamento farmacológico , Comércio/estatística & dados numéricos , Custos e Análise de Custo/estatística & dados numéricos , Estudos Transversais , Medicamentos Essenciais/economia , Medicamentos Essenciais/provisão & distribução , Medicamentos Genéricos/economia , Medicamentos Genéricos/provisão & distribução , Humanos , Líbano , Setor Privado/estatística & dados numéricos , Setor Público/estatística & dados numéricos , Catar , Inquéritos e Questionários
9.
Hum Genet ; 138(11-12): 1323-1330, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31677132

RESUMO

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.


Assuntos
Consanguinidade , DNA Helicases/genética , Doenças Genéticas Inatas/epidemiologia , Homozigoto , Mutação , Telômero/genética , Adolescente , Adulto , Feminino , Doenças Genéticas Inatas/genética , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Linhagem , Fenótipo , Adulto Jovem
11.
Zootaxa ; 4679(3): zootaxa.4679.3.1, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31715944

RESUMO

The species of genus Lacon Laporte, 1838 from the Levant are taxonomically revised. Currently, 18 species are known from the area covering the island of Cyprus and mainland from Hatay province of Turkey to Israel. Six species are described as new for science: Lacon mucheibensis sp. nov. (Israel), L. qatanensis sp. nov. (Syria), L. platiai sp. nov. (Jordan), L. safitensis sp. nov. (Syria), L. tafilensis sp. nov. (Jordan), and L. zenobiae sp. nov. (Lebanon, Syria). Lacon freidbergi Platia, 2010 is synonymized with L. lithophilus (Candèze, 1857), and L. kapleri Platia Schimmel, 1994 with L. graecus (Candèze, 1857). Lacon drusus (Marseul, 1870) is recorded for the first time from Israel. Lacon lithophilus is recorded for the first time from Israel and Jordan. Lacon graecus is removed from the fauna of Levant, because all earlier reports of this species from Lebanon and Syria were based on misidentifications. Figures of habitus and main diagnostic features are provided for all species and an identification key to the Lacon species of the Levant is given.


Assuntos
Besouros , Distribuição Animal , Animais , Chipre , Israel , Jordânia , Líbano , Síria , Turquia
12.
Zootaxa ; 4614(1): zootaxa.4614.1.6, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31716390

RESUMO

A checklist of Elateridae of Lebanon is provided. Altogether, 54 species classified in 23 genera are listed, with 11 species reported from the country for the first time. Elathous agilis sp. nov. and Megathous tannourinensis sp. nov. are described, compared with congeners, and their main diagnostic characters are figured.


Assuntos
Besouros , Distribuição Animal , Animais , Líbano
13.
Zootaxa ; 4658(2): zootaxa.4658.2.13, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31716753

RESUMO

Brachysomus (Hippomias) tannourinensis sp. nov. is described from Lebanon, compared with similar Brachysomus species, and its main diagnostic features are figured. The new species was discovered at the ancient cedar forest of Tannourine as the first known representative of the genus Brachysomus in Lebanon. It is easily recognizable by the body vestiture consisting of two types of scales, the prolonged shape of the  rostrum, and the parallel-sided penis.


Assuntos
Besouros , Gorgulhos , Animais , Líbano , Masculino
14.
Zootaxa ; 4656(3): zootaxa.4656.3.14, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31716821

RESUMO

Tychus meggiolaroi sp. n. from Lebanon is described and illustrated. It belongs to the Tychus cilicicus species group (Sabella Kurbatov 2002) and can be readily distinguished from related taxa by the different structure of the aedeagus and morphological features of antennae.


Assuntos
Besouros , Animais , Líbano
15.
Zootaxa ; 4652(3): zootaxa.4652.3.3, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31716855

RESUMO

The aequata-group of the subgenus Eucera s. str. Scopoli from the Eastern Mediterranean region, Bulgaria, and Iran is described, and the three species included are revised. The little-known E. aequata Vachal 1907 known from Turkey, Cyprus, Syria and Israel, is redescribed and a Lectotype is designated. Two species are described as new: E. dafnii sp. nov. from Iran, Israel, Syria, Turkey, Bulgaria, and Greece, and E. wattsi sp. nov. from Israel and Lebanon. An identification key is provided, and natural history information including assessment of preferred pollen host plants is presented.


Assuntos
Himenópteros , Distribuição Animal , Animais , Abelhas , Bulgária , Chipre , Grécia , Irã (Geográfico) , Israel , Líbano , Síria , Turquia
17.
Psychiatr Danub ; 31(4): 429-439, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31698399

RESUMO

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.


Assuntos
Autoimagem , Sintomas Afetivos/epidemiologia , Ansiedade/epidemiologia , Análise por Conglomerados , Estudos Transversais , Depressão/epidemiologia , Inteligência Emocional , Humanos , Líbano/epidemiologia , Fatores de Risco , Ideação Suicida
19.
Waste Manag Res ; 37(12): 1261-1270, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31607236

RESUMO

In this study, we examine the economic and environmental significance associated with the implementation of an EU waste-separated collection scheme in a developing context - Lebanon. Two scenarios, S1 and S2, representing different intensities of source segregation were analysed. In S1, the average source segregation intensity reached 25% and 13% for the Italian test area and Lebanese test area, respectively. In S2, source segregation intensity increased to 48% and 68% for the Italian and Lebanese test areas, respectively. Passing from S1 to S2 increased collection costs significantly, up to 44% with greater increases in the Italian test area where labour cost is higher. In both areas, environmental impacts decreased with greater source segregation intensity. Savings in the climate change impact and stratospheric ozone depletion potential were lower under the Lebanese test area in comparison with the Italian test area. In contrast, savings in freshwater eutrophication and acidification impact were lower for the Italian test area. The increase in the source segregation intensity resulted in maximum savings for the depletion of abiotic resources, 74% to 77% and 79% to 80% in a developing and developed context, respectively.


Assuntos
Mudança Climática , Meio Ambiente , Eutrofização , Itália , Líbano
20.
Curr Microbiol ; 76(12): 1503-1511, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31563972

RESUMO

The demand for sustainable and eco-friendly control methods of pests and insects is increasing worldwide. From this came the interest in Bacillus thuringiensis, an entomopathogenic bacterium capable of replacing chemical pesticides. However, the possibility of pests developing resistance to a particular strain may impair its use, and there is a need to identify novel strains of this species as potential commercial biopesticides. B. thuringiensis sv. israelensis is one of the most successful serovars, widely commercialized for its activity against black fly and mosquito larvae. In this study, we isolated, characterized, and sequenced a new Lebanese B. thuringiensis sv. israelensis isolate, strain AR23. Compared to the commercialized reference strain AM65-52 (Vectobac®, Sumitomo), AR23 showed an increased activity against several mosquito species. The genomic analysis revealed that this strain, compared to AM65-52, possesses a simplified plasmid content and an additional functional cry4Ba coding gene that most likely accounts for the increased effectiveness of this strain in mosquito larvae killing.


Assuntos
Bacillus thuringiensis/genética , Genoma Bacteriano/genética , Microbiologia do Solo , Animais , Bacillus thuringiensis/classificação , Bacillus thuringiensis/isolamento & purificação , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Endotoxinas/genética , Endotoxinas/metabolismo , Proteínas Hemolisinas/genética , Proteínas Hemolisinas/metabolismo , Larva/microbiologia , Líbano , Mosquitos Vetores/microbiologia , Filogenia , Plasmídeos/genética
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