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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.
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
3.
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
4.
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
5.
Medicina (Kaunas) ; 55(8)2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31405167

RESUMO

Background and Objectives: Breast cancer is the most prevalent cancer in women worldwide. Lebanon is a developing country in the Middle East with a prominent breast cancer incidence. The aim of our study was to explore the incidence rates of breast cancer in Lebanon from 2005 to 2015, and compare them to the rates of other countries. Materials and Methods: Breast cancer data for the years 2005-2015 was 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 in the world population (ASR(w)) were obtained for other countries, from two online databases. Results: Breast cancer was found to be the most prevalent cancer in Lebanon, accounting for 20% of all cancer cases. The average ASR(w) was 96.5 per 100,000. Over the studied period, breast cancer ASR(w) in Lebanon showed a significantly increasing trend with an annual percent change (APC) of +4.6. Moreover, the APC of breast cancer age-specific rates significantly increased for the age groups 45-49 (p = 0.013), 50-54 (p < 0.001), 55-59 (p = 0.001), 60-64 (p = 0.002), 65-69 (p = 0.003), 70-74 (p < 0.001), and 75+ years (p < 0.001). Lebanon had the highest breast cancer ASR(w), when compared to other regional countries, and trailed only behind Denmark, when compared to selected countries from different parts of the world. Conclusions: Breast cancer incidence in Lebanon is among the highest in the world. Future studies should focus on exploring the genetic profile of the Lebanese population in an aim to extrapolate proper prevention guidelines.


Assuntos
Neoplasias da Mama/diagnóstico , Idoso , Neoplasias da Mama/epidemiologia , Feminino , Humanos , Incidência , Líbano/epidemiologia , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos
6.
Pediatr Blood Cancer ; 66(11): e27959, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31423715

RESUMO

Retinoblastoma is an ocular tumor that occurs in young children, in either heritable or sporadic manner. The relative rarity of retinoblastoma, and the need for expensive equipment, anesthesia, and pediatric ophthalmologic expertise, are barriers for effective treatment in developing countries. Also, with an average age-adjusted incidence of two to five cases per million children, patient number limits development of local expertise in countries with small populations. Lebanon is a small country with a population of approximately 4.5 million. In 2012, a comprehensive retinoblastoma program was formalized at the Children's Cancer Institute (CCI) at the American University of Beirut Medical Center, and resources were allocated for efficient interdisciplinary coordination to attract patients from neighboring countries such as Syria and Iraq, where such specialized therapy is also lacking. Through this program, care was coordinated across hospitals and borders such that patients would receive scheduled chemotherapy at their institution, and monthly retinal examinations and focal laser therapy at the CCI in Lebanon. Our results show the feasibility of successful collaboration across borders, with excellent patient and physician adherence to treatment plans. This was accompanied by an increase in patient referrals, which enables continued expertise development. However, the majority of patients presented with advanced intraocular disease, necessitating enucleation in 90% of eyes in unilateral cases, and more than 50% of eyes in bilateral cases. Future efforts need to focus on expanding the program that reaches to additional hospitals in both countries, and promoting early diagnosis, for further improvement of globe salvage rates.


Assuntos
Institutos de Câncer/organização & administração , Países em Desenvolvimento , Hospitais Universitários/organização & administração , Internacionalidade , Colaboração Intersetorial , Neoplasias da Retina/terapia , Retinoblastoma/terapia , Institutos de Câncer/economia , Terapia Combinada/economia , Terapia Combinada/métodos , Diagnóstico Tardio , Gerenciamento Clínico , Estudos de Viabilidade , Feminino , Aconselhamento Genético , Hospitais Universitários/economia , Humanos , Incidência , Lactente , Recém-Nascido , Estimativa de Kaplan-Meier , Líbano/epidemiologia , Masculino , Oriente Médio/epidemiologia , Equipe de Assistência ao Paciente , Encaminhamento e Consulta , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/epidemiologia , Retinoblastoma/diagnóstico , Retinoblastoma/economia , Retinoblastoma/epidemiologia , Resultado do Tratamento , Estados Unidos
7.
Infect Dis Obstet Gynecol ; 2019: 5016810, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467477

RESUMO

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.


Assuntos
Candida/patogenicidade , Candidíase Vulvovaginal/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Adulto , Candida/classificação , Feminino , Humanos , Líbano/epidemiologia , Gravidez , Prevalência , Fatores de Risco , Vagina/microbiologia , Adulto Jovem
8.
PLoS One ; 14(7): e0219248, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31265481

RESUMO

Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m2. Pre-pregnancy BMI≥25 Kg/m2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48-6.91; OR: 2.84, CI: 1.15-7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.


Assuntos
Índice de Massa Corporal , Ganho de Peso na Gestação , Resultado da Gravidez/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Líbano/epidemiologia , Modelos Logísticos , Avaliação Nutricional , Gravidez , Catar/epidemiologia , Adulto Jovem
9.
PLoS One ; 14(6): e0218443, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31211820

RESUMO

Low serum levels of high-density lipoprotein cholesterol (HDL-C) have been shown to be a risk factor for coronary artery disease independent of low-density lipoprotein cholesterol (LDL-C) in different populations. In this study, we investigated genetic variants through genome-wide association studies to determine their association with HDL-C levels in a sample of 2,700 patients. We identified several SNPs associated with HDL-C levels in the Lebanese population using unadjusted and adjusted by biological factors models. We replicated the association of rs3764261 within CETP with HDL-C levels in the study population, and found other previously unidentified SNPs to be significant at the suggestive level, in both previously identified and unidentified genes. This paper reports the first genome-wide analysis of HDL-C in the Lebanese, Middle Eastern, population and supports the importance of genome-wide association studies across different and minor ethnicities to understand better the etiology of complex human diseases.


Assuntos
HDL-Colesterol/genética , Doença da Artéria Coronariana/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , LDL-Colesterol/genética , Estudos de Coortes , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/patologia , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética , Fatores de Risco
10.
Medicine (Baltimore) ; 98(25): e15993, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232932

RESUMO

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.


Assuntos
Serviços Médicos de Emergência/normas , Segurança do Paciente , Transferência de Pacientes/normas , Centros de Atenção Terciária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Serviços Médicos de Emergência/economia , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Transferência de Pacientes/economia , Transferência de Pacientes/estatística & dados numéricos , Melhoria de Qualidade , Estudos Retrospectivos , Adulto Jovem
11.
BMC Ophthalmol ; 19(1): 137, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248388

RESUMO

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.


Assuntos
Ambliopia/etiologia , Catarata/etiologia , Doenças da Córnea/etiologia , Medição de Risco/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Uveíte/epidemiologia , Acuidade Visual , Distribuição por Idade , Fatores Etários , Ambliopia/epidemiologia , Catarata/epidemiologia , Criança , Pré-Escolar , Doenças da Córnea/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Líbano/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Uveíte/complicações , Uveíte/fisiopatologia
12.
Comp Immunol Microbiol Infect Dis ; 64: 109-116, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31174685

RESUMO

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.


Assuntos
Anticorpos Antibacterianos/sangue , Coxiella burnetii/isolamento & purificação , Leite/microbiologia , Febre Q/veterinária , Ruminantes/microbiologia , Animais , Proteínas de Bactérias/genética , Bovinos , Doenças dos Bovinos/epidemiologia , Coxiella burnetii/genética , Estudos Transversais , Fazendas , Doenças das Cabras/epidemiologia , Cabras , Líbano/epidemiologia , Prevalência , Febre Q/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco , Estudos Soroepidemiológicos , Ovinos , Doenças dos Ovinos/epidemiologia
13.
BMC Public Health ; 19(1): 769, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208379

RESUMO

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.


Assuntos
Asma/prevenção & controle , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adolescente , Adulto , Asma/epidemiologia , Índice de Massa Corporal , Comorbidade , Estudos Transversais , Feminino , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
14.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184678

RESUMO

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


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Farmacêuticos/estatística & dados numéricos , Disponibilidade de Medicamentos Via Internet/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Educação de Pacientes como Assunto/estatística & dados numéricos , Líbano/epidemiologia , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Atitude Frente aos Computadores , Estudos Transversais , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos
15.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184679

RESUMO

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


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Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Prescrição Inadequada/estatística & dados numéricos , Lista de Medicamentos Potencialmente Inapropriados/estatística & dados numéricos , Doença Crônica/tratamento farmacológico , Líbano/epidemiologia , Múltiplas Afecções Crônicas/tratamento farmacológico , Polimedicação , Fatores de Risco , Saúde do Idoso
16.
PLoS One ; 14(5): e0216740, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31116760

RESUMO

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.


Assuntos
Serviços Médicos de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência , Centros de Atenção Terciária , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Transmissíveis/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adulto Jovem
17.
Int Health ; 11(6): 568-579, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-31089721

RESUMO

ARTICLE HISTORY: Following the refugee crisis in Lebanon, the on-going inflow of Syrian refugees presented new challenges to optimal immunization coverage for all the children living in the country. Healthcare facilities have been overburdened during this period and the country witnessed outbreaks of many infectious diseases. Thus, the evaluation of vaccine compliance for mandatory and non-mandatory vaccines as well as the factors affecting the vaccination rate among Lebanese residents and Syrian refugees is fundamental. BACKGROUND: Since 2012, Lebanon has hosted around 1.2 million Syrian refugees, a high number in a country whose population does not exceed 4.4 million. Healthcare facilities have been overburdened during this period, which has led to the spread of many infectious diseases, including outbreaks of measles, mumps and hepatitis. At the appearance of such outbreaks, it becomes essential to evaluate vaccine compliance and the factors influencing the vaccination rate among Lebanese residents and Syrian refugees in infants and children up to 15 y of age. METHODS: A total of 571 infants and children were recruited in Beirut and Mount Lebanon, two governorates that together host half of the Lebanese population. RESULTS: A very high rate of vaccine compliance was seen for mandatory vaccines, whereas an intermediate to very low rate of compliance was found for non-mandatory vaccines. Both bivariate and multiple regression analyses indicated that age group and regular consultation of a pediatrician were independently associated with immunization coverage. Bivariate analysis indicated that parental age, occupational and educational status of parents, family size and vaccine price were also independently associated with immunization coverage. Incomplete vaccination coverage was associated with socioeconomic factors. CONCLUSIONS: From these results, it becomes apparent that it may be necessary to reassess vaccination priorities considering the current socioeconomic situation.


Assuntos
Refugiados/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Vacinas/administração & dosagem , Adolescente , Criança , Pré-Escolar , Doenças Transmissíveis/epidemiologia , Estudos Transversais , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Líbano/epidemiologia , Masculino , Programas Obrigatórios/estatística & dados numéricos , Fatores Socioeconômicos , Síria/etnologia
18.
Poult Sci ; 98(11): 5883-5891, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31134283

RESUMO

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.


Assuntos
Infecções por Blastocystis/veterinária , Blastocystis/isolamento & purificação , Infecções por Campylobacter/veterinária , Campylobacter/genética , Galinhas , Variação Genética , Doenças das Aves Domésticas/epidemiologia , Animais , Infecções por Blastocystis/epidemiologia , Infecções por Blastocystis/parasitologia , Campylobacter/isolamento & purificação , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/microbiologia , Líbano/epidemiologia , Doenças das Aves Domésticas/microbiologia , Doenças das Aves Domésticas/parasitologia , Prevalência
19.
Medicina (Kaunas) ; 55(6)2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31141934

RESUMO

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.


Assuntos
Neoplasias Pulmonares/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Epidemiológicos , Feminino , Humanos , Incidência , Líbano/epidemiologia , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos
20.
Psychiatry Res ; 275: 338-344, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30954844

RESUMO

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.


Assuntos
Transtorno Bipolar/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Utilização de Instalações e Serviços/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adolescente , Transtorno Bipolar/psicologia , Criança , Análise por Conglomerados , Comorbidade , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Líbano/epidemiologia , Masculino , Prevalência , Fatores de Risco , Ideação Suicida , Suicídio/psicologia , Inquéritos e Questionários
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