Le Journal médical libanais. The Lebanese medical journal最新文献

{"title":"SYNOVIAL CHONDROMATOSIS OF THE POSTERIOR COMPARTMENT OF THE KNEE: A Case Report & Literature Review Focusing on Arthroscopic Treatment.","authors":"Amer Sebaaly,&nbsp;Ghassan Maalouf,&nbsp;Wael Bayyoud,&nbsp;Falah Bachour","doi":"10.12816/0023832","DOIUrl":"https://doi.org/10.12816/0023832","url":null,"abstract":"<p><p>Synovial chondromatosis is a rare panarticular synovial disease affecting large joints and especially the knee. When the disease is localized in the knee, it affects the anterior compartment. We report the case of a posterior localized disease with a review of the literature focusing on arthroscopic treatment.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"64 1","pages":"43-6"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34474362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DELTOID FLAP for MANAGEMENT of MASSIVE IRREPARABLE ROTATOR CUFF TEARS: Case Series.","authors":"Sami Roukoz,&nbsp;Linda Nabhane,&nbsp;Ali al-rida Aidibi,&nbsp;Amer Sebaaly","doi":"10.12816/0023825","DOIUrl":"https://doi.org/10.12816/0023825","url":null,"abstract":"<p><strong>Background: </strong>Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator cuff. The purpose of this study is to report the outcome of deltoid muscle flap transfer to restore shoulder function in patients with massive irreparable rotator cuff tear.</p><p><strong>Material and methods: </strong>This is a retrospective descriptive case series. Included patients had a lesion of two or more tendons of the rotator cuff or lesion of one tendon of more than 5 cm in width and no lesion to the subscapularis. Evaluation was done using the Constant score, visual analog scale for satisfaction and quality of life.</p><p><strong>Results: </strong>Twenty patients met the inclusion criteria. Three patients were lost to follow-up. The remaining (9 males and 8 females) had a mean follow-up period of 40.5 months. The mean age at surgery was 61.3 years. Thirty-five percent of patients were involved in heavy labor while the lesions affected the dominant side in 70% of the cases. Mean preoperative Constant score was 40.8 and increased to 78.8 (p < 0.05) with a difference of +38 points on the raw Constant score and an improvement rate of 64%. The greatest improvement involved essentially pain and quality of life (improvement rate of 82%) (p < 0.05). Eighty-nine percent of patients have good and excellent self-reported results.</p><p><strong>Conclusion: </strong>More than just a salvage procedure, deltoid muscle flap seems to be an adequate option in terms of appropriate pain relief, function recovery as well as patient satisfaction. Keywords: massive rotator cuff tears, deltoid muscle flap</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"64 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34476004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TUBERCULOSIS BURDEN IN LEBANON: EVOLUTION AND CURRENT STATUS.","authors":"George F Araj,&nbsp;Antoine Saade,&nbsp;Lina Y Itani,&nbsp;Aline Z Avedissian","doi":"10.12816/0023824","DOIUrl":"https://doi.org/10.12816/0023824","url":null,"abstract":"<p><strong>Background: </strong>In the absence of surveillance data and consolidated information about tuberculosis (TB) and its drug resistance burden in Lebanon, this retrospective study was conducted to shed light on TB and its other relevant aspects over the last 15 years in this country.</p><p><strong>Methods: </strong>To generate the TB data for this retrospective study, two main sources were used: 1) the records of patients in the National Tuberculosis Program (NTP); 2) the results of the Clinical Microbiology Laboratory (CML) at the American University of Beirut Medical Center (AUBMC). The TB data review pertained to its epidemiological aspect, implementation of the directly observed therapy strategy (DOTS) all over, the gender distribution, the impact of high risk groups (non-national population, Syrian refugees, patients with multi-drug resistance-TB [MDR-TB] and the inmate population) on the trend of TB in Lebanon between 1999 and 2013. Reviewed also are TB in children, extrapulmonary tuberculosis and the mycobacterium other than tuberculosis (MOTT).</p><p><strong>Results: </strong>During the last 15 years, 7548 TB cases were diagnosed and evaluated at the NTP. After the decreasing of TB incidence from 13/100 000 population in 2001 to 9/100 000 in 2006, the incidence started to increase in 2007, reaching 20/100 000 in 2013, mostly due to increased cases among non-national population. Fluctuations in TB rates over the years were seen among children, inmates, MDR-TB, and HIV patients. MOTT isolates recovery rates also fluctuated during the study period, M. simiae being the most common.</p><p><strong>Conclusion: </strong>After the decreasing trends of TB incidence between 1999 and 2006, Lebanon has been experiencing an increasing incidence in tuberculosis population since 2007. This is mainly attributed to the dramatic increase of TB patients among non-nationals and the influx of Syrian refugees. The ongoing collaboration between the public and private sectors, improvements of the surveillance system and TB control are important factors for successful elimination of TB in this country.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"64 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34476003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HENOCH-SCHONLEIN PURPURA IN CHILDHOOD A FIFTEEN-YEAR EXPERIENCE AT A TERTIARY HOSPITAL.","authors":"Jumana Albaramki","doi":"10.12816/0023826","DOIUrl":"https://doi.org/10.12816/0023826","url":null,"abstract":"<p><strong>Objective: </strong>To examine the epidemiological and clinical characteristics of children diagnosed with Henoch Sch6nlein purpura (HSP) and to compare them with other areas in the world.</p><p><strong>Methods: </strong>The medical records of children with HSP were retrospectively reviewed at the Jordan University Hospital between the years 1998 and 2012. The clinical and demographical features, laboratory tests, management and outcome were assessed.</p><p><strong>Results: </strong>There were 55 children with HSP, with a mean age of 7 years (60% were males); 85.4% of patients were less than 10 years; 72.7% of cases presented during the winter and autumn. There was a history of antecedent upper respiratory tract infection in 49.1% of cases; 32.7% of children had more than one hospitalization. Purpuric skin rash was seen in 100%, abdominal pain in 74.5%, arthritis in 58.2%, renal involvement in 30.9% of patients. In four patients HSP was the presenting feature of familial Mediterranean fever (FMF).</p><p><strong>Conclusion: </strong>HSP is a benign and self-limiting disease with an excellent prognosis. There are no significant differences in the epidemiological and clinical profile than reported elsewhere.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"64 1","pages":"13-7"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34539154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THROMBOTIC MICROANGIOPATHY ASSOCIATED WITH OPANA ER INTRAVENOUS ABUSE A Case Report.","authors":"Fadi I Jabr,&nbsp;Ling Yu","doi":"10.12816/0023831","DOIUrl":"https://doi.org/10.12816/0023831","url":null,"abstract":"<p><p>Thrombotic microangiopathy is characterized by endothelial changes and microvascular stenosis. Several entities such as pregnancy, infection, connective tissue diseases, and drugs are associated with secondary thrombotic microangiopathy. Recently, new reformulation of Opana ER had been associated with thrombotic microangiopathy when injected intravenously. Here, we report the case of a 37-year-old man who developed renal failure and hemolytic anemia secondary to Opana ER intravenous abuse. Renal biopsy pathology was consistent with thrombotic microangiopathy likely caused by Opana ER intravenous abuse.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"64 1","pages":"40-2"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34539153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE DESIGN OF PERFORMANCE MONITORING SYSTEMS IN HEALTHCARE ORGANIZATIONS: A STAKEHOLDER PERSPECTIVE.","authors":"Rima E Rouhana,&nbsp;Didier Van Caillie","doi":"10.12816/0023830","DOIUrl":"https://doi.org/10.12816/0023830","url":null,"abstract":"<p><p>Monitoring hospitals performance is evolving over time in search of more efficiency by integrating additional levels of care, reducing costs and keeping staff up-to-date. To fulfill these three potentially divergent aspects and to monitor performance, healthcare administrators are using dissimilar management control tools. To explain why, we suggest to go beyond traditional contingent factors to assess the role of the different stakeholders that are at the heart of any healthcare organization. We rely first on seminal studies to appraise the role of the main healthcare players and their influence on some organizational attributes. We then consider the managerial awareness and the perception of a suitable management system to promote a strategy-focused organization. Our methodology is based on a qualitative approach of twenty-two case studies, led in two heterogeneous environments (Belgium and Lebanon), comparing the managerial choice of a management system within three different healthcare organizational structures. Our findings allow us to illustrate, for each healthcare player, his positioning within the healthcare systems. Thus, we define how his role, perception and responsiveness manipulate the organization's internal climate and shape the design of the performance monitoring systems. In particular, we highlight the managerial role and influence on the choice of an adequate management system.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"64 1","pages":"33-9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34539152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PALLIATIVE CARE FOR OLDER ADULTS: STATE OF THE ART IN LEBANON.","authors":"Huda Abu-Saad Huijer,&nbsp;Mohammad Saab,&nbsp;Ramzi Hajjar","doi":"10.12816/0023829","DOIUrl":"https://doi.org/10.12816/0023829","url":null,"abstract":"<p><p>Palliative care (PC) for older adults constitutes an important human rights challenge and a major public health care priority due to the aging of the population and the lack of health care services addressing the needs of the older people. In Lebanon, the surge in the number of older people with complex needs is unmatched by any increase in the services offered to them. PC in Lebanon is still under- developed and is subject to a number of challenges. These challenges are alarming and must be overcome through introducing health care providers to basic PC principles as recommended by the National Committee for Pain Relief and Palliative Care (NCPRPC).</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"64 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34539643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHALLENGES IN THE TREATMENT OF ACUTE FULMINANT HEPATITIS B: Case Report and Literature Review.","authors":"Ali Alawieh,&nbsp;Rakan Nasser Eldine,&nbsp;Mona Youssef,&nbsp;Abdul Rahman Bizri","doi":"10.12816/0012559","DOIUrl":"https://doi.org/10.12816/0012559","url":null,"abstract":"<p><p>Acute hepatitis B is a serious cause of fulminant hepatic failure and subsequent mortality. No established guidelines are currently present for the treatment of this life threatening entity. Several therapeutic options were reported in the literature including the use of lamivudine as well as the more novel nucleoside analogue entecavir. We report an unfortunate case of fulminant hepatitis B that passed away despite intensive care unit management and treatment with entecavir in combination with steroids. Extensive review of the literature about various therapeutic approaches to manage fulminant hepatitis B was conducted. The aim of this report is to emphasize the need for larger more structured studies in order to improve the outcome of the treatment of this entity.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"63 2","pages":"102-6"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34000020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Screening of diabetic retinopathy and maculopathy in Lebanese population using retinography and SD-OCT: The role of telemedicine].","authors":"Elias Chelala,&nbsp;Nadine Saleh,&nbsp;Ali Dirani,&nbsp;Ali Fadlallah,&nbsp;Patrick Baz,&nbsp;Elise Slim,&nbsp;Georges Halaby,&nbsp;Riad Bejjani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes and diabetic retinopathy (DR) are nowadays a major public health threat. The aim of this study is the screening of DR and diabetic maculopathy (DM) in a primary medical care center in Lebanon. We study also the interest of retinography and of SD-OCT in a telemedicine screening program.</p><p><strong>Methods: </strong>This is a transversal study of patients with type 2 diabetes and with a regular follow-up in a primary medical care center in Beirut. For every patient, a retinography and an SD-OCT of the macula were obtained. Photos were sent by Internet to the Ophthalmology Department of Hôtel-Dieu de France to be evaluated by a retina specialist. Visual acuity and DR risk factors were assessed.</p><p><strong>Results: </strong>119 patients were included in this study. Mean age was 51.7 ± 10.2 years (54 females and 65 males). Mean diabetes duration was 12.15 years (SD 6:2). Mean of last three measurements of glycated hemoglobin was 8.1 ± 1.34%. Diabetic retinopathy was detected in 36 patients by retinography (30.3%). Diabetic maculopathy was confirmed by SD-OCT in 13 patients. Visual acuity was significantly correlated with central macular thickness. Mean diabetes duration, mean of last three measurements of glycated hemoglobin, peripheral neuropathy, positive macroalbuminuria and treatment with insulin were independently associated to diabetic retinopathy.</p><p><strong>Conclusion: </strong>Teleophthalmology is an efficient way for screening diabetic retinopathy in the Lebanese population. National screening program should be undertaken to adapt teleophthalmology on a larger scale.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"63 2","pages":"59-65"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34280262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREVALENCE OF DIABETES MELLITUS AMONG PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION.","authors":"Jad Chahoud,&nbsp;Jad Mrad,&nbsp;Adele Semaan,&nbsp;Roland Asmar","doi":"10.12816/0012554","DOIUrl":"https://doi.org/10.12816/0012554","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the prevalence of diabetes mellitus (DM) among patients with arterial hypertension, and indirectly, the crucial impact of adopting screening for diabetes as a standard procedure for all patients diagnosed with arterial hypertension.</p><p><strong>Materials & methods: </strong>This cross-sectional study was performed on a sample of hypertensive patients recruited from three different university hospitals in Lebanon. Blood pressure and glycemic blood measurements were determined in all subjects. In addition, a complete clinical history and physical exam were performed. Data was entered and analyzed using SPSS 19.0. Frequencies for the different variables were calculated, and the chi-square and independent sample t-tests were conducted.</p><p><strong>Results: </strong>This study included 294 patients. Prevalence of diabetes was 27%, and 23% of diabetic patients were newly diagnosed. More than half of the subjects suffering from DM had uncontrolled blood pressure, contrasted with only one third of the non-diabetic subjects with uncontrolled hypertension.</p><p><strong>Conclusion: </strong>The prevalence of DM in patients with essential hypertension was more than double that of the general population. Therefore, major recommendations would be to adopt strictly the diabetes screening requirements and aggressive management among hypertensive patients to minimize both the health and cost burdens associated with undetected DM.</p>","PeriodicalId":430072,"journal":{"name":"Le Journal médical libanais. The Lebanese medical journal","volume":"63 2","pages":"74-80"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33998980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}