ASH living guidelines on use of anticoagulation for thromboprophylaxis in patients with COVID-19: executive summary.

COVID-19-related critical and acute illness are associated with an increased risk of venous thromboembolism (VTE). These evidence-based recommendations of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other healthcare professionals in decisions about the use of anticoagulation for thromboprophylaxis in patients with COVID-19-related critical illness, acute illness, and those being discharged from the hospital, who do not have suspected or confirmed VTE. ASH formed a multidisciplinary panel, including three patient representatives, and applied a conflicts of interest management policy to minimize potential bias.

Tenecteplase Catheter-Directed Thrombolytic Therapy in Submassive Pulmonary Embolism: A Case Report.

In pulmonary embolism (PE), when used for catheter-directed thrombolysis (CDT), low-dose alteplase is associated with good outcomes. Tenecteplase has been only used as intravenous for this indication. In the context of our national economic crisis where alteplase was unavailable, we describe our experience with tenecteplase CDT.

Understanding contextual and practical factors to inform WHO recommendations on using chest imaging to monitor COVID-19 pulmonary sequelae: a qualitative study exploring stakeholders' perspective.

Background: A recommendation by the World Health Organization (WHO) was issued about the use of chest imaging to monitor pulmonary sequelae following recovery from COVID-19. This qualitative study aimed to explore the perspective of key stakeholders to understand their valuation of the outcome of the proposition, preferences for the modalities of chest imaging, acceptability, feasibility, impact on equity and practical considerations influencing the implementation of using chest imaging.

Methods: A qualitative descriptive design using in-depth interviews approach.

The impact of obesity on ventilator-associated pneumonia, a US nationwide study.

Background: Ventilator-associated pneumonia (VAP) is one of the leading causes of mortality in patients with critical care illness. Since obesity is highly prevalent, we wanted to study its impact on the outcomes of patients who develop VAP.

Methods: Using the National Inpatient Sample (NIS) database from 2017 to 2020, we conducted a retrospective study of adult patients with a principal diagnosis of VAP with a secondary diagnosis with or without obesity according to 10th revision of the International Statistical Classification of Diseases (ICD-10) codes.

Pulmonary arterial hypertension and COVID-19: Piecing the puzzle.

COVID-19 remains a health care concern despite the end of the pandemic. Patients with cardiovascular disease (CVD) are at a higher risk for developing severe COVID-19 complications. Studies investigating the COVID-19 clinical characteristics in pulmonary arterial hypertension (PAH) patients have reported discordant conclusions so far.

A Lethal Case of Acute Exacerbation of Rheumatoid Arthritis - Related Interstitial Lung Disease Induced by the COVID Vaccine.

Interstitial lung disease (ILD) exacerbation is a serious condition that can have a high morbidity and mortality. Identifying the triggers of ILD exacerbations is very challenging. Several case reports described COVID-19 vaccine-induced exacerbation of underlying interstitial lung disease, namely idiopathic interstitial pneumonias.

Key issues for stakeholder engagement in the development of health and healthcare guidelines.

Established in 2015, the Multi-Stakeholder Engagement (MuSE) Consortium is an international network of over 120 individuals interested in stakeholder engagement in research and guidelines. The MuSE group is developing guidance for stakeholder engagement in the development of health and healthcare guideline development. The development of this guidance has included multiple meetings with stakeholders, including patients, payers/purchasers of health services, peer review editors, policymakers, program managers, providers, principal investigators, product makers, the public, and purchasers of health services and has identified a number of key issues.

Development of an assessment tool to measure communication skills among family medicine residents in the context of electronic medical record use.

Background: The introduction of the electronic medical record (EMR) has led to new communication skills that need to be taught and assessed. There is scarce literature on validated instruments measuring electronic-specific communication skills. The aim is to develop an assessment checklist that assesses the general and EMR-specific communication skills and evaluates their content validity and reliability.

The under investigated facet of the COVID-19 pandemic: Molecular analysis of secondary bacterial infections at a COVID dedicated intensive care unit within a tertiary care center in Lebanon.

Background: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Secondary bacterial infections are associated with unfavorable outcomes in respiratory viral infections. This study aimed at determining the prevalence of secondary bacterial infections in COVID-19 patients admitted at a tertiary medical center in Lebanon.

Can interprofessional education change students' attitudes? A case study from Lebanon.

Background: Interprofessional collaboration is key to improving the health of individuals and communities. It is supported by provision of Interprofessional education (IPE) which has recently emerged in the Middle East region. This study investigated changes in healthcare students' attitudes towards interprofessional collaboration after undertaking the Interprofessional Education and Collaboration (IPEC) course.

Factors to Consider During Identification and Invitation of Individuals in a Multi-stakeholder Research Partnership.

Background: Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification.

Objective: We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams.

Impact of the COVID-19 pandemic on smoking behavior and beliefs among the American University of Beirut community.

Introduction: The current COVID-19 outbreak has led to sudden changes in routine and modifications in health behaviors. The study presented here investigates the changes in smoking behavior and beliefs due to the pandemic among a sample of individuals at the American University of Beirut (AUB) in Lebanon, between August and September 2020.

Methods: This is a cross-sectional exploratory study based on data collected through an anonymous, web-based questionnaire.

The Role of Angiotensin Converting Enzyme 1 Insertion/Deletion Genetic Polymorphism in the Risk and Severity of COVID-19 Infection.

Individuals infected with the COVID-19 virus present with different symptoms of varying severity. In addition, not all individuals are infected despite exposure. Risk factors such as age, sex, and comorbidities play a major role in this variability; however, genetics may also be important in driving the differences in the incidence and prognosis of the disease.

Physicians' approach to end of life care: comparison of two tertiary care university hospitals in Lebanon.

Background: The care of terminally ill patients is fraught with ethical and medical dilemmas carried by healthcare professionals. The present study aims to explore the approaches of Lebanese attending physicians towards palliative care, end of life (EOL) care, and patient management in two tertiary care university hospitals with distinct medical culture.

Methods: Four hundred attending physicians from the American University of Beirut Medical Center (AUBMC) and Hotel Dieu de France (HDF) were recruited.

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: July 2021 update on postdischarge thromboprophylaxis.

Background: COVID-19-related acute illness is associated with an increased risk of venous thromboembolism (VTE).

Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for thromboprophylaxis in patients with COVID-19 who do not have confirmed or suspected VTE.

Methods: ASH formed a multidisciplinary guideline panel, including 3 patient representatives, and applied strategies to minimize potential bias from conflicts of interest.

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients.

Background: COVID-19-related critical illness is associated with an increased risk of venous thromboembolism (VTE).

Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in making decisions about the use of anticoagulation for thromboprophylaxis in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE.

Methods: ASH formed a multidisciplinary guideline panel that included 3 patient representatives and applied strategies to minimize potential bias from conflicts of interest.

Human herpes virus-6 (HHV-6) pneumonitis and meningitis with viraemia in an immunocompetent adult patient.

Human herpes virus-6 (HHV-6) infection is a common infection in the paediatric population and is increasingly reported in immunosuppressed adult patients. It has been reported as the causative agent of disease in few case reports in immunocompetent adults. We report herein an unusual case of HHV-6-associated viraemia, pneumonitis and meningitis in a patient who presented with dyspnoea, hypoxia, dry cough and headache.

Primary care and pulmonary physicians' knowledge and practice concerning screening for lung cancer in Lebanon, a middle-income country.

Background: Screening for lung cancer with low-dose computed tomography (LDCT) was shown to reduce lung cancer incidence and overall mortality, and it has been recently included in international guidelines. Despite the rising burden of lung cancer in low and middle-income countries (LMICs) such as Lebanon, little is known about what primary care physicians or pulmonologists know and think about LDCT as a screening procedure for lung cancer, and if they recommend it.

Objectives: Evaluate the knowledge about LDCT and implementation of international guidelines for lung cancer screening among Lebanese primary care physicians (PCPs) and pulmonary specialists.

American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19.

Background: Coronavirus disease 2019 (COVID-19)-related critical illness and acute illness are associated with a risk of venous thromboembolism (VTE).

Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for thromboprophylaxis for patients with COVID-19-related critical illness and acute illness who do not have confirmed or suspected VTE.

Methods: ASH formed a multidisciplinary guideline panel and applied strict management strategies to minimize potential bias from conflicts of interest.

Current Status and Future Perspectives of Immunotherapy in Middle-Income Countries: A Single-Center Early Experience.

Background: Immunotherapy agents offer novel treatment options in advanced cancers. However, their use is limited in developing countries lacking unifying guidelines and can be followed by a financial burden. In this study, we aimed to provide an overview regarding the use of immunotherapy and the overall response to treatment in patients with metastatic disease in relation to cost-effectiveness.

Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19: A Living Systematic Review of Multiple Streams of Evidence.

Background: Mechanical ventilation is used to treat respiratory failure in coronavirus disease 2019 (COVID-19).

Purpose: To review multiple streams of evidence regarding the benefits and harms of ventilation techniques for coronavirus infections, including that causing COVID-19.

Data Sources: 21 standard, World Health Organization-specific and COVID-19-specific databases, without language restrictions, until 1 May 2020.

Impact of the Conditioning Regimen Dose Intensity Before Autologous Stem Cell Transplantation on the Pulmonary Function Test Abnormalities in Patients With Lymphoma and Multiple Myeloma: Single Center Experience.

Background: Most studies addressing the impact of hematopoietic stem cell transplantation (SCT) on pulmonary function test (PFT), and the various factors affecting that impact have been performed on the allogenic type. Few have addressed PFT changes in autologous SCT. This study describes PFT changes seen in autologous SCT recipients and addresses the various factors impacting these changes.

Novel EIF2AK4 mutations in histologically proven pulmonary capillary hemangiomatosis and hereditary pulmonary arterial hypertension.

Background: Pulmonary hypertension (PH) remains one of the rarest and deadliest diseases. Pulmonary Capillary Hemangiomatosis (PCH) is one of the sub-classes of PH. It was identified using histological and molecular tools and is characterized by the proliferation of capillaries into the alveolar septae.

Non-irradiated GCSF stimulated leukocyte transfusion for necrotizing fasciitis after allogeneic stem cell transplant: a case report and review of the literature.

Severe neutropenia remains among the most common complications associated with hematological diseases and their treatment, especially in the early poststem cell transplantation. Managing life-threatening infections associated with prolonged and profound neutropenia thus remains an essential component for the optimal care of patients undergoing transplant. Several therapeutic interventions have been attempted either to limit the duration of neutropenia through granulocyte colony stimulating factors (GCSF), or to treat associated infections through the use of granulocyte transfusions.