Patterns and predictors of positive multiplex polymerase chain reaction respiratory panel among patients with acute respiratory infections in a single center in Lebanon.

Background: Infectious agents associated with community-acquired acute respiratory infections (ARIs) remain understudied in Lebanon. We aim to assess the microbiological profiles of ARIs by employing polymerase chain reaction (PCR) and identifying predictors of positive PCR results among patients admitted for ARI.

Methods And Results: We conducted a retrospective single-center study at the American University of Beirut Medical Center, including all respiratory PCR panels performed on pediatric (< 18) and adult (≥ 18) patients presenting with an ARI from January 2015 to March 2018, prior to the onset of the COVID-19 pandemic.

A Framework for the Development of Living Practice Guidelines in Health Care.

Background: Living practice guidelines are increasingly being used to ensure that recommendations are responsive to rapidly emerging evidence.

Objective: To develop a framework that characterizes the processes of development of living practice guidelines in health care.

Design: First, 3 background reviews were conducted: a scoping review of methods papers, a review of handbooks of guideline-producing organizations, and an analytic review of selected living practice guidelines.

Black Urine and Methemoglobinemia in the Setting of Sepsis Due to Clostridium Perfringens.

Clostridium Perfringens is an anaerobic gram-positive bacillus able to produce different types of toxins and can cause septicemia. The mechanism is through translocation from a previously colonized gastrointestinal or genital tract. Massive intravascular hemolysis induced by this bacterium is a rare presentation reported in only 7% to 15% of cases of Clostridium Perfringens bacteremia with a mortality rate reaching 90%.

Comparison of the Oxygenation Factor and the Oxygenation Ratio in Subjects With ARDS.

Background: The oxygenation ratio (ie, [Formula: see text]/[Formula: see text]) remains the most commonly used index for assessing oxygenation and disease severity in patients with acute ARDS. However, the oxygenation ratio does not account for mechanical ventilation settings. We hypothesized that the oxygenation factor (ie, oxygenation ratio/mean airway pressure) is superior to the oxygenation ratio in reflecting oxygenation in patients with ARDS and results in a different classification of ARDS severity.

Clinical and genetic characteristics of pulmonary arterial hypertension in Lebanon.

Background: Pulmonary arterial hypertension (PAH) is a rare disease with an incidence rate of 2-6 cases per million per year. Our knowledge of the disease in the Middle East and North Africa (MENA) region is limited by the small number of clinical studies and the complete absence of genetic studies.

Methods: Our aim was to shed light on the clinical and genetic characteristics of PAH in Lebanon and the region by using exome sequencing on PAH patients referred to the American University of Beirut Medical Center (AUBMC).

Prediction of inspired oxygen fraction for targeted arterial oxygen tension following open heart surgery in non-smoking and smoking patients.

Simple and accurate expressions describing the PO-FO relationship in mechanically ventilated patients are lacking. The current study aims to validate a novel mathematical expression for accurate prediction of the fraction of inspired oxygen that will result in a targeted arterial oxygen tension in non-smoking and smoking patients receiving mechanical ventilation following open heart surgeries. One hundred PO-FO data pairs were obtained from 25 non-smoking patients mechanically ventilated following open heart surgeries.

Effect of heliox- and air-driven nebulized bronchodilator therapy on lung function in patients with asthma.

Background: This study compares the effect of heliox-driven to that of air-driven bronchodilator therapy on the pulmonary function test (PFT) in patients with different levels of asthma severity.

Methods: One-hundred thirty-two participants were included in the study. Participants underwent spirometry twice with bronchodilator testing on two consecutive days.

Ventilator auto-cycling from cardiogenic oscillations: case report and review of literature.

Background: Brain death is the total loss of all brain and brain stem functions, and its diagnosis is often confirmed by an apnoea test, which relies on disconnecting the patient from the ventilator. Auto-triggering or auto-cycling is defined as a ventilator being triggered in the absence of patient effort, intrinsic respiratory drive or inspiratory muscle activity. Ventilator auto-triggering could delay the diagnosis of brain death leading to unnecessary admission for the patient and false hopes of recovery for the family.

Weaning from mechanical ventilation.

Purpose Of Review: Liberation from mechanical ventilation is a defining moment for intubated patients, and thus a critical clinical decision. Extubating the patient too early exposes the patient to extubation failure and reintubation. Waiting too long increases the complications of prolonged intubation.

Antithrombotic prophylaxis in the middle East.

Several factors have been proposed to explain the persistence of a high incidence of venous thromboembolism worldwide with its associated morbidity and mortality. Underutilization of anticoagulants and failure of adherence to thromboprophylaxis guidelines are emerging global health concerns. We herein review this alarming observation with special emphasis on the Middle East region.

Transfusion-related Plasmodium ovale malaria complicated by acute respiratory distress syndrome (ARDS) in a non-endemic country.

46year old female presented with a one week history of high grade fever, chills, cough, and severe nausea. The patient had been admitted a month earlier with severe lower gastrointestinal bleeding from hemorrhoids necessitating transfusion of 7 units of packed red blood cells. Initial work-up was unremarkable.

Internalization and phagosome escape required for Francisella to induce human monocyte IL-1beta processing and release.

Macrophage responses to Francisella infection have been characterized previously by subdued proinflammatory responses; however, these studies have generally focused on macrophage cell lines or monocyte-derived macrophages. Therefore, we studied the ability of fresh human blood monocytes to engulf and respond to Francisella by using the live vaccine strain variant and Francisella novicida. Because Francisella organisms have been reported to escape from the phagolysosome into the cytosol, we hypothesized that this escape may trigger the activation of caspase-1.