A vision to strengthen resources and capacity of the Palestinian health research system: a qualitative assessment.

Background: The World Health Organization has proposed a global strategy to build a robust Health Research System Resources and Infrastructural Capacity (HRSRIC). Despite the growing research productivity, HRSRIC in Palestine has rarely been investigated.

Aims: To analyse perceptions of health research system performers to understand the status of HRSRIC, identify its gaps, and propose policy solutions to strengthen HRSRIC.

Mapping stakeholders of the Palestinian Health Research System: a qualitative study.

Background: There is a growing international and regional interest in Health Research Systems (HRSs) in light of a global strategy for HRS stakeholders' (HRSSHs) active involvement. HRSSHs in Palestine have rarely been investigated with regard to uncertainties.

Aims: This study aimed to analyse perceptions of HRSSHs in order to understand their roles and involvement, identify gaps, and offer policy solutions for stakeholders' engagement in the Palestinian HRS.

Rare case of diaphragmatic rupture following resuscitation in a pregnant woman first in literature.

Introduction: Complications following Cardiopulmonary resuscitation (CPR) are rare and usually follows a vigorous CPR or in special cases like pregnancy are due to lack of knowledge and clinical practice of how to preform CPR in pregnancy. One of this complication is diaphragmatic rupture with herniation of abdominal organs. Surgical intervention needs to be planned carefully in multidisciplinary team approach and requires fine surgical techniques for better outcome.

Mediators of gender effects on depression among cardiovascular disease patients in Palestine.

Background: Among patients suffering from coronary heart disease (CHD) and comorbid depression, women experience a higher burden compared to men. Little is known on the characteristics that differentiate men and women with both diseases and whether these factors mediate gender effects on depression. This study assessed whether women are more likely to suffer from depression and which characteristics mediate gender effects on depression among a cardiac population in Palestine, specifically addressing the role of post-traumatic stress disorder (PTSD).

Correction to: Case report and management approach in idiopathic pulmonary arteries aneurysm.

The original article [1] contained an error whereby the author, Ahmad Darwazah's name was spelt incorrectly.

Case report and management approach in idiopathic pulmonary arteries aneurysm.

Background: Idiopathic pulmonary artery aneurysm is a rare anomaly with only a handful reports in the literature. It is often asymptomatic, while the first presentation could be severe hemoptysis or death. Surgical intervention needs to be planned carefully with a multidisciplinary team approach to secure optimal outcome.

The Palestinian health research system: who orchestrates the system, how and based on what? A qualitative assessment.

Background: In 2011, the WHO Eastern Mediterranean Region committee launched a strategy for scaling up research in the region to address the countries' health needs through formulating and analysing the National Health Research System (HRS). Stewardship comprises three functions, namely governance, policy and priorities, and is a central pillar of this system to ensure a well-organised and functioning HRS. This study aims to examine the perceptions of the HRS performers to understand these functions and to generate insights for system strengthening.

Outcomes of ICDs and CRTs in patients with chronic kidney disease: a meta-analysis of 21,000 patients.

Purpose: The efficacy of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) in patients with chronic kidney disease (CKD) remains unclear. The aim of this meta-analysis is to explore the association between ICD/CRT and mortality in CKD patients.

Methods: An electronic search was conducted using MEDLINE.

Assessing policy-makers', academics' and experts' satisfaction with the performance of the Palestinian health research system: a qualitative study.

Background: There is a growing demand within international health agencies to ensure health research systems (HRSs) are strengthened and well-functioning to support healthcare systems (HCSs). Understanding HRS performance through system actors is an indispensable move in analysing this system. This study aims to examine policy-makers', academics' and experts' satisfaction with overall HRS performance, while also investigating their perceptions about political will and attention towards health research.

Understanding the concept and importance of the health research system in Palestine: a qualitative study.

Background: The importance of a health research system (HRS), namely an instrument for developing and enabling health systems, is increasing, particularly in developing countries. Assessing the perceptions of system performers is a necessary part of system analysis, which seeks to recognize a system's strengths and limitations aiming towards improvement. This study assesses the perceptions of policy-makers, academicians and experts regarding the HRS concept and its importance to generate insights for system strengthening.

Reduction in unnecessary ventricular pacing fails to affect hard clinical outcomes in patients with preserved left ventricular function: a meta-analysis.

Aims: Several pacing modalities across multiple manufacturers have been introduced to minimize unnecessary right ventricular pacing. We conducted a meta-analysis to assess whether ventricular pacing reduction modalities (VPRM) influence hard clinical outcomes in comparison to standard dual-chamber pacing (DDD).

Methods And Results: An electronic search was performed using Cochrane Central Register, PubMed, Embase, and Scopus.

Hemorrhoids screening and treatment prior to LVAD: is it a necessity?

Continuous-flow left ventricle assist devices (CF-LVADs) has become an essential modality in the management of stage D heart failure (HF) with significant improvement in survival and quality of life. Due to the durability of such devices and long term support complications such as bleeding and aortic insufficiency has emerged. Bleeding accounts for more than 20 % with the majority being from the gastrointestinal tract.

Saved Lives at Risk in the Middle East.

In the Middle East, heart failure prevalence seems to be high as the rest of the world. Few countries in the region recently have started implanting left ventricular assist devices (LVADs), basically as destination therapy. Terrorism and terrorist activities have been expanded worldwide especially in this part of the world.

Is lower base rate detrimental to transcatheter aortic valve implantation patients requiring pacemakers?

Sudden cardiac death related to polymorphic ventricular tachycardia/ventricular fibrillation has been well reported post atrioventricular junction ablation. The practice of faster pacing rate immediately after atrioventricular junction ablation is well recognized to decrease the risk of sudden cardiac death. We propose that this practice (faster pacing rate) be implemented in patients who need permanent pacemakers secondary to transcatheter aortic valve implantation (or even surgical aortic valve interventions).

Impact of Contact Force Technology on Atrial Fibrillation Ablation: A Meta-Analysis.

Background: Catheter-tissue contact is essential for effective lesion formation, thus there is growing usage of contact force (CF) technology in atrial fibrillation ablation. We conducted a meta-analysis to assess the impact of CF on clinical outcomes and procedural parameters in comparison to conventional catheter for atrial fibrillation ablation.

Methods And Results: An electronic search was performed using major databases.

Ventricular assist devices as rescue therapy in cardiogenic shock after subarachnoid hemorrhage.

We review the journey to myocardial and neurologic recovery of a 42-year-old mother with severe acute cardiogenic shock and multiorgan failure after extensive subarachnoid hemorrhage, who was salvaged successfully using a CentriMag short-term biventricular assist device.

How small is too small? A systematic review of center volume and outcome after cardiac transplantation.

Background: The aim of this study was to assess the relationship between the volume of cardiac transplantation procedures performed in a center and the outcome after cardiac transplantation.

Methods And Results: PubMed, Embase, and the Cochrane library were searched for articles on the volume-outcome relationship in cardiac transplantation. Ten studies were identified, and all adopted a different approach to data analysis and varied in adjustment for baseline characteristics.

Use of implantable cardioverter defibrillators in patients with left ventricular assist devices.

Patients with left ventricular assist devices (LVADs) are at high risk of sustained ventricular arrhythmias, but these may be remarkably well tolerated and the association with sudden death is unclear. Many patients who receive an LVAD already have an implantable cardioverter defibrillator (ICD). While it is standard practice to reactivate a previously implanted ICD in an LVAD recipient, this should include discussion of the revised risks and benefits of ICD therapy following LVAD implantation.

Local iodine pleurodesis versus thoracoscopic talc insufflation in recurrent malignant pleural effusion: a prospective randomized control trial.

Objective: To compare the efficacy, safety, and outcome of thoracoscopic talc poudrage (TTP) versus povidone-iodine pleurodesis (PIP) through a thoracostomy tube as a palliative treatment of pleural effusion due to metastatic breast carcinoma (MBC).

Methods: A total of 42 MBC patients were prospectively enrolled in a randomized controlled trial. Twenty-two patients received TTP (group A), whereas 20 patients (group B) underwent pleurodesis by instilling povidone-iodine through a thoracostomy tube, as a bedside procedure.

Unilateral extrapulmonary airway bypass in advanced emphysema.

Background: Gas trapping in emphysema results in resting and dynamic hyperinflation. We tested the hypothesis that a direct connection between the lung parenchyma and the atmosphere could increase expiratory flow and thereby potentially improve dyspnea through the relief of gas trapping.

Methods: Ex vivo we studied 7 emphysematous lungs and 3 fibrotic lungs (as controls) and measured expiratory flow before and after airway bypass insertion during a forced maneuver in an artificial thorax.

Bridging patients after salvage from bridge to decision directly to transplant by means of prolonged support with the CentriMag short-term centrifugal pump.

Objective: Optimum strategy for salvage in patients with acutely decompensated end-stage heart failure and severe multiorgan dysfunction is complex. We present our experience with prolonged CentriMag (Levitronix, Waltham, Mass) support for transitioning patients after successful salvage from bridge to decision directly to transplant.

Methods: Records of patients who underwent salvage with a CentriMag as bridge to decision and later to transplant were reviewed.

A reevaluation of the role of IgM Non-HLA antibodies in cardiac transplantation.

Background: Preexisting IgG antibodies to donor human leukocyte antigens (HLA) are a risk factor for rapid allograft rejection. However, non-HLA antibodies, of the IgM class, also called autoreactive antibodies, are not believed to affect graft survival. The aim of this study was to determine the incidence and clinical relevance of pretransplant lymphocytotoxic non-HLA IgM antibodies on long-term cardiac allograft survival.

Estrogen receptor beta: expression profile and possible anti-inflammatory role in disease.

Estrogen receptor (ER) beta agonists have been demonstrated to possess anti-inflammatory properties in inflammatory disease models. The objective of this study was to determine whether ERbeta agonists affect in vitro and in vivo preclinical models of asthma. mRNA expression assays were validated in human and rodent tissue panels.