Staging Cardiac Damage in Patients With Asymptomatic Aortic Valve Stenosis.

Background: The optimal timing of intervention in patients with asymptomatic severe aortic stenosis (AS) remains controversial.

Objectives: This multicenter study sought to test and validate the prognostic value of the staging of cardiac damage in patients with asymptomatic moderate to severe AS.

Methods: This study retrospectively analyzed the clinical, Doppler echocardiographic, and outcome data that were prospectively collected in 735 asymptomatic patients (71 ± 14 years of age; 60% men) with at least moderate AS (aortic valve area <1.

Consensus Opinions on Facial Beauty and Implications for Aesthetic Treatment in Middle Eastern Women.

Background: Middle Eastern women worldwide increasingly seek aesthetic treatment to enhance their beauty and improve self-esteem, but literature describing standards of beauty across the Middle East are scarce. Knowledge of facial anthropometry and Middle Eastern subregional beauty preferences and aesthetic weaknesses are key to develop an effective facial enhancement strategy that does not jeopardize ethnic identity or facial harmony.

Methods: Dermatologists and plastic surgeons from 8 Middle Eastern countries who had 7.

Pain during exacerbation of chronic obstructive pulmonary disease: A prospective cohort study.

Background And Objective: Pain, a symptom often present in patients with Chronic Obstructive Pulmonary Disease (COPD), alters quality of life. COPD exacerbation augments several mechanisms that may cause pain (dyspnea, hyperinflation and inflammation) and therefore we hypothesized that pain might be increased during exacerbation.

Methods: A prospective cohort study was conducted in patients admitted for acute exacerbations of COPD (AECOPD) in two emergency departments in France and Canada.

Defining ranges for certainty ratings of diagnostic accuracy: a GRADE concept paper.

Objective: The objective of the study was to clarify how the Grading of Recommendations Assessment, Development and Evaluation (GRADE) concept of certainty of evidence applies to certainty ratings of test accuracy.

Study Design And Setting: After initial brainstorming with GRADE Working Group members, we iteratively refined and clarified the approaches for defining ranges when assessing the certainty of evidence for test accuracy within a systematic review, health technology assessment, or guideline.

Results: Ranges can be defined both for single test accuracy and for comparative accuracy of multiple tests.

Decreasing complication rates for one-stage conversion band to laparoscopic sleeve gastrectomy: A retrospective cohort study.

Background: Laparoscopic adjustable gastric banding (LAGB) revision surgery is often necessary because of its high failure rate. The objective of this study was to demonstrate that better patient selection, when converting a failed LAGB to a laparoscopic sleeve gastrectomy (LSG) as a one-stage revision procedure, is safe, feasible and improves the complication rate.

Patients And Methods: A retrospective chart review was performed on patients who underwent a one-stage conversion of failed gastric banding to a LSG.

Blood donations mode: Assessment of the Lebanese model.

Voluntary non-remunerated donations remain the cornerstone for a safe and sustainable blood supply. According to the World Health Organization and other international scientific committees, all nations must switch their system of blood collection to voluntary non-remunerated donation. Several other types of blood donations still exist nowadays that will be discussed.

Tandem mass spectrometry analysis of urinary podocalyxin and podocin in the investigation of podocyturia in women with preeclampsia and Fabry disease patients.

Background: Podocytes are highly differentiated visceral cells, and several related specific proteins, such as podocalyxin and podocin are potential tools for the evaluation of podocyturia. However, precise quantitation of podocyturia-related proteins is complex and often unreliable.

Method: A reversed-phase ultra-performance liquid chromatography coupled to tandem mass spectrometry method was developed and validated to quantify podocalyxin and podocin levels in urine supernatant by using specific cleavable peptides and standards.

Susceptibility of consolidated procedural memory to interference is independent of its active task-based retrieval.

Reconsolidation theory posits that upon retrieval, consolidated memories are destabilized and need to be restabilized in order to persist. It has been suggested that experience with a competitive task immediately after memory retrieval may interrupt these restabilization processes leading to memory loss. Indeed, using a motor sequence learning paradigm, we have recently shown that, in humans, interference training immediately after active task-based retrieval of the consolidated motor sequence knowledge may negatively affect its performance levels.

Smell training improves olfactory function and alters brain structure.

Training and repeated exposure to odorants leads to enhanced olfactory sensitivity. So far, the efficacy of intensive olfactory training on olfactory function in a healthy population and its underlying neurobiological basis remain poorly known. This study investigated the effects of a 6-week intensive and well-controlled olfactory training on olfactory function and brain structure/neuroplasticity.

EMG in piriformis syndrome diagnosis: Reliability of peroneal H-reflex according to results obtained after surgery, Botox injection and medical treatment.

Diagnosing piriformis syndrome (PS) throughout the past decades was not that easy, however peroneal H-reflex was proved as reliable test for PS with the change in wave amplitude and delay in conduction as parameters for diagnosis. We interpreted these parameters according to treatment's results carried out for patients presenting clinical PS, aiming to define a threshold value for peroneal H-reflex delay to accurately diagnose. A retrospective mono-centric review of 27 patients, 9 females and 18 males, aged 22-65 years, benefited from peroneal H-reflex test and treated for clinical PS.

Ghrelin Enhances Food Odor Conditioning in Healthy Humans: An fMRI Study.

Vulnerability to obesity includes eating in response to food cues, which acquire incentive value through conditioning. The conditioning process is largely subserved by dopamine, theorized to encode the discrepancy between expected and actual rewards known as the reward prediction error (RPE). Ghrelin is a gut-derived homeostatic hormone that triggers hunger and eating.

Follicular carcinoma arising in a large ectopic lingual thyroid: a case report and review of literature.

Ectopic lingual thyroid has been described, however, follicular carcinoma arising within it is an extremely rare entity with only 40 cases reported in the literature. Lingual thyroid carcinoma is undistinguishable from benign enlargement of lingual thyroid, the later should also be differentiated from many oropharyngeal pathologies including but not limited to thyroglossal duct cyst, lipoma, dermoid cyst and salivary gland tumors. Ectopic lingual nature of thyroid tissue can be diagnosed with scintigraphy scan; however, malignant transformation confirms just after pathological examination.

Medical student education in transfusion medicine: Proposal from the "European and Mediterranean initiative in transfusion medicine".

A large body of observations indicate that there is an inconsistent knowledge of Transfusion Medicine among health care professionals as well as inconsistent knowledge in all aspects of the transfusion process, from blood donation to transfusion on the ward. It is obvious to consider that appropriate education in Transfusion Medicine should be achieved in the education of specialists who will prescribe transfusion on a regular basis (hematologists, critical care specialists, anaethesiologists and others.) However,we also believe that education in Transfusion Medicine should also be delivered to almost all other medical specialists who may prescribe blood components.

Impact of an invasive strategy in the elderly hospitalized with acute coronary syndrome with emphasis on the nonagenarians.

Background: Published data about nonagenarians with acute coronary syndrome (ACS) were mainly descriptive and limited by small sample sizes and unadjusted outcomes. We aim to describe the characteristics, management, and the impact of an invasive strategy on major adverse events in elderly patients hospitalized with ACS with focus on the nonagerians.

Methods And Results: We analyzed data collected as part of the AMI-OPTIMA study, a cluster-randomized study of knowledge translation intervention versus usual care on optimal discharge medications in patients admitted with ACS at 24 Canadian hospitals.

Quantity of opioids consumed following an emergency department visit for acute pain: a Canadian prospective cohort study.

Objectives: Prescription opioid diversion is a significant contributor to the opioid misuse epidemic. We examined the quantity of opioids consumed by emergency department (ED) discharged patients after treatment for an acute pain condition (musculoskeletal, fracture, renal colic, abdominal pain and other), and the percentage of unused opioids available for potential misuse.

Design: Prospective cohort study.

Noninvasive Administration of Inhaled Nitric Oxide and its Hemodynamic Effects in Patients With Acute Right Ventricular Dysfunction.

Objective: The authors aimed to assess the hemodynamic effects and demonstrate the feasibility of inhaled nitric oxide (iNO) in hemodynamically unstable patients with acute right ventricular (RV) dysfunction and to explore the safety profile of this approach.

Design: Retrospective cohort study.

Setting: Intensive care unit (ICU) of 2 tertiary care centers between January 2013 and 2017.

Periampullary Neuroendocrine Tumor as a Cause of Acute Pancreatitis.

BACKGROUND Duodenal and ampullary carcinoids are very rare tumors accounting respectively for 2% and 0.03% of all carcinoid tumors. Clinical findings vary according to the location of the tumor within the periampullary region; with epigastric pain being the most common presenting symptom in duodenal carcinoids and jaundice the most common clinical finding in ampullary carcinoids.

Domains and determinants of a person-centered index of aging well in Canada: a mixed-methods study.

Objectives: The objectives of this study were to explore the perspectives of older adults about the most important domains of aging well and to identify the social determinants of a person-centered index capturing these domains.

Methods: We conducted a mixed-methods study of 40 semi-structured interviews and epidemiological data from 670 older adults participating in the International Mobility in Aging Study (IMIAS) in Saint-Hyacinthe and Kingston. A composite index capturing the domains of aging well was constructed on the basis of findings from qualitative content analysis.

Quality of maternal behaviour during infancy predicts functional connectivity between default mode network and salience network 9 years later.

Infants' experiences are considered to determine to a large degree the strength and effectiveness of neural connections and fine tune the development of brain networks. As one of the most pervasive and potent relational experiences of infancy, parent-child relationships appear to be prime candidates to account for experience-driven differences in children's brain development. Yet, studies linking parenting and functional connectivity are surprisingly scarce, and restricted to the connectivity of limbic structures.

Olfactory and Trigeminal Systems Interact in the Periphery.

The olfactory and trigeminal systems are intimately connected as most odorants stimulate both sensory systems. They interact by mutually suppressing and enhancing each other. However, the location and the degree of their interaction remain unclear.

Can a decentralized blood supply system reach 100% voluntary nonremunerated donation?

Voluntary nonremunerated donation stands for the framework of a solid, safe, and sustainable blood supply; for this reason, the World Health Organization has set a goal toward achieving 100% voluntary nonremunerated blood donation in 2020. However, in Lebanon like in most developing countries, the majority of blood donations still come from family/replacement donors (around 75%) followed by voluntary donors for only 15%; compensated donors yet account for 10% of blood donations. Lebanon has a decentralized and fragmented blood supply system where private health care facilities predominate over the public system; thus, numerous challenges and roadblocks-that are discussed in this article-are likely to delay the fulfillment of the WHO resolution.

Numerical Reconstruction of Traumatic Brain Injury in Skiing and Snowboarding.

Purpose: Proper evaluation of ski helmet designs and safety standards should rely on head impact conditions involved in skiing and snowboarding head injuries. To study these impacts, main crash scenarios involving head injuries are numerically replicated.

Methods: Multibody models of skiers and snowboarders were developed to investigate five common crash scenarios involved in traumatic brain injury: forward and sideways skiing falls, snowboarding backward falls, collisions between users and collisions with obstacles.

Use of extracorporeal treatments in the management of poisonings.

Historically, the clinical application of extracorporeal treatments (ECTRs), such as hemodialysis or hemoperfusion, was first intended for poisoned patients. With time, ECTRs were used almost indiscriminately to facilitate the elimination of many poisons, albeit with uncertain clinical benefit. To determine the precise role of ECTRs in poisoning situations, multiple variables need to be considered including a careful risk assessment, the poison's characteristics including toxicokinetics, alternative treatments, the patient's clinical status, and intricacies of available ECTRs, all of which are reviewed in this article.