DXA evaluation of bone fragility 2 years after bariatric surgery in patients with obesity.

Purpose: The primary objective was to evaluate bone fragility on dual X-ray absorptiometry (DXA) in patients with obesity before and 2 years after bariatric surgery. The secondary objective was to identify risk factors for the development of a bone mineral density ≤ -2 SD at 2 years.

Methods: This descriptive study included patients with obesity who underwent DXA before and 2 years (±6 months) after bariatric surgery.

Refractory Autonomic Instability in Mild Traumatic Brain Injury: A Case Report.

Although the specific relationship between concussion and the autonomic nervous system (ANS) has not been fully elucidated, it is generally understood that the pathologic response after a traumatic brain injury (TBI) is linked with systolic cardiac dysfunction. In this case, we present a patient with multiple concussion injuries over a five-year period who exhibited severe cardiac and autonomic dysfunction, in addition to prolonged impairments in vestibular function, oculomotor function, cognitive function, and headaches. The patient is a 28-year-old male with a past medical history of multiple concussions, with the first concussion occurring due to a skiing accident in January 2015.

Acceptance and attitude of Lebanese lawyers and medical students toward surrogate pregnancy: a cross-sectional study.

Background: Little is known about the acceptance of specific populations of decision makers in Lebanon regarding surrogacy. This study aimed to explore the acceptance and attitude of Lebanese Lawyers and Medical Students regarding surrogacy.

Methods: In total 248 medical students and 204 lawyers completed a questionnaire to assess socio-demographic data, attitude toward surrogacy, and three different clinical scenarios to assess patterns of thinking.

An Update on Acute Appendicitis in Lebanon: Insights From a Single-Center Retrospective Study.

Background Acute appendicitis is the most common surgical emergency worldwide with scarce reports about its prevalence in the Middle East. To date, no epidemiological article has described the incidence of appendicitis in Lebanon. Our primary objective was to estimate the rate of appendicitis in a single center in Lebanon.

Zero echo time MRI in shoulder MRI protocols for the diagnosis of rotator cuff calcific tendinopathy improves identification of calcific deposits compared to conventional MR sequences but remains sub-optimal compared to radiographs.

Objective: To compare the diagnostic performance of standard MRI and standard MRI + ZTE images for the detection of rotator cuff calcific tendinopathy (RCCT) and to describe the artifacts encountered with ZTE images, using computed radiography (CR) as a reference.

Methods: In a retrospective study, patients with suspicion of rotator cuff tendinopathy who underwent standard MRI + ZTE images after radiography were enrolled between June 2021 and June 2022. Images were independently analyzed for calcific deposit presence and ZTE images artifacts, by two radiologists.

CT evaluation of bone fragility 2 years after bariatric surgery: an observational study.

Introduction: The objectives were to evaluate bone fragility on computed tomography (CT) in patients with obesity before and 2 years after bariatric surgery and to identify risk factors for a decrease in the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1).

Materials And Methods: Patients with obesity who underwent bariatric surgery and CT before and 2 years (± 6 months) after bariatric surgery were included. SBAC-L1 was measured on CT with a fracture threshold at 145 HU.

Prevalence of Osteoporosis Assessed by DXA and/or CT in Severe Obese Patients.

The primary objective was to evaluate bone fragility prevalence on dual X-ray absorptiometry (DXA) and computed tomography (CT) in patients with severe obesity. The secondary objective was to evaluate the risk factors for bone fragility. This monocentric study was conducted in patients with grade 2 and 3 obesity.

Gastrointestinal cancer characteristics in Lebanon.

Background And Study Aims: Gastrointestinal (GI) cancer is one of the top five common cancers in Lebanon. To implement a strategy for screening and early diagnosis through the initiation of prevention programs, a detailed study of GI cancers in Lebanon was conducted by focusing on the frequency and characteristics of each type.

Patients And Methods: This retrospective study was conducted in Lebanon between 2001 and 2015 and included patients diagnosed with different GI cancer types.

Relationship between spinal structural damage on radiography and bone fragility on CT in ankylosing spondylitis patients.

To evaluate whether the risk of bone fragility on computed tomography (CT) (scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1)) is associated with the severity of spine structural involvement (mSASSS) in patients with ankylosing spondylitis (AS). This retrospective study included AS patients, followed from 2009 to 2017, who fulfilled the New York criteria and who underwent thoraco-abdomino-pelvic CT and radiography (spine, pelvis). The structural involvement was retained for mSASSS ≥ 2.

A rare case of proximal gastric outlet obstruction misdiagnosed as pancreatic invasive tumor, case report.

Introduction: This report is a case of proximal gastric outlet obstruction, misdiagnosed after esophagogastroduodenoscopy as invasive pancreatic malignancy. We report this case because of its rarity and to encourage physicians to take this etiology into consideration as part of differential diagnosis.

Presentation Of Case: We present a case of 88 year-old lady presenting for 3 days history of post-prandial coffee ground vomiting associated with obstipation, misdiagnosed as pancreatic malignancy with duodenal invasion after outpatient gastroscopy.

Withholding and withdrawal of life-sustaining treatments in intensive care units in Lebanon: a cross-sectional survey of intensivists and interviews of professional societies, legal and religious leaders.

Background: Little is known about the attitudes and practices of intensivists working in Lebanon regarding withholding and withdrawing life-sustaining treatments (LSTs). The objectives of the study were to assess the points of view and practices of intensivists in Lebanon along with the opinions of medical, legal and religious leaders regarding withholding withdrawal of life-sustaining treatments in Lebanese intensive care units (ICU).

Methods: A web-based survey was conducted among intensivists working in Lebanese adult ICUs.

Consequences of spinal ankylosis on bone trabecular fragility assessed on CT scans in patients with ankylosing spondylitis. A retrospective study.

Introduction: Ankylosing spondylitis (AS) patients seems to be at risk of osteoporosis but bone screening is not often performed. The objective was to evaluate the effect of vertebral ankylosis on scanographic bone attenuation coefficient (SBAC) on lumbar vertebrae in AS patients.

Methods: This study included AS patients fulfilling New York criteria who underwent both thoraco-abdomino-pelvic computed tomography and X-rays during routine follow-up.

Small bowel obstruction due to splenosis 30 years after splenectomy.

Splenosis is the autotransplantation of splenic tissue into abnormal locations due to trauma or iatrogenically. Usually, this causes no symptoms, but in rare cases the mass effect of the transplanted nodules can cause small bowel obstruction. Resection of the culprit splenic tissue is recommended, but not more extensive dissection of non-involved nodules.

Normative Data for the Montreal Cognitive Assessment in a Lebanese Older Adult Population.

Introduction: The Montreal Cognitive Assessment (MoCA), a neuropsychological tool for cognitive decline screening is widely used. In the absence of normative data in Lebanon, this study offers normative data for the MoCA in Lebanese community-dwelling older people and compare scores to those of other countries.

Methods: 164 literate subjects aged 60 and above were recruited to complete the MoCA.

Unusual Pattern of Invasive Lobular Carcinoma Metastasis: A Case Report.

BACKGROUND Metastasis of breast cancer to the gastrointestinal (GI) tract is not common, however, invasive lobular carcinoma is more likely to metastasize to the GI tract than ductal carcinoma. The simultaneous metastasis of invasive lobular carcinoma to the GI tract and ovaries is an extremely uncommon presentation, which may mimic another rare entity that is peritoneal carcinomatosis secondary to breast cancer. Diagnosis of this entity is difficult as it can masquerade as a primary disease process instead of a secondary one.

A Rare Presentation of Gall Bladder Volvulus: A Case Report.

BACKGROUND Gall bladder volvulus is a rare clinical entity, with only around 500 cases reported in the literature. It is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic pedicle, although cases of torsion of the gallbladder fundus itself have been reported. CASE REPORT A 78-year-old woman presented for severe right upper-quadrant abdominal pain that began acutely 3 days prior.

Screening for dementia in Arabic: normative data from an elderly Lebanese sample.

Objective: Prevention and treatment of dementia is a global concern that requires involvement of international samples. The purpose of this study is to develop culturally sensitive norms based on normal older Lebanese adults using multiple cognitive screening measures translated into Arabic for regional use.

Methods: Participants were 164 community dwelling older Lebanese adults without cognitive complaints.

Depression and religiosity and their correlates in Lebanese breast cancer patients.

Background: Breast cancer bears considerable morbidity and mortality and is well known to increase the risk of major depression, whereas religiosity has been reported to be protective. We searched for an association between depression and religiosity in breast cancer patients. We also sought to find an association between depression and various sociodemographic and disease variables.

Sociolinguistic reflection on neuropsychological assessment: an insight into selected culturally adapted battery of Lebanese Arabic cognitive testing.

Neuropsychological tests (NPTs) are highly dependent on education, culture differences as well as age and sex. It is therefore essential to take these factors into consideration when translating NPTs to be used in screening for cognitive impairment. Translations into Arabic must respect the principles of linguistic relativity and cultural specificity of the population under study.

Attitudes Toward Placebo Use in Lebanon.

Purpose: Placebo use, both in clinical trials and patient care, is a problematic ethical issue surrounded by opposing arguments from those who advocate its use versus those who do not. This problematic aspect of placebo is more challenging in Lebanon where religious ideologies dominate people's beliefs, and where laws that guide medical care are vague. This paper aims to highlight the cultural ideologies that dominate medical care and the perspectives of people associated with the field.

Healthcare quality in a fragmented society: the Lebanese model.

Quality of health care is largely dependent on a holistic approach to human person (HP). In Lebanon, the medical field, including neurology, seems to be ignorant to the integrity of the human person. The objective of this study is to provide an insight to the importance of reintegrating the HP in the medical field attempting to offer a basis for scientists interested in carrying out similar research in face of the complete lack of studies in Lebanon.

Depressive symptoms among surrogate decision makers in Lebanese ICUs.

Surrogate decision making is advocated to protect the vulnerable patient. Family members of patients in intensive care units (ICUs) are prone to develop depressive symptoms which may undermine their decisional capacity. Lebanon is a multicultural country where paternalism still dominates the physician-patient relationship and ethics are far from being the subject of research and studies.

Fatal systemic reaction after multiple doses of intravesical bacillus Calmette-Guérin for polyposis.

Objective: To report a case of fatal systemic reaction after intravesical administrations of bacillus Calmette-Guérin (BCG) for polyposis.

Case Summary: A 72-year-old white man was treated by monthly injections of intravesical BCG immunotherapy for polyposis of the urinary bladder. He received a total of eight injections; four hours after the seventh injection, he presented with pyrexia associated with chills, sweating, headache, and vomiting, which quickly resolved.

Plasma concentration of atrial natriuretic peptide after acute reduction in functioning renal mass in the rat.

Both acute unilateral nephrectomy (UNX) and unilateral ureteral obstruction (UUO) result in a prompt rise in cation excretion from the contralateral kidney. An important role for atrial natriuretic peptide (ANP) has been recently proposed in the acute functional adaptation to UNX. The possible involvement of endogenous ANP in the response to UUO was investigated in anesthetized euvolemic Sprague-Dawley rats.

Control of the renal microcirculation: cellular and integrative perspectives.

Recent studies targeting ionic signalling events have revealed that considerable segmental heterogeneity exists between pre- and post-glomerular vascular smooth muscle cells, and that even preglomerular vascular smooth muscle cells are not a homogeneous population. Preglomerular branch points enriched with calcium channels may be critical for initiating contractile responses, with subsequent propagation along the vascular wall, and may also facilitate nephron-nephron coupling events. These processes ultimately promote coordinated network behaviour and can underlie development of synergistic vasoactive responses, such as those necessary to provide efficient autoregulation of blood flow and glomerular filtration rate.