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Journal articles on the topic 'American University of Beirut. Medical Center'

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Published: 4 June 2021
Last updated: 4 February 2022

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1

Haddad, Maurice C., Nabil J. Khoury, and Mukbil H. Hourani. "Radiology of terror injuries: the American University of Beirut Medical Center experience." Clinical Imaging 32, no. 2 (March 2008): 83–87. http://dx.doi.org/10.1016/j.clinimag.2007.09.007.

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2

Nasr, Rami, Ziad Tayara, Ramy Abou Ghayda, Ibrahim Alsheikh Deeb, Diamond Ghieh, Bassam El-Achkar, Charbel Saade, and Fadi El-Merhi. "The acute scrotum: Frequency and range of etiologies in a Middle Eastern setting." Urologia Journal 87, no. 1 (July 14, 2019): 15–18. http://dx.doi.org/10.1177/0391560319858491.

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Aim: To investigate the frequency of different etiologies of acute scrotal pain in males presenting to the emergency department at American University of Beirut Medical Center in Beirut, Lebanon. Materials and Methods: In all, 94 patients between the ages 18 and 40 years presenting to the emergency room at American University of Beirut Medical Center with acute scrotum were recruited. The scrotum was inspected with palpation, and Doppler Ultrasound of the testicle was performed by a radiology resident to confirm the diagnosis. The study results were then collected after the official reports were signed by a board-certified radiology attending with expertise in ultrasound. Results: Of the 94 patients presenting with acute scrotal pain, 23.4% (95% confidence interval (0.70–0.87)) had no ultrasound findings and were considered normal. On the other hand, 54.3% (95% confidence interval (0.45–0.66)) were diagnosed with varicocele, 9.6% (95% confidence interval (0.04–0.16)) were diagnosed with epididymo-orchitis, and 9.6% (95% confidence interval (0.04–0.16)) had a history of trauma to the testicle. Patients presenting with acute scrotum had a pain duration of 13.2 ± 4.5 h, with 10.6% (95% confidence interval (0.04–0.17)) having associated urinary symptoms, 18.1% (95% confidence interval (0.09–0.25)) have had sexual activity within 48 h of presentation, and 10.6% (95% confidence interval (0.04–0.17)) were pre-diagnosed with varicocele. Conclusion: Varicocele is the most common cause of acute scrotal pain in patients presenting to American University of Beirut Medical Center in Beirut. This should direct varicocele to the top of our differential when a patient with acute scrotum presents to the emergency department. Nevertheless, ruling out torsion remains the first step in the workup.
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3

Fuleihan, Faird J. D. "Summary of Quality Assurance Activities at the American University of Beirut Medical Center." QRB - Quality Review Bulletin 12, no. 4 (April 1986): 161–62. http://dx.doi.org/10.1016/s0097-5990(86)12121-x.

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4

Araj, G. F., N. K. Daher, and Z. A. Tabbarah. "Antifungal susceptibility of candida isolates at the American University of Beirut Medical Center." International Journal of Antimicrobial Agents 10, no. 4 (November 1998): 291–96. http://dx.doi.org/10.1016/s0924-8579(98)00048-x.

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5

Kanj, Souha S., Oussayma El-Dbouni, Zeina A. Kanafani, and George F. Araj. "Antimicrobial susceptibility of respiratory pathogens at the American University of Beirut Medical Center." International Journal of Infectious Diseases 11, no. 6 (November 2007): 554–56. http://dx.doi.org/10.1016/j.ijid.2007.01.012.

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6

Fadel, Roula, Ghenwa K. Dakdouki, Zeina A. Kanafani, George F. Araj, and Souha S. Kanj. "Clinical and Microbiological Profile of Urinary Tract Infection at a Tertiary-Care Center in Lebanon." Infection Control & Hospital Epidemiology 25, no. 1 (January 2004): 82–85. http://dx.doi.org/10.1086/502298.

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AbstractWe compared community-acquired urinary tract infection (UTI) with hospital-acquired UTI at the American University of Beirut Medical Center. Escherichia coli was the most frequently isolated organism. Hospital-acquired E. coli isolates were often rnultidrug resistant. These results can be used to improve empiric treatment of UTI.
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7

Aoun, Elie, Ali Shamseddine, Aref Chehal, Maya Obeid, and Ali Taher. "Transfusion-associated GVHD: 10 years’ experience at the American University of Beirut-Medical Center." Transfusion 43, no. 12 (December 2003): 1672–76. http://dx.doi.org/10.1046/j.0041-1132.2003.00578.x.

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8

El-Saghir, N. S., M. Seoud, M. Charafeddine, J. Abbas, Z. Salem, F. Geara, K. Bikhazi, M. Khalifeh, M. Sidani, and A. Shamseddine. "Clinical characteristics and long-term survival of advanced breast cancer at the American University of Beirut Medical Center, Beirut, Lebanon." Journal of Clinical Oncology 22, no. 14_suppl (July 15, 2004): 852. http://dx.doi.org/10.1200/jco.2004.22.14_suppl.852.

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9

El-Saghir, N. S., M. Seoud, M. Charafeddine, J. Abbas, Z. Salem, F. Geara, K. Bikhazi, M. Khalifeh, M. Sidani, and A. Shamseddine. "Clinical characteristics and long-term survival of advanced breast cancer at the American University of Beirut Medical Center, Beirut, Lebanon." Journal of Clinical Oncology 22, no. 14_suppl (July 15, 2004): 852. http://dx.doi.org/10.1200/jco.2004.22.90140.852.

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10

Geara, Fady B., Elie Nasr, Susan L. Tucker, Emile Brihi, George Zaytoun, Usama Hadi, Ziad Salem, Naji El Saghir, Philip Issa, and Ali Shamseddine. "Nasopharyngeal cancer in the Middle East: Experience of the American University of Beirut Medical Center." International Journal of Radiation Oncology*Biology*Physics 61, no. 5 (April 2005): 1408–15. http://dx.doi.org/10.1016/j.ijrobp.2004.08.049.

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11

Shamseddine, Ali, Teddy Saliba, Elie Aoun, Aref Chahal, Nagi El-Saghir, Ziad Salem, Ali Bazarbachi, Mazen Khalil, and Ali Taher. "Thrombotic thrombocytopenic purpura: 24 years of experience at the American University of Beirut Medical Center." Journal of Clinical Apheresis 19, no. 3 (2004): 119–24. http://dx.doi.org/10.1002/jca.20004.

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12

Hallal, Ali, Rebecca Andraos, George Abi Saad, Talar Boyajian, and Jamal Hoballah. "Mass casualty management during a pandemic surge: The American University of Beirut Medical Center experience." Seminars in Vascular Surgery 34, no. 2 (June 2021): 51–59. http://dx.doi.org/10.1053/j.semvascsurg.2021.04.005.

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13

Shamseddine, A., M. Seoud, J. Abbas, M. Charafeddine, Z. Salem, F. Geara, K. Bikhazi, M. Khalifeh, M. Sidani, and N. El- Saghir. "Clinical characteristics and long-term survival of early breast cancer cases in the American University of Beirut Medical Center, Beirut, Lebanon." Journal of Clinical Oncology 22, no. 14_suppl (July 15, 2004): 833. http://dx.doi.org/10.1200/jco.2004.22.14_suppl.833.

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14

Shamseddine, A., M. Seoud, J. Abbas, M. Charafeddine, Z. Salem, F. Geara, K. Bikhazi, M. Khalifeh, M. Sidani, and N. El- Saghir. "Clinical characteristics and long-term survival of early breast cancer cases in the American University of Beirut Medical Center, Beirut, Lebanon." Journal of Clinical Oncology 22, no. 14_suppl (July 15, 2004): 833. http://dx.doi.org/10.1200/jco.2004.22.90140.833.

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15

Faek, Jamali, Shamseddine Ali, Seoud Muhieddine, and Khalifeh Mohammad. "The Management of Peritoneal Surface Malignancies at the American University of Beirut Medical Center: Initial Experience." Annals of Oncology 25 (June 2014): ii96. http://dx.doi.org/10.1093/annonc/mdu165.256.

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16

Zaytoun, George M., Allan H. Shikhani, and Salah D. Salman. "Head and Neck War Injuries: 10-Year Experience at the American University of Beirut Medical Center." Laryngoscope 96, no. 8 (August 1986): 899–903. http://dx.doi.org/10.1002/lary.1986.96.8.899.

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17

Bove, Riley, Tanuja Chitnis, Bruce AC Cree, Mar Tintoré, Yvonne Naegelin, Bernard MJ Uitdehaag, Ludwig Kappos, et al. "SUMMIT (Serially Unified Multicenter Multiple Sclerosis Investigation): creating a repository of deeply phenotyped contemporary multiple sclerosis cohorts." Multiple Sclerosis Journal 24, no. 11 (August 29, 2017): 1485–98. http://dx.doi.org/10.1177/1352458517726657.

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Background: There is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis. Objective: Build a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient’s course. Methods: Serially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women’s Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d’Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)). Results and conclusion: We provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.
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18

Ismail, Ali, Abdul-Karim El-Hage-Sleiman, Marianne Majdalani, Rima Hanna-Wakim, Souha Kanj, and Rana Sharara-Chami. "Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center." Journal of Infection in Developing Countries 10, no. 06 (June 30, 2016): 554–62. http://dx.doi.org/10.3855/jidc.7303.

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Introduction: Device-associated healthcare-associated infections (DA-HAIs) are the principal threat to patient safety in intensive care units (ICUs). The primary objective of this study was to identify the most common DA-HAIs in the pediatric intensive care unit (PICU) at the American University of Beirut Medical Center (AUBMC). Length of stay (LOS) and mortality, antimicrobial resistance patterns, and suitability of empiric antibiotic choices for DA-HAIs according to the local resistance patterns were also studied. Methodology: This was a retrospective study that included all patients admitted to the PICU at AUBMC between January 2007 and December 2011. All patients admitted to the PICU having a placed central line, an endotracheal tube, and/or a Foley catheter were included. Data was extracted from the patients’ medical records through chart review. A total of 22 patients were identified with 25 central line-associated bloodstream infections (CLABSI), 25 ventilator-associated pneumonia (VAP), and 9 catheter-associated urinary tract infections (CAUTIs). The causing organisms, their resistance patterns, and the appropriateness of empiric antimicrobial therapy were reported. Results: Gram-negative pathogens were found in 53% of the DA-HAIs, Gram-positive ones in 27%, and fungal organisms in 20%. A total of 80% of K. pneumonia isolates were extended-spectrum beta-lactamases (ESBL) producers, and 30% of Pseudomonas isolates were multidrug resistant. No methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) were isolated. Based on culture results, the choice of empiric antimicrobial therapy was appropriate in 64% of the DA-HAIs. Conclusions: After the care bundle approach is adopted in our PICU, DA-HAIs are expected to decrease further.
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19

Ibrahim, Nuhad K., and Fadi W. Abdul-Karim. "Colorectal adenocarcinoma in young lebanese adults: The american university of Beirut-medical center experience with 32 patients." Cancer 58, no. 3 (August 1, 1986): 816–20. http://dx.doi.org/10.1002/1097-0142(19860801)58:3<816::aid-cncr2820580335>3.0.co;2-t.

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20

Nassar, Nabil T., and Helen C. Tourna. "Brief Report Susceptibility of Filipino Nurses to the Varicella-Zoster Virus." Infection Control 7, no. 2 (February 1986): 71–72. http://dx.doi.org/10.1017/s019594170006392x.

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AbstractFollowing an outbreak of varicella, 18% of a group of 174 young female Filipino nurses ranging in age from 20 to 25 years and working at the American University of Beirut Medical Center (AUMC) were found susceptible to the varicella-zoster virus; as compared to 3% of a matched group of 133 of their Lebanese colleagues. The level of antibody was determined by the Enzyme Linked Immunosorbent Assay (ELISA). Those susceptible were assigned duties in low-risk areas to varicella-zoster in the hospital.
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21

Adib, Salim M., Amjad A. Mufarrij, Ali I. Shamseddine, Spiridon G. Kahwaji, Philippe Issa, and Naji S. El-Saghir. "Cancer in Lebanon: An Epidemiological Review of the American University of Beirut Medical Center Tumor Registry (1983–1994)." Annals of Epidemiology 8, no. 1 (January 1998): 46–51. http://dx.doi.org/10.1016/s1047-2797(97)00109-9.

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22

Abdallah, Mouhammad, Wassef Karrowni, Wael Shamseddeen, Salam Itani, Loulou Kobeissi, Ziyad Ghazzal, Samir Alam, and Habib A. Dakik. "Acute Coronary Syndromes: Clinical Characteristics, Management, and Outcomes at the American University of Beirut Medical Center, 2002-2005." Clinical Cardiology 33, no. 1 (December 14, 2009): E6—E13. http://dx.doi.org/10.1002/clc.20636.

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23

Kanj, Nadim, Munir Khani, Hilda Harb, Juliette Jibrail, and Assad M. Taha. "LETHALITY OF PARATHION INTOXICATION AND DRUG OVERDOSE IN SUICIDAL ADMISSIONS TO THE AMERICAN UNIVERSITY OF BEIRUT MEDICAL CENTER." Critical Care Medicine 27, Supplement (January 1999): 67A. http://dx.doi.org/10.1097/00003246-199901001-00140.

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24

Ghorayeb, Bechara Y., and Alain H. Shikhani. "The use of dexamethasone in pediatric bronchoscopy." Journal of Laryngology & Otology 99, no. 11 (November 1985): 1127–29. http://dx.doi.org/10.1017/s0022215100098297.

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AbstractThe beneficial effect of intravenous corticosteroids in preventing traumatic laryngeal edema is controversial. Between 1968 and 1971, a controlled clinical study was conducted, at the American University of Beirut Medical Center, of 70 children who underwent bronchoscopy for removal of foreign bodies from the tracheobronchial tree.The patients were divided into two randomized groups; one group was given intravenous dexamethasone while the second was kept as a control. The length of hospitalization and the development of complications attributable to tracheobronchial edema were compared. Intravenous corticosteroids do not seem to reduce the incidence of post-bronchoscopy laryngeal edema.
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25

Harb, Dana. "The Off-Label Use of Rituximab for the Management of Inflammatory Disorders: American University of Beirut Medical Center Experience." Archives of Rheumatology 29, no. 3 (September 29, 2014): 194–202. http://dx.doi.org/10.5606/archrheumatol.2014.3855.

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26

Riachy, Ruba, Nisrine Ghazal, Mohamad B. Haidar, Ahmad Elamine, and Mona P. Nasrallah. "Early Sialadenitis After Radioactive Iodine Therapy for Differentiated Thyroid Cancer: Prevalence and Predictors." International Journal of Endocrinology 2020 (August 4, 2020): 1–7. http://dx.doi.org/10.1155/2020/8649794.

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Introduction. Sialadenitis is a frequent occurrence after radioactive iodine therapy (RAI). However, reports on its predictors and risk factors in the Eastern Mediterranean Region (EMRO) are scarce. Aim. This study aimed to identify risk factors for early sialadenitis in patients receiving RAI for differentiated thyroid cancer (DTC) at the American University of Beirut Medical Center. It also aimed to determine the prevalence and characteristics of such patients receiving RAI at our institution. Methods. This was a retrospective study conducted at the American University of Beirut Medical Center. Medical charts were reviewed for all patients 18–79 years of age admitted to receive RAI for DTC between 01/01/2012 and 31/12/2015. Sialadenitis was deemed present if there were any records of neck swelling/pain, dry mouth, or difficulty swallowing within 48 hours of RAI administration. Characteristics between patients with sialadenitis and those without were compared to determine predictors. Results. There were 174 patients admitted to receive RAI, predominantly females (71.3%), with papillary thyroid cancer (93.1%). The majority had lymph node involvement (64.5%). Pretreatment thyroid stimulating hormone (TSH) was greater than 75 mIU/ml in most patients (72.6%). The prevalence of sialadenitis was 20.1% (95% CI (15–27)). Being non-Lebanese and having a positive whole-body scan were associated with sialadenitis and persisted after adjustments (OR = 2.34 and 3.99). Non-Lebanese patients had higher rates of lymph nodes involvement (p value 0.005) and were kept off levothyroxine for longer periods (p value 0.02). Conclusion. The prevalence of sialadenitis at our institution was similar to other reported studies from the world. However, risk factors allude to more iodine exposure in the neck with positive whole-body scan uptake, lymph node involvement, and prolonged period of hypothyroidism.
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27

Atiyeh, Bishara S., Amir Abdelnour, Fadi F. Haddad, and Hussein Ahmad. "Lingual thyroid: tongue-splitting incision for transoral excision." Journal of Laryngology & Otology 109, no. 6 (June 1995): 520–24. http://dx.doi.org/10.1017/s0022215100130609.

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AbstractTwo patients presenting to the Central Military Hospital of Beirut with symptomatic lingual thyroid are reported. I131 thyroid scanning revealed the lingual thyroid to be the only functional thyroid tissue present in each patient. Subsequent CT scanning demonstrated the large size of these ectopic thyroids causing significant mechanical obstruction. These were excised transorally using a posterior midline tonguesplitting incision and reimplanted in the rectus abdominis muscles.Details of this modified tongue-splitting surgical approach are described. A brief review of the literature concerning lingual thyroid and its surgical treatment is also presented as well as three patients operated on for lingual thyroid at the American University of Beirut Medical Centre between 1975 and 1994 using an external neck incision.
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28

El Warea, Mohamad, Roula Sasso, Rana Bachir, and Mazen El Sayed. "Riots in Beirut: Description of the Impact of a New Type of Mass Casualty Event on the Emergency System in Lebanon." Disaster Medicine and Public Health Preparedness 13, no. 5-6 (June 6, 2019): 849–52. http://dx.doi.org/10.1017/dmp.2018.162.

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ABSTRACTIntroduction:In the summer of 2015, Beirut experienced a garbage crisis that led to rioting. Riot control measures resulted in multiple casualties. This study examines injury patterns of riot victims presenting to the emergency department of a tertiary care center in a developing country.Methods:A retrospective study was conducted in the emergency department of the American University of Beirut Medical Center between August 22 and August 30, 2015. Patients seen in the emergency department with riot injuries were included. Patient characteristics, injuries, and resources utilized in the emergency department were analyzed.Results:Ninety-five patients were identified. Most patients presented to the emergency department within a short time period. The mean age of the patients was 28.0 ± 8.7 years. Most (90.5%) of the patients were males and 92.6% were protestors. Emergency medical services were utilized by 41.0% of patients. Laceration was the most common presenting complaint (28.5%), and blunt trauma was the most common type of injury (50.5%). The head/face/neck was the most common injured body region (55.8%). Most patients did not require blood tests or procedures (91.6% and 61.0%, respectively), and 91.2% of patients were treated in the emergency department and discharged. One patient required intensive care unit admission and another was dead on arrival.Conclusions:Most patients had mild injuries on presentation. The emergency department experienced a high influx of patients. Complications and deaths can occur from seemingly nonlethal weapons used during riots and warrant effective prehospital and hospital disaster planning.
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El Zein, Saeed, Jinane Khraibani, Nada Zahreddine, Rami Mahfouz, Nada Ghosn, and Souha S. Kanj. "Atypical presentation of Middle East respiratory syndrome coronavirus in a Lebanese patient returning from Saudi Arabia." Journal of Infection in Developing Countries 12, no. 09 (September 30, 2018): 808–11. http://dx.doi.org/10.3855/jidc.9979.

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Around 2090 confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) from 27 countries have been reported to the World Health Organization (WHO) between September 2012 and October 2017, the majority of whom occurring in countries in the Arabian Peninsula, mainly in Saudi Arabia. MERS- CoV can have atypical and misleading presentations resulting in delays in diagnosis and is associated with a high mortality rate especially in elderly patients with multiple comorbidities. Herein, we present the first case of confirmed MERS-CoV infection diagnosed at the American University of Beirut Medical Center (AUBMC) - Lebanon in June 2017 presenting without any respiratory symptoms. This is the second confirmed case of MERS-CoV infection in Lebanon since 2014. The first case presented with a febrile respiratory infection with persistent symptoms despite antibiotic treatment.
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30

Issa, Perla. "INTERVIEW WITH DR. GHASSAN ABU SITTA." Journal of Palestine Studies 47, no. 4 (2018): 46–56. http://dx.doi.org/10.1525/jps.2018.47.4.46.

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In a wide-ranging and timely interview, the head of the Division of Plastic and Reconstructive Surgery at the American University of Beirut Medical Center, Ghassan S. Abu Sitta, discusses his most recent trip to Gaza to help treat wounded protesters in what has become a war-like zone. Abu Sitta addresses the current state of Gaza's healthcare infrastructure, the types of injuries that he operated on, and the implications of the Great March of Return for Palestine's political future. When Abu Sitta arrived on 11 May 2018, he quickly began preparation for what he expected (and what indeed turned out) to be the bloodiest week of the Great March. He speaks candidly about traumatizing scenes, with doctors and surgeons desperately attempting to save as many lives as possible without the benefit of proper medical equipment; and he explains how the injuries he saw are part of the Israeli army's deliberate effort to maim and incapacitate as many Palestinians as possible.
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Chidiac, Amanda, Radwan Massoud, Mohamad Haidar, Elie Fares, Ali Bazarbachi, and Jean El Cheikh. "Post Transplant Brentuximab Maintenance Appears More Effective Than Post Transplant Salvage Brentuximab for Relapsed/Refractory Hogkin's Lymphoma." Blood 128, no. 22 (December 2, 2016): 5357. http://dx.doi.org/10.1182/blood.v128.22.5357.5357.

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Abstract POST TRANSPLANT BRENTUXIMAB MAINTENANCE APPEARS MORE EFFECTIVE THAN POST TRANSPLANT SALVAGE BRENTUXIMAB FOR RELAPSED /REFRACTORY HODGKIN LYMPHOMA Amanda Chidiac1, Radwan Massoud 1, Mohamad Haidar1, Elie Fares1, Ali Bazarbachi1 and Jean El Cheikh1 1Bone Marrow Transplantation Program, American University of Beirut Medical Center, Beirut, Lebanon Keywords: Hodgkin Lymphoma, Relapsed/Refractory, Brentuximab. Context: Brentuximab Vedotin (BV) is a chimeric anti CD30 IgG1 antibody, conjugated to synthetic antitubulin momomethyl auristatin. BV is approved for the treatment of classical HL in relapse either after autologous stem cell transplantation (ASCT) or after two lines of combination chemotherapy in transplant ineligible patients. The AETHERA trial revealed increased PFS when BV is used as maintenance therapy after ASCT. Objective: Compare the effectiveness of BV as maintenance or salvage therapy after ASCT for relapsed/refractory (R/R) HL. Design: A retrospective analysis conducted on patients with R/R HL treated with BV after ASCT either as maintenance or salvage therapy. Analysis after a median follow up of 12 months is reported. Setting: The study was conducted in a single institution; American University of Beirut Medical Center (AUBMC) after IRB approval. Patients: The study included 15 adult patients with R/R HL treated with BV with the following indications: á Maintenance therapy after ASCT in high risk patients á Salvage therapy for relapse after ASCT or allo-SCT Intervention: BV at 1.8mg/kg IV every 4 weeks for the above indications. Main outcome measures: response rate (RR), overall survival (OS) and progression free survival (PFS). Results: Nine high-risk patients (60%) received 4 cycles of BV as maintenance therapy post ASCT. Six additional patients (40%) in relapse after ASCT (n=5) or after allo-SCT (n=1) received BV as salvage therapy for an average of 4 cycles (range 3-21). Patients characteristics are listed on Table 1. RR was 33% in 6 patients who received BV as salvage post SCT. Two patients proceeded with allo-SCT in the salvage group. After a median follow up of 9 months, only 2 patients (22%) in the maintenance group progressed and all patients are still alive. Conversely, in the salvage group, 4 patients (67%) progressed and 1 patient developed secondary AML and died. Conclusion: BV therapy showed an efficacy only as maintenance treatment after auto-SCT but was less successful when used as post-transplant salvage in R/R HL. Four cycles of maintenance may suffice. Prospective trials with larger samples are warranted to support these findings. Disclosures No relevant conflicts of interest to declare.
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32

Sleiman, Wissam H., Zade Asfahani, Ali T. Taher, Denize Al Rahawi, and Ismail Khalil. "Venous Thromboembolism in Cancer Patients Referred to the American University of Beirut—Medical Center Secondary to Deep Vein Thrombosis; Occurrence and Risk Factors." Journal of Thrombosis and Thrombolysis 20, no. 3 (December 2005): 179–82. http://dx.doi.org/10.1007/s11239-005-4048-9.

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33

Farhat, Mirna H., Ali I. Shamseddine, and Kassem A. Barada. "Small Bowel Tumors: Clinical Presentation, Prognosis, and Outcome in 33 Patients in a Tertiary Care Center." Journal of Oncology 2008 (2008): 1–5. http://dx.doi.org/10.1155/2008/212067.

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Introduction. Small bowel cancers are rare. Accumulation of data regarding their clinical presentation, pathologic features, prognostic factors, treatment modalities, and outcome is difficult.Methods. This is a retrospective study of the medical records of 33 patients with small bowel cancers treated at the American University of Beirut-Medical Center over a 20-year period.Results. The study included 25 males (76%) and 8 females (24%). Median age at presentation was 56 years. Most common symptoms were abdominal pain (66.7%) and weight loss (57.6%). Thirteen patients presented with abdominal emergencies (39.3%). Lymphoma was the most common malignant tumor (36.4%), followed by adenocarcinoma (33.3%), leiomyosarcoma (15.2%), gastrointestinal stromal tumors (12.1%), and neuroendocrine tumors (3.0%). Tumors were located in the duodenum in 30% of patients, jejunum in 33%, and ileum in 36%. Resectability rate was 72.7% and curative R0 resection was achieved in 54.1% (13/24) of patients. 5-year survival of the 33 patients was 24.2%.Conclusion. Small bowel cancers are difficult to diagnose because of the nonspecific symptoms. Most patients present with advanced disease and have poor prognosis. Adenocarcinoma and duodenal location have the worst 5-year survival in contrast to stromal tumors and those with ileal location which have the best survival.
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Abboud, Miguel R., Samar Muwakkit, Mireille Kattar, Ruby Khoury, Ghazi Zaatari, and Bassem Razzouk. "High Rates of Epstein Barr Virus Expression in Hodgkin’s Lymphoma in Lebanese Children." Blood 106, no. 11 (November 16, 2005): 4644. http://dx.doi.org/10.1182/blood.v106.11.4644.4644.

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Abstract Introduction: Hodgkin’s disease (HD) accounts for around 6% of all cancers in Lebanese children ≤ 15 years of age. HD shows wide geographic variation in its association with EBV virus. The prognostic significance of Latent EBV infection in HD is still controversial Purpose: To examine EBV (LMP-1) positivity in pediatric patients treated for HL at the American University of Beirut-Medical Center and the Children’s Cancer Center of Lebanon and its association with age, sex, histologic subtype and treatment outcome. Methods: The charts of all pediatric patients treated for Hodgkin’s Lymphoma at the American University of Beirut Medical Center between 1980 and 1996, and at the Children’s Cancer Center of Lebanon from 2002 to 2005 were reviewed. Their paraffin blocks were studied for Epstein-Barr virus association by latent membrane protein-1 (LMP-1) immunohistochemistry. Results: The charts of 34 patients with HD were reviewed. The median age was 7.5 years (range: 2–16 yrs); only 4 patients were above 13 years of age. The M: F ratio was 4.6:1, and the mean follow-up was 4.5 yrs (range 4 months −12y). 6 had stage I, 10 had stage II, 15 had stage III (5 patients IIIA and 10 patients IIIB disease), and 3 had stage IVA disease. 53% had advanced stage disease. 16 patients (47%) had mixed cellularity histologic subtype, 15 patients (44%) had nodular sclerosis subtype, and 3 patients had the lymphocyte predominance subtype. All nine patients who were tested for EBV- IgG were positive. Twenty-three patients were studied for the LMP-1 and 17 (74%) tested positive. These 17 patients make up 89% of the children under 13 years of age who were tested. LMP-1 positivity was associated with young age (≤13 yrs 100%), MC subtype (14 patients; 82.4%) and male sex (16 patients; 94%). Four patients with stage IIIB relapsed. Their treatment consisted of 6–9 cycles of COPP or COPP alternating with ABVD. Three of the relapsed patients were LMP-1 positive and had the MC subtype. Two patients had siblings who had HD; one of them who later relapsed was positive for LMP-1, had the MC subtype, and both he and his brother had immune deficiency and lymphoproliferative disorder. Conclusions: Our findings show a high prevalance of EBV expression in HD in Lebanese children. These rates are higher than those reported from other neighboring countries and much higher than those of North American and European countries. This may be related to earlier in life infection with EBV. LMP-1 positivity in Lebanese children was associated with younger age, male sex and mixed cellularity subtype. The impact of LMP-1 on treatment outcome remains to be determined.
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Youssef, Mona, Saeed El Zein, and Souha Kanj. "Dengue fever in Lebanon: First confirmed case since 1945 and review from the region." Journal of Infection in Developing Countries 12, no. 04 (April 30, 2018): 286–89. http://dx.doi.org/10.3855/jidc.9954.

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Lebanon yearly witnesses a high flux of expatriates and workers from Dengue virus (DENV) endemic regions. Multiple cases of Dengue fever have been documented at the American University of Beirut Medical Center (AUBMC) in travellers to endemic regions. Given the presence of the Aedes aegypti mosquito in Lebanon, introduction of DENV to the country is highly likely. We report a case of DENV infection in Lebanon diagnosed in April 2012 in a patient with no prior travel history. The patient presented with fever (39°C) and lower urinary tract symptoms and was initially diagnosed with culture negative prostatitis. He was started on empiric antibiotics but continued to have severe headache, diffuse myalgias, bone pain, and fatigue. He later developed a faint rash with leukopenia and thrombocytopenia. Extensive work-up was unrevealing. DENV IgM and IgG were positive suggesting acute infection. This is the first reported case since 1945 from Lebanon in a patient with no prior travel history.
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BIZRI, A. R., A. AZAR, N. SALAM, and J. MOKHBAT. "Human rabies in Lebanon: lessons for control." Epidemiology and Infection 125, no. 1 (August 2000): 175–79. http://dx.doi.org/10.1017/s0950268899004306.

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Human rabies is known to be endemic in countries bordering Lebanon, but its prevalence in Lebanon has not been studied before. All eight cases of human rabies reported to the Lebanese Ministry of Public Health between 1991 and 1999 were reviewed, as well as three other cases admitted to the American University of Beirut Medical Center. A total of 1102 cases of animal bites to humans, the majority of which were dog bites, were reported to the Ministry of Public Health between 1991 and 1996. In this period, 2487 doses of rabies vaccine were administered to the above group, as post-exposure prophylaxis. Veterinarians, a high risk and educated group, were interviewed, and only 7 out of 72 were found to have been vaccinated. Major improvements in surveillance and reporting, better control of animal rabies, more awareness especially among high risk groups, and regional cooperation, are all needed to prevent and control this deadly infection.
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Adib, Hayat, Mohamad Ali El Natout, Georges Zaytoun, and Usamah Al Hadi. "Rhinolithiasis: A Misleading Entity." Allergy & Rhinology 9 (January 2018): 215265671878359. http://dx.doi.org/10.1177/2152656718783596.

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Introduction Rhinolithiasis is a rare entity; it entails a stone located in the nasal cavity. The entity presents with different signs and symptoms that can be easily confused with other more common clinical entities such as chronic rhinosinusitis. However, it can also mimic sinonasal tumors, making its proper diagnosis crucial. Materials and Methods In this article, we present a case series of 15 patients over the past 13 years between 2002 and 2015 who were seen in the clinics at the American University of Beirut Medical Center. We will shed light on the common presenting symptoms, physical examination findings, proper diagnostic modalities, and treatment options. Our data will be compared to the literature. Conclusion Rhinolithiasis could present with a wide spectrum of signs and symptoms and could be overlooked or mistaken for other diagnosis such as sinusitis or malignancy. It could be differentiated from other entities by rigid nasal endoscopy and computed tomography scan. The diagnosis of rhinolithiasis requires a high index of suspicion.
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Kanafani, Zeina A., Layla Kara, Shady Hayek, and Souha S. Kanj. "Ventilator-Associated Pneumonia at a Tertiary-Care Center in a Developing Country: Incidence, Microbiology, and Susceptibility Patterns of Isolated Microorganisms." Infection Control & Hospital Epidemiology 24, no. 11 (November 2003): 864–69. http://dx.doi.org/10.1086/502151.

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AbstractObjective:Ventilator-associated pneumonia (VAP) complicates the course of up to 24% of intubated patients. Data from the Middle East are scarce. The objective of this study was to evaluate the incidence, microbiology, and antimicrobial susceptibility patterns of isolated microorganisms in VAP in a developing country.Design:Prospective observational cohort study.Setting:The American University of Beirut Medical Center, a tertiary-care center that serves as a major referral center for Lebanon and neighboring countries.Patients:All patients admitted to the intensive care and respiratory care units from March to September 2001, and who had been receiving mechanical ventilation for at least 48 hours, were included in the study. Results of samples submitted for culture were recorded and antimicrobial susceptibility testing of isolated pathogens was performed.Results:Seventy patients were entered into the study. The incidence of VAP was 47%. Gram-negative bacilli accounted for 83% of all isolates. The most commonly identified organism was Acinetobacter anitratus, followed by Pseudomonas aeruginosa. Fifty percent of all gram-negative bacterial isolates were classified as antibiotic resistant. Compared with patients without VAP, patients with VAP remained intubated for a longer period and stayed in the intensive care unit longer. VAP was not associated with an increased mortality rate.Conclusion:Compared with other studies, the results from this referral center in Lebanon indicate a higher incidence of VAP and a high prevalence of resistant organisms. These data are relevant because they direct the choice of empiric antibiotic therapy for VAP.
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Duhaini, Ibrahim, Bilal Shahine, Youssef Zeidan, Abbas Mkanna, Ahmad Maarouf, and Mahmoud Korek. "The effectiveness of the DIBH technique in protecting the heart of radiotherapy breast cancer patients treated at the American University of Beirut Medical Center in Lebanon." Health and Technology 11, no. 4 (May 31, 2021): 851–57. http://dx.doi.org/10.1007/s12553-021-00569-z.

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Roukoz, Cynthia, Rama Kanj, Fadi T. Maalouf, and Pia Zeinoun. "Neuropsychological Findings in Hamamy Syndrome: A Clinical Case Report." Journal of the International Neuropsychological Society 25, no. 3 (February 7, 2019): 336–42. http://dx.doi.org/10.1017/s1355617718001133.

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AbstractThis study, reports for the first time, the neuropsychological profile of a child with Hamamy syndrome—a rare genetic disorder with only five published cases (Buget, Canbolat, Akgul, & Kucukay, 2015). The patient was seen for a neuropsychological evaluation at ages 6 and 7, at the American University of Beirut Medical Center. Procedures included an extended clinical interview with the parent, behavioral observations, formal tests, and a series of parental rating scales. Patient was found to have relatively spared nonverbal intelligence, borderline-impaired language, and clinically impaired verbal reasoning, attention, and motor coordination. Additionally, he showed clinically significant concerns with behavioral regulation, metacognition, attention-deficit, and hyperactivity/impulsivity. The patient was diagnosed with a DSM-V Language Disorder, Speech Sound Disorder, and Attention Deficit/Hyperactivity Disorder, combined presentation, in the context of low-average intelligence. At follow-up, the neuropsychological profile was consistent, albeit improvement was noted following pharmacotherapy. This is the first published report that describes the neuropsychological functions of Hamamy syndrome. We make recommendations for early identification of cognitive strengths and weaknesses, and interventions to address them. Future research should evaluate additional functions such as memory and social/emotional development. (JINS, 2019,25, 336–342)
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Farra, Chantal, Rose Daher, Rebecca Badra, Rym el Rafei, Rachelle Bejjany, Lama Charafeddine, and Khalid Yunis. "Incidence of Alpha-Globin Gene Defect in the Lebanese Population: A Pilot Study." BioMed Research International 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/517679.

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Background. It is well established that the Mediterranean and Arab populations are at high risk for thalassemias in general and for alpha-thalassemia in particular. Yet, reports on alpha-thalassemia in Lebanon are still lacking. In this study, we aim at assessing the incidence of alpha-thalassemia in the Lebanese population.Methods. 230 newborns’ dried blood cards remaining from routine neonatal screening at the American University of Beirut Medical Center were collected for DNA extraction. Samples were screened for the 21 most commonα-globin deletions and point mutations reported worldwide, through multiplex Polymerase Chain Reaction (PCR) and Reverse-Hybridization technique.Results. Upon analyses, the carrier rate ofα-thalassemia was found to be 8%. Two mutations detected the −α3,7single gene deletion found in 75% of cases and the nongene deletionα2 IVS1 [−5nt] in the remaining samples.Conclusion. This study is the first dedicated to investigateα-thalassemia trait incidence in Lebanon. Data obtained demonstrates a high carrier rate in a relatively, highly consanguineous population; it also highlighted the presence of two common mutations. These results may be of an important impact on premarital and newborn screening policies in our country.
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Al-Haddad, Christiane, Zeinab El Moussawi, Stephanie Hoyeck, Carl-Joe Mehanna, Nasrine Anais El Salloukh, Karine Ismail, Mona Hnaini, and Rose-Mary N. Boustany. "Amblyopia risk factors among pediatric patients in a hospital-based setting using photoscreening." PLOS ONE 16, no. 7 (July 29, 2021): e0254831. http://dx.doi.org/10.1371/journal.pone.0254831.

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Purpose The aim of our study was to determine the prevalence of amblyopia risk factors in children visiting the American University of Beirut Medical Center (AUBMC) using automated vision screening. Methods This was a hospital-based screening of 1102 children aged between 2 and 6 years. Vision screening was performed using PlusoptiX S12 over 2 years (2018–2020). The need for referral to a pediatric ophthalmologist was based on the amblyopia risk factors set forth by the American Association for Pediatric Ophthalmology and Strabismus. Referred patients underwent a comprehensive eye examination. Results A total of 1102 children were screened, 63 were referred for amblyopia risk factors (5.7%); 37/63 (59%) underwent comprehensive eye examination and 73% were prescribed glasses. Of the non-referred group of children, 6.35% had astigmatism, 6.25% were hyperopic and 3.27% were myopic. The refractive errors observed among the examined patients were distributed as follows: 41% astigmatism, 51% hyperopia, and 8% myopia; amblyopia was not detected. Refractive amblyopia risk factors were associated with the presence of systemic disorders. Bland-Altman plots showed most of the differences to be within limits of agreement. Conclusion Using an automated vision screener in a hospital-based cohort of children aged 2 to 6 years, the rate of refractive amblyopia risk factors was 5.7%. Hyperopia was the most commonly encountered refractive error and children with systemic disorders were at higher risk.
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43

Mehanna, Carl-Joe, Maamoun Abdul Fattah, Hani Tamim, Mona P. Nasrallah, Raya Zreik, Sandra S. Haddad, Jaafar El-Annan, Samih Raad, Randa S. Haddad, and Haytham I. S. Salti. "Five-Year Incidence and Progression of Diabetic Retinopathy in Patients with Type II Diabetes in a Tertiary Care Center in Lebanon." Journal of Ophthalmology 2017 (May 31, 2017): 1–7. http://dx.doi.org/10.1155/2017/9805145.

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Objective. To estimate the 5-year incidence of progression rate and regression rate and risk factors for diabetic retinopathy (DR) in a cohort of Lebanese patients with type II diabetes. Methods. We followed a cohort of 462 Lebanese patients with type II diabetes for over 5 years at the American University of Beirut Medical Center. Patients underwent yearly complete ophthalmic evaluation and fundus photographs and were assessed for the incidence, stage, and evolution of DR using modified Airlie House classification. Results. Among the 462 patients, 281 had no DR at baseline. The 5-year cumulative incidence of any DR was 10% (95% CI: 6–13), and only baseline microalbuminuria correlated with the development of DR (OR=10.53, 95% CI: 4.39–25.23, p<0.0001). Among the 181 patients with baseline DR, the worsening and regression rates of DR were 31.5% (95% CI: 25–38) and 9% (95% CI: 5–13), respectively. Microalbuminuria also approached statistical significance as a risk factor for DR worsening (OR=1.89, 95% CI: 0.97–3.70, p=0.06). Conclusion. The 5-year incidence of DR in this hospital-based cohort is relatively low. Microalbuminuria was independently associated with the incidence and progression of the disease. We recommend to screen patients with type II diabetes for microalbuminuria as prognostic for the development and worsening of DR.
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Naja, Farah, Bilal Anouti, Hibeh Shatila, Reem Akel, Yolla Haibe, and Arafat Tfayli. "Prevalence and Correlates of Complementary and Alternative Medicine Use among Patients with Lung Cancer: A Cross-Sectional Study in Beirut, Lebanon." Evidence-Based Complementary and Alternative Medicine 2017 (2017): 1–11. http://dx.doi.org/10.1155/2017/8434697.

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Patients with lung cancer are increasingly seeking complementary and alternative medicine (CAM) to improve their physiological and psychological well-being. This study aimed to assess CAM use among lung cancer patients in Lebanon. Using a cross-sectional design, 150 lung cancer patients attending the Basile Cancer Institute at the American University of Beirut Medical Center were interviewed. Participants completed a questionnaire addressing sociodemographic characteristics, lung cancer condition, and use of CAM. The main outcome of interest was “use of any CAM therapy since diagnosis.” Prevalence of CAM use was 41%. The most commonly used CAM modality among study participants was “dietary supplements/special foods.” Results of the multiple logistic regression analyses showed that CAM use was positively associated with Lebanese nationality and paying for treatment out of pocket and was negatively associated with unemployment and having other chronic diseases. About 10% of patients used CAM on an alternative base, 58% did not disclose CAM use to their physician, and only 2% cited health professionals as influencing their choice of CAM. This study revealed a prevalent CAM use among lung cancer patients in Lebanon, with a marginal role for physicians in guiding this use. Promoting an open-communication and a patient-centered approach regarding CAM use is warranted.
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Rebeiz, Abdallah G., Ziyad Mahfoud, Maamoun Abdul Fattah, Alain Saad, Ammar Safar, and Ziad F. Bashshur. "Change in cardiac troponin T level after intravitreal anti-vascular endothelial growth factor treatment: Prospective pilot study." European Journal of Ophthalmology 30, no. 3 (February 27, 2019): 563–69. http://dx.doi.org/10.1177/1120672119832171.

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Background: Evaluate subclinical myocardial injury associated with intravitreal anti-vascular endothelial growth factor therapy by measuring serum high-sensitivity cardiac troponin T. Methods: This is a prospective pilot comparative study conducted at American University of Beirut Medical Center, Beirut, Lebanon. In total, 40 consecutive patients were randomized to receive either intravitreal bevacizumab or ranibizumab. Patients received three consecutive monthly injections of the assigned drug, then continued treatment as needed. Systemic concentrations of high-sensitivity cardiac troponin T and vascular endothelial growth factor were obtained at baseline, week 9, and week 24. Primary endpoint measure was change in high-sensitivity cardiac troponin T levels compared to baseline. Secondary endpoint measure was change in systemic vascular endothelial growth factor levels. Results: There was no significant difference in high-sensitivity cardiac troponin T levels over time ( p = 0.227) within each treatment group and no significant difference between treatments at any time point ( p = 0.276). There was a significant decrease in plasma vascular endothelial growth factor levels at week 9 ( p = 0.001) and week 24 ( p < 0.001) compared to baseline. In the ranibizumab group, vascular endothelial growth factor levels were not significantly different at weeks 9 and 24 compared to baseline ( p = 0.708 and p = 0.117, respectively). There was a significant association between the number of bevacizumab injections from weeks 8 to 24 and the decrease in vascular endothelial growth factor levels at week 24 ( R = −0.67, p = 0.032). This correlation was not observed in the ranibizumab group ( R = −0.341, p = 0.141). Conclusion: Repeated intravitreal bevacizumab or ranibizumab did not influence serum high-sensitivity cardiac troponin levels. Intravitreal bevacizumab but not ranibizumab lowered free-systemic vascular endothelial growth factor levels, which was observed in this study to be inversely related to the number of bevacizumab injections.
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Salame, A. Anastasia, Mohammad J. Jaffal, Fatin Khalifeh, Dalia Khalife, and Ghina Ghazeeri. "Hormone Replacement Therapy: Lebanese Women’s Awareness, Perception, and Acceptance." Obstetrics and Gynecology International 2020 (June 16, 2020): 1–7. http://dx.doi.org/10.1155/2020/5240932.

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Objectives. Hormone replacement therapy (HRT) had been the gold standard for the treatment of menopausal symptoms until the publication of the World Health Initiative (WHI) study. After the WHI study, the use of HRT changed among the physicians and patients all over the world despite newer more reassuring data. This study aimed to investigate the knowledge and attitudes of women towards HRT and the factors affecting it for better counseling. Study design. A clinic-based cross-sectional study using a survey was offered to women aged 40 years and above coming to the women’s health center at the American University of Beirut Medical Center (AUBMC) from October 1st, 2017, till March 31st, 2018. The questionnaire included questions about demographics and menopausal symptoms in addition to knowledge and attitudes towards menopause and HRT. Main outcome measures. Our main hypothesis was that women would be aware of HRT as a treatment modality; however, the majority would have a negative attitude towards its usage. Results. The response rate was 87.8%. Seventy-three percent of the respondents had already heard about HRT with 57.9% supporting the use of HRT; however, 47.9% did not know when to use it. The significant predictor for having heard about HRT and a positive attitude towards HRT were having HRT prescribed as a part of treatment and employment status, respectively. Conclusions. Lebanese women are aware of HRT as a treatment option; however, a lack of both proper information and positive attitude towards HRT use was noted.
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Allaw, Fatima, Nada Kara Zahreddine, Ahmad Ibrahim, Joseph Tannous, Hussein Taleb, Abdul Rahman Bizri, Ghassan Dbaibo, and Souha S. Kanj. "First Candida auris Outbreak during a COVID-19 Pandemic in a Tertiary-Care Center in Lebanon." Pathogens 10, no. 2 (February 3, 2021): 157. http://dx.doi.org/10.3390/pathogens10020157.

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Candida auris is an emerging fungal pathogen considered as a global health threat. Recently there has been growing concern regarding drug resistance, difficulty in identification, as well as problems with eradication. Although outbreaks have been reported throughout the globe including from several Arab countries, there were no previous reports from Lebanon. We herein report the first cases of C. auris infection from the American University of Beirut Medical Center, a tertiary care center in Lebanon describing the clinical features of the affected patients in addition to the infection control investigation and applied interventions to control the outbreak. Fourteen patients with C. auris infection/colonization identified using MALDI-TOF and VITEK 2- Compact system were reported over a period of 13 weeks. Patients were admitted to four separate critical care units. All of them came through the emergency room and had comorbid conditions. Half of the patients were infected with COVID-19 prior to isolation of the C. auris. C. auris was isolated from blood (two isolates), urine (three isolates), respiratory tract (10 isolates) and skin (one isolate). All the patients had received broad spectrum antibiotics prior to isolation of C. auris. Six patients received antifungal treatment, while the remaining eight patients were considered colonized. Environmental cultures were taken from all four units and failed to isolate the organism from any cultured surfaces. A series of interventions were initiated by the Infection Prevention and Control team to contain the outbreak. Rapid detection and reporting of cases are essential to prevent further hospital transmission. A national standardized infection control registry needs to be established to identify widespread colonization.
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Massoud, Radwan, Rita Assi, Elie Fares, Nabila Kreidieh, Rami Mahfouz, Souha Kanj, Aline El-Zakhem, Mohamed A. Kharfan-Dabaja, Ali Bazarbachi, and Jean El Cheikh. "Incidence of Cytomegalovirus (CMV) Reactivation after Autologous Peripheral Blood Stem Cell Transplantation (ASCT) in 324 Patients with Multiple Myeloma and Lymphoma: A Single-Center Study at the American University of Beirut Medical Center (AUBMC)." Blood 128, no. 22 (December 2, 2016): 5824. http://dx.doi.org/10.1182/blood.v128.22.5824.5824.

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Abstract CONTEXT: Cytomegalovirus reactivation (R-CMV) is often diagnosed in allogeneic hematopoietic cell transplant recipients and could determine a CMV-related disease in these immunocompromised patients, involving any organ. R-CMV and end-organ disease after ASCT has not been studied thoroughly. Autograft recipients are generally considered to have low risk of R-CMV or end-organ disease. OBJECTIVE: Evaluate the incidence, risk factors, and outcome of R-CMV in adult patients with hematologic malignancies undergoing ASCT. DESIGN: Retrospective single center study. SETTING: This study was approved by the institutional review board of AUBMC and conducted at our institution PATIENTS OR OTHER PARTICIPANTS: A total of 324 consecutive ASCT were performed at AUBMC between January 2005 and March 2016. All patients and transplant-related characteristics are listed on Table 1. CMV DNA load in blood was measured by quantitative polymerase chain reaction (PCR) weekly as a routine monitoring strategy in all patients. Irrespective of PCR results, some patients suspected to have gastrointestinal involvement were biopsied. Also, in the presence of symptomatic CMV reactivation, appropriate anti-CMV therapy was instituted. MAIN OUTCOMES MEASURES: The primary outcome is understanding the potential relationship between R-CMV and Overall Survival (OS). Secondary outcomes included the effect of CMV reactivation on transplant related mortality (TRM), and progression free survival (PFS). RESULTS: Overall, 53 (16%) patients had R-CMV and 38 (72%) required anti-CMV treatment. Five (1,5%) had CMV disease with positive PCR on colon biopsy, yet two had PCR negative in blood. After a median follow up of 21.5 months (range: 1 to 125 months), there was no significant difference in OS or PFS between patients with or without R-CMV. TRM has increased from 1.1% in patients with no R-CMV to 13% in patients with R-CMV (P=0.003). We didn't observe any impact for age, sex, type of disease, pre-transplant treatment types/lines on the incidence R-CMV following ASCT. CONCLUSIONS: Our data suggest that R-CMV is not uncommon in ASCT recipients and may contribute to increased TRM. Biopsy is recommended in case of high suspicion of R-CMV irrespective of PCR results. Disclosures No relevant conflicts of interest to declare.
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Massoud, Radwan, Rita Assi, Elie Fares, Nabila Kreidieh, Rami Mahfouz, Souha Kanj-Sharara, Aline El-Zakhem, Mohamed Kharfan-Dabaja, Ali Bazarbachi, and Jean El Cheikh. "Incidence of Cytomegalovirus (CMV) Reactivation after Autologous Peripheral Blood Stem Cell Transplantation (ASCT) in 324 Patients with Multiple Myeloma and Lymphoma: a Single-Center Study at the American University of Beirut Medical Center (AUBMC)." Clinical Lymphoma Myeloma and Leukemia 16 (September 2016): S122—S123. http://dx.doi.org/10.1016/j.clml.2016.07.180.

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50

Taha, Jamal M., Maurice I. Saba, and Jeffrey A. Brown. "Missile Injuries to the Brain Treated by Simple Wound Closure: Results of a Protocol during the Lebanese Conflict." Neurosurgery 29, no. 3 (September 1, 1991): 380–84. http://dx.doi.org/10.1227/00006123-199109000-00007.

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Abstract This is a prospective study of the treatment of penetrating missile injuries to the brain without intracranial surgery carried out at the American University of Beirut Medical Center between 1981 and 1988. Of 600 patients treated for missile injuries to the head. 32 satisfied the study criteria. There were 27 shrapnel and 5 bullet injuries. The mean patient age was 23 years (range, 3-51 years). Twenty patients had intracranial indriven bone fragments. Six patients had exposed brain tissue. The mean follow-up was 3.5 years (range, 1-7.5 years). The superficial entry wound was debrided and closed without drainage in the Emergency Room within a mean of 3 hours (range, 0.5-6 hours), and the patient received methicillin for 14 days. All patients survived and had no or improved neurological deficits. No leakage of the cerebrospinal fluid, infection, or seizures occurred in 31 patients. One patient with indriven bone fragments had leakage of the cerebrospinal fluid and developed seizures and a brain abscess 20 days after the injury. The management of penetrating missile injuries to the brain without intracranial surgery in a select patient population is a reasonable option. This treatment becomes important for a surgeon facing large numbers of casualties, or when operative personnel or resources are limited or unavailable.
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