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Two-year follow-up of a thyroid cartilage metastasis from prostate cancer: A case report
Get PDFFew case reports describe metastatic prostate cancer to the thyroid cartilage. While earlier reports identified the metastatic lesions upon developing symptoms, more recent ones have detected them via prostate-specific membrane antigen positron emission tomography (PSMA PET). Herein, we report the case of a patient with metastatic castrate-resistant prostate cancer and a PSMA PET-detected lesion in the thyroid cartilage. Over the course of 2 years, he received multiple lines of chemotherapy and hormonal therapy, and his overall disease status fluctuated — some nodal and bony metastases resolved while others appeared anew. His thyroid cartilage lesion, however, slowly progressed in a consistent fashion with increasing uptake on successive PSMA PET images. Apart from mild dysphonia, the patient remained to be asymptomatic from this lesion, and no local therapies were used. To our knowledge, this is the first close follow-up of prostate cancer metastatic to the thyroid cartilage, shedding light on the course of such lesions and helping answer management-related questions, which are particularly relevant as more occult metastases are discovered in the PSMA PET era. © 202
Comparison of oral health characteristics in pediatric cancer and cancer free patients: A multicenter study
Get PDFIntroduction: Comparing oral health of cancer to non-cancer children proves that cancer and its treatment can cause oral complications. Design: Two groups of children, 50 treated for cancer, and 51 cancer-free, at two different centers, signed informed consent forms. Both the examination of teeth, oral functions and soft tissue with a questionnaire including the patients’ demographic characteristics, medical history, dietary and oral hygiene, and changes due to the oncologic treatment allowed gathering data. Results: The two groups had no demographic nor socio-economic differences. Dietary habits were not significantly different. Daily brushing was more frequent in cancer-free (96.1%) versus sick (76%) children. Oral hygiene was poor (34%) or very poor (24%) in cancer patients and average for non-cancer subjects (68.6%). Cancer patients had more caries, without significant differences between groups. Gingiva was healthy in 96.1% of non-cancer and 76% of cancer patients (p = 0.044). In cancer patients, intra-oral soft tissue lesions were aphtous ulcers (52.9%), candidiasis (23.5%), and herpes (17.6%). Xerostomia was significantly different (p = 0.001) between cancer (32%) and non-cancer subjects (3.9%). Chemotherapy alone is an independent predictor of poor oral health (HR 17.7, 95% CI [5.2–60.9], p < 0.001). Conclusion: Cancer patients had poor oral health compared to non-cancer children, with insufficient knowledge concerning the relationship between oral and general health. Education programs, screenings and treatment at cancer centers may help reduce risks of complications. © 2023 Japanese Society of Pediatric Dentistr
The Socio-Environmental Impact of White Phosphorous Ammunition in South Lebanon: Analysis and Risk Mitigation Strategies
Get PDFA brief that examine the direct and indirect impact of the use of White Phosphorous in South Lebanon.Includes bibliographical references (pages 10-13)Arabic version: الأثر الاجتماعي والبيئي لذخائر الفسفور الأبيض المُستخدمة في جنوب لبنان: تحليل و إستراتيجيات الحد من المخاطر http://hdl.handle.net/10938/24629Southern Lebanon witnessed an increase in military strikes by the Israel Defense Forces (IDF) on civilian population, land and infrastructure following the start of the October 2023 hostilities. In several of these attacks, White Phosphorus (WP) ammunition was used.1 These munitions are causing significant environmental damage, threats to public health and economic losses. The use of WP by the IDF against Lebanese territories is a repetitive phenomenon over the years. While their legality remains a contentious topic, their use is impacting civilian health and livelihood. The threat they pose on welfare and collective wellbeing therefore imposes the intervention of public institutions. Local and central governments must develop a clear and comprehensive strategy to mitigate the danger of these attacks. Alongside mitigation, this strategy should include recovery projects in the areas where WP ammunition was deployed. In this brief, we examine the direct and indirect impact of the use of WP in warfare, specifically in Lebanon. We also discuss appropriate mitigation measures to combat its long-lasting effect on local communities
Academic pharmacist competencies in ordinary and emergency situations: content validation and pilot description in Lebanese academia
Get PDFBackground: In the absence of a similar study in the Lebanese context, this study aimed to validate the content of the specialized competencies frameworks of academic pharmacists (educators, researchers, and clinical preceptors) and pilot their use for practice assessment in the context of multiple severe crises. Methods: A web-based cross-sectional study was conducted between March and September 2022 among academic pharmacists enrolled by snowball sampling using a questionnaire created on Google Forms. Results: The suggested frameworks had appropriate content to assess the competencies of academic pharmacists. Educators and clinical preceptors were confident in all their competencies except for emergency preparedness. Researchers had varying levels of confidence, ranging from moderate to high confidence for many competencies, but gaps were reported in fundamental research, conducting clinical trials, and pharmacy practice research (mean < 80). Educators and researchers relied primarily on experience and postgraduate studies, while clinical preceptors emphasized undergraduate studies to acquire their respective competencies. Continuing education sessions/programs were the least cited as a competency-acquiring venue across all roles. Conclusion: This study could develop and validate the content of frameworks for specialized competencies of academic pharmacists, including educators, researchers, and clinical preceptors, in a challenging setting. The frameworks were also piloted for practice assessment, which could contribute to supporting effective performance and sustained development of practitioners and help link the skills and competencies pharmacists learn during their studies with those required for a career in academia. © 2023, BioMed Central Ltd., part of Springer Nature
Post-Fire Response of S235 Steel Plates Considering Different Bolt Hole-Making Processes
Get PDFThis study aims at investigating the effect of bolt hole-making processes on the post-fire behavior of S235 steel plates. To address this issue, a total of nine steel plates with a
single bolt hole are tested in this study. The single bolt holes are fabricated using three different hole-making processes: drilling, waterjet, and plasma. Among the nine steel plates, three fabricated specimens are control specimens and are tested at ambient temperature. The six remaining steel plates with a single bolt hole are subjected to a
complete heating-cooling cycle and then monotonically loaded until failure. The six
fabricated specimens are first heated up to two different temperatures 800°Cand 925°C and then cooled back to the ambient prior to loading. The residual responses are characterized as load-displacement characteristics after being exposed to a complete
heating and cooling cycle.
The results show that after being exposed to post-fire temperatures (800°C and 925°C), the maximum decrease in strength of the S235 steel plate was 6% (at 925°C), 14% (at 925°C), and 22% (at 800°C) when compared to the results of ambient specimens for waterjet, drilled, and plasma bolt holes, respectively. In addition, for post-fire temperature tests, drilled and waterjet bolt hole-making processes result in having approximately the same load-displacement response and both have larger strength and ductility than those obtained using plasma cutting.
This study provides preliminary data to guide the steel designers and fabricators in choosing the most suitable hole-making process for fire applications and to quantify the reduction in capacity of the S235 steel plates after fire exposure
Late relapse after hematopoietic stem cell transplantation for acute leukemia: a retrospective study by SFGM-TC
Get PDFLate relapse (LR) after allogeneic hematopoietic stem cell transplantation (AHSCT) for acute leukemia is a rare event (nearly 4.5%) and raises the questions of prognosis and outcome after salvage therapy. We performed a retrospective multicentric study between January 1, 2010, and December 31, 2016, using data from the French national retrospective register ProMISe provided by the SFGM-TC (French Society for Bone Marrow Transplantation and Cellular Therapy). We included patients presenting with LR, defined as a relapse occurring at least 2 years after AHSCT. We used the Cox model to identify prognosis factors associated with LR. During the study period, a total of 7582 AHSCTs were performed in 29 centers, and 33.8% of patients relapsed. Among them, 319 (12.4%) were considered to have LR, representing an incidence of 4.2% for the entire cohort. The full dataset was available for 290 patients, including 250 (86.2%) with acute myeloid leukemia and 40 (13.8%) with acute lymphoid leukemia. The median interval from AHSCT to LR was 38.2 months (interquartile range [IQR], 29.2 to 49.7 months), and 27.2% of the patients had extramedullary involvement at LR (17.2% exclusively and 10% associated with medullary involvement). One-third of the patients had persistent full donor chimerism at LR. Median overall survival (OS) after LR was 19.9 months (IQR, 5.6 to 46.4 months). The most common salvage therapy was induction regimen (55.5%), with complete remission (CR) obtained in 50.7% of cases. Ninety-four patients (38.5%) underwent a second AHSCT, with a median OS of 20.4 months (IQR, 7.1 to 49.1 months). Nonrelapse mortality after second AHSCT was 18.2%. The Cox model identified the following factors as associated with delay of LR: disease status not in first CR at first HSCT (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.04 to 1.64; P = .02) and the use of post-transplantation cyclophosphamide (OR, 2.23; 95% CI, 1.21 to 4.14; P = .01). Chronic GVHD appeared to be a protective factor (OR, .64; 95% CI, .42 to .96; P = .04). The prognosis of LR is better than in early relapse, with a median OS after LR of 19.9 months. Salvage therapy associated with a second AHSCT improves outcome and is feasible, without creating excess toxicity. © 2023 The American Society for Transplantation and Cellular Therap
Second-line Modified GTX versus Gemcitabine-Nab-Paclitaxel (GmAb) Following First-Line FOLFIRINOX in Advanced Pancreatic Cancer: A Retrospective Analysis at the American University of Beirut Medical Center (AUBMC)
Get PDFBackground: Pancreatic cancer is characterized by its generally poor prognosis and ranks seventh worldwide in cancer-related mortality. We previously conducted a prospective study on the use of modified GTX regimen (a combination of gemcitabine, docetaxel, and capecitabine), which has appreciable activity and is well-tolerated, in this setting. We compared the efficacy of GTX regimen versus Gemcitabine-nab-paclitaxel (GmAb) as second-line chemotherapy in advanced pancreatic cancer patients receiving first-line therapy with FOLFIRINOX. Method: This retrospective chart review aimed to collect and record data corresponding to patients diagnosed with advanced pancreatic cancer at the American University of Beirut Medical Center who received FOLFIRINOX as first-line chemotherapy and who then had GTX or GmAb as second-line treatment between 2013 and 2019. We measured the progression-free survival, overall survival, and toxicity of GTX versus GmAb as second-line treatment for pancreatic adenocarcinoma at AUBMC. Results: The median overall survival for the GmAb group was around 52 months, which is greater than that of the GTX group, which was 25 months. 26.7% of patients who received GTX required dose reduction starting from cycle one, while only 3.1% of those who received GmAb required dose reduction from cycle one. 38.7% of patients who received GmAb did not have anemia throughout the course of treatment, while the majority of patients who received GTX, 93.3%, had grade I anemia. Conclusion: Our data show that GmAb is a possibly better second-line treatment option than GTX with better tolerance to the dose, less anemia, and a better survival profile. More studies are needed with a larger sample size and a prospective design to prove such a possible difference between the two regimens. © 2023, Shiraz University of Medical Sciences. All rights reserved
Role of Early Intravenous Immunoglobulins in Halting Clinical and Radiographic Disease Progression in Rasmussen Encephalitis
Get PDFBackground: Rasmussen encephalitis (RE) is a rare progressive presumed autoimmune disorder characterized by pharmacoresistant epilepsy and progressive motor and cognitive deterioration. Despite immunomodulation, more than half of the patients with RE ultimately require functional hemispherotomy. In this study, we evaluated the potential beneficial effects of early initiation of immunomodulation in slowing disease progression and preventing the need for surgical interventions. Methods: A retrospective chart review over a 10-year period was conducted at the American University of Beirut Medical Center to identify patients with RE. Data were collected on seizure characteristics, neurological deficits, electroencephalography, brain magnetic resonance imaging results (including volumetric analyses for an objective assessment of radiographic progression), and treatment modalities. Results: Seven patients met the inclusion criteria for RE. All patients received intravenous immunoglobulins (IVIGs) as soon as the diagnosis was entertained. Five patients with only monthly to weekly seizures at the time of IVIG initiation had favorable outcomes without resorting to surgery, along with a relative preservation of the gray matter volumes in the affected cerebral hemispheres. Motor strength was preserved in those patients, and three were seizure free at their last follow-up visit. The two patients who required hemispherotomy were already severely hemiparetic and experiencing daily seizures at the time of IVIG initiation. Conclusions: Our data suggest that the early initiation of IVIG as soon as a diagnosis of RE is suspected, and particularly before the appearance of motor deficits and intractable seizures, can maximize the beneficial effects of immunomodulation in terms of controlling seizures and reducing the rate of cerebral atrophy. © 2023 Elsevier Inc
Impact of measurable residual disease on outcomes of unrelated donor haematopoietic cell transplantation with post-transplant cyclophosphamide in AML in first complete remission
Get PDFPre-transplant measurable residual disease (MRD) predicts relapse and outcome of allogeneic haematopoietic cell transplantation (allo-HCT). The impact of MRD on the outcomes of post-transplant cyclophosphamide (PTCy)-based allo-HCT from a matched unrelated donor (UD) is unknown. This study assessed the impact of MRD in acute myeloid leukaemia (AML) in the first complete remission (CR1). A total of 272 patients (MRD negative [MRD−], n = 165; MRD positive [MRD+], n = 107) with a median follow-up of 19 (range: 16–24) months were studied. The incidence of grades II–IV and grades III–IV acute GVHD at day 180 was 25.2% and 25% (p = 0.99), and 10.6% and 6.8% (p = 0.29), respectively, and 2-year chronic GVHD was 35% and 30.4% (p = 0.96) in MRD+ and MRD− cohorts, respectively. In multivariate analysis, MRD+ status was associated with a higher incidence of relapse (RI) (hazard ratio [HR] = 2.56, 95% CI: 1.39–4.72), lower leukaemia-free survival (LFS) (HR = 2.04, 95% CI: 1.23–3.39), overall survival (OS) (HR = 1.83, 95% CI: 1.04–3.25) and GVHD-free, relapse-free survival (GRFS) (HR = 1.69, 95% CI: 1.10–2.58). MRD status did not have a significant impact on non-relapse mortality (NRM), or acute or chronic GVHD risk. Among patients with AML undergoing UD allo-HCT with PTCy, pre-transplant MRD+ status predicted a higher relapse rate, lower LFS, OS and GRFS. © 2023 British Society for Haematology and John Wiley & Sons Ltd
Determinants of research productivity and efficiency among the Arab world’s accredited business schools
Get PDFThis article presents a bibliometric analysis of the research output of the Arab world’s 30 AACSB- and EQUIS-accredited business schools between 2013 and 2022. The analysis aims to provide an overview of the research performance of these schools, identify research strengths, and highlight areas for improvement. The study examines 12,693 publications indexed in the Scopus database. The findings reveal remarkable progress in research productivity, including a steady increase in publications in high-impact journals. Notably, business schools in Lebanon, Oman, Qatar, and the United Arab Emirates demonstrate exceptional research performance. The study also reveals variations in citation impact based on publication type, co-authorship patterns, international collaborations, journal rankings, and disciplines. The research themes explored by the Arab world’s accredited business schools cover a wide variety of topics, including personnel, innovation, trade openness, mobile banking/payment, stock and financial markets, economic growth, supply chain, corporate social responsibility, entrepreneurship, community participation, and oil prices and markets, among others. The research areas align with several United Nations sustainable development goals. These findings offer valuable insights for the region’s business schools to benchmark their research performance and gain a nuanced understanding of the factors that contribute to increased research productivity and impact. The study concludes that business schools in the Arab region must continue to enhance their publication rates in top-tier journals, foster improved international collaborations, and implement new research incentive schemes and excellence initiatives that recognize and reward high-quality research. © 2023, The Author(s)