Since 1925, the LAU Medical Center-Rizk Hospital on Zahar Street in Beirut, Lebanon has been dedicated to fostering and advancing the health of humankind. The hospital has evolved through its history in becoming more comprehensive with its services, facilities and offerings; continuously developing with the core purpose of humanizing medicine.
Objective:Surgical site infections (SSIs) pose a significant healthcare challenge, raising patient morbidity, mortality, and costs. Various intrinsic, patient-specific, and perioperative factors contribute to SSIs. This study aims to identify SSI-associated risk factors, microorganism types, and antibiotic susceptibility patterns in surgical patients. Design:This is a matched-case control study. Setting:The Lebanese American University Medical Center - Rizk Hospital, Beirut Lebanon. Patients:The study included surgical patients. Methods:This retrospective case-control study analyzed data from surgical patients over a five-year period, matching 113 SSI cases with controls in a 1:3 ratio by gender and surgery type. Results:Among 324 patients (81 cases vs 243 controls), hypoalbuminemia (<3.5 g/dL) and age ≥65 years were significantly associated with SSIs (P = .025 and P = .039), respectively. Antibiotic redosing was associated with lower odds of SSIs (OR = 0.19, P = .042), indicating a potential protective effect. Conclusions:Our findings were consistent with similar studies. Elderly patients and those with hypoalbuminemia were found to be at significantly higher risk of SSIs. Also, antibiotic redosing during prolonged surgeries was associated with reduced SSI risk. In terms of SSI rates, gastrointestinal surgeries (GIs) were the highest with 42.3% of GI cases followed appropriate antibiotic protocols. Like other studies, predominant microorganisms at wound site included E. coli and coagulase-negative staphylococci.
Background/Objectives: Thyroid eye disease (TED) can lead to structural and microvascular changes in the orbit and retina. This study aimed to investigate the associations between Clinical Activity Score (CAS), orbital magnetic resonance imaging (MRI) measurements, and retinal microvascular changes in TED patients. Methods: This cross-sectional study included 38 patients (76 eyes) with TED. Each patient underwent a comprehensive ophthalmological evaluation, CAS assessment, and a detailed medical history. Optical coherence tomography angiography (OCTA) was performed to quantify vessel density (VD) in the superficial and deep capillary plexus (SCP and DCP). Exophthalmos, extraocular muscle thickness and orbital fat thickness were measured on MRI scans to evaluate structural changes. Laboratory analyses included thyroid hormone levels, thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase antibodies (anti-TPO), and lipid profile. Results: Active TED patients (CAS ≥ 3) had significantly higher TRAb levels (p < 0.001), while anti-TPO did not differ between groups. Active eyes showed significantly higher DCP VD in the whole image (p = 0.013), parafovea (p = 0.012), and perifovea (p = 0.009) across all quadrants, with no difference in SCP or the foveal avascular zone (FAZ). In linear mixed model regression analyses, after adjusting for previous glucocorticosteroid therapy, higher triglycerides, greater medial rectus thickness, and whole-image DCP VD independently predicted higher CAS values (R2 = 42, p < 0.001). After adjusting for age and sex, CAS remained significantly positive predictor of DCP VD in the parafovea (R2 = 0.22, p < 0.001). Conclusions: Changes in DCP VD reflect TED activity and structural orbital involvement.
BackgroundVacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is a rare, adult-onset autoinflammatory disease that has only been described since late 2020. Given the rarity of the disease and the absence of established treatment guidelines, management remains challenging and largely based on clinical experience and case reports.Case presentationThis paper reports the first documented case of VEXAS syndrome in Lebanon. A 73-year-old man presented with fever, severe asthenia, erythematous skin lesions, and anemia, initially diagnosed as giant cell arteritis. Following a diagnosis of VEXAS syndrome, he was treated with corticosteroids and methotrexate but developed refractory anemia and required erythropoietin therapy. Tocilizumab was introduced to manage inflammation, but the patient's condition remained challenging due to corticosteroid dependence and myelodysplastic syndrome (MDS). Given the patient's comorbidities and intermediate-risk MDS, azacitidine was initiated as a therapeutic option. Despite initial neutropenia and infections, adjustments to the azacitidine regimen led to significant clinical and hematologic improvements. The patient achieved complete remission, became transfusion-independent, and maintained stable hemoglobin levels.ConclusionThis case highlights the efficacy of azacitidine in managing VEXAS syndrome with MDS, particularly among patients ineligible for hematopoietic stem cell transplantation, offering a potential pathway to sustained remission and reduced corticosteroid dependence.
Objective: To compare the ongoing pregnancy rate per initiated cycle between patients with functional hypothalamic amenorrhea (FHA) and patients with congenital hypogonadotropic hypogonadism (CHH) treated with pulsatile gonadotropin-releasing hormone (GnRH) administration. Design: Retrospective monocentric cohort study conducted at the University Hospital of Lille from 2004 to 2022. Subjects: A total of 141 patients diagnosed with central suprapituitary amenorrhea during infertility evaluation and subsequently treated with pulsatile GnRH therapy. 111 and 30 patients were diagnosed with FHA or CHH, respectively. Exposure: Pulsatile GnRH administration. Main Outcome Measure(s): Ongoing pregnancy rate per initiated cycle. Result(s): Ongoing pregnancy rates per initiated cycle were comparable between groups: 21.5% in the FHA group vs. 22% in the CHH group. Comparison of baseline characteristics showed a more pronounced follicle-stimulating hormone (FSH) deficiency in patients with CHH than in those with FHA: 2.55 (0.6-4.92) vs. 4.80 (3.90-5.70) UI/L. Within the CHH group, basal FSH level was positively associated with the occurrence of ongoing pregnancies (odds ratio, 1.57; 95% confidence interval, 1.11-2.22). In the CHH group, the duration of treatment was higher than in the FHA group: 23.59 (+/- 8.02) vs. 18.16 (+/- 7.66) days. Conclusion(s): The baseline FSH level is lower in patients with CHH than in patients with FHA. The lower the FSH, the lower the chance of pregnancy in patients with CHH. These patients also require more days of GnRH administration. However, the rate of ongoing pregnancies is comparable between the two groups. (Fertil Steril (R) 2025;123:270-9. (c) 2024 by American Society for Reproductive Medicine.) El resumen est & aacute; disponible en Espa & ntilde;ol al final del art & iacute;culo.
