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Heudel P, Favier B, Assaad S, Zrounba P, Blay JY. Reduced SARS-CoV-2 infection and death after two doses of COVID-19 vaccines in a series of 1503 cancer patients. Ann Oncol 2021; 32:1443-1444. [PMID: 34333128 PMCID: PMC8321960 DOI: 10.1016/j.annonc.2021.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- P Heudel
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | - B Favier
- Department of Pharmaceutical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | - S Assaad
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | - P Zrounba
- Department of Surgery, Centre Léon Bérard Cancer Center, Lyon, France
| | - J-Y Blay
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France; Lyon East Faculty of Medicine, Université Claude Bernard Lyon 1, Lyon, France; President, Unicancer, Paris, France.
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Heudel P, Chabaud S, Perol D, Flechon A, Fayette J, Combemale P, Tredan O, Desseigne F, de la Fouchardiere C, Boyle H, Perol M, Bachelot T, Cassier P, Avrillon V, Terret C, Michallet AS, Neidhardt-Berard EM, Nicolas-Virelizier E, Dufresne A, Belhabri A, Brahmi M, Lebras L, Nicolini F, Sarabi M, Rey P, Bonneville-Levard A, Rochefort P, Provensal AM, Eberst L, Assaad S, Swalduz A, Saintigny P, Toussaint P, Guillermin Y, Castets M, Coutzac C, Meeus P, Dupré A, Durand T, Crochet H, Fervers B, Gomez F, Rivoire M, Gregoire V, Claude L, Chassagne-Clement C, Pilleul F, Mognetti T, Russias B, Soubirou JL, Lasset C, Chvetzoff G, Mehlen P, Beaupère S, Zrounba P, Ray-Coquard I, Blay JY. Immune checkpoint inhibitor treatment of a first cancer is associated with a decreased incidence of second primary cancer. ESMO Open 2021; 6:100044. [PMID: 33516148 PMCID: PMC7844579 DOI: 10.1016/j.esmoop.2020.100044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background Second primary cancers (SPCs) are diagnosed in over 5% of patients after a first primary cancer (FPC). We explore here the impact of immune checkpoint inhibitors (ICIs) given for an FPC on the risk of SPC in different age groups, cancer types and treatments. Patients and methods The files of the 46 829 patients diagnosed with an FPC in the Centre Léon Bérard from 2013 to 2018 were analyzed. Structured data were extracted and electronic patient records were screened using a natural language processing tool, with validation using manual screening of 2818 files of patients. Univariate and multivariate analyses of the incidence of SPC according to patient characteristics and treatment were conducted. Results Among the 46 829 patients, 1830 (3.9%) had a diagnosis of SPC with a median interval of 11.1 months (range 0-78 months); 18 128 (38.7%) received cytotoxic chemotherapy (CC) and 1163 (2.5%) received ICIs for the treatment of the FPC in this period. SPCs were observed in 7/1163 (0.6%) patients who had received ICIs for their FPC versus 437/16 997 (2.6%) patients receiving CC and no ICIs for the FPC versus 1386/28 669 (4.8%) for patients receiving neither CC nor ICIs for the FPC. This reduction was observed at all ages and for all histotypes analyzed. Treatment with ICIs and/or CC for the FPC are associated with a reduced risk of SPC in multivariate analysis. Conclusion Immunotherapy with ICIs alone and in combination with CC was found to be associated with a reduced incidence of SPC for all ages and cancer types. From 2013 to 2018, 3.9% of the 46 829 patients diagnosed with a first cancer presented with an SPC. Treatment of the first cancer with ICIs was associated with a major reduction of SPC. CC given for an FPC was also associated with a lower magnitude of reduction of SPC. There were no SPC in cancer patients treated with ICIs in the localized phase of their first cancer.
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Affiliation(s)
- P Heudel
- Centre Léon Bérard, Lyon, France
| | | | - D Perol
- Centre Léon Bérard, Lyon, France
| | | | | | | | - O Tredan
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | | | | | - H Boyle
- Centre Léon Bérard, Lyon, France
| | - M Perol
- Centre Léon Bérard, Lyon, France
| | - T Bachelot
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | | | | | - C Terret
- Centre Léon Bérard, Lyon, France
| | | | | | | | - A Dufresne
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | | | - M Brahmi
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | - L Lebras
- Centre Léon Bérard, Lyon, France
| | - F Nicolini
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | - M Sarabi
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | - P Rey
- Centre Léon Bérard, Lyon, France
| | | | | | | | - L Eberst
- Centre Léon Bérard, Lyon, France
| | - S Assaad
- Centre Léon Bérard, Lyon, France
| | | | - P Saintigny
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | | | | | - M Castets
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | - C Coutzac
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France
| | - P Meeus
- Centre Léon Bérard, Lyon, France
| | - A Dupré
- Centre Léon Bérard, Lyon, France
| | - T Durand
- Centre Léon Bérard, Lyon, France
| | | | | | - F Gomez
- Centre Léon Bérard, Lyon, France
| | - M Rivoire
- Centre Léon Bérard, Lyon, France; Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | | | - L Claude
- Centre Léon Bérard, Lyon, France
| | | | - F Pilleul
- Centre Léon Bérard, Lyon, France; Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | | | | | | | - C Lasset
- Centre Léon Bérard, Lyon, France; Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | | | - P Mehlen
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France; Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - S Beaupère
- Centre Léon Bérard, Lyon, France; Unicancer, Paris, France
| | | | - I Ray-Coquard
- Centre Léon Bérard, Lyon, France; Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - J-Y Blay
- Centre Léon Bérard, Lyon, France; Cancer Research Center of Lyon (CRCL), Lyon, France; Centre Léon Bérard & Université Claude Bernard, Lyon, France; Unicancer, Paris, France.
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3
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Trefond L, Frances C, Nathalie C, Piette J, Assaad S, Sailler L, Viallard J, Jego P, Connault J, Galempoix J, Aumaître O, Andre M. Syndrome des abcès aseptiques : série française de 71 patients. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yaacoub H, Haddad C, Dib T, Zoghbi M, Assaad S, Obeid S, Sacre H, Hallit S, Kazour F. Posttraumatic stress disorders and depression among male inpatient adults involved in the Lebanese war. Perspect Psychiatr Care 2020; 56:263-269. [PMID: 31318076 DOI: 10.1111/ppc.12421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/10/2019] [Accepted: 07/05/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE to evaluate factors associated with posttraumatic stress disorder (PTSD) and depression in a sample of hospitalized Lebanese adult males who directly or indirectly were involved in armed conflicts. DESIGN Cross-sectional. METHODS Seventy-seven hospitalized males were enrolled between June and December 2016. The Hamilton Anxiety and Depression Scale and the Mini International Neuropsychiatric Interview were used to assess anxiety, depression, and PTSD. RESULTS Participation in war (adjusted odds ratio [ORa] = 6.35) and depression (ORa = 1.08) were associated with higher PTSD, whereas age (ORa = 0.94) and substance use (ORa = 0.19) were associated with lower PTSD. Anxiety (β = .87), substance use (β = 6.27) and PTSD (β = 8.78; P = .008) were associated with higher depression. PRACTICE IMPLICATIONS People who experienced war conflicts (directly or indirectly) are more prone to suffer from mental health disorders.
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Affiliation(s)
- Hiba Yaacoub
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Chadia Haddad
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Tania Dib
- Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Marouan Zoghbi
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Shafika Assaad
- Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Sahar Obeid
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Philosophy and Human Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Faculty of Pedagogy, Lebanese University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Francois Kazour
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Philosophy and Human Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Faculty of Pedagogy, Lebanese University, Beirut, Lebanon.,INSERM U930, équipe 4 "Troubles Affectifs", Université François-Rabelais de Tours, Parc de Grandmont, Tours, France
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Abstract
Intradialytic hypotension is a major complication during hemodialysis session, associated with increased risk of cardiovascular events and mortality. Its pathophysiology is believed to be multifactorial and remains not well elucidated. The aim of this study is to put forward new mechanisms behind the development of intradialytic hypotension. The study included sixty-five subjects on chronic hemodialysis, divided into two groups: intradialytic hypotensive (n=12) and normotensive (n=53), according to the variation of systolic blood pressure between post-dialysis and pre-dialysis measurements. Renin and angiotensin converting enzyme I plasma concentrations increased in both groups but more likely in normotensive group. Aldosterone plasma concentration is increased in the normotensive group while it decreased in the intradialytic hypotension group. Plasma endothelin concentrations showed higher values in intradialytic hypotension group. Post-dialysis asymmetric dimethylarginine and angiotensin converting enzyme 2 plasma concentrations were significantly higher in intradialytic hypotension group as compared to normotensive one. Collectrin plasma concentrations were significantly lower in intradialytic hypotension group. Finally, post-dialysis vascular endothelial growth factor C plasma concentration significantly increased in intradialytic hypotension group. In conclusion, endothelial dysfunction characterized by a lower level of vasoactive molecule seems to play a critical role in intradialytic hypotension development.
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Affiliation(s)
- J Hajal
- Physiology and Pathophysiology Research Laboratory, Pole of Technology and Health, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
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Assaad S, Chaaban R, Tannous F, Costanian C. Dietary habits and Helicobacter pylori infection: a cross sectional study at a Lebanese hospital. BMC Gastroenterol 2018; 18:48. [PMID: 29661143 PMCID: PMC5902873 DOI: 10.1186/s12876-018-0775-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 04/09/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To examine the association between dietary habits and Helicobacter pylori (H. pylori) infection among patients at a tertiary healthcare center in Lebanon. METHODS This cross-sectional study was conducted on 294 patients in 2016, at a hospital in Northern Lebanon. Participants were interviewed using a structured questionnaire to collect information on socio-demographic and lifestyle characteristics; dietary habits were ascertained via a short food frequency questionnaire (FFQ). H. pylori status (positive vs. negative) was determined after upper GI endoscopy where gastric biopsy specimens from the antrum, body, and fundus region were collected and then sent for pathology analysis. Multivariable logistic regression was conducted to identify the association between socio-demographic, lifestyle, dietary and other health-related variables with H pylori infection. RESULTS The prevalence of H. pylori infection was found to be 52.4% in this sample. Results of the multivariable analysis showed that H. pylori infection risk was higher among participants with a university education or above (OR = 2.74; CI = 1.17-6.44), those with a history of peptic ulcers (OR = 3.80; CI = 1.80-8.01), gastric adenocarcinoma (OR = 3.99; CI = 1.35-11.83) and vitamin D level below normal (OR = 29.14; CI = 11.77-72.13). In contrast, hyperglycemia was protective against H. pylori (OR = 0.18; CI = 0.03-0.89). No relationship between dietary habits and H. pylori infection was found in the adjusted analysis. CONCLUSIONS Socio-demographic and clinical variables are found to be associated with H. pylori, but not with dietary factors. Further studies are needed to investigate the effect of diet on H. pylori risk.
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Affiliation(s)
- Shafika Assaad
- Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Rawan Chaaban
- International Committee of the Red Cross, Beirut, Lebanon
| | - Fida Tannous
- Faculty of Sciences, Beirut Arab University, Beirut, Lebanon
| | - Christy Costanian
- School of Kinesiology and Health Science, York University, Toronto, ON M3J1P3 Canada
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Assaad S, Anouti S, Naja F, Nasreddine L, Hwalla N, Sibai AM. Adolescents' self-perceived and actual weight: Which plays a dominant role in weight loss behaviour in Lebanon? Child Care Health Dev 2018; 44:124-130. [PMID: 28872218 DOI: 10.1111/cch.12512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 07/23/2017] [Accepted: 08/15/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The decision to lose weight among adolescents is complex and is guided by a number of body-related factors. This study examined the extent of agreement between actual weight, measured as body mass index, and self-perceived weight and assessed their relative importance in weight loss behaviour among Lebanese adolescents. METHODS Data on 278 adolescents aged 13-17 years were drawn from the nationwide Nutrition and Non-Communicable Disease Risk Factor Survey (Lebanon, 2009). Binary multivariable logistic regressions were conducted to test associations with "effort to lose weight" as the outcome variable, controlling for a number of potential confounders. RESULTS Close to 36% reported trying to lose weight. Around 21% and 13% were overweight and obese, respectively, and 40% and 10% perceived their weight as slightly high and very high, respectively. Inaccurate perceivers, those underestimating or overestimating their weight, constituted 39%, with overall percent agreement between actual and self-perceived weight being 60.8% (kappa statistic = 0.319, 95% CI [0.242, 0.396]). About a third of the overweight adolescents (30.5%) and more than half of the obese (56.8%) underestimated their weight. In the multivariable analysis, self-perceived weight was statistically significant and a stronger predictor of weight loss effort than body mass index (adjusted odds ratios = 14.42 and 6.42 for slightly high and very high perceived weight, respectively, compared to odds ratios = 1.47 and 2.31 for overweight and obese adolescents, respectively). CONCLUSION Health professionals need to consider self-perceived weight in conjunction with actual weight in their pursuit of weight management goals and in planning prevention programmes that guide weight loss behaviours for adolescents.
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Affiliation(s)
- S Assaad
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - S Anouti
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - F Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - L Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - N Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - A M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Boschetti G, Assaad S, Balme B, Boyer S, Flourié B, Nancey S. A challenging case of multiple splenic and pancreatic lesions in a patient with Crohn's disease. Gut 2016; 65:295, 312. [PMID: 26246245 DOI: 10.1136/gutjnl-2015-310130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 07/15/2015] [Indexed: 12/08/2022]
Affiliation(s)
- G Boschetti
- Department of Gastroenterology, Lyon-Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
| | - S Assaad
- Internal Medicine Department, Saint-Luc Saint-Joseph Hospital, Lyon, France
| | - B Balme
- Department of Pathology, Saint-Luc Saint-Joseph Hospital, Lyon, France
| | - S Boyer
- Department of Gastroenterology, Lyon-Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
| | - B Flourié
- Department of Gastroenterology, Lyon-Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
| | - S Nancey
- Department of Gastroenterology, Lyon-Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
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Khneisser I, Adib S, Assaad S, Megarbane A, Karam P. Cost-benefit analysis: newborn screening for inborn errors of metabolism in Lebanon. J Med Screen 2015; 22:182-6. [PMID: 26062758 DOI: 10.1177/0969141315590675] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 05/12/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Few countries in the Middle East-North Africa region have adopted national newborn screening for inborn errors of metabolism by tandem mass spectrometry (MS/MS). We aimed to evaluate the cost-benefit of newborn screening for such disorders in Lebanon, as a model for other developing countries in the region. METHODS Average costs of expected care for inborn errors of metabolism cases as a group, between ages 0 and 18, early and late diagnosed, were calculated from 2007 to 2013. The monetary value of early detection using MS/MS was compared with that of clinical "late detection", including cost of diagnosis and hospitalizations. RESULTS During this period, 126000 newborns were screened. Incidence of detected cases was 1/1482, which can be explained by high consanguinity rates in Lebanon. A reduction by half of direct cost of care, reaching on average 31,631 USD per detected case was shown. This difference more than covers the expense of starting a newborn screening programme. CONCLUSION Although this model does not take into consideration the indirect benefits of the better quality of life of those screened early, it can be argued that direct and indirect costs saved through early detection of these disorders are important enough to justify universal publicly-funded screening, especially in developing countries with high consanguinity rates, as shown through this data from Lebanon.
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Affiliation(s)
- I Khneisser
- Medical Genetic Unit, Saint-Joseph University, Beirut, Lebanon
| | - S Adib
- Epidemiology and Population Studies Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - S Assaad
- Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - A Megarbane
- Medical Genetic Unit, Saint-Joseph University, Beirut, Lebanon
| | - P Karam
- Department of Pediatrics and Adolescent Medicine, American University of Beirut- Medical Center, Beirut, Lebanon
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Costanian C, Tamim H, Assaad S. Prevalence and factors associated with irritable bowel syndrome among university students in Lebanon: Findings from a cross-sectional study. World J Gastroenterol 2015; 21:3628-3635. [PMID: 25834330 PMCID: PMC4375587 DOI: 10.3748/wjg.v21.i12.3628] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 01/08/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To describe the bowel habits and the prevalence of irritable bowel syndrome (IBS) and to investigate the influence of health behavior and social factors on IBS prevalence in university students.
METHODS: This cross-sectional study was conducted at five major universities in Greater Beirut and its suburbs, between February and June 2014. Using a convenience sample, a total of 813 students aged 18 years old and above participated in this study. Participants were asked to complete a comprehensive anonymous questionnaire which detailed characteristics on socio-demographic, health-related, and lifestyle factors, as well as IBS. The ROME III criteria were used as a tool to ascertain IBS. A χ2 test was used to determine differences between categorical variables; stepwise logistic regression was used to measure the association between IBS and its risk factors.
RESULTS: An overall prevalence of IBS of 20% was recorded among university students. The bivariate analysis showed that females were significantly more likely to report having IBS than males (29.1% vs 18.2%, P < 0.01). Those living at the school dormitory or in a private residence (39.5%) were more likely to have IBS than those living with their families (16.3%) (P < 0.01). The multivariate analysis showed that those who had a relatively high family income level (US$ > 2000) were almost 6 times more likely to report having IBS than their counterparts.
CONCLUSION: This is the first study to describe the nature of IBS among young adults in Lebanon. The prevalence of IBS among university students in our sample was higher than that reported in the West.
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Catinon M, Chemarin C, Assaad S, Vuillermoz-Blas S, Roux E, Traverse-Glehen A, Cavalin C, Rosental PA, Vincent M. Wire brushing wood furniture, granulomatosis and microscopic mineralogical analysis. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31:262-264. [PMID: 25363230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 10/07/2014] [Accepted: 04/16/2014] [Indexed: 06/04/2023]
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Costanian C, Bennett K, Hwalla N, Assaad S, Sibai AM. Prevalence, correlates and management of type 2 diabetes mellitus in Lebanon: findings from a national population-based study. Diabetes Res Clin Pract 2014; 105:408-15. [PMID: 25005850 DOI: 10.1016/j.diabres.2014.06.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 05/05/2014] [Accepted: 06/15/2014] [Indexed: 12/19/2022]
Abstract
AIMS This study aims to examine the prevalence, associated risk factors and complications of diabetes, as well management and preventive care in Lebanon, a small, middle-income country of the Mediterranean region. METHODS Using a comprehensive multi-dimensional questionnaire, a cross-sectional national survey of 2195 Lebanese adults aged ≥25 years was conducted based on the WHO STEPwise guidelines. The outcome variable, diabetes, was self-reported. Measures for diabetes management included frequency of blood glucose testing and regular eye and foot exams. Macrovascular and microvascular complications were also recorded. RESULTS The prevalence of type 2 diabetes was 8.5% (95%CI=7.3-9.7). Factors associated with an increased risk of having diabetes were: being divorced or widowed (OR=2.56; 95%CI=1.07-5.42) compared to single, being obese (OR=1.50, 95%CI=1.00-2.57), and having a family history of diabetes (OR=3.40;95%CI=2.48-5.19). Vigorous physical activity significantly decreased the odds of diabetes (OR=0.42; 95%CI=0.24-0.72). Diabetes management and self-care goals were as follows: 82% were not measuring their blood sugar via dextro on a daily basis, 64.2% did not have a foot exam within the past year, and 52.4% did not obtain the recommended yearly eye exam. The most common complications included heart disease (27.8%) and retinopathy (16.6%). CONCLUSIONS Prevalence of diabetes in Lebanon was comparable to that found in the West, yet remained lower than estimates in other resource-rich neighboring countries. Adherence to management and self-care measures was sub-optimal resulting in high complication rates. Contextual factors play a role in increasing diabetes risk. Population-based interventions to enhance and promote self-management behaviors are essential to improve complication rates.
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Affiliation(s)
- Christy Costanian
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| | - Kathleen Bennett
- Department of Pharmacology and Therapeutics, Trinity Centre of Health Sciences, St James's Hospital, Dublin 8, Ireland
| | - Nahla Hwalla
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon; Member of the Public Health and Nutrition (PHAN) Research Group at the American University of Beirut, Lebanon
| | - Shafika Assaad
- Lebanese University, Faculty of Sciences, Beirut, Lebanon
| | - Abla M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon; Member of the Public Health and Nutrition (PHAN) Research Group at the American University of Beirut, Lebanon.
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Catinon M, Chemarin C, Blanchet AS, Vuillermoz-Blas S, Cavalin C, Rosental PA, Assaad S, Thiberville L, Vincent M. Sarcoïdose ou réaction granulomateuse à une surcharge métallique : à propos de trois cas. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Assaad S, Costanian C, Haddad G, Tannous F. Sleep patterns and disorders among university students in Lebanon. J Res Health Sci 2014; 14:198-204. [PMID: 25209906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 04/11/2014] [Accepted: 04/21/2014] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Insufficient sleep is a significant public health issue with adverse medical consequences. Sleep disturbances are common among university students and have an effect on this group's overall health and functioning. The aim of this study was to investigate sleep habits and disorders in a population of university students across Lebanon. METHODS This was a cross-sectional study carried out in 2012 among 735 students aged 18-25 yrs. old, enrolled at six universities across Lebanon. The Pittsburg Sleep Quality Index (PSQI) was used to assess sleep quality and habits. RESULTS Less than half of the total study population (47.3%) were good sleepers (PSQI<5). Upon bivariate analysis, males experienced more sleep difficulties than females (57.8% vs. 40.8%). The majority (60%) of males vs. 40% of females had trouble performing daily activities more than once per week (P=0.02). Results of the multivariate analysis revealed that reporting poor sleep quality was strongly associated with daytime dysfunction and sleep- enhancing medication use especially more than once per week. CONCLUSIONS This is the first study to describe the nature of sleep problems among university students in Lebanon. This study suggests that sleep problems among Lebanese college students were common and such problems may interfere with daily performance. Findings from this study have important implications for programs intended to improve academic performance by targeting sleep habits of students.
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Affiliation(s)
- Shafika Assaad
- Department of Biology-Neuroscience, Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Christy Costanian
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| | - Georges Haddad
- Department of Psychiatry, La Croix Hospital, Beirut, Lebanon
| | - Fida Tannous
- Department of Biology, Faculty of Sciences, Beirut Arab University, Beirut, Lebanon
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Assaad S, Tannous F, Costanian C. Sleep patterns and sleep disorders among university students in lebanon. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sibai AM, Costanian C, Tohme R, Assaad S, Hwalla N. Physical activity in adults with and without diabetes: from the 'high-risk' approach to the 'population-based' approach of prevention. BMC Public Health 2013; 13:1002. [PMID: 24153099 PMCID: PMC4015809 DOI: 10.1186/1471-2458-13-1002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 10/11/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prevalence rates of physical inactivity and diabetes in the MENA region are among the highest in the world. However, studies that focus on factors that influence the pattern of physical activity in the region remain very scarce. This study aimed to determine the prevalence and correlates of physical activity in the general population and among subjects with and without diabetes in Lebanon, a small middle-income country in the MENA region. METHODS We conducted a cross-sectional nation-wide study of 2,195 randomly selected adults aged 25 years and older. Participants completed a comprehensive questionnaire based on the WHO-STEPwise guidelines. Physical activity was assessed using the International Physical Activity Questionnaire. Type 2 diabetes risk factors examined were age ≥ 45 years, BMI ≥ 25 kg/m², hypertension, hyperlipidemia, cardiovascular disease and family history of diabetes. RESULTS Close to 10% of adults with diabetes were physically active versus 23·4% without diabetes. Prevalence rates of physical activity declined consistently as the number of diabetes risk factors increased. Odds ratios for physical activity were lower among the educated (0.75, 95% CI= 0.57-0.98), those who owned at least one car (0.71, 95% CI= 0.57-0.88) and those who resided in the capital city (0.62, 95% CI 0.47-0.83). Health professionals gave 'advice to exercise' most to patients with or at highest risk for diabetes, and these were more likely to engage in physical activity than those without diabetes receiving the same advice, net of the effect of other covariates (OR=3.68 and 1.17, respectively). CONCLUSIONS The inverse associations between physical activity and SES indicators suggest a negative influence of urbanization on activity levels of Lebanese adults. The missed opportunity for clinical primary preventive services for the majority non-diabetic population calls for population-based public health approaches that promote physical activity as a routine lifestyle in the general population.
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Affiliation(s)
- Abla Mehio Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut (AUB), PO Box: 11-0236, Riad el Solh, Beirut 1107-2020, Beirut-Lebanon.
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Karnib HH, Gharavi AG, Aftimos G, Mahfoud Z, Saad R, Gemayel E, Masri B, Assaad S, Badr KF, Ziyadeh FN. A 5-year survey of biopsy proven kidney diseases in Lebanon: significant variation in prevalence of primary glomerular diseases by age, population structure and consanguinity. Nephrol Dial Transplant 2010; 25:3962-9. [PMID: 20525974 DOI: 10.1093/ndt/gfq302] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Differences in epidemiology of kidney disease across the Middle East may arise from variations in indication for biopsy, environmental exposure and socio-economic status. The Lebanese population is composed of different ethnicities, with distinct ancestry and religion, enabling comparison of their effect on the prevalence of kidney disease within a confined geographic setting and uniform practices. Here we report 5 years' detailed epidemiology of renal diseases, based on histological diagnosis, in a sample from three large pathology centres in Lebanon. METHODS Records of renal biopsies analysed at the American University of Beirut Medical Center, Hotel Dieu de France Hospital and the Institut National de Pathologie from January 2003 till December 2007 were retrospectively examined. We recorded the following data for each patient: age, gender, indication for renal biopsy and histopathological diagnosis. Religious affiliation and parents' consanguinity were recorded when feasible. RESULTS The mean age at renal biopsy was 36.76 ± 20 years (range 1-84). The most common diagnosis was mesangioproliferative glomerulonephritis (GN; 20%), followed by focal segmental glomerulosclerosis (13.2%). While there were no differences in age, gender or indications for biopsy among different religious affiliations, mesangioproliferative GN was significantly more frequent among Muslims (P = 0.039) and offspring of consanguineous unions (P = 0.036). On the other hand, focal segmental glomerulosclerosis was most prevalent in Christians (P < 0.001). CONCLUSIONS Variation in the distribution of diagnoses between Muslim and Christian groups likely reflects differences in population structure and ancestry. In particular, the increased prevalence of mesangioproliferative GN among offspring of consanguineous unions in Muslims suggests a recessive genetic component to this disease which may be identified via homozygosity mapping. These findings have important implications for formulating renal health policies and designing research studies in this population.
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Affiliation(s)
- Hussein H Karnib
- Department of Physiology, American University of Beirut, Beirut, Lebanon.
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Nozières C, Pariset C, Assaad S, Bachet P. Une fièvre prolongée. Med Mal Infect 2008; 38:370-1. [DOI: 10.1016/j.medmal.2007.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2007] [Accepted: 11/29/2007] [Indexed: 11/28/2022]
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19
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Chen Y, Taghian A, Goldberg S, Assaad S, Abi Raad R, Michaelson J, Powell S. Influence of margin status and tumor bed boost dose on local recurrence rate in breast-conserving therapy: does a higher radiation dose to the tumor bed overcome the effect of close or positive margin status in breast-conserving therapy? Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01260-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chawla A, Taghian A, Powell S, Assaad S, Zapton D, Kachnic L. Radiation therapy and breast reconstruction: complications and cosmesis with tram versus tissue expanders. Int J Radiat Oncol Biol Phys 2001. [DOI: 10.1016/s0360-3016(01)02113-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Chahine R, Lasserre B, Assaad S. The anti-thromboxane A2 synthetase activity of myocardial tissue and its variation during ischemia and reperfusion in isolated rabbit heart. Prostaglandins Leukot Essent Fatty Acids 1999; 60:101-6. [PMID: 10328329 DOI: 10.1054/plef.1998.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this investigation, an anti-thromboxane A2 (TXA2) synthetase activity in the myocardial tissue, which can be modulated by ischemia and reperfusion, was observed. Regional ischemia was induced by 60 min occlusion of the left anterior descending coronary artery in isolated Langendorff rabbit hearts. Biosynthesis of TXA2 was carried out by using arachidonic acid (AA) as substrate, horse platelet microsomes (HPM) as the source of TXA2 synthetase and left ventricle microsomes (LVM) from ischemic and non-ischemic areas as effectors TXB2, the stable metabolite of TXA2, was determined by radioimmunoassay. Experiments carried out under the adopted conditions showed that LVM from control hearts were able to inhibit by up to 50% the biosynthesis of TXA2 from HPM. This anti-TXA2 synthetase activity was more pronounced when LVM from the non-ischemic area were used, rather then LVM from the ischemic one. A 60 min reperfusion decreased the anti-TXA2 activity. A superfused rabbit aorta strip was also used as a cascade bioassay to study the effect of LVM on the TX2-synthetase activity of HPM, and this confirmed our findings. These results suggest that the left ventricle possesses a self-defense mechanism against acute myocardial ischemia, independently from the circulation. The postulated mechanism may be initiated in the non-ischemic area.
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Affiliation(s)
- R Chahine
- Institut de Physiologie, Toulouse, France
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Taghian A, Assaad S, Kuter I, Younger J, Schoenthaler R, Czito B, Roche M, Powell S. 2074 Increased risk of radiation pneumonitis in breast cancer patients treated by concomitant taxol and radiation therapy. Int J Radiat Oncol Biol Phys 1999. [DOI: 10.1016/s0360-3016(99)90344-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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el Khwsky F, Bedwani R, D'Avanzo B, Assaad S, el Shafei Ali A, Mokhtar S, La Vecchia C. Risk factors for non-melanomatous skin cancer in Alexandria, Egypt. Int J Cancer 1994; 56:375-8. [PMID: 8314325 DOI: 10.1002/ijc.2910560314] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The role of constitutional and environmental factors on the risk of non-melanomatous skin cancer was evaluated in a case-control study conducted in 1992 in Alexandria, Egypt, on 136 incident histologically confirmed (99 basal-cell and 37 squamous-cell) cases of non-melanomatous skin cancer (NMSC) and 145 controls in hospital for a broad spectrum of acute non-sun-related dermatological conditions. In relation to skin colour, compared with brown-skinned subjects, the multivariate relative risks (RR) were 2.3 for olive-skinned subjects and 3.8 for fair/medium-skinned subjects. Three cases and 29 controls were black (RR = 0.2). The trend in risk with skin colour was significant. Likewise, compared with subjects with brown or hazel eyes, those with green or blue eyes had a RR of 3.1. In relation to acute sun reaction, compared with subjects reporting easy tanning, the RRs were 2.5 for subjects reporting moderate tanning and 4.7 for those reporting easy burning. The risk of NMSC was higher for subjects reporting an outdoor occupation than for those reporting an indoor occupation (RR = 7.7). A significant trend in risk was observed with degree of sun exposure: compared with subjects reporting light sun exposure, the RR was 3.0 for those reporting moderate exposure, and 6.1 for those reporting heavy sun exposure. There was an indication of a relationship between clothing pattern and skin-cancer risk: compared with subjects reporting frequent use of traditional Egyptian clothes, the RR for dressing in short clothes was 1.8. The presence of signs of photodamage was also associated with NMSC (RR = 3.7). Exposure to arsenic was reported by 10 cases and 1 control (RR = 9.5). A positive interaction between sun exposure and skin colour was observed, and the RR rose to 14.2 for medium- or fair-skinned subjects with heavy exposure compared with brown- or black-skinned subjects with light or moderate sun exposure. In this Egyptian population, over 60% of NMSC could be attributed to sun exposure and approximately 45% to skin colour.
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Affiliation(s)
- F el Khwsky
- Medical Research Institute, University of Alexandria, El Hadara, Egypt
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