HOpital Mont Liban

Beirut, Lebanon

HOpital Mont Liban

Beirut, Lebanon
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Haidar M.,American University of Beirut | Jreige M.,Hotel Dieu de France | Shdeed I.,Lebanese University | Nasr F.,Hotel Dieu de France | And 3 more authors.
Journal Medical Libanais | Year: 2017

Staging of non-small cell lung cancer (NSCLC) plays a key role in the therapeutic choice and directly affects the prognosis. The role of PET/CT (positron emission tomography) using 18-Fluorodeoxyglucose (FDG) for the staging of NSCLC was studied in the Lebanese population. We compared the results of PET/CT with those of the conventional CT scan in T and N staging for 72 patients; we correlated PET/CT outcome with tumor grade and determined the impact of the difference between staging NSCLC using PET/CT and CT on the therapeutic options. A positive correlation between the results of PET/CT and CT scan was found in 85% of cases. PET/CT has correctly classified pleural effusion as benign in three cases and as malignant in one case and increased the N stage by one point in three cases compared to injected CT scan. PET/CT improves the accuracy of staging of NSCLC allowing a good delineation of the primary tumor, a better evaluation of locoregional lymph node involvement and metastases and identification of the nature of pleural effusion.

Moaouad J.,Hotel Dieu de France | Kazour F.,Hopital Psychiatrique de la Croix | Haddad R.,Hopital Mont Liban | Rouhayem J.,Hopital Psychiatrique de la Croix | Richa S.,Hotel Dieu de France
Encephale | Year: 2012

Objective: Evaluate chemical and behavioural dependence of medical students, and compare it to a control group (students in non-medical faculties), in order to underline the harmful effect of university on medical students' dependence. Methods: A three-part questionnaire was distributed to a sample of 140 medical students at the Saint-Joseph university of Beirut (USJ), and to 140 students in many other USJ faculties, and filled in anonymously. The first part is about demographic criteria and the second and third parts are respectively about chemical and behavioural dependence, based on DSM IV criteria. Results: There is no statistically significant difference between the two studied populations concerning the dependence on alcohol, cannabis, sedatives, opiates, amphetamines, workaholism, gambling and Internet. However, the prevalence of addiction to caffeine, cocaine, nicotine; sexual addiction, and compulsive buying are significantly lower in medical students when compared to the control group. Men, compared to women, did not show significantly higher levels of dependence on chemical substances. Workaholism is not significantly more prevalent in women. Sexual addiction and compulsive buying are not significantly higher in men. However, pathological gambling and Internet addiction are significantly more prevalent in men. Finally, this study does not show a variation in dependence through the years of medical studies. Discussion: Most studies show that medical students have high levels of dependence on alcohol, opiates and sedatives. The results of our study show greater dependence on caffeine followed by nicotine, alcohol and sedatives. Medical students in our population did not reveal higher dependence rates compared to other university students. Overall, substance addiction in medical students may be related to the stress of medical studies, and easy access to drugs and prescriptions. These factors may be balanced by perfectionist traits, ethical standards and knowledge of adverse effects seen in medical students resulting in more adjusted prevalence of addiction when compared to other university students. Conclusion: The prevalence of chemical and behavioural dependency of medical students is not higher than the other population. © L'Encéphale, Paris, 2011.

Bteich G.,Hopital Mont Liban | Bteich G.,Lebanese University | Lecardeur L.,Caen University Hospital Center | Lecardeur L.,French National Center for Scientific Research | And 2 more authors.
Journal de Therapie Comportementale et Cognitive | Year: 2015

Introduction. - The knowledge about cognitive dysfunction and schizophrenia treatment has made considerable progress over the last decade. Cognitive impairments have been recognized as responsible for the majority of these patients' functional deficits. Despite growing efforts to develop drugs aimed at decreasing cognitive impairments, results are still disappointing. These disturbances, however, are accessible to different therapeutic approaches: Cognitive-Behavioral Therapy (CBT), Cognitive Remediation (CR, Psychosocial Rehabilitation PsR), Integrated Psychological Treatment Program (IPT), among others. IPT has been validated in French and is an efficient treatment for the management of the typical deficits in patients with schizophrenia (Roger et al., 2011). This therapeutic program is composed of 6 sub-programs, the first three, "cognitive differentiationg", "social perceptiong" and "verbal communicationg" aim at working on cognitive deficits. The other 3 sub-programs, "social skillsg", "emotion managementg", and "problem solvingg" aim at the acquisition of skills to manage interpersonal problems, emotional experiences, and social difficulties. Method. - The aim of this naturalistic study was to test the efficacy of Brenner's IPT in combination with antipsychotic medication. Two groups (experimental and control groups, respectively), each composed of 36 women and men meeting DSM-IV-R criteria for schizophrenia, hospitali-zed at Hôpital Psychiatrique de La Croix (Beirut, Lebanon) for at least 7 years were compared. The experimental group was treated with the IPT program once a week during 18 months. Thepatients in the control group received their usual treatment. A test battery comprising cognitivetasks and clinical scales related to the evaluation of each therapeutic sub-program was administrated to the participants at the beginning and at the end of the therapy. The comparisonof results gave the opportunity to test the impact of the IPT program compared to the control(treatment as usual). Results. - In the control group, the results demonstrated significant deterioration of executive functioning (Stroop Test P < 0.002, Tower of London Test P < 0.002), as well as an increasein thought disorders and alogia (all P < 0.002). The results of the experimental group showedsignificant and generalized improvements in cognitive (verbal and non verbal memory, executive functions, concentration, all P < 0.002) and social functioning, along with a decrease ofboth positive and negative symptoms (all P < 0.002) following therapy. Discussion. - Cognitive impairments are considered as one of the core deficits in patients withschizophrenia. They induce major disturbance in psychosocial functioning, inhibit professionaland scholarly achievement, and diminish subjective quality of life. The results of this studydemonstrate that IPT showed better efficacy than usual treatment to improve cognitive deficitsin patients with schizophrenia. This program also produces a decrease in positive and, mostimportantly, negative symptoms of schizophrenia as well as improvement in social adaptation. The current pharmacological treatments for schizophrenia are only moderately effective againstthese symptoms. IPT should be considered as a relevant add-on therapy to manage persistentand enduring symptoms of schizophrenia. Moreover, the current study is among the first todemonstrate the effectiveness of IPT in severely ill patients, since they are hospitalized forseveral years. The results show that the IPT is beneficial for patients with a high level ofsymptoms suffering from severe chronicity. These patients were able to learn and use skillsessential to a good functioning in daily life. To improve efficacy over positive symptoms suchas delusions or hallucinations, IPT can be efficiently associated with cognitive therapy (Tarrieret al., 2004). Limits. - In the control group, a decrease of executive functioning and a worsening of thoughtdisorders and alogia were found. This finding should prompt caution in interpreting the resultsdemonstrating cognitive improvement in the experimental group. © 2015 Association française de thérapie comportementale et cognitive.

Jreige M.,Hotel Dieu de France | Chehade F.,Hopital Mont Liban | Chokr J.,American University of Beirut | Haddad M.M.,Hopital Mont Liban | And 3 more authors.
Medecine Nucleaire | Year: 2015

Since its implementation in the evaluation and monitoring of squamous cell carcinoma of the head and neck, PET/CT has become the imaging modality of choice for this category providing anatomical and metabolic information at once. 18F-FDG-PET/CT is useful in identifying a cancer of unknown primary, extension of the primary tumor, detection of regional lymph node involvement even with infracentimetric lymph node, detecting a metastatic lesion and in few instances identifying a synchronous primitive tumor. It provides a vital role in assessing the response to treatment, monitoring the long-term recurrence and recently in planning radiotherapy. © 2014 Elsevier Masson SAS.

The prevalence of neuroendocrine tumors (NET) is rare. Although some aggressive forms may exist, most NET shows a slow growth. The diagnosis is frequently made at a metastatic stage with more than 50% of hepatic metastasis. The only curative treatment is radical surgery and the other non-surgical therapeutic choices are chemotherapy, hepatic chemoembolization, alpha interferon, cold or non-radioactive somatostatin analogues and, more recently introduced, metabolic or internal radiotherapy with a somatostatin analogue coupled to an appropriate radioisotope. Nowadays, imagining of NET with a 68Ga-DOTATATE PET allows obtaining a better image quality and an effective dosimetry before treating with a somatostatin analogue coupled to an appropriate radioisotope such as 177Lu-DOTATATE. This latter can stabilize a rapidly progressive disease and improve quality of life enough and change it deeply. We are presenting our Lebanese experience by reporting six cases treated with 177Lu-DOTATATE after a PET/CT 68Ga-DOTATATE, and a review of literature. © 2013 Elsevier Masson SAS.

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