Imatinib a Tyrosine Kinase Inhibitor: a potential treatment for SARS- COV-2 induced pneumonia

Introduction: As the coronavirus disease (COVID-19) spreads worldwide, awaiting the development of a vaccine, researchers are looking among the arsenal of available drugs, for a potential cure or medication to improve patients’ outcome. A highly elevated levels of cytokines in COVID-19 patients requiring ICU admission, has suggested that a “cytokine storm” was associated with disease severity. Methods: We summarize published key findings about imatinib, aiming to rationalize its use as a potential pharmacologic treatment for COVID-19. Results: Data from cellular, animal models and clinical trials, showed a beneficial role of tyrosine kinase inhibitors in the regulation of inflammation, the maintenance of endothelial barrier integrity, as well as the expression of antiviral properties. This data is especially derived from imatinib, the most studied Abl family kinase inhibitor, that is currently in clinical use for multiple medical conditions. Discussion: Based on this encouraging data, we hypothesize that imatinib might be beneficial for the treatment of patients with SARS-CoV-2 pneumonia, in the aim of preventing disease progression into the severe phenotype of hypoxic respiratory failure and acute respiratory distress syndrome. This concept can be considered for evaluation in a randomized controlled study

Etat des lieux de l'éducation à la sexualité dans les établissements privés et publics au Liban

Ce travail tente de tracer un état des lieux de l'éducation à la sexualité dans les divers établissements scolaires libanais : privés religieux, privés non confessionnels et publics. Il présente les résultats d'une enquête dans plus d'une centaine d'établissements divers pour savoir dans lesquels l'enseignement de ce thème est ou non, ou plus ou moins, mis en œuvre, et pour analyser les caractéristiques de cet enseignement quand il existe (classes et matières concernées, thèmes abordés,...). Des directeurs, des coordonnateurs et des enseignants de 104 établissements libanais répartis selon les diverses zones géographiques du Liban ont répondu à un questionnaire. L'ensemble des analyses a montré, selon les établissements, une diversité qui porte sur le degré d'implémentation de l'ES, sur sa définition, sur les cadres et les personnes les plus appropriés pour la mettre en œuvre. Cette diversité sans corrélation significative avec le statut de l'établissement peut constituer un obstacle à l'implémentation de l'ES dans le cadre scolaire libanais

Sex Education in Lebanon and France

International audienceThis work is a comparison between France and Lebanon. It analyzes the conceptions of Lebanese and French teachers on issues concerning human sexuality and its education. Our goal is to highlight the different conceptions of teachers in both countries and to identify the parameters to which these differences are correlated. All the multivariate analyses conducted show two very different systems of conceptions, very significantly differentiating Lebanese teachers' conceptions of French teachers ones. French teachers, unlike their Lebanese colleagues, are more conducive to early learning topics related to sexuality to students between 6 and 15 years old depending on the subject. They are more likely to accept abortion and homosexuality, to focus on safer sex as an attitude that can reduce the spread of AIDS, and to consider that the teaching of STIs is not only the issue of biology teachers. The differences between Lebanon and France are not reducible to religion: each country has its own identity rooted in its specific geographical, historical, economic and cultural context

L'Education à la Sexualité (ES) dans les établissements privés et publics au Liban

International audienceCe travail concerne une facette de l'état des lieux sur l'implémentation de l'éducation à la sexualité (ES) dans divers types d'établissements scolaires libanais : privés religieux, privés non confessionnels et publics. Il présente les résultats d'une enquête dans plus d'une centaine d'établissements pour savoir dans lesquels l'enseignement de ce thème est ou non, ou plus ou moins, mis en œuvre, et pour analyser les caractéristiques de cet enseignement quand il existe (classes et matières concernées, thèmes abordés,...). Des directeurs, des coordonnateurs et des enseignants de 104 établissements répartis selon les diverses zones géographiques du Liban ont répondu à un questionnaire. L'ensemble des analyses a montré, selon les établissements, certaines convergences et une diversité, sans corrélation significative avec le statut de l'établissement, portant sur le degré d'implémentation de l'ES, sur les cadres et les personnes les plus appropriés pour la mettre en œuvre. Les points de vue aussi bien convergents, que divergents, peuvent participer aux difficultés d'implémentation de l'ES dans le cadre scolaire libanais

Barriers to the delivery of diabetes care in the Middle East and South Africa: a survey of 1,082 practising physicians in five countries

SUMMARY Aims: Developing countries face a high and growing burden of type 2 diabetes. We surveyed physicians in a diverse range of countries in the Middle East and Africa (Egypt, Kingdom of Saudi Arabia, United Arab Emirates, South Africa and Lebanon) with regard to their perceptions of barriers to type 2 diabetes care identified as potentially important in the literature and by the authors. Methods: One thousand and eighty-two physicians completed a questionnaire developed by the authors. Results: Most physicians enroled in the study employed guideline-driven care; 80–100% of physicians prescribed metformin (with lifestyle intervention, where there are no contraindications) for newly diagnosed type 2 diabetes, with lifestyle intervention alone used where metformin was not prescribed. Sulfonylureas were prescribed widely, consistent with the poor economic status of many patients. About one quarter of physicians were not undertaking any form of continuing medical education, and relatively low proportions of practices had their own diabetes educators, dieticians or diabetic foot specialists. Physicians identified the deficiencies of their patients (unhealthy lifestyles, lack of education and poor diet) as the most important barriers to optimal diabetes care. Low-treatment compliance was not ranked highly. Access to physicians did not appear to be a problem, as most patients were seen multiple times per year. Conclusions: Physicians in the Middle East and South Africa identified limitations relating to their patients as the main barrier to delivering care for diabetes, without giving high priority to issues relating to processes of care delivery. Further study would be needed to ascertain whether these findings reflect an unduly physician-centred view of their practice. More effective provision of services relating to the prevention of complications and improved lifestyles may be needed. What's known It is known that the success of care for diabetes depends critically on the delivery of optimised care for diabetic patients. Many barriers to the delivery of such care have been identified. Relatively little is known regarding how these barriers influence the delivery of diabetes care in the Middle East and South Africa. What's new Physicians generally followed management guidelines in type 2 diabetes care. Perceived barriers to optimal diabetes care mainly focussed on attributes of patients, rather than process issues in care or aspects of the physicians' practice

Knowledge, Perception, Attitudes and Behavior on Influenza Immunization and the Determinants of Vaccination

BACKGROUND: We sought to determine the knowledge of, perception, attitudes, and behaviors toward influenza virus and immunization, and the determinants of vaccination among students, patients, and Healthcare Workers (HCWs) at the American University of Beirut and its affiliated Medical Center. METHODS: We conducted a cross-sectional study between October 2016 and January 2017 utilizing a self-administered questionnaire that was provided to 247 randomly selected adult participants. Data collected included socio-demographic characteristics, prior vaccination against influenza, knowledge, perception, attitudes, and behaviors toward influenza and influenza immunization. A multivariable regression model was used to evaluate for independent associations between the different variables and regular or yearly vaccination as a primary outcome. RESULTS: The overall survey response rate was 77%. A substantial proportion of respondents (47.4%) had never received the influenza vaccine. Only 10.2% of students, 19.1% of patients, and 35.6% of HCWs reported regular or yearly influenza vaccine uptake. HCWs had the lowest knowledge score about influenza and its vaccine despite high self-reported levels of knowledge. Barriers to vaccinations included lack of information (31%), fear of adverse effects (29%), and a perception of not being at risk (23%). Several factors were independently associated with regular or yearly vaccination uptake including having children (adjusted OR = 3.8; 95% CI 1.2-12.5), a "very good" self-reported level of knowledge (OR = 16.3; 95% CI 1.4-194.2) and being afraid of the consequences of influenza (OR = 0.2; 95% CI 0.1-0.6). CONCLUSION: Adherence rates with regular or yearly vaccination against influenza remain low across all study groups. We were able to identify predictors as well as barriers to vaccination. Future awareness and vaccination campaigns should specifically aim at correcting misconceptions about vaccination, particularly among HCWs, along with addressing the barriers to vaccination. Predictors of vaccination should be integrated in the design of future campaigns

Prediabetes management in the Middle East, Africa and Russia: Current status and call for action:

Most data on the burden of diabetes and prediabetes are from countries where local infrastructure can support reliable estimates of the burden of non-communicable diseases. Countries in the Middle ..

Relation of the Mediterranean diet with the incidence of gestational diabetes

Background/objectives: Some studies document relationships of the incidence of gestational diabetes mellitus (GDM) with individual components of the diet, but studies exploring relationships with patterns of eating are lacking. This observational study aimed to explore a possible relationship between the incidence of GDM and the Mediterranean diet (MedDiet) pattern of eating. Subjects/methods: In 10 Mediterranean countries, 1076 consecutive pregnant women underwent a 75-g OGTT at the 24th-32nd week of gestation, interpreted both by the ADA-2010 and the International Association of the Diabetes and Pregnancy Study Groups (IADPSG)-2012 criteria. The dietary habits were assessed by a previously validated questionnaire and a Mediterranean Diet Index (MDI) was computed, reflecting the degree of adherence to the MedDiet pattern of eating: a higher MDI denoting better adherence. Results: After adjustment for age, BMI, diabetes in the family, weight gain and energy intake, subjects with GDM, by either criterion, had lower MDI (ADA-2010, 5. 8 vs 6. 3, P=0. 028; IADPSG-2012, 5. 9 vs 6. 4, P<0. 001). Moreover, the incidence of GDM was lower in subjects with better adherence to the MedDiet (higher tertile of MDI distribution), 8. 0% vs 12. 3%, OR=0. 618, P=0. 030 by ADA-2010 and 24. 3% vs 32. 8%, OR=0. 655, P=0. 004 by IADPSG-2012 criteria. In subjects without GDM, MDI was negatively correlated with both fasting plasma glucose and AUC glucose, P<0. 001 for both. Conclusions: Adherence to a MedDiet pattern of eating is associated with lower incidence of GDM and better degree of glucose tolerance, even in women without GDM. The possibility to use MedDiet for the prevention of GDM deserves further testing with intervention studies.peer-reviewe

Registries in rheumatological and musculoskeletal conditions. Paediatric Behçet's disease: an international cohort study of 110 patients. One-year follow-up data

Objective. To set-up an international cohort of patients suspected with Behçet's disease (BD). The cohort is aimed at defining an algorithm for definition of the disease in children. Methods. International experts have defined the inclusion criteria as follows: recurrent oral aphthosis (ROA) plus one of following—genital ulceration, erythema nodosum, folliculitis, pustulous/acneiform lesions, positive pathergy test, uveitis, venous/arterial thrombosis and family history of BD. Onset of disease is <16 years, disease duration is ≤3 years, future follow-up duration is ≥4 years and informed consent is obtained. The expert committee has classified the included patients into: definite paediatric BD (PED-BD), probable PED-BD and no PED-BD. Statistical analysis is performed to compare the three groups of patients. Centres document their patients into a single database. Results. At January 2010, 110 patients (56 males/54 females) have been included. Mean age at first symptom: 8.1 years (median 8.2 years). At inclusion, 38% had only one symptom associated with ROA, 31% had two and 31% had three or more symptoms. A total of 106 first evaluations have been done. Seventeen patients underwent the first-year evaluation, and 36 had no new symptoms, 12 had one and 9 had two. Experts have examined 48 files and classified 30 as definite and 18 as probable. Twenty-six patients classified as definite fulfilled the International Study Group criteria. Seventeen patients classified as probable did not meet the international criteria. Conclusion. The expert committee has classified the majority of patients in the BD group although they presented with few symptoms independently of BD classification criteri