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Journal ; Article ; Online: COVID-19, the economic crisis, and the Beirut blast

Georges Mjaess / Aya Karam / Roy Chebel / Georges Abi Tayeh / Fouad Aoun

what 2020 meant to the Lebanese health-care system

2021

Abstract: ... 535 ... ...

Abstract	535 537
Keywords	Coronavirus Disease (COVID-19) ; COVID-19 ; Economic Recession ; Pandemics ; Delivery of Health Care ; economics
Language	English
Publisher	World Health Organization. Regional Office for the Eastern Mediterranean
Document type	Journal ; Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Penile Rehabilitation after Pelvic Cancer Surgery

Fouad Aoun / Alexandre Peltier / Roland van Velthoven

The Scientific World Journal, Vol

2015 Volume 2015

Keywords	Science ; Q ; Science (General) ; Q1-390
Publishing date	2015-01-01T00:00:00Z
Publisher	Hindawi Publishing Corporation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Penile Rehabilitation after Pelvic Cancer Surgery

Fouad Aoun / Alexandre Peltier / Roland van Velthoven

The Scientific World Journal, Vol

2015 Volume 2015

Abstract: Erectile dysfunction is the most common complication after pelvic radical surgery. Rehabilitation programs are increasingly being used in clinical practice but there is no high level of evidence supporting its efficacy. The principle of early penile ... ...

Abstract	Erectile dysfunction is the most common complication after pelvic radical surgery. Rehabilitation programs are increasingly being used in clinical practice but there is no high level of evidence supporting its efficacy. The principle of early penile rehabilitation stems from animal studies showing early histological and molecular changes associated with penile corporal hypoxia after cavernous nerve injury. The concept of early penile rehabilitation was developed in late nineties with a subsequent number of clinical studies supporting early pharmacologic penile rehabilitation. These studies included all available phosphodiesterase type 5 inhibitors, intracavernosal injection and intraurethral use of prostaglandin E1 and to lesser extent vacuum erectile devices. However, these studies are of small number, difficult to interpret, and often with no control group. Furthermore, no studies have proven an in vivo derangement of endothelial or smooth muscle cell metabolism secondary to a prolonged flaccid state. The purpose of the present report is a synthetic overview of the literature in order to analyze the concept and the rationale of rehabilitation program of erectile dysfunction following radical pelvic surgery and the evidence of such programs in clinical practice. Emphasis will be placed on penile rehabilitation programs after radical cystoprostatectomy, radical prostatectomy, and rectal cancer treatment. Future perspectives are also analyzed.
Keywords	Technology ; T ; Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Lower Urinary Tract Dysfunction in Pelvic Gynecologic Cancer

Fouad Aoun / Alexandre Peltier / Roland van Velthoven

Advances in Urology, Vol

The Role of Urodynamics

2014 Volume 2014

Keywords	Diseases of the genitourinary system. Urology ; RC870-923 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Hindawi Publishing Corporation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Comprehensive Review of Contemporary Role of Local Treatment of the Primary Tumor and/or the Metastases in Metastatic Prostate Cancer

Fouad Aoun / Alexandre Peltier / Roland van Velthoven

BioMed Research International, Vol

2014 Volume 2014

Abstract: To provide an overview of the currently available literature regarding local control of primary tumor and oligometastases in metastatic prostate cancer and salvage lymph node dissection of clinical lymph node relapse after curative treatment of prostate ... ...

Abstract	To provide an overview of the currently available literature regarding local control of primary tumor and oligometastases in metastatic prostate cancer and salvage lymph node dissection of clinical lymph node relapse after curative treatment of prostate cancer. Evidence Acquisition. A systematic literature search was conducted in 2014 to identify abstracts, original articles, review articles, research articles, and editorials relevant to the local control in metastatic prostate cancer. Evidence Synthesis. Local control of primary tumor in metastatic prostate cancer remains experimental with low level of evidence. The concept is supported by a growing body of genetic and molecular research as well as analogy with other cancers. There is only one retrospective observational population based study showing prolonged survival. To eradicate oligometastases, several options exist with excellent local control rates. Stereotactic body radiotherapy is safe, well tolerated, and efficacious treatment for lymph node and bone lesions. Both biochemical and clinical progression are slowed down with a median time to initiate ADT of 2 years. Salvage lymph node dissection is feasible in patients with clinical lymph node relapse after local curable treatment. Conclusion. Despite encouraging oncologic midterm results, a complete cure remains elusive in metastatic prostate cancer patients. Further advances in imaging are crucial in order to rapidly evolve beyond the proof of concept.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Minimal Invasive Urologic Surgery and Postoperative Ileus

Fouad Aoun / Marc Zanaty / Alexandre Peltier / Roland van Velthoven

Open Access Journal of Science and Technology, Vol 3, Pp 1-

2015 Volume 8

Abstract: Postoperative ileus (POI) is the most common cause of prolonged length of hospital stays (LOS) and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress ... ...

Abstract	Postoperative ileus (POI) is the most common cause of prolonged length of hospital stays (LOS) and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress in the future. In the field of gastrointestinal surgery, several studies had reported lower incidence rates for POI following minimal invasive surgery compared to conventional open procedures. In contrast, little is known about the effect of minimal invasive approach on the recovery of bowel motility after urologic surgery. We performed an overview of the potential benefit of minimal invasive approach on POI for urologic procedures. The mechanisms and risk factors responsible for the onset of POI are discussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radical cystectomy but it is rarely of clinical significance for other minimal invasive interventions. Laparoscopy or robotic assisted laparoscopic techniques when studied individually may reduce to their own the duration and prevent the onset of POI in a subset of procedures. The potential influence of age and urinary diversion type on postoperative ileus is contradictory in the literature. There is some evidence suggesting that BMI, blood loss, urinary extravasation, existence of a major complication, bowel resection, operative time and transperitoneal approach are independent risk factors for POI. Treatment of POI remains elusive. One of the most important and effective management strategies for patients undergoing radical cystectomy has been the development and use of enhanced recovery programs. An optimal rational strategy to shorten the duration of POI should incorporate minimal invasive approach when appropriate into multimodal fast track programs designed to reduce POI and shorten LOS.
Keywords	postoperative ileus ; minimal invasive ; urologic malignancies ; Science (General) ; Q1-390 ; Science ; Q
Subject code	610
Language	English
Publishing date	2015-07-01T00:00:00Z
Publisher	AgiAl Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Validated Prospective Assessment of Quality of Life After Robot-Assisted Laparoscopic Prostatectomy

Simone Albisinni / Fouad Aoun / Thierry Quackels / Grégoire Assenmacher / Alexandre Peltier / Roland van Velthoven / Thierry Roumeguère

American Journal of Men's Health, Vol

Beyond Continence and Erections

2019 Volume 13

Abstract: Continence and erectile function represent major concerns after robot-assisted laparoscopic prostatectomy (RALP), although the analysis of only these results may underestimate the impact of surgery on quality of life (QoL). The aim of the study is to ... ...

Abstract	Continence and erectile function represent major concerns after robot-assisted laparoscopic prostatectomy (RALP), although the analysis of only these results may underestimate the impact of surgery on quality of life (QoL). The aim of the study is to prospectively analyze QoL after RALP according to the validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire prostate cancer–specific module (EORTC-QLQ-PR25) and C30 and explore risk factors for the deterioration of QoL after surgery. A total of 584 patients undergoing RALP were prospectively enrolled. QoL was assessed with the validated EORTC-QLQ-PR25 and C30. Differences across QoL items were assessed via Wilcoxon rank-sum test and associations between risk factors and QoL scores were tested via univariate and multivariate linear regression analyses. All items of the PR25 questionnaire showed a significant deterioration at 1 month after RALP and began to normalize 3 months after surgery. At 24 months follow-up, urinary, bowel, and sexual activity scores were not significantly different from preoperative scores, while incontinence aid, treatment-related symptoms, and sexual functioning remained significantly worse. Preoperative sexual activity was more important in determining 3-month sexual outcomes than preoperative 5-item version of the International Index of Erectile Function (IIEF-5) or nerve-sparing approach. An overall return to preoperative QoL was registered at 3 months after RALP in global and physical QoL, and most important, global, physical, social, and role-functioning QoL scores were improved at 12 and 24 months compared to preoperative scores. In this prospective study, detailed data on QoL are reported via the EORTC-PR25 and C30 questionnaires. While urinary, bowel, and sexual activity scores return to baseline values 24 months after surgery, incontinence aid, treatment-related symptoms, and sexual functioning may remain significantly deteriorated. Larger studies are needed to validate these findings.
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2019-05-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Influence of Lumbar Plexus Block for Proximal Modular Megaprostheses in Metastatic Bone Disease of the Femur

Mohammed Ben Aziz / Maher Khalife / Sonia Hontoir / Maurice Sosnowski / Michael Gebhart / Fouad Aoun

Open Access Journal of Science and Technology, Vol 3, Pp 1-

2015 Volume 6

Abstract: Background Modular megaprosthesis for proximal femur reconstruction after wide resection of metastatic lesion is a long-lasting painful procedure associated with prolonged hospital stay and significant blood loss. We evaluated the influence of lumbar ... ...

Abstract	Background Modular megaprosthesis for proximal femur reconstruction after wide resection of metastatic lesion is a long-lasting painful procedure associated with prolonged hospital stay and significant blood loss. We evaluated the influence of lumbar plexus block on intraoperative and postoperative complications as well as length of hospital stay. Materials and Methods A retrospective study comparing two groups of patients for intraoperative and postoperative complications undergoing modular megaprosthesis for metastatic bone disease of the femur according to the type of anesthesia received. Group 1 included 20 patients undergoing the procedure under general anesthesia and group 2 had 19 patients undergoing the same procedure by the same surgeon under general anesthesia combined to lumbar plexus block. Results The two groups were comparable in terms of demographic characteristics and the primary location of the tumor except for smoking and lung cancer which were more frequent in group 1. Intraoperative variables were not statistically different between the two groups except for intraoperative blood loss (P = 0.046) and transfusion (P = 0.007). Respiratory complications were more frequent in the group 1 compared to group 2 (32% vs. 0%, P = 0.006) while there were no statistically significant difference for local complications, postoperative Hb and LOS. On multivariate analysis, NSAIDs consumption and general anesthesia were found to be and independent predictive factors for intraoperative blood loss. Age and ASA score were independent predictive factors for prolonged LOS. Smoking and lung cancer were predictive factors for respiratory complications. General anesthesia alone was not found to be a predictive risk factor for respiratory complications (P = 0.245) and prolonged LOS (P = 0.052). Conclusion Lumbar plexus block is an effective complement to general anaesthesia and intraoperative analgesic management of modular megaprosthesis for proximal femoral malignant lesions, reducing blood loss and transfusion during the surgical procedure. Prospective randomized trials are needed to confirm these findings.
Keywords	lumbar plexus block ; anesthesia ; prostheses ; metastatic ; femur ; Technology ; T ; Science ; Q
Subject code	610
Language	English
Publishing date	2015-03-01T00:00:00Z
Publisher	AgiAl Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: MRI-Targeted Biopsies versus Systematic Transrectal Ultrasound Guided Biopsies for the Diagnosis of Localized Prostate Cancer in Biopsy Naïve Men

Alexandre Peltier / Fouad Aoun / Marc Lemort / Félix Kwizera / Marianne Paesmans / Roland Van Velthoven

BioMed Research International, Vol

2015 Volume 2015

Abstract: Introduction. To compare, in the same cohort of men, the detection of clinically significant disease in standard (STD) cores versus multiparametric magnetic resonance imaging (mpMRI) targeted (TAR) cores. Material and Methods. A prospective study was ... ...

Abstract	Introduction. To compare, in the same cohort of men, the detection of clinically significant disease in standard (STD) cores versus multiparametric magnetic resonance imaging (mpMRI) targeted (TAR) cores. Material and Methods. A prospective study was conducted on 129 biopsy naïve men with clinical suspicion of prostate cancer. These patients underwent prebiopsy mpMRI with STD systematic biopsies and TAR biopsies when lesions were found. The agreement between the TAR and the STD protocols was measured using Cohen’s kappa coefficient. Results. Cancer detection rate of MRI-targeted biopsy was 62.7%. TAR protocol demonstrated higher detection rate of clinically significant disease compared to STD protocol. The proportion of cores positive for clinically significant cancer in TAR cores was 28.9% versus 9.8% for STD cores (P<0.001). The proportion of men with clinically significant cancer and the proportion of men with Gleason score 7 were higher with the TAR protocol than with the STD protocol (P=0.003; P=0.0008, resp.). Conclusion. mpMRI improved clinically significant prostate cancer detection rate compared to STD protocol alone with less tissue sampling and higher Gleason score. Further development in imaging as well as multicentre studies using the START recommendation is needed to elucidate the role of mpMRI targeted biopsy in the management of prostate cancer.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: LIVING DONOR NEPHRECTOMY: OPEN vs LAPARASCOPY. Renal Function and Complications.

Maroun, Moukarzel / Anthony, Kallas Chemaly / Samir, Rahhal / Fouad, Aoun / Fouad, Nakhle / David, Atallah / Samir, Mallat / Chebl, Mourani

Le Journal medical libanais. The Lebanese medical journal

2015 Volume 63, Issue 3, Page(s) 144–149

Abstract: Objectives: This study is to compare the short and long-term renal function between adult recipients of living laparoscopic and open donors (LR vs OR) to highlight the effect of the surgical technique on graft function. Moreover, we chose to compare the ...

Abstract	Objectives: This study is to compare the short and long-term renal function between adult recipients of living laparoscopic and open donors (LR vs OR) to highlight the effect of the surgical technique on graft function. Moreover, we chose to compare the organic (hypertension, proteinuria, serum creatinine) and psychological (aspect of libido, need for anxiolytics) long-term effect of the surgery between laparoscopic and open donors (LD vs OD). Methods: After census of adult recipients and living donors between 2003 and 2012, and after application of exclusion criteria and selection of homogeneous groups of donors and recipients, a retrospective cohort study was conducted between October 2008 and January 2012. In recipients, renal function in the short term was reported by the value of serum creatinine at ± D5 post-op and the long-term values of serum creatinine at 6 and 12 months after surgery. Delayed graft function was defined by a serum creatinine value ≥ 2.5 mg/dl on D5 post-op. A questionnaire for donors was established. Results: The two groups OR and LR were homogeneous concerning age, sex and body mass index (BMI). Different groups OD and LD, chosen according to the variable of interest, were made homogeneous. Despite a different warm ischemia time between the 2 groups (175.54 seconds in LR vs 44.67 seconds in OR, p < 0.001), renal function in the short- and long-term in recipients was not statistically different (At day 5, 1.54 vs 1.50 mg/dl, p = 0.781; at 6 months, 1.37 vs 1.38, p = 0.871; at 12 months, 1.34 vs 1.36, p = 0.569, in OR and LR respectively). Similarly, there was no significant statistical difference concerning organic and psychological complications between OD and LD except for a shorter period between hospital discharge and return to work in LD. Conclusion: In our center, renal function in the short- and long-term was similar in OR and LR. Apart from the advantages offered by the laparoscopic technique, organic and psychological long-term effects were similar between OD and LD. Nevertheless, laparoscopy seemed to facilitate kidney donation and is requested by almost all living donors independently of their social status.
MeSH term(s)	Adult ; Cohort Studies ; Female ; Humans ; Kidney/physiology ; Kidney Transplantation ; Laparoscopy ; Living Donors ; Male ; Nephrectomy/methods ; Postoperative Complications/epidemiology ; Retrospective Studies ; Time Factors
Language	English
Publishing date	2015-11-16
Publishing country	Lebanon
Document type	Clinical Study ; Comparative Study ; Journal Article
ZDB-ID	412536-8
ISSN	0023-9852
ISSN	0023-9852
DOI	10.12816/0015837
Database	MEDical Literature Analysis and Retrieval System OnLINE

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