Le Journal médical libanais. The Lebanese medical journal
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Comparative Study
COMPARATIVE STUDY on the MANAGEMENT of GLENOHUMERAL JOINT DISLOCATION. Closed Reduction vs. Arthroscopic Remplissage with Bankart Lesion Repair.
Conservative treatment of posttraumatic anteroinferior shoulder instability leads to a high failure rate and consequently high recurrence in young and active population. Each recurrence can increase the structural damage of both bony structures and soft tissues (Hill-Sachs lesion, Bankart lesion). Remplissage technique combined with Bankart repair have been proposed as a treatment option. ⋯ Conservative management after anterior shoulder dislocation including immobilization in neutral position leads to significantly higher and unacceptable high failure rate compared with early arthroscopic remplissage with Bankart repair. The slight restriction in external rotation post remplissage does not significantly affect the quality of life and return to sports activities and further supports the use of this safe, relatively short procedure, in the management of glenohumeral instability with concurrent Hill-Sachs lesions.
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This retrospective study evaluates the results of wireless tension band wire (WTBW) which is a modified technique of tension band wires (TBW) for Mayo type II A and III A olecranon fractures. In this technique the K-wires of the TBW are replaced by a cerclage wire while keeping the figure of eight wiring.
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Palliative care focuses on relieving suffering in patients with serious illness. Patients who receive palliative care have better control of distressing symptoms, are less likely to suffer from depression and have a better quality of life. ⋯ In Lebanon, Palliative care was only recently recognized as a specialty and there are not enough palliative care providers to cover the needs of the population. This article describes the opportunities and barriers to the development of palliative care in the Lebanese context.
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Lumbar disc herniation frequently affects young patients and is responsible for high rate of worker's compensation claims. The aim of this study is to evaluate at short and long-term the results of microdiscectomy in terms of pain control, quality of life and patient's satisfaction. ⋯ Microdiscectomy for lumbar disc herniation offers a marked improvement in back and radicular pain. Quality of life is much improved. Although satisfaction is high, it is somewhat decreased for patients with high expectations.
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Practice Guideline
The Lebanese Society for Infectious Diseases and Clinical Microbiology (LSIDCM) guidelines for adult community-acquired pneumonia (Cap) in Lebanon.
Adult community-acquired pneumonia (CAP) is a common cause of morbidity and mortality which is managed by different disciplines in a heterogeneous fashion. Development of consensus guidelines to standardize these wide variations in care has become a prime objective. The Lebanese Society of Infectious Diseases and Clinical Microbiology (LSIDCM) convened to set Lebanese national guidelines for the management of CAP since it is a major and a prevalent disease affecting the Lebanese population. ⋯ This document includes the following: 1/ Rationale and scope of the guidelines; 2/ Microbiology of CAP based on Lebanese data; 3/ Clinical presentation and diagnostic workup of CAP; 4/ Management and prevention strategies based on the IDSA/ATS Consensus Guidelines, 2007, and the ESCMID Guidelines, 2011, and tailored to the microbiological data in Lebanon; 5/ Comparison to regional guidelines. The recommendations made in this document were graded based on the strength of the evidence as in the 2007 IDSA/ATS Consensus Guidelines. Hopefully, these guidelines will be an important step towards standardization of CAP care in Lebanon and set the agenda for further research in this area.