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Surgical management of gallstone ileus after one anastomosis gastric bypass: A case report

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世界胃肠外科杂志:英文版(电子版) 2023年第9期15卷 2083-2088页

作者： Elie El feghali Rhea Akel Bilal Chamaa Daniel Kazan Ghassan Chakhtoura Department of General Surgery Saint Joseph UniversityBeirut 1107Lebanon Department of Radiology Saint Joseph UniversityBeirut 1107Lebanon

BACKGROUnD Gallstone ileus following one anastomosis gastric bypass(OAGB)is an exceptionally rare *** presented case report aims to highlight the unique occurrence of this condition and its surgical *** the clinical presentation,diagnostic challenges and successful surgical inter-vention in such cases is crucial for healthcare professionals involved in bariatric *** SUMMARY We present a case report of gallstone ileus following OAGB and discuss its diagnosis and surgical management.A 66-year-old female with a history of OAGB presented to the emergency room with symptoms of small bowel *** tomography scan revealed a gallstone impacted in the distal ileum,causing *** patient underwent a laparoscopically assisted enterolithotomy,during which the gallstone was extracted and the enterotomy was *** patient had an uneventful recovery and was dis-charged on postoperative day *** Gallstone ileus should be considered as a possible complication after OAGB,and prompt surgical intervention is usually required for its *** case report contributes to the limited existing literature,providing insights into the management of this uncommon complication.

关键词： Gallstone ileus One anastomosis gastric bypass Bariatric surgery Intestinal occlusion Bilio-digestive fistula Enterolithotomy Case report

Updates in arteriovenous malformation management: the post-ARUBA era

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Stroke & Vascular neurology 2020年第1期5卷 34-39页

作者： James feghali Judy Huang Department of neurosurgery Johns Hopkins University School of MedicineBaltimoreMarylandUSA

Brain arteriovenous malformations(AVMs)are complex and heterogeneous lesions that can rupture,causing significant morbidity and *** ruptured lesions are usually treated,the management of unruptured AVMs remains unclear.A Randomized trial of Unruptured Brain Arteriovenous Malformations(ARUBA)was the first trial conducted to compare the effects of medical and interventional *** it concluded that medical therapy was superior in preventing stroke and death over a follow-up period of 33 months,the findings were met with intense criticism regarding several aspects of study design,progression,and analysis/***,the increased use of stand-alone embolisation relative to microsurgery in a cohort with predominantly low-grade lesions combined with a short follow-up period amplified treatment ***,several observational studies were conducted on ARUBA-eligible patients to investigate the safety and efficacy of microsurgery,radiosurgery,and endovascular embolisation over longer follow-up *** reports showed that favourable safety profiles and cure rates can be achieved with appropriate patient selection and judicious use of different treatment modalities in multidisciplinary *** large prospective randomised trials on AVMs may not be feasible,it is important to make use of practice-based data beyond the flawed ARUBA study to optimise patients’lifetime outcomes.

关键词： treatment lifetime alone

PERMEABILITY COMPUTATIOn On A REPRESEnTATIVE VOLUME ELEMEnT （RVE） OF. UnIDIRECTIOnAL DISORDERED FIBER ARRAYS

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Journal of Computational Mathematics 2016年第3期34卷 223-239页

作者： Karim Hitti Stephanie feghali Marc Bernacki Department of Mathematics Faculty of Sciences University of Balamand Lebanon Notre Dame University-Louaize Faculty of Natural and Applied Sciences Department of Mathematics and Statistics Lebanon Lebanese University Faculty of Sciences II Mathematics Department P.O. Box 90656 Fanar-Matn Lebanon Mines-ParisTech PSL-Research University CEMEF- Centre de mise en forme des matdriaux CNRS UMR 7635 CS 10207 rue Claude Daunesse 06904 Sophia Antipolis Cedex France

An efficient method to compute the permeability of disordered fibrous arrays is pro- posed. A stabilized mixed finite element method is used with an immersed domain ap- proach to represent the porous material at its microscopic scale. Therefore, the Stokes e- quations are solved in the whole domain （including solid part） using a penalization method. The accuracy is controlled by refining the mesh around the fluid-solid interface defined by a level-set function. Using homogenization techniques, the permeability of an RVE is obtained. Furthermore, a new method to generate disordered fibers in function of the porosity, Ф, and other microstructural parameters is proposed and a study of the effect of inter-fiber spacing on K：, the permeability tensor, is performed using parallel computation and over 460 simulations were carried RVEs consisting of over 555 fibers. This task was achieved out in two-dimensional

关键词： Permeability Fibrous Media Finite Element Method Level-set.

Tracking chloride and metal diffusion in proofed and unproofed concrete matrices using ablative laser technology (ICP-MS)

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natural Science 2010年第8期2卷 809-816页

作者： Avin Pillay Mirella Elkadi Fadi feghali Sai Cheong Fok Ghada Bassioni Sasi Stephen 不详

Depth profiling studies (laser ICP-MS) of ions (Cl-, na+, Mg2+) in concrete-based material can be used to provide useful information on the migration paths of these ionic species. In particular, deterioration of concrete through infiltration of chloride could lead to costly corrosion problems with serious impact on the environment. Many modeling studies on concrete matrices depend on the tortuosity of these transport paths. Our work showed that dispersion paths of ionic species in concrete are intermittent and sporadic, suggesting that applications of simplifying assumptions in treatment of such data could lead to appreciable perturbations in related mathematical models. This paper examines the capability of using a high resolution ICP-MS laser ablation technique to track Cl– migration in concrete samples in the presence of other ions such as na+ and Mg2+. Cationic migration in such materials is underexplored and data in this particular area could contribute to modeling studies. Concrete bricks (with and without surface coatings) were specially prepared in cubic configurations and allowed to saturate in a ponding medium (sea water). The study subsequently examined the distribution of Cl– , na+ and Mg2+ with depth in protected (epoxy coated) and unprotected cored concrete slivers (5 mm diameter;2 mm thick) using an 80 μm- diameter laser beam coupled to an ICP-MS instrument. The laser (213 nm) was programmed to ablate a total depth of 50 μm at each point at 5-μm intervals. The results in unprotected samples indicated that chloride intensity showed a general decline with depth, suggesting that mobility of the chloride is a function of its interaction with the concrete matrix. In some cases ‘hotspots’ were observed at certain points indicating that transport of the intruding ion was limited. no significant mobility was observed in coated samples. The depth-profiling results for na+ and Mg2+ were somewhat unexpected. Strong similarities in their spectra purported that th

关键词： Concrete Cl– na+ Mg2+ Laser Ablation Depth-Profiling ICP-MS

Consensus statement on the epidemiology,diagnosis,prevention,and management of cow's milk protein allergy in the Middle East:a modified Delphi-based study

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World Journal of Pediatrics 2021年第6期17卷 576-589页

作者： Moustafa A.El-Hodhod Mortada H.F.El-Shabrawi Ahmed AIBadi Ahmed Hussein AM Almehaidib Basil nasrallah Ebtsam Mohammed AIBassam Hala El feghali Hasan M.Isa Khaled Al Saraf Maroun Sokhn Mehdi Adeli najwa Mohammed Mousa Al-Sawi Pierre Hage Suleiman Al-Hammadi Department of Pediatrics Faculty of MedicineAin Shams UniversityCairoEgypt Faculty of Medicine October 6 UniversityGizaEgypt Faculty of Medicine Cairo UniversityCairoEgypt International Pediatric Association(IPA) MarengoUSA International Society of Tropical Pediatrics(ISTP) ManilaPhilippines DRC Hospital MuscatOman Al Amiri and Al Adan Hospitals KuwaitKuwait Pediatric Gastroenterology Department of PediatricsKing Faisal Specialist Hospital and Research Center RiyadhRiyadhSaudi Arabia American Hospital Dubai DubaiUnited Arab Emirates nutrition Service Department King Faisal Specialist and Research Center RiyadhRiyadhSaudi Arabia CHU notre Dame de Secours ByblosLebanon Pediatric Department Salmaniya Medical ComplexManamaBahrain Pediatric department Arabian Gulf UniversityManamaBahrain Pediatrics Department Dar Al Shifa HospitalKuwaitKuwait Pediatric Gastroenterology Hepatologyand Nutrition DepartmentSaint George University Medical CenterUniversity of BalamandBeirutLebanon Sidra Medicine DohaQatar Department of Pediatrics Doctor Sulaiman Alhabib Medical GroupAlrryan BranchRiyadhSaudi Arabia Pediatric Pulmonology and Allergology University of BalamandBeirutLebanon College of Medicine Mohanuned Bin Rashid University of Medicine and Health SciencesBuilding 14505055 DubaiUnited Arab Emirates

Background This study aimed to develop an expert consensus regarding the epidemiology,diagnosis,and management of cow’s milk protein allergy(CMPA)in the Middle *** A three-step modified Delphi method was utilized to develop the *** specialized pediatricians participated in the development of this *** statement was considered a consensus if it achieved an agreement level of>80%.Results The experts agreed that the double-blind placebo-controlled oral challenge test(OCT)should be performed for 2-A weeks using an amino acid formula(AAF)in formula-fed infants or children with suspected ***-fed infants with confirmed CMPA should be offered a therapeutic *** panel stated that an extensively hydrolyzed formula(eHF)is indicated in the absence of red flag *** the same time,the AAF is offered for infants with red flag signs,such as severe anaphylactic *** panel agreed that infants on an eHF with resolved symptoms within 2-4 weeks should continue the eHF with particular attention to the growth and nutritional *** the other hand,an AAF should be considered for infants with persistent symptoms;the AAF should be continued if the symptoms resolve within 2-4 weeks,with particular attention to the growth and nutritional *** cases with no symptomatic improvements after the introduction of an *** measures should be *** panel developed a management algorithm,which achieved an agreement level of 90.9%.Conclusion This consensus document combined the best available evidence and clinical experience to optimize the management of CMPA in the Middle East.

关键词： Consensus Cow's milk protein allergy Infant formula Middle East Milk hypersensitivity

Flu Vaccine Coupled to Vitamin D Decrease the Frequency of Lower Respiratory Tract Infections (Randomized Controlled Trial)

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Open Journal of Pediatrics 2017年第4期7卷 353-358页

作者： C. Tayeh P. noun A. Farah Y. Khalife G. Abi Fares M. Amm H. feghali G. nicolas M. C. Fadous Khalife Holy Spirit University of Kaslik University Hospital (UH)-Notre Dame Des Secours Byblos Lebanon

Introduction: Influenza disease is one of the major health concerns in pediatrics. One of the most recently suggested effects of vitamin D is preventing infectious diseases. The aim of our study was to compare flu vaccine effect to flu vaccine associated to vitamin D (100,000 UI per OS) in reducing respiratory tract infections in children. Patients and Methods: 347 healthy children aged 2 to 5 years randomly selected during fall 2012 and the following season fall 2013 were included;upper and lower respiratory tract infections following vaccination were noted. Our results were analyzed using SPSS program (Chi-square and T-test). Results: Out of a total of 347 children included, 150 received flu vaccine and 197 received flu vaccine plus vitamin D. 88 children from both groups manifested upper respiratory tract infections and 64 had lower respiratory tract infections. The statistical analysis revealed no significant difference between the two groups concerning the upper respiratory tract infection (p = 0.207) and a significant difference between groups for the lower respiratory tract infection (p = 0.001). Conclusion: Coupling vitamin D to flu vaccine provides no protection against upper respiratory infections but provides an effective strategy to decrease the rate of lower respiratory infections in children 2 - 5 years of age.

关键词： Influenza Flu Vaccine Vitamin D Upper and Lower Respiratory Tract