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Open Journal of Emergency Medicine 2024年第3期12卷 77-84页

作者： youssef abboud Lalarukh Burki Dalal Abdalkarim Department of Emergency Medicine Fakeeh University Hospital Dubai United Arab Emirates

Introduction: Acute hemoperitoneum due to the spontaneous rupture of hepatocellular carcinoma (HCC) is a rare case of non-traumatic intra-abdomen bleeding that requires a high index of suspicion to approach, especially if no known history of HCC. It can mislead the physicians when the patient presents in an atypical way. Case Presentation: In this case report, we describe a fortuitous rupture of hepatocellular carcinoma in a 58-year-old male who was not previously diagnosed as having HCC and who came with atypical symptoms and signs of hemoperitoneum. He was then treated by trans-arterial embolectomy. Discussion: Diagnosis of hemoperitoneum in a case with bradycardia and hypotension is uncommon, as it goes more towards cardiogenic shock than hypovolemic shock, especially in a patient who is previously not symptomatic and has no risk factor for hepatocellular carcinoma. Conclusion: physicians should be alert to the possibility of encountering a hemorrhagic shock, although no trauma injury in any hypotensive patient with no clear reason for his condition.

关键词： Hepatocellular Carcinoma Rupture of HCC Trans-Arterial Embolectomy Hemoperitoneum Liver Cancer

A Case of Euglycemic Diabetic Ketoacidosis in Patient with Type 2 DM

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Open Journal of Emergency Medicine 2023年第4期11卷 174-179页

作者： Lamiz Tannouri Shahinaz Gouda youssef abboud Department of Emergency Soliman Fakeeh University Hospital Dubai United Arab Emarites

Diabetic ketoacidosis (DKA) can cause significant morbidity and mortality in patient with both type 1 and type 2 diabetes mellitus. A subset of DKA cases termed euglycemic diabetic ketoacidosis (EDKA) is characterized by euglycemic (<200 mg/dl), high anion gap metabolic acidosis, and increased plasma ketone concentration. This clinical syndrome is primary related to a general state of starvation, resulting in the development of ketosis while maintaining normoglycemia. It can lead to severe complication, such as extreme dehydration, altered mental status and coma. Early recognition and treatment are essential to avoid this life-threatening complication. EDKA represents approximately 2.6% to 3.2% of total DKA admissions, making it a rare condition. In this case report, a male patient was diagnosed with type 2 DM, 1 week prior to his symptoms and admission in hospital. Despite normal glucose levels at the time of presentation to the ED, he displayed severe acidemia and ketonemia, and was diagnosed with EDKA.

关键词： Euglycemic DKA Glucose Level Acidosis

Cardiopulmonary Resuscitation Induced Consciousness—A Case Report from United Arab Emirates

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Open Journal of Emergency Medicine 2022年第2期10卷 80-84页

作者： youssef Saleem abboud Sreya Varanasi Fakeeh University Hospital Dubai UAE

Cardiopulmonary resuscitation-induced consciousness (CPRIC) is increasingly being reported across the world. High quality cardiopulmonary resuscitation (CPR) may transiently generate sufficient cerebral perfusion to cause signs of consciousness during CPR which disappears on cessation of CPR. Here we present the case of a 56-year-old male presenting with myocardial infarction that led to cardiac arrest and initiation of CPR during which he showed signs of consciousness. This led to multiple disruptions in delivering high quality CPR. CPR providers are often unaware and inexperienced in managing these patients. However, CPRIC has an association with improved survival. Hence, more research needs to be conducted in this field and guidelines need to be developed to better manage CPRIC.

关键词： Consciousness Cardiopulmonary Resuscitation Spontaneous Movement

Complete Neurological Recovery after Prolonged Resuscitation in a Young Patient with Non-Shockable Rhythm

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Open Journal of Emergency Medicine 2023年第1期11卷 16-20页

作者： youssef abboud Laila Kalan Sreya Varanasi Fakeeh University Hospital Dubai UAE

Background: Out-of-hospital cardiac arrest (OHCA) with ongoing CPR on arrival to emergency department still a challenge to decide how long the resuscitation should continue or when to terminate it. Case Summary: A patient with a 1-week history of difficulty in breathing suffered from an OHCA. The electrocardiogram upon arrival to the hospital showed pulseless electrical activity. Cardiopulmonary resuscitation was initiated and continued for a total of 90 minutes without any interruption until return of spontaneous circulation (ROSC) was achieved. Post-cardiac care was offered, and the patient was discharged with complete neurological recovery. Discussion: In non-shockable rhythms, the powerful defibrillator machine is not used during resuscitation. In such cases, identifying the offending cause, performing high quality CPR and administering epinephrine are the only effective tools in resuscitating a patient.

关键词： Cardiac Arrest Out of Hospital Cardiac Arrest Resuscitation

How to Approach Real Mathematical Modeling in Surge Capacity: Clinical Review

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Open Journal of Emergency Medicine 2017年第2期5卷 85-91页

作者： Ali Ziaee Shervin Assari Helia Ghanean A. Jalali Saleem abboud youssef Emergency Department Saudi German Hospital Dubai UAE University of Michigan Michigan USA Research Associate UHN Toronto Canada Karolinska Institute Sweden Emergency Specialist Saudi German Hospital Dubai UAE

Objectives: Science of surge is one of most important topics in the realm of disaster preparedness. Since 2006, after Academic Emergency Medicine (AEM) Consensus Conference, few articles with quantitative data address decision making in surge capacity. The aim of this article is looking forward to the facts about mathematical modeling and proposes real modeling in decision making to have better outcome. Methods: Literature Research was performed on database for the last ten years (2007-2017). Articles with mathematical modeling were separated and classified based on the usage of them in the field. Results: All current mathematical studies compared based on pre-hospital and hospital setting and flexibility in change of global level of care in time. Integrated model of sigmoid curve and HASC (Hospital Acute Care Surge Capacity) with name B-H integrated modeling in two-hour interval proposed. Conclusion: This study shows dynamic process of disaster planning based on outcome and reality. The proposed model makes surge capacity more predictable and adjustable.

关键词： Surge Capacity Disaster Mathematical and Modeling

Hepatocellular Carcinoma Incidence and Mortality in the USA by Sex, Age, and Race: A Nationwide Analysis of Two Decades

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Journal of Clinical and Translational Hepatology 2024年第2期12卷 172-181页

作者： Yazan abboud Mohamed Ismail Hamza Khan Esli Medina-Morales Saqr Alsakarneh Fouad Jaber Nikolaos T.Pyrsopoulos Department of Internal Medicine Rutgers New Jersey Medical SchoolNewarkNJUSA Department of Internal Medicine University of Missouri-Kansas CityKansas CityMOUSA Division of Gastroenterology and Hepatology Rutgers New Jersey Medical SchoolNewarkNJUSA

Background and Aims:While the incidence rates of hepa-tocellular carcinoma(HCC)are increasing,there are limited comprehensive data on demographic-specific incidence and mortality trends in the *** aimed to evaluate recent trends in HCC incidence and mortality among different de-mographic groups in the ***:Age-adjusted HCC incidence rates were calculated from the Centers for Disease Control's United States Cancer Statistics database,which combines incidence data on newly diagnosed cancer cases and covers approximately 98%of the population in the ***,age-adjusted HCC mortality rates were obtained from the Centers for Disease Control's National Center for Health Statistics database,which offers comprehensive Cov-erage spanning nearly 100%of deaths attributed to HCC in the *** were stratified by sex,age(older[≥55 years]and younger[<55 years]adults),race and ethnicity(Non-Hispanic White,Non-Hispanic Black,Hispanic,Non-Hispanic Asian/Pacific Islander,and Non-Hispanic American Indian/Alaska Native),and tumor stage at diagnosis(early and late).Annual and average annual percentage change(AAPC)were calculated using joinpoint regression.A sex-specific pairwise comparison was ***:Between 2001 and 2020,there were 467,346 patients diagnosed with HCC(26.0%women),with increasing incidence in both sexes without significant difference(p=0.65).In younger adults(78,169 patients),the incidence decreased in men but not in women(AAPC difference=-2.39,p=0.002).This was seen in various racial and ethnic groups,mostly driven by early-stage tumors(AAPC difference=-2.65,p=0.02).There were 329,973 deaths attributed to HCC between 2000 and 2020(28.4%women).In younger adults(43,093 deaths),mortal-ity decreased in men at a greater rate than in women(AAPC difference=1.61,p=0.007).This was seen in various racial and ethnic groups,most notably in non-Hispanic American Indian/Alaska Natives(AAPC difference=-4.51,p=0.01).Conclusions:Nationwide USA data,coveri

关键词： Liver cancer Hepatocellular carcinoma Incidence Mortality Epidemiology Health disparity

Unroofed coronary sinus,left-sided superior vena cava and mitral insufficiency:A case report and review of the literature

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World Journal of Cardiology 2024年第10期16卷 595-603页

作者： Fouad Bitar Ziad Bulbul Yehya Jassar Rana Zareef Jennifer abboud Mariam Arabi Fadi Fouad Bitar Department of Pediatric and Adolescent American University of Beirut Medical CenterBeirut 1103Lebanon Department of Surgery American University of Beirut Medical CenterBeirut 1103Lebanon

BACKGROUND Unroofed coronary sinus(UCS)is a rare subtype of atrial septal *** is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac *** SUMMARY This report describes a rare case of an adolescent patient with UCS featuring atrial situs solitus,absence of the right superior vena cava and a persistent left superior vena cava draining into the left atrium consistent with total unroofing of the coronary *** was associated with concurrent severe mitral insufficiency secondary to redundant and prolapsing leaflets,and a substantial left-to-right shunt across the coronary sinus orifice.A comprehensive examination of the existing literature is included,shedding light on the diagnostic challenges of UCS and describing the available surgical options within the context of mitral valve *** UCS is a complex condition requiring careful consideration of associated anomalies and a tailored surgical approach.

关键词： Unroofed coronary sinus Mitral insufficiency Single left superior vena cava Surgical options Absent right superior vena cava Case report

Dissolved Organic Matter Features of Three Adjacent Eastern Mediterranean Urbanized Watersheds

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Open Journal of Modern Hydrology 2024年第3期14卷 153-173页

作者： Nour abboud Elias Michel Maatouk Zeinab Matar Veronique Kazpard Research and Analysis Platform for Environmental Sciences (PRASE) Doctoral School of Sciences and Technology (EDST) The Lebanese University Rafic Hariri Campus Hadat Lebanon Laboratory of Georessources Geosciences and Environment (L2GE) Faculty of Sciences The Lebanese University Fanar Lebanon Department of Earth and Life Sciences Faculty of Sciences The Lebanese University Hadat Lebanon

Landscape urbanization broadly affects ecosystems in coastal watersheds, but, until now, the influence of nonpoint source urban inputs on dissolved organic matter (DOM) amount, composition, and source is poorly understood. To understand how DOM composition varied with urbanization, fluorescence excitation-emission matrices (EEMs) were determined for urban and non-urban waters from upstream to downstream sites along three adjacent coastal watersheds that flow into the Mediterranean Sea. Two humic DOM fluorescent components (humic-like and fulvic-like peaks) and two proteinic components (tyrosine-like and tryptophane-like peaks) were identified by EEM fluorescence. The results indicated that urbanization had an important influence on DOM concentration and composition, with urban waters having a high degree of DOM variation due to different land uses surrounding each body of water. Urban waters show a higher DOM fluorescence index (FI), the highest fluorescence intensity of protein-like manifested also by BIX values, and a lower value of the humification index (HIX) than non-urban waters which were dominated by allochthonous inputs. In addition, the EEM was compared in dry and wet season where higher DOM amounts and FI appeared in summer due to autochthonous production coming from algae growth compared to allochthonous input from rainfall dominated in wet season. The concentration of DOC increased from upstream to downstream for the three rivers, especially Beirut River. The increase in DOC values was observed in both dry and wet seasons by 39 and 19 times respectively compared to upstream (0.93 - 0.91 mgC/L).

关键词： Dissolved Organic Matter DOM EEM Fluorescence Spectroscopy Autochthonous/Allochthonous DOM Urbanization Upstream/Downstream Wet/Dry Season

Surface Water Processes in Coping with Anthropogenic Impact in a Coastal Eastern Mediterranean Region

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Open Journal of Modern Hydrology 2024年第2期14卷 69-86页

作者： Nour abboud Zeinab Matar Elias Maatouk Véronique Kazpard Research and Analysis Platform for Environmental Sciences (PRASE) Doctoral School of Sciences and Technology (EDST) Lebanese University Hadat Lebanon Laboratory of Georessources Geosciences and Environment (L2GE) Faculty of Sciences Lebanese University Fanar Lebanon Department of Earth and Life Sciences Faculty of Sciences Lebanese University Hadat Lebanon

Rivers are progressively being exposed to increased anthropogenic pollution stresses that are undermining their designated uses and affecting sensitive coastal areas. In this study, three adjacent eastern Mediterranean coastal rivers, Ibrahim, Kaleb and Beirut, were evaluated. Water quality samples were collected in dry and wet seasons from different sampling sites along the river from the source to the outlet which represent a gradient of increased urbanization. The spatiotemporal variability of the physio-chemical properties, heavy metals (Zn, Pb, Cu, Cr, and Cd) and organic matter (DOC) were statistically analyzed to better understand the contribution of point and nonpoint pollution sources. The three rivers (Beirut, Kaleb and Ibrahim) show a similar behavior in calcium and carbonate alkalinity due to the carbonate mineral weathering effect, so they are of calcium bicarbonate type due to their calcareous geological nature. The speciation of anions was affected by temporal variation. Moreover, it is obvious that the Beirut River has a different behavioral characteristic where the water is a sulfate type water with a preferable metal-OM complexation mainly with lead, zinc and copper, whereas Kaleb and Ibrahim are considered to be of a nitrate phosphate type with a preferable metal inorganic complexation, especially copper, that has a consistent behavior in both types of waters. This difference is attributed to the urbanization effect highly impacting the Beirut River.

关键词： Anions/Cations Metals DOC Complexation Coastal Rivers Spatiotemporal Variability

Will artificial intelligence reach any limit in gastroenterology?

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Artificial Intelligence in Gastroenterology 2024年第2期5卷 1-9页

作者： Joseph Bou Jaoude Rose Al Bacha Bassam abboud Department of Gastroenterology Levant HospitalBeirut 166830Lebanon Department of General Surgery Geitaoui HospitalFaculty of MedicineLebanese UniversityLebanonBeirut 166830Lebanon

Endoscopy is the cornerstone in the management of digestive *** the last few decades,technology has played an important role in the development of this field,helping endoscopists in better detecting and characterizing luminal ***,despite ongoing advancements in endoscopic technology,the incidence of missed pre-neoplastic and neoplastic lesions remains high due to the operator-dependent nature of endoscopy and the challenging learning curve associated with new *** intelligence(AI),an operator-independent field,could be an invaluable *** can serve as a“second observer”,enhancing the performance of endoscopists in detecting and characterizing luminal *** utilizing deep learning(DL),an innovation within machine learning,AI automatically extracts input features from targeted endoscopic *** encompasses both computer-aided detection and computer-aided diagnosis,assisting endoscopists in reducing missed detection rates and predicting the histology of luminal digestive *** applications in clinical gastrointestinal diseases are continuously expanding and evolving the entire digestive *** all published studies,real-time AI assists endoscopists in improving the performance of non-expert gastroenterologists,bringing it to a level comparable to that of *** development of DL may be affected by selection *** have utilized different AI-assisted models,which are *** the future,algorithms need validation through large,randomized ***,AI has no limit to assist endoscopists in increasing the accuracy and the quality of endoscopic ***,practically,we still have a long way to go before standardizing our AI models to be accepted and applied by all gastroenterologists.

关键词： Artificial intelligence Digestive tract Gastroenterology Gastroscopy Coloscopy