This paper reviews the escalating burden of breast cancer (BC) in the Middle East (ME) and the prevalence of modifiable risk factors and underscores opportunities to promote the prevention of the disease. Similar to more developed countries, BC is the most frequent cancer among women in countries of the ME, accounting for one-third of total cancer cases and 24% of total cancer deaths. Average age at BC diagnosis appears to be a decade earlier in Middle Eastern countries compared to the Western countries, and its incidence is predicted to further increase. Although incidence rates of BC are still lower in Middle Eastern countries than Western ones, mortality rates are similar and at times even higher. It is estimated that 30% of BC cases are due to environmental and lifestyle factors, such as obesity and diet and hence can be preventable. The ME suffers from surging rates of obesity, with eight of its countries ranking among the highest worldwide in obesity prevalence among adults aged 18 and above. ME countries with the highest prevalence of obesity that are among the top 20 worldwide include United Arab Emirates (UAE), Lebanon, Egypt, Libya, Qatar, Saudi Arabia, Jordan, and Kuwait with rates ranging from 30% in UAE to 37% in Kuwait. In parallel, studies in the ME have consistently showed a shift in dietary intake whereby traditional diets, rich in fruits and vegetables, are progressively eroding and being replaced by westernized diets high in energy and fat. Accumulating evidence is reporting convincing association between consumption of such westernized diets and higher BC risk. Addressing these risk factors and studying their association with BC in terms of their nature and magnitude in Middle Eastern countries could provide the basis for intervention strategies to lower the risk and alleviate the burden of BC in these countries.
RÉSUMÉ Les infections nosocomiales constituent un problème majeur et tout hôpital doit connaître sa situation en matière d'infections nosocomiales. Cette étude rétrospective visait à identifier les infections nosocomiales bactériennes chez les patients admis au Centre Hospitalier Libanais de janvier 2006 à janvier 2008, déterminer les germes en cause, étudier la sensibilité de ces germes aux antibiotiques et évaluer le traitement adopté à l'hôpital. Au total, 96 patients développant une infection nosocomiale ont été recensés. Les infections nosocomiales les plus courantes étaient les infections urinaires (42 %), suivies par les infections pulmonaires (28 %). Les bacilles à Gram négatif étaient responsables dans 89 % des cas et les staphylocoques dans 7 %, Escherichia coli et Pseudomonas aeruginosa étant les plus fréquents (46 % et 26 % respectivement), avec une résistance majeure à divers antibiotiques ; 18 % des patients infectés étaient traités par imipénème, 7 % par vancomycine, 42 % par céphalosporines de 3 e génération et 24 % par amikacine. La lutte contre les infections nosocomiales doit passer par des mesures d'hygiène dans l'hôpital et par une politique de prescription d'antibiotiques adaptée à l'évolution des résistances bactériennes. Current status of nosocomial infections in the Lebanese Hospital Center, BeirutABSTRACT Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections (42%) followed by pulmonary infections (28%). Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Esherichia coli and Pseudomonas aeruginosa being the most common (46% and 26% respectively) The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms.
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