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Background Aging is a social factor that every human considers. Consequently, myths and stereotypes have been associated with old age, sometimes depicting a negative image. The human perception of old age is formed by knowledge, opinions, and cultural realities. Some people perceive old age as a sign of wisdom, while others consider old age as a loss of or decline in independence. This study aims to explore the perceptions, opinions, and attitudes of a representative sample of the inhabitants of Beirut, Lebanon toward old age and institutions for the elderly. Methods We conducted a cross-sectional survey of the inhabitants of Beirut using an anonymous, self-administered questionnaire in the Arabic Language, filled out voluntarily by the respondents. The information obtained through the survey included socio-demographic characteristics, perception of old age and residential institutions for the elderly, and factors influencing the fear of old age. Results A total of 400 individuals completed the questionnaire, 50.3% of whom were male. Only 7% of the respondents were 65 years and older. The mean age considered by respondents as old age was 64.23 years. For 28.8% of the respondents, old age mainly meant illness and health problems. Most of the respondents (89%) expressed worry when thinking about old age. The respondents expressed several concerns about old age; the most prominent were health concerns (38.4%) and loss of autonomy (23.7%). Furthermore, our sample’s perception of homes for the elderly was positive: good (39.8%) and very good (11.8%). However, only 3.5% of the respondents had an elderly relative in such institutions. Finally, 33.5% of the respondents agreed to pay for the services in such institutions, and 28.3% suggested an increase in compulsory levies to improve the care of people in such institutions. Conclusions Most of the respondents had a negative perception of old age, which was marked by pessimism about their health and autonomy. Similarly, institutions for the elderly represent an undesirable option as the respondents outlined several factors that explain their reluctance. The findings indicate an urgent need for action to improve people’s perceptions and attitudes toward old age.

Oral health indicators are usually collected to alert for the presence of infectious diseases, but the impact of poor oral health on the nutritional status of older people with dementia is often neglected. This study aims to explore the relationship between the number of posterior dental functional units (PFUs) and the anthropometric measure of malnutrition, the mid-upper arm circumference (MUAC), in older people with dementia while controlling for other variables, and to analyze whether the number of PFUs is considered when adjusting the texture of the food provided at mealtimes. A total of 103 individuals who were 70 years or older with dementia were recruited from seven institutions. Cognitive impairment was assessed using the Mini Mental State Examination. Data were collected from medical records (sociodemographic characteristics, presence of chronic diseases, prescribed medications, results of serum albumin level), as well as questionnaires (type of feeding routes, type of food texture, supplements intake, Activity of Daily Living index), clinical examinations (MUAC), and oral health parameters (PFUs, oral dryness, oral hygiene). MUAC was the dependent outcome variable. MUAC was associated with the number of PFUs (p = 0.032); participants with PFU ≤ 4 were 7.5 times more likely to have MUAC < 21 cm than others. Other associations were found between MUAC and albumin level (OR = 12.5; p = 0.001), modified food texture (OR = 4.2; p = 0.035), and length of institutional stay (OR = 5.2; p = 0.033); however, the type of oral feeding was not significantly related to the number of PFUs (p = 0.487) so there is an inadequate correlation between food texture and oral health status. Similar to MUAC, the number of PFUs could be an oral anthropometric criterion that is recorded during routine hygiene care to alert for the risk of malnutrition and the inappropriate choice of food texture in older individuals with dementia.

To compare the psychometric properties of three OHRQoL indicators (GOHAI, OHIP-14, and OHIP-EDENT) in a group of complete edentulous subjects and to explore the ability of these instruments to distinguish between individuals with different prosthetic and oral health status. This was a cross-sectional study. Edentulous individuals aged 60 years and more were recruited between January 2019 and February 2020 in a medical and dental care centers. The Lebanese versions of GOHAI, OHIP-14, and OHIP-EDENT were used. External and internal consistencies were assessed using intraclass correlation coefficient (ICC) and Cronbach alpha, respectively. The concurrent validity was evaluated by testing the indicators against a proxy measure of a similar concept. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile, respectively, and multivariate analyses were performed using sociodemographic, clinical, and subjective health parameters as explanatory variables. Two hundred and two edentulous subjects (age: 72.94 ± 7.378 years) were included. The proportion of subjects with no impact was lower for OHIP-EDENT (7.9%) compared to GOHAI (28.2%) and OHIP-14 (38.6%). Reproducibility was satisfactory for all OHRQoL tools since they were able to reproduce the results consistently in time (ICC > 0.80). The Cronbach alpha values were greater than 0.8 indicating acceptable internal consistency. The concurrent validity of the three tools was acceptable since subjects with lower OHRQoL score were less satisfied with their dentures and reported a higher need for self-rated therapy. Concerning the discriminant validity, OHIP-EDENT was more discriminant than OHIP-14 and GOHAI, since it was more able to identify patients with poor prosthetic issues or using instable denture. The OHIP-EDENT was more effective in identifying edentulous individuals with oral and prosthetic problems. Our results can help decide which dental instrument to use to assess the perception of oral health in edentulous individuals. More prospective studies are required to compare their evaluative properties.

Objectives The objective of this study was to compare ICDAS and DMFT/S in the evaluation of caries status of the first permanent molar in 200 children aged 7 to 13 years. Methods This was a cross-sectional design study. Participants were selected from two private schools in Lebanon. The examinations were performed by two trained and calibrated examiners using a dental mirror and a WHO probe. The number of decayed (D), missing (M) and filled (F) teeth was recorded in DMFT/S form, and the numbers related to D, M and F were then added to record the DMFT/S value (D1MFT/S, D2MFT/S and D3MFT/S). In the ICDAS, the assessment of caries associated with restorations and sealant was recorded. Student t tests/and Mann-Whitney tests were used to compare the continuous variables. Chi-square tests and Fisher exact tests were used to compare the categorical variables. Results The average age of the participants was 9.21 ± 1.927 (7-13 years old). No significant difference was found between the mean time to score DMFT, DMFS and ICDAS indices (-p-value > 0.05). The prevalence of caries with D1MFS, D2MFS and D3MFS was 80.5%, 54% and 30.5%, respectively. However, the prevalence of caries with ICDAS II was 77.5%. Conclusion The DMF index is an international user-friendly system that shows the carious history of teeth. However, the ICDAS assesses the different stages of caries and describes the restorative status of the tooth, promoting new preventive approaches and curative needs. More studies should be done to confirm these findings.

Background Measuring health status of elderly is essential for the prediction of their health care needs. Health research usually considers objective outcome measure; however there is a need to increase self-reported measures of health. Aims The aim of this study was to assess the psychometric properties of the SF36 among a group of Lebanese elderly. Methods It was a cross-sectional observational study. A systematic sample of elderly people aged 60 years and more was selected from dispensary, private and governmental hospitals in Lebanon. Data were collected using face-to-face interview. The first part of the questionnaire consisted of sociodemographic characteristics. The second part consisted of the Arabic version of the SF-36. The third part consisted of Activity of Daily Living (ADL) scale, presence of health problems and number of medication consumed per day. Results A total of 250 elderly people were included. The mean age was 70.69±7.70 years. Cronbach alphas for all SF-36 scales exceeded 0.798. The intra-Class correlation coefficient varied between 0.675 (item 2) and 0.980 (items 14, 16 and 18) indicating good reliability. The quality of life (QoL) of women was poorer than men (p

This study aims to assess the annual prevalence, associated factors, and characteristics of musculoskeletal disorders among Lebanese national-level athletes.Lebanese athletes aged 18 and over and who competed in a top-level national championship during an entire athletics season were invited to participate in the study. Data were collected through questionnaire assessing self-reported injury during the past year. Injury, dependent variable of the study, was defined as a musculoskeletal condition that made the athlete partially or completely abstains from training or competition for a 1-week minimum injury period.Among the 250 eligible athletes, 210 (84.0%) (25.5±6.7 years) completed the questionnaire. The 1-year retrospective injury prevalence was 51.9% (95% confidence interval, 45.1%-58.7%). Injured athletes reported 150 injuries: 128 (85.3%) affected the lower extremities, and 111 (74.0%) occurred during training. The most common type was muscle cramps/spasm (n=53; 35.3%); and overuse (n=121; 80.7%) was the predominant cause. Athletes who mainly practiced endurance disciplines (-p-value=0.042), who participated in international athletics championships (-p-value=0.047), and who were taking chronic medications (-p-value=0.049) had more injuries in the past year.These findings may help inform potential injury prevention programs, which should target injuries affecting the lower extremities, and consider the factors associated with injury risk among Lebanese athletes.

This study is aimed at evaluating the Oral Health Related Quality of Life (OHRQoL) in adolescents aged 11-14 years-old during orthodontic therapy and 18 months after the start of treatment and the possible role of psychological parameters. Sixty patients were recruited, and data were collected using self-administrated questionnaires and intraoral clinical examinations. The questionnaires included sociodemographic characteristics (age, gender), the Lebanese version of the Child Perception Questionnaire between 11 and 14 years CPQ11-14 to assess the OHRQoL, the Discrepancy Aesthetic Index (DAI) for malocclusion, and the Child Health Questionnaire « CHQ-CF87 » to appraise Self-Esteem (SE) and Psychological Well-Being (PWB). The mean scores of CPQ11-14 and its four subdomains were significantly better for participants with high SE /PWB compared to those with low SE / PWB at baseline. These same scores improved significantly during orthodontic treatment (p < 0.001). However, DAI was significantly better in patients with low self-esteem and psychological well-being. Our findings showed improvement in oral health perception and psychologic parameters during orthodontic treatment. Investigators should consider the need to control the psychological parameters of patients when assessing orthodontic treatment need and improvement in OHRQoL during orthodontic treatment.

This study explores whether the chemotherapy regimen has a role in inducing oral health problems and malnutrition in elderly patients with other cancers than head and neck malignancies. An observational cross-sectional study was designed to compare the relationships between oral health and nutritional status between four groups of elderly differing in cancer or chemotherapy regimen. Data were collected using a questionnaire including the Mini-Nutritional Assessment (MNA), the Geriatric Oral Health Assessment Index (GOHAI) and questions about perception of xerostomia. The oral examinations recorded the number of functional dental units (PFU) and the presence of oral lesions. The sample comprised 46 patients receiving chemotherapy, 48 patients on a non-chemotherapy regimen, 45 persons in complete remission not under treatment and 53 non-cancer patients. Oral health perception was significantly worse in chemotherapy patients. They reported limiting the kinds of food they consumed, the discomfort felt when eating and took medications for oral pain. Oral lesions were frequent in chemotherapy participants. Nutritional status was related to the cancer treatment regimen (OR = 4.17; p value = 0.017), the presence of oral lesions (OR = 4.51; p value = 0.003), perception of xerostomia (OR = 3.54; p value = 0.012), the number of PFU (OR = 2.51; p value = 0.046) and GOHAI score (OR = 1.617; p value = 0.019). The presence of oral lesions and the chemotherapeutic regimen were highly associated with nutritional status in older patients with cancer. Dental professionals should be asked to intervene preventively and per-therapy to optimise oral health status in elderly patients with other cancers than head and neck malignancies.

Summary Background & aims Improvement of nutritional status and perception of oral health are supposed to be different with complete conventional denture or implant-supported fixed or removable prostheses. Since no study has been conducted in Lebanon, the aim of our study was to assess the nutritional status and oral heath related quality of life (OHRQoL) in totally edentulous patients after treatment with complete denture or implant supported-prostheses. Material and methods This was an observational clinical prospective study. A convenient sample of Lebanese people aged 60 years or more was selected between September 2013 and July 2015 from the Departments of removable and fixed prosthesis at Saint-Joseph University of Beirut. The treatment options included complete denture, implant-supported complete denture and implant-supported fixed prostheses. Nutritional status and OHRQoL were assessed with the Mini-Nutritional Assessment Index (MNA) and the Geriatric Oral Health Assessment Index ( GOHAI) respectively at Baseline (first visit before treatment), 2–3 weeks after treatment (t1), 3 months (t2) and 6 months (t3) after treatment. Results Fifty-one participants (mean age: 69.39 ± 7.164 years) were included. The results have shown an improvement over time in nutritional status and OHRQoL for all treatment groups. However, 2–3 weeks after treatment the number of participants at risk of malnutrition was higher with complete removable denture, intermediate with implant-supported complete denture and lower with implant-supported fixed prostheses (p-value = 0.049). Moreover, the mean GOHAI score was significantly lower over time with complete removable denture compared to implant-supported prostheses (p-value Conclusion Our study has shown an enhancement in the quality of life and the nutritional status for implant supported-prostheses compared to conventional removable dentures. Therefore, it is fundamental that dentists communicate with their patients about implant treatment to understand their expectations, to explain the outcomes and achieve the desired clinical result.

Bisphosphonates have been proven to be effective and safe to millions of osteoporotic and cancer patients but were associated with multiple complications. The most prevalent and well established are upper gastrointestinal discomfort for oral bisphosphonates and acute phase reactions for intravenous forms. Although rare, hypocalcaemia and renal injury could be potentially serious. Severe musculoskeletal pain and ocular events may be ignored by physicians, which delay their diagnosis and management. Recently there are growing concerns over two long-term and emerging adverse effects, which are still of unclear pathophysiology and unproven causality. Osteonecrosis of the jaw is more common in cancer sufferers who receive high doses of intravenous bisphosphonates. Atypical femoral fractures are very rare compared with osteoporotic fractures that bisphosphonates prevent. Based on current data, the association of bisphosphonates with esophageal cancer, hepatotoxicity and atrial fibrillation remains doubtful. Overall, the adverse effect profile of these drugs is still unclear. Physicians must be vigilant to bisphosphonate-reported side effects and recognize the level of evidence supporting them, to better communicate the balance between benefits and potential risks to patients.

Summary Background and purpose In hospitals, poor nutritional status could be associated with a higher incidence of nosocomial infections, postoperative complications and mortality. Subsequently the costs of providing health care and social services will increase. Malnutrition has often been described as the skeleton in the hospital closet, as it is often ignored, undiagnosed and untreated. Our study aimed to describe the nutritional status of hospitalized patients aged 60 years or more and to evaluate the associated risk factors. Materials and methods This was an observational cross-sectional study conducted at a major tertiary teaching hospital in Beirut city. During a 7 months period, patients aged 60 and over and admitted in the medical and surgical units of the hospital were invited to participate in the study. Data were collected by means of a questionnaire including sociodemographic and medical characteristics, the Arabic version of the Mini Nutritional Assessment (MNA), the Activity of Daily Living (ADL) scale, and the American Society of Anesthesiologists (ASA) score. Results 171 participants aged 73.15 ± 8.06 years were included in the study. 52% of them were at risk of malnutrition and 13.5% were malnourished. Prevalence of malnutrition was higher in medical compared to surgical departments (16.2% vs. 10.5%, p = 0.003). Moreover, malnutrition was significantly associated with low level of education, high age, prolonged hospital stay, high number of medical comorbidities, polymedication, high ASA score and low ADL score (p Conclusions Malnutrition or risk of malnutrition are found in 2 out of 3 hospitalized patients aged 60 years or more, and is associated with several specific risk factors. Screening and management of malnutrition should be considered a priority in order to improve the overall medical status of older people, reduce hospital stay and improve outcome and quality of life.

Glycosyltransferases in bacteria are built using only four known architectures, but this structural core is often supplemented by fusions with a wide variety of other domains, including those that help recruit them to the membrane. Structural and functional characterization of these proteins is often simplified by making a subconstruct that is better behaved in solution, and perhaps monofunctional. In this chapter we review bioinformatics tools and strategies that can be used for designing such constructs of glycosyltransferases.

Measuring health status of elderly is essential for the prediction of their health care needs. Health research usually considers objective outcome measure; however there is a need to increase self-reported measures of health.The aim of this study was to assess the psychometric properties of the SF36 among a group of Lebanese elderly.It was a cross-sectional observational study. A systematic sample of elderly people aged 60 years and more was selected from dispensary, private and governmental hospitals in Lebanon. Data were collected using face-to-face interview. The first part of the questionnaire consisted of sociodemographic characteristics. The second part consisted of the Arabic version of the SF-36. The third part consisted of Activity of Daily Living (ADL) scale, presence of health problems and number of medication consumed per day.A total of 250 elderly people were included. The mean age was 70.69±7.70 years. Cronbach alphas for all SF-36 scales exceeded 0.798. The intra-Class correlation coefficient varied between 0.675 (item 2) and 0.980 (items 14, 16 and 18) indicating good reliability. The quality of life (QoL) of women was poorer than men (p0.001). It was significantly lesser when the number of health problems (p0.001) and medications (p0.001) increased, and the ADL score (p0.05) decreased.SF-36 is a valid and reliable instrument for measuring QoL among Lebanese elderly and could be used for monitoring the QoL of this population.التحقق من المسح الصحي القصير المُكوَّن من 36 بنداً (36–SF)، استبيان جودة الحياة الصحية العامة للمسنين في لبنان.ندى الأسطا، فاطمة قانصو، روبير سعد، ليديا رباع خباز، جهاد فاخوري، لنا الأسطا.قياس الحالة الصحية للمسنين أمر ضروري للتنبؤ باحتياجاتهم من الرعاية الصحية. وعادةً ما تراعي البحوث الصحية قياس النتائج قياساً موضوعياً، ومع ذلك توجد حاجة إلى زيادة المقاييس الصحية المُبلغ عنها ذاتياً.هدفت الدراسة إلى تقييم خصائص القياس النفسي للمسح الصحي القصير المُكوَّن من 36 بنداً (36–SF) لدى مجموعة من المسنين اللبنانيين.من خلال دراسة رصدية مقطعية، وجرى اختيار عينة منتظمة من المُسنين الذين يبلغون من العمر 60 عاماً أو أكثر من مستوصفات ومستشفيات خاصة وحكومية في لبنان. وجُعت البيانات من خلال مقابلة مباشرة وجهاً لوجه. وتألف الجزء الأول من الاستبيان من الخصائص الاجتماعية السكانية. وتألف الجزء الثاني من النسخة العربية للمسح الصحي القصير المُكوَّن من 36 بنداً (36–SF). وتألف الجزء الثالث من مقياس «أنشطة الحياة اليومية»، والمشكلات الصحية الموجودة، وعدد الأدوية المُستهلكة يومياً.بلغ مجموع المُسنين المشمولين بالدراسة 250 مسناً. وكان متوسط أعمارهم 7.70 ± 70.69 سنة. وكانت نتائج مُعامل ألفا كرونباخ في جميع مقاييس المسح الصحي القصير المُكوَّن من 36 بنداً (36–SF) أكثر من 0.798. وتراوح معامل الارتباط الداخلي بين 0.675 (البند 2) و0.980 (البنود 14 و16 و18) مما يدل على الثَّبات الجيد. وكانت جودة حياة النساء أسوأ من الرجال (0.001P). وكانت أقل بكثير حينما زاد عدد المشكلات الصحية (0.001P) والأدوية (0.001P)، وانخفضت درجة مقياس أنشطة الحياة اليومية (0.05P).يُعدّ المسح الصحي القصير المُكوَّن من 36 بنداً (36–SF) أداة صحيحة وموثوقة لقياس جودة حياة المسنين اللبنانيين، ويمكن استخدامه لرصد جودة حياة هذه الفئة السكانية.Validation du SF-36, questionnaire générique de la qualité de vie liée à la santé chez les personnes âgées au Liban.Le SF-36 est un instrument de référence pour les enquêtes de qualité de vie menées en recherche clinique et en santé publique mais aucun questionnaire n’a été validé chez les personnes âgées au Liban.Évaluer les propriétés psychométriques du SF-36 dans un groupe de Libanais âgés de 60 ans et plus.Il s'agit d'une étude observationnelle transversale. Un échantillon de personnes âgées de 60 ans et plus a été sélectionné dans un dispensaire et dans les cliniques d’un hôpital privé et d’un hôpital gouvernemental au Liban. L’entretien personnel avait inclus des questions sur les caractéristiques sociodémographiques, la satisfaction de la santé, le score d’activité et le SF-36. Des questions ont été posées sur la présence de problèmes de santé, le nombre de médicaments. L’examen clinique comportait l’examen du poids, de la taille, ainsi que la présence d’oedème au niveau des membres inférieurs.Deux cent cinquante Libanais âgés de 60 ans et plus ont été inclus. Le coefficient de corrélation intraclasse variait entre 0,675 (item Q2) et 1,000 (items Q14, Q16, Q18). Le coefficient alpha de Cronbach était supérieur à 0,798. Le SF-36 était apte à discriminer les participants selon les caractéristiques sociodémographiques et la santé générale.Les propriétés psychométriques du SF-36 étaient satisfaisantes sur le groupe de Libanais âgés de 60 ans et plus. Le SF-36 pourra être utilisé dans les études nationales de santé des personnes âgées.

The percentage of Lebanese older people has increased considerably. Given that Lebanese seniors are marginalized in the health policy-making process, we suggest a high social inequality in oral health that has not been studied so far. The purpose of our study was to describe and compare oral health status in a group of Lebanese older people according to their socioeconomic status (SES) MATERIALS AND METHODS: Participants were recruited from three different primary health care clinics in Beirut, Lebanon. Data were collected from an administered questionnaire that included sociodemographic variables, perception of oral health, and regular dental visits. Oral examination included the number of missing and decayed teeth, the prosthetic status, and the number of functional dental units (FUs). The SES of the participants was determined by educational level, previous or actual work, and neighborhood level.264 participants aged 71.4 ± 6.27 years (64.7% female) were included in the study. Regular dental visit, dental status, FU, and oral health perception were significantly related to the participants' place of residence, educational level, and work. Moreover, the mean number of missing teeth (p = 0.048) and decayed teeth (p = 0.018) was significantly elevated in the low SES.There is a clear socioeconomic inequality in oral health among the Lebanese older people. Further researches should explore the potential contribution of psychosocial and behavioral factors in explaining these disparities.

Lebanon is in demographic transition as more people reach increasingly older age; 10% of the population in Lebanon is elderly. The incidence of chronic diseases and oral diseases increases significantly with age. However, 55% of the elderly have no health insurance and 82% have no dental insurance. Both noncommunicable diseases (NCDs) and oral diseases are a major health burden in the country and share the same risk factors. The WHO strategy for prevention and control of noncommunicable diseases should therefore be a new approach for the prevention and control of dental diseases among Lebanese elderly. This paper aims to increase the awareness of the medical community in Lebanon about the interrelationship between general and oral health in the elderly and concludes with the need for the Ministry of Health to develop policies and national action plans against NCDs to reduce not only mortality from NCDs but also morbidity from oral diseases.

Bisphosphonate-induced osteonecrosis of the jaw (ONJ) is a potentially destructive complication, particularly encountered in oncology. It is supposed that awareness and good knowledge of this disease by physicians are important factors of its early detection and management. This study aims to evaluate the level of knowledge among a sample of Lebanese physicians with regard to this complication. An observational cross-sectional study was conducted at Hotel-Dieu de France hospital between March and June 2013. Data were collected through a self-administered questionnaire distributed to 190 eligible physicians in the departments involved in prescribing bisphosphonates and managing the ONJ. A total of 136 valid responses were obtained (response rate 71.6 %). Eighty-six (63.2 %) physicians were treating patients with bisphosphonates: the most prescribed form being the weekly oral bisphosphonates for osteoporosis followed by zoledronate several times yearly for bone malignancies. Fifty-one (37.5 %) participants were unaware of bisphosphonate-related ONJ. Furthermore, the level of knowledge was relatively poor: the mean score of all participants was 12.42 ± 10.08, while 77 (56.6 %) had a global score more than 16 over 30. There were statistically significant associations between the level of knowledge and physicians’ specialty (p value

This observational cross-sectional study aimed to examine the knowledge and practices of pregnant women in North Lebanon regarding periconceptional folic acid (FA) supplementation. A convenience sample of pregnant women attending gynecology clinics in North Lebanon was recruited between May and September 2013. Data were collected from a face-to-face interview performed by a trained local dietician as well as from review of obstetric charts. A total of 465 women were included in the study. Only 37 (7.9%) were aware of the role of FA in preventing birth defects, while 129 (27.7%) were able to identify one food item rich in FA or folate. Only 125 (26.9%) were taking FA supplementation before pregnancy. While 440 (94.6%) participants were taking FA supplements during pregnancy, 158 (34%) were receiving an inadequate dose. Adequate preconceptional supplementation of FA was significantly associated with the women's level of education (p =.008), planned pregnancy (p

Dans cet article, on abordera les methodes pertinentes recommandees actuellement pour estimer l’âge dentaire des personnes decedees inconnues et des personnes vivantes. Chez les enfants, les techniques histologiques ainsi que les methodes d’eruption et de calcification dentaire sont appropriees pour evaluer l’âge dentaire en post-mortem. Apres 15 ans, il devient difficile d’estimer l’âge, puisque les phenomenes lies a la formation et a l’eruption dentaire sont termines. Le taux de racemisation et la methode de Lamendin sont les plus adaptees. Finalement, chez les jeunes vivants ou la determination de l’âge presente des interets medico-legaux, la mineralisation de la dent de sagesse constitue un critere pour evaluer l’âge dentaire. L’ajustement des methodes globales d’estimation de l’âge dentaire et leur application sur la population Libanaise permettra de determiner avec plus de certitude l’âge dentaire. The study of the dentition is a common manner for age determination. In this article, we will discuss the pertinent methods to estimate the dental age of unknown dead or young alive people. In children, histological techniques as well as tooth eruption or calcification are appropriate to assess dental age in postmortem . After 15 years, it becomes difficult to estimate the age, since the phenomena related to the tooth eruption or calcification is completed. Therefore, the rate of racemization and Lamendin method are pertinent to determine the age adults in postmortem . Finally, in young alive people where age determination has legal interest, the mineralization of the wisdom tooth is a fundamental criterion for evaluating dental age. The determination of age depends on physiologic, environmental, genetic and pathologic factor. Thus, the age estimation in Lebanese population might be appraised using the methods universally adopted after adjustment, to obtain an accurate evaluation.

Physicians’ knowledge and attitude regarding bisphosphonates-related adverse events: An observational study

summary Background and aim: Studies concerning the more appropriate criteria for evaluating oral health in relation to nutrition in the elderly vary greatly. There is a need to identify the most relevant criteria for classifying dental indicators of mastication in nutritional studies, so these indicators may be considered for epidemiological and clinical purposes. The aim of this study was to explore the associations between nutritional deficit and measures of oral health in a group of elderly. Methods: A convenience sample of independent elderly aged 65 years or more attending two primary care clinics in Beirut, Lebanon was selected. Data were collected from a questionnaire including the MiniNutritional Assessment (MNA), Geriatric Oral Health Assessment Index (GOHAI) and questions about perception of xerostomia and chewing problems. The oral examinations recorded decayed, missing and filled teeth (DMFT), the prosthetic status and the number of functional units (FU). Results: The sample was composed of 121 women (mean age: 71.59 � 5.97 years) and 80 men (mean age: 72.74 � 6.98 years). They were allocated to two groups: 85 participants suffering from malnutrition (MNA score < 17, n ¼ 17) or at risk of malnutrition (17 < MNA score < 24, n ¼ 68) and 116 participants with a normal nutritional status (MNA score � 24). Parameters that explain MNA variations were perception of xerostomia (OR ¼ 3.49, 95% CI [1.66e7.34]), number of FU (OR ¼ 2.79, 95% CI [1.49; 5.22]), and GOHAI score (OR ¼ 2.905, 95% CI [1.40; 6.00]). Conclusion: Further studies exploring factors affecting nutrition in the elderly should take into consideration perception of xerostomia, number of FUs and GOHAI score. 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.

Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief.

Background The respective abilities of the GOHAI and OHIP-14 to discriminate between aged patients with different levels of oral diseases have rarely been studied in developing countries. The aim of this study was to compare the discriminative abilities of the OHIP-14 and the GOHAI in an elderly Lebanese population, and particularly to identify persons with different masticatory function. Methods A sample of elderly, aged 65 years or more, living independently was recruited in two primary care offices in Beirut, Lebanon. Data were collected by means of personal interview and clinical examination. The Arabic OHIP-14 and GOHAI questionnaires were used after cultural adaptation for use in Lebanon. The internal consistency, reproducibility and concurrent validity were verified. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile respectively and logistic regressions were conducted using socio-demographic, clinical and subjective explanatory variables. Results Two hundred and six participants were included; mean age was 72 years and 60% were women. Good psychometric properties were observed for both questionnaires for internal consistency (Cronbach’s alpha>0.88), reproducibility (ICC>0.86) and concurrent validity. Strong correlations were found between GOHAI and OHIP-14 scores but a high prevalence of subjects with no impact was observed using the OHIP-14. Both questionnaires were able to discriminate between participants according to age, perception of temporomandibular joint (TMJ) pain or functional status as represented by the number of dental Functional Units (FU). GOHAI was more discriminant since it identified participants with high dental care needs: high numbers of decayed teeth, low numbers of teeth and socially deprived status. Conclusions Lebanese elderly with high dental care needs and impaired oral health were identified more easily with the GOHAI. These results may guide the choice of dental indicators to use in a national geriatric survey.

e20534 Background: The role of Physical Performance Test (PPT) as a screening tool for patients in geriatric oncology requiring a Comprehensive Geriatric Assessment (CGA) has not been studied so far. We undergo this study to assess PPT as a screening tool in comparison with Karnofsky Performance Status (KPS) and CGA. Methods: One hundred patients, aged ≥ 70 and diagnosed with cancer participated in our study. Inclusion criteria were knowledge of Arabic, French or English and absence of significant cognitive impairment. Exclusion criteria were: KPS