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. These guidelines, besides being helpful in direct clinical practice, play a major role in establishing stewardship programs in hospitals in an effort to contain antimicrobial resistance on the national level. These guidelines are intended for primary care practitioners and emergency medicine physicians. They constitute an appropriate starting point for specialists' consultation being based on the available local epidemiological and resistance data. 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.

[Ultrasonography and fluoroscopy-guided insertion of subcutaneous intravenous infusion port. Prospective study over 120 patients]. / Insertion des chambres à catheter implantables sous guidage echographique et scopique. Etude prospective portant sur 120 cas.

GOAL: We compare our results of a prospective study, on 120 totally implantable venous access ports (TIVAP) inserted at angiographic unit, under ultrasound and fluoroscopic guidance, with those of the literature. MATERIALS AND METHODS: The 120 AP data, placed under ultrasound and fluoroscopic control for chemotherapy treatment, were prospectively analyzed. The detailed technique of insertion is noted. Data related to the technical success rate and to complications were classified into major, minor, early or late, according to the recommendations of the interventional radiology society. RESULTS: The technical success rate is 100% with no major complication noted. Eight (6.6%) TIVAP were withdrawn because of infection in 4 cases (33%), and end of treatment in the other four. The withdrawals took place in chemotherapy clinics. Three (25%) are classified as early infections, within two months of the procedure, two of which were associated to wound non-healing. Four patients (33%) presented early minor complications (hematoma surrounding TIVAP insertion site). CONCLUSION: Our results correspond to previously published data. The insertion of AP at the angiographic unit under ultrasound and fluoroscopic control has lower risk of complications and a success rate higher than that being inserted following anatomical location. Collaboration with a specialized care nurses team is of paramount importance.