The IX t h Makassed Medical Congress - American University of Beirut

NEW ORAL ANTICOAGULANTS
Ismaïl Elalamy MD
“Thrombosis, both venous and arterial, is a major cause of morbidity and mortality worldwide.
Consequently, there is an ongoing search for new antithrombotic drugs, particularly novel
anticoagulants. Recently, this armamentarium undergoes a major change with the introduction
of new specific and oral anticoagulants that are likely to fulfil many of the unmet needs of
current warfarin and heparin therapies. A direct thrombin inhibitor, dabigatran etexilate,
and a direct factor Xa inhibitor, rivaroxaban are actually marketed for an easier and safer
venous thromboembolism prevention following orthopaedic surgery. Large ongoing trials try
to demonstrate that these drugs would also simplify and optimize stroke prevention in atrial
fibrillation, treatment of venous thromboembolism and prevention of ischemic events in acute
coronary syndrome. This presentation reviews the latest developments of new anticoagulants
and focuses on those which have been approved or are in advanced development”.
ADVANCES AND CHALLENGES IN PEDIATRICS ONCOLOGY
Rima Fuad Jubran MD, MPH
Cancer is the leading cause of disease related mortality in children in the United States and
approximately 12, 4000 children are diagnosed in the U.S. every year. During this talk we will
discuss the history of major advances in pediatric oncology therapy and approach to patients.
We will discuss the future challenges for the field as well as overall strategies for developing more
effective therapies for high risk pediatric cancers. Finally we will talk about cancer survivorship
and issues faced by survivors.
BREAST SCREENING WITH MRI FOR HIGH RISK WOMEN IN ADJUNCT TO
MAMMOGRAPHY
Nagi Atallah, MD
The demand for breast MRI is increasing. Image quality is improving. The sensibility is high and
with high resolution. Image specificity is higher, based on enhancement or DWI or spectroscopy.
Screening high risk women represent 70% of the indications in the USA in response to the
recommendations of the ACS.
What is high risk women?
- Women with genetic mutation (BRCA), with strong family history or personal history of
breast or ovarian cancer
Life time risk >20-25% is considered as high risk depending on the risk models (Gail or Tyrer-Cuzick).
Used for risk estimation (NCI, IBIS).
Breast MRI is done in adjunct to mammography because there are some DCIS or ILC that do not
enhance.
In that group of women MRI alone detects twice more cancers than mammography alone. But
there are some radiologists or other specialists that believe we are living the impending decline
of screening mammography.
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