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Background The natural history of colonic diverticulosis is unclear. Methods Patients with incidental diverticulosis identified in a previous prospective cross-sectional screening colonoscopy study were evaluated retrospectively for clinic or hospital visit(s) for diverticular disease (DD= acute diverticulitis or diverticular bleeding) using review of electronic health records and patient phone interview. Results 826 patients were included in the screening colonoscopy study. Three were excluded for prior DD. In all, 224 patients (27.2%; mean age 62.3 ± 8.2) had incidental diverticulosis distributed in the left colon (67.4%), right colon (5.8%), or both (22.8%). Up-to-date information was available on 194 patients. Of those, 144 (74.2%) could be reached for detailed interview and constituted the study population. Over a mean follow-up of 7.0 ± 1.7 years, DD developed in 6 out of 144 patients (4.2%) (4 acute cases of diverticulitis, 1 probable case of diverticular bleeding, and 1 acute case of diverticulitis and diverticular bleeding). Two patients were hospitalized, and none required surgery. The time to event was 5.1 ± 1.6 years and the incidence rate was 5.9 per 1000 patient-years. On multivariate analysis, none of the variables collected at baseline colonoscopy including age, gender, obesity, exercise, fiber intake, alcohol use, constipation, or use of NSAIDs were associated with DD. Conclusion The natural history of incidental diverticulosis on screening colonoscopy was highly favorable in this well-defined prospectively identified cohort. The common scenario of incidental diverticulosis at screening colonoscopy makes this information clinically relevant and valuable to physicians and patients alike.

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Background Interns in the internal medicine program at American University of Beirut Medical Center (AUBMC) come from diverse educational backgrounds based on American, French, and Egyptian systems, similar to other settings in the Middle East. To help this diverse group of trainees integrate into their new role, the institution launched an intern retreat in 2014 and repeated the event 3 times to date. Objective We describe the experience with the AUBMC intern retreat and discuss the format and interns' perceptions of the benefits of the event. Methods The retreat was divided into workshops and team-building sessions. Workshop topics focused on communication, teamwork, time management, survival tips, patient-physician interaction, and resident well-being. Fun activities were meant to strengthen peer-to-peer relationship and included a treasure hunt, Jeopardy game, and basketball. Results Retreats took place in 2014, 2016, and 2017, and involved 72 of 102 interns (71%), as participation was optional. The 2015 retreat had to be canceled due to logistical problems. Of 72 eligible interns, 61 (85%) responded to the evaluation survey. The majority rated the activity as fun or interesting; sessions with the highest ratings included communication, patient-physician interaction, and resident well-being. There was unanimous agreement to make the retreat a yearly tradition. Each year, we collected feedback and made changes to further improve the retreat experience. Conclusions The retreat is now an established activity. In an institution that accepts interns from different backgrounds, the retreat has strengthened peer-to-peer relations, improved communication, and contributed to a collegial and supportive work environment.

Background: Hepatitis B virus (HBV) reactivation can be asymptomatic or manifest as fatal fulminant hepatitis. Most international guidelines recommend screening patients prior to immunosuppressive therapy. Aims: To determine HBV screening rates and modalities in patients receiving chemotherapy at the American University of Beirut Medical Center. Methods: A retrospective cohort review of electronic health records of  adult patients who received chemotherapeutic agents, between June 2015 and June 2016. Patients clinical characteristics were documented. Adequate screening was defined as performing all: HBsAg, HBs Abs, and anti HBc Abs(total). Results: A total of 1547 patients were initially assessed. 45.6% were males with a mean age of 56. 382(30%) had hematologic malignancies, of whom 111 underwent HSCT. Of those included, 303(24%) patients were screened by at least one test for HBV and 42(3.3%) for HBsAg, anti HBc Abs and HBs Abs. Patients who were appropriately screened were significantly younger(p=0.008) and more likely to have hematologic malignancies (n=35, 83.3%, p<0.0001). Among patients with hematologic malignancies, appropriately screened patients (n=35) were younger (p=0.042) and had a history of HSCT(n=19, 54.3%, p=0.001). Conclusion: Rates of screening for HBV prior to chemotherapy at our medical center are low, and not always complete or adequate. There is an urgent need to implement a better screening policy.