Training to Housestaff and Fellows
Students, residents and fellows can rotate through the program as part of the endocrine elective rotation, or as part of more specialized comprehensive rotations. Individuals rotating through the program as fellows or housestaff get exposed to the following:

• Clinical Training:
  1. Learn about the pathophysiology of primary osteoporosis: postmenopausal and senile.
  2. Understand the etiology of steroid –induced bone loss, transplantation induced bone loss and other secondary causes of osteoporosis.
  3. Review the diagnostic criteria for osteoporosis based on bone mineral density (BMD) measurement as outlined by the WHO working group and understand its application to the local population.
  4. Understand the technology of BMD testing and its use in the prediction of fracture risk.
  5. Review the indications for BMD testing as outlined by the National Osteoporosis Foundation in their earlier report in 1989 and in their cost-effectiveness analyses issued in 1999.
  6. Understand biochemical markers and their role in the clinical management of the osteoporotic patient.
  7. Review the work-up and clinical evaluation of patients suffering from osteoporosis.
  8. Review the evidence-based treatment modalities for the prevention and treatment of osteoporosis including  hormone replacement therapy, calcitonin, bisphosphonate and the SERMs such as Raloxifene.


• Research Training:
  The implementation of clinical research protocols related to disturbances in mineral metabolism, involving all aspects of clinical research. Specifically this will entail:
  
  
  1. Write up of protocols and submission to the Institutional Review Board.
  2. Data management under the supervision of the Program Director and with the help of one of the Program’s research assistants. All assistants    have received training in implementing basic statistical tests and have all passed proficiency tests for conducting clinical research. They are certified by the National Institutes of Health and the Johns Hopkins Medical Institutes.
  3. Participate in presentations at scientific meetings.
  4. Write up results in a manuscript format.

1. 1999. Sevag Demerjian. Med IV student  was involved in initiating  an epilepsy protocol. One publication.  Farhat G, Yamout B, Mikati MA, Demirjian S, Sawaya R, El-Hajj Fuleihan G. Effect of antiepileptic drugs on bone density in ambulatory patients. Neurology 2002; 58:1348-1353.



2. 1999. El-Ali Hussam. Endocrine fellow. Was involved in a literature search and two case reports on two relatively rare topics. El-Ali Hussam, El-Hajj Fuleihan G. Nutritional Osteomalacia:  Substantial Clinical Improvement and Gain in Bone density Post-Therapy. J Clin Densit 2000;3:97-101. El-Ali H, Abu Yabis A, Issa E, Salem Z, Tawil A, Khoury N, El-Hajj Fuleihan G. Hypercalcemia in Langerhan cell granulomatosis with elevated calcitriol levels. Bone 2002; 30:331-334.



3. 1999. Ballout H. Initiated breast cancer protocol, was involved in write up and original recruitment.



4. 2001. Hashem Younis. Fourth year resident in Internal Medicine, was involved in one project evaluating the efficacy of pamidronate in patient with low bone density.  Younis H, Farhat G,  El-Hajj Fuleihan G. Efficacy and tolerability of cyclical intravenous pamidronate in patients with low bone mass. J Clin Dens 2002;5(2):1-7.



5. 2001. Zayour Dani. Second year endo fellow. Worked on a protocol in collaboration with the nephrology division. One publication, Zayour D, Daouk M, Salamoun  M, Medawar W, El-Hajj Fuleihan G. Predictors of bone mineral density in patients on hemodialysis.Transplant Proc. 2004 Jun;36(5):1297-301.



6. 2001. Eid Fares Jocelyn. Second year endocrine fellow. Was involved in a project evaluating the effect of hypovitaminosis D on bone remodeling markers. Eid-Fares J, Choucair M, Nabulsi M, Salamoun M, Hajj-Shahine M, El-Hajj Fuleihan G. Effect of gender, puberty, and vitamin  D status on biochemical markers of bone remodeling. Bone 2003; 33:242-247.



7. 2003. Hreybeh H. Third year resident spent one year rotating through the program, was involved in a hip fracture protocol. One publication.  Herybeh H, Salamoun M, Badra M, Afeiche N, Baddoura O, Boulos S, Haidar R, Lakkis R, Musharafieh R, Nsouli A, Taha A, Tayim A, El-Hajj Fuleihan G. Hip fractures in Lebanese patients: determinants and prognosis. J Clin Densitometry 2004 in press.



8. 2001-2003. Badra M. Orthopedic Chief Resident. Worked on a prospective hip fracture protocol over two years. Manuscript in preparation. El-Hajj Fuleihan G, Badra M, Tayim A, et al .  Bone mineral density in hip fracture patients in Lebanon.



9. 2001-2003. Khalifeh H. Pediatrics resident. Was involved in the prospective randomized trial testing the impact of vitamin D supplementation on musculoskeletal parameters. Arabi A, Tamim H, Nabulsi M, Maalouf J, Khalife H, Choucair M, Veith R, El-Hajj Fuleihan G.Sex differences in the effect of body-composition variables on bone mass in healthy children and adolescents, Am J Clin Nutr 2004;80:1428-1435.   Arabi A, Nabulsi, Maalouf J, Choucair M, Khalifeh H, Vieth R, El-Hajj Fuleihan G. Bone mineral density by age, gender, pubertal stages and socioeconomic status in healthy children and adolescents. Bone 2004; 35:1169-79.



10. 2002-2004. Arabi Asma. Endocrine fellow spent one year rotating through the Program, subsequently has joined the program as junior faculty July 2003. Was involved in several protocols. Has two publications . Arabi A, Tamim H, Nabulsi M, Maalouf J, Khalife H, Choucair M, Veith R, El-Hajj Fuleihan G.Sex differences in the effect of body-composition variables on bone mass in healthy children and adolescents, Am J Clin Nutr 2004;80:1428-1435.  Arabi A, Nabulsi, Maalouf J, Choucair M, Khalife H, Vieth R, El-Hajj Fuleihan G. Bone mineral density by age, gender, pubertal stages and socioeconomic status in healthy children and adolescents. Bone 2004; in press.



11. 2004-2005. Special Research Assistant. Cynthia Farah. Hypovitaminosis D in patients tested at AUBMC.



12. 2004-2006. Endocrine fellow, American University of Beirut: Joumana Shaiban. Bone metabolism and prevention of cancer-treatment induced bone loss in children with malignancies.



13. 2004-2006.Endocrine fellow, American University of Beirut: Walid Khairallah. Clinical risk factors and inflammatory markers as predictors of hip fractures and its outcomes.