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Bounafaa A.,Sultan Moulay Slimane University | Bounafaa A.,Pasteur Institute of Morocco | Bounafaa A.,Université de Sherbrooke | Berrougui H.,Sultan Moulay Slimane University | And 6 more authors.
Clinical Biochemistry | Year: 2014

Objective: The functionality of HDL has been suggested as an important factor in the prevention of cardiovascular and coronary artery diseases. The objective of the present study was to investigate the functionality of HDL and the factors that may affect the anti-atherogenic properties of HDL in ACS patients. Methods and results: One hundred healthy subjects and 205 ACS patients were recruited. HDL functionality was evaluated by measuring their capacity to mediate cholesterol efflux from J774 macrophages. Oxidative stress status was determined by measuring plasma malondialdehyde (MDA), protein carbonyl, and vitamin E levels by HPLC. The PON1 Q192R polymorphism status and PON1 paraoxonase and arylesterase activities of the healthy subjects and ACS patients were also determined. The HDL of ACS patients displayed a limited capacity to mediate cholesterol efflux, especially via the ABCA1-pathway. MDA (7.06 ± 0.29. μM) and protein carbonyl (9.29 ± 0.26. μM) levels were significantly higher in ACS patients than in healthy subjects (2.29 ± 0.21. μM and 3.07 ± 0.17. μM, respectively, p. <. 0.0001), while α- and γ-tocopherol (vitamin E) levels in ACS patients were 8-fold (p. <. 0.001) and 2-fold (p. <. 0.05) lower than in healthy subjects. Paraoxonase, arylesterase and HDL-corrected PON1 activities (PON1 activity/HDL ratio) were significantly lower in ACS patients. Logistic regression analyses showed that high PON1 paraoxonase and arylesterase activities had a significant protective effect (OR = 0.413, CI 0.289-0.590, p. <. 0.001; OR = 0.232 CI 0.107-0.499, p. <. 0.001, respectively) even when adjusted for HDL level, age, BMI, and PON1 polymorphism. Conclusion: The results of the present study showed that the functionality of HDL is impaired in ACS patients and that the impairment may be due to oxidative stress and an alteration of PON1 activities. © 2014 The Canadian Society of Clinical Chemists.


Ali A.Y.M.,National Rehabilitation Center | Safwat T.,Ain Shams University | Onyemelukwe G.,Ahmadu Bello University | Otaibi M.A.A.,Ministry of Health | And 5 more authors.
Respiration | Year: 2012

Despite the abundance of scientific evidence confirming the health consequences of smoking and other forms of tobacco use, the tobacco epidemic remains an important public health problem and by 2030 it is predicted that more than 80% of tobacco deaths will be in developing countries. In Africa and the Middle East, many local factors contribute to the initiation and maintenance of tobacco use. Although efforts to reduce the mortality and morbidity associated with smoking and tobacco dependence are underway, there is a need for guidance on how to utilize appropriate tobacco control policies and psychology-and pharmacology-based therapies to counter tobacco dependence as recommended by the Framework Convention on Tobacco Control (FCTC). A group of tobacco cessation experts from public health services and/or academic institutions in Africa and the Middle East participated in a series of four meetings held in Cairo, Cape Town, and Dubai between May 2008 and February 2011 to develop a draft guideline tailored to their region. This article provides the background to the development of this draft smoking cessation guideline and discusses how the recommendations can be implemented and progress monitored to promote both primary prevention and cessation of tobacco use within our countries. The draft guideline for Africa and the Middle East provides an important resource in combating the devastating effects of tobacco use in these regions which can be further localized through engagement with local stakeholders in the countries of the region. © 2012 S. Karger AG, Basel.


Berraho M.,Clinical Research and Community Health | Berraho M.,French Institute of Health and Medical Research | Bendahhou K.,Clinical Research and Community Health | Obtel M.,Clinical Research and Community Health | And 4 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2012

Background: In Morocco, the epidemiological profile of cervical cancer is not well established. The focus of the present study was both epidemiological and pathological characteristics. Methods: For all cases of cervical cancer treated between 2003 and 2007 in the National Institute of Oncology and the Oncology Department of the IbnRochd hospital (Casablanca), 900 cases were randomly selected. Results: The mean age was 52.1±11.8 years. The most (90.5%) represented histological type was squamous cell carcinoma. For more than 57.0% cases the mean distance between patient's origin and center of treatment was greater than 100km. According to the FIGO classification, only 17.2% of patients were identified as being in early stages (0 and I). For 72.2% patients the follow-up did not exceed 2 years. At 1 year of following-up 55.8% of patients were alive and 43.4% were lost to following-up. Conclusion: Our study addressed the issue of the burden of cervical cancer in Morocco. The result provides a basis for decision-makers for the development of strategic measures to implement the fight against cervical cancer in Morocco.


El Khayat S.S.,Ibn Rochd University Hospital Center
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2013

Care in dialysis is often associated with significant morbidity and mortality during the first year. Knowledge of its magnitude and causes could improve the prognosis of these patients. The aim of this study was to evaluate the survival and morbidity during the first year of dialysis for patients who initiated their dialysis between January 1, 2009 and December 31, 2009 and to study their possible correlation with baseline status at the beginning of treatment. A multi-center retrospective study was conducted in 11 dialysis centers. Clinical data at the beginning of dialysis and during the following year were collected. Mortality and morbidity risk factors were assessed by comparing different groups. Statistical analysis was performed with SPSS version 11. This study involved 134 patients, 79 men and 55 women, of whom 132 were on hemodialysis and two patients were on peritoneal dialysis. The mean age at initiation of treatment was 54.37 ± 18.09 years. Initial causes of nephropathy were dominated by diabetes (44.02%) and hypertension (11.19%). Among these patients, 39.55% had never received prior nephrological follow-up and 64.92% had started renal replacement therapy on an emergency basis. The initial clinical state was dominated by the presence of hypertension (50.74%), diabetes (44.02%), coronary insufficiency (13.43%) and heart failure (7.46%). Only 26.86% of the incident patients showed no comorbidity. During the first year of follow-up, 37.31% of the patients experienced at least one episode of comorbidity. Hospitalization was necessary in about half of these cases (17.91% of all patients). The overall mortality rate was 14.17%. One patient received a kidney transplant. The mortality rate in the first year of dialysis was lower in our study than in other series. Regular nephrological follow-up of these patients before they reach end-stage could have a significant influence on survival in dialysis.


Rafiqi K.,Ibn Rochd University Hospital Center | Yousri B.,Ibn Rochd University Hospital Center | Arihi M.,Ibn Rochd University Hospital Center | Bjitro C.,Ibn Rochd University Hospital Center | And 2 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2013

Introduction: Unusual locations of osteoarticular tuberculosis (OA-TB) raise diagnostic issues due to their untypical and non-suggestive clinical and radiological presentation. Objectives: The present retrospective study analyzed the various clinical, radiological and therapeutic aspects. Patients and methods: A retrospective series included 12 children (mean age, 7. years 4. months; sex-ratio, 0.7), treated in our department between 1980 and 2010. Knee, hip and spine locations were excluded. Results: Mean time to diagnosis was 32. months. Active TB infection was identified in 42% of cases. Pain was the presenting symptom in 83% of cases, with a preponderance of osteitis. Bone loss was the main radiological sign. Phemister's triad was found in two cases of combined articular and bone infection. Diagnosis was confirmed on histology in 92% of cases. All patients were managed according to the Moroccan national TB protocol. Surgery was indicated in five cases, comprising abscess drainage with or without bone surgery (notably for joint dislocation). Four patients showed orthopedic sequelae, including two with associated spinal locations. Discussion: Rare osteoarticular tuberculosis locations often cause diagnostic problems. Any chronic clinical presentation or suspected atypical bone lesion should suggest a diagnosis of osteoarticular tuberculosis. Level of evidence: Level IV. Retrospective study. © 2013 .


Naamane H.,Pasteur Institute | El Maataoui O.,Ibn Rochd University Hospital Center | Ailal F.,Ibn Rushd Hospital | Barakat A.,Pasteur Institute | And 5 more authors.
European Journal of Pediatrics | Year: 2010

Major histocompatibility complex class II plays a key role in the immune response, by presenting processed antigens to CD4+ lymphocytes. Major histocompatibility complex class II expression is controlled at the transcriptional level by at least four trans-acting genes: CIITA, RFXANK, RFX5 and RFXAP. Defects in these regulatory genes cause MHC class II immunodeficiency, which is frequent in North Africa. The aim of this study was to describe the immunological and molecular characteristics of ten unrelated Moroccan patients with MHC class II deficiency. Immunological examinations revealed a lack of expression of MHC class II molecules at the surface of peripheral blood mononuclear cells, low CD4+ T lymphocyte counts and variable serum immunoglobulin (IgG, IgM and IgA) levels. In addition, no MHC class II (HLA DR) expression was observed on lymphoblasts. The molecular analysis identified the same homozygous 752delG26 mutation in the RFXANK genes of all patients. This finding confirms the association between the high frequency of the combined immunodeficiency and the defect in MHC class II expression and provides strong evidence for a founder effect of the 752delG26 mutation in the North African population. These findings should facilitate the establishment of molecular diagnosis and improve genetic counselling for affected Moroccan families. © Springer-Verlag 2010.


Bounafaa A.,Hassan iversity | Bounafaa A.,Sultan Moulay Slimane University | Bounafaa A.,Pasteur Institute of Morocco | Bounafaa A.,Université de Sherbrooke | And 9 more authors.
Clinical Biochemistry | Year: 2014

Objective: The functionality of HDL has been suggested as an important factor in the prevention of cardiovascular and coronary artery diseases. The objective of the present study was to investigate the functionality of HDL and the factors that may affect the anti-atherogenic properties of HDL in ACS patients. Methods and results: One hundred healthy subjects and 205 ACS patients were recruited. HDL functionality was evaluated by measuring their capacity to mediate cholesterol efflux from J774 macrophages. Oxidative stress status was determined by measuring plasma malondialdehyde (MDA), protein carbonyl, and vitamin E levels by HPLC. The PON1 Q192R polymorphism status and PON1 paraoxonase and arylesterase activities of the healthy subjects and ACS patients were also determined. The HDL of ACS patients displayed a limited capacity to mediate cholesterol efflux, especially via the ABCA1-pathway. MDA (7.06 ± 0.29 μM) and protein carbonyl (9.29 ±. 0.26 μM) levels were significantly higher in ACS patients than in healthy subjects (2.29. ±. 0.21. μM and 3.07 ± 0.17 μM, respectively, p < 0.0001), while α- and γ-tocopherol (vitamin E) levels in ACS patients were 8-fold (p. <. 0.001) and 2-fold (p. <. 0.05) lower than in healthy subjects. Paraoxonase, arylesterase and HDL-corrected PON1 activities (PON1 activity/HDL ratio) were significantly lower in ACS patients. Logistic regression analyses showed that high PON1 paraoxonase and arylesterase activities had a significant protective effect (OR = 0.413, CI 0.289-0.590, p < 0.001; OR = 0.232 CI 0.107-0.499, p < 0.001, respectively) even when adjusted for HDL level, age, BMI, and PON1 polymorphism. Conclusion: The results of the present study showed that the functionality of HDL is impaired in ACS patients and that the impairment may be due to oxidative stress and an alteration of PON1 activities. © 2014 The Canadian Society of Clinical Chemists.


PubMed | Ibn Rochd University Hospital Center, Hassan First University, Université de Sherbrooke and Pasteur Institute of Morocco
Type: Journal Article | Journal: PloS one | Year: 2015

The purpose of the present study was to investigate the distribution of PON1 Q192R and L55M polymorphisms and activities in a North African population and to determine their association with cardiovascular complications. The prevalence of the QQ, QR, RR, LL, LM, and MM genotypes in the study population was 55.4%, 34.09%, 9.83%, 41.97%, 48.20%, and 9.83% respectively. The Q, R, L, and M alleles had a gene frequency of 0.755, 0.245, 0.67, and 0.33, respectively. The PON1 192 RR genotype was significantly more prevalent among ACS patients than among healthy subjects. There was a 4.33-fold increase in the risk of ACS in subjects presenting the PON1 192 RR genotype compared to those with the QQ genotype (OR=4.33; 95% CI=1.27-17.7). There was a significantly different distribution of PON1 L55M in the ACS patient groups (UA, STEMI, NSTEMI). Moreover, individuals presenting the PON1 55MM genotype present a higher risk for ACS than those with LL genotype (OR=3.69; 95% CI=1.61-11.80). Paraoxonase activities were significantly lower in coronary patients than in healthy subjects. The decrease in PON1 activity was inversely correlated with the number of concomitant risk factors for CVD (r=0.57, p<0.0001). The results of the present study suggested that the PON1 R and M alleles may play a role in the pathogenesis of cardiac ischemia in our North African population and that a decrease in PON1 activity may be a valuable marker for monitoring the development of the atherosclerosis process and the associated cardiovascular complications.


El Hyaoui H.,Ibn Rochd University Hospital Center | Messoudi A.,Ibn Rochd University Hospital Center | Rafai M.,Ibn Rochd University Hospital Center | Garch A.,Ibn Rochd University Hospital Center
Joint Bone Spine | Year: 2016

Glomus tumor is an uncommon benign neuromyoarterial tumor. The extradigital location at the knee is unusual. Ignorance of this disease characterized by atypical clinical signs and the absence of specific imaging are responsible for a significant diagnostic delay in these forms localized in the knee. Complete resection of the tumor results in an immediate resolution of the pain. We report three rare locations of glomus tumor in the knee with an exceptional location in the quadriceps tendon and discuss epidemiological, diagnostic and therapeutic aspects of these tumors. © 2015 Société française de rhumatologie.


PubMed | Ibn Rochd University Hospital Center
Type: Journal Article | Journal: Joint, bone, spine : revue du rhumatisme | Year: 2016

Glomus tumor is an uncommon benign neuromyoarterial tumor. The extradigital location at the knee is unusual. Ignorance of this disease characterized by atypical clinical signs and the absence of specific imaging are responsible for a significant diagnostic delay in these forms localized in the knee. Complete resection of the tumor results in an immediate resolution of the pain. We report three rare locations of glomus tumor in the knee with an exceptional location in the quadriceps tendon and discuss epidemiological, diagnostic and therapeutic aspects of these tumors.

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