[Intoxications with trace metal elements: A new concept of the metal profile]. / Intoxications aux éléments traces métalliques : nouveau concept du profil métallique.

Present in quantities ranging from hundreds of milligrams to several grams in various environmental compartments, trace metal elements (TMEs), formerly known as "heavy metals," have been the subject of much discussion in recent years due to their major toxicological impact on human health. They are divided into essential elements such as iron, zinc, copper, selenium, manganese, and toxic elements such as mercury, cadmium, lead, lithium, and arsenic. Essential trace elements play a vital role in the body, and their deficiency can alter important physiological functions, while toxic elements have no physiological role and can lead to serious illnesses. However, essential elements can also cause intoxication depending on their concentrations and chemical forms. The industrialization of the modern world exposes the global population to high concentrations of trace elements that can be toxic in the short or long term. These TMEs enter the human body through various pathways (inhalation, ingestion, or dermal contact). The clinical manifestations of TME intoxications are highly varied and nonspecific, making their diagnosis and management difficult. Inductively coupled plasma mass spectrometry (ICP-MS) allows the detection of TME intoxications. Indeed, it enables the simultaneous quantification of around thirty trace metal elements in biological media. Thus, it has led to the establishment of a new approach: the metal profile, which has many applications in clinical biology and clinical, forensic, occupational, or environmental toxicology.

[Toxicology of synthetic cannabinoids]. / Toxicologie des cannabinoïdes de synthèse.

Synthetic cannabinoids (CS), or synthetic endocannabinoid receptor agonists, were initially synthesized for basic research into exocannabinoid signaling pathways, as well as in clinical research for their analgesic properties. The use of CS for recreational purposes is a recent phenomenon, but one that has grown very quickly in recent years, since these molecules now represent the main category of new synthetic products (NPS). This literature review aims to bring together current data regarding the use and effects caused by CS in humans. The relationship between the structure and activity of these CSs, the pharmacology and adverse effects of these CSs and finally the different methods of analyzing CSs. A better understanding of this phenomenon is essential to raise awareness among stakeholders in the health field.

Impact of anti-cancer drugs shortages in oncology and hematology departments in a Moroccan hospital.

INTRODUCTION: Drug shortages have been a growing global problem in recent years. Some of them are of vital necessity and importance for the patient, such as those used to treat pathologies in clinical hematology and oncology departments. The objectives of this study are to determine the impact of anti-cancer drugs shortages on both: treatment and patient in the hematology and oncology departments, to describe the actions that have been put in place to manage the shortages and to survey patients about their perspectives and experiences. MATERIALS AND METHODS: It was a prospective, observational study, it took place in the oncology and hematology departments. It was carried out with the help of an operating sheet, which contained two parts: patient and treatment data. This sheet was filled out after the interview with the patient and on the basis of the medical file. RESULTS: Of the 101 patients interviewed, 67.3% were impacted by the shortage of drugs. The treated pathology that was most impacted by the rupture was Non-Hodgkin lymphoma (55.8%), vincristine was the drug most responsible for the shortages (34%). Most patients (51.4%) went to a non-local pharmacy to buy the medicine that was in short supply in the hospital. Delayed care was the main impact of the drug shortage (42.6%). As a result of these shortages, the majority of patients (45.6%) were frustrated and anxious about the situation. CONCLUSION: Drug shortages have a profound impact on patient safety, clinical outcomes, quality of treatment, hospital management and other important factors. In-depth collaboration between different health actors and timely communication strategies are essential elements of an effective drug shortage management plan.

Diagnostic Utility of Human Leukocyte Antigen B*15:02 Screening in Severe Carbamazepine Hypersensitivity Syndrome.

BACKGROUND: Despite many studies suggesting an association between human leukocyte antigen (HLA)-B*15:02 and carbamazepine (CBZ)-induced severe cutaneous adverse drug reactions essentially toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), the evidence of association in different populations and the degree of association remain uncertain. MATERIALS AND METHODS: The primary analysis was based on population control studies. Data were pooled by means of a random-effects model, and sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), diagnostic odds ratios (DOR), and areas under the summary receiver operating characteristic curve (AUC) were calculated. RESULTS: In 23 population control studies, HLA-B*15:02 was measured in 373 patients with CBZ-induced TEN/SJS and 3452 patients without CBZ-induced TEN/SJS. The pooled sensitivity, specificity, LR+, LR-, DOR, and AUC were 0.67 (95% confidence interval [CI] = 0.63-0.72), 0.98 (95% CI = 0.98-0.99), 19.73 (95% CI = 10.54-36.92), 0.34 (95% CI = 0.23-0.49), 71.38 (95% CI = 34.89-146.05), and 0.96 (95% CI = 0.92-0.98), respectively. Subgroup analyses for Han Chinese, Thai, and Malaysian populations yielded similar findings. Specifically, racial/ethnic subgroup analyses revealed similar findings with respect to DOR for Han Chinese (99.28; 95% CI = 22.20-443.88), Thai (61.01; 95% CI = 23.05-161.44), and Malaysian (30; 95% CI = 7.08-126.68) populations, which are similar to the pooled DOR for the relationship between the HLA-B*15:02 allele and CBZ-induced TEN/SJS across all populations (71.38; 95% CI = 34.89-146.05). CONCLUSIONS: The present study reveals that CBZ is the leading cause of TEN/SJS in many countries. Screening of HLA-B*15:02 may help patients to prevent the occurrence of CBZ-induced TEN/SJS, especially in populations with a higher (≥5%) risk allele frequency.

Detection and analysis of drug-drug interactions among hospitalized cardiac patients in the Mohammed V Military Teaching Hospital in Morocco.

INTRODUCTION: Drug-drug interactions (DDIs) are defined as two or more drugs interacting in such a manner that the effectiveness or toxicity of one or more drugs is altered. Patients with cardiovascular disorders are at higher risk for DDIs because of the types and number of drugs they receive. The aim of the present study was to assess the prevalence of DDIs in patients admitted to the cardiology department of a hospital in Morocco. METHODS: A prospective observational study from June 2016 to September 2016 was carried out in the cardiology department of a hospital in Morocco. Those patients who were taking at least two drugs and had a hospital stay of at least 48 hours were included in the study. The medications of the patients were analysed for possible interactions. All the prescriptions of the study population were screened for drug-drug interactions using a computerized DDI database system (Theriaque®). RESULTS: During the study period, 138 patients were included; 360 interactions were detected among 94 patients, with an average number of drugs taken of 5.2. The prevalence of DDIs was estimated at 68.11%, the most common of which concerned Kardegic/Plavix (12.22%), Kardegic/Heparin (8.33%), and Lasilix/Spironolactone (5.83%). Among the 726 prescribed drugs, (372 [51.24%]) were drugs of the cardiovascular system, followed by blood and hematopoietic organ drugs (288 [39.67%]) according to the Anatomical Therapeutic Chemical Classification codes. These interactions were categorized on the basis of level of severity: interactions with major severity accounted for 11.11% (40) of the total DDIs while those with moderate and minor severity accounted for 37.22% (134) and 51.66% (186), respectively. CONCLUSION: This study reports the prevalence of DDIs in patients admitted to the cardiology department of a hospital in Morocco. This study shows that DDIs are frequent among hospitalized cardiac patients and highlights the need to screen prescriptions of cardiovascular patients for possible DDIs, as this helps in their detection and prevention.Pan African Medical Journal - ISSN: 1937- 8688 (www.panafrican-med-journal.com)Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net)Pan African Medical Journal - ISSN: 1937- 8688 (www.panafrican-med-journal.com)Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net).

Enquête sur les aspects toxicologiques de la phytothérapie utilisée par un herboriste à Fès, Maroc

Introduction:Dans le but d'étudier l'aspect toxicologique des plantes médicinales utilisées en médecine traditionnelle, une étude ethnobotanique a été réalisée à la ville de Fès au centre du Maroc. Méthodes: Ont été inclus dans l'étude tous les patients ayant bénéficié d'une prescription par l'herboriste de plantes à visée thérapeutique. La discussion de nos résultats s'est faite sur la base d'une revue de la littérature avec identification des principales plantes toxiques utilisées en phytothérapie au Maroc. L'approche bibliographique a permis de compléter les informations. Résultats: L'âge moyen des patients traités par des plantes (38 femmes, 32 hommes) était de 35 ± 18 ans. L'enquête ethnobotanique à révélé que la majorité des plantes médicinales étaient utilisées contre les affections urinaires (21%), suivi des maladies de l'appareil digestif (19.6%) et des maladies rhumatologiques (18.2%). Le nombre de plantes prescrits par l'herboriste a été de 53 dont 5 sont potentiellement toxiques. L'identification taxonomique des plantes prescrites a recensé 30 familles dont les plus représentées sont les Lamiaceae (23.33%), les Apiaceae (13,33%) et les Asteraceae (10%). La prescription des plantes considérées comme toxiques a concerné 7,1% des consultants traités par les plantes médicinales. Aucune complication inhérente aux plantes prescrites n'a été déplorée. Conclusion: Malgré les résultats encourageants de notre enquête sur le compte de la phytothérapie, la pratique de la phytothérapie est laissée à la vulgarisation et à l'oubli scientifique, législatif et universitaire

[Development and validation of an assay method of the paraphenylene diamine by gas chromatography-mass spectrometry]. / Développement et validation d'une méthode de dosage de la paraphénylène diamine par chromatographie gazeuse couplée à la spectrométrie de masse.

Paraphenylenediamine is an aromatic amine used as a hair dye; it is responsible for poisoning characterized by respiratory distress involving life-threatening. The objective of this work is the development and validation of an assay of para-phenylenediamine in the whole blood. The method is based on the determination of paraphenylene diamine in whole blood by gas chromatography-mass spectrometry after liquid-liquid extraction and derivatization. The validation protocol has included the study of the recovery factor of extraction, the measurement range, accurency, repetability and intermediate precision. The calibration curve was linear between 98 and 1350 µg/L (r = 0.999), the limit of detection and quantification were 37 µg/L and 63 µg/L respectively. The accuracy were 94.7%. Coefficients of variation were (2.3/6.8/9.7%) for repeatability and (4.4/8.7/9.8%) for intermediate precision. The method is suitable for quantification of PPD in acute poisoning situations. A method for the determination of the paraphenylene diamine in the whole blood by gas chromatography coupled to mass spectrometry was developed. The validation of the method showed good linearity, good accuracy and low limit of quantification.

Determination of fluoride in tap water in Morocco using a direct electrochemical method.

This study aimed to analyze the fluoride concentration in tap drinking water in different cities of Morocco using an electrochemical ion-selective method. Three samples were collected from each thirteen selected cities in the period between March and May 2011. The median value of fluoride was 0.94 mg/L (0.21-2.97). High fluoride concentrations (>0.8 mg/L) were found in sixteen cities. Very high values were found in phosphate regions such as Khouribga which is known to be an endemic dental fluorosis area. This study has shown that the concentration of fluoride in drinking water exceeds the limit especially in phosphate regions.