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1.
Tunis Med ; 98(4): 266-282, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32395789

RESUMO

CONTEXT: The Maghreb Central, like all the countries of the world, was strongly mobilized (governments, ministries of health, population, civil society) in the response against COVID-19, immediately after the registration of the first cases on its territory (end of February, beginning of March) and according to pre-established control strategies. OBJECTIVES: Describe the perceptions of health professionals in the Central Maghreb (Tunisia, Algeria and Morocco) as to the Strengths/Opportunities and Weaknesses/Threats of the national response plans against COVID-19, during the first weeks of their execution, and report their proposals for optimizing the performance of control strategies. METHODS: This is a qualitative study of the perceptions of health professionals in the Maghreb Central regarding their experience of the first six weeks of fighting the COVID-19 pandemic. The data was collected using the "Delphi" technique in one turn, based on an electronic form such as "Google Form", developed according to SWOT analysis. The respondents' verbatim was grouped into homogeneous groups of items, the occurrence of which was subsequently measured. RESULTS: A total of 382 health professionals from the Maghreb Central participated in this study, with a median age of 37 years and a median professional tenure of 10 years. The major force of the Maghreb response strategies, the most shared by the respondents, was the performance of the human resources mobilized (doctors, biologists, nurses, etc.) who succeeded in quickly learning from the international epidemiological expertise accumulated in Asia and in Europe. The fight against COVID-19 in the Central Maghreb was confronted with the general and chronic fragility of the national health systems and the low support of the general population for the recommendations of the steering committees of response, threatening the capacity of the Maghreb to confront new epidemics. CONCLUSION: The success of the national response plans against COVID-19 and of possible epidemics or pandemics in the Central Maghreb, is strongly attributed to the commitment of health professionals and to community participation, necessitating the launch of assistant motivation programs. and development of health personnel and mobilization and loyalty of civil society.


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Adulto , Argélia/epidemiologia , Pessoal de Saúde , Humanos , Marrocos/epidemiologia , Programas Nacionais de Saúde , Inquéritos e Questionários , Tunísia/epidemiologia , Adulto Jovem
3.
PLoS Negl Trop Dis ; 14(3): e0008139, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32210438

RESUMO

BACKGROUND: Zoonotic visceral leishmaniasis (VL) is endemic in the Mediterranean basin. However, large-scale comparative analyses of the commercial kits for the serological diagnosis of this neglected disease are lacking. This study compared the performances of four enzyme-linked immunosorbent assays (ELISA) and two immunochromatographic tests (ICT) as screening tests for the serodiagnosis of human VL in the Mediterranean region. METHODOLOGY/PRINCIPAL FINDINGS: Serum samples from 319 patients living in France, Tunisia or Morocco were tested using two ICT (IT LEISH and TruQuick LEISH IgG/IgM Meridian) and four ELISA reagents (NovaLisa Leishmania infantum IgG, Bordier Leishmania infantum, Ridascreen Leishmania IgG, and Vircell Leishmania). The population with proven VL (n = 181) included 65 immunocompromised patients. Significantly higher percentages of false-negative results were obtained with all assays in immunocompromised patients, compared with the immunocompetent population. In the whole population, sensitivity and specificity ranged from 80.7% to 93.9% and from 95.7% to 100%, respectively. The maximum accuracy was observed with the Bordier and Vircell ELISA kits (96.2%), and the lowest accuracy with Ridascreen reagent (88.7%). New thresholds of positivity are proposed for the Bordier, Vircell and NovaLisa ELISA kits to achieve 95% sensitivity with the highest possible specificity. Western blot (WB), used as a confirmation method, showed 100% sensitivity and identified 10.1% of asymptomatic carriers among the control population from the South of France. CONCLUSIONS/SIGNIFICANCE: This is the first study that compared commercially available kits for VL serodiagnosis in the endemic region of the Mediterranean basin. It provides specific information about the tests' performance to help clinicians and biologists to select the right assay for VL screening.


Assuntos
Leishmaniose Visceral/diagnóstico , Kit de Reagentes para Diagnóstico , Testes Sorológicos/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , França , Humanos , Imunoensaio/métodos , Lactente , Masculino , Programas de Rastreamento/métodos , Região do Mediterrâneo , Pessoa de Meia-Idade , Marrocos , Sensibilidade e Especificidade , Tunísia , Adulto Jovem
4.
BMC Med Genet ; 21(1): 47, 2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131761

RESUMO

BACKGROUND: Choreoacanthocytosis (ChAc), is a rare neurodegenerative disease, characterized by movement disorders and acanthocytosis in the peripheral blood smears, and various neurological, neuropsychiatric and neuromuscular signs. It is caused by mutations in VPS13A gene with autosomal recessive pattern of inheritance. CASE PRESENTATION: Here we report two patients belonging to a consanguineous Moroccan family who present with movement disorder pathology. They were suspected to have choreoacanthocytosis according to biological, clinical and radiological finding. Thus, whole-exome sequencing was performed for precise diagnosis and identified a homozygous novel nonsense mutation c.337C > T (p.Gln113*) in exon 5 of VPS13A in the two affected siblings. CONCLUSION: Here, we report a novel nonsense p.Gln113* mutation in VPS13A identified by whole-exome sequencing, which caused ChAc in a Moroccan family. This is the first description of ChAc in Morocco with genetic confirmation, that expands the mutation diversity of VPS13A and provide clinical, neuroimaging and deep brain stimulation findings.


Assuntos
Neuroacantocitose/genética , Polimorfismo de Nucleotídeo Único , Proteínas de Transporte Vesicular/genética , Adulto , Códon sem Sentido , Consanguinidade , Feminino , Humanos , Marrocos , Neuroacantocitose/patologia , Linhagem , Convulsões/complicações , Convulsões/genética , Irmãos , Espasmo/complicações , Espasmo/genética
5.
J Environ Manage ; 261: 109907, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32148249

RESUMO

The Mediterranean aquaculture has been developed mostly in brackish environment in inactive coastal salt production areas. This study aims to utilise Technosols made with aquaculture sediments for Limonium algarvense Erben cultivation. This species that has nutraceutical potential thrives in halophilic environments in the southwest of the Iberian Peninsula and in Morocco. A microcosm assay was set up with plants grown in bottom sediments (C+), commercial substrate (C-), and Technosols with amendments mixture application at 180 g/kg (Tec180) or at 360 g/kg (Tec360). These plants were irrigated with saline (assay 1) and/or with deionised water (assay 2). The bottom pond sediments, coffee wastes and the estuarine water were evaluated for diverse physicochemical parameters. Plant growth was characterised through a combined methodology using morphometric, SEM and physiological analysis. The Technosols were constructed with bottom sediments and a mixture of organic wastes used as amendments. Results revealed that the bottom sediments had low pH 3.2, Corg and extractable P and K contents, and high electroconductivity (EC) and N-NH4 concentration. The estuarine water had a neutral pH, high EC and high Cl-, HCO3-, Na+, Mg2+ and Ca2+ but low N-NO3- content. The Technosols showed a significant increase of pH, Corg, K and P and a decrease in N-NH4 and EC in comparison with sediments. Principal component analysis separated the different experiments in three groups: C-, A1 and A2 assays. The C- was highly correlated with Corg, P, K, N-NO3 parameters and total ascorbate. The A1 assay showed a strong association with Na, Ca and EC parameters, whereas the A2 assay presented a strongly correlation with plant growth. Plants from Technosols had greater development when irrigated with deionised water than under salty irrigation as opposed to plants cultivated in unamend sediments. In conclusion, these results support that highly saline sediments could be valorised through Technosols construction to cultivate plants with saline water, with potential application in the agro-food and pharmaceutical industry.


Assuntos
Tanques , Plantas Tolerantes a Sal , Aquicultura , Sedimentos Geológicos , Marrocos , Águas Salinas
6.
PLoS One ; 15(2): e0228897, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092070

RESUMO

Scedosporium species are opportunistic pathogens causing various infections, including disseminated infections in severely immunocompromised patients. Preventive measures aiming to reduce the risk of exposure to these fungi require a better knowledge on their ecology and on the sources of contamination of the patients. In this context, 99 soil samples from the Rabat-Sale-Kenitra and Fez-Meknes regions in Morocco were analyzed. Samples were inoculated on the highly selective Scedo-Select III culture medium, and seven chemical parameters of the soils were measured. Scedosporium species were detected in 48 of the samples, with the highest density in soils from wastewater treatment plants and landfills, followed by those from roadsides and polluted riverbanks, thus confirming the impact of human activities on their ecology. Scedosporium apiospermum was the most common species, followed by S. boydii and S. aurantiacum. Analysis of the chemical parameters of the soils revealed the presence of Scedosporium species was mainly associated with a moderate electrical conductivity, a pH range of 7.0 to 7.6, a nutrient-rich content and a moderate phosphorus amount. Thereby, these results demonstrated the relatively high occurrence of Scedosporium in Morocco and highlighted the impact of phosphorus content on their ecology.


Assuntos
Scedosporium/genética , Scedosporium/isolamento & purificação , Ecologia , Ecossistema , Humanos , Marrocos , Scedosporium/patogenicidade , Solo , Microbiologia do Solo
7.
BMC Dermatol ; 20(1): 1, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31918687

RESUMO

BACKGROUND: Mycetoma is an uncommon chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). It is the prerogative of young men between the third and fourth decade and is transmitted through any trauma causing an inoculating point. The classic clinical triad associates a painless hard and swelling subcutaneous mass, multiple fistulas, and the pathognomonic discharge of grains. Although endemic in many tropical and subtropical countries, mycetoma can also be found in non-endemic areas as in Morocco, and causes then diagnosis problems leading to long lasting complications. Therefore, we should raise awareness of this neglected disease for an earlier management. Under medical treatment however, mycetoma has a slow healing and surgery is often needed, and relapses are possible. CASE PRESENTATION: Herein we report a case of a 64 years old patient, with a history of eumycetoma occurring ten years ago treated with oral terbinafine coupled with surgery. A complete remission was seen after 2 years. He presented a relapse on the previous scar 6 months ago. There wasn't any bone involvement in the magnetic resonance imaging (MRI). The patient was put under oral terbinafine with a slow but positive outcome. CONCLUSION: Through this case report, we perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.


Assuntos
Doenças do Pé/diagnóstico , Madurella/isolamento & purificação , Micetoma/diagnóstico , Antifúngicos/uso terapêutico , Diagnóstico Diferencial , Pé/diagnóstico por imagem , Pé/microbiologia , Pé/patologia , Doenças do Pé/microbiologia , Doenças do Pé/patologia , Doenças do Pé/terapia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Marrocos , Micetoma/microbiologia , Micetoma/patologia , Micetoma/terapia , Doenças Negligenciadas , Medicina Tropical
8.
J Educ Eval Health Prof ; 17: 4, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000301

RESUMO

PURPOSE: This study aimed to assess the educational environment of resident in Morocco and to compare the residents' perception depending on their specialties. METHODS: We applied the French version of the postgraduate hospital educational environment measure (PHEEM) to measure the educational environment in 6 hospitals in Rabat from January to June 2017. Internal reliability of the questionnaire was assessed using Cronbach's alpha coefficient. Principal component analysis was conducted to assess the construct validity of the three subscales of the PHEEM questionnaire. Variance analysis (ANOVA test) was performed to compare means of PHEEM overall, subscale, and each item score among 6 specialties. RESULTS: The response of 255 resident was included. The 40 items PHEEM questionnaire showed reliability with a Cronbach's alpha of 0.91. Principal component analysis on all 40 items suggested three factors explaining 48% of the variance with better results for the teaching subscale. Moroccan resident perceived their educational environment as more positive than negative. There was a significant difference in the overall and subscales score among the 6 specialties. CONCLUSION: French version of the PHEEM score is a valid and reliable instrument in Morocco. Moroccan resident perceived their educational environment as more positive than negative but room for improvement of many challenges particularly the poor infrastructure, the suboptimal quality of supervision, and teaching and inadequate work regulation remained.


Assuntos
Avaliação Educacional , Hospitais Universitários , Internato e Residência/normas , Aprendizagem , Adulto , Feminino , Cirurgia Geral/educação , Humanos , Idioma , Masculino , Marrocos , Inquéritos e Questionários
9.
Plant Dis ; 104(3): 752-760, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31910116

RESUMO

Leaf rust, caused by Puccinia triticina Erikss., is globally the most widespread rust of wheat. Populations of P. triticina are highly diverse for virulence, with many different races found annually. The genetic diversity of P. triticina populations has been previously assessed using different types of DNA markers. Genotyping technologies that provide a higher density of markers distributed across the genome will be more powerful for analysis of genetic and phylogenetic relationships in P. triticina populations. In this study, we utilized restriction-associated DNA (RAD) genotyping-by-sequencing (GBS) adapted for the Ion Torrent sequencing platform for the study of population diversity in P. triticina. A collection of 102 isolates, collected mainly from tetraploid and hexaploid wheat, was used. The virulence phenotypes of the isolates were determined on 20 lines of Thatcher wheat near isogenic for leaf rust resistance genes. Seven races were found among 57 isolates collected from tetraploid wheat, and 21 races were observed among 40 hexaploid wheat type isolates. This is the first study to report durum wheat virulent races to Lr3bg in Tunisia, Lr14a in Morocco, and Lr3bg and Lr28 in Mexico. Ethiopian isolates with high virulence to durum wheat but avirulent on Thatcher (hexaploid wheat) were tested for virulence on a set of durum (tetraploid) differentials. A subset of 30 isolates representing most of the virulence phenotypes in the 102 isolates were genotyped using RAD-GBS. Phylogenetic analysis of 30 isolates using 2,125 single nucleotide polymorphism (SNP) markers showed nine distinct clusters. There was a general correlation between virulence phenotypes and SNP genotypes. The high bootstrap values between clusters of isolates in the phylogenetic tree indicated that RAD-GBS can be used as a new genotyping tool that is fast, simple, high throughput, cost effective, and provides a sufficient number of markers for the study of genetic diversity in P. triticina.[Formula: see text] Copyright © 2020 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.


Assuntos
Doenças das Plantas , Genótipo , México , Marrocos , Filogenia
10.
BMC Infect Dis ; 20(1): 43, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937256

RESUMO

BACKGROUND: In recent decades, there has been a marked increase in the number of reported cases of pertussis around the world, and pertussis continues to be a frequently occurring disease despite an effective childhood vaccination. This study aims to determine the role of household contacts of children diagnosed with pertussis in Casablanca Morocco. METHODS: From November 2015 to October 2017, children suspected of whooping cough that consulted Ibn Rochd University hospital at Casablanca with their household contacts were enrolled in the study. Nasopharyngeal (NP) samples of the suspected children were analyzed by culture and RT-PCR. For the household contacts, NP and blood samples were collected and analyzed by RT-PCR and specific detection of pertussis toxin antibodies by ELISA, respectively. RESULTS: During the study period, the survey was carried out on 128 infants hospitalized for pertussis suspicion and their families (N = 140). B. pertussis DNA was specifically detected in 73 (57%) samples, coexistence of B. pertussis and B. parapertussis DNA in 3 (2.3%) samples, coexistence of B. pertussis and B. holmesii DNA in 10 (7.81%) and only one (0.78%) sample was IS 481 RT-PCR positive without the possibility of determining the Bordetella species with the diagnostic tools used. Confirmations of Pertussis infection in household contacts by culture, RT- PCR and serology were 10, 46 and 39%, respectively. B. pertussis DNA was confirmed in the infants as well in their mothers in 38% of the cases. Co detection of B. pertussis and B. parapertussis DNA in 2% and co-detection of B. pertussis and B. holmesii DNA in 4%. B. holmesii DNA alone was detected in 5 NP samples of index cases and their mothers. CONCLUSIONS: The results of this study confirm that B. pertussis is still circulating in children and adults, and were likely a source of pertussis contamination in infants still not vaccinated. The use of RT-PCR specific for B. pertussis in the diagnosis of adults is less sensitive and should be associated with serologic tests to improve diagnosis of pertussis and contributes to preventing transmission of the disease in infants.


Assuntos
Bordetella pertussis/genética , Mães , Coqueluche/diagnóstico , Coqueluche/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , DNA Bacteriano/análise , Testes Diagnósticos de Rotina , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Marrocos/epidemiologia , Nasofaringe/microbiologia , Toxina Pertussis/imunologia , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Testes Sorológicos
11.
Int J Biometeorol ; 64(3): 377-387, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31773321

RESUMO

Climatic factors are of a big importance for the determination of phenological stages of several fruit tree species, including apple, during the pre- and post-blooming periods causing their modifications and consequently affecting the fruit quality and productivity. This study aimed to identify the important dormancy phases (chilling and forcing periods) involved in determination of the flowering time in Gala apple trees in order to estimate temperature and chill/heat requirements, useful to assess the effect of climatic factors and phenological modifications on apple productivity and quality. Phenological and climatic data (temperatures, rainfall, irrigation, chilling and heat requirements) were collected, calculated, and measured from orchard in Imouzzer-Kandar, Morocco. Fruit productivity and quality parameters (total yield, fruit weight, size, firmness, and sweetness) were measured. Results showed a prolonged chilling period basing on the pre-blooming phases identified using partial least squares regression. Inadequate chill during warm seasons (insufficient chilling requirements) induces some phenological perturbations: late flowering, extended flowering duration, and period from flowering to harvesting. These phenological anomalies affect negatively the fruit quality of apple as a cause of inadequate climatic factors, mainly temperature and chilling requirements during the chilling period. Our findings demonstrated that sufficient chilling and heat requirements correlate positively with fruit weight, size, and firmness, although the low irrigation applied during the period from flowering to the harvesting times. In unfavorable conditions, total yield and fruit sweetness could be improved by supplementary irrigation during the same period. Practically, chilling requirements of 645-677 chill hours, 709-1157 chill units, and 43.4-55.2 chill portions according to 0-7 °C, Utah model, and Dynamic model respectively and heat requirements of 26,290-27,057 growing degree hours are sufficient for good fruit quality. These are equivalent to temperature of 9.3-9.9 °C during the chilling period and 11.1-12.5 °C during the forcing period. These findings are useful for eventual management measures in order to improve apple production in their cropping area. At long terms, we propose necessity of rearrangement of high-chill apple varieties by low-chill cultivars as a way of apple crop adaptation to climate variations.


Assuntos
Malus , Mudança Climática , Flores , Frutas , Marrocos , Estações do Ano , Temperatura , Utah
12.
Int J Cancer ; 146(5): 1333-1345, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31525258

RESUMO

The current study aimed to investigate the relationship between red and white meat subtypes, processed meat (divided into traditional "Khlii, Kaddid" and industrially processed meat) and colorectal cancer (CRC) risk, considering CRC subsites, in Moroccan adults. A case-control study was conducted including 2,906 matched case-control pairs recruited from the five largest university hospitals in Morocco. Dietary data were collected through a validated Food Frequency Questionnaire (FFQ). Multivariable odds ratios (OR) and 95% confidence intervals (CI), for the association of CRC risk with meat consumption (high vs. low intake), were estimated using conditional logistic regression models, adjusted for relevant confounding variables. Overall, consumption of red meat was positively associated with colon cancer and CRC risk (OR = 1.23, 95% CI = 1.05-1.44; OR = 1.14, 95% CI = 1.02-1.27), respectively. In contrast, no significant association was observed between the consumption of red meat and rectal cancer risk (OR = 1.05, 95% = 0.90-1.23). Interestingly, while processed meat from industrial processes was positively associated with colon cancer, rectal cancer and CRC (OR = 1.61, 95% CI = 1.27-2.04; OR = 1.73, 95% CI = 1.34-2.23; OR = 1.67, 95% CI = 1.41-1.98), processed meat prepared using traditional methods was inversely associated with colon cancer and CRC risk (OR = 0.74, 95% CI = 0.57-0.98; OR = 0.77, 95% CI = 0.64-0.93), respectively. Furthermore, positive associations were observed between poultry intake and colon cancer risk among men (OR = 1.27, 95% CI = 1.01-1.59). Our study showed similar associations between the consumption of red meat and CRC risk in Morocco as in developed countries, while inverse associations were found for traditionally processed meat products. This is the first study to investigate the differential effects of traditional vs. westernized processed meat products in a developing country. Other studies are needed to confirm these findings and to understand the physiological pathways underlying these associations.


Assuntos
Neoplasias Colorretais/epidemiologia , Produtos da Carne/estatística & dados numéricos , Carne/estatística & dados numéricos , Animais , Estudos de Casos e Controles , Neoplasias Colorretais/etiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Marrocos/epidemiologia , Aves Domésticas , Carne Vermelha/estatística & dados numéricos , Risco , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos
13.
Int J Occup Saf Ergon ; 26(1): 121-128, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30422083

RESUMO

In Morocco, the construction sector is very dynamic economically, but suffers from weak safety performance. The few available statistics about the rates of occupational injuries and fatalities point to an alarming situation. However, root causes are yet to be identified. To fill this gap in knowledge, we conducted this study using an exploratory approach. Literature review, onsite observations and a survey were conducted to gather information about safety and risk aspects on construction sites. We conducted a series of correlation tests and a regression analysis using IBM SPSS version 20. The results showed that: (a) there is a relatively strong risk perception bias among workers, with an underestimation of risk severity and occurrence probability; (b) risk perception was not found to predict safety behavior; (c) a positive safety climate seems to neutralize the negative impact that high risk tolerance had on safety behavior.


Assuntos
Indústria da Construção , Saúde do Trabalhador , Acidentes de Trabalho/prevenção & controle , Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Marrocos , Observação , Cultura Organizacional , Medição de Risco , Inquéritos e Questionários , Adulto Jovem
14.
Dis Markers ; 2019: 3210710, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31885734

RESUMO

Background: Tumors with microsatellite instability (MSI tumors) have distinct clinicopathological features. However, the relation between these tumor subtypes and survival in colon cancer remains controversial. The aim of this study was to evaluate the overall survival (OS) in patients with MSI phenotype, in FES population. Methods: The expression of MMR proteins was evaluated by immunohistochemistry for 330 patients. BRAF, KRAS, and NRAS mutations were examined by Sanger sequencing and pyrosequencing methods. The association of MSI status with a patient's survival was assessed by the Kaplan-Meier method and log-rank test. Results: The mean age was 54.6 years (range of 19-90 years). The MSI status was found in 11.2% of our population. MSI tumors were significantly associated with male gender, younger patients, stage I-II, right localization, and a lower rate of lymph node and distant metastasis. The OS tends to be longer in MSI tumors than MSS tumors (109.71 versus 74.08), with a difference close to significance (P = 0.05). Conclusion: Our study demonstrates that MSI tumors have a particular clinicopathological features. The results of survival analysis indicate that the MSI status was not predictive of improved overall survival in our context with a lower statistical significance (P = 0.05) after multivariate analysis.


Assuntos
Neoplasias do Colo/genética , Neoplasias do Colo/mortalidade , Instabilidade de Microssatélites , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/patologia , Reparo de Erro de Pareamento de DNA , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos , Estadiamento de Neoplasias , Prognóstico , Análise de Sobrevida , Adulto Jovem
15.
BMC Infect Dis ; 19(1): 1069, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856744

RESUMO

BACKGROUND: Tuberculosis represents a serious public health problem and a significant diagnostic and therapeutic challenge worldwide. Molecular diagnostic techniques are crucial in the World Health Organization's new tuberculosis control strategy. This study aims to evaluate the performance of GeneXpert MTB/RIF (Cepheid Sunnyvale, CA, United States) in diagnosis of extra-pulmonary tuberculosis then compare it's performance in detecting Rifampicin resistance to GenoType MTBDRplus (HAIN Life Sciences, Nehren, Germany). METHODS: Samples from pulmonary and/or extra-pulmonary origins were analysed in a 21 months retrospective study. Samples were sent to the bacteriology laboratory for Mycobacterium tuberculosis detection using conventional bacteriological and molecular methods (GeneXpert MTB/RIF and MTBDRplus). Sensitivity and specificity were calculated for the stained smear and GeneXpert according to culture (Gold Standard) as well as for GeneXpert MTB/RIF in both negative and positive microscopy tuberculosis cases. Data's statistical analysis was performed with SPSS13.0 software. RESULTS: Seven hundred fourteen patients' samples were analysed; the average age was 47.21 ± 19.98 years with a male predominance (66.4%). Out of 714 samples: 285 were from pulmonary and 429 were from extra-pulmonary origins. The positivity rates for microscopy, GeneXpert MTB/RIF and culture were 12.88, 20.59 and 15.82%, respectively. These rates were 18.9, 23.85 and 20.35% for pulmonary samples and 9.71, 18.41 and 12.82% for extra-pulmonary samples, respectively. The sensitivity and specificity of GeneXpert MTB/RIF were almost the same in both pulmonary and extra-pulmonary samples (78.2 and 90.4%) and (79,3 and 90.3%) respectively. Rifampicin resistance rate found by GeneXpert MTB/RIF was 0.84%. Comparison of Rifampicin resistance obtained by GeneXpert MTB/RIF and Genotype MTBDRplus, showed 100% agreement between the two techniques for studied samples. CONCLUSIONS: This confirms GeneXpert MTB/RIF advantage for tuberculosis diagnosis, particularly extra-pulmonary tuberculosis with negatively stained smear. The performance of GeneXpert and Genotype MTBDRplus are similar in detection of Rifampicin resistance. However, variability of detection performance according to tuberculosis endemicity deserves more attention in the choice of screening techniques of Rifampicin resistance, hence the interest of conducting comparative studies of detection performance under low and medium endemicity on large samples of tuberculosis populations.


Assuntos
Testes Diagnósticos de Rotina/métodos , Técnicas de Diagnóstico Molecular/métodos , Mycobacterium tuberculosis/genética , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Farmacorresistência Bacteriana Múltipla , Feminino , Genótipo , Humanos , Incidência , Masculino , Microscopia , Pessoa de Meia-Idade , Marrocos/epidemiologia , Estudos Retrospectivos , Rifampina/efeitos adversos , Rifampina/uso terapêutico , Sensibilidade e Especificidade , Tuberculose/tratamento farmacológico , Adulto Jovem
16.
PLoS One ; 14(12): e0226342, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851709

RESUMO

BACKGROUND: Older women perform consistently poorer on physical performance tests compared to men. Risk groups for this "female disadvantage" in physical performance and it's development over successive birth cohorts are unknown. This is important information for preventive strategies aimed to enhance healthy aging in all older women. This study aims to longitudinal investigate whether there are risk groups for a more apparent female disadvantage and study its trend over successive birth cohorts. METHODS: Data of the Longitudinal Aging Study Amsterdam (LASA) were used. All participants were aged 55-65 years at baseline. Longitudinal data of two birth cohorts with baseline measurements in 1992/1993 (n = 966, 24 year follow-up) and 2002/2003 (n = 1002, 12 year follow-up) were included. Follow-up measurements were repeated every three/four years. Cross-sectional data of two additional cohorts were included to compare ethnic groups: a Dutch cohort (2012/2013, n = 1023) and a Migration cohort (2013/2014, n = 478) consisting of migrants with a Turkish/Moroccan ethnicity. RESULTS: Mixed model analysis showed that women aged 55 years and older had a lower age- and height-adjusted gait speed (-0.03 m/s; -0.063-0.001), chair stand speed (-0.05 stand/s; -0.071--0.033), handgrip strength (-14,8 kg; -15.69--13.84) and balance (OR = 0.71; 0.547-0.916) compared to men. The sex difference in handgrip strength diminished with increasing age, but remained stable for gait speed, chair stand speed and balance. In general, results were consistent across different, educational levels and Turkish/Moroccan ethnic groups and birth cohorts. CONCLUSIONS: There is a consistent "female disadvantage" in physical performance among older adults, which remains stable with increasing age (except for handgrip strength) and is consistent across different educational levels, ethnic groups and successive birth cohorts. So, no specific risk groups for the female disadvantage in physical performance were identified. Preventive strategies aimed to enhance healthy aging in older women are needed and should target all older women.


Assuntos
Envelhecimento , Escolaridade , Desempenho Físico Funcional , Caracteres Sexuais , Idoso , Envelhecimento/etnologia , Estatura , Estudos de Coortes , Grupos Étnicos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Marrocos/etnologia , Países Baixos , Turquia/etnologia
17.
Pan Afr Med J ; 34: 6, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762875

RESUMO

Introduction: Heart Failure (HF) is a growing public health concern in Morocco and there is a striking paucity on determinants of severe HF (SHF) in this population. The aim of this study was to identify patients admitted with HF at Ibn Rochd Hospital, Casablanca from 2011 onwards, when electronic record keeping began. Methods: A total of 105 patients underwent a series of cardiological examinations between July 2011 and January 2014. The New York Heart Association (NYHA) criteria was used to evaluate the severity of HF. Patients with NYHA classification gradings of I and II were defined as having moderate HF (MHF) and those graded as III and IV were defined as having a SHF. Univariable and multivariable risk factors associated with SHF were explored using logistic regression. The results were reported following the RECORD (Reporting of studies Conducted using Observational Routinely-collected Data) statement. Results: A total of 24 (33%) patients were identified as having a SHF. Four predictors of SHF were identified in univariate analysis: haemoglobin <12g/dL, neutrophil-to-lymphocyte ratio (NLR) >3, mean corpuscular haemoglobin concentration (MCHC) <32 picolitre, and high density lipoprotein (HDL) <0.35 (mmol/L). Only NLR>3 and HDL <0.35 mmol/L remained independent predictors in multivariable analysis. Patients with NLR >3 were at 6-fold increased odds of SHF [adjusted odds ratio (AOR): 6.78, 95% confidence interval (CI): 1.40-32.80, p=0.017], and those with HDL<0.35 (mmol/L) were at 10-fold increased odds of SHF [AOR: 10.11, 95% CI: 2.26-45.27, p=0.002]. Conclusion: The independent biomarkers of SHF identified in this study provide valuable information to ward clinicians in resource-constrained facilities to identify patients vulnerable to developing severe heart complications.


Assuntos
Insuficiência Cardíaca/epidemiologia , Hemoglobinas/metabolismo , Linfócitos/metabolismo , Neutrófilos/metabolismo , Idoso , Biomarcadores/metabolismo , Registros Eletrônicos de Saúde , Feminino , Insuficiência Cardíaca/fisiopatologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos , Fatores de Risco , Índice de Gravidade de Doença
18.
Pan Afr Med J ; 34: 64, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31762928

RESUMO

Introduction: Dermatoscopy is an innovative non-invasive technique for clinical morphology of pigmented lesions and skin tumor. The purpose of our study was to highlight the morphological and dermoscopic features of basal cell carcinoma (CBC) in our study population. Methods: We conducted a prospective unicentric study over a period of 2 years. We used dermoscopy in all patients with BCC. Statistical analysis was performed using SPSS software version 17. Results: The study included 100 patients with BCC, the average age of patients was 51.87 years, with a sex ratio F/M = 0.6. BCC most commonly occurred in the face and most patients were prototype III and IV. We established conventional and non-conventional dermatoscopic criteria. Our study showed that there is a significant relationship between prototype and the degree of BCC pigmentation. Conclusion: This study highlighted the key role of dermoscopy in detecting small-sized BCC and in facilitating the diagnosis of pigmented BCC.


Assuntos
Carcinoma Basocelular/diagnóstico , Dermoscopia/métodos , Neoplasias Cutâneas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos , Pigmentação , Estudos Prospectivos , Neoplasias Cutâneas/patologia , Adulto Jovem
19.
Pan Afr Med J ; 33: 193, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692677

RESUMO

Introduction: Blood cultures are the best diagnostic tool for the detection of bacteremia. However, false positive results may lead to confusion about antibiotic regimens, putting the lives of patients at risk. The main purpose of this study was to assess the prevalence of coagulase negative Staphylococci (CoNS) as well as of Corynebacterium spp and Bacillus spp in the bags of blood culture analyzed in the microbiology laboratory at the Ibn-Rochd University Hospital in Casablanca. This prevalence was evaluated according to various Hospital Departments over the year 2016. Methods: We conducted a descriptive, retrospective study by analysing the computerized database of the Laboratory of bacteriology and virology at the Ibn-Rochd University Hospital in Casablanca over a 12-month period from 1st January to 31st December 2016. Our study focused on bacteria forming part of the commensal flora (coagulase negative Staphylococcus, Corynebacteria spp and Bacillus spp). The blood culture bags were incubated in the automated blood culture system (Bactec FX). The identification of the germs from a positive culture was performed according to the standard techniques of bacteriology and susceptibility testing was performed according to EUCAST 2015. We conducted an analysis of the computerized database of KALISIL system (Netika) version (2.2.10.) of the Microbiology Laboratory at the Ibn-Rochd University Hospital in Casablanca. Results: Out of 7959 requests for blood cultures obtained from 5801 patients addressed to the laboratory of bacteriology, 2491 were positive, of which 848, reflecting a rate of 34% of positive bags or 10.6% of the whole of bags received over the year 2016, were positive for coagulase negative Staphylococcus, 56 bags of blood cultures, reflecting a rate of 2.2%, were positive for Corrynébacteruim SP, followed by 60 bags of blood cultures, reflecting a rate of 2.4%, which were positive for Bacillus sp. The frequency of isolation of coagulase negative Staphylococcus compared to other bacteria according to Clinical Departments showed a higher frequency in the Paediatric Department (47.2%) followed by the Medicine Department (44.1%). Conclusion: This study shows that coagulase negative Staphylococci are the organisms most frequently isolated from blood cultures. They are a non-negligible cause of nosocomial infections, but they are also the most common blood culture contaminants.


Assuntos
Bacteriemia/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus/isolamento & purificação , Bacteriemia/diagnóstico , Bacteriemia/microbiologia , Hemocultura , Coagulase , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Hospitais Universitários , Humanos , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/microbiologia , Staphylococcus/enzimologia
20.
Pan Afr Med J ; 33: 188, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692728

RESUMO

Brain radionecrosis is a rare but life-threatening complication of external-beam radiotherapy for ENT cancers, in particular of the nasopharynx, and for brain tumors. Very few studies were conducted on this complication in the African population as well as in the Maghreb population. Therefore our study aims to describe the demographic, clinical, paraclinical, therapeutic and evolutionary features of cerebral radionecrosis in the Department of Neurology at the Mohammed V Military Teaching Hospital in Rabat over a period of 18 years (2000-2017). The study involved 4 women and 13 men, with an average age of 50 years. The mean time between the end of the radiotherapy and the onset of neurological signs was 28 months. Systematic Brain MRI, sometimes complemented by spectro-MRI, allowed the diagnosis in 100% of cases. Etiologically, this complication occurred after radiotherapy for nasopharyngeal carcinoma and cancer of the larynx in all cases. Fifteen patients were treated with a combination of: bolus application of corticosteroids, platelet aggregation inhibitors associated with hyperbaric oxygen therapy with good evolution of two patients in whom oxygen therapy was contraindicated due to a lung problem and ENT cancer, received a combination of bolus application of corticosteroids and platelet aggregation inhibitors with unchanged evolution. These results demonstrate the importance of early diagnosis in patients with potentially serious conditions, in particular neuropsychiatric conditions, as well as of treatment combining bolus application of corticosteroids and hyperbaric oxygen therapy because this is the best guarantee of a favorable outcome, without omitting the crucial role of preventive measures.


Assuntos
Encéfalo/patologia , Oxigenação Hiperbárica/métodos , Lesões por Radiação/diagnóstico por imagem , Corticosteroides/administração & dosagem , Adulto , Idoso , Feminino , Hospitais Militares , Humanos , Neoplasias Laríngeas/radioterapia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Marrocos , Neoplasias Nasofaríngeas/radioterapia , Necrose , Inibidores da Agregação de Plaquetas/administração & dosagem , Lesões por Radiação/terapia , Estudos Retrospectivos
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