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Biomedical subjects

A Bennani

Publications and source records attributed to A Bennani.

At least 19 recordsLinked to original sources

[A rare cause of urinary obstruction: urogenital tuberculosis].

The authors reported a rare cause of urogenital tuberculosis complicated by an obstructive acute renal failure in 44 years old man with solitary anatomic kidney. The authors insisted of using the upper urinary tract opacification by percutaneous nephrostomy for diagnosis, the urogenital tuberculosis with this exploration, we can suspected the tuberculosis by abnormalities of the radiologic imagine, and confirmed the koch bacilli urinary into urinary tract. The upper chance of positives of finding koch bacilli in higher than urinary bladder.

Adult↗

Some characteristics of the HIV epidemic in Morocco.

The first case of AIDS in Morocco was declared in 1986 and since then the number of AIDS cases has steadily increased. According to the Ministry of Health, the cumulative number of AIDS cases in December 2002 was 1085. HIV in Morocco is acquired mainly through heterosexual intercourse. Individuals aged between 30 and 39 years and in the regions of Marrakech and Agadir have been the most affected. Monitoring of the trend of the epidemic by sentinel surveillance surveys indicates that Morocco is still a low prevalence zone, since prevalence among pregnant women is less than 1%. The estimated number of HIV-infected people in Morocco is around 15 000. It is not clear why the epidemic here has not evolved as it has in the sub-Saharan countries where it is spreading at an alarming rate. Late introduction of HIV-1 subtype B in Morocco, which is relatively less transmissible, circumcision and reduced risk behaviours of Muslims may explain this. Nonetheless, because prevalence has increased in recent years, unless preventive measures are strengthened, the HIV epidemic will worsen in Morocco.

Adult↗

Erosive polyarthritis in Crohn's disease. Report of a case.

Erosive polyarthritis in Crohn's disease is rare and raises diagnostic and pathophysiological problems. A case with destructive lesions of the shoulders and hips is reported in a 43-year-old woman with a 26-year history of Crohn's disease. Ankylosis of the spine and hips, motion range limitation of the shoulders and wrists, and boutonnière deformity of the third finger of the right hand were present. Tests were negative for rheumatoid factor and the HLA-B27 antigen. Plain radiographs showed a triple rail pattern at the spine; synostosis of the hips; and destructive lesions of the shoulders, wrists, tarsal bones, and third proximal interphalangeal joint of the right hand. Glucocorticoid therapy was effective in suppressing the bowel symptom flares but only partially improved the joint symptoms, whose treatment relied mainly on nonsteroidal antiinflammatory agents and rehabilitation therapy. Erosive arthritis in Crohn's disease is frequently monoarticular, with the hip being the most common target. It can complicate a spondylarthropathy or reveal granulomatous synovitis. Polyarticular forms pose difficult diagnostic and therapeutic challenges and add to the disability caused by the bowel disease. The potential role of genetic factors remains to be studied.

Adult↗

Acetylation polymorphism expression in patients before and after liver transplantation: influence of host/graft genotypes.

The consequences of liver transplantation on NAT2 activity were studied in 58 patients of Caucasian origin and compared with a group control of 119 unrelated healthy individuals of the same ethnic origin. Acetylation phenotypes were determined using caffeine as a probe drug before and repeatedly after liver transplantation. NAT2 genotypes were determined with three separate polymerase chain reactions to detect either the NAT2*4 wild-type allele or the NAT2*5A, NAT2*6A and NAT2*7A mutated alleles, associated with a decrease in NAT2 enzyme activity. In patients, the molar urinary elimination ratio AFMU/(AFMU+1X+1U) appeared more reliable than AFMU/1X for assessing the acetylation phenotype and fitted better with the various haplotypes. The variation of xanthine oxidase activity as measured by the 1U/1X urinary elimination ratio, appeared to be responsible for the poor phenotype prediction from the AFMU/1X ratio in post-transplanted patients. Regardless of the pathologic conditions of the treatment in progress, the genotype of the liver played an overwhelming role in the phenotypic expression of NAT2 compared with the genotype of other organs, where NAT2 was expressed in patients who presented a chimerism after liver transplantation.

Acetylation↗

Inhaled nitric oxide in acute respiratory distress syndrome with and without septic shock requiring norepinephrine administration: a dose-response study.

BACKGROUND: The aim of this prospective study was to assess whether the presence of septic shock could influence the dose response to inhaled nitric oxide (NO) in NO-responding patients with adult respiratory distress syndrome (ARDS). RESULTS: Eight patients with ARDS and without septic shock (PaO2 = 95 +/- 16 mmHg, PEEP = 0, FiO2 = 1.0), and eight patients with ARDS and septic shock (PaO2 = 88 +/- 11 mmHg, PEEP = 0, FiO2 = 1.0) receiving exclusively norepinephrine were studied. All responded to 15 ppm inhaled NO with an increase in PaO2 of at least 40 mmHg, at FiO2 1.0 and PEEP 10 cmH2O. Inspiratory intratracheal NO concentrations were recorded continuously using a fast response time chemiluminescence apparatus. Seven inspiratory NO concentrations were randomly administered: 0.15, 0.45, 1.5, 4.5, 15, 45 and 150 ppm. In both groups, NO induced a dose-dependent decrease in mean pulmonary artery pressure (MPAP), pulmonary vascular resistance index (PVRI), and venous admixture (QVA/QT), and a dose-dependent increase in PaO2/FiO2 (P </= 0.012). Dose-response of MPAP and PVRI were similar in both groups with a plateau effect at 4.5 ppm. Dose-response of PaO2/FiO2 was influenced by the presence of septic shock. No plateau effect was observed in patients with septic shock and PaO2/FiO2 increased by 173 +/- 37% at 150 ppm. In patients without septic shock, an 82 +/- 26% increase in PaO2/FiO2was observed with a plateau effect obtained at 15 ppm. In both groups, dose-response curves demonstrated a marked interindividual variability and in five patients pulmonary vascular effect and improvement in arterial oxygenation were dissociated. CONCLUSION: For similar NOinduced decreases in MPAP and PVRI in both groups, the increase in arterial oxygenation was more marked in patients with septic shock.

Journal Article↗

[Fibroepithelial polyps of the ureter and the kidney pelvis. Report of 3 cases].

The authors report 3 cases of fibroepithelial polyps, one of which was an incidental finding and 2 were symptomatic, presenting in the form of macroscopic haematuria and chronic back pain, respectively. These lesions required 2 nephroureterectomies because of their renal repercussions or their multifocal nature, combined with segmental resection of the ureter, including the base of the tumour. In the light of these cases, the authors review the literature and analyse the current management of this rare disease, in particular the indications for endourological techniques which appear to have a major diagnostic contribution as a complement to IVU and retrograde urography, but whose therapeutic value has yet to be defined.

Adult↗

[Chlamydial infections and male infertility in Morocco].

Chlamydia trachomatis infection of the lower genital is recognised as the most common sexually transmitted disease, is role in male infertility is controversial, the objective of this study was to evaluate the part that this pathogen agent takes in male infertility among maroccan population, to compare serological tests, sperm abnormalities, antisperm-antibodies and DNA research in semen. Microimmunofluorescence (MIF) was done for 139 patients, 124 were checked for sperm abnormalities, 87 for antisperm-antibodies and 92 for DNA research in sperm. The results showed that MIF is positive in 24,5%, 11% of the subjects in antisperm antibodies, 8% of them simultaneously in anti-Chlamydia and antisperm antibodies and 5 of them had sperm abnormalities. Azoospermy was more observed in positives subjects in Chlamydia trachomatis antibodies. C. trachomatis DNA was found in 7,6% and there was no association between the detection of C. trachomatis in semen specimens and the presence of anti-Chlamydia trachomatis, antibodies in serum. We conclude that, because of the complexity of the Chlamydia's physiopathology, association between several tests is necessary in male infertility workup.

Adult↗

The management of upper urinary tract calculi by piezoelectric extracorporeal shock wave lithotripsy in spinal cord injury patients.

From May 1988 to September 1994, 15 spinal cord injury patients were treated by piezoelectric extracorporeal shock wave lithotripsy. Aged from 23 to 71 years (mean = 39), they presented with a total of 23 stones, of which 18 were located in the calyces, three in the renal pelvis and two in the proximal ureter. The maximum dimensions of calculi varied from 5 to 35 mm (mean = 11). Patients were placed in a dorsal decubitus position during the sessions, three being sedated with diazepam, while the other 12 remained unsedated. All were treated routinely with systemic antibiotics. Auxiliary procedures consisted of two pyelocalyceal flushings, three double J ureteral stenting and three ureteroscopies with fragment removal with a Dormia basket. No episode of autonomic dysreflexia was observed. Short term side effects were limited to a few cases of gross haematuria which regressed spontaneously. Overall, eight successes (53%), and seven failures (47%), were registered. Of the failures, one was the result of a partial fragmentation, while six were related to intrarenal retention of residual fragments resulting in four cases in rapid recurrences. Extracorporeal shock wave lithotripsy can be easily applied to spinal cord injury patients. Its usefulness and limitations need to be well understood and a global consideration must be applied to the prevention and early detection of the upper urinary calculi in this exposed population of patients.

Adult↗

Treatment of 150 ureteric calculi with the Lithoclast.

From May 1992 to October 1993, 150 ureteral stones, impervious to piezoelectric extracorporeal shock wave lithotripsy (ESWL) with ultrasound localization (EDAP LT.01), were treated with the Lithoclast. The maximum dimensions varied from 5 to 25 mm with a mean of 11 mm. 46 calculi were situated in the pelvic ureter, 82 in the abdominal ureter, and 22 were stuck in the ureteropelvic junction. There was no complete failure of fragmentation, but 39 abdominal calculi (48%) required additional treatment by ESWL due to migration of the fragments into the calyces. Apart from a few needle-sized perforations, ureteral tissue was not damaged by the Lithoclast. The use of this endoscopic lithotripter, which is highly efficient and painless, is, however, limited by the significant effect of retrograde propulsion of very mobile stones or fragments in the urinary tract.

Adolescent↗

[Early postoperative complications of rigid uretero-renoscopy: screening for iatrogenic vesico-ureteral reflux. 30 cases].

From April to September 1992, systematic screening for iatrogenic vesicoureteric reflux was performed in a series of 30 patients treated by rigid ureterorenoscopy. Most of these endoscopies were performed for renal stones using a Wolff Multiscope (7.5/12 F) without prior dilatation of the urinary tract. The study protocol was essentially based on pre- and postoperative retrograde and voiding cystography. The site and tone of the ureteric orifice and the compliance of the intramural ureter were also evaluated and the operating time was determined. Out of 33 ureteric endoscopies, only one case of type I pelvic vesicoureteric reflux was demonstrated following an operation with no particular technical problems. This rare and benign deferred complication draws attention to the potential consequences of rigid ureterorenoscopy on the vesicoureteric antireflux device.

Adult↗

[Ballistic (Lithoclast) and hydro-electric (Riwolith) endo-ureteral lithotripsy. Report of 60 cases].

25 hydroelectric endoureteric lithotripsies (Group 1, Riwolith) and 35 ballistic endoureteric lithotripsies (Group 2, Lithoclast) were analysed. 60 stones were treated, including 18 pelvic stones (Group 1 : 10, Group 2 : 8), 39 iliolumbar stones (Group 1 : 14, Group 2 : 25), and 3 stones of the ureteropelvic junction (Group 1 : 1, Group 2 : 2). The mean maximal diameter was 9.9 mm (Group 1 : 8.2, Group 2 : 11). Complementary Dormia extraction was performed in 24 cases (Group 1 : 8, Group 2 : 16), 55 double J stents were implanted (Group 1 : 24, Group 2 : 31) and 23 immediate ECL sessions were performed (Group 1 : 8, Group 2 : 15). Overall, 57 good results were recorded, but 3 complete failures of fragmentation and 2 severe ureteric lesions were attributed to hydroelectric lithotripsy. The Lithoclast, much less traumatic, had a greater stone fragmentation potential, but its efficacy on very mobile stones is limited due to its more intense stone propulsion effect.

Adult↗

Rioprostil in the short-term treatment of duodenal ulcer: a multicentre double-blind trial vs. cimetidine.

The efficacy and safety of the new prostaglandin E1 (PGE1) synthetic analogue, rioprostil, 300 micrograms b.d. and cimetidine, 400 mg b.d., on duodenal ulcer healing are compared in an international, multicentre, double-blind study. A total of 257 patients have entered the study; 243 are considered eligible for efficacy analysis and 207 for safety analysis. After 4 and 6 weeks of treatment, the endoscopic healing rates do not significantly differ between the two groups, being 55% and 83% respectively with rioprostil vs. 60% and 78% respectively with cimetidine. The major adverse effect attributable to rioprostil is diarrhoea, which was documented in 11% of patients compared with 1% of patients taking cimetidine. However, central nervous system complaints are twice as frequent in the cimetidine group. Monitoring of clinical laboratory tests show no significant abnormalities when compared with the baseline values during the administration of either drug. This study documents that rioprostil, at the dosage of 300 micrograms b.d., is as effective and safe as cimetidine in the short-term therapy of duodenal ulcer.

Anti-Ulcer Agents↗

[Diagnostic and therapeutic aspects of peritoneal tuberculosis in Morocco. Apropos of 300 cases].

We describe 300 cases of peritoneal tuberculosis observed in the space of 11 years in Morocco. The most usual terrain presented is the young woman in precarious socio-economic conditions. The febrile ascitic form was observed in 229 cases. The ulcero-caseous was observed in 51 cases, and the fibro-adhesive form in 14 cases. Diagnostic was based on laparoscopy with peritoneal biopsy. A controlled prospective study done randomly on 100 patients showed that corticotherapy associated with tuberculous antibiotherapy did not speed up clinical recovery but tended, rather, to slow down the disappearance of granulations and indeed facilitate the constitution of peritoneal adherence phenomena.

Adolescent↗