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Biomedical subjects

H Benjelloun

Publications and source records attributed to H Benjelloun.

At least 19 recordsLinked to original sources
PubMed2005

[Autonomic profile of patients with migraine].

OBJECT: Dysfunction of autonomic nervous system (ANS) is implicated in the genesis and persistence of migraine. The objective of this study was to compare autonomic nervous system (ANS) profile of migraineurs during headache-free periods to a group of normal subjects based on cardio-vascular reactivity. METHODS: Patients with migraine according to the criteria of IHS 2004 were selected for the study. After a 30 min resting blood pressure (BP), the following standard tests were performed: deep-breathing (DB), hand grip (HG) of 15 s and 3 min, valsalva maneuver, echo stress, (ES) and tilt test (TT). Results were compared to 44 normal subjects, age similar, 37 female, (84.1%) using the Student test, with P < 0.005 as significant. RESULTS: Thirty-two patients (27 female (84.38%), 16-51 years, mean 40.41 +/- 7.8) were studied. Twenty-two patients (69%) had systolic blood pressure below 94 mmHg and 25 patients (78%) had diastolic blood pressure below 60 mmHg. Compared to normal, migraineurs exhibited a significantly higher vagal response (P < 0.001) and a significantly lower alpha sympathetic response, central by using ES as well as peripheral by using HG of 3 min (P < 0.001). CONCLUSIONS: Autonomic cardiovascular reactivity of patients with migraine showed a vagal hyperactivity and a deficiency of the alpha sympathetic system. This leads to further studies with new therapeutical approaches.

Adolescent↗
PubMed2005

[Clear cell carcinoma of the parotid gland].

OBJECTIVES: Clear cell carcinomas of the parotid gland are hardly reported only fifty cases are known. They are characterized by a proliferation of acinic epithelial cells and of clear myo epithelial cells. What makes them remarkable is a slow process of evolution. MATERIAL AND METHODS: Three cases which were treated in the Ibn Rochd center of oncology are gathered from the 1999-2003 period into a review in order to discover the epidemic and anatomopathological characteristics of these tumours. The goal of study is to contribute to a best knowledge of the clinical features, pare clinical, anatomopathological and therapeutic characteristic of this tumour. RESULTS: Two men, aged of 62 and 71 and a 82-years-old-woman were concerned. Growing cervical mass was the most revealing symptom. The diagnosis was established by the parotid biopsy in 2 cases and after surgery in the third case. The treatment consisted in a total parotidectomy with conservation of the facial nerve and postoperative radiation at the extend of 65 Gy for the first patient. After 12 months the patient is still alive. As for the two other patients, given the extend of advancement of the tumour, palliative treatment was decided. It resulted in stabilization of the disease and a receding of 22 months for one patient and no trace of the second one because of a loss of the evolutionary pursuit. CONCLUSION: With an in-depth analysis we can notice that clear cell carcinomas of the parotid gland are rare and mostly occur to old patients. Immunohistochemistry is the essential first step to sort these tumour with other salivary ones. Basic treatment is surgery. Radiation therapy linked to surgery seems to improve the local control of the disease. The prognosis remains relatively good despite discusses. Because of the few published cases, it's hard to analyze these tumours.

Adenocarcinoma, Clear Cell↗
PubMed2004

[Autonomic profile and cardiovascular symptoms].

UNLABELLED: The autonomic nervous system controls all body functions. Dysregulation of this system, called dysautonomia, is responsible of polymorphic functional symptoms. Its exploration can reveal abnormalities which explains the clinical symptoms. The objective of this work is to try to find a connection between functional signs, mainly cardio-vascular and autonomic abnormalities. We also consider the autonomic profile of a group of patients with primary hypertension. METHODS: Patients with functional symptoms and normal clinical and paraclinical examinations underwent autonomic profile study. The following tests were performed: deep breathing, hand grip, echo stress, Valsalva maneuver and tilt test. RESULTS: Two hundred and eighty four patients were included in this study, females 70%, mean age 44 years (extremes 9 and 81). In this group of patients, the main autonomic syndromes found were: orthostatic hypotension, 88 patients in whom the alpha peripheral sympathetic activity is decreased and the vagal one is increased, postural orthostatic tachycardia syndrome (POTS), 123 patients who describe orthostatic symptoms and in whom beta sympathetic activity is high, the neurocardiogenic syncope, four patients in whom vagal activity is high, and the baro-receptor abnormality (115 patients) of variable degree. In patients with primary hypertension (137), the alpha sympathetic activity is high (mean increase of blood pressure of 38.5%), meanwhile the vagal one is low. Twelve patients having diabetes showed a low vagal activity, (mean EKG RR variation of 8%). The treatment, depending on the autonomic abnormality (hygienodietetic measures, éthyléphrine, fludrocortisone, phenobarbital, clonidine, maproptyline, sérotonine recapture inhibitor) showed an improvement in the functional state of the patients. CONCLUSION: Autonomic profile study helps to explain the causes of symptoms described by the patients whose clinical and conventional paraclinical examinations are normal.

Adolescent↗
PubMed2003

[Cardiovascular calcifications in hemodialysis patients. Prevalence and risk factors].

OBJECTIVES: Cardiovascular diseases are the leading cause of morbidity and mortality in chronic hemodialysed patients. The aim of our study was to determine the prevalence of cardiovascular calcifications in dialysed patients and to evaluate their risk factors. METHODS: We did a transversal study in 86 chronically hemodialysed patients in the hemodialysis department, Ibn Sina university hospital (Rabat). All patients, 44 men and 42 females, mean age 42 +/- 15.5 years were hemodialysed for more than one year. FINDINGS: The prevalence of cardiovascular calcifications was 24.5%. Chronic hemodialysed patients with cardiovascular calcifications were older (50.5 years +/- 15.4 vs 39 years +/- 14.6; p = 0.003). They had a long hemodialysis duration (81 months +/- 51 vs 59 months +/- 43; p = 0.05) and a higher calcium plasmatic concentration (2.27 +/- 0.15 vs 2.1 +/- 0.19 mmol/l; p = 0.03). We noted a male gender predominance (sex ratio M/W = 18/3 vs 26/39; p = 0.0002). Multivariate analysis showed, as an independent predictor of cardiovascular calcifications, the old age (p = 0.01). Cardiovascular calcifications seem uncommon in our hemodialysis patients. Older age, longer hemodialysis duration and male gender are risk factors. The use of low doses of calcium carbonate, vitamin D and low milk products diet may explain this low prevalence.

Adult↗
PubMed1998

[Syphilitic aortitis and "accelerated" atherosclerosis].

The authors present the case of a 42 year old patient admitted for surgery of massive aortic regurgitation. Investigation of this patient who had no significant cardiovascular risk factors, showed diffuse and accelerated atherosclerosis (severe stenosis at the origin of both subclavian arteries at both superficial femoral arteries). Tertiary syphilis with neurological involvement and aortitis was confirmed by histological examination (peroperative biopsy of the aortic wall). This case is unusual due to the association of early atherosclerosis with tertiary syphilis and raises the question of the causality of syphilis in the generation of these atherosclerotic lesions.

Adult↗
PubMed1995

[Association of coronary-pulmonary fistula and intercoronary fistula. Apropos of a case].

The authors present the case of a 30-year-old woman admitted to hospital for investigation of a systolodiastolic murmur. Assessment revealed a fistula between the trunk of the left coronary artery and the pulmonary artery, with an aneurysm on the left anterior descending artery (LAD), associated with an intercoronary anastomosis between the left conus artery and the LAD. Thallium myocardial scintigraphy demonstrated reversible decreased uptake in the anterolateroapical region. Simple coronaro-pulmonary fistulas are a rare disease. The positive diagnosis is suggested by echocardiography and confirmed by coronary angiography. The clinical course is generally favourable, except in the presence of complications such as aneurysm, heart failure or coronary insufficiency. This case raises the difficult problem of the operative indication in these young, usually asymptomatic patients.

Adult↗
PubMed1993

Rapid assessment of aortic regurgitation and left ventricular function using cine nuclear magnetic resonance imaging and the proximal convergence zone.

In patients with aortic regurgitation (AR), knowledge of the severity of AR, and the degree of left ventricular (LV) dysfunction are important for optimal management. Previous nuclear magnetic resonance (NMR) studies to assess these parameters used multiple tomographic planes that are time-consuming to obtain and analyze, and thus not cost-effective. In addition, these studies assessed the severity of AR by looking simply at the size of the regurgitant jet, a parameter that relates only poorly to regurgitant volume. The present study evaluates a rapid, single-plane, cine NMR approach (scan time < 10 minutes), and a new grading system for AR that is based on the presence, size and persistence of not only the regurgitant jet, but also the zone of proximal signal loss. Compared with color Doppler echocardiography (n = 42), the NMR approach detected AR with a specificity of 100% and a sensitivity of 95%. NMR regurgitant jet area correlated well with color Doppler regurgitant jet area (n = 20; r = 0.81; p < 0.01), but did not discriminate well between all grades of AR as compared with x-ray contrast aortography (n = 14). Using the new NMR grading criteria, AR grade by NMR was in accordance with aortographic grade in 12 patients, differing by only 1 grade in the remaining 2 patients. NMR grade was in accordance within 1 grade of Doppler in all patients compared (n = 20). LV volumes and ejection fraction using this single-plane approach correlated well with a previously validated, NMR biplane approach (r > 0.87; n = 18).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Interstudy reproducibility of biplane cine nuclear magnetic resonance measurements of left ventricular function.

Cine nuclear magnetic resonance (NMR) imaging, as a noninvasive and high-resolution imaging modality, has been shown to be reliable for determining absolute left ventricular (LV) volumes and ejection fraction. A relatively new gradient echo cine NMR approach using 2 orthogonal long-axis planes (2- and 4-chamber) aligned with the true axes of the left ventricle has been previously developed and validated against radiographic biplane LV cineangiography. The aim of the present investigation was to determine the reproducibility of this more rapid cine NMR approach for the measurement of LV volumes and ejection fraction. Eighteen normal subjects underwent 2 cine NMR studies, on different days, using a 1.5-tesla clinical imaging system. Studies were analyzed on-line and blindly by 2 independent observers. Intraobserver error was also determined in a blinded manner. Mean values of measurements determined by this method in this group of normal subjects were end-diastolic volume (120 +/- 20 ml), end-systolic volume (39 +/- 9 ml) and ejection fraction (67 +/- 4%). Paired analysis of data revealed no significant bias between interstudy, interobserver or intraobserver measurements, except for interobserver end-diastolic volume, where the first observer measurements were slightly elevated (5.6 +/- 7.8 ml) compared with the second. This resulted in a small difference in ejection fraction (1.7 +/- 2.3%) between observers. The absolute variation between measurements (square root of variance components) was low for all interstudy, interobserver and intraobserver comparisons: end-diastolic volume was less than +/- 6.7 ml, end-systolic volume less than +/- 3.5 ml and ejection fraction less than +/- 2.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Discriminant analysis of thallium-201 myocardial scintigrams.

In a group of 207 patients undergoing coronary angiography, myocardial scintigrams have been performed at rest (n = 95), after exercise testing (n = 50) or after dipyridamole vasodilation (n = 62). Pictures recorded in anterior and 45 degrees left anterior oblique projections have been analysed according to a model which divides each projection into 5 territories. Thallium uptake has been visually assessed using a three grade scale: 0 = normal uptake, + = sightly abnormal uptake, ++ = evident hypoactivity. With reference to angiography, sensitivity and specificity for prediction of coronary artery disease have been calculated in a classical way using three different criteria of positivity of increasing severity, and by a computerized method based on discriminant analysis. In the first case, sensitivity and specificity were highly dependent one on the other and, as could be expected, varied in opposite directions, a high sensitivity (89 to 100%) being only achieved by accepting a lack of specificity (33 to 57%). Discriminant analysis, on the contrary, provided for each type of protocol: rest, stress, dipyridamole and redistribution, a single optimized combination of sensitivity (74 to 87%) and specificity (92 to 100%). The corresponding point, when located on the receiver operating characteristics (ROC) diagram, demonstrated a clear improvement in diagnostic accuracy. The same method has been applied for discrimination, not only between normals and abnormals, but also between normals and patients with and without myocardial infarction (correct diagnosis in 50 to 68% of cases), and between normals and patients with single-, double- or triple-vessel disease (correct diagnosis in 17 to 65% of cases) with a high specificity (correct classification of normals in 86 to 100% of cases).

Coronary Angiography↗
PubMed1985

[Ultrasonic diagnosis of renal lymphoma in children. A series of 18 cases].

Ultrasound tomography imaging is a very effective diagnostic examination for lymphoma of the kidneys, organs which are frequently the site of these tumors (51,5% of cases). A total of 18 cases of renal lymphoma explored by ultrasound tomography over the last 2 years were reviewed, the first patients seen in this series also undergoing intravenous urography and two others a CT scan. In most cases diagnosis from ultrasound imaging was based on findings typical of renal lymphoma and on the almost constant detection of other parenchymatous localizations (liver, spleen, pancreas) or lymph node and/or serous lesions. Tumors were bilateral in 13 cases and unilateral in 5. Ultrasound images showed: a) nephromegaly that was usually bilateral (9 cases) or sometimes unilateral (2 cases), while the kidney or kidneys were of normal size in 4 patients; b) the almost constant presence of hypoechogenic nodules scattered throughout the kidney or kidneys (16 cases); c) global hypoechogenicity of the kidney or kidneys (3 cases)--a sign not reported it the literature--; d) hydronephrosis that was either isolated (2 cases) or associated with the renal lymphomatous lesion (3 cases). The diagnostic reliability, cost and safety of ultrasound imaging make in the examination of choice for the exploration of this affection.

Abdominal Neoplasms↗
PubMed1984

[Radioisotopic quantification of isolated mitral insufficiency].

A group of 23 consecutive patients with isolated mitral regurgitation confirmed by angiography, 8 of whom had normal and 15 abnormal coronary arteriographies, were compared with a control group of 27 subjects without valvular heart disease (normal coronary arteriography in 7 cases, abnormal coronary arteriography in 20 cases). After injection of technetium 99m labelled albumin, gamma-angiocardiography was performed in the left anterior oblique plane at equilibrium with electrocardiographic synchronisation. Fourier's analysis of the images excluded hepatic pulsation and dephasing of the two ventricles: amplitude images were used to trace the right and left ventricular zones of interest. The ratio of right to left ventricular ejection fraction was calculated in these zones from the radioactive count at end diastole and end systole. The ratio of the ejection fractions was 1.15 +/- 0.18 in subjects without valvular disease compared to 2.66 +/- 0.47 in patients with mitral regurgitation and normal coronary arteries, and 2.50 +/- 1.28 in mitral regurgitation with coronary artery disease (no significant difference between these two sub-groups). When compared with angiographic quantification of the mitral regurgitation, the ratio of ejection fractions increased progressively with the severity of the leak: 1.81 +/- 0.44 for grade I (9 cases), 2.37 +/- 0.80 for grade 2 (5 cases), 3.02 +/- 1.07 for grade 3 (4 cases) and 3.73 +/- 1.50 for grade 4 (5 cases). The differences between each sub-group are not statistically significant because of the small number of patients in each sub-group but all the values are significantly higher than the reference values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Beat-to-beat assessment of left ventricular ejection in atrial fibrillation.

Beat-to-beat left ventricular ejection was evaluated in a group of 20 patients with chronic atrial fibrillation using a computerized single probe detector. The reference group consisted of 10 patients with sinus rhythm. For each patient 30 successive cardiac cycles were analyzed and the relative variations of four parameters were assessed: R-R interval, diastolic and systolic time intervals, and ejection amplitude, corresponding to the left ventricular stroke volume. The mean variations were respectively 3.4%, 10.4%, 8.4%, and 11.8% in patients with sinus rhythm, and 21.9%, 37.9%, 10.6% and 30.5% in patients with atrial fibrillation. This demonstrates that changes in ejection are mainly related to the duration of the filling phase, with nearly constant systolic times. Correlations between R-R intervals and systolic ejection amplitudes were highly significant (P less than 0.001) in patients with atrial fibrillation in 85% of cases. This information complements the average ejection fraction obtained from multiple cycle superimposition.

Adult↗
PubMed1983

Negative lung thallium-201 uptake in right ventricular infarction.

In a case of right ventricular infarction, a negative lung image was observed on the resting thallium-201 scan, with a pulmonary activity much lower than the surrounding background. The myocardial image showed only a moderate inferior hypoactivity and the left ventricular ejection fraction was normal. This seems to be related to right ventricular failure with normal left ventricular function. It represents the opposite mechanism to the increased pulmonary thallium uptake commonly seen in severe left ventricular impairment.

Aged↗
PubMed1983

[Anencephaly and prolonged pregnancy. Apropos of the etiology of prolonged pregnancy].

The authors report on a study carried out in the University Clinic of Gynaecology and Obstetrics in Rabat on 13 cases of anencephaly without hydramnios in which post-maturity occurred. This gives them an opportunity of pointing out: --that there is a raised level of anencephaly in Morocco: --that the male sex is more commonly affected with anencephaly associated with post-maturity. And they wish to go through: --the physiological theories that are concerned with the role of the fetus in the onset of labour: --and the screening that has become possible since ultrasound and estimation of alpha-feto-protein levels have been in use, and that these should be used systematically in all pregnant women before they deliver an infant with a central nervous system malformation.

Age Factors↗