Introduction: Cardio-renal syndrome (CRS) is a complex pathophysiological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can induce acute or chronic dysfunction of the other ...Introduction: Cardio-renal syndrome (CRS) is a complex pathophysiological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can induce acute or chronic dysfunction of the other organ. Five types of CRS have been described. Methods: The study explored the prevalence and types of Cardiorenal Syndrome (CRS) at CHU Ibn Sina in Rabat. Over a year, 120 CRS patients were assessed, excluding those with end-stage chronic renal failure. We analyzed the epidemiological, clinical, therapeutic and evolutionary profile of these patients. Results: The average age of our patients is 67.8 ± 12 years, with extremes ranging from 39 years to 92 years. The sex ratio is 1.35. The different types of CRS types (1, 2, 4 and 5) were noted respectively in 28.4%, 20.8%, 5%, 45.8%, however, we did not note patients having CRS type 3. On the renal level, we noted acute renal failure (ARF) in 51.6% of patients, of whom 61.3% had functional ARF and 38.7% presented with acute tubular necrosis. Chronic renal failure (CRF) is found in 48.4% of cases, of which 39% are at stage III and 61% are at stage IV. The etiology of CKD is dominated by hypertensive nephropathy (72.4%) followed by diabetic nephropathy (60.3%). Therapeutically diuretics are administered in 51% of our patients. We used hemodialysis in 9.1% of patients who are resistant to diuretics. Vasoactive drugs are used in 9.5% of our patients. Mortality risk factors for patients with CRS are significantly related to advanced age, long hospital stay, type 1 CRS, re-hospitalization, acute pulmonary edema (APE), use of hemodialysis, right heart failure (RHF), valvulopathy and hemodynamic instability (OR = 1.15, p = 0.01;OR = 4.5, p = 0.03;OR = 5.2, p = 0.019;p Conclusion: CRS type 5 was most common, with hypertension and diabetes being primary causes of Chronic Kidney Disease. Mortality factors were linked to acute pulmonary edema, hemodialysis, right heart failure, valvulopathy, and re-hospitalization.展开更多
Background: chronic subdural hematoma is a common pathology, especially in the elderly. Although it has a good prognosis, it poses the problem of recurrence after surgical evacuation. Objective: To analyze the risk fa...Background: chronic subdural hematoma is a common pathology, especially in the elderly. Although it has a good prognosis, it poses the problem of recurrence after surgical evacuation. Objective: To analyze the risk factors of reoperation in patients surgically treated for chronic subdural hematoma (cSDH) and evaluate the outcome of patients who benefited from a reoperation. Materials and Methods: A retrospective review was conducted in a single University Hospital Center in Rabat (Morocco) on 49 patients operated on from January 2020 to June 2021 for cSDH. Possible risk factors described in the literature were analyzed and the outcome of post-operative course was evaluated. Statistical significance was defined by p-value Results: 49 patients underwent surgical evacuation of cSDH. The sex ratio of male/female was 3.08. The mean age was 70.6 years. Concerning the medical history, 8.2% were diabetics, 10.2% had heart disease, 18.4% had hypertension, 16.3% associated of comorbidities, 2% had pulmonary embolism, and 2% had neoplasm. 18.4% were on anticoagulation therapy, no patients were on new oral anticoagulants. The clinical findings upon admission were motor deficit at 57.1%, signs of intracranial hypertension at 20.4%, altered consciousness at 16.9% and impaired behavior at 6.1%. 28.6% of patients had a past history of head trauma. The pre-operative CT scan showed unilateral cSDH at 81.6%, midline shifts at 77.6%, and false membranes at 34.7%. Blood appeared chronic at 40.8%, subacute at 24.5%, and mixed densities at 34.7%. The post-operative course was uneventful in 73.5%. According to Ibanez grading 8 patients had mild complications (grade I) and 5 moderate complications (grade II) after the first surgery. We recorded 10.2% of patients who needed a second surgery because of the deterioration of neurologic status or motor deficit associated with an abnormal CT scan. According to the GOS, 85.7% of patients had a good recovery while 10.2% died. None of the factors assessed was found to be a risk factor for reoperation. Conclusion: No risk factors of reoperation after an initial burr hole evacuation for cSDH were found. However medical history and male sex was common condition among reoperated patients with their CT scan showing a chronic aspect of blood, midline shift and false membranes. Most patients who underwent revision surgery died on the postoperative course.展开更多
Goal: Evaluate the techniques and results obtained from the mammary Oncoplastic in the conservative treatment of breast cancer. Patients and methods: This is a retrolective descriptive study conducted during the perio...Goal: Evaluate the techniques and results obtained from the mammary Oncoplastic in the conservative treatment of breast cancer. Patients and methods: This is a retrolective descriptive study conducted during the period from 3 April 2017 to 3 April 2019, the Gynecologic Breast pole of the Oncology National Institute of Rabat. Results: Out of 105 files listed, the locations of the tumours were: 35% 37/105 QSE, QSI QSE + 21/105 or 20%, QSI 19/105 or 18%, QSI 12/105 or 11%, other maps 16/105 or 16%. The techniques were Oncoplastic: Pamectomy 10/105 or 10% Round Block 58/105 or 55%, plasty inverted T 21/105 or 20%, and other technical 16/105 or 15%. The aesthetic results and the quality of resection were correct and above all stable at 82/105 patients 78% of cases. The lymphocele 13/105 or 12% 5/105 5% lymphoedema represented early complications occurred as late complications consisted of retractile unsightly scars 15/105 or 14%, breast asymmetry 13/105 soit12% and cutaneous sclerosis 3/105 or 3%. Conclusion: The oncoplastic surgery is a part of multidisciplinary management of breast cancer. It imposes oncologic resections and reassuring cosmetic results for the patient and the practitioner.展开更多
<strong>Background and Purpose:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Paragangliomas are rare tumors of the he...<strong>Background and Purpose:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Paragangliomas are rare tumors of the head and </span><span style="font-family:Verdana;">neck. Their management remains problematic and</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">varies considerably de</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pending on the center. This study reported 14 years of experience in the</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> management of head and neck paraganglioma (HNPGls)</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> We aimed to assess the therapeutic results of these tumors in terms of local control and overall survival. </span><b><span style="font-family:Verdana;">Materials and Methods</span></b><span style="font-family:Verdana;">: We included 16 patients followed for HNPGls and treated by radiotherapy from January 2006 to June 2018 in the National Institute of Oncology in Rabat. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The median age was 44.5 years (15 - 67). 13 patients were female and three male with a sex ratio of 4.3. Cervical mass was the common sign (56</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">3%). All patients received radiation therapy. This radiation was exclusive in 43.7% of cases or adjuvant to partial surgical resection in 56.3%. The median dose of radiotherapy was 54 Gy (46 - 60) and it was delivered by a three-dimensional conformal radiotherapy technique in 15 patients and volumetric modulated arc therapy in one. There were few acute complications such as grade I and II mucositis and dermatitis. After a median follow-up of 5.6 years (2 - 13.4), local control, defined by radiological stability or regression, was obtained in 14 patients, two patients progressed and one died. Progression-free survival rates at 5 and 7 years were 93.8% and 78.1% respectively, and overall survival at 5 and 7 years was 92.3%. </span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sions:</span></b><span style="font-family:Verdana;"> Surgery is the first-line treatment for HNPGls. When surgery is not</span><span style="font-family:Verdana;"> possible or incomplete, radiotherapy has its place in the therapeutic strategy of this rare disease for long-term local control.</span></span></span></span>展开更多
This study is focused on two types of Moroccan rocks, among the most widely used as building stones: the calcarenite of Salé (CS) and the marble of oued Akrech (MA). The two rocks, lithologically different, show ...This study is focused on two types of Moroccan rocks, among the most widely used as building stones: the calcarenite of Salé (CS) and the marble of oued Akrech (MA). The two rocks, lithologically different, show a clear contrast of their P-wave velocities (Vp): 3.90 vs 5.10 km/s at dry state and 4.29 vs 5.64 km/s at saturation. The “Artificial fractures” created in the two rock types reveal that their Vp undergo diminutions which the rates vary depending of the number and the plane orientation of the fractures. In the CS, Vp shows an increasing of cumulative diminution (Dc) according to the number of fractures, but with a variable rate of unitary diminution (Du) from one fracture to the other. This defines a linear regression with a low coefficient of determination (Dc = 10.18NbFr + 10.96;r2 = 0.87). The mode of the Vp evolution would be related to the roughness of fractures surface, which itself depends upon the petrographic nature of the calcarenite (friable structure, high porosity and heterogenous composition). The MA manifested an increasing Dc with a fairly constant rate of Du from a fracture to another, giving a regression line with a high coefficient of determination (Dc = 12.17NbFr – 10.69;r2 = 0.99). This steady diminution of Vp would be related to the granoblastic texture and the monomineral composition of the marble, which engender smoother fracture surfaces. The rates of Vp diminution also depend on the orientation plane of the fractures relative to the direction of wave propagation. The fractures parallel (θ = 0°) amplify slightly the Vp, playing a significant role of “waveguide”. The fractures oriented at 45° lead to a diminution lower than those of fractures oriented at 25° and 90°. The same trend of diminution, but at variable rates, appears on the samples of the two types of stones at dry and saturated state. This can be explained by the compressive nature of P-waves, which obey the physic laws of the transmission of the constraints in the solid mediums.展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Chordoma is a rare bone tumor, which develops main...<strong>Introduction:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Chordoma is a rare bone tumor, which develops mainly from the sacrum, the base of the skull, or the spine. Surgery + radiotherapy (if necessary) is the standard treatment. Data on chordoma are scarce in this re</span><span style="font-family:Verdana;">gion, and thus, here we summarized 9 patients with this tumor whom we</span><span style="font-family:Verdana;"> treated in this institute. </span><b><span style="font-family:Verdana;">Material: </span></b><span style="font-family:Verdana;">Nine chordoma patients were summarized, who were treated in National Institute of Oncology in Rabat between 2013 </span><span style="font-family:Verdana;">and 2018. We retrieved data from medical charts and analyzed the clinical</span><span style="font-family:Verdana;"> characteristics of this tumor. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The average age was 49 years (range: 29 </span><span style="font-family:Verdana;">- 72), with male: female of 3:6. The manifestation-diagnosis time was 4</span><span style="font-family:Verdana;"> months (range: 2 - 14). Regarding the tumor location, lumbosacral spine;5, the skull;4. Mass was evident in 6. Signs of locoregional compressions (paraparesis or tetraparesis) were observed in 3. As for treatment, a partial tumor excision was performed in 8, with 3 patients undergoing a wide excision. Radiotherapy was done;3 patients with a dose of 46 Gy, 3 patients with 66 Gy, 1 patient with 50 Gy, and 1 patient with a 16 Gy gamma radio-knife in a single session. 4 patients with a dose of 46 Gy, 2 patients with 60 Gy, and 1 patient with a 16 Gy gamma radio-knife in a single session. Of 9, 4 patients had good locoregional control whereas 5 patients had local recurrence. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Chordoma is a predominantly local aggressive tumor with low metastatic potential. The surgical excision remains the main prognostic factor. Advances in radiotherapy may improve local control. These data are of use in management of this tumor in Rabat (Morocco).</span></span></span></span>展开更多
Natural materials(e.g. rocks and soils) are porous media, whose microstructures present a wide diversity.They generally consist of a heterogeneous solid phase and a porous phase which may be fully or partially saturat...Natural materials(e.g. rocks and soils) are porous media, whose microstructures present a wide diversity.They generally consist of a heterogeneous solid phase and a porous phase which may be fully or partially saturated with one or more fluids. The prediction of elastic and acoustic properties of porous materials is very important in many fields, such as physics of rocks, reservoir geophysics, civil engineering, construction field and study of the behavior of historical monuments. The aim of this work is to predict the elastic and acoustic behaviors of isotropic porous materials of a solid matrix containing dry, saturated and partially saturated spherical pores. For this, a homogenization technique based on the Morie Tanaka model is presented to connect the elastic and acoustic properties to porosity and degree of water saturation. Non-destructive ultrasonic technique is used to determine the elastic properties from measurements of P-wave velocities. The results obtained show the influence of porosity and degree of water saturation on the effective properties. The various predictions of Morie Tanaka model are then compared with experimental results for the elastic and acoustic properties of calcarenite.展开更多
Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during ...Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during the first six months as a significant public health tool. The present study aims to assess the impact of educational materials on mothers’ behaviour with regard to keeping up EB as long as six months, at least. Methods: This is a cohort study with a prospective collection of data over a period of one year, through a questionnaire-based survey of 500 women who delivered at the Souissi Maternity Hospital in Rabat. The subjects were divided into an intervention group sensitized, during the medical visit, by means of information delivered orally about breastfeeding and a booklet containing instructions on breastfeeding management and the benefits of EB, especially when extended for the first six months;and a control group attending the same operation with no awareness-rising through educational materials. To assess EB rates, the subjects had been followed for six months through telephone. Results: 372 women who delivered were followed, 194 from the intervention group and 178 from the control group. The remaining 128 women not followed were lost sight of. A higher percentage of mothers in the intervention group exclusively breastfed their babies up to the age of six months compared to the control group, 55.2% against 38.8% (p = 0.002). The main reason produced by most mothers who ceased to exclusively breastfeed their babies is milk insufficiency. Conclusion: The postnatal nutritional education strategy based on the distribution of educational materials has considerably raised the number of women who exclusively breastfed their babies until the age of six months.展开更多
Hypofractionated radiation therapy has proven effective on locoregional control and tolerance in the adjuvant treatment of breast cancer. The aim of this study is to compare the results of hypofractionated radiation t...Hypofractionated radiation therapy has proven effective on locoregional control and tolerance in the adjuvant treatment of breast cancer. The aim of this study is to compare the results of hypofractionated radiation therapy versus conventional radiation therapy in terms of local control and tolerance. It was a retrospective study of patients observations collected from January 2007 to December 2008 in Department of Radiation Therapy in Institut National d’Oncologie de Rabat. The treatment results were evaluated by the rate of locoregional recurrence, distant recurrence and research of late toxicities. Radiotherapy was delivered using the same technique in both groups, by gamma photons of cobalt 60 with an energy of 1.25 MeV. They were 2 groups: the first group treated with standard dose rate and the second group treated by hypofractionated radiation therapy. The mean age of the patients was 42.8 ± 6.9 years old in the standard group and 43.22 ± 7.2 years old in the hypofractionation group. We noted a predominance of infiltrating ductal carcinoma. The majority of patients were pT<sub>2</sub>, pN<sub>0</sub> and pN<sub>1</sub>.<sub> </sub>The majority of patients had radical surgery and chemotherapy with anthracyclines in both groups. We noted a statistically significant difference in the irradiation of chest wall between the standard (89.2%) and hypofractionated group (70.3%), with p = 0.043. The median duration of radiation therapy was statistically different in both groups: 39 days in the standard and 23 days in the hypofractionated group (p 0.001). The local recurrences were statistically identical to 12 and 24 months (p = 0.999). Concerning toxicities, the frequency of adverse event was similar in both groups. Hypofractionated radiation therapy with a total dose of 42 Gy at 2.8 Gy per fraction in 5 fractions weekly is comparable to standard radiotherapy in terms of local control and tolerance and is therefore a very good alternative to standard treatment.展开更多
Risk of infection by hepatitis B (HBV) and C (HCV) viruses remains a permanent problem, not only for health care workers but also for patients. It is often a major public health concern in low incomes countries. The a...Risk of infection by hepatitis B (HBV) and C (HCV) viruses remains a permanent problem, not only for health care workers but also for patients. It is often a major public health concern in low incomes countries. The aims of this study were to determine seroprevalence of viral hepatitis B (HBV) and C (HCV), frequency occurrence of blood exposure accidents (BEA) and identify key risk factors for infection among 601 health care workers of Ibn Sina Hospital in Rabat. In this study nineteen health personnel (3.16%) were HBsAg positive and fifteen (2.50%) were anti-HCV antibodies positive. The seropositivity to hepatitis B and C in the surgical department respectively was 4.22% and 3.45%. Nurses were the most affected by hepatitis virus infections. We noticed that HCV came first with a prevalence of 4.44%. The seropositivity reached its acme within the health staff having practiced for more than 20 years, hepatitis C coming first with a prevalence of 4.27%. Globally, 34 health care personnel are positive for HBV or HCV, 32 among them were victims at least once of blood exposure accident (BEA) while practicing. The needlestick represented 81.25% of the BEA type. Prevalence of hepatitis B and C serologic markers in health care workers in our Hospital outnumbered that of the general population. Nurses, surgery department personnel and the professional having worked for a long time were the main factors behind the high risks of infections.展开更多
Carbon monoxide （CO） intoxication is one of the most common types of poisoning in the modem world. To better tailor messages and communication needs to the public, a perception survey of CO and his risk was conducte...Carbon monoxide （CO） intoxication is one of the most common types of poisoning in the modem world. To better tailor messages and communication needs to the public, a perception survey of CO and his risk was conducted among the population of Rabat-Sale-Zemmour-Zaer. The authors included 400 people in this survey. The demographic characteristics of the respondents consisted of： 85.0% female, 92.9% adults, 29.7% had a high level of education, 49.6% unemployed, 89.5% were home owners and 53.9% lived in apartments. Water heaters were present in the homes of 91.0% of respondents and 6.5% of them used gas. Gas was used as fuel in 45.4% of cases. For water heaters, 20.8% had an exhaust duct, 9.9% were serviced regularly and 47.5% were installed in a well ventilated area. Regarding the media, television was the medium that allowed 73.4% of the CO to know, regardless of age, sex and level of education among the 94.3% of who ever heard of this deadly gas before the survey.展开更多
BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential thera...BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and cost.The most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation molecules.This open-label prospective study randomized 328 patients with confirmed H.pylori infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the H.pylori eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath test.RESULTS In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)respectively.However,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),respectively.The overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three groups.CONCLUSION The optimized 14-d sequential therapy is a safe and effective alternative.Its eradication rate is comparable to that of the 14-d concomitant therapy while causing fewer AEs and allowing a gain in terms of cost.展开更多
Upper mantle earthquakes are usually associated with plate boundary tectonics, but rarely occur beneath intracontinental orogenic belts. In the Moroccan Atlas Mountains, earthquakes determined at subcrustal depths are...Upper mantle earthquakes are usually associated with plate boundary tectonics, but rarely occur beneath intracontinental orogenic belts. In the Moroccan Atlas Mountains, earthquakes determined at subcrustal depths are a controversial topic because they are few in number compared to subduction zones and are not related to plate boundary tectonics. A recent increase of broadband stations in Morocco has revealed numerous events below the Atlas belts, thought to occur from the upper mantle. Using additional available stations, these Atlas events were relocated and new epicenter resolutions were acquired following rigorous depth and RMS error criteria. 309 events were reprocessed and epicenter depths obtained were between 31 and 240 km during the last 23 years. Temporal variations of High Atlas events appear to be continually dipping while Anti Atlas events show no temporal variation trends. In addition, a recent strong event M6.8 occurred in September 2023 at the transition crust-uppermost mantle followed by several aftershocks which have been relocated at uppermost mantle depths. These events support delamination model under the High-Middle Atlas which could flow southward beneath the Anti Atlas lithosphere, and explain the large variation observed in lithosphere thickness between the High-Middle Atlas, and the Anti Atlas. Subcrustal events beneath the Atlas may be related to upper mantle earthquakes beneath the neighboring Canary Islands which have experienced recent swarms and eruptions. This possible correlation cannot be excluded since descending and ascending material is necessary for a regional geodynamic balance.展开更多
Recent studies have underscored the significance of the capillary fringe in hydrological and biochemical processes.Moreover,its role in shallow waters is expected to be considerable.Traditionally,the study of groundwa...Recent studies have underscored the significance of the capillary fringe in hydrological and biochemical processes.Moreover,its role in shallow waters is expected to be considerable.Traditionally,the study of groundwater flow has centered on unsaturated-saturated zones,often overlooking the impact of the capillary fringe.In this study,we introduce a steady-state two-dimensional model that integrates the capillary fringe into a 2-D numerical solution.Our novel approach employs the potential form of the Richards equation,facilitating the determination of boundaries,pressures,and velocities across different ground surface zones.We utilized a two-dimensional Freefem++finite element model to compute the stationary solution.The validation of the model was conducted using experimental data.We employed the OFAT(One_Factor-At-Time)method to identify the most sensitive soil parameters and understand how changes in these parameters may affect the behavior and water dynamics of the capillary fringe.The results emphasize the role of hydraulic conductivity as a key parameter influencing capillary fringe shape and dynamics.Velocity values within the capillary fringe suggest the prevalence of horizontal flow.By variation of the water table level and the incoming flow q0,we have shown the correlation between water table elevation and the upper limit of the capillary fringe.展开更多
This case report investigates the manifestation of cerebral amyloid angiopathy (CAA) through recurrent Transient Ischemic Attacks (TIAs) in an 82-year-old patient. Despite initial diagnostic complexities, cerebral ang...This case report investigates the manifestation of cerebral amyloid angiopathy (CAA) through recurrent Transient Ischemic Attacks (TIAs) in an 82-year-old patient. Despite initial diagnostic complexities, cerebral angiography-MRI revealed features indicative of CAA. Symptomatic treatment resulted in improvement, but the patient later developed a fatal hematoma. The discussion navigates the intricate therapeutic landscape of repetitive TIAs in the elderly with cardiovascular risk factors, emphasizing the pivotal role of cerebral MRI and meticulous bleeding risk management. The conclusion stresses the importance of incorporating SWI sequences, specifically when suspecting a cardioembolic TIA, as a diagnostic measure to explore and exclude CAA in the differential diagnosis. This case report provides valuable insights into these challenges, highlighting the need to consider CAA in relevant cases.展开更多
Introduction: Type 1 cardiorenal syndrome (CRS 1) is characterized by acute impairment of cardiac function leading to acute renal dysfunction. CRS1 is present in 25% of patients admitted for heart failure. The objecti...Introduction: Type 1 cardiorenal syndrome (CRS 1) is characterized by acute impairment of cardiac function leading to acute renal dysfunction. CRS1 is present in 25% of patients admitted for heart failure. The objective of our study is to analyze the epidemiological, clinical, therapeutic profile and the risk and prognostic factors of these patients. Materials and Methods: We identified 120 patients with cardiorenal syndrome (CRS) over a one-year period to determine the prevalence and risk factors for developing CRS 1. We analyzed the clinical, biological, and evolutionary profiles of patients with CRS 1 and determined the risk factors for the occurrence of acute kidney injury (AKI) as well as the mortality factors in these patients. Résultats: The average age of our patients with CRS1 is 58 ± 9 years, with a sex ratio of 1.4. The average eGFR of our patients is 35 ± 6.5 ml/min/1.73m2. Diabetes was found in 17% of our patients and hypertension in 14%. The etiology of cardiac impairment is predominantly acute coronary syndrome (ACS), followed by rhythm disorders. Renally, all our patients have acute kidney injury (AKI), with 86% having functional acute renal failure and 14% having acute tubular necrosis. Therapeutically, 50% of our patients are on diuretics, 42% receive beta-blocker treatment, and RAAS blockers are used in 29% of cases. Renal replacement therapy (RRT) sessions were required in 13.8% of cases. In univariate analysis, male gender, tachyarrhythmia, and hypertension are associated with the early onset of acute kidney injury (AKI). The use of diuretics, anemia, and low left ventricular ejection fraction (LVEF) are linked to a higher risk of developing CRS 1 (p = 0.021, p = 0.037, p = 0.010 respectively). In multivariate analysis, advanced age is significantly associated with increased mortality risk in CRS 1 patients (p = 0.030), while beta-blocker use is considered a protective factor (p = 0.014). Conclusion: Our study identifies several key factors associated with outcomes in type 1 CRS. Male gender, tachyarrhythmia, and hypertension are linked to early-onset AKI. The use of diuretics and the presence of anemia increase the risk of developing CRS1. Advanced age is significantly associated with higher mortality rates. Conversely, the use of beta-blockers appears to be protective in this patient population. .展开更多
In a study comparing grain filling and yield in a large-and a small-grain-size wheat cultivar under two planting patterns and two irrigation regimes,plastic-covered ridge and furrow planting with sprinkler irrigation ...In a study comparing grain filling and yield in a large-and a small-grain-size wheat cultivar under two planting patterns and two irrigation regimes,plastic-covered ridge and furrow planting with sprinkler irrigation increased grain filling and yield in both cultivars.The largest contributors to grain yield were an extended active grain-filling period in Shuangda 1 and an increased mean grain-filling rate in XN538.展开更多
Low temperatures during germination inhibit seed growth,lead to small and weak seedlings,and significantly reduce the wheat yield.Alleviating the adverse effects of low temperature on wheat seed germination is highly ...Low temperatures during germination inhibit seed growth,lead to small and weak seedlings,and significantly reduce the wheat yield.Alleviating the adverse effects of low temperature on wheat seed germination is highly important for achieving high and stable wheat yields.In this study,Tongmai 6(insensitive)and Zhengmai 113(sensitive),which have different low-temperature sensitivities during germination were treated with low temperature during germination.The transcriptome,metabolome and physiological data revealed that low temperature decreased the germination rate,downregulated the expression of a large number of genes involved in regulating glycometabolism,and inhibited carbon,nitrogen(especially amino acids)and energy metabolism in the seeds.Arginine content increased at low temperature,and its increase in the low-temperature-tolerant variety was significantly greater than that in the sensitive variety.Arginine priming experiment showed that treatment with an appropriate concentration of arginine improved the seed germination rate.The conversion of starch to soluble sugar significantly increased under exogenous arginine conditions,the content of key metabolites in energy metabolism increased,and the utilization of ATP in the seeds increased.Taken together,arginine priming increased seed germination at low temperature by relieving inhibition of seed carbon and nitrogen metabolism and improving seed energy metabolism.展开更多
Orthodontic treatment offers great advantages in improving facial and smile aesthetics, self-confidence and the function of the stomatognathic apparatus. The pursuit of these advantages makes use of orthodontic applia...Orthodontic treatment offers great advantages in improving facial and smile aesthetics, self-confidence and the function of the stomatognathic apparatus. The pursuit of these advantages makes use of orthodontic appliances that could be fixed or removable. However, it’s worth stating that these appliances interfere with tooth brushing, making it more difficult to brush teeth effectively. Orthodontics appliances therefore promote the accumulation of dental plaque, which results in both quantitative and qualitative changes in the oral microbiota, hence, exposing patients to several adverse effects such as White spot lesions, dental caries, periodontal pathologies and halitosis. For this reason, oral assessment of patients before, during and after treatment is necessary as well as oral hygiene instructions and motivation. Orthodontists therefore, should educate patients on oral and periodontal hygiene in order to control dental and periodontal complications. Prescriptions of plaque control materials adapted to each patient are done in order to optimize the final result and minimize unwanted complications.展开更多
The Tarfaya-Laayoune-Boujdour basin is of great interest to oil exploration;on this aspect, there has been exploration by the Moroccan National Office of Hydrocarbons and Mining, which has shown indices of oil and/or ...The Tarfaya-Laayoune-Boujdour basin is of great interest to oil exploration;on this aspect, there has been exploration by the Moroccan National Office of Hydrocarbons and Mining, which has shown indices of oil and/or gas recorded in most wells drilled in the Moroccan Atlantic margin. FD-1 well, object of this study, is one of these wells located in the offshore Tarfaya-Laayoune-Boujdour basin. A palynological examination of the processed samples revealed the existence of organic palynomorphs, well conserved and rich in dinoflagellate cysts. The latter are composed of worldwide marker taxa of high stratigraphic resolutions. Thus, the middle upper Albian (3408 - 3408.5 m) is determined by the presence of Cribroperidinium tensiftense, Tehamadinium coummia, Spiniferella cornuta, Chichaouadinium vestitum, Dinopterygium alatum and Litosphaeridium arundum. The upper Albian (3406.5 - 3408 m) is characterized by the FOs of marker taxa: Cyclonephelium chabaca, Cribroperidinium auctificum and Chichaouadinium vestitum. Lastly, the upper Albian-lower Cenomanian transition is defined between 3404 m and 3406.50 m, as suggested by the FOs of Chichaouadinium boydii, Dinopterygium tuberculatum, Sepispinula ancorifera, Litosphaeridium conispinum, Prolixosphaeridium conulum and Xenascus ceratioides.展开更多
文摘Introduction: Cardio-renal syndrome (CRS) is a complex pathophysiological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can induce acute or chronic dysfunction of the other organ. Five types of CRS have been described. Methods: The study explored the prevalence and types of Cardiorenal Syndrome (CRS) at CHU Ibn Sina in Rabat. Over a year, 120 CRS patients were assessed, excluding those with end-stage chronic renal failure. We analyzed the epidemiological, clinical, therapeutic and evolutionary profile of these patients. Results: The average age of our patients is 67.8 ± 12 years, with extremes ranging from 39 years to 92 years. The sex ratio is 1.35. The different types of CRS types (1, 2, 4 and 5) were noted respectively in 28.4%, 20.8%, 5%, 45.8%, however, we did not note patients having CRS type 3. On the renal level, we noted acute renal failure (ARF) in 51.6% of patients, of whom 61.3% had functional ARF and 38.7% presented with acute tubular necrosis. Chronic renal failure (CRF) is found in 48.4% of cases, of which 39% are at stage III and 61% are at stage IV. The etiology of CKD is dominated by hypertensive nephropathy (72.4%) followed by diabetic nephropathy (60.3%). Therapeutically diuretics are administered in 51% of our patients. We used hemodialysis in 9.1% of patients who are resistant to diuretics. Vasoactive drugs are used in 9.5% of our patients. Mortality risk factors for patients with CRS are significantly related to advanced age, long hospital stay, type 1 CRS, re-hospitalization, acute pulmonary edema (APE), use of hemodialysis, right heart failure (RHF), valvulopathy and hemodynamic instability (OR = 1.15, p = 0.01;OR = 4.5, p = 0.03;OR = 5.2, p = 0.019;p Conclusion: CRS type 5 was most common, with hypertension and diabetes being primary causes of Chronic Kidney Disease. Mortality factors were linked to acute pulmonary edema, hemodialysis, right heart failure, valvulopathy, and re-hospitalization.
文摘Background: chronic subdural hematoma is a common pathology, especially in the elderly. Although it has a good prognosis, it poses the problem of recurrence after surgical evacuation. Objective: To analyze the risk factors of reoperation in patients surgically treated for chronic subdural hematoma (cSDH) and evaluate the outcome of patients who benefited from a reoperation. Materials and Methods: A retrospective review was conducted in a single University Hospital Center in Rabat (Morocco) on 49 patients operated on from January 2020 to June 2021 for cSDH. Possible risk factors described in the literature were analyzed and the outcome of post-operative course was evaluated. Statistical significance was defined by p-value Results: 49 patients underwent surgical evacuation of cSDH. The sex ratio of male/female was 3.08. The mean age was 70.6 years. Concerning the medical history, 8.2% were diabetics, 10.2% had heart disease, 18.4% had hypertension, 16.3% associated of comorbidities, 2% had pulmonary embolism, and 2% had neoplasm. 18.4% were on anticoagulation therapy, no patients were on new oral anticoagulants. The clinical findings upon admission were motor deficit at 57.1%, signs of intracranial hypertension at 20.4%, altered consciousness at 16.9% and impaired behavior at 6.1%. 28.6% of patients had a past history of head trauma. The pre-operative CT scan showed unilateral cSDH at 81.6%, midline shifts at 77.6%, and false membranes at 34.7%. Blood appeared chronic at 40.8%, subacute at 24.5%, and mixed densities at 34.7%. The post-operative course was uneventful in 73.5%. According to Ibanez grading 8 patients had mild complications (grade I) and 5 moderate complications (grade II) after the first surgery. We recorded 10.2% of patients who needed a second surgery because of the deterioration of neurologic status or motor deficit associated with an abnormal CT scan. According to the GOS, 85.7% of patients had a good recovery while 10.2% died. None of the factors assessed was found to be a risk factor for reoperation. Conclusion: No risk factors of reoperation after an initial burr hole evacuation for cSDH were found. However medical history and male sex was common condition among reoperated patients with their CT scan showing a chronic aspect of blood, midline shift and false membranes. Most patients who underwent revision surgery died on the postoperative course.
文摘Goal: Evaluate the techniques and results obtained from the mammary Oncoplastic in the conservative treatment of breast cancer. Patients and methods: This is a retrolective descriptive study conducted during the period from 3 April 2017 to 3 April 2019, the Gynecologic Breast pole of the Oncology National Institute of Rabat. Results: Out of 105 files listed, the locations of the tumours were: 35% 37/105 QSE, QSI QSE + 21/105 or 20%, QSI 19/105 or 18%, QSI 12/105 or 11%, other maps 16/105 or 16%. The techniques were Oncoplastic: Pamectomy 10/105 or 10% Round Block 58/105 or 55%, plasty inverted T 21/105 or 20%, and other technical 16/105 or 15%. The aesthetic results and the quality of resection were correct and above all stable at 82/105 patients 78% of cases. The lymphocele 13/105 or 12% 5/105 5% lymphoedema represented early complications occurred as late complications consisted of retractile unsightly scars 15/105 or 14%, breast asymmetry 13/105 soit12% and cutaneous sclerosis 3/105 or 3%. Conclusion: The oncoplastic surgery is a part of multidisciplinary management of breast cancer. It imposes oncologic resections and reassuring cosmetic results for the patient and the practitioner.
文摘<strong>Background and Purpose:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Paragangliomas are rare tumors of the head and </span><span style="font-family:Verdana;">neck. Their management remains problematic and</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">varies considerably de</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pending on the center. This study reported 14 years of experience in the</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> management of head and neck paraganglioma (HNPGls)</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> We aimed to assess the therapeutic results of these tumors in terms of local control and overall survival. </span><b><span style="font-family:Verdana;">Materials and Methods</span></b><span style="font-family:Verdana;">: We included 16 patients followed for HNPGls and treated by radiotherapy from January 2006 to June 2018 in the National Institute of Oncology in Rabat. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The median age was 44.5 years (15 - 67). 13 patients were female and three male with a sex ratio of 4.3. Cervical mass was the common sign (56</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">3%). All patients received radiation therapy. This radiation was exclusive in 43.7% of cases or adjuvant to partial surgical resection in 56.3%. The median dose of radiotherapy was 54 Gy (46 - 60) and it was delivered by a three-dimensional conformal radiotherapy technique in 15 patients and volumetric modulated arc therapy in one. There were few acute complications such as grade I and II mucositis and dermatitis. After a median follow-up of 5.6 years (2 - 13.4), local control, defined by radiological stability or regression, was obtained in 14 patients, two patients progressed and one died. Progression-free survival rates at 5 and 7 years were 93.8% and 78.1% respectively, and overall survival at 5 and 7 years was 92.3%. </span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sions:</span></b><span style="font-family:Verdana;"> Surgery is the first-line treatment for HNPGls. When surgery is not</span><span style="font-family:Verdana;"> possible or incomplete, radiotherapy has its place in the therapeutic strategy of this rare disease for long-term local control.</span></span></span></span>
文摘This study is focused on two types of Moroccan rocks, among the most widely used as building stones: the calcarenite of Salé (CS) and the marble of oued Akrech (MA). The two rocks, lithologically different, show a clear contrast of their P-wave velocities (Vp): 3.90 vs 5.10 km/s at dry state and 4.29 vs 5.64 km/s at saturation. The “Artificial fractures” created in the two rock types reveal that their Vp undergo diminutions which the rates vary depending of the number and the plane orientation of the fractures. In the CS, Vp shows an increasing of cumulative diminution (Dc) according to the number of fractures, but with a variable rate of unitary diminution (Du) from one fracture to the other. This defines a linear regression with a low coefficient of determination (Dc = 10.18NbFr + 10.96;r2 = 0.87). The mode of the Vp evolution would be related to the roughness of fractures surface, which itself depends upon the petrographic nature of the calcarenite (friable structure, high porosity and heterogenous composition). The MA manifested an increasing Dc with a fairly constant rate of Du from a fracture to another, giving a regression line with a high coefficient of determination (Dc = 12.17NbFr – 10.69;r2 = 0.99). This steady diminution of Vp would be related to the granoblastic texture and the monomineral composition of the marble, which engender smoother fracture surfaces. The rates of Vp diminution also depend on the orientation plane of the fractures relative to the direction of wave propagation. The fractures parallel (θ = 0°) amplify slightly the Vp, playing a significant role of “waveguide”. The fractures oriented at 45° lead to a diminution lower than those of fractures oriented at 25° and 90°. The same trend of diminution, but at variable rates, appears on the samples of the two types of stones at dry and saturated state. This can be explained by the compressive nature of P-waves, which obey the physic laws of the transmission of the constraints in the solid mediums.
文摘<strong>Introduction:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Chordoma is a rare bone tumor, which develops mainly from the sacrum, the base of the skull, or the spine. Surgery + radiotherapy (if necessary) is the standard treatment. Data on chordoma are scarce in this re</span><span style="font-family:Verdana;">gion, and thus, here we summarized 9 patients with this tumor whom we</span><span style="font-family:Verdana;"> treated in this institute. </span><b><span style="font-family:Verdana;">Material: </span></b><span style="font-family:Verdana;">Nine chordoma patients were summarized, who were treated in National Institute of Oncology in Rabat between 2013 </span><span style="font-family:Verdana;">and 2018. We retrieved data from medical charts and analyzed the clinical</span><span style="font-family:Verdana;"> characteristics of this tumor. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The average age was 49 years (range: 29 </span><span style="font-family:Verdana;">- 72), with male: female of 3:6. The manifestation-diagnosis time was 4</span><span style="font-family:Verdana;"> months (range: 2 - 14). Regarding the tumor location, lumbosacral spine;5, the skull;4. Mass was evident in 6. Signs of locoregional compressions (paraparesis or tetraparesis) were observed in 3. As for treatment, a partial tumor excision was performed in 8, with 3 patients undergoing a wide excision. Radiotherapy was done;3 patients with a dose of 46 Gy, 3 patients with 66 Gy, 1 patient with 50 Gy, and 1 patient with a 16 Gy gamma radio-knife in a single session. 4 patients with a dose of 46 Gy, 2 patients with 60 Gy, and 1 patient with a 16 Gy gamma radio-knife in a single session. Of 9, 4 patients had good locoregional control whereas 5 patients had local recurrence. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Chordoma is a predominantly local aggressive tumor with low metastatic potential. The surgical excision remains the main prognostic factor. Advances in radiotherapy may improve local control. These data are of use in management of this tumor in Rabat (Morocco).</span></span></span></span>
文摘Natural materials(e.g. rocks and soils) are porous media, whose microstructures present a wide diversity.They generally consist of a heterogeneous solid phase and a porous phase which may be fully or partially saturated with one or more fluids. The prediction of elastic and acoustic properties of porous materials is very important in many fields, such as physics of rocks, reservoir geophysics, civil engineering, construction field and study of the behavior of historical monuments. The aim of this work is to predict the elastic and acoustic behaviors of isotropic porous materials of a solid matrix containing dry, saturated and partially saturated spherical pores. For this, a homogenization technique based on the Morie Tanaka model is presented to connect the elastic and acoustic properties to porosity and degree of water saturation. Non-destructive ultrasonic technique is used to determine the elastic properties from measurements of P-wave velocities. The results obtained show the influence of porosity and degree of water saturation on the effective properties. The various predictions of Morie Tanaka model are then compared with experimental results for the elastic and acoustic properties of calcarenite.
文摘Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during the first six months as a significant public health tool. The present study aims to assess the impact of educational materials on mothers’ behaviour with regard to keeping up EB as long as six months, at least. Methods: This is a cohort study with a prospective collection of data over a period of one year, through a questionnaire-based survey of 500 women who delivered at the Souissi Maternity Hospital in Rabat. The subjects were divided into an intervention group sensitized, during the medical visit, by means of information delivered orally about breastfeeding and a booklet containing instructions on breastfeeding management and the benefits of EB, especially when extended for the first six months;and a control group attending the same operation with no awareness-rising through educational materials. To assess EB rates, the subjects had been followed for six months through telephone. Results: 372 women who delivered were followed, 194 from the intervention group and 178 from the control group. The remaining 128 women not followed were lost sight of. A higher percentage of mothers in the intervention group exclusively breastfed their babies up to the age of six months compared to the control group, 55.2% against 38.8% (p = 0.002). The main reason produced by most mothers who ceased to exclusively breastfeed their babies is milk insufficiency. Conclusion: The postnatal nutritional education strategy based on the distribution of educational materials has considerably raised the number of women who exclusively breastfed their babies until the age of six months.
文摘Hypofractionated radiation therapy has proven effective on locoregional control and tolerance in the adjuvant treatment of breast cancer. The aim of this study is to compare the results of hypofractionated radiation therapy versus conventional radiation therapy in terms of local control and tolerance. It was a retrospective study of patients observations collected from January 2007 to December 2008 in Department of Radiation Therapy in Institut National d’Oncologie de Rabat. The treatment results were evaluated by the rate of locoregional recurrence, distant recurrence and research of late toxicities. Radiotherapy was delivered using the same technique in both groups, by gamma photons of cobalt 60 with an energy of 1.25 MeV. They were 2 groups: the first group treated with standard dose rate and the second group treated by hypofractionated radiation therapy. The mean age of the patients was 42.8 ± 6.9 years old in the standard group and 43.22 ± 7.2 years old in the hypofractionation group. We noted a predominance of infiltrating ductal carcinoma. The majority of patients were pT<sub>2</sub>, pN<sub>0</sub> and pN<sub>1</sub>.<sub> </sub>The majority of patients had radical surgery and chemotherapy with anthracyclines in both groups. We noted a statistically significant difference in the irradiation of chest wall between the standard (89.2%) and hypofractionated group (70.3%), with p = 0.043. The median duration of radiation therapy was statistically different in both groups: 39 days in the standard and 23 days in the hypofractionated group (p 0.001). The local recurrences were statistically identical to 12 and 24 months (p = 0.999). Concerning toxicities, the frequency of adverse event was similar in both groups. Hypofractionated radiation therapy with a total dose of 42 Gy at 2.8 Gy per fraction in 5 fractions weekly is comparable to standard radiotherapy in terms of local control and tolerance and is therefore a very good alternative to standard treatment.
文摘Risk of infection by hepatitis B (HBV) and C (HCV) viruses remains a permanent problem, not only for health care workers but also for patients. It is often a major public health concern in low incomes countries. The aims of this study were to determine seroprevalence of viral hepatitis B (HBV) and C (HCV), frequency occurrence of blood exposure accidents (BEA) and identify key risk factors for infection among 601 health care workers of Ibn Sina Hospital in Rabat. In this study nineteen health personnel (3.16%) were HBsAg positive and fifteen (2.50%) were anti-HCV antibodies positive. The seropositivity to hepatitis B and C in the surgical department respectively was 4.22% and 3.45%. Nurses were the most affected by hepatitis virus infections. We noticed that HCV came first with a prevalence of 4.44%. The seropositivity reached its acme within the health staff having practiced for more than 20 years, hepatitis C coming first with a prevalence of 4.27%. Globally, 34 health care personnel are positive for HBV or HCV, 32 among them were victims at least once of blood exposure accident (BEA) while practicing. The needlestick represented 81.25% of the BEA type. Prevalence of hepatitis B and C serologic markers in health care workers in our Hospital outnumbered that of the general population. Nurses, surgery department personnel and the professional having worked for a long time were the main factors behind the high risks of infections.
文摘Carbon monoxide （CO） intoxication is one of the most common types of poisoning in the modem world. To better tailor messages and communication needs to the public, a perception survey of CO and his risk was conducted among the population of Rabat-Sale-Zemmour-Zaer. The authors included 400 people in this survey. The demographic characteristics of the respondents consisted of： 85.0% female, 92.9% adults, 29.7% had a high level of education, 49.6% unemployed, 89.5% were home owners and 53.9% lived in apartments. Water heaters were present in the homes of 91.0% of respondents and 6.5% of them used gas. Gas was used as fuel in 45.4% of cases. For water heaters, 20.8% had an exhaust duct, 9.9% were serviced regularly and 47.5% were installed in a well ventilated area. Regarding the media, television was the medium that allowed 73.4% of the CO to know, regardless of age, sex and level of education among the 94.3% of who ever heard of this deadly gas before the survey.
文摘BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and cost.The most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation molecules.This open-label prospective study randomized 328 patients with confirmed H.pylori infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the H.pylori eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath test.RESULTS In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)respectively.However,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),respectively.The overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three groups.CONCLUSION The optimized 14-d sequential therapy is a safe and effective alternative.Its eradication rate is comparable to that of the 14-d concomitant therapy while causing fewer AEs and allowing a gain in terms of cost.
文摘Upper mantle earthquakes are usually associated with plate boundary tectonics, but rarely occur beneath intracontinental orogenic belts. In the Moroccan Atlas Mountains, earthquakes determined at subcrustal depths are a controversial topic because they are few in number compared to subduction zones and are not related to plate boundary tectonics. A recent increase of broadband stations in Morocco has revealed numerous events below the Atlas belts, thought to occur from the upper mantle. Using additional available stations, these Atlas events were relocated and new epicenter resolutions were acquired following rigorous depth and RMS error criteria. 309 events were reprocessed and epicenter depths obtained were between 31 and 240 km during the last 23 years. Temporal variations of High Atlas events appear to be continually dipping while Anti Atlas events show no temporal variation trends. In addition, a recent strong event M6.8 occurred in September 2023 at the transition crust-uppermost mantle followed by several aftershocks which have been relocated at uppermost mantle depths. These events support delamination model under the High-Middle Atlas which could flow southward beneath the Anti Atlas lithosphere, and explain the large variation observed in lithosphere thickness between the High-Middle Atlas, and the Anti Atlas. Subcrustal events beneath the Atlas may be related to upper mantle earthquakes beneath the neighboring Canary Islands which have experienced recent swarms and eruptions. This possible correlation cannot be excluded since descending and ascending material is necessary for a regional geodynamic balance.
文摘Recent studies have underscored the significance of the capillary fringe in hydrological and biochemical processes.Moreover,its role in shallow waters is expected to be considerable.Traditionally,the study of groundwater flow has centered on unsaturated-saturated zones,often overlooking the impact of the capillary fringe.In this study,we introduce a steady-state two-dimensional model that integrates the capillary fringe into a 2-D numerical solution.Our novel approach employs the potential form of the Richards equation,facilitating the determination of boundaries,pressures,and velocities across different ground surface zones.We utilized a two-dimensional Freefem++finite element model to compute the stationary solution.The validation of the model was conducted using experimental data.We employed the OFAT(One_Factor-At-Time)method to identify the most sensitive soil parameters and understand how changes in these parameters may affect the behavior and water dynamics of the capillary fringe.The results emphasize the role of hydraulic conductivity as a key parameter influencing capillary fringe shape and dynamics.Velocity values within the capillary fringe suggest the prevalence of horizontal flow.By variation of the water table level and the incoming flow q0,we have shown the correlation between water table elevation and the upper limit of the capillary fringe.
文摘This case report investigates the manifestation of cerebral amyloid angiopathy (CAA) through recurrent Transient Ischemic Attacks (TIAs) in an 82-year-old patient. Despite initial diagnostic complexities, cerebral angiography-MRI revealed features indicative of CAA. Symptomatic treatment resulted in improvement, but the patient later developed a fatal hematoma. The discussion navigates the intricate therapeutic landscape of repetitive TIAs in the elderly with cardiovascular risk factors, emphasizing the pivotal role of cerebral MRI and meticulous bleeding risk management. The conclusion stresses the importance of incorporating SWI sequences, specifically when suspecting a cardioembolic TIA, as a diagnostic measure to explore and exclude CAA in the differential diagnosis. This case report provides valuable insights into these challenges, highlighting the need to consider CAA in relevant cases.
文摘Introduction: Type 1 cardiorenal syndrome (CRS 1) is characterized by acute impairment of cardiac function leading to acute renal dysfunction. CRS1 is present in 25% of patients admitted for heart failure. The objective of our study is to analyze the epidemiological, clinical, therapeutic profile and the risk and prognostic factors of these patients. Materials and Methods: We identified 120 patients with cardiorenal syndrome (CRS) over a one-year period to determine the prevalence and risk factors for developing CRS 1. We analyzed the clinical, biological, and evolutionary profiles of patients with CRS 1 and determined the risk factors for the occurrence of acute kidney injury (AKI) as well as the mortality factors in these patients. Résultats: The average age of our patients with CRS1 is 58 ± 9 years, with a sex ratio of 1.4. The average eGFR of our patients is 35 ± 6.5 ml/min/1.73m2. Diabetes was found in 17% of our patients and hypertension in 14%. The etiology of cardiac impairment is predominantly acute coronary syndrome (ACS), followed by rhythm disorders. Renally, all our patients have acute kidney injury (AKI), with 86% having functional acute renal failure and 14% having acute tubular necrosis. Therapeutically, 50% of our patients are on diuretics, 42% receive beta-blocker treatment, and RAAS blockers are used in 29% of cases. Renal replacement therapy (RRT) sessions were required in 13.8% of cases. In univariate analysis, male gender, tachyarrhythmia, and hypertension are associated with the early onset of acute kidney injury (AKI). The use of diuretics, anemia, and low left ventricular ejection fraction (LVEF) are linked to a higher risk of developing CRS 1 (p = 0.021, p = 0.037, p = 0.010 respectively). In multivariate analysis, advanced age is significantly associated with increased mortality risk in CRS 1 patients (p = 0.030), while beta-blocker use is considered a protective factor (p = 0.014). Conclusion: Our study identifies several key factors associated with outcomes in type 1 CRS. Male gender, tachyarrhythmia, and hypertension are linked to early-onset AKI. The use of diuretics and the presence of anemia increase the risk of developing CRS1. Advanced age is significantly associated with higher mortality rates. Conversely, the use of beta-blockers appears to be protective in this patient population. .
基金supported by the National Key Research and Development Program of China(2017YFD0300202-2)the National Natural Science Foundation of China(31871567)the Young Scholar of Tang(2017)。
文摘In a study comparing grain filling and yield in a large-and a small-grain-size wheat cultivar under two planting patterns and two irrigation regimes,plastic-covered ridge and furrow planting with sprinkler irrigation increased grain filling and yield in both cultivars.The largest contributors to grain yield were an extended active grain-filling period in Shuangda 1 and an increased mean grain-filling rate in XN538.
基金supported by the Key Research and Development Program of Shaanxi(2021NY-083)the National Natural Science Foundation of China(31871567).
文摘Low temperatures during germination inhibit seed growth,lead to small and weak seedlings,and significantly reduce the wheat yield.Alleviating the adverse effects of low temperature on wheat seed germination is highly important for achieving high and stable wheat yields.In this study,Tongmai 6(insensitive)and Zhengmai 113(sensitive),which have different low-temperature sensitivities during germination were treated with low temperature during germination.The transcriptome,metabolome and physiological data revealed that low temperature decreased the germination rate,downregulated the expression of a large number of genes involved in regulating glycometabolism,and inhibited carbon,nitrogen(especially amino acids)and energy metabolism in the seeds.Arginine content increased at low temperature,and its increase in the low-temperature-tolerant variety was significantly greater than that in the sensitive variety.Arginine priming experiment showed that treatment with an appropriate concentration of arginine improved the seed germination rate.The conversion of starch to soluble sugar significantly increased under exogenous arginine conditions,the content of key metabolites in energy metabolism increased,and the utilization of ATP in the seeds increased.Taken together,arginine priming increased seed germination at low temperature by relieving inhibition of seed carbon and nitrogen metabolism and improving seed energy metabolism.
文摘Orthodontic treatment offers great advantages in improving facial and smile aesthetics, self-confidence and the function of the stomatognathic apparatus. The pursuit of these advantages makes use of orthodontic appliances that could be fixed or removable. However, it’s worth stating that these appliances interfere with tooth brushing, making it more difficult to brush teeth effectively. Orthodontics appliances therefore promote the accumulation of dental plaque, which results in both quantitative and qualitative changes in the oral microbiota, hence, exposing patients to several adverse effects such as White spot lesions, dental caries, periodontal pathologies and halitosis. For this reason, oral assessment of patients before, during and after treatment is necessary as well as oral hygiene instructions and motivation. Orthodontists therefore, should educate patients on oral and periodontal hygiene in order to control dental and periodontal complications. Prescriptions of plaque control materials adapted to each patient are done in order to optimize the final result and minimize unwanted complications.
文摘The Tarfaya-Laayoune-Boujdour basin is of great interest to oil exploration;on this aspect, there has been exploration by the Moroccan National Office of Hydrocarbons and Mining, which has shown indices of oil and/or gas recorded in most wells drilled in the Moroccan Atlantic margin. FD-1 well, object of this study, is one of these wells located in the offshore Tarfaya-Laayoune-Boujdour basin. A palynological examination of the processed samples revealed the existence of organic palynomorphs, well conserved and rich in dinoflagellate cysts. The latter are composed of worldwide marker taxa of high stratigraphic resolutions. Thus, the middle upper Albian (3408 - 3408.5 m) is determined by the presence of Cribroperidinium tensiftense, Tehamadinium coummia, Spiniferella cornuta, Chichaouadinium vestitum, Dinopterygium alatum and Litosphaeridium arundum. The upper Albian (3406.5 - 3408 m) is characterized by the FOs of marker taxa: Cyclonephelium chabaca, Cribroperidinium auctificum and Chichaouadinium vestitum. Lastly, the upper Albian-lower Cenomanian transition is defined between 3404 m and 3406.50 m, as suggested by the FOs of Chichaouadinium boydii, Dinopterygium tuberculatum, Sepispinula ancorifera, Litosphaeridium conispinum, Prolixosphaeridium conulum and Xenascus ceratioides.
