Objectifs Le but de notre travail est de discuter les modalites diagnostiques de cette complicati... more Objectifs Le but de notre travail est de discuter les modalites diagnostiques de cette complication rare de la maladie hydatique. Materiels et methodes Un patient de 49 ans, agriculteur, presente depuis 3 mois une symptomatologie faite de dyspnee stade II-III de la NYHA, claudication intermittente, dorsalgies et epigastralgies sans vomissements ni hematemeses. Une radiographie thoracique, une echographie abdominale et une angio-IRM ont ete realisees. Resultats La radiographie thoracique montre un elargissement du mediastin moyen et inferieur, l’echographie abdominale revele une masse kystique, multivesiculaire retroperitoneale, dont l’origine vertebrale est fort probable (D10-D11). L’angio-IRM conclut a un kyste hydatique mediastinal posterieur multivesiculaire de topographie para-vertebrale droite responsable d’une lyse de l’hemicorps droit de D10 sans compression medullaire et met en evidence un anevrysme de la face posterieure de l’aorte descendante avec un collet de 14 mm situe a 11 cm de la crosse aortique. Conclusion La maladie hydatique est causee par le parasite Ecchinococcus granulosus dans sa phase larvaire et constitue un reel probleme de sante publique dans les pays du pourtour mediterraneen. La localisation aortique reste exceptionnelle. L’apport de la TDM, ou mieux de l’IRM, est necessaire mais doit etre couple aux donnees epidemiologiques et biologiques pour porter le diagnostic. Le traitement est chirurgical.
Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible fo... more Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19), is behind the current pandemic. At the start of the pandemic, gastrointestinal symptoms initially described as rare were reported, but their spread to other countries increased rapidly. This study aimed to determine the prevalence of digestive symptoms among COVID-19 patients and to assess the correlation between these symptoms and disease severity. Methods This retrospective observational study was conducted in the Cheikh Khalifa University Hospital of Casablanca, Morocco. Patients were divided into two groups based on the presence or absence of gastrointestinal symptoms upon initial assessment and hospital admission. Results A total of 154 patients were included in this study from March 21 to April 26, 2020. The mean age of patients was about 48.5 (± 20.0) years, and 85 (55.2%) of them were men. In our population, 8.17% of patients had toxic habits. Digestive symptoms were present at admission in 30% of our patients. The most frequent digestive symptoms were diarrhea (15%), abdominal pain (5.6%), vomiting (5%), and anorexia (3.1%). We found a significant difference in COVID-19 patients with digestive symptoms and toxic habits contrary to all other comorbidities. Neurologic symptoms were significantly associated (p=0,004) with digestive symptoms in 50%. Conclusion In this study, we found that digestive symptoms were present in 22.64% of patients diagnosed with COVID-9. The clinician must know the different digestive symptoms to evoke the diagnosis and take charge of the patient early.
Bradycardia is rare in children and may be asymptomatic or cause fatigue or discomfort leading to... more Bradycardia is rare in children and may be asymptomatic or cause fatigue or discomfort leading to syncope. It may be a warning sign of underlying pathology. A check-up for a cardiac or extra-cardiac organic cause should be performed. We report the case of an 8-year-old child admitted to the emergency room for bradycardia with a sino-atrial block that caused syncope. The assessment has objectified a brain tumor. We will discuss the different mechanisms that can explain the occurrence of bradycardia during a brain tumor, and the specificities of the management.
Background Coronavirus disease 2019 (COVID-19), poses a threat to the global public health. Early... more Background Coronavirus disease 2019 (COVID-19), poses a threat to the global public health. Early identification of critical cases is crucial to providing timely treatment to patients. Here, we investigated whether white immune cell levels could predict respiratory decline, complications and mortality. Methods We performed a retrospective study including 119 patients presenting with COVID-19. We divided our cohort into two categories, using two different classifications. Comparison tests, prediction analysis and the logistic regression analysis were used in this study. Results The study revealed that a rise in neutrophils levels was associated with respiratory deterioration and intubation. In contrast, neutrophils levels plateaued in patients who remained stable. Neutrophils levels, during the first 5 days of hospitalization, positively correlated with the procalcitonin and C-reactive protein levels. Interestingly, neutrophils levels at day 5 proved to be a better predictor of intub...
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and public health crisis across the... more Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and public health crisis across the world. The severity of this situation is escalating in certain populations, particularly when the COVID-19 diagnosis may delay the recognition of more dramatic illnesses such as infective endocarditis, which is a dreaded complication in patients with cardiac disease. We report the case of two patients who presented with infective endocarditis initially mistaken for COVID-19 pneumonia, which was responsible for a delay in diagnosis. We discuss the diagnostic difficulties as well as the management of this complication in the COVID-19 era. As a physician, one must remain alert to this dreaded complication, especially in patients with a cardiac history, in order to prevent it, detect it early, and manage it in time.
Patients with acute respiratory distress syndrome due to infection with the novel coronavirus SAR... more Patients with acute respiratory distress syndrome due to infection with the novel coronavirus SARS-COV2 are currently considered at high risk of developing thromboembolic complications in both venous and arterial vessels. The use of anticoagulants for preventive or curative purposes should be considered to reduce the risk of thromboembolic events. We report a case of a patient with severe COVID-19 acute respiratory distress syndrome who consecutively developed a right femoral deep vein thrombosis related to the femoral central line and acute ischemia of the left upper limb related to a radial arterial line. He was under a therapeutic dose of low molecular weight heparin twice a day three days before. The femoral vein was free of thrombosis while the central line was placed under a duplex ultrasound.Thromboembolic events can occur in patients with severe COVID-19 despite therapeutic anticoagulants. Close monitoring of vascular access with duplex ultrasound may be required.
Since December 2019, the coronavirus disease (COVID-19) pandemic has catapulted the world into a ... more Since December 2019, the coronavirus disease (COVID-19) pandemic has catapulted the world into a marked health crisis, with over 29 million cases and >930,000 deaths. To better detect affected individuals at an early stage and stop disease progression to an advanced stage, several studies have been conducted to identify the clinical, biological, and radiological characteristics of COVID-19. This study aimed to enrich the literature by critically analyzing the clinical and biological characteristics of 134 patients from the North African Mediterranean region, including numerous genetic, epigenetic, and environmental factors that may influence disease evolution. This single-center retrospective study included all patients older than 18 years confirmed to have COVID-19 and hospitalized at the Cheikh Khalifa University Hospital affiliated with Mohammed VI University of Health Sciences, Casablanca, Morocco. Clinical, demographic, and biological data were analyzed in a cohort of severe...
Background: The aim of this study was to evaluate the impact of additional coronary revasculariza... more Background: The aim of this study was to evaluate the impact of additional coronary revascularization on the early results in patients submitted to valve surgery. Patients and Methods: A retrospective review of the cardiac surgical database between January 2000 and December 2018 was performed. A total of 1667 patients were included and divided into two groups: Group A isolated valve surgery (IVS n = 1608) and Group B with valve surgery combined to coronary artery bypass grafting (VS + CABG n = 59). Demographic, operative data and postoperative outcomes were compared between groups. Results: Patients with combined procedure were older than patients who underwent isolated valvular surgery (64.9 ± 9.2 years vs 44.4 ± 13.1 years; p = 0.0001) and there was a higher proportion of diabetics (40.7% vs 6.6%; p = 0.0001). The 30 days mortality rate in the combined procedure group was 18.6% versus 6.2% in isolated valve surgery (p = 0.001). Also post-operative complications were more frequent than for patients who underwent IVS. Additionally we noted a high prevalence of coronary artery risk factors in patients with combined procedures. Conclusion: Surgical mortality and morbidity of coexisting coronary and heart valve disease were substantially higher than IVS. More efforts in medical management may reduce the incidence of adverse outcomes.
Acta Crystallographica Section E Structure Reports Online, 2011
m1292 Yang et al. [Cu(C 4 H 5 NO 4)(C 6 H 6 N 2 O)(H 2 O)] Acta Cryst. (2011). E67, m1291-m1292 s... more m1292 Yang et al. [Cu(C 4 H 5 NO 4)(C 6 H 6 N 2 O)(H 2 O)] Acta Cryst. (2011). E67, m1291-m1292 supplementary materials supplementary materials sup-1
Background Morocco was affected, as were other countries, by the coronavirus disease 2019 (COVID-... more Background Morocco was affected, as were other countries, by the coronavirus disease 2019 (COVID-19) pandemic. Many risk factors of COVID-19 severity have been described, but data on infected patients in North Africa are limited. We aimed to explore the predictive factors of disease severity in COVID-19 patients in a tertiary hospital in Casablanca. Methods In this single-center, retrospective, observational study, we included all adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, admitted to Sheikh Khalifa International University Hospital in Casablanca between March 18 and May 20, 2020. Patients were separated into two groups: Non-severe patients were those with mild or moderate forms of COVID-19, and severe patients were those admitted to the intensive care unit (ICU) who had one of the following signs-respiratory rate > 30 breaths/min; oxygen saturation < 93% on room air; acute respiratory distress syndrome (ARDS); or required mechanical ventilation. Demographic, clinical, laboratory data, and outcomes were reviewed. We used univariable and multivariable logistic regression to explore predictive factors of severity. Results We reported 134 patients with confirmed SARS-CoV-2 infection. The median age was 53 years (interquartile range [IQR], 36-64), and 73 (54.5%) were men. Eighty-nine non-severe patients (66.4%) were admitted to single bedrooms, and 45 (33.6%) were placed in the ICU. The median time from illness onset to hospital admission was seven days (IQR, 3.0-7.2). Ninety-nine patients (74%) were admitted directly to the hospital, and 35 (26%) were transferred from other structures. Also, 68 patients (65.4%) were infected in clusters. Of the 134 patients, 61 (45.5%) had comorbidities, such as hypertension (n = 36; 26.9%), diabetes (n = 19; 14.2%), and coronary heart disease (n = 16; 11.9%). The most frequent symptoms were fever (n = 61; 45.5%), dry cough (n = 59; 44%), and dyspnea (n = 39; 29%). A total of 127 patients received hydroxychloroquine and azithromycin (95%). Eleven critical cases received lopinavir/ritonavir (8.2%). Five patients received tocilizumab (3.7%). We reported 13 ARDS cases in ICU patients (29%), eight with acute kidney injury (17.8%), and four thromboembolic events (8.8%). Fourteen ICU patients (31.1%) died at 28 days. In univariable analysis, older men with one or more comorbidities, infection in a cluster, chest scan with the COVID-19 Reporting and Data System (CO-RADS) 5, lymphopenia, high rates of ferritin, C-reactive protein (CRP), D-dimer, and lactate dehydrogenase were associated with severe forms of COVID-19. Multivariable logistic regression model founded increasing odds of severity associated with older age (odds ratio [OR] 1.05, 95% confidence interval [
Objectifs Le but de notre travail est de discuter les modalites diagnostiques de cette complicati... more Objectifs Le but de notre travail est de discuter les modalites diagnostiques de cette complication rare de la maladie hydatique. Materiels et methodes Un patient de 49 ans, agriculteur, presente depuis 3 mois une symptomatologie faite de dyspnee stade II-III de la NYHA, claudication intermittente, dorsalgies et epigastralgies sans vomissements ni hematemeses. Une radiographie thoracique, une echographie abdominale et une angio-IRM ont ete realisees. Resultats La radiographie thoracique montre un elargissement du mediastin moyen et inferieur, l’echographie abdominale revele une masse kystique, multivesiculaire retroperitoneale, dont l’origine vertebrale est fort probable (D10-D11). L’angio-IRM conclut a un kyste hydatique mediastinal posterieur multivesiculaire de topographie para-vertebrale droite responsable d’une lyse de l’hemicorps droit de D10 sans compression medullaire et met en evidence un anevrysme de la face posterieure de l’aorte descendante avec un collet de 14 mm situe a 11 cm de la crosse aortique. Conclusion La maladie hydatique est causee par le parasite Ecchinococcus granulosus dans sa phase larvaire et constitue un reel probleme de sante publique dans les pays du pourtour mediterraneen. La localisation aortique reste exceptionnelle. L’apport de la TDM, ou mieux de l’IRM, est necessaire mais doit etre couple aux donnees epidemiologiques et biologiques pour porter le diagnostic. Le traitement est chirurgical.
Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible fo... more Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19), is behind the current pandemic. At the start of the pandemic, gastrointestinal symptoms initially described as rare were reported, but their spread to other countries increased rapidly. This study aimed to determine the prevalence of digestive symptoms among COVID-19 patients and to assess the correlation between these symptoms and disease severity. Methods This retrospective observational study was conducted in the Cheikh Khalifa University Hospital of Casablanca, Morocco. Patients were divided into two groups based on the presence or absence of gastrointestinal symptoms upon initial assessment and hospital admission. Results A total of 154 patients were included in this study from March 21 to April 26, 2020. The mean age of patients was about 48.5 (± 20.0) years, and 85 (55.2%) of them were men. In our population, 8.17% of patients had toxic habits. Digestive symptoms were present at admission in 30% of our patients. The most frequent digestive symptoms were diarrhea (15%), abdominal pain (5.6%), vomiting (5%), and anorexia (3.1%). We found a significant difference in COVID-19 patients with digestive symptoms and toxic habits contrary to all other comorbidities. Neurologic symptoms were significantly associated (p=0,004) with digestive symptoms in 50%. Conclusion In this study, we found that digestive symptoms were present in 22.64% of patients diagnosed with COVID-9. The clinician must know the different digestive symptoms to evoke the diagnosis and take charge of the patient early.
Bradycardia is rare in children and may be asymptomatic or cause fatigue or discomfort leading to... more Bradycardia is rare in children and may be asymptomatic or cause fatigue or discomfort leading to syncope. It may be a warning sign of underlying pathology. A check-up for a cardiac or extra-cardiac organic cause should be performed. We report the case of an 8-year-old child admitted to the emergency room for bradycardia with a sino-atrial block that caused syncope. The assessment has objectified a brain tumor. We will discuss the different mechanisms that can explain the occurrence of bradycardia during a brain tumor, and the specificities of the management.
Background Coronavirus disease 2019 (COVID-19), poses a threat to the global public health. Early... more Background Coronavirus disease 2019 (COVID-19), poses a threat to the global public health. Early identification of critical cases is crucial to providing timely treatment to patients. Here, we investigated whether white immune cell levels could predict respiratory decline, complications and mortality. Methods We performed a retrospective study including 119 patients presenting with COVID-19. We divided our cohort into two categories, using two different classifications. Comparison tests, prediction analysis and the logistic regression analysis were used in this study. Results The study revealed that a rise in neutrophils levels was associated with respiratory deterioration and intubation. In contrast, neutrophils levels plateaued in patients who remained stable. Neutrophils levels, during the first 5 days of hospitalization, positively correlated with the procalcitonin and C-reactive protein levels. Interestingly, neutrophils levels at day 5 proved to be a better predictor of intub...
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and public health crisis across the... more Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and public health crisis across the world. The severity of this situation is escalating in certain populations, particularly when the COVID-19 diagnosis may delay the recognition of more dramatic illnesses such as infective endocarditis, which is a dreaded complication in patients with cardiac disease. We report the case of two patients who presented with infective endocarditis initially mistaken for COVID-19 pneumonia, which was responsible for a delay in diagnosis. We discuss the diagnostic difficulties as well as the management of this complication in the COVID-19 era. As a physician, one must remain alert to this dreaded complication, especially in patients with a cardiac history, in order to prevent it, detect it early, and manage it in time.
Patients with acute respiratory distress syndrome due to infection with the novel coronavirus SAR... more Patients with acute respiratory distress syndrome due to infection with the novel coronavirus SARS-COV2 are currently considered at high risk of developing thromboembolic complications in both venous and arterial vessels. The use of anticoagulants for preventive or curative purposes should be considered to reduce the risk of thromboembolic events. We report a case of a patient with severe COVID-19 acute respiratory distress syndrome who consecutively developed a right femoral deep vein thrombosis related to the femoral central line and acute ischemia of the left upper limb related to a radial arterial line. He was under a therapeutic dose of low molecular weight heparin twice a day three days before. The femoral vein was free of thrombosis while the central line was placed under a duplex ultrasound.Thromboembolic events can occur in patients with severe COVID-19 despite therapeutic anticoagulants. Close monitoring of vascular access with duplex ultrasound may be required.
Since December 2019, the coronavirus disease (COVID-19) pandemic has catapulted the world into a ... more Since December 2019, the coronavirus disease (COVID-19) pandemic has catapulted the world into a marked health crisis, with over 29 million cases and >930,000 deaths. To better detect affected individuals at an early stage and stop disease progression to an advanced stage, several studies have been conducted to identify the clinical, biological, and radiological characteristics of COVID-19. This study aimed to enrich the literature by critically analyzing the clinical and biological characteristics of 134 patients from the North African Mediterranean region, including numerous genetic, epigenetic, and environmental factors that may influence disease evolution. This single-center retrospective study included all patients older than 18 years confirmed to have COVID-19 and hospitalized at the Cheikh Khalifa University Hospital affiliated with Mohammed VI University of Health Sciences, Casablanca, Morocco. Clinical, demographic, and biological data were analyzed in a cohort of severe...
Background: The aim of this study was to evaluate the impact of additional coronary revasculariza... more Background: The aim of this study was to evaluate the impact of additional coronary revascularization on the early results in patients submitted to valve surgery. Patients and Methods: A retrospective review of the cardiac surgical database between January 2000 and December 2018 was performed. A total of 1667 patients were included and divided into two groups: Group A isolated valve surgery (IVS n = 1608) and Group B with valve surgery combined to coronary artery bypass grafting (VS + CABG n = 59). Demographic, operative data and postoperative outcomes were compared between groups. Results: Patients with combined procedure were older than patients who underwent isolated valvular surgery (64.9 ± 9.2 years vs 44.4 ± 13.1 years; p = 0.0001) and there was a higher proportion of diabetics (40.7% vs 6.6%; p = 0.0001). The 30 days mortality rate in the combined procedure group was 18.6% versus 6.2% in isolated valve surgery (p = 0.001). Also post-operative complications were more frequent than for patients who underwent IVS. Additionally we noted a high prevalence of coronary artery risk factors in patients with combined procedures. Conclusion: Surgical mortality and morbidity of coexisting coronary and heart valve disease were substantially higher than IVS. More efforts in medical management may reduce the incidence of adverse outcomes.
Acta Crystallographica Section E Structure Reports Online, 2011
m1292 Yang et al. [Cu(C 4 H 5 NO 4)(C 6 H 6 N 2 O)(H 2 O)] Acta Cryst. (2011). E67, m1291-m1292 s... more m1292 Yang et al. [Cu(C 4 H 5 NO 4)(C 6 H 6 N 2 O)(H 2 O)] Acta Cryst. (2011). E67, m1291-m1292 supplementary materials supplementary materials sup-1
Background Morocco was affected, as were other countries, by the coronavirus disease 2019 (COVID-... more Background Morocco was affected, as were other countries, by the coronavirus disease 2019 (COVID-19) pandemic. Many risk factors of COVID-19 severity have been described, but data on infected patients in North Africa are limited. We aimed to explore the predictive factors of disease severity in COVID-19 patients in a tertiary hospital in Casablanca. Methods In this single-center, retrospective, observational study, we included all adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, admitted to Sheikh Khalifa International University Hospital in Casablanca between March 18 and May 20, 2020. Patients were separated into two groups: Non-severe patients were those with mild or moderate forms of COVID-19, and severe patients were those admitted to the intensive care unit (ICU) who had one of the following signs-respiratory rate > 30 breaths/min; oxygen saturation < 93% on room air; acute respiratory distress syndrome (ARDS); or required mechanical ventilation. Demographic, clinical, laboratory data, and outcomes were reviewed. We used univariable and multivariable logistic regression to explore predictive factors of severity. Results We reported 134 patients with confirmed SARS-CoV-2 infection. The median age was 53 years (interquartile range [IQR], 36-64), and 73 (54.5%) were men. Eighty-nine non-severe patients (66.4%) were admitted to single bedrooms, and 45 (33.6%) were placed in the ICU. The median time from illness onset to hospital admission was seven days (IQR, 3.0-7.2). Ninety-nine patients (74%) were admitted directly to the hospital, and 35 (26%) were transferred from other structures. Also, 68 patients (65.4%) were infected in clusters. Of the 134 patients, 61 (45.5%) had comorbidities, such as hypertension (n = 36; 26.9%), diabetes (n = 19; 14.2%), and coronary heart disease (n = 16; 11.9%). The most frequent symptoms were fever (n = 61; 45.5%), dry cough (n = 59; 44%), and dyspnea (n = 39; 29%). A total of 127 patients received hydroxychloroquine and azithromycin (95%). Eleven critical cases received lopinavir/ritonavir (8.2%). Five patients received tocilizumab (3.7%). We reported 13 ARDS cases in ICU patients (29%), eight with acute kidney injury (17.8%), and four thromboembolic events (8.8%). Fourteen ICU patients (31.1%) died at 28 days. In univariable analysis, older men with one or more comorbidities, infection in a cluster, chest scan with the COVID-19 Reporting and Data System (CO-RADS) 5, lymphopenia, high rates of ferritin, C-reactive protein (CRP), D-dimer, and lactate dehydrogenase were associated with severe forms of COVID-19. Multivariable logistic regression model founded increasing odds of severity associated with older age (odds ratio [OR] 1.05, 95% confidence interval [
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