Biomedical subjects

Abdellah El Maghraoui

Publications and source records attributed to Abdellah El Maghraoui.

13 recordsLinked to original sources

PubMed2006

Body mass index and gynecological factors as determinants of bone mass in healthy Moroccan women.

UNLABELLED: Several studies have shown that low body mass index (BMI) is associated with low BMD and fractures. However, the results that have been published from studies on reproductive factors and BMD are extremely controversial, with some demonstrating a beneficial effect, while others show a detrimental impact of these factors on bone mass. OBJECTIVE: To study the influence of several gynecological factors (years since menopause (YSM), age at menarche and gynecological age or reproductive life) simultaneously with anthropometric factors as determinants of bone mineral density (BMD) in healthy women older than 40. METHODS: BMD was determined by dual energy X-ray absorptiometry (DXA) at the lumbar spine and femurs in women aged >40 randomly chosen from the population of Rabat with a cluster sampling method. RESULTS: Four hundred and twenty-two healthy women older than 40 years were included in the study. The mean age was 57.2 years (8.4) [40-79] and the mean number of parities was 4.42 (2.9) [0-14]. Osteoporosis according to the classification of WHO (T-score<or=-2.5) was observed in 133 women (32.2%). The increase in the number of parities was associated to a larger body mass index and a lower BMD as well in the hips and the lumbar spine after adjustment for age. The comparison of groups of patients according to the age at menarche, the age at menopause or the period of fertility did not highlight an association with BMD. BMD at the lumbar spine and the hips was correlated negatively with age, YSM and parity and positively with BMI. Multivariate analysis showed that the determinant of BMD are BMI (OR=0.88; 95% CI: 0.83-0.92), parity (OR=1.10; 1.01-1.56) and YSM (OR=1.06; 1.03-1.10). CONCLUSION: Bone loss in women older than 40 is a function of aging, parity and years since menopause; and there is a definite bone-protective effect of body mass weight. Further studies are required to evaluate the role of these parameters in the fracture risk.

Absorptiometry, Photon↗

PubMed2006

Bone mineral density of the spine and femur in healthy Moroccan women.

Bone mineral density (BMD) measurements using dual-energy X-ray absorptiometry (DXA) are widely used to diagnose osteoporosis and assess its severity. Previous studies show the necessity to establish reference data for bone mass measurements for each particular population. Such data are lacking for the Moroccan population. The aim of this study was to determine spine and femur BMD reference values for the Moroccan female population and to compare them with values from western and other Arab countries. A cross-sectional study of 569 Moroccan women, (randomly selected in the area of Rabat, the capital of Morocco, aged between 20 and 79 yr) was carried out to establish reference values of BMD. Measurements were taken at the lumbar spine and proximal femurs using DXA (Lunar Prodigy Vision, GE). The data were compared with published normative data taken by United States (U.S.), European, Kuwaiti, Lebanese, and Saudi women over 6 decades of age. The percentage of osteoporosis in postmenopausal women using our reference curve was compared to that observed when the other curves (US, European and Arab) implemented in the Lunar machine was used. Our results showed that the Moroccan women showed the expected decline in BMD at both sites with age after peaking at 20-29 years of age. Moroccan females have lower BMD at the spine than U.S., Europeans, and Kuwaitis (approximately 10-12% for patients older than 50 yr). The BMD values of the total femur in Moroccan females were close to western (European and American), and Kuwaitis, but higher than Lebanese and Saudis. Using our reference database, 37.9% of postmenopausal women had spine osteoporosis vs. 39.6% and 23.4% using US/European and Arabic Lunar reference values respectively. At the femurs, 6.7% had osteoporosis vs. 2.5% using the Arabic Lunar reference values. In conclusion, our study emphasizes the importance of using population-specific reference values for BMD measurements to avoid over or underdiagnosis of osteoporosis.

Absorptiometry, Photon↗

PubMed2006

Monitoring of dual-energy X-ray absorptiometry measurement in clinical practice.

Bone densitometry has become the "gold standard" in osteoporosis diagnosis and treatment evaluation. It has also become more and more common to perform a second dual-energy X-ray absorptiometry (DXA) measurement to monitor bone mineral density (BMD) status or the effect of therapeutic intervention. When a second measurement is performed on a patient, the clinician needs to distinguish between a true change in BMD and a random fluctuation related to variability in the measurement procedure. The reproducibility of DXA measurements is claimed to be good. Such variability is due to multiple causes, such as device errors, technician variability, patients' movements, and variation due to other unpredictable sources. The precision error is usually expressed as the coefficient of variation (CV). However, several other statistics to express reproducibility exist such as the smallest detectable difference (SDD) or the least significant change (LSC). The SDD represents a cut-off that can be measured in an individual and is usually considered more useful than the CV in clinical practice. Indeed, the use of the SDD is preferable to the use of the CV and LSC because of its independence from BMD level and its expression in absolute units (g/cm2). At each measurement center, the SDD must be calculated from in vivo reproducibility data. The choice of the optimum time and site for performing follow-up scans depends on the ratio of the expected BMD treatment effect to the precision of the measurements.

Absorptiometry, Photon↗

PubMed2005

Dramatical improvement of chemoresistant bone lymphoma with rituximab.

Non-Hodgkin's lymphoma of the bone is a very rare disease that accounts for approximately 5% of all extranodal non-Hodgkin's lymphomas and for 7-10% of primary bone tumours. We report the case of a 28-year-old man who, in June 2001, presented with a right humerus showing painful destructive lesions with pathological fractures. Biopsy revealed diffuse, large B-cell non-Hodgkin's lymphoma expressing CD20. The patient received six cycles of conventional chemotherapeutic regimen, including cyclophosphamide, doxorubicin, vincristine and prednisone, and VP-16 (etoposide), ifosfamide and mitoxantrone. His arm pain worsened, and x-rays demonstrated progressive disease. He began a trial of rituximab, 750 mg/week, for 4 weeks. There was improvement in pain after the first infusion. Radiographic studies conducted 3 months after rituximab therapy showed marked improvement in his humerus disease. MRI showed a decrease of tumour volume with residual minor signal abnormalities of the bone marrow. He had no evidence of recurrent lymphoma 24 months later.

Adult↗

PubMed2005

Bone metabolism in male patients with type 2 diabetes.

Few reports are available on bone turnover in type 2 diabetes. Impaired bone turnover in type 2 diabetes appears to result from decreased bone formation. Studies also suggest that poor glycaemic control in type 2 diabetes may contribute to osteopaenia. The aim of this study was to investigate biochemical markers of bone turnover in males with poorly controlled type 2 diabetes and look for correlations with glycaemic control and gonadal and hypophyseal hormonal axis. Consecutive male patients with poorly controlled type 2 diabetes and attending the internal medicine department during a period of 6 months were enrolled. The patients were receiving oral hypoglycaemic agents (metformin or sulphonylureas or both). None of the patients had any evidence of macroangiopathy, nephropathy or neuropathy. Only two patients had proliferative retinopathy. Serum osteocalcin, crosslaps (C-telopeptide, CTx), parathyroid hormone (PTH), testosterone, oestrogen, prolactin, follicle-stimulating hormone (FSH) and luteinising hormone (LH) were measured in 35 patients and 35 controls. The mean age of the study population was 53.7 (10.3) years (range: 50.2-57.3) and the mean disease duration was 8.6 (6.0) years (range: 6.5-10.7). No differences between patients and controls were observed in serum calcium, phosphorus, creatinine, albumin, PTH, CTx, oestrogen, testosterone, LH, FSH, prolactin and urinary calcium. Patients had lower serum levels of osteocalcin than controls with a significant statistical difference [15.3 (4.1) vs 18.3 (5.3), p=0.012]. There was a negative significant statistical correlation between CTx levels and HbA1c (r=-0.41, p< 0.05). Our study suggested that bone formation is altered in type 2 diabetes and that bone turnover is affected by glycaemic control status.

Biomarkers↗

PubMed2005

Pleuropulmonary involvement in ankylosing spondylitis.

Pleuropulmonary involvement was long described as an uncommon and late event in the course of ankylosing spondylitis (AS). This belief was based on studies that relied on symptoms and chest radiographs to evaluate the lungs. However, pleuropulmonary involvement in AS patients is usually asymptomatic, and the early lesions are undetectable on chest radiographs. Apical fibrosis, interstitial infiltrates, and pleural thickening were considered to be the main patterns. However, the introduction of high-resolution computed tomography (HRCT) has led to the description of many pulmonary abnormalities that are clinically silent and undetectable on plain radiographs. These abnormalities mainly affect the interstitium and have no influence on respiratory function, which is dependent on the severity of chest wall inflammation or ankylosis in recent-onset and established AS, respectively. Cytological and histological studies suggest that, in common with uveitis and aortic regurgitation, the structural lung changes shown by HRCT may be specific of AS.

Bronchoalveolar Lavage↗

PubMed2004

Bone turnover markers, anterior pituitary and gonadal hormones, and bone mass evaluation using quantitative computed tomography in ankylosing spondylitis.

The objective of this study was to determine bone mineral density (BMD) distribution in ankylosing spondylitis (AS) using quantitative computed tomography (QCT), to study bone turnover and anterior pituitary and gonadal hormonal axis in AS, and to look for correlations between BMD, bone remodeling markers and gonadal and anterior pituitary hormones. Forty-three male consecutive patients with AS were enrolled prospectively [mean (SD) age of 36.4 (11.3) years (range: 17-67) and mean disease duration of 6.8 (5.2) years (range: 0.4-19)]. Spine BMD was measured in all patients by QCT, and the results were compared to 29 male patients undergoing lumbar CT scan for sciatica. Bone turnover and anterior pituitary and gonadal axis were assessed in 29 patients, and the results were compared to 30 male healthy blood donors. The mean (SD) BMD was 127.7 mg/cm(3) (48.9) (range: 8.8-265.7) and 152.1 (25.3) (range: 34.2-190.4) in patients and controls, respectively (p = 0.018). Patients had lower serum levels of osteocalcin and higher levels of serum testosterone, luteinizing hormone (LH), and prolactin than controls with a significant statistical difference. There was a positive significant statistical correlation between BMD and chest expansion, Schober's test, C7-wall distance, and negative significant statistical correlation with age, disease duration, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI), and serum prolactin. No correlation was observed between bone turnover parameters and AS symptomatic and structural severity indexes. BMD is lower with increasing age and late and severe disease. Decreased bone formation with normal resorption and increased levels of serum prolactin may be involved in its pathophysiology.

Adolescent↗

PubMed2004

[Ankylosing spondylitis].

UNLABELLED: A FREQUENT AFFECTION: Ankylosing spondylitis is a chronic inflammatory rheumatism usually affecting young adults and characterized by an inflammatory enthesiopathy progressing towards ossification and ankylosis. It is ranked in second position of chronic inflammatory rheumatism, after rheumatoid arthritis. IMPROVING ITS EVOLUTION: Early diagnosis and adapted therapy would contribute in improving its prognosis and avoid the evolution to severe forms of the disease. RECENT PROGRESS: The recent advances in this disease are the enhanced knowledge of its physiopathology and the development of efficient drugs (anti-TNFalpha).

Acquired Hyperostosis Syndrome↗

PubMed2004

[Corticosteroid-induced osteoporosis].

A FREQUENT PRESCRIPTION: Corticosteroids are widely prescribed in the long-term treatment of various pathologies (chronic inflammatory rheumatic diseases, asthma and allergic diseases, auto-immune diseases...). CONSEQUENCE OF BONE LOSS: Corticosteroids can be responsible for side effects such as corticosteroid-induced osteoporosis and the increase in risk of fracture is one of the major problems. Great progress in the field of epidemiology, diagnosis, physiopathology and treatment has led to the elaboration of rational and efficient care of patients receiving corticosteroids.

Adrenal Cortex Hormones↗

PubMed2004

Epidemiology of hip fractures in 2002 in Rabat, Morocco.

Hip fracture has never been studied before, either in Morocco or in the adjacent countries of the south bank of the Mediterranean Sea. The aim of this study was to investigate the incidence rate of hip fracture in 2002 in Rabat Province, a large area in the northwest of The Kingdom of Morocco, by the use of register information and medical records collected from the five public hospitals of the region. The hip fracture data were restricted to cervical or trochanteric types. There was a total of 150 hip fractures (83 in women and 67 in men) in the over-50-year-old population in the Province of Rabat during 2002. The age-adjusted 1-year cumulative incidence of hip fracture was 52.1/100,000 [95% confidence interval (CI) 40.9-63.3/100,000] in women and 43.7/100,000 (95% CI 33.3-52.2/100,000) in men. The standardized incidence rate against the 1985 US population was 80.7/100,000 (95% CI 78.5-93.0/100,000) for women and 58.5/100,000 (95% CI 47.9-68.1/100,000) for men. The mean (standard deviation) age of patients with a hip fracture was 70.7 (9.4) years for women and 70.4 (10.0) years for men. The overall female-to-male ratio of hip fracture was 1.19 for age-adjusted hip fracture incidence and 1.30 for standardized incidence. A marked increase in incidence rate was found for both men and women with increasing age, becoming exponential after the age of 50 years. The mean age for hip fracture was 70.7 (9.4) years in women and 70.4 (10.0) years in men (P > 0.05). Women had a cervical-to-trochanteric ratio of 0.97 compared to men, at 1.03. The characteristics of hip fractures described in this study suggest that fragility fractures occur in North Africa, although substantially less frequently than in most European, North American and Asian countries but more frequently than sub-Saharan African countries, in agreement with the north-south gradient observed in the epidemiology of osteoporosis. The low incidence of hip fragility fracture rate is most likely the result of reduced longevity in Morocco.

Age Distribution↗

PubMed2004

Lung findings on thoracic high-resolution computed tomography in patients with ankylosing spondylitis. Correlations with disease duration, clinical findings and pulmonary function testing.

The aim of this study was to identify the spectrum of abnormalities revealed on high-resolution computerized tomography (HRCT) in patients with ankylosing spondylitis (AS), to compare findings with those of plain radiography and pulmonary function testing (PFT), and to look for correlations between lung involvement and AS severity. We prospectively studied 55 consecutive patients with a diagnosis of AS according to the modified New York criteria who attended our department over a period of 2 years. All patients had a detailed rheumatological examination and underwent plain chest radiography, chest HRCT and PFT. HRCT revealed abnormalities in 29 patients (52.7%), whereas plain chest radiography was abnormal in only 2. Abnormalities consisted of interstitial lung disease (ILD) ( n=4), apical fibrosis ( n=5), emphysema ( n=5), bronchiectasis ( n=4), ground glass attenuation ( n=2), and non-specific interstitial abnormalities ( n=26). Only apical fibrosis and bronchiectasis were statistically more frequent with increasing disease duration (significant trend chi(2)test, p=0.0029 and 0.028, respectively). PFT showed a restrictive process in 19 patients (34.5%). No correlation was noted between HRCT and PFT, nor with AS symptomatic and structural severity parameters. However, there was a statistically significant correlation between PFT and AS symptomatic and structural severity parameters. In conclusion,: this study confirms that the chest HRCT of patients with AS showed a great number of abnormalities undetectable by standard X-rays. The high incidence of lung abnormalities emphasizes the importance of excluding such a diagnosis in patients with AS even without respiratory symptoms.

Adolescent↗

PubMed2004

Osteoporosis and ankylosing spondylitis.

Ankylosing spondylitis is a chronic inflammatory joint disease in which inflammation of the entheses gradually causes local ossification and ankylosis. Diffuse osteoporosis responsible for bone fragility is another feature established by recent data. The bone loss predominates at the spine and can cause vertebral fractures that are rare but nonnegligible sources of mortality and morbidity late in the course of the disease.

Bone Density↗

PubMed2002

[Sarcoidosis and ankylosing spondylitis. A case report and review of the literature].

UNLABELLED: Ankylosing spondylitis is a very uncommon finding in patients with sarcoidosis. Thirteen cases have been reported in the literature. We report a new case. Observation. - A 40-year-old man had inflammatory low back pain since 1983 which formerly responded to nonsteroidal inflammatory drugs (NSAIDs). He developed dyspnea and skin rash in 1993. Physical exam found cervical and lumbar spine stiffness and violaceous and circular lesions on the forehead, nose and right cheek. Laboratory tests showed: ESR at 50 mm, increased serum angiotensin-1-converting enzyme, and negative HLA B27. X-rays showed sacroiliac ankylosis, cervical and lumbar syndesmophytes and cervical facet joint ankylosis. The plain chest x-ray showed an interstitial syndrome. Chest CT scan showed mediastinal adenopathies. Skin biopsy disclosed non-caseating epitheliod and giant-cell granuloma. Outcome was good with steroid therapy but back pain was only improved by NSAIDs. DISCUSSION: - This association raises a diagnostical problem because spine involvement in sarcoidosis can mimic ankylosing spondylitis. It also suggests the hypothesis of a pathophysiological link between the two diseases.

Adult↗