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Biomedical subjects

H Afif

Publications and source records attributed to H Afif.

At least 19 recordsLinked to original sources
PubMed2006

[Disseminated erythematous lupus with bilateral diaphragmatic involvement].

The diaphragm is an unusual localization for disseminated erythematous lupus and is generally not recognized. We present the case of a 34-year-old woman who developed bilateral pain in the base of the thorax 15 days before hospitalization without any bronchial signs and NYHA stage II dyspnea. The patient's general health status remained satisfactory and the physical examination was normal except for diffuse inflammatory joint pain and cutaneous photosensitivization. The chest x-ray disclosed ascension of both hemidiaphragms with retracted lungs associated with bilateral basal atalectasia. The diagnosis of lupus with diaphragmatic involvement was retained due to the clinical presentation with diffuse joint pain, photosensitization with facial erythema, pericardial effusion and elevated antinuclear antibody and lymphopenia (1 100/mm3). Lung function tests revealed a restrictive syndrome. Oral corticosteroids 1 mg/kg/d enabled clinical and functional improvement. In light of this observation we discuss the pathogenic mechanisms of this uncommon localization of lupus and the difficulty of establishing a sure diagnosis.

Adrenal Cortex Hormones↗
PubMed2006

Association of polymorphisms in the peroxisome proliferator-activated receptor gamma gene and osteoarthritis of the knee.

OBJECTIVES: To study the association between two common polymorphisms in the peroxisome proliferator-activated receptor gamma (PPARgamma) gene and susceptibility to, and severity of, osteoarthritis in a French-Canadian population. METHODS: Genomic DNA was obtained from 172 patients with osteoarthritis and 210 ethnically matched healthy controls. Genotyping for the polymorphisms in the PPARgamma gene (Pro12Ala and C1431T) was carried out using polymerase chain reaction-restriction fragment length polymorphism. The standard Kellgren-Lawrence grading score and the French version of the Western Ontario and McMaster Universities Osteoarthritis Index were used to assess the radiological and functional severity of the disease. Estimated haplotypes were generated using the expectation maximisation algorithm. Genotype and allele frequencies were analysed using the chi2 test. RESULTS: Genotype and allele frequencies for either polymorphism in the PPARgamma gene did not differ significantly between patients with osteoarthritis and controls. Moreover, no significant differences were observed after stratification of patients according to age at disease onset, radiological or functional severity. Similarly, haplotype analysis of both polymorphisms in the PPARgamma gene showed no association of any haplotype with susceptibility to, or severity of, osteoarthritis. CONCLUSION: These findings suggest that the examined polymorphisms in the PPARgamma gene do not contribute to susceptibility to, or severity of, osteoarthritis in the French-Canadian population.

Age of Onset↗
PubMed2006

Validation of the St. George's Respiratory Questionnaire in patients with COPD or asthma in Morocco.

SETTING: Chronic obstructive pulmonary disease (COPD) and asthma are a public health problem in Morocco. Their evaluation should be supplemented by quality of life measurement, but there is no specific instrument available in local Moroccan Arabic. OBJECTIVE: To validate a Moroccan Arabic version of the St George's Respiratory Questionnaire (SGRQ) in patients with COPD or asthma in Morocco. DESIGN: After a rigorous translation process of the SGRQ into local Moroccan Arabic (SGRQm), the SGRQm, spirometry, Fletcher scale and a visual analogical scale (VAS) were administered to each patient at recruitment. Data were used to examine the construct validity and reliability of the SGRQm. To examine the test-retest reliability, patients completed the SGRQm a second time 10 days later. RESULTS: A total of 131 patients with a mean age of 52 years were recruited into the study. Patients had a mean forced expiratory volume in one second (FEV1) of 1.70 1 and a mean VAS of 51.5 mm. Internal consistency of symptoms, activity and impact components was assessed using Cronbach's alpha (a) reliability coefficient; they were 0.94, 0.91 and 0.90, respectively. The test-retest reliability of components scores ranged from 0.70 to 0.87. The Fletcher scale correlated with all SGRQm scores, while the VAS had a similar correlation except with symptoms (P > 0.05). FEV1 values were negatively correlated with all SGRQm scores. CONCLUSION: The SGRQm yielded satisfactory psychometric properties.

Adolescent↗
PubMed2005

[Hypoglycemic coma revealing a solitary fibrous tumor of the pleura].

INTRODUCTION: Solitary fibrous tumor of the pleura (TFSP) is rare. When associated with hypoglycemia it is commonly referred to as Doege-Potter syndrome. CASE: A 51-year-old man was hospitalized for recurrent near-syncope associated with hypoglycemia. Clinical examination and then thoracic imaging clearly showed anomalies that corresponded to a mass occupying the entire left hemithorax. After resection, histological analysis diagnosed a fibrous tumor of the pleura. DISCUSSION: Solitary fibrous tumors of the pleura are observed most often in patients aged 50 and 70 years. Hypoglycemia is rare, occurring in approximately 4% of cases. It is explained by the abnormal secretion of a type-II insulin-like growth factor. This tumor is treated by complete surgical excision.

Coma↗
PubMed2004

[Pleural fibroma revealed by hypoglycemia].

Pleural fibroma or solitary fibrous tumor of the pleura (SFTP) is a rare tumor generally discovered fortuitously or in patients with non-specific respiratory symptoms, more rarely with hypoglycemia. We report the case of a 51-year-old man with a history of smoking (30 pack-years) and no other disease history whose chest x-ray revealed an enormous opacity occupying the lower two-thirds of the left hemithorax. This radiological anomaly had led to episodes of lipothymia three months earlier together with mental confusion in the morning as well as an episode of hypoglycemia (0.48 g/l) which rapidly resolved after administration of hypertonic dextrose. Ultrasonography and chest scan were performed later and confirmed the tissular nature of the opacity which was well limited with a left base. Minimally abundant homolateral pleural effusion was also noted. The diagnosis of SFTP revealed by hypoglycyemia was the most probably diagnosis. Emergency thoracotomy enabled removal of a hard tumor weighing 2115 g. Histology confirmed the diagnosis of benign SFTP. Hypoglycemia in the context of SFTP would be related to tumor secretion of insulin-like proteins. Complete emergency resection is required to avoid the risk of life-threatening hypoglycemia.

Fibroma↗
PubMed2003

[A rare and benign etiology of Pancoast-Tobias syndrome].

Although lung cancer is the leading cause of Pancoast-Tobias syndrome, benign etiologies have been rarely described in the literature. We report two cases of Pancoast-Tobias syndrome caused by hydatidosis of the apex. Outcome was favorable after surgical treatment.

Echinococcosis↗
PubMed2001

The ratio between CcdA and CcdB modulates the transcriptional repression of the ccd poison-antidote system.

The ccd operon of the F plasmid encodes CcdB, a toxin targeting the essential gyrase of Escherichia coli, and CcdA, the unstable antidote that interacts with CcdB to neutralize its toxicity. Although work from our group and others has established that CcdA and CcdB are required for transcriptional repression of the operon, the underlying mechanism remains unclear. The results presented here indicate that, although CcdA is the DNA-binding element of the CcdA-CcdB complex, the stoichiometry of the two proteins determines whether or not the complex binds to the ccd operator-promoter region. Using electrophoretic mobility shift assays, we show that a (CcdA)2-(CcdB)2 complex binds DNA. The addition of extra CcdB to that protein-DNA complex completely abolishes DNA retardation. Based on these results, we propose a model in which the ratio between CcdA and CcdB regulates the repression state of the ccd operon. When the level of CcdA is superior or equal to that of CcdB, repression results. In contrast, derepression occurs when CcdB is in excess of CcdA. By ensuring an antidote-toxin ratio greater than one, this mechanism could prevent the harmful effect of CcdB in plasmid-containing bacteria.

Bacterial Proteins↗
PubMed2001

[Parietal thoracic tuberculosis in the absence of immunosuppression by HIV infection].

Parietal thoracic abscess formation of a tuberculous nature is a rare form of extrapulmonary tuberculosis, usually described in cases of severe tuberculosis encountered in HIV-infected patients. We report 13 cases of parietal tuberculosis in patients without HIV infection who were investigated between October 1988 and December 1999. During this period, we cared for 2 663 patients with tuberculosis. The series included 9 women and 4 men age 17 to 60 years, mean age 39 years. The clinical aspect of the parietal abscess was variable. Cold fluctuating abscess was dominant in 10 cases. In 3 cases, the parietal abscess had a hard consistence simulating a malignant tumor. The parietal abscess was in a posteriosuperior or posteriobasal location in 4 cases, and in an anterosuperior, anterobasal or axillary location in 6. Multiple thoracic abscesses were observed in only 3 cases. The size of the abscess varied from 2 to 2.5 cm. Radiologically, rib damage was present in 4 cases, scapular damage in 1, with bone lysis in 3 cases. Other localizations of tuberculosis were observed in 4 cases. one patient had multiple peripheral node enlargement, another had parenchymal lung damage and a third had a vertebral localization. Culture of abscess pus provided the diagnosis in 10 cases. the diagnosis was confirmed by pathology in 8 cases on a biopsy of the abscess border. Anti-tuberculosis drugs allowed successful recovery in all patients. We analyzed the clinical aspects of cold thoracic abscesses and discuss differential diagnosis. Early diagnosis and treatment is essential.

Abscess↗
PubMed2001

[Serous fibrinous pleurisy disclosing hydatid cyst of the liver fistulizing into the pleura].

Hydatic cyst of the liver remains a serious public health problem in Morocco and several other Mediterranean countries. This benign affection can cause serious sometimes fatal complications such as cyst rupture into the biliary ducts or the thorax. We present the case of a patient with serofibrous pleurisy and recall the often late diagnosis of hydatic cyst. Biliary pleural fistulization is a rare but serious complication.

Adult↗
PubMed2000

[Multiple pulmonary hydatidosis with floating balloon appearance and cardiac localization].

Multiple hydatidosis in a thoracic localization is unusual and a cardiac localization very exceptional. We report a case of multiple hydatidosis greatly improved by medical treatment with albendazole which was associated with a cardiac cyst successfully treated by surgical resection. No recurrence has been observed at 4 year follow-p. We point out therapeutic management options in these unusual forms of the disease.

Adult↗
PubMed1999

[Unusual diagnosis of cavitating pulmonary opacity].

The authors reported a case of Hodgkin disease with excavated lung localisation discovered during a systematic detection in the occupational medicine framework. This observation raised the differential diagnosis problems mainly with tuberculosis in endemic countries.

Adult↗
PubMed1997

Outbreak of poliomyelitis in Gizan, Saudi Arabia: cocirculation of wild type 1 polioviruses from three separate origins.

In 1989, a localized outbreak of 10 cases of poliomyelitis occurred in Saudi Arabia. Wild poliovirus type 1 was isolated from 5 patients. To determine the patterns of poliovirus circulation, partial nucleotide sequences of the poliovirus isolates were compared. These isolates were remarkably diverse. Two isolates were closely related to each other and to viruses isolated during the 1988 epidemic in Oman. Two other isolates were very similar to viruses found in Egypt. The fifth isolate was distantly related to the latter pair. The molecular data suggest that the 10 cases represented three separate outbreaks. The virologic findings underscore the potential for Saudi Arabia, which receives millions of guest workers and their families each year from countries in which polio is endemic, to be exposed to frequent importations of wild polioviruses. To restrict the circulation of imported polioviruses, Saudi Arabia must maintain high population immunity to poliovirus in all geopolitical divisions.

Child↗