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Biomedical subjects

M Bartal

Publications and source records attributed to M Bartal.

At least 19 recordsLinked to original sources
PubMed2002

[Smoking in Casablanca hospitals: knowledge, attitudes and practices].

This cross sectional study took place with a self administered questionnaire between June and September 1999 and involved 1,388 subjects of whom 62.4% were men and 37.6% women. The total prevalence of smoking was 14.9%, ranging from 12.5% in paramedical staff to 15.5% in manual workers, 16.2% in doctors, 17.1% in laboratory staff, and 22.2% in administrators. The prevalence was 35.9% among men as against 2.2% among women. The study of smokers showed that 51.5% had started before the age of 21. The most common motive for starting smoking was "pleasure". Among the 45.5% who smoked at the workplace 60.5% felt concerned about it. Evaluation of the degree of nicotine dependence using the Fagerstrom score found high dependence in 21.3% of subjects. Only 24.5% of doctors warned patients against smoking in the absence of smoking related diseases or symptoms. In more than 75% of cases doctors advised against smoking in the workplace and in the home. 66.8% of staff were aware of the anti-smoking law but the legislative measures were poorly understood. Only 9% of those interviewed had taken part in an anti-smoking campaign. In conclusion, the prevalence of smoking in the hospitals of Casablanca has definitely diminished in the past 10 years but it remains relatively high in men. Hospital staff should be more involved in the fight against smoking.

Adolescent↗
PubMed2001

[Skin sensitization to pollens in Morocco. Multicenter study].

The objective of this study was to determine the prevalence of skin sensitization to certain pollens in some regions of Morocco. This multicentric study involving 10 centres included a consecutive series of 640 patients consulting for the first time between february and april 1998 for asthma and/or rhinitis and/or conjunctivitis. Skin prick tests (SPT) were performed with stallerpointes (Stallergenes) and interpreted according to standard procedures. Pollinosis was ascertained when SPT was positive to one or more pollens. Epi-Info was used to analyze the data. SPT were positive in 75.9% and prevalence of sensitization to pollens was equal to 28% (179 cases). It ranked second after house dust mites (63%), olive, 5 grass, cupressus, parietaria and corylus sensitization were encountered in 19.8%, 10.9%, 3.8%, 1.7% and 1.3% respectively. Prevalence of sensitization to pollens didn't vary significatively according to age: 25.4% in females versus 31.1% in males (p = 0.13). Prevalence of pollen sensitization was 26.6% in case of asthma versus 30.9% in non asthmatics patients (p = 0.30), 30.1% in case of rhinitis versus 16.9% in non rhinitics (p = 0.009), 36.4% in case of conjunctivitis versus 22.7% in case without conjunctivitis (p < 0.0002). According to the regions, prevalence was significatively high in areas like Meknes (56%), Beni-Mellal (48.1%), Marrakech (43.5%) where olive is abundant in comparison with Oujda (30.8%), Agadir (30.8%), Tanger (27.3%), Rabat (21.8%), Safi (21.3%), Casablanca (11.6%) and El Jadida (10%). The prevalence was up to 84.3% when symptoms were predominant in spring versus 16.8% in other seasons (p < 0.0001). Thus, although SPT did not include numerous other pollens, olive pollinosis seems to be prevalent in Morocco, followed by allergy to grass pollen. Such studies need to be carried out in line with pollen count.

Adolescent↗
PubMed2001

Health effects of tobacco use and exposure.

Tobacco is still widely consumed in a variety of different ways, mainly as smokeless tobacco and cigarette smoking. Four traits characterize tobacco use whatever the way of using it: 1) addiction linked to nicotine is behind all the tobacco hazards; 2) individual variation in tobacco susceptibility; 3) dose-response relationship; 4) time-lag effect. Smokeless tobacco, chewed or snuffed can lead mainly to inflammation of the oral cavity and oral cancers. Cigarette smoking accounts for 65-85% of global tobacco consumption. Active smoking can cause: 1) respiratory disorders culminating in chronic obstructive pulmonary disease (COPD) and emphysema; 2) cardiovascular hazards by way of increased vascular spasm and atherosclerosis leading to acute and chronic myocardial events, cerebral and peripheral vascular diseases; 3) cancers: twelve types are caused or related to cigarette smoking. Lung cancer is still the leading cause of cancer death in most high-income countries where data are available. An excess mortality is associated with smoking, with a 2-fold greater risk in smokers than in nonsmokers throughout middle age. The exposed pregnant woman subjects herself and her pregnancy to risks, and her fetus to growth retardation and perinatal morbidity and mortality. Passive smoking implicates 20-80% of the whole population. It can be nearly as harmful as active smoking depending upon risk factors, and can lead to short as well as to long-term effects. Children are the most vulnerable population particularly during the first years of life. Passive smoking increases risks for higher and lower respiratory tract illness but a smoke-free environment improves all these disorders. Ischemic heart diseases and lung cancer are the main risks for non smoking adults exposed to cigarette smoke. Tobacco use and exposure is the single most important source of preventable morbidity, disability and premature mortality. But giving up smoking helps at any time, the sooner the better. Health professionals should be the key advocates in tobacco prevention.

Female↗
PubMed2000

[Smoking knowledge, attitudes, and behaviors of patients in Morocco].

Smoking is a serious public health problem. In Morocco, the number of smokers varies from 24% to 52% depending on different social categories (school children, university students, public health workers, industrial workers, civil servants). The aim of our descriptive study was to analyze knowledge about smoking and smoking habits in patients hospitalized or followed by two units in the Ibn Rochd Hospital, cardiology and respiratory diseases. A questionnaire was given to a consecutive series of 200 patients between January and March 1997 (100 patients in each unit). Twenty percent of the patients were smokers and 23% were former smokers. The most well known health risks of smoking in the two groups of patients were respiratory and cardiovascular risks (88% and 71% respectively). Smokers and former smokers were more aware of these health risks. 86% of the smokers and former smokers had attempted to stop smoking at least once, mainly for a "health" reasons. 60% of smokers and former smokers decided to never smoke or never take a cigarette again. 66% of the patients said they had not been advised at the hospital about the risk of smoking. Our study provides a basis for further studies. It points out the importance of the smoking phenomena and the minimal role played by health personnel in advising patients. Health care workers should participate in antismoking activities during their consultation activities at the hospital in order to help patients stop smoking and also help implement rigorous antismoking laws in Morocco.

Adult↗
PubMed1999

[Smoking among medical students in Casablanca].

OBJECTIVES: Smoking is a real public health problem, even in the medical profession. Our work was aimed at determining the prevalence of smoking in medical students in Casablanca and assess their attitude towards this problem. MATERIALS AND METHODS: A questionnaire enquiry was carried out during the 1994-1995 university year. All medical students in Casablanca (2,640) were invited to participate the questionnaire but only 1,321 (50%) responded. RESULTS: Prevalence of occasional or regular smoking was 13%. It increased progressively from first year students (13%) to sixth year students (21.5%) and was significantly higher in male students (25.7% versus 3.2% in females). 53.8% of the smokers were trying to stop. Ex-smokers accounted for 10.3% of the total 76.3% of the smokers hoped they would not be smoking within five years although level was 90% in ex-smokers. 90.9% of the students admitted that smoking is dangerous to health, (76% of the first year students and 94% of the fifth and sixth year students). The respiratory risks of smoking were well understood. 73.6% of students thought that convincing others not to smoke is a responsibility of doctors, but only 31.6% would do this in the absence of disease linked to smoking. CONCLUSIONS: There has been a net fall in the prevalence of smoking since 1982 (34% at that time compared with 13% in 1994) and the dangers of tobacco are better understood. Medical students understand the problem better. Courses about the pathology of tobacco smoking since 1983 have certainly contributed.

Adult↗
PubMed1999

[Phantom thoracic opacity].

The etiology of the respiratory distress syndrome is dominated by pulmonary edema and the septic shock. We report a rare etiology of a respiratory distress secondary to a rupture of a well treated tuberculous latero-tracheal adenopathy. A 24-year-old woman was treated a year ago for a peripheral and mediastinal lymph node tuberculosis confirmed by the biopsy of a left supra clavicular adenopathy, by two months of isoniazid-rifampicin-pyrazinamide-ethambutol and seven months of isoniazid-rifampicin. The patient completed 9 month treatment with a good clinical and radiology course. Two months after stopping the antibacillary treatment, the patient was admitted to an intensive care unit with a respiratory distress syndrome requiring both intubation and artificial ventilation. The bronchial aspiration brought back plain pus. The telethorax from admission was normal and the retrospective history suggested the diagnostic of a ganglio-bronchial fistula which was confirmed by bronchial fibroscopy demonstrating right latero-tracheal fistula. The course was good with recovery of consciousness on the seventh day. Direct bacilloscopies and culture were negative. The digestive fibroscopy was normal. Finally, fistulization of a tuberculous adenopathy must be considered among the etiologies of respiratory distress even in a patient appropriately treated for mediastinal lymph node tuberculosis.

Acute Disease↗
PubMed1997

[Aneurysms of the pulmonary artery in Behçet disease. Apropos of 5 new cases].

Behçet's disease is a systemic vascularitis generally involving the venous system. Many organs may be involved, but pulmonary localizations are uncommon. We report 5 cases of pulmonary artery aneurysms observed in a series of Behçet's disease collected over a 10-year period. All patients were males, age range 18-41 years. Hempotysia was the inaugural event in all cases. Behçet's disease was recognized in only 2 of the patients initially. The diagnosis was made after recognition of the pulmonary artery aneurysms in the others. Chest x-ray showed round perihilar opacities varying in number from 2 to 4. Computed tomography with vascular opacification was performed in 4 patients and confirmed the aneurysmal nature of the opacities. Angiography was performed in 3 cases. Medical treatment with corticosteroids and/or colchicine was prescribed in all cases. One patient had left inferior lobectomy. In one case regression of the aneurysms precluded embolization. Two patients refused surgery and in one, surgery was not retained due to the large number of aneurysms. Outcome was fatal in one patient who died after cataclysmic hemoptysia. These findings underline the uncommon nature of pulmonary aneurysms in Behçet's disease and the diagnostic difficulties encountered in absence of specific signs as well as the poor prognosis of such localizations.

Adult↗
PubMed1996

[Pneumocystis infection in a non-immunocompromised patient].

Pneumocystis is typically described in the immunodepressed. We report a case of pneumocystis occurring in a patient without known depression of the immune system. The patient, aged 50, was hospitalised for a diffused infiltration pneumonia which developed sub-acutely, and presented with increasing dyspnoea of effort, thoracic pain and a disturbances of general health. The initial assessment did not reveal any risk factors for HIV infection nor any past history of note. The diagnosis of pneumocystis was confirmed by the presence of Pneumocystis carinii in the bronchoalveolar lavage from two samples. There was a favourable outcome following the prescription of Cotrimoxazole for three months and steroid therapy. HIV serology was negative and the sub-population of lymphocytes was normal. A search for neoplasia or systematic disease remained negative.

Adrenal Cortex Hormones↗
PubMed1995

House dust mite allergen content in two areas with large differences in relative humidity.

BACKGROUND: Striking differences in mite counts and mite-allergen levels have been documented between dwellings located at sea level and high altitude. Apart from relative humidity (RH), several other factors, ie, temperature, UV exposure, and altitude per se could account for this difference. OBJECTIVE: To evaluate whether RH by itself could influence mite infestation by comparing mite-allergens levels in two towns differing only with respect to RH. METHODS: We compared group I allergen content in two Moroccan towns: Casablanca, located on the seashore and Marrakech located at 1404 feet. Mean (+/- SD) RH in years 1990 and 1991 was 81.2 +/- 2.9% in Casablanca and 56.0 +/- 7.6% in Marrakech. Mean annual temperatures were 17.7 +/- 4.0 degrees C and 20.2 +/- 6.4 degrees C in Casablanca and Marrakech, respectively. In each town, 20 asymptomatic subjects agreed to participate in the study. Their mattresses were vacuum-cleaned for a standardized duration (2 min/m2). Mite allergen-content was evaluated using monoclonal antibodies and ELISA and results expressed as micrograms of group I (Der pI+Der f I) allergens per gram of dust (micrograms/g dust). RESULTS: Mean (+/- SD) group I allergen level was 8.3 +/- 8.8 micrograms/g in Casablanca and 0.6 +/- 0.6 micrograms/g dust in Marrakech, a difference that is highly significant (P = .001). In both areas, mean Der f I allergen level was low (0.7 +/- 0.5 and < 0.1 micrograms/g dust, in Casablanca and Marrakech, respectively). CONCLUSION: This study shows that house dust mite allergen content in households depends on RH rather than on temperature.

Allergens↗
PubMed1995

[Pancoast-Tobias syndrome of hydatid etiology].

The authors report a case of right-sided complete Pancoast and Tobias syndrome related to a multivesicular extrapleural hydatid cyst developing at the cervico-thoracic area with involvement of the first rib. This occurred in a 27 year old country dweller who was a non-smoker who presented with a progressive history of right sided cervico-brachial neuralgia some four months before hospitalisation, there was a subclavicular tumour swelling (8-10 cm), solid, non-inflammatory and a right sided Claude-Bernard-Horner syndrome. Screening of the thorax showed an opacity at the right apex, dense and homogeneous, with a pseudo-fracture of the first right rib. A cervical echo showed a multiloculated liquid filled mass without connection to the thyroid. Computer tomographic scanning showed a multiloculated voluminous liquid filled mass in the right cervico-thoracic area with a regular polycyclic outline, the lungs were normal. The serology was positive for hydatid disease (haemagglutination and ELISA). The patient was operated on by an exclusively supraclavicular approach with excision of the hydatid membranes and vesicles as well as the right first rib. The immediate outcome resulted in the disappearance of the neuralgia and the persistence of the Claude-Bernard-Horner syndrome.

Adult↗
PubMed1995

[Purulent pleurisy due to Salmonella typhi associated with a splenic abscess].

We report a case of 25 year old man who presented with a febrile illness and bilateral lower chest pain a pain in the left hypochondrium with fever and weight loss; investigations revealed a left sided empyema. The cause of the empyema was confirmed following the isolation in the pleural pus of Salmonella typhi. There was also a mass in the left hypochondrium which was shown on ultrasound to be a splenic abscess. After antibiotic therapy with Cotrimoxazole, repeated pleural aspirates and physiotherapy, there was a satisfactory outcome and the pleural effusion dried up and there was a significant reduction in the volume of the splenic abscess. In the light of their observations, the authors report the rare presentation of empyemas due to Salmonella typhi, the late presentation during the course of the third septenaire and the often favourable outcome under general antibiotic therapy associated with pleural aspirates to evacuate the pus and respiratory physiotherapy.

Abscess↗
PubMed1993

Iron deficiency anemia: recovery from in vitro oxidative stress.

Red blood cells in iron deficiency anemia (IDA) have a decreased activity of essential antioxidant enzymes. The present study examined the effect of in vitro exposure to oxidative agents in IDA cells and their recovery capacity. Red cells of 26 IDA patients and 10 healthy subjects were examined. Cells of IDA patients had higher levels of reduced glutathione (GSH), and normal methemoglobin and malonyldialdehyde (MDA) levels. Exposure to butyl hydroperoxide revealed a dose-dependent sensitivity in IDA cells, with extensive GSH depletion and increased MDA levels. These changes were partially reversible by incubation with dithiothreitol. Exposure to phenazine methosulfate, to produce intracellular superoxide ions, resulted in moderate GSH depletion and methemoglobin production. IDA cells were more sensitive than control cells to high concentrations of this substance. This effect was further augmented by preincubation with a superoxide dismutase inhibitor. Our data demonstrate that IDA cells are more susceptible to oxidation but have good capacity for recovery.

Adolescent↗
PubMed1992

[Clinical characteristics and etiology in hemoptysis in a pneumology service. 291 cases].

The aim of this work is to determine the clinical characteristics of haemoptysis and their principal aetiologies in a retrospective study of 291 cases collected over 5 years and occurring in adults who were hospitalised in a pneumology service. The annual incidence of haemoptysis was 8.8% of the in-patient population. The mean age of the patients was 46 and 47% were less than 50. The males were most frequent (69.4%) and haemoptysis was the presenting feature in 35.4%; it was minimal in 71.1% of average quantity in 26.8% and severe in 2.1%. The thoracic radiograph was judged abnormal in all cases and the abnormalities noted were suggestive of a particular aetiology in 70.8% of cases. The aetiological cause was dominated by bronchial cancer and of active pulmonary tuberculosis or its sequalae with levels of 34.4% and 18.9% respectively. For the other causes bronchial dilatation was important with 15.1% and hydatic cysts another 9.3%. Other aetiologies were represented by bacterial pneumonias with or without abscesses 7.2%, pulmonary aspergilloma 6.9%, chronic bronchitis with or without emphysema 3.5% and by rare causes in 4 cases. The cause for the haemoptysis was not found in 3.1%. This study brings out the preponderant place of bronchial cancer as a cause of haemoptysis in a country which still has a high prevalence of tuberculosis. Nevertheless the existence of tuberculosis services where the greater part of tuberculosis patients are hospitalised explains in part the predominance of bronchial cancer increasing very rapidly in our service.

Adolescent↗
PubMed1991

[Management and follow-up of asthma patients].

The reasons for the good management of asthma are explained and the underlying factors for the poor observance of their disease by patients and/or inadequate prescriptions are discussed. The author recalls the principal objectives of management and in passing mentions those necessary demands to guarantee successful management. These demands are: 1) a good relationship between the medical team, the patient and the family 2) the information and education of the patient and his family, which should dwell on a) the disease b) precipitating factors c) subjective factors without forgetting the equivalents of crises d) therapeutic methods and their correct usage stressing the importance of teaching good aerosol technique e) the potential progress of the disease. Benefit will flow from the education of the patients so that they will automatically take their medication in a better understood fashion and will assume their responsibilities more consistently, and the therapy will be controlled and readjusted by the medical team. 3) a good appreciation of the severity of the asthma and also of the degree of importance of any impending crisis. 4) This type of follow up of the asthmatic implies that the responsibility is not only that of the doctor but of the patient too. 5) A healthy system with quality assurance a) a good medical and paramedical team b) good accessibility to health care c) structures of health care within and without hospital which are sufficient both in quantity and quality d) a good public information service. The assessment of studies based on shared care of patients has shown an improvement in well being vis a vis their disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

Asthma↗
PubMed1991

[Non-Hodgkin's lymphoma disclosed by an intrabronchial tumor. Apropos of a case].

Non Hodgkin's lymphoma (LNH) presenting as a localised tumour is exceptional and nearly always appears during the course of disseminated disease. We report a case where the primary disease was an endobronchial tumour and the entire clinical picture related to pulmonary symptoms. A 70 year old lady was found to have a left sided pulmonary opacity following a cough with minimal expectoration and accompanied by chest pains and dyspnoea. The chest abnormality progressed for 3 years 9 months before an endobronchial tumour was discovered at bronchoscopy in the left upper lobe and from which a biopsy revealed an LNH with small cells of low degree of malignancy. In addition there was splenomegaly and an infiltration of bone marrow by the lymphomatous process which was evidence of a disseminated form of LNH. To our knowledge our observation is an extremely rare case where an endobronchial tumour revealed a non Hodgkins lymphoma.

Aged↗