R. Afifi

Centre Hospitalier Universaitaire IBN Sina de Rabat, Rabat, Rabat-Salé-Zemmour-Zaër, Morocco

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Publications (71)42.51 Total impact

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    ABSTRACT: L’hématome spontané du foie est une complication rare mais gravissime de la toxémie gravidique sévère et plus particulièrement du HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count). De siège le plus souvent sous-capsulaire, la localisation intrahépatique des hématomes est exceptionnelle. Nous rapportons le cas d’une patiente de 33 ans, multipare, qui a présenté en postpartum, des hématomes intrahépatiques intéressant tout le foie ayant compliqué un HELLP syndrome, la particularité de notre observation réside dans le siège intrahépatique des hématomes et leur survenue en post-partum. Nous discuterons à travers une revue de littérature les aspects épidémiologiques, topographiques, diagnostiques, thérapeutiques et pronostiques de cette affection.
    Journal Africain d?Hépato-Gastroentérologie 09/2012; 6(3). DOI:10.1007/s12157-012-0385-4
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    ABSTRACT: Introduction L’hépatoblastome est la tumeur hépatique primaire la plus commune de l’enfant. Cette tumeur est extrêmement rare chez l’adulte et son pronostic est sombre. Seuls quelques cas ont été rapportés chez l’adulte. Ainsi, nous présentons dans ce travail le cas d’un hépatoblastome diagnostiqué chez une jeune femme de 22 ans. Observation Patiente de 22 ans sans antécédents, accusant depuis quelques mois des douleurs de l’hypochondre droit. L’examen clinique ainsi que le bilan hépatique étaient sans particularité. Ni la biologie ni les examens morphologiques n’étaient en faveur d’un foie de cirrhose. L’échographie, le scanner et l’IRMhépatiquesmettaient en évidence une énorme masse hépatique de 11 cm de diamètre. Les résultats histologiques des biopsies écho-guidées sur foie tumoral et foie restant étaient en faveur d’un hépatoblastome de type foetal associé à une fibrose extensive. L’exploration chirurgicale détectait une large masse occupant tout le foie droit avec un foie restant cirrhotique. Cette patiente bénéficiait d’une résection hépatique qui consistait en une trisegmentectomie VI, VII, VIII avec des marges de résection saines. Les suites opératoires étaient simples avec un recul sans récidive de 22 mois. Conclusion L’hépatoblastome survient de façon extrêmement rare chez l’adulte chez qui la présentation est assez agressive. Le pronostic chez l’adulte est plus sombre par rapport à l’enfant mais meilleur que celui du carcinome hépatocellulaire. Le traitement actuel de cette tumeur inclus la chimiothérapie et la chirurgie mais cette dernière demeure l’essentiel du traitement chez l’adulte.
    Journal Africain d?Hépato-Gastroentérologie 09/2012; 6(3). DOI:10.1007/s12157-012-0392-5
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    ABSTRACT: La maladie coeliaque et la maladie de Crohn sont deux maladies digestives chroniques d’étiopathogénie complexe, leur association chez un même malade est rare, posant un problème diagnostique et étiopathogénique. Nous rapportons l’observation d’une jeune patiente présentant une diarrhée chronique chez qui les bilans biologique, immunologique, endoscopique et histologique ont conclu à une maladie coeliaque associée à une maladie de Crohn colique droite et duodénale. La patiente a été mise sous régime sans gluten, inhibiteurs de la pompe à protons et corticothérapie orale puis un traitement par azathioprine. Après un recul d’un an, l’évolution a été marquée par une rémission clinique, biologique, endoscopique et histologique. À travers cette observation, nous soulignons la rareté de cette association et nous insistons sur l’étiopathogénie complexe de la maladie coeliaque qui pourrait avoir des points communs avec celle de la maladie de Crohn.
    Acta Endoscopica 09/2012; 42(4). DOI:10.1007/s10190-012-0257-1 · 0.16 Impact Factor
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    ABSTRACT: Le syndrome des antiphospholipides est une atteinte auto-immune rare chez l’homme. Elle est caractérisée par la formation récurrente de caillots sanguins dans les vaisseaux, notamment au niveau des grosses artères et des veines profondes des jambes. L’atteinte du système porte est rare. Nous rapportons l’observation d’un homme âgé de 30 ans présentant un syndrome d’hypertension portale secondaire à une thrombose des branches portales droite et gauche révélant un syndrome des antiphospholipides secondaire à un lupus érythémateux disséminé.
    Journal Africain d?Hépato-Gastroentérologie 06/2012; 6(2). DOI:10.1007/s12157-012-0360-4
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    ABSTRACT: Qu’avez-vous retenu de cet article ? Testez si vous avez assimilé les points importants de cet article en répondant à ce questionnaire sous forme de QCM.
    Feuillets de Radiologie 02/2012; 52(1):58. DOI:10.1016/j.frad.2011.11.005 · 0.05 Impact Factor
  • Feuillets de Radiologie 02/2012; 52(1):34-38. · 0.05 Impact Factor
  • Feuillets de Radiologie 02/2012; 52(1):34–38. DOI:10.1016/j.frad.2011.11.001 · 0.05 Impact Factor
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    ABSTRACT: The implication of hemochromatosis (HFE) gene mutations in chronic viral hepatitis remains controversial. The aim of the present study was to measure the frequencies of the common HFE gene mutations in Moroccan subjects with chronic viral hepatitis B and C and to assess their influence on the progression of liver disease. H63D and C282Y mutations were screened by the polymerase chain reaction followed by restriction fragment length polymorphism analysis in 170 chronic hepatitis B patients, 168 chronic hepatitis C patients, and 200 healthy controls. A very small proportion of patients infected with hepatitis B virus (HBV) or hepatitis C virus (HCV; 1.8% and none, respectively) were heterozygous for the C282Y mutation, that is, rates not statistically different from those observed in healthy control (2%, P > 0.05). Similarly, the frequency of the H63D allele was not significantly different between HBV (13.8%) or HCV (14.3%) patients and controls (13.5%, P > 0.05). Multivariate analysis showed that carriers of the H63D mutation infected with HBV are at higher risk to progress towards an advanced liver disease when compared with patients infected with HBV with wild-type (OR = 2.45, 95% CI = 1.07-5.58). In contrast, no association between HFE mutated HCV-infected patients and an increased risk of disease progression was found (OR =  1.24, 95% CI = 0.61-2.50, P = 0.547). In conclusion, in Morocco the frequency of the HFE C282Y allele is very low and H63D mutation carriage occurs in almost 14% of the patients, a rate similar in chronic hepatitis patients and healthy controls. In the case of chronic hepatitis B, the carriage of the H63D variant represents a risk factor of evolution towards a more active disease.
    Journal of Medical Virology 12/2011; 83(12):2096-102. DOI:10.1002/jmv.22245 · 2.22 Impact Factor
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    ABSTRACT: Single-nucleotide polymorphisms (SNPs) in codon 72 of the TP53 gene (rs1042522) and in the promoter region of the MDM2 gene (SNP309; rs2279744) have been shown to play a role in the predisposition to many cancers. However, these findings were inconsistent in other tumor types, and ethnicity is suspected to be a critical factor influencing the effects of these SNPs on the cancer risk. The aim of the present study was to investigate whether these functional SNPs were associated with an enhanced risk of liver tumorigenesis in Moroccan patients. We have genotyped both polymorphisms in 96 patients with hepatocellular carcinoma (HCC) and 222 controls without HCC matched for age, gender and ethnicity by PCR-RFLP confirmed by sequencing. A joint effect between the MDM2 and TP53 polymorphisms and an increased risk of liver cancer was detected, with the odds ratio for the presence of both MDM2 309GG and TP53 72Pro/Pro genotypes being 10 (95% confidence interval 0.39-255.55). Interestingly, a significant increase in the HCC risk was observed when at least two deleterious alleles were present, indicating an allele dosage effect. There was no evidence for any association with early age of HCC onset when deleterious alleles of MDM2 SNP309 and TP53 Arg72Pro where present. Our findings suggest that the combination of TP53 72Pro and MDM2 309G polymorphisms enhance the risk of developing HCC. These results deserve further confirmation in other populations.
    The International journal of biological markers 10/2011; 26(4):229-33. DOI:10.5301/JBM.2011.8881 · 1.36 Impact Factor
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    ABSTRACT: The implication of haemochromatosis (HFE) gene mutations in chronic viral hepatitis remains controversial. The aim of the present study was to assess the frequencies of the common haemochromatosis gene mutations in Moroccan subjects with chronic viral hepatitis B and C. H63D and C282Y mutations were screened by using polymerase chain reaction followed by restriction fragment length polymorphism analysis in 170 chronic hepatitis B patients, 168 chronic hepatitis C patients and 200 healthy controls. The distribution of allele frequency was then compared between different groups of patients. No subject homozygous for the C282Y mutation was found while 1.76% and 0% were heterozygous for this mutation in HBV and HCV patients, that is, rates not statistically different from those observed in healthy control (2%, 0.129< p<1.000). Similarly, the frequency of the H63D allele was not significantly different between HBV (13.8%) or HCV (14.3%) patients and controls (13.5%, 0.60< p<0.89). Although they do not reach the significance threshold, serum ferritin levels, indicative of body iron content, were higher in HBV or HCV patients than in control individuals with HFE mutations (110.7±43.61 and 149.67±43.52 ng/ml respectively vs 80.84±21.38 ng/ml, 0.229< p<0.607). In conclusion, in Morocco the frequency of the HFE C282Y allele is very low and H63D mutation carriage occurs in <14% of the subjects, a rate similar in chronic hepatitis patients and control individuals. Thus, we assume that the carriage of the common HFE mutations does not represent a risk factor for evolution towards chronic hepatitis B or C in the genetic and environmental context of North Africa.
    Journal of epidemiology and community health 09/2011; 65. DOI:10.1136/jech.2011.142976i.10 · 3.29 Impact Factor
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    ABSTRACT: Objective. In the present study, we aimed to investigate epidemiological, clinical, and etiological characteristics of acute upper gastro-intestinal bleeding. Materials and Methods. This retrospective study was conducted between January 2003 and December 2008. It concerned all cases of acute upper gastroduodenal bleeding benefited from an urgent gastro-intestinal endoscopy in our department in Morocco. Characteristics of patients were evaluated in terms of age, gender, medical history, presenting symptoms, results of rectal and clinical examinations, and endoscopy findings. Results. 1389 cases were registered. As 66% of the patients were male, 34% were female. Mean age was 49. 12% of patients had a history of previous hemorrhage, and 26% had a history of NSAID and aspirin use. Endoscopy was performed in 96%. The gastroduodenal ulcer was the main etiology in 38%, followed by gastritis and duodenitis in 32.5%. Conclusion. AUGIB is still a frequent pathology, threatening patients' life. NSAID and aspirin are still the major risk factors. Their impact due to peptic ulcer remains stable in our country.
    07/2011; 2011:457946. DOI:10.5402/2011/457946
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    ABSTRACT: Intussusception is highly uncommon in adults and accounts for only 5% of all reported cases. It is more commonly secondary to an identifiable bowel lesion in 90% of cases, whereas 10% have no discernable cause. Diagnosis is difficult due to non-specific symptoms of the disease. Diagnostic imaging plays an important role in the diagnosis of the condition. Sonography and computed tomography are the most commonly used imaging techniques. In adults, intussusception usually requires treatment by surgical resection of the affected bowel. A 35-year-old Moroccan woman presented with a five-month history of intermittent abdominal pain and one episode of bleeding from the rectum. At physical examination an abdominal mass was noted. Abdominal sonography revealed a 6.3 × 8.5 cm midline mass in her upper abdomen that was tender. In transverse section, the mass had the multiple concentric rings of hypoechoic and echogenic layers associated with the sonographic appearance of intussusception. In longitudinal section, the mass had the sonographic aspect of multiple parallel lines, giving the so-called "sandwich appearance".A corresponding contrast-enhanced abdominal computed tomography scan also demonstrated the intussusception. Surgery confirmed a colocolic intussusception with a large, firm, indurated mass as the lead point. A right hemicolectomy was undertaken because of concern about possible malignancy. The resected ascending colon was then opened up, to find a protruding tumor of the ascending colon that was acting as the lead point. It measured 7.6 × 6.9 × 2.4 cm. Pathology diagnosed an infiltrating, differentiated adenocarcinoma of the ascending colon invading through the muscularis propria. No lymphovascular invasion was seen. Our patient has recovered well. Intussusception is relatively rare in the adult population, and this, along with the vague clinical features, makes diagnosis difficult. Ultrasonography and computed tomography have been proven to be effective diagnostic modalities. Ultrasonography can be performed quickly and accurately, and is widely available. In adults, intussusception is usually associated with an underlying cause and requires treatment by surgical resection.
    Journal of Medical Case Reports 07/2011; 5:294. DOI:10.1186/1752-1947-5-294
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    ABSTRACT: RésuméLa nature des corps étrangers (CE) ingérés varie selon les conditions socio-économiques. Matériels et méthodesNotre étude portait sur 33 patients ayant ingéré des CE colligés au sein de notre unité d’endoscopie. RésultatsIl s’agit de 16 femmes et de 17 hommes d’un âge moyen de 35,5 ans. L’ingestion et le type du CE étaient précisés à l’interrogatoire sauf dans un cas (retard psychomoteur), et confirmés par la fibroscopie qui était systématique. Il s’agissait d’os dans 13 cas, d’épingle dans cinq cas, de dentier dans six cas, de morceau de verre dans deux cas, de manche de cuillère dans un cas, d’un gros morceau de viande dans un cas, de deux manchons de cuillère avec deux couvercles de boîte de conserve dans un cas (un prisonnier) et autres (bridge, olive…) dans trois cas. Le CE était dans l’oesophage dans 69,7 % et dans l’estomac dans 27,3 %. Une extraction endoscopique était réalisée chez 75 % des patients sans complication, souvent sous sédation. Le recours à la chirurgie était nécessaire dans 25 % des cas, car le CE était très incrusté dans la paroi rendant l’extraction endoscopique impossible. ConclusionL’ingestion de CE bien que souvent bénigne est facilement résolue par l’endoscopie, peut nécessiter un recours à la chirurgie notamment en cas de « dentiers incrustés dans l’oesophage ». La nature des CE était similaire à celle rapportée dans la littérature. Toutefois, nous attirons l’attention sur la possibilité de survenue de tels accidents en rapport avec la tendance à la généralisation du voile et chez les femmes manipulant au quotidien les aiguilles. AbstractThe types of foreign bodies (FB) that are ingested vary according to socio-economic conditions. Patients and methodsOur study involves 33 patients seen in our endoscopy unit after swallowing foreign bodies. ResultsThere were 16 women and 17 men with a mean age of 35.5 years. The fact of ingestion and the nature of the foreign body were ascertained by the history taken except in one case (psychomotor retardation) and were confirmed at routine endoscopy. The numbers of swallowed objects were as follows: 13 cases involved a bone, five a pin, six a denture, two a piece of glass, the handle of a spoon in one case, a large piece of meat in another, two spoon handles and two lids of food tins (a prisoner) and there were three other cases (dental bridge, olive…). The foreign body was located in the oesophagus in 69.7% of cases and in the stomach in 27.3%. It was removed endoscopically in 75% of patients without complication, usually with sedation. Surgery proved necessary in 25% of cases because the foreign body was embedded in the oesophageal or stomach wall making endoscopic removal impossible. ConclusionAlthough ingestion of foreign bodies is often benign and easily resolved at endoscopy, it can also require surgery especially when dentures become embedded in the oesophagus. The variety of foreign bodies was similar to that described in the literature. However, we draw attention to the possibility of occurrence of such accidents in relation to the increasing use of the Islamic veil and in women who handle needles on a daily basis. Mots clésCorps étranger–Ingestion–Tractus digestif KeywordsForeign body–Ingestion–Digestive tract
    Acta Endoscopica 06/2011; 41(3):123-128. DOI:10.1007/s10190-011-0160-1 · 0.16 Impact Factor
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    ABSTRACT: Résumé L’hypertension portale segmentaire ou gauche est l’une des rares causes d’hypertension portale extrahépatique. Elle est due à une thrombose ou à une compression de la veine splénique ou du tronc splénomésaraique due le plus à une pathologie pancréatique. L’originalité de notre observation émane de l’étiologie exceptionnelle de cette hypertension portale segmentaire qui est un phéochromocytome gauche.
    Journal Africain d?Hépato-Gastroentérologie 06/2011; 5(2). DOI:10.1007/s12157-011-0250-x
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    ABSTRACT: The ingestion of foreign bodies is common, it may be voluntary but is usually accidental. Sharp foreign bodies and their location in the gastrointestinal tract can be dangerous. We report cases of young women wearing headscarves who accidentally ingested needles. In three cases, endoscopic removal of needles was performed successfully and in two cases, the needles passed through the gastrointestinal tract, with close radiological monitoring until their expulsion. Needle ingestion can cause gastrointestinal injury and severe complications, we recommend dropping the habit of holding needles between lips while fixing headscraf. L’ingestion de corps étrangers est relativement fréquente, elle peut être volontaire, mais elle est le plus souvent accidentelle. Les objets ingérés peuvent être dangereux de par leur caractère tranchant et leur localisation dans le tractus digestif. Nous rapportons cinq observations de jeunes femmes portant le voile ayant ingéré accidentellement les épingles qu’elles tenaient entre les lèvres lors de l’arrangement du voile. Dans trois cas, l’extraction endoscopique des épingles a été réalisée avec succès, et dans deux cas, les épingles ont migré le long du tube digestif avec une surveillance radiologique étroite jusqu’ à leur expulsion dans les selles. Dans notre contexte en gardant à l’esprit les complications relatives à l’ingestion des aiguilles, il est conseillé d’éviter de tenir les aiguilles entre les lèvres lors de la fixation du voile avec des épingles. KeywordsForeign body–Needles–Endoscopic extraction–Prevention Mots clésCorps étranger–Épingle–Extraction endoscopique–Prévention
    Acta Endoscopica 03/2011; 41(2):65-69. DOI:10.1007/s10190-011-0148-x · 0.16 Impact Factor
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    BMC proceedings 01/2011; 5(Suppl 1). DOI:10.1186/1753-6561-5-S1-P22
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    ABSTRACT: ButLe but de ce travail est d’évaluer l’apport diagnostique de la ponction-biopsie échoguidée dans le diagnostic des masses abdominales. Matériel et méthodeIl s’agit d’une étude rétrospective portant sur 523 biopsies échoguidées colligées dans le service de médecine C sur une période de six années, allant de décembre 2003 à décembre 2009, incluant tous les patients adultes présentant une masse abdominale. RésultatsDeux cent quatre-vingt-trois patients étaient des femmes (54,1 %), et 240 des hommes (45,9 %). Les âges extrêmes étaient respectivement de 17 et 84 ans. Les manifestations cliniques étaient dominées par les douleurs abdominales retrouvées dans 319 cas (61 %), puis la tuméfaction abdominale dans 83 cas (15,8 %). À l’échographie, la masse abdominale siégeait au niveau hépatique chez 370 patients (70,8 %), il s’agissait d’une adénopathie abdominale profonde chez 60 patients (11,5 %), elle siégeait au niveau du pancréas chez 27 patients (5,2 %), du péritoine chez 18 patients (3,4 %), il s’agissait d’un épaississement digestif chez 17 patients (3,2 %). Enfin, la masse était localisée au niveau du pelvis chez sept patientes (1,4 %), des surrénales chez six patients (1,1 %), et de la rate chez trois patients (0,6 %). L’examen histologique retrouvait au niveau hépatique: 279 cas de cancer du foie et 44 cas de tumeur bénigne du foie. Concernant les adénopathies profondes: il s’agissait de 26 cas d’adénite tuberculeuse, 21 cas de LMNH, 12 cas d’adénocarcinome (ADK), six cas d’adénite non spécifique et un cas de sarcoïdose. Au niveau du pancréas: 19 cas d’ADK pancréatique, six cas de pancréatite chronique et un cas de tumeur neuroendocrine. Au niveau du péritoine: dix cas de carcinose péritonéale et trois cas de mésothélium péritonéal. Au niveau surrénalien: quatre cas de métastase surrénale de carcinomes hépatocellulaires (CHC) et un cas de phéochromocytome. Au niveau du pelvis: cinq cas de métastase ovarienne d’ADK digestif. Au niveau digestif et de la rate: cinq cas de LMNH gastrique et trois cas de splénite tuberculeuse. Seules 14,7 % des biopsies (77 cas) n’étaient pas concluantes surtout en raison d’un fragment biopsique trop exigu. Aucune complication majeure n’a été enregistrée. ObjectiveThe objective of this study was to measure the diagnostic value of ultrasound-guided needle biopsy in the diagnosis of abdominal masses. Patients and MethodsThis is a retrospective study of 523 echo-guided biopsies performed in the Department of Medicine C over a 6-year period from December 2003 to December 2009, and includes all adult patients presenting with an abdominal mass. ResultsTwo hundred and eighty-three patients were females (54.1%) and 240 males (45.9%). Ages ranged from 17 to 84 years. Abdominal pain was the predominant clinical feature, being present in 319 of the patients (61%), followed by abdominal swelling in 83 cases (15.8%). On ultrasound examination, the abdominal mass was found to be hepatic in 370 patients (70.8%). In 60 (11.5%), it was due to deep lymphadenopathy; in 27 (5.2%), it was situated in the pancreas; in 18 (3.4%), it was peritoneal; and in 17 (3.2%), there was thickening of the digestive tract. The mass was located in the pelvis in 7 women (1.4%), in the adrenal in 6 patients (1.1%), and in the spleen in 3 (0.6%). Histology of liver biopsies revealed 279 cases of liver cancer and 44 of benign liver tumor. Of the lymphadenopathy cases, 26 were tuberculous adenitis, 21 were non-Hodgkin’s lymphoma, 12 were adenocarcinoma, 6 non-specific adenitis, and 1 sarcoidosis. The pancreatic pathologies were: 19 cases of pancreatic adenocarcinoma, 6 chronic pancreatitis, and 1 neuro-endocrine tumor. Of the peritoneal lesions, 10 were carcinomatosis and 3 were peritoneal mesothelioma. In the adrenal gland, there were 4 cases of metastasis of hepatocellular cancer and 1 phaeochromocytoma. In the pelvis, 5 of the patients had ovarian metastasis from gastro-intestinal adenocarcinoma. In the digestive tract, 5 patients had non-Hodgkin’s lymphoma of the stomach. There was tuberculous involvement of the spleen in 3 cases. Only 14.7% of the biopsies (77 cases) were inconclusive, usually because the specimen was too small. No major complication was recorded. Mots clésDiagnostic-Ponction biopsie échoguidée-Tumeurs abdominales KeywordsDiagnosis-Ultrasound guided needle biopsy-Abdominal tumours
    Journal Africain d?Hépato-Gastroentérologie 12/2010; 4(4):220-224. DOI:10.1007/s12157-010-0206-6
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    ABSTRACT: Reactive oxygen species have been related to the aetiology of cancer as they are known to be mitogenic and therefore capable of tumour promotion. The aim of this study was to assess the role of common variation in three polymorphic genes (MnSOD Ala-9Val, GPX1 Pro198Leu and CAT -262 C > T) coding for antioxidant defence enzymes in modulating individual susceptibility to hepatocellular carcinoma (HCC) using a case-control study (cases = 96 and controls = 222). PCR-RFLP and sequencing methods were used to determine the genotype. Overall, there were no associations between genotypes GPX1 and HCC risk (OR, 1.16; 95% CI, 0.56-2.42; p = 0.685). The MnSOD Ala/Ala and CAT TT genotypes were more frequent in HCC than in control (p = 0.001 and p = 0.072, respectively). Further analyses stratified by gender or HCV infection revealed that men and HCV-infected patients carrying CAT TT genotype had a higher risk to develop HCC when compared with controls (OR = 15.94; 95% CI, 3.48-72.92; p < 0.000001 and 12.01; 95% CI, 0.64-223.63, p = 0.056, respectively). Combined MnSOD Ala/Ala and GPx1 Leu/Leu had a synergistic effect on HCC risk, with an OR of 3.84 (p = 0.029). Furthermore an even more pronounced risk was observed when we combined MnSOD Ala/Ala and CAT TT (OR = 13.60, p = 0.023). It appears that variants in MnSOD, CAT or GPX1 have an influence on HCC risk in this cohort. Furthermore, it is possible that cumulative defects in protection from oxidative stress may result in increased risk of liver cancer in the Moroccan population.
    Free Radical Research 02/2010; 44(2):208-216. · 2.99 Impact Factor
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    ABSTRACT: Reactive oxygen species have been related to the aetiology of cancer as they are known to be mitogenic and therefore capable of tumour promotion. The aim of this study was to assess the role of common variation in three polymorphic genes (MnSOD Ala-9Val, GPX1 Pro198Leu and CAT -262 C > T) coding for antioxidant defence enzymes in modulating individual susceptibility to hepatocellular carcinoma (HCC) using a case-control study (cases = 96 and controls = 222). PCR-RFLP and sequencing methods were used to determine the genotype. Overall, there were no associations between genotypes GPX1 and HCC risk (OR, 1.16; 95% CI, 0.56-2.42; p = 0.685). The MnSOD Ala/Ala and CAT TT genotypes were more frequent in HCC than in control (p = 0.001 and p = 0.072, respectively). Further analyses stratified by gender or HCV infection revealed that men and HCV-infected patients carrying CAT TT genotype had a higher risk to develop HCC when compared with controls (OR = 15.94; 95% CI, 3.48-72.92; p < 0.000001 and 12.01; 95% CI, 0.64-223.63, p = 0.056, respectively). Combined MnSOD Ala/Ala and GPx1 Leu/Leu had a synergistic effect on HCC risk, with an OR of 3.84 (p = 0.029). Furthermore an even more pronounced risk was observed when we combined MnSOD Ala/Ala and CAT TT (OR = 13.60, p = 0.023). It appears that variants in MnSOD, CAT or GPX1 have an influence on HCC risk in this cohort. Furthermore, it is possible that cumulative defects in protection from oxidative stress may result in increased risk of liver cancer in the Moroccan population.
    Free Radical Research 11/2009; 44(2):208-16. DOI:10.3109/10715760903402906 · 2.99 Impact Factor
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    ABSTRACT: L’œsophagite disséquante chronique est une entité rare d’étiopathogénie inconnue. Nous rapportons une observation d’une femme âgée de 42 ans qui a consulté pour un tableau de dysphagie chronique d’allure organique et chez qui l’exploration endoscopique a permis de poser le diagnostic d’œsophagite disséquante. L’intérêt de ce travail est de faire le point sur l’aspect clinique, endoscopique et thérapeutique de cette affection rare et souvent méconnue. Chronic oesophagitis dissecans is a rare disorder with unknown pathogenesis. We report the case of a 42 year old woman who presented with chronic dysphagia. Endoscopic examination enabled a diagnosis of dissecans oesophagitis to be made. The purpose of this work is to review the clinical, endoscopic and therapeutic aspects of this rare and often unrecognized disorder.
    Acta Endoscopica 10/2009; 39(5):345-347. DOI:10.1007/s10190-009-0096-x · 0.16 Impact Factor

Publication Stats

182 Citations
42.51 Total Impact Points

Institutions

  • 1995–2012
    • Centre Hospitalier Universaitaire IBN Sina de Rabat
      Rabat, Rabat-Salé-Zemmour-Zaër, Morocco
  • 2009–2011
    • Ibn Sina Hospital Dhanmondi
      Baghdād, Mayorality of Baghdad, Iraq
    • Centre Hospitalier Ibn Sina
      Rabat, Rabat-Salé-Zemmour-Zaër, Morocco