ABSTRACT
Fundamento: A insuficiência renal é comum em pacientes com insuficiência cardíaca crônica, com uma prevalência entre 20% a 57%, e está associada a um mau prognóstico e um alto risco de reinternações. Objetivo: O objetivo deste estudo foi apresentar características epidemiológicas, clínicas e terapêuticas de pacientes marroquinos com insuficiência cardíaca crônica que desenvolveram insuficiência renal crônica. Métodos: Foram avaliados 563 pacientes acompanhados por insuficiência cardíaca crônica na Unidade de Insuficiência Cardíaca do Departamento de Cardiologia do Hospital Universitário de Ibn Rushd em Casablanca, Marrocos, entre 30 de julho de 2012 e 30 de julho de 2016. Os pacientes foram divididos em dois grupos de acordo com a presença ou ausência de síndrome cardiorrenal. Resultados: Em comparação a pacientes que não desenvolveram síndrome cardiorrenal, os pacientes com síndrome cardiorrenal tenderam a ser mais velhos, hipertensos e diabéticos. Clinicamente, uma porcentagem mais alta dos pacientes apresentou dispneia estágio III ou IV. Biologicamente, os pacientes com SCR apresentaram níveis menores de hemoglobina e níveis plasmáticos maiores de ácido úrico. Em relação aos achados ecocardiográficos, esses pacientes também apresentaram menor FE do ventrículo esquerdo, com maior prevalência de hipertensão ventricular direita e hipertensão pulmonar, e maior risco de readmissão hospitalar (p < 0,0001). Conclusão: A deterioração da função renal na insuficiência renal crônica está associada com um pior prognóstico, incluindo um maior risco de readmissão hospitalar, eventos cardiovasculares, e morte. Maior atenção deve ser dada a pacientes idosos, diabéticos, com valores muito baixos de fração de ejeção do ventrículo esquerdo ou com hipertensão pulmonar
Background: Renal failure is common in patients with chronic heart failure, with a prevalence ranging from 20 % to 57% worldwide. It is associated with a poor prognosis and a high risk of readmission. Objectives: The purpose of our study is to show the epidemiological, clinical, paraclinical and therapeutic features of Moroccan patients with chronic heart failure who had developed a chronic renal failure. The endpoints were cardiac death and any cause of hospitalization. Methods: 563 patients followed for chronic heart failure at the heart failure unit in the Department of Cardiology of the University Hospital Ibn Rushd of Casablanca in Morocco, between July 30, 2012 and July 30, 2016 were assessed. Patients were divided into two groups according to the presence or absence of cardiorenal syndrome. Results: Compared to patients who had no cardiorenal syndrome, patients with cardiorenal syndrome tended to be more aged, hypertensive and diabetic. Clinically more patients were at dyspnea stage III or IV. Biologically their hemoglobin was lower and their blood uric acid level was higher. Regarding echocardiography, their ejection fraction of the left ventricle was lower, with more of systolic dysfunction of the right ventricle and pulmonary hypertension in the CRS group, with a higher risk of readmission (p < 0.0001). The mortality was significantly higher in the group CRS (p < 0.0001). Conclusion: The deterioration of renal function in chronic renal failure is associated with poor prognosis, including a high risk of rehospitalization, cardiovascular events and death. Patients who are elderly, diabetic, with a low left ventricular ejection fraction and pulmonary hypertension are the most concerned
Subject(s)
Humans , Male , Female , Middle Aged , Cardio-Renal Syndrome/epidemiology , Prognosis , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/mortality , Survival , Chronic Disease , Diabetes Mellitus , Heart Failure/physiopathology , Hypertension/complications , Morocco/epidemiology , Multivariate Analysis , Observational Study , Patient Readmission , Risk Factors , Data Interpretation, StatisticalSubject(s)
Adult , Aged , Humans , Male , Middle Aged , /genetics , Breast Neoplasms, Male/genetics , Carcinoma, Ductal, Breast/genetics , Carcinoma, Lobular/genetics , Carcinoma, Papillary/genetics , Receptors, Androgen/genetics , Breast Neoplasms, Male/complications , Breast Neoplasms, Male/epidemiology , Carcinoma, Ductal, Breast/epidemiology , Carcinoma, Lobular/ethnology , Carcinoma, Papillary/epidemiology , Egypt/epidemiology , Genetic Predisposition to Disease , Liver Cirrhosis/complications , Morocco/epidemiology , Trinucleotide Repeats/geneticsABSTRACT
The objective of this investigation was to assess the prevalence of oral lichen planus (OLP) in Moroccan patients infected with hepatitis C virus (HCV) from the Hepatology service of Ibn Sina University hospital of Rabat. The study group consisted of 149 patients with HCV infection. All patients with clinical features of OLP were submitted to the service of oral surgery for confirmation. Among the 149 HCV-infected patients of the study group, 35 patients had OLP which represents a prevalence of 23.5 percent. Two out of these 35 patients with OLP-HCV association had cutaneous lichen planus (CLP) as well. Our findings indicate that there is a significant association between OLP and HCV infection especially for reticular and erosive types of OLP.
El objetivo de esta investigación fue evaluar la prevalencia de liquen plano oral (LPO) en los pacientes marroquíes infectados con hepatitis C (VHC) del Servicio de Hepatología del Hospital Universitario Ibn Sina de Rabat. El grupo de estudio consistió de 149 pacientes con infección por el VHC. Todos los pacientes con características clínicas de LPO se presentaron al servicio de cirugía oral para su confirmación. Entre los 149 pacientes infectados por VHC del grupo de estudio, 35 pacientes presentaban LPO, una prevalencia de 23,5 por ciento. Dos de estos 35 pacientes con LPO asociado al VHC tenían también liquen plano cutáneo (LPC). Nuestros hallazgos indican que existe una asociación significativa entre la LPO y la infección por el VHC, especialmente para los tipos de LPO reticular y erosivo.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , Hepatitis C/epidemiology , Lichen Planus, Oral/epidemiology , Hepatitis C Antibodies/analysis , Enzyme-Linked Immunosorbent Assay , Morocco/epidemiology , Polymerase Chain Reaction , PrevalenceABSTRACT
This study defined a wealth index that was strongly correlated with a health indicator: the survival of children aged less than five years. This index allowed the most vulnerable social groups for health outcomes to be identified. These groups could become the target for focused interventions and in particular for health-insurance schemes. The study was based on a thorough analysis of data collected in Morocco in the 1992 Demographic and Health Survey (DHS). Results of the analysis showed that a simple score based on 15 socioeconomic indicators provided a proper discriminatory tool for screening families at higher risk of infant and child mortality. The score was based on characteristics of housing and household goods which are easy to collect in the field. The scoring system was shown to be as powerful as more complex statistical techniques, such as discriminant analysis. It could be used for determining who could be eligible for free health insurance.