Aortic infective endocarditis decompensated by alithiasic cholecystitis in a patient on hemodialysis: Case report.

Infective endocarditis is an uncommon disease, which most often affects elderly subjects at risk or with favorable factors. Its prognosis is guarded with complications or decompensating factors that are often formidable. We report the case of an acute endocarditis decompensated by acute alithiasic cholecystitis in a 52-year-old patient, with a history of diagnosed end-stage renal failure (GFR 7 ml/min according to the MDRD) for 4 weeks, of undetermined etiology, undergoing hemodialysis, followed for aortic disease for 6 years (IAO grade II, RAO loose). After 6 weeks, the evolution was favorable under adapted and early antibiotic treatment and associated hygiene measures including gastric rest. Infective endocarditis remains a serious pathology, due to its high morbi-mortality. The association of acute infective endocarditis and acute alithiasic cholecystitis is of reserved prognosis especially on a ground of immunodepression like the end-stage chronic renal failure. This association requires a rapid and efficient management.

[Medication adherence among elderly patients with coronary artery disease: our experience in Morocco]. / Adhésion médicamenteuse chez les coronariens âgés: expérience marocaine.

The treatment of coronary artery diseases has made significant progress. Medication adherence among patients with coronary artery disease, in particular among elderly patients, is a major challenge to disease control and prevention of its complications. Medication adherence could be influenced by the demographic and socio-economic vulnerable situation in the African countries. We conducted a cross-sectional study of elderly patients treated for stable coronary artery disease on an ambulatory basis from March to October 2016. Medication adherence was evaluated by a questionnaire: Morisky Medication Adherence Scale. The informations about predictive factors of medication adherence were obtained from a multidimensional adherence model. The study involved 115 elderly patients (age > 65 years). Medication adherence accounted for 72.2%, according to Morisky Medication Adherence Scale. Physical inactivity was found in 59% of patients, hypertension and diabetes in 42.6% and 41.7% of patients respectively. Poor compliance predictive factors were: the absence of a mutual health (p = 0.02), the severity of symptoms (p = 0.001), patients who had acute coronary syndrome (p = 0.006), the level of social support (p = 0.011) and depression (p = 0.006). Medication adherence is a health problem in Morocco, particularly among elderly subjects. Health care providers should be aware of factors associated with a higher probability of stopping treatment, in particular of variable factors, in order to implement personalized strategies to improve adherence to treatment.

[Predictive factors of medication adherence in patients with chronic heart failure: Morocco's experience]. / Facteurs prédictifs de l'adhésion médicamenteuse chez les patients en insuffisance cardiaque chronique: expérience marocaine.

Medication adherence in patients with chronic heart failure is recognized as one of the major issues in the management of this pathology. Demographic status and socioeconomic conditions in African countries may have an impact on chronic heart failure treatment adherence. We conducted a cross-sectional study of patients with heart failure treated in the center of heart failure in the Department of Cardiology at the IBN ROCHD University Hospital (Morocco) from September 2014 to January 2015. The extent of medication adherence was based on a questionary: CARDIA-Questionary. The informations related to predictive factors of medication adherence were derived from the multidimensional adherence model. 147 patients with chronic heart failure were included in the study. Medication adherence rate was 83.6%, according to CARDIA-Questionary. Predictive factors that significantly influenced medication adherence were: depression (p=0.034), level of social support (p=0.03) and patient self administration of the drugs (p=0.0001). Medication adherence in patients with chronic heart failure is a health problem in Morocco as well as in several world regions. Strategies affecting predictive factors might improve medication adherence.