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Ve studii se věnuji konceptualizaci medicínského pluralismu v Maroku. Pozornost kladu zejména na berberskou etnomedicínu v pohoří Vysokého Atlasu na základě vlastního terénního výzkumu realizovaného v průběhu let 2014 až 2017. Moje vlastní závěry a poznatky se opírají o studium marockých medicínských systémů v širším vývojovém a kulturním kontextu. V první části studie se zaměřuji na vymezení etnomedicíny a biomedicíny v Maroku. V další části přibližuji berberskou etnomedicínu s důrazem na oblast Vysokého Atlasu, kde charakterizuji roli léčitelek, jejich metody léčby a způsoby využití léčivých rostlin. V obecné rovině pak provádím deskripci léčivých rostlin, jejich účinků a způsobů využití ve zkoumaném areálu. V poslední části studie představuji tradiční model udržitelného využití přírodních zdrojů a aktuální vývoj neudržitelného využití přírodních zdrojů, které se mohou projevovat ve změně berberské etnomedicíny, ale současně také vést až k zániku pluralitního medicínského systému v Maroku.
In the paper I discuss the conceptualization of the medical pluralism in Morocco. I pay special attention to Berber ethnomedicine in the High Atlas, making use of my field research carried out in 2014 and 2017. My conclusions and findings are based on studying Moroccan health systems in a broader developmental and cultural context. In the first part of my paper I define ethnomedicine and biomedicine in Morocco. In the following part I describe Berber ethnomedicine with emphasis on the High Atlas, focusing on the role of traditional women healers, the main principles of their treatment methods and use of healing herbs. On a more general note I describe healing herbs, their effects and how they are used in the High Atlas. In the final part of my paper I present the traditional model of sustainable use of natural resources and the current development of unsustainable use of natural resources that may have impact on Berber ethnomedicine and even result to the extinction of medical pluralism in Morocco.
- MeSH
- fytoterapie MeSH
- komplementární terapie MeSH
- léčivé rostliny MeSH
- lidé MeSH
- tradiční lékařství MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Maroko MeSH
Holcophloeus caldarai sp. n. is described as a fifth species of the genus from central Morocco. The new species differs from all other species of the genus and, generally the entire tribe, by unique irregularly star-shaped appressed scales.
Although intranuclear coccidiosis was first identified in chelonians less than 30 years ago, it is now considered an important emerging disease. Symptoms include anorexia, weakness and weight loss, potentially leading to death of the infected animal. The use of molecular tools has led to improved diagnosis and has also led to an increase in known host species. Here we report a putative intranuclear coccidium in Mauremys leprosa (Schweigger), from Morocco, based on 18S rDNA sequence analysis. This is, to the best of our knowledge, the first report of this parasite from a freshwater terrapin species.
- MeSH
- Coccidia genetika izolace a purifikace MeSH
- kokcidióza parazitologie veterinární MeSH
- ribozomální DNA genetika MeSH
- sladká voda parazitologie MeSH
- želvy parazitologie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Geografické názvy
- Maroko MeSH
Phlebotomus (Ph.) sergenti is the main vector of Leishmania (L.) tropica (Trypanosomatida: Trypanosomatidae), the causative agent of anthroponotic cutaneous leishmaniasis in Morocco. This species has an extended geographical distribution, wider than that of the parasite. The main objective of our study was to analyze the genetic diversity of Ph. sergenti collected in four foci in Morocco: Taza, Foum Jemâa, El Hanchane, and Ouarzazate. We studied a set of diversity and population structure indices by sequencing two markers; nuclear EF-1α and mitochondrial Cyt b from 175 individual sand flies. Our results showed a considerable degree of intraspecific polymorphism with a high number of haplotypes identified in both genes. Many polymorphic sites detected in the Cyt b sequences (SCyt b = 45) indicate that it is the most polymorphic marker showing a distinct distribution of haplotypes according to their geographical origin, whereas the EF-1α marker showed no geographical isolation. Analysis by Tajima's D and Fu's Fs tests revealed a possible recent expansion of the populations, especially with the EF-1α marker, showing significant values in Taza and Ouarzazate sequences. The present study revealed significant genetic diversity within Ph. sergenti populations in Morocco. The results warrant further research using a combination of more than two markers including mitochondrial and non-mitochondrial markers, which may provide more information to clarify the genetic status of Ph. sergenti.
- MeSH
- cytochromy b MeSH
- elongační faktor 1 genetika MeSH
- leishmanióza kožní * parazitologie MeSH
- Phlebotomus * genetika parazitologie MeSH
- populační genetika MeSH
- Psychodidae * parazitologie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Maroko MeSH
Cíl: Cílem této studie bylo zhodnotit kvalitu péče o nemocné se srdečním selháním ve srovnání se současnými doporučenými postupy na Klinice kardiologie Vojenské nemocnice Muhammada V. v Rabatu. Materiály a metody: Do naší retrospektivní studie byli zařazováni po sobě následující jedinci přijatí pro echokardiograficky potvrzené srdeční selhání od ledna 2017 do března 2018 na Klinice kardiologie Vojenské nemocnice Muhammada V. v Rabatu. Pro analýzu údajů byl použit software SPSS 19.0. Výsledky: Do studie bylo zařazeno 120 pacientů průměrného věku 66,42 ± 10,78 roku. Hlavním zjištěným rizikovým faktorem byla hypertenze následovaná kouřením a diabetem. Dyspnoe jako hlavní symptom byla uvedena v 97,5 % případů. Klinický obraz zahrnoval oboustranné srdeční selhání (83,3 %), levostranné srdeční selhání (80,8 %) a pravostranné srdeční selhání (38,3 %). Transtorakální echokardiografie prokázala srdeční selhání se sníženou ejekční frakcí u 68,3 % pacientů a srdeční selhání se zachovanou ejekční frakcí v 31,6 % případů. Koronarografické vyšetření, provedené u 52 pacientů, prokázalo ischemickou chorobu srdeční v 65 % případů. Za hlavní etiologické faktory byly označeny ischemická choroba srdeční (57,5 %), chlopenní srdeční vada (24,1 %) a arteriální hypertenze (38,3 %). Ve farmakoterapii jsou nejčastěji užívanými léky diuretika (97,5 %), inhibitory angiotenzin konvertujícího enzymu (ACE) / blokátory receptoru AT1 pro angiotenzin II (86,6 %), beta-blokátory (33,6 %) a spironolacton (70 %), kombinace sacubitril/valsartan a ivabradin u 1,67 % pacientů. Mezi další používané léky patří digoxin (11,2 %) a amiodaron (9,2 %) u pacientů s fibrilací síní a refrakterním srdečním selháním. Na kardiovaskulární rehabilitaci bylo odesláno 16,6 % pacientů. Výkony jako elektrická kardioverze ani strukturovaná terapeu- tická edukace všech pacientů se neprováděly. Nemocniční mortalita dosáhla 1,6 %. Závěr: Přes epidemiologické a klinické charakteristiky vykazuje námi popsaná skupina pacientů řadu podobných znaků, jaké lze nalézt v evropských nebo amerických registrech. Je třeba vynaložit maximální úsilí k optimalizaci medikamentózní léčby. © 2021, ČKS.
Objective: The aim of this study is to make an inventory of the quality of care regarding HF, in comparison with current recommendations, at the Cardiology Department of Mohammed V Military Hospital in Rabat. Materials and methods: This is a retrospective study performed in consecutive patients admitted for heart failure documented by echocardiography, from January 2017 to March 2018, at the Cardiology Department of Mohammed V Military Hospital of Rabat. Data analysis is done by SPSS 19.0 software. Results: One hundred and twenty patients with a mean age of 66.42±10.78 years were included. The main risk factor observed in our series was hypertension followed by smoking and diabetes. Dyspnea is the main symptom reported in 97.5% of cases. The clinical picture is that of biventricular HF (83.3%), left-sided HF (80.8%) and right-sided HF (38.3%). On transthoracic echocardiogram, HF with impaired ejection fraction is found in 68.3%. HF with preserved ejection fraction constitutes 31.6% of the cases. 52 patients underwent coronary angiography showing coronary artery disease in 65 % of cases. The main etiologies found are ischemic heart disease (57.5%), heart valve disease (24.1%), and arterial hypertension (38.3%). Therapeutically, the most used drugs are furosemides (97.5%). ACE inhibitors/ARBs (86.6%), beta-blockers (33.6%), and spironolactone (70%), sacubitril/valsartan and ivabradine (1.67%). Other used drugs are digoxin (11.2%) and amiodarone (9.2%) in patients with atrial fibrillation or refractory HF. 16.6% of patients were referred to the cardiac rehabilitation service. There was neither electrical treatment nor a structured therapeutic education for all patients. Intra-hospital mortality rate was 1.6%. Conclusion: Despite the epidemiological and clinical features, our present series have many similarities with those of European and American registries. Efforts must be made to optimize medical treatment.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- senioři MeSH
- srdeční selhání * diagnóza epidemiologie etiologie farmakoterapie MeSH
- statistika jako téma MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
- Geografické názvy
- Maroko MeSH
OBJECTIVES: The authors aimed to evaluate whether blood cadmium (B-Cd), lead (B-Pb) and mercury (B-Hg) in children differ regionally in 9 countries, and to identify factors correlating with exposure. MATERIAL AND METHODS: The authors performed a cross-sectional study of children aged 7-14 years, living in 2007-2008 in urban, rural, or potentially polluted ("hot spot") areas (ca. 50 children from each area, in total 1363 children) in 6 European and 3 non-European countries. The authors analyzed Cd, Pb, and total Hg in blood and collected information on potential determinants of exposure through questionnaires. Regional differences in exposure levels were assessed within each country. RESULTS: Children living near industrial "hot-spots" had B-Cd 1.6 (95% CI: 1.4-1.9) times higher in the Czech Republic and 2.1 (95% CI:1.6-2.8) times higher in Poland, as compared to urban children in the same countries (geometric means [GM]: 0.13 μg/l and 0.15 μg/l, respectively). Correspondingly, B-Pb in the "hot spot" areas was 1.8 (95% CI: 1.6-2.1) times higher than in urban areas in Slovakia and 2.3 (95% CI: 1.9-2.7) times higher in Poland (urban GM: 19.4 μg/l and 16.3 μg/l, respectively). In China and Morocco, rural children had significantly lower B-Pb than urban ones (urban GM: 64 μg/l and 71 μg/l, respectively), suggesting urban exposure from leaded petrol, water pipes and/or coal-burning. Hg "hot spot" areas in China had B-Hg 3.1 (95% CI: 2.7-3.5) times higher, and Ecuador 1.5 (95% CI: 1.2-1.9) times higher, as compared to urban areas (urban GM: 2.45 μg/l and 3.23 μg/l, respectively). Besides industrial exposure, traffic correlated with B-Cd; male sex, environmental tobacco smoke, and offal consumption with B-Pb; and fish consumption and amalgam fillings with B-Hg. However, these correlations could only marginally explain regional differences. CONCLUSIONS: These mainly European results indicate that some children experience about doubled exposures to toxic elements just because of where they live. These exposures are unsafe, identifiable, and preventable and therefore call for preventive actions. Int J Occup Med Environ Health. 2023;36(3):349-64.
Digestive cancers are the most severe complications of celiac disease (CD), which can lead to death. We can report 12 patients with CD associated with cancer. It is retrospective study of 12 patients with CD complicated by cancers, collected in the department of diseases of the digestive system "Medicine C", from 1995 to 2017. Six patients had lymphoma, three were gastric tumors, two were small intestine tumors, and one had liver tumor. The diagnosis of lymphoma was made at the same time as that of CD in one patient, three months later in two patients, 18 months later in two patients and 8 years later in one patient. Morphological and histological data were in favor of malignant non-Hodgkin's lymphoma with intestinal localization in four patients, with lymph node localization in one patient and one patient with refractory celiac disease type 2 with intraepithelial lymphoma. The treatment consisted of chemotherapy in four patients and corticosteroid therapy with parenteral nutrition in one patient. The evolution was marked by the death of 03 patients and 2 patients were lost without any idea about their evolution. The diagnosis of the gastric tumor was retained after the realization of a upper gastrointestinal endoscopy with biopsies. The histopathologic examination was in favor of a well-differentiated adenocarcinoma in two patients, and of an adenocarcinoma moderately differentiated in one patient. The diagnosis of the well-differentiated neuroendocrine tumor was carried out 30 years after that of CD. The patient underwent a resection of the first two duodenal portions with duodeno-jejunal anastomosis and a colonic resection with termino-terminal anastomosis. The evolution was good with a 2 years follow-up. The second patient with intestinal cancer was a moderately differentiated adenocarcinoma of intestinal origin; the diagnosis was retained after an abdominal CT scan with mass biopsy. The treatment was palliative chemotherapy, with an abdominal scan three months later showed partial response. The hepatocellular carcinoma on healthy liver was diagnosed at the same time as CD on angio-CT scan data and liver biopsy with patient death at the time of diagnosis. Digestive cancers are severe complications of CD requiring early management and follow-up of patients to reduce the rate of death.
Gill monogenean species of Ligophorus Euzet et Suriano, 1977 were studied from the teleost Mugil cephalus Linneaus (Mugilidae) from the Mediterranean and Atlantic coasts of Morocco. We report the presence of L. mediterraneus from both the Mediterranean and Atlantic coast and L. cephali and L. maroccanus sp. n. from the Atlantic coast only. The latter species, which is described herein as new, resembles L. guanduensis but differs from this species mainly in having a shorter penis compared to the accessory piece, a proportionally longer extremity of the accessory piece and a less developed heel. The utility of Ligophorus spp. as markers of cryptic species of the complex M. cephalus is discussed in the context of species diversity and geographical distribution of these monogeneans on this host around the world. Presence of different species of Ligophorus on M. cephalus sensu stricto from the Atlantic and Mediterranean coast of Morocco demonstrates the usefulness of these species as fine resolution markers of genetic populations of their host, which are known to inhabit those coasts.
- MeSH
- biologické markery MeSH
- druhová specificita MeSH
- infekce červy třídy Trematoda epidemiologie parazitologie veterinární MeSH
- nemoci ryb epidemiologie parazitologie MeSH
- Smegmamorpha klasifikace MeSH
- Trematoda klasifikace izolace a purifikace MeSH
- žábry parazitologie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Atlantský oceán MeSH
- Maroko MeSH
- Středozemní moře MeSH
In Morocco, leishmaniases are a major public health problem due to their genetic diversity and geographical distribution. Cutaneous leishmaniasis (CL) is an infectious disease caused by various species of Leishmania and transmitted typically by bite of phlebotomine sand flies. This study identifies sand fly fauna in Ibaraghen village, province of Azilal, which is a focus of CL, by combination of morphological and molecular methods (sequencing of COI gene, MALDI-TOF MS protein profiling). Nested-kDNA PCR was used to detect and identify Leishmania species within potential vector species. 432 CDC light traps were placed at different heights above ground level at four capture sites during a whole year. Traps at 1.5 m above the ground yielded capture of sand flies almost double compared to above ground level (29.33%), while the collection reached 55.09% when the traps were placed 2.5 m above ground. A total of 2,830 sand flies were collected, 2,213 unfed specimens were morphologically identified, 990 males (44.73%) and 1,223 females (55.26%) of 13 species; ten Phlebotomus species and three Sergentomyia species. Six species were analysed by MALDI-TOF MS protein profiling (4 Phlebotomus and 2 Sergentomiya species), and their identification was confirmed by COI sequencing. 1,375 unfed females were screened for the presence of Leishmania by nested-kDNA PCR in pools, 11/30 pools of P. sergenti showing a single band of 750 bp corresponding to L. tropica. Our results confirm the role of P. sergenti as a proven vector in Azilal focus of cutaneous leishmaniasis; however, the relative abundance of other species known as vectors of Leishmania species emphasizes the risk of introduction of L. infantum and L. major in this province. For the first time in Morocco, a combined approach to identify sand flies by both morphology and molecular methods based on DNA barcoding and MALDI-TOF MS protein profiling was applied.
- MeSH
- hmyz - vektory MeSH
- kinetoplastová DNA MeSH
- Leishmania * genetika MeSH
- leishmanióza kožní * epidemiologie veterinární MeSH
- Phlebotomus * MeSH
- Psychodidae * MeSH
- spektrometrie hmotnostní - ionizace laserem za účasti matrice veterinární MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Maroko MeSH
