Psychometric evaluation of the Moroccan version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for use in patients with ankylosing spondylitis

The objectives of this study are to translate, adapt in the Moroccan cultural context, and validate in patients with ankylosing spondylitis (AS) the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The cross-cultural adaptation of the BASFI and BASDAI was obtained in accordance with the guidelines for translation of the health status measures. Eighty-five patients with AS were included in the study. The test–retest reliability and the internal consistency were analyzed, and both questionnaires were assessed for external construct validity. Structural validity was analyzed with correlation matrix. Twenty-four-hour test–retest reliability was good: BASFI intraclass correlation coefficient (ICC) = 0.96 (confidence interval (CI) at 95%, 0.93–0.97), BASDAI ICC = 0.93 (CI at 95%, 0.90–0.95). Cronbach’s alpha was 0.90 for the BASFI and 0.86 for BASDAI. The construct validity of the instruments was evaluated. The BASFI showed a strong validity when correlating its results with Schober’s test (r = −0.56), occipital wall distance (r = 0.46), chest expansion (r = −0.46), BASDAI (r = 0.54), Bath Ankylosing Spondylitis Metrology Index (r = 0.70), Bath Ankylosing Spondylitis Global Score (BAS-G; r = 0.58), Bath Ankylosing Spondylitis Radiology Index (r = 0.61), and the radiological changes in sacroiliac joints (r = 0.54). A good correlation was observed between the BASDAI and the spinal pain (r = 0.53), the number of nocturnal awakenings (r = 0.57), the morning stiffness (r = 0.65), the enthesic index (r = 0.47), the BAS-G (r = 0.53), the BASFI (r = 0.54), and the erythrocyte sedimentation rate (r = 0.41; for all p < 0.001). The correlation matrix showed an intermediate correlation between items. The Moroccan version of the BASFI and the BASDAI showed adequate reliability and validity. These instruments can be used in the clinical evaluation of Moroccan and Arabic-speaking patients with AS.     

Psychometric evaluation of a Moroccan version of health assessment questionnaire for use in Moroccan patients with rheumatoid arthritis

Objective of the study is to test the reliability and validity of a translated version of health assessment questionnaire (HAQ) on Moroccan patients with rheumatoid arthritis (RA). We led a prospective study from July 2004 to September 2005. A total of 100 Moroccan patients were recruited. After translation to dialect Arabic, back translation, expert committee review and pretesting of the questionnaire, it was administered to the selected patients and tested for construct validity, reliability and internal consistency. The construct validity was evaluated by correlating the yield of the questionnaire with other disease activity and severity parameters. The questionnaire was administered again after a time interval of between 2 and 10 days for evaluation of the reliability of this test. All the items were tested for their loyalty to the principal component. The adapted questionnaire showed a good internal consistency. Cronbach's alpha test was 0.994. The test-retest showed a strong reliability with a kappa test ranging from 0.70 to 0.92 for all domains. Intraclass correlation coefficient for the total score was 0.987. The Moroccan HAQ showed a strong validity. It correlates significantly with disease activity and severity parameters. The unidimentionality has been demonstrated. About 71.5% of all variabilities was accounted for by the first principal component. The Moroccan Arabic dialect version of HAQ is a reliable and valid instrument that can be self-administered by Moroccan RA patients to assess their functional disability.     

3H-domperidone binding sites differ in rat striatum and pituitary

Summary ³H-Domperidone (³H-DOMP) binding sites were compared in rat striatum and pituitary, regarding the effects of the non-hydrolysable GTP analog, Gpp(NH)p and inhibition by various dopamine (DA) antagonists. Gpp(NH)p (0.1 mM) elicited in both tissues a rightward shift in DA concentration-inhibition curves, but the changes in either IC₅₀ values or pseudo-Hill coefficients were larger in pituitary than in striatum. Computer analysis of the data showed that, in the presence of Gpp(NH)p, the curve obtained in striatum is best explained by the presence of two classes of binding site, a high-affinity site (K _i=95 nM, 27% of total binding) and a low-affinity site (K _i=5, 100 nM, 73% of total binding), whereas in pituitary only a low-affinity site (K _i=5,070 nM) could be detected.In striatum, several discriminant benzamide derivatives (DBD), (–)-sulpiride and recently developped compounds, allowed to distinguish two components among ³H-DOMP binding sites: a high-affinity site representing one-third of total binding and a low-affinity component displaying a 8–17 fold lower affinity. Classical neuroleptics like haloperidol, chlorpromazine and metoclopramide inhibited striatal ³H-DOMP binding in a monophasic manner. In pituitary a single component could be detected for all tested antagonists including the DBD and K _i values for the latters were identical to those found for the low-affinity component in striatum.Gpp(NH)p (0.1 mM) had no effect on the biphasic inhibition of striatal binding by the most discriminant compound RIV 2093, suggesting that the presence of two components for this DBD is not related to the two conformational states of the D-2 receptor. Also the discriminant property of RIV 2093 is not related to its binding to a sodium-dependent site, since the sodium effects (leftward shift of the inhibition curve) are very similar for RIV 2093 and the non discriminant substituted benzamide metoclopramide.It is concluded that, in addition to a fully GTP-sensitive site, analogous to the D-2 receptor detected in pituitary, striatum also contains a distinct class of binding site, not or less affected by GTP, for which DBD display a high affinity.     

Extracranial carotid aneurysm in Behçet disease: Report of two new cases

Extracranial carotid aneurysm due to Beh?et disease is extremely rare. To our knowledge, this complication has been previously reported in only 12 cases. We report two new cases of extracranial carotid aneurysm in Beh?et disease and discuss the clinical features, therapeutic modalities, and postoperative complications of these uncommon lesions.     

Laparoscopic treatment for renal hydatid cyst

A multivesicular hydatid cyst was removed from the left kidney of a 26-year-old woman by retroperitoneal laparoscopy to avoid contamination of the abdominal cavity. A scolicidal agent (20% hypertonic saline) was injected around the kidney initially and then instilled into the cyst after the contents had been evacuated. There were no complications and no anaphylactic shock. This appears to be the first reported case of treatment of renal hydatid cyst by laparoscopy.