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Introduction The novel coronavirus, since its first identification in China, in December 2019, has shown remarkable heterogeneity in its clinical behavior. It has affected humans on every continent. Clinically, it has affected every organ system. The outcome has also been variable, with most of the older patients showing grave outcomes as compared with the younger individuals. Here we present a rare and severe variant of Guillain–Barre syndrome that complicated the disease in recovery phase. Case presentation A 60-year-old Afghan man, who had been recovering from symptoms related to novel coronavirus associated disease, presented with sudden onset of progressive muscle weakness and oxygen desaturation. Electrophysiological workup confirmed the diagnosis of Guillain–Barre syndrome, and early institution of intravenous immunoglobulin resulted in complete resolution. Conclusion Guillain–Barre syndrome has recently been reported in many patients diagnosed with novel coronavirus associated disease. While clinical suspicion is mandatory to guide towards an effective diagnostic workup, early diagnosis of this complication and timely institution of therapeutic interventions are indispensable and lifesaving.

Aggressive angiomyxoma is a rare benign and locally invasive mesenchymal tumor that is found most frequently in women at reproductive age. We report typical CT and MRI appearances of a 36-year old young woman with an aggressive angiomyxoma of the pelvis and perineum that was proved by ultrasound guided biopsy.This study describe the imaging features of theses tumors,wich may help to approch the diagnosis by their distinctive imaging with high signal intensity on T2-weighted image related to the myxomatous stroma and their characteristic of swirling or layering internal pattern after intravenous gadolinium contrast administration.We also review the CT and MRI features of this disease in the current literature.

Intradermal vaccination with Mycobacterium bovis bacillus Calmette–Guérin (BCG) protects infants from disseminated tuberculosis, and i.v. BCG protects nonhuman primates (NHP) against pulmonary and extrapulmonary tuberculosis. In humans and NHP, protection is thought to be mediated by T cells, which typically recognize bacterial peptide Ags bound to MHC proteins. However, during vertebrate evolution, T cells acquired the capacity to recognize lipid Ags bound to CD1a, CD1b, and CD1c proteins expressed on APCs. It is unknown whether BCG induces T cell immunity to mycobacterial lipids and whether CD1-restricted T cells are resident in the lung. In this study, we developed and validated Macaca mulatta (Mamu) CD1b and CD1c tetramers to probe ex vivo phenotypes and functions of T cells specific for glucose monomycolate (GMM), an immunodominant mycobacterial lipid Ag. We discovered that CD1b and CD1c present GMM to T cells in both humans and NHP. We show that GMM-specific T cells are expanded in rhesus macaque blood 4 wk after i.v. BCG, which has been shown to protect NHP with near-sterilizing efficacy upon M. tuberculosis challenge. After vaccination, these T cells are detected at high frequency within bronchoalveolar fluid and express CD69 and CD103, markers associated with resident memory T cells. Thus, our data expand the repertoire of T cells known to be induced by whole cell mycobacterial vaccines, such as BCG, and show that lipid Ag-specific T cells are resident in the lungs, where they may contribute to protective immunity.

The adenocarcinoma of the small intestine is a rare tumor of all gastrointestinal cancers often occurs on a predisposing ground we report the case of a 40-year-old patient chronic smoker has 1 pack year weaned 2 years ago, alcoholic weaned 5 years ago whose symptomatology dates back to 3 months by the appearance of epigastralgia and vomiting post prandial, Complicated by a high occlusive syndrome made of post prandial vomiting with abdominal pain all evolving in a context of alteration of general state made the patient was addressed to the service of digestive cancer surgery and liver transplantation of CHU Ibn Rochd Casablanca. The patient had an abdominal CT scan which showed duodenojejunal distension with incarceration of an undistended loop at the level of the aorto-mesenteric clamp. The patient was sent to the operating room in emergency, he underwent a segmental Greco-Resection of 15 cm taking away a jejunal mass under laparoscopy with extra corporal anastomosis latero-lateral jejuno-jejunal with at the exploration one notes the presence of a tumoral mass of 3cm mobile at the level of the 2nd loop jejunal stenosing responsible for a jejunal distension upstream measuring 4cm in diameter. The anatomopathological study of the specimen showed a moderately differentiated and invasive adenocarcinoma, classified as pT3N1Mx. The postoperative follow-up was marked by a deep venous thrombosis involving the ileo-femoral-popliteal axis of the ilio-femoral-popliteal trunk on day 2 postoperatively, for which the patient was put on low molecular weight Heparin at a curative dose with compression stockings and monitoring. The patient had resumed transit in the form of gas on postoperative day 3, with a correct assessment, and was declared discharged on postoperative day 6. The patient's file was discussed in a multidisciplinary consultation meeting and the decision was to undergo adjuvant chemotherapy and oesogastroduodal fibroscopy (FOGD) and colonoscopy to look for predisposing diseases.

High-dose therapy and autologous stem cell transplantation (HDT/ASCT) is an effective salvage treatment for eligible patients with follicular lymphoma (FL) and early progression of disease (POD). Since the introduction of rituximab, HDT/ASCT is no longer recommended in first remission. We here explored whether consolidative HDT/ASCT improved survival in defined subgroups of previously untreated patients. We report survival analyses of 431 patients who received frontline rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) for advanced FL, and were randomized to receive consolidative HDT/ASCT. We performed targeted genotyping of 157 diagnostic biopsies, and calculated genotype-based risk scores. HDT/ASCT improved failure-free survival (FFS; hazard ratio [HR], 0.8, P = .07; as-treated: HR, 0.7, P = .04), but not overall survival (OS; HR, 1.3, P = .27; as-treated: HR, 1.4, P = .13). High-risk cohorts identified by FL International Prognostic Index (FLIPI), and the clinicogenetic risk models m7-FLIPI and POD within 24 months–prognostic index (POD24-PI) comprised 27%, 18%, and 22% of patients. HDT/ASCT did not significantly prolong FFS in high-risk patients as defined by FLIPI (HR, 0.9; P = .56), m7-FLIPI (HR, 0.9; P = .91), and POD24-PI (HR, 0.8; P = .60). Similarly, OS was not significantly improved. Finally, we used a machine-learning approach to predict benefit from HDT/ASCT by genotypes. Patients predicted to benefit from HDT/ASCT had longer FFS with HDT/ASCT (HR, 0.4; P = .03), but OS did not reach statistical significance. Thus, consolidative HDT/ASCT after frontline R-CHOP did not improve OS in unselected FL patients and subgroups selected by genotype-based risk models.

Objective To describe the spontaneous evolution of age-related changes affecting knee joint articular cartilage, walking speed and a serum biomarker of cartilage remodeling in C57BL/6-JRj wild-type male mice. Design Histological changes were assessed by the Osteoarthritis Research Society International (OARSI) score (0=normal, 6=vertical clefts/erosion to the calcified cartilage extending >75% of the articular surface) in newborn, 1-week- and 1-, 3-, 6-, 9- and 12-month-old C57BL/6-JRj wild-type male mice, walking speed by the Locotronic system, and serum C-terminal telopeptide of type II collagen (CTX-II) content by ELISA in 1-, 3-, 6-, and 9-month-old C57BL/6-JRj wild-type male mice. Results Mean (SD) OARSI score significantly increased from 0.2 (0.3) to 1.3 (0.6) ( p=0.03) between 1 and 3 months of age and from 1.3 (0.6) to 3.3 (0.6) ( p=0.04) between 3 and 6 months of age. Mean walking speed was stable between 1 and 6 months of age but significantly decreased from 11.4 (1.8) to 3.2 (0.8) cm.s-1 ( p=0.03) between 6 and 9 months of age. Serum CTX-II content was maximal at 1 month of age, then decreased from 12.2 (8.5) to 2.4 (8.4) pg/ml ( p=0.02) between 1 and 3 months of age, remaining low and stable thereafter. Conclusions C57BL/6-JRj wild-type male mice showed continuously increasing osteoarthritic changes but delayed decreasing walking speed with age. These variations were maximal between 3 and 9 months of age. Maximal serum CTX-II content preceded these changes.

Background Because auricular reconstruction is a complex and relatively uncommon procedure, there are many patients that have had disappointing reconstructions. This study describes the authors' large experience with secondary procedures in patients with unsatisfactory or failed initial ear reconstruction. Methods A prospectively maintained database of all consecutive patients who underwent secondary total ear reconstruction from March of 1991 to December of 2017 was reviewed. Demographic data and outcomes were assessed. Patients with acquired absence of the ear were not included. Results There were 144 microtia patients that met the inclusion criteria. Patient age at the time of the secondary reconstruction ranged from 3 to 59 years. Follow-up duration ranged from 1 to 21 years. Primary reconstruction was performed with rib cartilage in 91 patients, porous polyethylene implant in 47 patients, prosthesis in four patients, and irradiated cadaver rib cartilage in two patients. All secondary reconstructions were performed with porous polyethylene implants. The alloplastic framework was covered with a temporoparietal fascia flap in 76 patients, an occipital fascia flap in 64 patients, and a free fascia flap in four patients (two radial forearm flaps in the same patient, one contralateral temporoparietal fascia flap, and one lateral arm flap). Fourteen patients (10 percent) had complications requiring revision surgery. Secondary surgery was successful in all but one patient. Conclusions These data represent the largest series of secondary total ear reconstructions. The use of a porous polyethylene implant is an ideal method for these patients because of its minimal morbidity and relatively low complication rate. Clinical question/level of evidence Therapeutic, IV.

An increased expression of oncogenic microRNA miR551b-3p (also known as miR551b) occurs in a subset of breast cancer due to genomic amplification of 3q26.2 locus. Using in silico and clinical sample analysis of breast cancer patient datasets, we identified that those breast cancer samples that encompass miR551b amplification express high levels of STAT3 mRNA and Oncostatin (OSM) family genes in triple-negative breast cancer (TNBC). Furthermore, high expression of Oncostatin family genes associates with poor outcome in estrogen receptor- negative breast cancer patients. In this study, we identified a previously unexplored mechanism that miR551b-3p promotes breast cancer progression and tumor growth by direct interaction of miR551b-3p with STAT3 promoter thereby activating STAT3 transcription. As a consequence, STAT3 upregulates a cytokine Oncostatin and its receptor Oncostatin M receptor (OSMR) and their interaction further induces STAT3 phosphorylation and an autocrine self-reinforcing loop in TNBC cells. In this study, we demonstrate that overexpression of miR551b-3p promoted proliferation, invasion and migration, epithelial to mesenchymal transition (EMT) and spheroid formation of breast cancer cells and its inhibition decreased the expression of miR551b-3p by inhibiting OSM, OSMR, IL6ST, IL31RA, phosphorylated and total STAT3 in breast cancer cells and reduced tumor cell growth. Overall, our results provide the first evidence that miR551b regulates OSM family gene expression by activating STAT3 and thereby promoting tumor cell growth and metastasis in breast cancer cells. Therefore, targeting miR-551b-3p-STAT3-OSMR axis and inhibiting their levels will provide an unprecedented therapeutic opportunity in breast cancer. Citation Format: Anjali Geethadevi, Deepak Parashar, Miriam Ragle Aure, Jasmine George, Changliang Chen, Jyotsna Mishra, Andliena Tahiri, Bindu Nair, Amadou Camara, Vessela N Kristensen, Sunila Pradeep, Pradeep Chaluvally Raghavan. miR551b-3p promotes Oncostatin M signaling in breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-05-04.

Dysplasia is a preneoplastic lesion. Histological diagnosis is based on the presence of architectural and cytological modifications, and dedifferentiation, which the intensity is variable. Dysplasia is commonly graded as low and high grade. We achieved a retrospective study of 90 cases of gastrointestinal dysplasia collected in the Department of Pathology of Hassan II university hospital of Fez, during a period of 3 years. The cases were reviewed independently and blindly without clinical information by two pathologists. Their diagnoses were compared to the initial diagnosis. Interobserver concordance in the diagnosis of the degree of dysplasia was evaluated. The average age of our patients was 56 years oldwithout predominance of sex. The interobserver concordance in the diagnosis of digestive dysplasia between the three pathologists was moderate (with a Kappa estimated at 0.42). Concordant diagnosis for digestive low grade dysplasia was observed in 50 cases of the 55 cases (90%) and only 18 cases of high-grade dysplasia of 35 cases studied (50%). The agreement for the low-grade dysplasia is more significant. However, there is significant variation in the analysis of high-grade dysplasia. This work reveals a moderate reproducibility in the diagnosis of gastrointestinal dysplasia lesions and mostly well marked for high-grade dysplasia.

Transition to being a parent is a stress-producing process that involves adapting both parents and their families even in the most favorable circumstances. Information on the level of psychological adaptation of women and family before and during pregnancy is very important as anxiety and the effects of accumulated life stress can directly affect individual and family well-being in the postnatal period. Especially for women or families facing multiple stresses and limited resources, ensuring security, understanding, compassion and direction may have a significant positive effect during this phase. A sample of 91 women immediately after birth at the Obstetrics-Gynecology Clinic (KOGJ) at the University Clinical Center of Kosovo (UCCK) completed two self-administered questionnaires. Initially, literature on postpartum depression was investigated. Two instruments for this paper have been selected from the range of instruments available for postnatal depression research literature: Patient health questionnaire (PHQ-9) and Postpartum Depression Screening Scale (PDSS). The introduction and analysis of data is done with the Statistical Package of Social Sciences (SPSS), Version 21 (Statistical Package for the Social Sciences—SPSS). Failure or frustration and sleep problems are the highest mean postnatal depression indicators 1.8. Then there is fatigue or lack of energy, increased appetite or anorexia and suicidal thoughts and self-esteem with a mean attendance of 1.7 in the post-depression indicator group. Depression or loss of hope and dissatisfaction or interest in activities are in the group of indicators with an average of 1.6. Movement or speech problems and concentration problems are the least affected indicators in the post-depression indicator group, with only 1.5. Our statistics show a relatively high level of postpartum depression, which includes women of all categories without taking into account the economic situation, the level of education or the number of births, the results derived from the correlation analysis which is non-aligning during the comparison of these categories. Involvement of nurses/midwives at a time setting of this phenomenon is a necessity for which to invest?

Summary: Genomic amplification of 3q26.2 locus leads to the increased expression of microRNA 551b-3p (miR551b-3p) in triple-negative breast cancer (TNBC). Our results demonstrate that miR551b-3p translocates to the nucleus with the aid of importin-8 (IPO8) and activates STAT3 transcription. As a consequence, miR551b upregulates the expression of oncostatin M receptor (OSMR) and interleukin-31 receptor-α (IL-31RA) as well as their ligands OSM and IL-31 through STAT3 transcription. We defined this set of genes induced by miR551b-3p as the “oncostatin signaling module,” which provides oncogenic addictions in cancer cells. Notably, OSM is highly expressed in TNBC, and the elevated expression of OSM associates with poor outcome in estrogen-receptor-negative breast cancer patients. Conversely, targeting miR551b with anti-miR551b-3p reduced the expression of the OSM signaling module and reduced tumor growth, as well as migration and invasion of breast cancer cells. : Parashar et al. demonstrate that the mature microRNA-551b-3p translocates to the nucleus for transcriptional activation of STAT3 gene. As a consequence, miR551b activates an autocrine signaling loop through the upregulation of oncostatin family genes, including oncostatin, and its receptors for the growth and metastasis of triple-negative breast cancer. Keywords: miR551b, oncostatin, STAT3, OSMR, miRNA-therapy, IPO8, RNAi

Background The occurrence of intestinal stenosis is a common and potentially serious complication of Crohn’s disease (CD). These strictures represent 20% of the surgical indications in CD. Endoscopic dilation is an alternative to surgery for endoscopically accessible stenosis. The aim of this study is to evaluate the effectiveness of endoscopic balloon dilation (EBD) in CD intestinal stenosis. Methods This retrospective, descriptive study realized between January 2015 and October 2020, included CD patients diagnosed at least 6 months before and complicated with symptomatic intestinal stenosis (abdominal pain, bloating, nausea and vomiting). Anorectal strictures were excluded. All patients had a cross-sectional imaging before intestinal dilation to determine the characteristics of the stenosis and exclude abscess and fistula tract near the stenosis which constitute a contraindication of EBD. All patients underwent an EBD during a colonoscopy under sedation by propofol. The short-term success of EBD has been established on both technical (passage of the endoscope across the site of stenosis after dilation) and clinical level (relief of intestinal obstructive symptoms). The long-term efficacy was defined by no need for surgery within 6 months after dilation. Results Twelve patients (6 males and 6 females), with an average age of 32 years +/-7.7, were included. The average interval between onset of CD and the onset of intestinal stricture was 8 years. Eight patients had a history of bowel resection. The stenosis was located at the terminal ileum or ileocaecal valve in 4 cases, ileocolic anastomosis in 8 cases. The stenosis was ulcerated in 9 cases, inflammatory in 5 cases and polypoid in 3 cases. All patients were on medical treatment corticosteroids, Azathioprine and / or Anti TNF. We performed 18 EBD, divided into several sessions depending on the degree of stenosis (1 EBD, 2 EBD and 3 EBD in respectively 11, 3 and 2 patients). Two patients required surgery for persisting symptoms. Technical success was obtained in 11 patients (92% of cases). Clinical success, defined by a disappearance of clinical symptoms with an HBI score of less than 4, was obtained in 9 patients (75% of cases). The mean follow-up after dilation was 23 months (range from 8 to 42 months). No major complications were observed in this study. Conclusion EBD is an effective therapeutic technique relatively safe for intestinal CD stenosis, allowing to delay or better, to avoid surgical treatment when the stenosis is well selected (stenosis

The most complications of the vascular access are: thrombosis, aneurysm, infection. Aneurysms can be either true, containing all layers of a venous wall, or false (pseudoaneurysm), lined by fibrous tissue and thrombosis. Aneurysm dilatation is one of the major complications of vascular access. The incidence increased with the duration of the usage, repeated puncture at the same or nearby site, and increased intraluminal pressure of the graft. We present an uncommon case in which aneurysm and pseudoaneurysm of the native fistula is caused by puncture, in both sides. Repeated punctures at the same site, may progressively weaken the venous wall resulting in dilation of the outflow vein. A 68- year-old Albanian women had been in a hemodialysis program for 4 years, using a left brachiocephalic fistula. The inflow artery, outflow vein, and the deep veins were examined in detail. During the study period the patient have had three surgeries, for aneurysm of hemodialysis access on one hand, and for pseudoanurysm of hemodialysis access on the other hand. But, even that the patient survived and everything went well. The idea of our paper was that in patients we have predisposition for the formation of aneurysm and pseudoaneursym, the medical staff have more frequent meetings, so that such cases are treated more specifically, with more frequent visits to vascular surgeon, with more frequent measurements of draining vein diameter and flow of vascular access. The K/DOQI guidelines recommend a regular program of monitoring and surveillance of the vascular access. Color Doppler ultrasound s considered a valuable tool in the preoperative evaluation and in the follow-up.

Background Hyperparathyroidism (HPT) is a common endocrine disorder resulting from overproduction of parathyroid hormone (PTH). Usually HPT is caused by parathyroid adenoma (PA) or parathyroid hyperplasia (PH). Our aim is to assess clinicopathologic features associated with PA and PH in patients with HPT. Methods We retrospectively collected 29 cases of HPT recorded at the Department of Pathology of Hassan II University Hospital of Fes, Morocco, from 2013 to 2016. Results The mean age was 52.14 ± 15.7 years (range of 22–76 years), 13 patients (44.8%) had primary HPT, 16 (55.2%) had secondary HPT. The largest size of the resected parathyroid specimens ranged from 1 to 3.6 cm (mean of 2.26 ± 0.66 cm). Seventeen patients (58.6%) had PA, the remaining cases were diagnosed as PH. There were no significant statistical differences between PA and PH in age, sex, clinical presentation, preoperative serum PTH, or in parathyroid gland size (P > 0.05). However compared to PH, PA is more often a single-gland disease, found in primary HPT with higher preoperative calcium level (P ˂ 0.05). Conclusions In patients surgically treated for HPT, PA is associated with some distinctive clinicopathologic features. These findings could be helpful to pathologists and clinicians for appropriate clinicopathologic management., Highlights • Hyperparathyroidism (HPT) is a common endocrine disorder resulting from overproduction of parathyroid hormone (PTH). • Usually HPT is caused by parathyroid adenoma (PA) or parathyroid hyperplasia (PH). • Surgical resection is the main treatment of patients with HPT. • PA and PH have distinctive clinicopathologic features that are used to adapt patients' surgical management.

Introduction:Trichilemmal cysts are lesions originating in the isthmus of the hair follicle. They are more common in women and occur in 90% on the scalp. Presentation of case:A 10-year-old female patient presented with a hard, slightly painful, nonexophytic mass in the right cervical region (Ia). After surgical resection in healthy margins, the diagnosis of trichilemmal cyst was made on histopathological examination. Discussion:The age of the patient as well as the cervical location of this type of lesion is an extremely rare presentation of trichilemmal cyst. Follow-up is rigorous in search of a triad: ichthyosis, keratosis, deafness, particularly in this patient. Conclusion:Close follow-up in this clinical case is indicated because the risk of malignant degeneration and development of similar lesions is present. Keywords:Follicular cyst; KID syndrome; Trichilemmal cyst; Neck surgery; Trichilemmal carcinoma

Bacillus Calmette and Guérin (BCG), widely used as a vaccination to prevent tuberculosis, is also used as immunotherapy, by intrabladder instillation, to treat superficial bladder cancers and prevent recurrence. Complications following instillation of BCG are most often localized reactions, such as cystitis or hematuria. They can more rarely be generalized and potentially severe such as hepatitis, pneumopathies, aortitis, and localization to hematopoietic tissue. We have reported the observation of a 47-year-old patient followed up for a bladder tumor operated for transurethral resection of the bladder, then having benefited from an instillation of BCG therapy complicated by occurrence a week later of an acute hepatitis. The diagnostic time was 2 days, and the outcome was favorable with corticosteroid therapy.

Highlight • NET possesses pro-tumorigenesis effect on human breast epithelial MCF10A cells. • NET upregulates PGRMC1/EGFR and suppresses PTEN expression. • NET stimulates the PI3K/Akt/mTOR signal pathway. • Overexpression of miR-181a abrogates the effects of NET., Background Research suggests that hormone replacement therapy may increase the risk of breast cancer, and progestins such as norethisterone (NET) play a key role in this phenomenon. We have demonstrated that microRNA-181a (miR-181a) suppresses NET-promoted breast cancer cell survival. Nonetheless, the effects of NET and miR-181a on the tumorigenesis of human breast epithelial cells have not yet been elaborated. Methods Assays of cell viability, proliferation, migration, apoptosis, and colony formation were performed to investigate the pro-tumorigenesis effect of NET and the effects of miR-181a on human breast epithelial MCF10A cells. The expressions of cell-proliferation-related genes and apoptotic factors were analyzed by quantitative RT-PCR and Western blot in MCF10A cells treated with NET and miR-181a. Results NET significantly increased MCF10A cell viability, proliferation, migration, and colony formation, but reduced cellular apoptosis. In addition, NET increased the expression of progesterone receptor membrane component 1 (PGRMC1), EGFR, B-cell lymphoma 2, cyclin D1, and proliferating cell nuclear antigen, but decreased the expression of pro-apoptosis factors, such as Bax, caspase-7, and caspase-9. Overexpression of miR-181a strongly inhibited the effects of NET on MCF10A cells and abrogated NET-stimulated PGRMC1, EGFR, and mTOR expression. Conclusions Activation of the PGRMC1/EGFR–PI3K/Akt/mTOR signaling pathway is the primary mechanism underlying the pro-tumorigenesis effects of NET on human breast epithelial MCF10A cells. Additionally, miR-181a can suppress the effects of NET on these cells. These data suggest a therapeutic potential for miR-181a in reducing or preventing the risk of breast cancer in hormone replacement therapy using NET.

Echinococcus granulosus is the etiological agent of cystic echinococcosis (CE), also commonly called hydatidosis. This is a zoonotic infection endemic worldwide, including the Mediterranean basin and Morocco. The genetic variability of Echinococcus granulosus is known to influence development of parasitic cysts in different intermediate hosts, and therefore the epidemiology of infection. Molecular studies have identified nine genotypes of Echinococcus granulosus, eight of them affect humans, grouped today in four distinct species. In Morocco, molecular studies on CE cysts from animals showed the presence, for the large majority of cases, of the G1 genotype (« sheep strain » or Echinococcus granulosus sensu stricto), which is also the cause of the majority of human infections worldwide, and to a lesser extent of the other genotypes (G2 and G3) within Echinococcus granulosus sensu stricto complex. However, so far no genotyping of echinococcal cysts in Morocco has been carried out. We collected CE cysts material from 15 patients diagnosed with abdominal CE in the Meknès-Tafilalt region, Middle Atlas of Morocco, and an endemic area and genotyped by multiplex PCR. The only five cysts from which it was possible to successfully amplify the DNA were all belonging to the G1–G3 genotype, in line with the epidemiology of CE in animals in the same area. Our results add new information, on the human side, to the epidemiological picture of CE in the region, which are important in the context of any control plan for the infection.

The use of a porous polyethylene implant covered with a well-vascularized fascial flap allows ear reconstruction at an early age (before school) with minimal morbidity and psychological trauma. Excellent outcomes with minimal morbidity can be obtained using this technique. This type of microtia reconstruction provides a more holistic approach because it is done at a younger age, in a single stage, as an outpatient and could address the functional hearing issues earlier.

The anti-synthetase syndrome is represented by the association of in-flammatory myopathy (polymyositis/dermatomyositis), interstitial pneu-monitis, Raynaud’s syndrome, inflammatory polyarthritis, and characteristic skin abnormalities. We found also a clinical aspects of Mechanic’s hand with high level of anti-synthetases. We report the case of a 66-year-old patient with polyar- thralgias of large and small inflammatory joints, myositis, Raynaud’s phenomenon, and cutaneous involvement of the hands and feet, with fissure hyperkeratosis feet and an appearance of mechanic’s hands. The patient had an inflammatory syndrome, elevated muscle enzymes, positivity of anti-Jo1 antibodies, PID at chest CT and the presence of inflammatory mononuclear cell infiltrates at muscle biopsy. The evolution under immunosuppressive treatment combining corticosteroids and methotrexate was marked by an oedemato-ascitic decompensation of a post-HVB cirrhosis unknown.

Background. The management of patients with aphakia and/or lack of capsular support remains debated. The sutureless posterior chamber IOL (PCIOL) fixation is a very useful surgical option. The purpose of the study was to compare the early outcomes as well as post-operative best corrected visual acuity, refractive errors and complications of two different techniques of sutureless PCIOL secondary implantation. Methods. Patients who underwent secondary implantation from December 2019 to January 2021 in the Department of Ophthalmology of Creteil Hospital, and in the Granville Ophthalmology Center, were retrospectively included. Eyes implanted with the iris claw lens (Artisan Aphakia IOL model 205, Ophtec BV, Groningen, The Netherlands) were included in group 1, and eyes implanted with a newly developed sutureless trans-scleral plugs fixated lens (STSPFL, Carlevale lens, Soleko, Pontecorvo, Italy) were included in group 2. Results. Twenty-two eyes of 22 patients were enrolled in group 1, and twenty eyes of 20 patients in group 2. No difference was found in visual acuity between two groups (0.35 +/− 0.29 logmar for group 1 and 0.23 +/− 0.51 logmar for group 2) (p = 0.15) at mean post-operative follow up (6.19 +/− 3.44 months for group 1 and 6.42 +/− 3.96 months for group 2) (p = 0.13). Both the mean refractive error (MRE) and induced astigmatism (IA) were greater in group 1 compared to group 2, respectively: the MRE was 0.99 +/− 0.57 vs. 0.46 +/− 0.36 (p &lt, 0.01), and IA was 1.72 +/− 0.96 vs. 0.72 +/− 0.52 (p &lt, 0.01). Conclusions. No significant differences in terms of the recovery of visual acuity were found between the two groups. Group 2 (STPFL) gives better results in our sample due to less post-operative induced astigmatism and less refractive error.

Objective Autophagy is a physiological self-eating process that can promote cell survival or activate cell death in eukaryotic cells. In skeletal muscle, it is important for maintaining muscle mass and function that is critical to sustain mobility and regulate metabolism. The UV radiation resistance-associated gene (UVRAG) regulates the early stages of autophagy and autophagosome maturation and plays a key role in endosomal trafficking. This study investigated the essential in vivo role of UVRAG in skeletal muscle biology. Methods To determine the role of UVRAG in skeletal muscle in vivo, we generated muscle-specific UVRAG knockout mice using the Cre-loxP system driven by Myf6 promoter that is exclusively expressed in skeletal muscle. Myf6-Cre+ UVRAGfl/fl (M-UVRAG−/−) mice were compared to littermate Myf6-Cre+ UVRAG+/+ (M-UVRAG+/+) controls under basal conditions on a normal chow diet. Body composition, muscle function, and mitochondria morphology were assessed in muscles of the WT and KO mice at 24 weeks of age. Results M-UVRAG−/− mice developed accelerated sarcopenia and impaired muscle function compared to M-UVRAG+/+ littermates at 24 weeks of age. Interestingly, these mice displayed improved glucose tolerance and increased energy expenditure likely related to upregulated Fgf21, a marker of muscle dysfunction. Skeletal muscle of the M-UVRAG−/− mice showed altered mitochondrial morphology with increased mitochondrial fission and EGFR accumulation reflecting defects in endosomal trafficking. To determine whether increased EGFR signaling had a causal role in muscle dysfunction, the mice were treated with an EGFR inhibitor, gefitinib, which partially restored markers of muscle and mitochondrial deregulation. Conversely, constitutively active EGFR transgenic expression in UVRAG-deficient muscle led to further detrimental effects with non-overlapping distinct defects in muscle function, with EGFR activation affecting the muscle fiber type whereas UVRAG deficiency impaired mitochondrial homeostasis. Conclusions Our results show that both UVRAG and EGFR signaling are critical for maintaining muscle mass and function with distinct mechanisms in the differentiation pathway., Highlights • Deletion of UVRAG in skeletal muscle accelerates muscle wasting with aging. • UVRAG in skeletal muscle regulates mitochondrial dynamics and function. • UVRAG deletion leads to EGFR accumulation in skeletal muscle. • Constitutively active EGFR contributes to muscle fiber type determination.

Mucorales are the causal agents for the lethal disease known as mucormycosis. Mortality rates of mucormycosis can reach up to 90%, due to the mucoralean antifungal drug resistance and the lack of effective therapies. A concerning urgency among the medical and scientific community claims to find targets for the development of new treatments. Here, we reviewed different studies describing the role and machinery of a novel non-canonical RNAi pathway (NCRIP) only conserved in Mucorales. Its non-canonical features are the independence of Dicer and Argonaute proteins. Conversely, NCRIP relies on RNA-dependent RNA Polymerases (RdRP) and an atypical ribonuclease III (RNase III). NCRIP regulates the expression of mRNAs by degrading them in a specific manner. Its mechanism binds dsRNA but only cuts ssRNA. NCRIP exhibits a diversity of functional roles. It represses the epimutational pathway and the lack of NCRIP increases the generation of drug resistant strains. NCRIP also regulates the control of retrotransposons expression, playing an essential role in genome stability. Finally, NCRIP regulates the response during phagocytosis, affecting the multifactorial process of virulence. These critical NCRIP roles in virulence and antifungal drug resistance, along with its exclusive presence in Mucorales, mark this pathway as a promising target to fight against mucormycosis.

Summary Purpose To describe en face anterior segment optical coherence tomography (EF-OCT) characteristics of pterygia and their correlation with in vivo confocal microscopy (IVCM). Patients and methods In this observational case series, we prospectively included 21 eyes of 17 subjects with pterygium. All subjects underwent detailed ophthalmic examination, anterior segment photography, an ocular surface disease index (OSDI) questionnaire, IVCM , and EF-OCT. Eyes were divided into two groups according to pterygium severity (Modified Pterygium Classification System) and OSDI score. EF-OCT images for both groups were analyzed for surface area of Fuchs Patches (FP). The IVCM activity score was based on the number of inflammatory cells, blood vessels, activated keratocytes and the appearance of the cornea/pterygium at the head of the pterygium. The correlations between EF-OCT and IVCM images were then analyzed and compared in both groups. Results EF-OCT permits clear visualization and evaluation of FPs and the border between the pterygium and the adjacent cornea. The severe pterygium group was characterized by irregular borders and larger FPs (0.13 ± 0.06 mm2 versus 0.06 ± 0.02 mm2 respectively) (P = 0.003). The mean IVCM activity score was 2.36 ± 0.81 in the severe pterygium group and 1.2 ± 0.42 in the mild pterygium group (P = 0.0013). There was a positive correlation between FP surface area and IVCM activity score. A larger FP surface area was associated with a higher activity score on IVCM. Conclusion EF-OCT allows good evaluation of pterygium extension, borders and FP surface area. EF-OCT analysis of pterygium could represent a simple, non-invasive and reproducible method to evaluate pterygium severity and activity.

INTRODUCTION: Le but de cette A©tude A©tait de faire une corrA©lation entre le syndrome mA©tabolique et le niveau de l´activitA© physique chez une population de Marrakech, au Maroc. METHODES: l´A©tude a A©tA© menA©e A l´hA´pital rA©gional Ibn Zohr A Marrakech. L´indice de masse corporelle (IMC) a A©tA© calculA© pour A©valuer le degrA© d´obA©sitA© de chaque sujet. Pour dA©terminer le niveau d´activitA© physique, nous avons utilisA© la version courte du questionnaire IPAQ (International Physical Activity Questionnaire); Les paramA¨tres sanguins ont A©tA© mesurA©s par un automate de biochimie. Toutes les analyses statistiques ont A©tA© effectuA©es A l´aide du logiciel SPSS. RESULTATS: au total, 300 sujets ont participA© A l´A©tude, dont 57,3% de femmes et 42,7% d´hommes avec un sex-ratio de 0,74. L´A¢ge moyen de notre population A©tait de 51,6 ± 13,42 ans. Soixante-dix-neuf des participants (26,3%) avaient un syndrome mA©tabolique, avec une prA©dominance fA©minine: 60 femmes (34,9%) et 19 hommes (14,8%). Il existe une relation significative entre le niveau d´activitA© physique et la prA©sence de syndrome mA©tabolique (p = 0,002), entre le niveau d´activitA© physique et l´IMC et le tour de taille (p < 0,001) et (p = 0,003) respectivement. CONCLUSION: les rA©sultats approuvent l´association significative entre l´obA©sitA©, le syndrome mA©tabolique et le niveau de l´activitA© physique, ce qui nous inciterait A encourager l´application des rA¨gles hygiA©no-diA©tA©tiques, notamment l´activitA© physique, qui reste l´une des meilleures actions de prA©vention contre cette pathologie.

We report two cases of lipoma of the parotid gland. Case 1 presented with a left parotid soft and painless tumefaction. The MRI showed a hypersignal-T1 hypersignal-T2 mass measuring 5cm in diameter, which disappeared after the suppression of the fat signal. Case 2 presented with a well defined and mobile tumefaction in the right parotid region. The MRI showed a lipomatous mass measuring 8.8cm in diameter, with a mass-effect on the sub-maxillary artery. The histological examination of the two cases revealed a parotid gland with an adipose proliferation arranged in lobules. It was compound of mature adipocytes, without atypia, lipoblasts or necrosis.

Purpose The aromatase inactivator exemestane may cause clinical disease stabilization following progression on non-steroidal aromatase inhibitors like letrozole in patients with metastatic breast cancer, indicating that additional therapeutic effects, not necessarily related to estrogen-suppression, may be involved in this well-known “lack of cross-resistance”. Methods Postmenopausal women with ER positive, HER-2 negative, locally advanced breast cancer were enrolled in the NEOLETEXE-trial and randomized to sequential treatment starting with either letrozole (2.5 mg o.d.) or exemestane (25 mg o.d.) followed by the alternative aromatase inhibitor. Serum levels of 54 cytokines, including 12 adipokines were assessed using Luminex xMAP technology (multiple ELISA). Results Serum levels of leptin were significantly decreased during treatment with exemestane (p Conclusions Our findings suggest an additional and direct effect of exemestane on CYP-19 (aromatase) synthesis presumably due to effects on the CYP19 promoter use that is not present during therapy with the non-steroidal aromatase inhibitor letrozole. Our findings provide new insights into the influence of clinically important aromatase inhibitors on cytokine levels in vivo that contribute to the understanding of the clinically observed lack of cross-resistance between non-steroidal and steroidal aromatase inhibitors in breast cancer patients. Trial registration Registered on March 23rd 2015 in the National trial database of Norway (Registration number: REK-SØ-84-2015).

Signet ring cell carcinoma (SRC) is a distinct histological subtype of gastric carcinoma. Our aim is to investigate differential characteristics between gastric SRC and other non SRC carcinomas (nSRC). It was a retrospective study including 183 patients diagnosed with gastric carcinoma over a period of 5 years at our pathology department. We performed statistical comparison of clinicopathological features between patients with SRC and those with nSRC. 127 patients (69.4%) had nSRC, 56 had SRC (30.6%), the mean age was 56.67 ± 14.03 years. Patients with SRC were younger than those with nSRC (mean age of 49.66 versus 59.76, P = 0.030). Patients with SRC tend to have more diffuse tumors in the stomach ( P = 0.005), with flat macroscopic appearance ( P = 0.001). Patients with SRC present more often with pT3 tumors ( P < 0.001), lymph node metastasis ( P = 0.024) and perineural invasion ( P = 0.003). There were no significant differences between SRC and nSRC in gender, vascular invasion or distant metastasis ( P > 0.05). The median survival time was 42.82 ± 1.70 months. Patients with nSRC live longer than those with SRC, but the difference was not significant ( P = 0.28). SRC is a histological subtype of gastric carcinoma with distinctive clinicopathologic features. The clinical management of patients should take into account these particular features.

Objectives: To evaluate oral hygiene status in Rheumatoid arthritis (RA) patients, to analyse possible related factors, and to investigate the role of the rheumatologist in information about importance of adequate oral hygiene status in RA patients. Methods: A cross-sectional study that included 100 consecutive RA patients (89% female, mean age 46.7 ± 11.7 years). For each patient, we recorded oral symptoms, oral hygiene status and role of rheumatologist in information on the oral hygiene status. Factors associated with regular brushing (≥2/day) were also analysed. Results: Median disease duration was 8 years (4;2). Dental pain was reported by 74% of patients and bleeding by 51% of them. Regular brushing was noted in 45% of patients. The use of a correct brushing method was noted in 14% of cases. Two patients reported visiting a dentist regularly. Information explaining that poor oral hygiene has a negative impact on RA was delivered by rheumatologist to 11 patients. Regular brushing of teeth was recommended by rheumatologist to 8 patients and 10 patients were advised by their rheumatologist to consult a dentist. Regular brushing was more important in women (48,3% vs 18,2%; p=0.05) and in the literate patients (57,6 vs 31,2%, p

The aim of the study was to estimate the annual direct costs of biological therapies in rheumatoid arthritis (RA), and to establish possible factors associated with those costs. The main data source was the Moroccan registry of biological therapies in rheumatic diseases (RBSMR Registry). We included patients with available 1-year data. Variables related to socio-economic status, disease and biological therapy were collected. Direct costs included prices of biologics, costs of infusions, and subcutaneous injections. Differences in costs across groups were tested by Mann–Whitney and Kruskal–Wallis tests. Correlations analysis was performed in search of factors associated with high costs. We included 197 rheumatoid arthritis patients. The mean age was 52.3 ± 11 years, with female predominance 86.8%. Receiving one of the following therapies: rituximab (n = 132), tocilizumab (n = 37), or TNF-blockers (n = 28). Median one-year direct costs per patient were €1665 [€1472–€9879]. The total annual direct costs were € 978,494. Rituximab, constituted 25.7% of the total annual budget. TNF-blockers and tocilizumab represented 27.3% and 47% of this overall budget, respectively. Although the costs were not significantly different in terms of gender or level of study, the insurance type significantly affected the cost estimation. A positive correlation was found between the annual direct cost and body mass index (r = 0.15, p = 0.04). In Morocco, a developing country, the annual direct costs of biological therapy are high. Our results may contribute to the development of strategies for better governance of these costs.

Background: Depression is a group of syndromes characterized by notable and persistent mood disorders, and is one of the most prevalent psychiatric disorders, while the existing treatments have an altered risk-benefit balance. The therapeutic properties of Nigella have been confirmed, suggesting the reliance on phytotherapy. The objective of the present paper is to investigate the antidepressive-like effect of Nigella sativa on rats exposed to the Unpredictable Chronic Mild Stress procedure. Methods: Wistar rats were used to investigate the antidepressive-like effect. The stress procedure used in this study combined many stressful conditions. After 6 weeks of treatment, behavioral test (forced swim test) was conducted, and histological changes of the hippocampus were examined. Results: Treatment by nigella and fluoxetine significantly reduced the struggling time. Conclusion: Histopathological analysis showed that control treatments result in more loosely arranged cells, significant apoptotic neurons characterized by an irregular appearance, and pyknotic hyperchromatic. A reduction of the thickness of the pyramid layer was also observed in the groups treated with nigella and fluoxetine, suggesting that nigella could be used as a treatment or an adjuvant preventing depressive-like disorders.

Pre-extensively drug resistant tuberculosis (pre-XDR-TB) has been an area of growing concern, and posing a threat to global efforts of TB control. We report a case of PreXDR-TB spondylodiscitis with resistance to a Fluoroquinolone, in an immunocompetent patient under antibacillary treatment for pleural tuberculosis, managed with drug sensitivity-based second-line antituberculous drug regimen. Our case shows the challenges of the diagnostic and management of Drug-resistant TB spondylodiscitis.

Objectives The interferon (IFN) is known to bridge innate and adaptive immune responses, and to play a critical role particularly against hepatitis B virus (HBV) infection. Defects in IFN signals may result, therefore, in attenuated responses against HBV. Accordingly, polymorphisms in genes coding for immune response effectors may affect the clinical outcome of HBV infection. We analyzed the putative association between IFNL4 rs12979860 polymorphism and the outcome of HBV infection in Moroccan patients. Methods In this study, 237 chronic HBV (CHB) patients and 129 spontaneously resolved HBV (SRB) individuals were enrolled and genotyped using a predesigned Taqman allelic discrimination assay. Results Our data show a significant increase of HBV DNA loads in patients with IFNL4 rs12979860 CC genotype compared to patients with CT and TT genotypes (p = 0.0008). However, there was no consistent association between IFNL4 rs12979860 polymorphism and the outcome of HBV infection. Conclusions Although IFNL4 rs12979860 polymorphism seems to modulate circulating HBV DNA levels, it is disconnected from chronic disease progression. This observation suggests that the role of rs12979860 in liver disease is restricted to viral control and inactive in the deleterious immune pathology that affects liver tissue. Taken together, our data suggest that rs12979860 CC genotypes could be useful as a predictor of success or failure of IFN-based therapy in chronic HBV-infected patients.

To understand the genetics of steroid-sensitive nephrotic syndrome (SSNS), we conducted a genome-wide association study in 987 childhood SSNS patients and 3,206 healthy controls with Japanese ancestry. Beyond known associations in the HLA-DR/DQ region, common variants in NPHS1-KIRREL2 (rs56117924, P=4.94E-20, odds ratio (OR) =1.90) and TNFSF15 (rs6478109, P=2.54E-8, OR=0.72) regions achieved genome-wide significance and were replicated in Korean, South Asian and African populations. Trans-ethnic meta-analyses including Japanese, Korean, South Asian, African, European, Hispanic and Maghrebian populations confirmed the significant associations of variants in NPHS1-KIRREL2 (P(meta)=6.71E-28, OR=1.88) and TNFSF15 (P(meta)=5.40E-11, OR=1.33) loci. Analysis of the NPHS1 risk alleles with glomerular NPHS1 mRNA expression from the same person revealed allele specific expression with significantly lower expression of the transcript derived from the risk haplotype (Wilcox test p=9.3E-4). Because rare pathogenic variants in NPHS1 cause congenital nephrotic syndrome of the Finnish type (CNSF), the present study provides further evidence that variation along the allele frequency spectrum in the same gene can cause or contribute to both a rare monogenic disease (CNSF) and a more complex, polygenic disease (SSNS).

International audience; Hepatitis C virus (HCV) is still one of the main causes of liver disease worldwide. Metabolic disorders, including non-alcoholic fatty liver disease (NAFLD), induced by HCV have been shown to accelerate the progression of fibrosis to cirrhosis and to increase the risk of hepatocellular carcinoma. An optimal peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PPARGC1A) activity is crucial to prevent NAFLD installation. The present study aims to investigate the associations between two common PPARGC1A polymorphisms (rs8192678 and rs12640088) and the outcomes of HCV infection in a North African context. A series of 592 consecutive Moroccan subjects, including 292 patients with chronic hepatitis C (CHC), 100 resolvers and 200 healthy controls were genotyped using a TaqMan allelic discrimination assay. PPARGC1A variations at rs8192678 and rs12640088 were not associated with spontaneous clearance of HCV infection (adjusted ORs = 0.76 and 0.79 respectively, P > 0.05, for both). Furthermore, multivariable logistic regression analysis showed that both SNPs were not associated with fibrosis progression (OR = 0.71; 95% CI 0.20-2.49; P = 0.739; OR = 1.28; 95% CI 0.25-6.54; P = 0.512, respectively). We conclude that, in the genetic context of South Mediterranean patients, rs8192678 and rs12640088 polymorphisms of PPARGC1A are neither associated with spontaneous clearance nor with disease progression in individuals infected with HCV.

Purpose The aim of this study was to assess protein tyrosine kinase profiles in primary breast cancer samples in correlation with the distinct hormone and growth receptor profiles ER, PR, and HER2. Experimental design Pamchip® microarrays were used to measure the phosphorylation of 144 tyrosine kinase substrates in 29 ER+ breast cancer samples and cell lines MCF7, BT474 and ZR75-1. mRNA expression data from the METABRIC cohort and publicly available PR chip-sequencing data were used for validation purposes, together with RT-PCR. Results In ER+ breast tumors and cell lines, we observed that the loss of PR expression correlated to higher kinase activity in samples and cell lines that were HER2−. A number of kinases, representing mostly proteins within the PI3K/AKT pathway, were identified as responsible for the differential phosphorylation between PR− and PR+ in ER+/HER2− tumors. We used the METABRIC cohort to analyze mRNA expression from 977 ER+/HER2− breast cancers. Twenty four kinase-encoding genes were identified as differentially expressed between PR+ and PR−, dividing ER+/HER2− samples in two distinct clusters with significant differences in survival (p Conclusions Our results suggest that the PR status has a profound effect on tyrosine kinases, especially for FGFR4 and LCK genes, in ER+/HER2− breast cancer patients. The influence of these genes on the PI3K/AKT signaling pathway may potentially lead to novel drug targets for ER+/PR− breast cancer patients.

The order Mucorales is a group of ancient fungi with limited tools for gene manipulation. The main consequence of this manipulation unwillingness is the limited knowledge about its biology compared to other fungal groups. However, the emerging of mucormycosis, a fungal infection caused by Mucorales, is attracting the medical spotlight in recent years because the treatments available are not efficient in reducing the high mortality associated with this disease. The result of this renewed interest in Mucorales and mucormycosis is an extraordinarily productive effort to unveil their secrets during the last decade. In this review, we describe the most compelling advances related to the genetic study of virulence factors, pathways, and molecular mechanisms developed in these years. The use of a few genetic study models has allowed the characterization of virulence factors in Mucorales that were previously described in other pathogens, such as the uptake iron systems, the mechanisms of dimorphism, and azole resistances. More importantly, recent studies are identifying new genes and mechanisms controlling the pathogenic potential of Mucorales and their interactions with the host, offering new alternatives to develop specific strategies against mucormycosis.

Introduction the purpose of this study was to bring out some epidemiological and clinical characteristics of metabolic syndrome. Methods a total of 300 subjects willingly participated in the present study which was conducted at Ibn Zohr regional hospital in Marrakesh. We were interested in socio-demographic variables, body mass index (BMI) which assesses the degree of obesity of each subject. The blood parameters were determined by an adequate biochemistry automaton. All statistical analyses were performed using SPSS software. Results among the 300 subjects who participated in the study, 57.3% were females and 42.7% were males with a sex-ratio of 0.74. The average age was 51.6 ± 13.42 years old. Seventy nine of the participants (26.3%) had a metabolic syndrome, with a predominance of women: 60 women (34.9%) and 19 men (14.8%). Illiterates (33.8%) and married subjects (25.6%) were the most affected by the metabolic syndrome. The high waist circumference found in 97.5% was the predominant criteria in our study. Finally, the statistical analysis showed a significant association between high waist circumference, BMI and the presence of metabolic syndrome (P = 0.001>) and (P < 0.001) respectively. Conclusion the metabolic syndrome is slowly but surely setting. Implementing prevention strategies and encouraging healthy lifestyles will surely minimize serious public health problems in the city.

Introduction metabolic steatopathy or non-alcoholic fatty liver disease (NAFLD) is frequently associated with type 2 diabetes mellitus (T2DM) with an increased risk of progression to advanced fibrosis. The purpose of our study was to determine the interest of hepatic steatosis index (HSI) in the detection of hepatic steatosis in patients with type 2 diabetes in order to establish an appropriate screening program of this disease in our population. Methods cross-sectional study involving 281 type 2 diabetics hospitalized in the Department of Endocrinology in collaboration with the Hepato-gastroenterology Department at the University Hospital Ibn Rochd Casablanca between January 2018 and June 2018. Anthropometric variables studied were, biological, hepatic steatosis index (HSI) and liver ultrasound. The HSI score of> 36 predicted the presence of fatty liver. The HSI score (fatty liver index) was calculated for all patients using the following formula: 8 × (ALT / AST) + BMI + 2 (if type 2 diabetes) + 2 (if female). Statistical analysis was performed with SPSS Version 19 software. The sensitivity and the specificity of the HSI score were calculated by 2x2 contingency table. The area under the receiver operating characteristic curve (AUROC) was also analyzed. Results average age of patients was 54.15 ± 13.14 years with a female predominance (76.9% of cases), and a sex ratio of 3.32. Mean duration of diabetes of 10.5 ± 8.03 years with an average glycated hemoglobin of 10.23 ± 1.96%. BMI was 29.53 ± 4.55 kg/m2, the average waist circumference was 99.51 ± 10.98 cm. 39.1% of patients were hypertensive, 58% were dyslipidemic. Abnormalities in transaminases were found in 6% of patients. Prevalence of NAFLD was 45.2% based on the HSI score > 36. This prevalence is consistent with the findings made by the liver ultrasound (47.7% of cases). Hepatic steatosis was significantly correlated with dyslipidemia (P=0.006), overweight (P=0.00015), obesity (P=0.001) and hypertriglyceridemia (P=0.0003). The sensitivity of HSI was 89.55%, negative predictive value (NPV) was 90.91%, specificity was 95.24%, and positive predictive value (PPV) was 94.49%. AUROC for HSI was at 0.979 (95% CI, 0.962-0.997). Conclusion hepatic steatosis is common among our patients; it is correlated with dyslipidemia, obesity and hypertriglyceridemia.

Objectives Cystic echinococcosis (CE) is a cosmopolitan zoonosis caused by Echinococcus granulosus. The highest annual incidence in humans in Morocco is recorded in the provinces of Ifrane and El Hajeb. Hospital statistics underestimate the prevalence of this infection because a proportion of cases is not recorded on official registers and does not reach medical care. We aimed to estimate the actual prevalence of abdominal hydatidosis in these provinces of the Middle Atlas of Morocco. Materials and methods We performed a cross-sectional descriptive study of prevalence between September 2013 and February 2015 in the two towns of Timahdite and Ain Leuh in the province of Ifrane and the towns of Bouderbala and Sebt Jahjouh in the province of El Hajeb. This was a mass screening survey of liver hydatid cysts coupled with serological diagnosis. Results A total of 5367 participants underwent abdominal ultrasound, and 102 were selected. CE prevalence was 1.9%; 69 patients were screened in the province of Ifrane and 33 in the province of El Hajeb. The M/F sex ratio was 0.52 and the mean age was 39.6 ± 18 years. Conclusion Our results indicated a high prevalence and continuous transmission of hydatidosis in the provinces of Ifrane and El Hajeb of the Middle Atlas in Morocco. Mass screening campaigns are useful for evaluating the baseline prevalence, evolution of transmission, and risk factors for hydatidosis in endemic areas.

International audience; Objective: To examine the relationship between a Parkinson's disease (PD) polygenic risk score (PRS) and impulse control disorders (ICDs) in PD. Background: Genome wide association studies (GWAS) have brought forth a PRS associated with increased risk of PD and younger disease onset. ICDs are frequent adverse effects of dopaminergic drugs and are also more frequent in patients with younger disease onset. It is unknown whether ICDs and PD share genetic susceptibility. Methods: We used data from a multicenter longitudinal cohort of PD patients with annual visits up to 6 years (DIG-PD). At each visit ICDs, defined as compulsive gambling, buying, eating, or sexual behavior were evaluated by movement disorders specialists. We genotyped DNAs using the Megachip assay (Illumina) and calculated a weighted PRS based on 90 SNPs associated with PD. We estimated the association between PRS and prevalence of ICDs at each visit using Poisson generalized estimating equations, adjusted for dopaminergic treatment and other known risk factors for ICDs. Results: Of 403 patients, 185 developed ICDs. Patients with younger age at onset had a higher prevalence of ICDs (p < 0.001) as well as higher PRS values (p = 0.06). At baseline, there was no association between the PRS and ICDs (overall, p = 0.84). The prevalence of ICDs increased over time similarly across the quartiles of the PRS (overall, p = 0.88; DA users, p = 0.99). Conclusion: Despite younger disease onset being associated with both higher PRS and ICD prevalence, our findings are not in favor of common susceptibility genes for PD and ICDs.

E-learning systems are the result of the new era of digitalization, which has affected many areas including education. These systems offer many benefits like ease of access and time management. Therefore, the educational paradigm has been changed. Otherwise, since E-learning systems consider only the cognitive state of the learner regardless of his emotional state, they cannot instruct students effectively. Moreover, if the target learner has non-ordinary cognitive and socio-emotional abilities, such as a child with ASD (Autism Spectrum Disorder). So, the e-learning system must be able to satisfy those needs and propose a suitable content according to his learning rhythm.

One of the major types of cardiovascular diseases is Coronary Artery Disease (CAD). This study tackles the problem of CAD detection using a new accurate hybrid machine learning model. The proposed ensemble model combines several classical machine learning techniques. Our base algorithm is used with four different kernel functions (linear, polynomial, radial basis and sigmoid). The new model was applied to analyze the well-known Cleveland CAD dataset from the UCI repository. To improve the performance of the model, we first selected the most important features of this dataset using a genetic search algorithm. Second, we applied a multi-level filtering technique to balance the data using the ClassBalancer and Resample methods. Our model provided the average CAD prediction accuracy of 98.34% for the Cleveland data (the average was taken over the four kernel functions).

Non-steroidal anti-inflammatory drugs (NSAIDS) are commonly used because of their remarkable cure over mild and moderate pain including osteoarthritis and rheumatoid arthritis. Medical doct...