A comparison of human metapneumovirus and respiratory syncytial virus WHO-defined severe pneumonia in Moroccan children.

Acute respiratory infections remain the principal cause of morbidity and mortality in Moroccan children. Besides bacterial infections, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are prominent among other viruses due to their high prevalence and association with severe clinical episodes. We aimed to describe and compare RSV- and hMPV-associated cases of WHO-defined severe pneumonia in a paediatric population admitted to Morocco's reference hospital. Children aged 2-59 months admitted to the Hôpital d'Enfants de Rabat, Morocco meeting WHO-defined severe pneumonia criteria were recruited during 14 months and thoroughly investigated to ascertain a definitive diagnosis. Viral prevalence of RSV, hMPV and other viruses causing respiratory symptoms was investigated in nasopharyngeal aspirate samples through the use of molecular methods. Of the 683 children recruited and included in the final analysis, 61/683 (8·9%) and 124/683 (18·2%) were infected with hMPV and RSV, respectively. Besides a borderline significant tendency for higher age in hMPV cases, patients infected with either of the viruses behaved similarly in terms of demographics, patient history, past morbidity and comorbidity, vaccination history, socioeconomic background and family environment. Clinical presentation on arrival was also similar for both viruses, but hMPV cases were associated with more severity than RSV cases, had a higher risk of intensive care need, and received antibiotic treatment more frequently. RSV and hMPV are common and potentially life-threatening causes of WHO-defined pneumonia in Moroccan children. Both viruses show indistinctive clinical symptomatology, but in Moroccan children, hMPV was associated with a more severe evolution.

Knowledge and management of fever among Moroccan parents.

Parents often have misperceptions about childhood fever, and little information is available about the home management of feverish children in Morocco. In this study of the perceptions, knowledge and practices of families regarding children's fever, the parents of 264 febrile children aged 0-16 years were interviewed in a paediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definition for fever, 54.4% determined their children's fever using a thermometer, and the preferred site was rectal. Most of them (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as brain damage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was used by 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantly associated with parents' profession, educational level and receipt of previous information and advice from health professionals.

Knowledge and management of fever among Moroccan parents

كثرا ما يكون لدى الآباء أفكار خاطئة عن الحمى التي تصيب الأطفال، كما أن المعلومات المتاحة عن التدبير العلاجي المنزلي للطفل المصاب بالحمى قليلة في المغرب. وقد استهدفت هذه الدراسة معرفة مدركات ومعارف وممارسات الأسر حول الحمى التي تصيب الأطفال، فأجرى الباحثون مقابلات مع 264 من آباء الأطفال الذين أصيبوا بالحمى في أعمار تراوحت بين 0 - 16 عاما، وذلك في قسم طوارئ الأطفال في الرباط في عام 2011 . واتضح للباحثين أن 3.5 % فقط من الآباء يعرفون التعريف الصحيح لدرجة الحرارة أثناء الحمى، وأن 54.4 % منهم يتعرفون على إصابة الطفل بالحمى باستخدام مقياس الحرارة، وأن الموضع المفضل لقياس درجة الحرارة هو الشرج، وأن معظم الآباء [96.8 % منهم]يعترون الحمى حالة خطرة قد تقود إلى تأثرات جانبية مثل تخرب الدماغ [28.9 %]، والاختلاجات [18.8 %]، والشلل [19.5 %]، وضيق النفس [14.8 %]، والسبات [14.8 %]. وقد تم استخدام الباراسيتامول في 85.9 % من الحالات، والمعالجات التقليدية في % 45.1 من الحالات. وقد ترابطت المعرفة المتعلقة بالتعريف الصحيح للحمى بمقدار يعتد به إحصائيا مع مهنة الآباء، ومستواهم التعليمي ومع تلقيهم معلومات مسبقة ومنشورات من المهنيين الصحيين

ABSTRACT Parents often have misperceptions about childhood fever, and little information is available about thehome management of feverish children in Morocco. In this study of the perceptions, knowledge and practicesof families regarding children’s fever, the parents of 264 febrile children aged 0–16 years were interviewed in apaediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definitionfor fever, 54.4% determined their children’s fever using a thermometer, and the preferred site was rectal. Most ofthem (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as braindamage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was usedby 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantlyassociated with parents’ profession, educational level and receipt of previous information and advice from healthprofessionals.

RÉSUMÉ Les parents ont souvent des perceptions erronées concernant la fièvre chez l'enfant, et les informationssur la prise en charge des enfants fébriles à domicile sont rares au Maroc. Dans la présente étude sur lesperceptions, les connaissances et les pratiques des familles au sujet de la fièvre chez l'enfant, les parents de 264enfants fébriles âgés de 0 à 16 ans ont été interrogés au sein d'un service d'urgence pédiatrique de la ville deRabat en 2011. Seuls 3,5 % des parents connaissaient la température exacte définissant un état fébrile et 54,4 %déterminaient la fièvre de leur enfant à l'aide d'un thermomètre, de préférence par voie rectale. La plupartd'entre eux (96,8 %) considéraient que la fièvre était une affection très grave qui pouvait conduire à des effetssecondaires tels que des lésions cérébrales (28,9 %), des convulsions (18,8 %), une paralysie (19,5 %), une dyspnée(14,8 %) et un coma (14,8 %). Le paracétamol a été utilisé par 85,9 % des parents et les traitements traditionnelspar 45,1 %. La connaissance de la définition exacte de la fièvre était significativement associée à la profession desparents, à leur niveau d'études et à la prise de conseils et d'informations préalable auprès des professionnels desanté.

Psammomatous melanotic schwannoma of a spinal nerve root. Relationship with the Carney complex.

A 36-year-old man had an oval, black, extradural tumor partly removed from the left C4 spinal root, with total removal 4 months later. In both specimens, most tumor cells were spindle-shaped. A few cells were large, epithelioid-like, with a prominent nucleolus. Mitoses were rarely seen. Many tumor cells contained coarse or fine granules of a brown pigment. Such cells were immunopositive for S-100 protein and HMB-45. Additionally, psammoma bodies were numerous in certain areas, indicating a diagnosis of psammomatous melanotic schwannoma (PMS). Periumbilical spotty pigmentation was found in the patient and in six of his siblings and their mother. The search for cardiac myxoma and endocrine overactivity was negative in the patient. Features of Carney's complex must be sought in a patient with PMS and in their primary relatives. So far, more than 150 patients and seven families with Carney's complex have been reported.

Skeletal lesions in early congenital syphilis (a review of 86 cases).

Early congenital syphilis is still common in Morocco, where it causes a large number of stillbirths and neonatal deaths. Over the last 16 years, we managed 86 cases of congenital syphilis in infants aged one day to four months. Multiple organs were affected in half the patients. Skeletal lesions were found in 65% of patients, Wimberger's sign in nearly 20% (17/86), and pseudoparalysis in 23%. The significance of the skeletal lesions often seen in congenital syphilis in Morocco is emphasized.

Comparison of MRC-5 and continuous cell lines for detection of cytomegalovirus in centrifugation cultures.

Continuous cell lines were assessed for use for rapid human cytomegalovirus (HCMV) detection procedures combining tissue culture, centrifugation, and immediate early antigen (IEA) immunostaining. Human cells (MRC-5 embryonic fibroblasts, U-373MG astrocytoma cells, differentiated teratocarcinoma (Tera-2) cells), murine cells (BALB/c-3T3 and Y-1 cells), BHK21 hamster cells, and mink lung (ML) cells were first inoculated with HCMV laboratory strain. IEA synthesizing cells were detected by immunoperoxidase assay using a monoclonal antibody. ML cells and differentiated Tera-2 cells exhibited more positive cells than MRC-5 cells. BHK21, and MRC-5 cells were equivalent in sensitivity whereas U-373MG, BALB/c-3T3, and Y-1 cells had only reduced IEA positive cells. When 63 urine specimens were inoculated onto MRC-5, ML and differentiated Tera-2 cells, 20 (31.7%) were positive in MRC-5 cells versus 18 (28.5%) in ML or Tera-2 cells. Moreover, greater numbers of infected cells were detected in MRC-5 cells than in these two cell lines. MRC-5 cells were superior for detection of HCMV in clinical samples by centrifugation cultures.