Translation and validation of EORTC QLQ-H&N 35 into Moroccan Arabic for ENT head and neck cancer patients in Morocco.

Disease-specific quality of life (QOL) measures have enhanced the capacity of outcome measures to evaluate subtle changes and differences between groups. As many of the QOL measures have been developed in English, they require translation to ensure their usefulness in a multi-cultural and/or international society. Published guidelines provide formal methods to achieve cross-culturally comparable versions of a QOL tool. The aim of this study was to adapt the head and neck specific module of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-H&N 35 questionnaire) into Moroccan Arabic and to determine its psychometric properties. After translation, back translation and pretesting of the pre-final version, the translated version was submitted to a committee of professionals composed by otolaryngologists and epidemiologists. The psychometric properties were tested in patients with ENT cancer. Internal consistency was tested using Cronbach's alpha and the test-retest reliability using interclass correlation coefficients. Construct validity was assessed by examining item convergent and divergent validity. It was also tested using Spearman's correlation between QLQ-H&N 35 scales and EQ-5D. The study was conducted in 120 patients. The Moroccan version was internally reliable, Cronbach's α ranged from 0.71 for "trouble with social contact" to 0.94 for "senses impairment", indicating good internal consistency. Test-retest reliability was assessed using the intra-class correlation coefficient, which ranged from 0.64 for "speech trouble" to 0.89 for "physical activities". The instrument demonstrated a good construct and concomitant validity. We have developed a semantically equivalent translation with cultural adaptation of EORTC QLQ-H&N 35 questionnaire. The assessment of its measurement properties showed that it is quite reliable and a valid measure of the effect of cancer on the quality of life in Moroccan patients.

Endoscopic treatment of anterior glottic webs according to Lichtenberger technique and results on 18 patients.

Anterior glottic webs are most frequently acquired and result in a major vocal handicap. Many treatment modalities have been reported in the literature. None of them achieves perfect morphological or functional results. We present our series treated by an endoscopic technique based on CO(2) laser section of the web, mitomycin application and placement of a temporary silastic stent. We retrospectively reviewed the charts of 18 consecutive patients with anterior webs treated at our university hospital between 2003 and 2010. The endoscopic technique consisted of the section of the web with the CO(2) Acublade system, immediate application of mitomycin C and placement of a silastic stent. No tracheostomy was required. The stent was removed 3 weeks later. Patients had a vocal evaluation pre and postoperatively. It consisted of a video-stroboscopic examination, the global score of the Voice Handicap Index, the global and roughness scores of the perceptive voice evaluation according to Hirano, acoustic and aerodynamic parameters. Eighteen patients were included in the study with a mean age of 46 years (min. = 5, max. = 76). Twenty-two percent were women. All patients had postoperative speech therapy. The mean follow-up is 48.4 months (3-87 months). At the last follow-up, none of the patients had recurrence of the laryngeal web. The grade G of dysphonia significantly decreased from 2 to 1 (p = 0.035). CO(2) laser resection of anterior webs with mitomycin C application and placement of a silastic stent for 3 weeks induces a good morphological result with absence of web reformation but without substantial voice improvement observed in our series.

Retropharyngeal abscess in adults.

OBJECTIVES: Retropharyngeal abscess in adults can be life-threatening. The otolaryngologist is on the front line in making the diagnosis and treatment of this disease. The aim of this study is to review the clinical features, the diagnostic tools and the management of retropharyngeal abscesses in adults. PATIENTS AND METHODS: Retrospective study of retropharyngeal abscesses in adults admitted in the ENT department from 2005 to 2010. RESULTS: In total 4 patients were included in this study: mean age of 53 years (range 45 to 62 years), sex ration F/M = 3. Cultures obtained from the abscesses identified group A beta-hemolytic streptococci susceptible to amoxicilline-clavulanate in three cases. The treatment consisted in surgical drainage of the collection and intravenous antibiotics. CONCLUSIONS: Retropharyngeal abscesses in adults are critical infections requiring prompt diagnosis and treatment. Computed tomography scan was the crucial tool for the diagnosis, notably to differentiate cellulitis from abscesses. The management includes intravenous broad-spectrum antibiotics associated, if necessary, with surgical drainage in cases of persistent abscess. The outcome is usually good.

[Exophthalmos arising from paranasal sinuses]. / Exophtalmie d'origine naso-sinusienne en ORL.

INTRODUCTION: Proptosis due to intraorbital process is frequent and secondary to various aetiologies. Its findings in ENT practice is the sign of a serious complication. The purpose of this study is to review a series of patients who presented an exophtalmy. MATERIAL AND METHODS: We conducted a retrospective analysis of 15 patients with exophthalmos complicating a rhinosinusal benign disease, diagnosed and treated in our department between January 2003 and December 2010. As their management is different, we excluded all cases of orbital cellulitis. RESULTS: Average age of presentation was 38 years, without sex predominance. Exophthalmos was unilateral, non axial and irreductible in all cases. The average duration of symptoms installation was 18 months. The most common aetiology was fronto-ethmoidal osteomas (9 cases), followed by fronto-ethmoidal mucoceles (5 cases) and spheno-orbito-frontal fibrous dysplasia (1 case). The functional prognosis of the affected eye depended on the aetiology and the degree of ocular injury. CONCLUSION: In our experience, sinusal causes of exophthalmos comprise osteomas and ethmoidal mucoceles. Medical history, clinical and radiological data as provide the diagnostic. In case of benign tumours, surgery is the curative treatment.

[Benign cementoblastoma. Apropos of a case and review of the literature]. / Le cémentoblastome bénin. A propos d'un cas et revue de la littérature.

The cementoblastoma is a rare benign tumor of odontogen origin that interests the roots of the teeth especially the lower molars. The evolution is often silent, the radiological exam is not specific, the diagnosis of certainty is histological. The surgical treatment assures the recovery without aftermath. The authors report a case of cementoblastoma at a patient of 37 years for which he has benefited of a resection by vestibular way and debate diagnosis and therapeutic modes of this affection.

Effects of dietary fat and adipose tissue location on insulin action in young boar adipocytes.

1. Regulation of lipogenesis and lipolysis by insulin was studied on adipocytes isolated from 100 kg Large white male pigs. Two adipose tissues were studied: subcutaneous and perirenal. Animals were fed either a control low fat diet or a diet containing 14.7% sunflower seed oil. 2. The cell diameter was higher in the group fed the sunflower diet. 3. De novo lipogenesis was decreased for each adipose tissue in the group fed the sunflower diet. The perirenal site had a higher lipogenic activity than subcutaneous site whatever the diet. 4. Insulin did not significantly stimulate lipogenesis but had an important antilipolytic effect on stimulated lipolysis by isoproterenol. 5. The antilipolytic action of insulin was higher in perirenal adipocytes with the control diet. With the sunflower diet, the decrease was about 54.4% for subcutaneous adipocytes, whereas the inhibition was decreased in perirenal adipocytes. Addition of theophylline reversed the antilipolytic action of insulin. 6. Insulin binding was not affected neither by the dietary fat nor by the adipose tissue location. 7. Absence of de novo lipogenesis stimulation by insulin was not due to an impairment in insulin binding. 8. The different effects of dietary fat and adipose tissue location on the antilipolytic action of insulin could not be explained by a modification of insulin binding but rather by a latter event, probably at a post-insulin binding stage.

Effects of castration, dietary fat and adipose tissue sites on adipocyte plasma-membranes cyclic AMP phosphodiesterase activity in the pig.

1. cAMP Phosphodiesterase activity and kinetic parameters (Km and Vmax) were measured in subcutaneous and perirenal adipocyte plasma membranes from Large White male and castrated pigs. The animals were fed a control low fat diet or a sunflower diet enriched with linoleic acid (C18:2 n-6). 2. Phosphodiesterase activity, low Km and Vmax were lowered by castration. 3. In animals fed the sunflower diet, phosphodiesterase activity decreased without affecting either Km or Vmax. 4. Phosphodiesterase activity was higher in perirenal sites than in subcutaneous ones, particularly in male pigs. This may be explained by a lower Km or a higher cAMP phosphodiesterase affinity to cAMP in perirenal sites. 5. Theophylline was a potent inhibitor of phosphodiesterase activity principally in perirenal sites. 6. The intermediate role of cAMP phosphodiesterase in adenylate cyclase activity and lipolytic processes is discussed.

[Presence of Phlebotomus bergeroti, Phlebotomus chabaudi, Phlebotomus chadlii and Sergentomyia christophersi in Morocco]. / Présence au Maroc de Phlebotomus bergeroti, Phlebotomus chabaudi, Phlebotomus chadlii et Sergentomyia christophersi

The authors indicate the presence at Morocco of the four following sandflies: Phlebotomus bergeroti Parrot, 1934, Phlebotomus chabaudi Croset, Abonnenc et Rioux, 1970, Phlebotomus chadlii Rioux, Juminer et Gibily, 1966 and Sergentomyia christophersi (Sinton, 1927). Among them, Phlebotomus bergeroti, an element of eremitic affinity, is found at the north of the Atlas under a sub-humide bioclimat.