Prevalence and antibiotic resistance profiles of Staphylococcus sp. isolated from food, food contact surfaces and food handlers in a Moroccan hospital kitchen.

Food poisoning risk related to the consumption of contaminated food with known foodborne pathogens or antibiotic-resistant bacteria is currently a serious threat for public health. Thus, pathogenic methicillin-resistant Staphylococcus strains are considered as one of the major cause of foodborne diseases in hospitals. The present study aims to determine the prevalence and the antibiotic resistance patterns of Staphylococcus in various types of hospital food samples, work surfaces and its carriage by food handlers. A total of 608 collected samples including 300 food samples, 238 food contact surfaces and 70 nasal and hand samples were tested. The identified Staphylococcus and their antibiotic resistance patterns were analysed using the agar disk-diffusion and PCR method was used for mecA resistance gene amplification. The prevalence of S. aureus and the coagulase-negative staphylococci were 17·33 and 23·33%, respectively. The antibiotic resistance reached 100% towards oxacillin and Penicillin G for both S. aureus and CoNs. The mecA gene was detected in 5·71% (4/70) and 7·69% (4/52) of S. aureus and CoNs strains, respectively. The outcome of this study enlightens isolation of MRSA strains and resistant CoNs from food, food contact surfaces and food handlers. The presence of this resistant species in this critical setting, where products were intended to vulnerable and immunocompromised patients, represents a serious threat to this community. It can be a source of nosocomial infection and more precautions must be taken to prevent staphylococci food contamination mainly in hospitals. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study describing the antibiotic resistance patterns of Staphylococcus aureus and coagulase-negative Staphylococcus isolated from hospital food, food contact surfaces and food handlers samples in a Moroccan hospital kitchen. High levels of multi-resistance were reported. The alarming outcome of this study emphasizes the crucial need of implementing an approach to fight multidrug-resistant staphylococci mainly in healthcare settings, where the community have already compromised health issues.

A three-dimensional geometric quantification of human cortical canals using an innovative method with micro-computed tomographic data.

The complex architecture of bone has been investigated for several decades. Some pioneer works proved an existing link between microstructure and external mechanical loading applied on bone. Due to sinuous network of canals and limitations of experimental acquisition technique, there has been little quantitative analysis of three-dimensional description of cortical network. The aim of this study is to provide an algorithmic process, using Python 3.5, in order to identify 3D geometrical characteristics of voids considered as canals. This script is based on micro-computed tomographic slices of two bone samples harvested from the humerus and femur of male cadaveric subject. Slice images are obtained from 2.94 µm isotropic resolution. This study provides a generic method of image processing which considers beam hardening artefact so as to avoid heuristic choice of global threshold value. The novelty of this work is the quantification of numerous three-dimensional canals features, such as orientation or canal length, but also connectivity features, such as opening angle, and the accurate definition of canals as voids which ranges from connectivity to possibly another intersection. The script was applied to one humeral and one femoral samples in order to analyse the difference in architecture between bearing and non-bearing cortical bones. This preliminary study reveals that the femoral specimen is more porous than the humeral one whereas the canal network is denser and more connected.

Dairy products and colorectal cancer in middle eastern and north African countries: a systematic review.

BACKGROUND: This systematic review was conducted to explain the association between dairy products and colorectal cancer (CRC) risk in Middle Eastern and North African countries (MENA). METHODS: The database consulted were PubMed, Clinical Trials, and Cochrane to extract the relevant studies published till the 31stof December 2016, using inclusion and exclusion criteria according to Prisma Protocol. The characteristics of these studies comprised the consumption of all types of dairy products in relation to CRC risk. RESULTS: Seven studies were included in this review. For dairy products overall, no significant association was found. Regarding modern dairy products, included studies found controversial results with OR = 9.88 (95% CI: 3.80-24.65) and ORa = 0.14 (95% CI: 0.02-0.71). A positive association was reported between traditional dairy products and CRC risk, to OR = 18.66 (95% CI: 3.06-113.86) to OR = 24 (95% CI: 1.74-330.82) to ORa = 1.42 (95% CI: 0.62-3.25), ptrend = 0.03. Calcium was inversely associated with the CRC risk with ORa = 0.08 (95% CI: 0.04-0.17). CONCLUSION: This is the first systematic review which illustrated the association between dairy consumption and CRC risk in MENA region. The results were inconsistent and not always homogeneous. Further specified studies may be warranted to address the questions about the association between CRC and dairy products in a specific context of MENA region.

[Digital ischemia revealing multiple myeloma]. / Une ischémie digitale révélant un myélome multiple.

Digital ulcers generally arise in a context of microangiopathy-related focal ischemia. In women, connective tissue diseases are the main etiology, while in men the cause is often diffuse arterial disease, e.g. Leo-Buerger disease, or emboligenic heart disease. A paraneoplastic origin of digital necrosis due to ischemia is rarely reported. A 75-year-old man presented with cyanosis of the fingertips and toes that had begun one month earlier. The physical examination found pulp ulcers on the fingers and toes of both hands and feet. Two weeks later, necrotic damage developed distally, with no other associated symptoms. Blood tests were suggestive of Kahler disease; immunodeficiency disorders tests were negative; the cyroglobulin test was positive. Multiple-drug chemotherapy was followed by clinical improvement. Distal necrotic damage is a frequent inaugural symptom in vascular disease. If the common causal mechanisms (iatrogenic, occupational, toxic, atheromatous, emboligenic heart disease, or systemic disease) have been ruled out, it is important to search for a blood disorder or cancer as the cause of distal necrotic damage.

[Efficacy of diuretics in the treatment of Morbihan's disease: three cases]. / Efficacité des diurétiques dans la prise en charge thérapeutique de la maladie de Morbihan: trois cas.

BACKGROUND: Morbihan's disease (MD), also known as 'persistent facial oedema' or 'rosaceous lymphoedema', is an uncommon facial condition that is difficult to treat. Its cause remains unclear. AIM: We report three new cases of solid persistent facial oedema, which, after treatment with furosemide, showed dramatic improvement. PATIENTS AND METHODS: Three men (respectively aged 38, 66 and 76 years) presented Morbihan's disease progressing respectively for 2, 5 and 8 years. These patients presented with facial oedema, mainly affecting the eyelids. The diagnosis of MD was based on clinical and laboratory criteria (after exclusion of other aetiologies such as sarcoidosis, lupus erythematosus, facial demodicidosis and rosacea). After several unsuccessful treatments (tetracyclines, synthetic antimalarials, danazol, systemic steroids and isotretinoin), the patients received diuretics: furosemide (60 mg/d) in two cases and spironolactone 75 mg twice daily for the third patient. The patients were evaluated after 1 month, then every 3 months. RESULTS: Regression of oedema was complete or almost complete with follow-up of between 1 and 16 years. No adverse effects were reported. DISCUSSION: Treatment of Morbihan's disease remains difficult and empirical. Diuretics may be of value since they help significantly reduce swelling even if they do not definitely cure patients.

Prevalence and distribution of Helicobacter pylori cagA and vacA genotypes in the Moroccan population with gastric disease.

Helicobacter pylori infection is the etiologic agent of various gastric pathologies. The severity of disease outcome has been attributed to some H. pylori genotypes, which varies geographically. In Morocco, there are no data regarding the pattern of H. pylori genotypes; therefore, this is the first prospective study conducted in our country to investigate the genotype profiles (vacA and cagA) of H. pylori in patients with gastric pain. Endoscopic biopsies were obtained in patients attending the gastroenterology department of the Hospital University Hassan II of Fez for gastric pain and were directly used for H. pylori detection and genotyping by polymerase chain reaction (PCR). The SPSS software program was used to study the genotype correlation to different clinical outcomes. A total of 429 patients were included in this study, with an infection rate of 69.9%. cagA was detected in 42.3% of cases. However, vacA genotyping reveal a large predominance of s2m2. Infection with multiple strains was detected in 10.8% of cases and incomplete vacA was observed in 31.5%. In Morocco, vacA s1m1 was significantly associated to peptic ulcer diseases, while s2m2 was associated to gastritis. Moroccan H. pylori vacA genotype profiles differ from the Latin American, European, and South African profiles, with more similarities to the North African profile. Because of the small number of cases with gastric cancer, no correlations with H. pylori have been studied, so, further studies will be required in order to highlight the effects of those genes on this disease.

[Pityriasis rubra pilaris after vaccination]. / Pityriasis rubra pilaire après vaccination.

BACKGROUND: Pityriasis rubra pilaris (PRP) following vaccination is rarely described in the literature. We report a case of PRP occurring two weeks after measles-mumps-rubella (MMR) vaccination. CASE REPORT: A 17-month-old infant was referred for a rash appearing two weeks previously. The child was presenting diffuse erythematous scaly exanthema with follicular papules and orange palmoplantar keratoderma. The clinical features were highly evocative of PRP. The histology was non-specific, displaying epidermal acanthosis with a regular and thick parakeratosis, and without any impairment of the follicular infundibulum. An MMR vaccination had been given two weeks before onset of the rash. Treatment with topical corticosteroids and emollients proved effective. DISCUSSION: Post-vaccinal PRP is rarely described in the literature. We report only the 3rd case. The first case concerned a 32-year-old woman presenting two episodes of PRP 10 days after diphtheria-tetanus-polio vaccination. The second case concerned a 47-year-old woman presenting PRP 18 days after anti-influenza vaccination and requiring treatment with acitretin. No cases have been described with MMR. These three vaccines (DTP, Tetragrip and ROR) have no shared pharmacological constituents, and the trigger mechanism could be immunological or parainfectious. CONCLUSION: Questioning about recent vaccination during history taking appears necessary to assess the importance of this trigger factor as well as the mechanism responsible for the onset of PRP.

La fracture du corps caverneux: à propos de 123 cas

Objectif : Analyser les aspects diagnostiques et thérapeutiques de la fracture du corps caverneux et comparer nos résultats avec ceux de la littérature. Patients et méthodes : Entre janvier 1976 et juin 2002, 123 cas de fractures du corps caverneux ont été traités dans notre service. L'âge moyen des patients était de 25 ans. Dans la majorité des cas (71,5), la fracture du pénis s'est produite par manipulation forcée du pénis en érection. Le diagnostic était basé sur un examen clinique. Les patients ont été traités chirurgicalement par réparation de la tunique albuginée, le plus souvent (74 cas) après dégantage de la peau du pénis. Un cas de rupture de l'uretère a été rencontré après la fracture des deux corps caverneux. Résultats : Chez 95 patients ; le résultat postopératoire a été satisfaisant. Cependant, 8 cas de plaques fibreuses et 4 cas de courbure du pénis ont été rencontrés. Aucun de nos patients n'a présenté de dysfonctionnement érectile postopératoire. Conclusion : La fracture du corps caverneux est une pathologie qui reste assez rare. Le diagnostic est basé sur l'examen clinique et le traitement est chirurgical dans la majorité des cas. Le résultat du traitement de ces fractures est généralement satisfaisant à condition que les patients se présentent à un stade précoce