[Hemoptysis revealing an endobronchial metastasis of testicular choriocarcinoma]. / Hémoptysie révélant une métastase endobronchique d'un choriocarcinome testiculaire.

The choriocarcinoma are neoplasms developed from testicular germ cells in men or fetal trophoblasts in women. The most common sites for metastatis are in the lung, but the endobronchial location is unusual. We report the case of a young patient of 27 years, hospitalized for hemoptysis of moderate volume, occurring in the context of deterioration in his general condition. The radiological assessment revealed an opacity of the right lung and bronchoscopy showed a highly vascularized middle lobe stenosis with biopsy confirming the diagnosis of choriocarcinoma. Urogenital examination found an enlarged left testicle and ultrasound confirmed a tumor-like expansive process with no liver or spleen involvement. HCG levels were high. The patient underwent a left orchiectomy via inguinal, pathological and immunohistochemical study confirmed the diagnosis of testicular choriocarcinoma. The patient received three cycles of chemotherapy based on the BEP with good tolerability. This has allowed chemotherapy, despite endobronchial metastasis, to achieve remission of good quality. The frequency of atypical choriocarcinoma metastases is very low, and treatment is mainly based on chemotherapy.

[Adrenal tuberculosis: case report]. / La tuberculose surrénalienne : à propos d'un cas.

Isolated adrenal tuberculosis is rare, and represents between 1-2% of the etiologies of adrenal masses called incidentalomas. A 32-year-old woman, without notable medical history, was hospitalized for pain in the left hypochondrium, lasting for two months in a context of apyrexia and weight loss amounted to 5 kg. Clinical examination was normal, but abdominopelvic CT objectified bilateral adrenal hypertrophy predominantly left with bilateral linear calcifications. The chest radiograph was normal, adrenal hormones were normal. The research of BK in sputum and urine were negative on direct examination and culture. The tuberculin was 12 mm and HIV status was negative. A left adrenal biopsy was done and histopathological study of tuberculous lesions was found confirming caseofolliculaire adrenal tuberculosis. The patient has been treated with antibacillaire with favorable evolution. In light of this observation, the authors make the point on this rare disease.

Estado nutricional de adolescentes y niños bereberes de las Montañas del Anti Atlas en Marruecos / Nutritional Status of adolescent Berber Children from Anti Atlas Mountains in Morocco

Introducción: La desnutrición tiene consecuencias físicas y mentales para los individuos, hogares y comunidades. Sin embargo, hay una escasez de información sobre el estado nutricional de los adolescentes en Marruecos. Objetivo: Este estudio se realizó para evaluar el estado nutricional y las mediciones de la presión arterial de los escolares rurales bereberes de Lucha contra el Atlas en Marruecos. Métodos: Se midió la altura, peso, circunferencia de la cintura y la cadera, así como la presión arterial (PA)en una muestra de 152 adolescentes de escuelas rurales bereberes de edad 12-18 años de la ciudad de Tafraout en las montañas del Anti Atlas, Marruecos. La delgadez y el sobrepeso se definen, mediante el índice de masa corporal por debajo del percentil 5 y por encima del percentil 85, respectivamente, para la edad y (..) (AU)

Introduction: Malnutrition has physical and mental consequences for individuals, households and communities. However, there is a dearth of information on the nutritional status of adolescents in Morocco. Objective: This study was conducted to evaluate the nutritional status and blood pressure measurements of rural Berber schoolchildren from Anti Atlas Mountains in Morocco. Material and Methods: Height, weight, hip and waist circumference as well as blood pressure (BP) are measured on a sample of 152 rural Berber school adolescent aged 12-18 years from Tafraout city in the Anti Atlas Mountains, Morocco. Thinness and overweight were defined as a body mass index <5th percentile value and >85th percentile value for age-and sex-specific reference data from the WHO 2007 respectively. Stunting (..) (AU)

Paradoja nutricional en la población marroquí: coexistencia de desnutrición y obesidad / Nutritional paradox of the Moroccan population: coexistence of undernutrition and obesity

Introducción: Marruecos, como la mayoría de los países en desarrollo del mundo, ha sido objeto de importantes cambios demográficos, sociales y económicos durante las últimas cinco décadas, que han dando lugar a una transición epidemiológica y nutricional. Objetivo: Analizar la evolución del estado nutricional de la población marroquí. Material y métodos: Este informe se realiza para poner de relieve la tendencia de la desnutrición en Marruecos durante los últimos 50 años mediante la compilación de información de diferentes informes y publicaciones de diversas fuentes. Para tal fin se han empleado Estadísticas anuales e informes de la Oficina Nacional de Estadística, así como los datos de la Organización para la Alimentación y la Agricultura(FAO), Organización Mundial de la Salud (OMS), UNICEF y las encuestas nacionales sobre la nutrición y la situación de salud de la población marroquí. Resultados y discusión: Durante los últimos 50 (..) (AU)

Introduction: Morocco, as most developing countries of the world, has undergone important demographic, social, and economic changes during the last five decades, leading to an epidemiologic and nutritional transition. Objective: To examines the evolution of nutritional status of Moroccan population. Material and methods: This report is performed to highlight the trend of malnutrition prevalence in Morocco during the last 50 years by compiling information from various reports and publications from several sources. Yearly statistics and reports from the National Statistical Office were used as well as data from the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF and national surveys on the nutrition and health situation of the Moroccan population. Results and discussion: During the last 50 years, Morocco has had important demographic, nutritional and epidemiological changes. The demographic transition has occurred through a decrease in fecundity, an increase in life expectancy and changes in the age (..) (AU)

[Adverse effects of BCG revaccination: 12 cases]. / Complications de la revaccination par le BCG: 12 observations.

INTRODUCTION: Calmette-Guérin bacillus (BCG) is a live attenuated strain used in tuberculosis vaccination. Local and systemic side-effects, although rare, are associated with BCG vaccine. They are common in cases of overdose and with poor vaccination techniques. These complications also occur in some cases of revaccination. PATIENTS AND METHODS: This was a retrospective study over a period of 5 years between January 2000 and March 2005. 12 patients presenting complications following revaccination with BCG were observed. Patients were revaccinated with BCG following a negative intradermal reaction test. The following parameters were recorded: age, gender, history, vaccination method, type of complication, treatment and outcome. RESULTS: There were 10 men and 2 and women of mean age 21 years (19 to 23 years). Mean time to consultation was 4 weeks. Complications comprised subcutaneous abscess in 8 cases, deep chronic ulcers in 4 cases complicated by humeral osteitis in one case. The dose administered was 0.1 ml in 9 patients and 1 ml in 3 others (i.e. 10 times the recommended dose). Six patients had extensive and progressive ulceration, with one positive culture, the presence of a granuloma with caseum necrosis and one case of humeral osteitis, and specific treatment was given. DISCUSSION: Revaccination is no longer recommended by the WHO since efficacy is considered to be low or even nil. Intradermal injection is the reference method for BCG vaccination. Technical errors such as injection of an excessively high dose of the vaccine or subcutaneous administration of the vaccine solution increase the incidence of adverse effects. In our study, three patients erroneously received 1 ml of vaccine and the injection was too deep in 9 cases. There are few reports in the literature concerning the underlying mechanisms of these post-revaccination accidents; two major physiopathological mechanisms, infectious and immunological, are discussed. There is no consensus regarding treatment of these complications. Six of the 12 patients received specific therapy for 6 months.

Prevalence of obesity in Morocco.

Data on measured heights and weights indicate that the prevalence of obesity has increased among Moroccan population over the past 15 years. In 1984/1985, 4.1% of the adult population was obese, and the prevalence increased to 10.3% in 1998/1999. In the most recent survey in the year 2000, 13.3% of individuals aged 20 years and more were obese (22% among women and 8% among men). Excessive weight is more prevalent in urban than in rural areas, varies by geographical residence, positively associated with age and negatively with education level. The increasing prevalence of obesity poses challenges for researchers and policy makers.

[Sequestration of the posterobasal segment of the right lower pulmonary lobe]. / Séquestration du segment postérobasal du lobe pulmonaire inférieur droit.

Pulmonary sequestration is a rare congenital malformation that receives its blood supply from a systemic artery. We report a case of pulmonary sequestration treated by ligature of the anomalous artery without pulmonary resection. Pulmonary sequestration must be treated surgically before the occurrence of severe complications.

Fattening practices among Moroccan Saharawi women.

To study obesity in Moroccan Saharawi culture, 249 women were questioned about their desired body size and diet practices. The majority of women (90.4%) reported wanting to gain weight currently or at some time in the past. To gain weight, women used a fattening period (tablah) of at least 40 days of overeating with a reduction of physical activity and special traditional meals. Appetite enhancers (therapeutic drugs or fenugreek) and traditional suppositories were also used. Some women used corticosteroids to gain weight rapidly. The study highlights the need for health education about the dangers of obesity and steroid use in this culture.

Fattening practices among Moroccan Saharawi women

To study obesity in Moroccan Saharawi culture, 249 women were questioned about their desired body size and diet practices. The majority of women [90.4%] reported wanting to gain weight currently or at some time in the past. To gain weight, women used a fattening period [tablah] of at least 40 days of overeating with a reduction of physical activity and special traditional meals. Appetite enhancers [therapeutic drugs or fenugreek] and traditional suppositories were also used. Some women used corticosteroids to gain weight rapidly. The study highlights the need for health education about the dangers of obesity and steroid use in this culture

[Pulmonary artery aneurysms in Behcet syndrome]. / Anévrysmes artériels pulmonaires au cours du syndrome de Behçet.

Behcet syndrome is a systemic disease with venous tropism, generally expressed by thrombosis and phlebitis. Arterial involvement is more exceptional but can lead to aneurysm of the pulmonary artery, generally not more than three. We report a patient with Behcet syndrome who developed multiple aneurysms of the pulmonary artery and discuss the clinical, radiological aspects as well as the disease course and therapeutic management.

[Chronic alveolar syndrome]. / Syndrome de condensation alvéolaire chronique.

We report a case of primary pulmonary Hodgkin's disease in a 20 year-old woman. The chest x-ray showed a chronic alveolar syndrome. The diagnosis was established from a pulmonary biopsy. The radiological features and the options for diagnosis of primary pulmonary Hodgkin's disease are discussed.

[A rare cause of posterior mediastinal tumors: extramedullary hematopoiesis]. / Une cause rare des tumeurs du médiastin postérieur: l'hématopoïèse extra-médullaire.

We report a case of a patient with intrathoracic extramedullary hematopoiesis presenting as a posterior mediastinal tumor, without associated myelofibrosis. Pathophysiology and the options for diagnosis and treatment in this condition are discussed.

[Multifocal tuberculosis: fatal outcome due to toxic drug reactions]. / La tuberculose multifocale.

We report a case of multifocal tuberculosis with the following features: - skin involvement with multiple gommes disseminated on the left upper limb, the left flank, the right hypocondrium, and the right leg; - nodal involvement including the left supraclavicular, left axillary, right laterotracheal, pre and subcarineal, ceoeliomesenteric, and liver hilus nodes; splenic involvement; right pleural involvement; - spondylodiscitis of T11-T12 and of the head of the right fibula; - peritoneal involvement leading to ascitis; - multi-organ involvement. This 43-year-old woman had not particular history: no diabetes, no renal failure, no long-term corticosteroid treatment, no immunosuppressor treatment, negative HIV-1 and HIV-2 serology. Treatment with anti-tuberculosis agents led to severe drug reactions causing death due to hepatic encephalitis.

[Mediastinitis caused by Klebsiella pneumoniae with a pharyngeal portal]. / Médiastinite à Klebsiella pneumoniae à point de départ pharyngé.

We report a case of Klebsiella pneumoniae medisatinitis secondary to a retrophyarygeal abscess in a 40-year-old patient. The patient was treated with antibiotics and pleural drainage. Surgery was not necessary and the clinical course was favorable. We recall the pathophysiological and clinical aspects of this now uncommon condition and discuss the prognosis and therapeutic options.