Factors influencing health-related quality of life in patients with chronic obstructive pulmonary disease: insights from the Burden of Obstructive Lung Disease Study in Fez, Morocco.

The respiratory symptoms experienced by patients with chronic obstructive pulmonary disease (COPD) are a burden on daily life. The objective of this study was to measure health-related quality of life (HRQoL) and comprehensively identify its associated factors in Moroccan COPD patients. A cross-sectional, randomized study was carried out in the city of Fes, Morocco, as part of the large multicenter Burden of Obstructive Lung Disease Study on people with COPD. Data collection was carried out using a questionnaire containing sociodemographic, clinical, and quality-of-life data. The diagnosis of COPD was based on spirometry, and quality of life was measured by the Short Form Survey (SF-12) questionnaire. Using multiple linear regression, we assessed the relationship between several sociodemographic and clinical factors and SF-12 mental and physical quality-of-life scores. A total of 107 patients were included, with a male predominance (63.6%) and the most common age category being 60 years and older (51.4%). Additionally, 46.7% of participants were classified as Global Initiative for Obstructive Lung Disease (GOLD) stage 1. The mean SF-12 mental component score was 41.32±9.18, and the mean SF-12 physical component score was 41.91±11.93. Multivariate analysis revealed that a greater mental HRQoL was associated with the male gender, a body mass index of 25 or higher, and GOLD stage 1, while a greater physical HRQoL was associated with the male gender, an age less than 60 years, absence of respiratory comorbidities, and GOLD stage 1. Our results show low scores of the mental and physical components of HRQoL in COPD patients in Morocco, suggesting the implementation of measures to reduce first the prevalence of the disease and then adopt an appropriate COPD management strategy to improve those people's quality of life.

Anti-Synthetase Syndrome: A Case Report on the Elevated Risk of Pneumocystosis.

Pneumocystis carinii pneumonia (PCP), now referred to as Pneumocystis jirovecii pneumonia (PJP), occurs in immunocompromised patients. It is particularly associated with cellular immunodeficiency due to certain diseases or treatments. The risk of PCP is likely correlated with the severity of cellular immunity damage. However, excluding AIDS, the precise degree of immunosuppression required to develop PCP is not yet clearly understood. We report the case of a 58-year-old patient who presented with progressively worsening dyspnea. The clinical examination revealed a SaO2 of 88% on room air and the appearance of mechanic's hands. A thoracic CT scan showed interstitial lung disease (ILD). The immunological work-up was positive for antinuclear antibodies (ANA) and anti-JO-1 antibodies. Bronchoscopy with bronchoalveolar lavage (BAL) was performed, and the test for PJP came back positive.

Economic burden of chronic obstructive pulmonary disease in Morocco: a cost of illness study.

Chronic obstructive pulmonary disease (COPD) carries an important economic burden worldwide. However, the cost of this disease in Morocco is not well explored. This study aimed to estimate the economic cost associated with COPD in Morocco and identify its determinants. A cost of illness, prevalence-based study using a bottom-up approach method, including COPD patients, was carried out in 2021-2022. The cost was estimated from a societal perspective, and the time horizon was 1 year. Data collection was performed using a questionnaire including socio-demographic, clinical data, and utilization of health care resources in 2019: hospitalization, medical tests, medications, and medical visits. Direct health cost (DHC) was estimated by multiplying the use of health services by the official prices (unit costs) published by the National Agency for Health Insurance. The indirect cost (IC) represented by labor productivity losses was calculated using the human capital method. Costs were compared according to different socio-demographic and clinical factors. We included 159 patients; 82.4% were men, 80.4% were current or former smokers, and 78.7% were categorized as "high-risk" groups (grades C-D). The DHC was estimated at $1816.6 per patient per year. Pharmaceutical and hospitalization costs represented the highest part of the total DHC (42.5% and 22.1%, respectively). The IC was estimated at $709.5±1081.3 per patient per year. DHC increased with increasing disease severity and with the number of severe exacerbations (p<0.001). Current and former smokers were more costly to the healthcare system than nonsmokers (p=0.029). IC also increased with the number of severe exacerbations (p=0.003). In this study, we showed that COPD in Morocco generates important costs for the health system, mainly related to smoking and the severity of the disease. It is therefore important to strengthen tobacco control measures in our country.

Hydatid pulmonary embolism secondary to a right ventricular hydatid cyst: A case report.

Hydatid pulmonary embolism is an exceptional but serious condition. It complicates the rupture of a hydatid cyst in the venous return circulation, often of hepatic origin, or the endo-cavitary rupture of a hydatid cyst in the right heart. We report the case of a young patient with hydatid pulmonary embolism revealed by recurrent episodes of hemoptysis.

AB thymoma revealed by a huge intraparenchymal lung mass: a case report.

Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum. Unusually it can be found in other locations as well. Ectopic thymoma rarely presents as an intrathoracic tumor. We report a case of ectopic thymoma presenting as a giant right intrathoracic tumor, the patient was 51-year-old, and who was presented with heaviness in chest and breathlessness. Detailed investigation including chest computed tomography scan revealed a well-defined large solid tumor in the right thoracic cavity, in this case, immunohistochemical analysis demonstrated a thymome AB. The tumor was metastatic to the lung. Patient received a neoadjuvant chemotherapy, with favorable evolution.

Determinants of tuberculosis treatment default in Morocco: results from a national cohort study.

INTRODUCTION: Studies have shown an association between smoking and tuberculosis (TB) infection, disease and TB-related mortality. We thus documented the impact of smoking and others factors on TB treatment default. METHODS: A cohort of 1039 new TB cases matched on smoking status was followed between 2004 and 2009 in eight Moroccan regions. Treatment default was defined according to international criteria. Univariate analyses were used to assess associations of treatment default with smoking status and demographic characteristics. Multivariate logistic regression was used to adjust for potential confounding. RESULTS: Patients' mean age was 35.0 ±13.2 years. The rate of treatment default was 30.2%. Default was significantly higher among men, smokers, persons living in urban areas and non-religious Muslims. After adjusting for confounding variables, factors that remained significantly associated with treatment default were: being male (OR = 3.2; 95% CI: 1.2-8.7), being a non-religious Muslim (OR = 2.0; 95% CI: 1.4-2.9) and living in an urban area OR = 3.0; 95% CI: 1.8-4.9). CONCLUSION: The high rate found for default suggests important program's inadequacies and an urgent need for change. Therefore continued research of predictors of default and strategies to reinforce adherence is recommended.

Askin's tumor: a case report and literature review.

Askin's tumor is a primitive neuroectodermal tumor developing from the soft tissues of the chest wall. Its diagnosis approach is complex and requires a multidisciplinary team. Given the rarity of this entity, no regimen has been validated in the literature. We report two cases of Askin's tumor with a major response to polychemotherapy and surgical resection in one case. These cases show that treatment of Askin's tumor should be multimodal, requiring discussion in multidisciplinary tumor working groups.

Pseudotumoral tracheobronchial amyloidosis mimicking asthma: a case report.

INTRODUCTION: Tracheobronchial amyloidosis is an uncommon localized form of amyloidosis that can simulate a tracheal tumor. Clinical signs are not specific and the diagnosis is rarely given before performing a bronchoscopy with multiples biopsies. CASE PRESENTATION: We report the case of a 60-year-old Moroccan woman, complaining of dyspnea and wheezing for three years, who was treated at our institution for management of severe asthma. A bronchoscopy revealed a tumor formation of her trachea; multiples biopsies were performed and a diagnosis made of amyloid light-chain amyloidosis. She successfully received an endoscopic resection. CONCLUSION: This case highlights the importance of routinely carrying out an endoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma. Tracheal amyloidosis is a rare disease, confirmed by histological examination of bronchial biopsies, and the treatment of choice is based on the bronchoscopic resection.