Le syndrome de cushing chez l’adolescent: à propos de 18 patients

Le syndrome de Cushing est une pathologie rare mais grave chez l'enfant et l'adolescent. Elle diffère de la pathologie adulte par le mode de présentation et la prise en charge. Il s'agit d'une étude rétrospective des dossiers de patients suivis pour syndrome de Cushing au service d'endocrinologie de Casablanca entre 2002 - 2015, incluant les patients âgés au moment du diagnostic de moins de 22 ans, et ayant un suivi d'au moins 1 an. Au total 18 dossiers ont été inclus. L'âge moyen est de 19,55 ans, avec une prédominance féminine. La durée d'évolution moyenne est de 4,05 ans. Le tableau clinique est fait souvent d'une cassure de poids, une obésité ou une séborrhée et acné. La démarche diagnostique est comparable à celle de l'adulte. Sur le plan étiologique on retrouve une prédominance de la maladie de Cushing (15 patients). Sur le plan thérapeutique, 14 patients ont bénéficié d'une chirurgie hypophysaire, avec complément par radiothérapie chez 3 patients devant l'échec de la chirurgie, Une ablation d'une tumeur surrénalienne chez une patiente et une surrénalectomie bilatérale chez trois patients. L'évolution a été marquée par une guérison chez 9 patients et le décès chez 4 (suite à un syndrome de Nelson, infection sévère, choc hémorragique, corticosurrénalome). Les résultats de cette étude soulignent la gravité de cette maladie, ce qui nécessite d'organiser le suivi, en élaborant des programmes spécifiques de suivi médical et de prise en charge psychologique.Pan African Medical Journal 2015; 2

Pulmonary epidermoid carcinoma in a patient with acromegaly: a rare entity

A 56-years-old woman was referred to our unit for partially treated acromegaly. She had a high level of insulin growth factor. She did not complain of any pulmonary symptoms and was a non-smoker. Physical examination revealed clinical features of acromegaly. She had a 13 mm pituitary adenoma and was proposed for surgical intervention. Her chest X-ray showed a right paracardiac tumor. Computed tomography scan revealed a large right-sided fowler tumor. Pituitary surgery was cancelled and lobectomy after biopsy with lymph nodes excision was performed through thoracotomy. Histological study of the tumor revealed a medium differentiated epidermoid carcinoma with positive lymph nodes and extension to pleura. She was referred to chemotherapy protocol. Association between carcinoma and acromegaly has previously been reported. Most common tumors are colorectal and thyroid neoplasia. As we see in this case report, we need to consider other carcinomas in acromegalic patients like pulmonary carcinoma, despite their rarity in women.Pan African Medical Journal 2012; 12:2

Association hyperthyroïdie et cancers différenciés de la thyroïde

La présence d’une hyperthyroïdie n’est plus une assurance contre la survenue d'un cancer thyroïdien. L’association des deux n’est pas rare. Il s’agit d’une étude rétrospective de 355 dossiers de patients suivis pour cancer différenciés de la thyroïde au service d’endocrinologie du CHU Ibn Rochd entre 1986 et 2014, on retrouve douze patients suivis pour hyperthyroïdie chez qui une association fortuite avec un cancer différenciés de la thyroïde a été découverte sur l’examen anatomopathologique, soit une prévalence de 3.38%. L’âge moyen à la découverte est de 44,8 ans, avec une nette prédominance féminine (8/12). Huit patients avaient un nodule toxique, 3 goitres basedowifiés et un cas de maladie de basedow. Tous ont bénéficié d’une thyroïdectomie totale. Il s’agissait de carcinome papillaire chez tous les patients. Le microcarcinome était le plus prédominant (6 patients). Un carcinome insulaire était retrouvé chez une patiente, avec présence de métastases rachidiennes et rétro orbitaire. Un traitement par l’iode radioactif a été indiqué chez cinq patients. Le diagnostic de l’hyperthyroïdie n’élimine pas la possibilité d’un cancer thyroïdien associé. La malignité doit toujours être gardée à l’esprit et de ce fait proposer une démarche diagnostique comparable à celle établie pour tout nodulethyroïdien. Pan African Medical Journal 2016; 2

Bioactive Constituents and Antioxidant Activity of Moroccan garlic (allium sativum L).

Garlic (Alliym sativum) is a good source of total polyphenols content. These compounds reveal activity effectiveness not less than synthetics. The aim of current research is to study and compare an antiradical activity, phenolic, flavonoid and flavonol contents of garlic of five areas in Morocco. Those contents were determined using spectrophotometric method. Antioxidant activities were studied using two methods: DPPH and ABTS radical scavenging activity. On the basis of findings it turned out that total polyphenolic compounds and antioxidant activities varied from one area to another. Moreover, ABTS radical scavenging activity demonstrated better results compared to DPPH method and the results showed, in general, a good correlation could be found between antioxidant activity and polyphenolic compounds. Keywords: Garlic, Allium sativum, polyphenol compounds, antioxidant activity.

Pathological complete response in advanced gastric stromal tumor after imatinib mesylate therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gastrointestinal stromal tumors are a rare neoplasm exhibiting, in most cases, mutations of <it>c-kit</it>. Imatinib mesylate is the standard treatment for patients who have advanced gastrointestinal stromal tumors. Although the response rate in patients treated with imatinib mesylate in prospective clinical studies is above 50%, a complete response is very rare. We report the case of a patient with a gastric gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Case presentation</p> <p>We report the case of a 54-year-old Arab woman with a gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Conclusion</p> <p>The pathological examination of our patient documented a complete pathological response after imatinib therapy. Recently, it has been confirmed that the kinase genotype of <it>KIT </it>and <it>platelet-derived growth factor receptor α </it>can accurately predict a good response to imatinib mesylate therapy. We propose that this patient had a mutation conferring high sensitivity to imatinib mesylate.</p

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Thyroid Ectopia Revealed in the Adulthood: About One Case

Thyroid ectopia is defined as the presence of thyroid tissue outside its normal pre-tracheal location. It’s may be discovered at any age. It’s clinical impacts are highly variable, precocious or late, depending on whether the thyroid is functional or not. We describe from this case an ectopic thyroid revealed in the adulthood. It is about a 44 years old woman with a medical history of goiter under supervision in her sister also followed for a chronic nasolacrimal duct obstruction. She benefitted from orbital and sinus computer tomography that showed a tongue’s base lesion process of with a strong contrast. Tongue MRI objectified a tongue base process measuring 43x37 mm with heterogeneous enhancement after gadolinium injection with total thyroid atrophy. Thyroid scintigraphy 131 confirmed the diagnosis of an ectopic thyroid: There was a rounded hyperfixation, a retro-mandibular median projecting as sub-lingual, without visualing uptake tracer on the thyroid lodge level. Physical examination and hormonal exploration were without abnormalities. In front of the uncomplicated asymptomatic sub-lingual thyroid, regular supervision was recommended based on thyroid hormones dosage and a scintigraphy or MRI

Case Report: Insula Carcinoma of the Thyroid Combined with Hyperthyroidism and Revealed by Orbital and Osseous Metastases

It is unusual to find an association between thyroid cancer and hyperthyroidism. The coexistence of insular carcinoma which is a poorly differentiated tumor with toxic nodular goiter is rarely described. The insular carcinoma is very rare, which results in a poor prognosis in front of precocious distant metastases, yet the orbital location of metastases is exceptional. We report here a unique clinical case involving hyperthyroidism and insular carcinoma revealed by orbital and spinal metastases