The Middle East and Eastern Europe rabies Expert Bureau (MEEREB) third meeting: Lyon-France (7-8 April, 2015).

MEEREB is an inter-regional network of countries from North Africa, Europe, the Middle East and Central Asia that work together with the aim of improving rabies control and prevention at local, regional and global level. MEEREB members met for the third time in 2015 in France (Lyon) to review the current rabies situation within the network and to discuss the way forward the prospect of a One Health approach against rabies. Dogs were the main vector of transmission in all MEEREB countries except for Croatia and Serbia where foxes represented the primary source. The number of rabies animal cases reported in 2014 varied substantially between countries with Ukraine reporting the highest number of animal cases. Human cases still occur in North Africa and all Middle East and Eurasian countries while no cases of human rabies were reported in Croatia, Serbia and Romania, although cases of rabies were identified in both dogs and foxes in 2014. Participants concluded that MEEREB can act as a think-tank where countries can share data, information, experiences and best practices to jointly address challenges in rabies control and prevention. They called for elimination of dog-transmitted rabies through vaccine and rabies immunoglobulin stockpiles and implementation of a One Health approach to achieve rabies's eradication.

Preparedness and health risks associated with Moulay Abdellah Amghar moussem, Morocco, 2009-2010.

The objective of this study was to describe the risks and human health outcomes associated with attendance at the Moulay Abdellah Amghar moussem (a pre-planned mass gathering attracting more than 360 000 participants) for the purposes of public health prevention, planning, preparedness and response. We performed an environmental health risk assessment and retrospectively reviewed local health centre records before, during and after the event. In addition, standardized interviews with key stakeholders were performed to qualitatively evaluate local public health preparedness and response capacities. During the event, average daily health centre visits increased 5-fold. The sex ratio of health-care visits changed significantly from an average of 1.8:1 female:male visits per day to 1.2:1. The proportion of injuries varied from an average of 3.7% pre- and post-event to 14.8% (P < 0.01) during the event. A significant increase in digestive diseases was also observed during the event. Recommendations include increasing accessibility to free sanitation and hygiene facilities and improving health communications concerning hand washing and food and water safety.

[Effects of food restriction imposed to adult rats on the bone growth and the histological structure of the thyroid in their youth]. / Effets de la restriction alimentaire appliquée à des rates adultes sur la croissance osseuse et la structure histologique de la thyroïde chez leurs jeunes.

STUDY PURPOSE: Our objective was the study of the development and the maturation of pups whose mothers were subjected to intermittent fasting. MATERIALS AND METHODS: Eight pregnant female Wistar rats were distributed into two groups of four adult females. The rats of the first group were subjected to intermittent fasting beginning on the 14th day of gestation and continued 21 days after parturition. The rats of the second group were normally fed. The young of both groups of rats were sacrificed at the age of 21 days. RESULTS: The pups of the female rats submitted to food restriction showed a reduction of the body weight (-35%), of the thyroid iodine content (P<0.001) and of segment thyroxin (P<0.05). The histological study revealed that these pups presented colloid depletion of this follicular thyroid, non-anastomosing trabeculae, cortical bone thinning, decreased bone mineral content, absence of osteoid formation and decreased number of osteoclasts. CONCLUSION: Dietary restriction imposed on adult rats, from gestation, led to the installation in their pups of a state of malnutrition and a description of thyroid histology. This thyroid abnormality is associated with hypothyroidism that led, at least in part, to the collapse of the ability to regulate bone remodeling.

[Schistosomiasis in Morocco: from discovery to after elimination]. / La schistosomiase au Maroc: de sa découverte a l'après-elimination.

This paper outlines the history of schistosomiasis in Morocco and the efforts made to eliminate it from the country. Since it was first diagnosed in 1914 in Marrakesh, schistosomiasis remained for decades a public health problem in Morocco. A national control programme was launched in 1982 and it led to a considerable reduction in the incidence and morbidity associated with the disease. Consequently, the programme shifted from disease control to an elimination process launched in 1994. This process aimed to eliminate the disease transmission by the end of 2004 and has helped to clear all known foci. Today, the challenge is to maintain schistosomiasis elimination and to be certified schistosomiasis-free by the World Health Organization.

Parasitic infection of the digestive tract in children in a regional hospital center in Gharb (Kenitra, Morroco): some epidemiological features.

Intestinal parasites are very common in children. We propose to study the prevalence and Epidemiological profile of the port of intestinal parasites in 300 children hospitalized in the Regional Hospital of Gharb area (Kenitra, Morocco) from June to December 2007. This study Identified 11 intestinal parasites. Of the 300 children, 157 at least one intestinal have Parasitism was 52.3% with 91 boxes of poly-Parasitism. Among the intestinal protozoan Identified, Is The first Amebiasis intestinal parasites. The rate of infestation of Amoebiasis IS 46.5%, Followed by Blastocystis hominis (28.7%) of giardiasis (14%). That shows 128 children in the study population IS a carrier of Various species of helminths, the main ones: Enterobius vermicularis (35%), Ascaris lumbricoides (29.9%), Trichuris trichiura (10.2%), Hymenolepis nana (3.8%) and Taenia saginata (2.5%). The survey shows the age group most That exposed to intestinal parasites IS Between 1 and 4 years and sex does not appear to significantly interferes in the distribution of different parasite species. The results show the necessity of improvement of the sanitation of the environment and the health education of the population. Then will Come the deworming campaign of which will be therefor effective.

[Epidemiological retrospective survey intestinal parasitism in the Provincial Hospital Center (Kenitra, Morocco): review of 10 years (1996-2005)]. / Enquête épidémiologique rétrospective sur les parasitoses intestinales au Centre hospitalier provincial El Idrissi (Kénitra, Maroc) : bilan de 10 ans (1996-2005).

The survey drew up the epidemiological situation of intestinal parasitism in the center of health El Idrissi (Kenitra, Morocco). The number of reviews has decreased between 1996 and 2005. A correlation between the number of examinations and years of the study period was observed (p <0.001). 4285 stool specimens collected in 1996-2005 were tested by parasitologic examination. Among the persons examined, 606 of them were parasited by one or several species, say an infestation index of 14.15%. Amoeba were frequently observed (47.04%) with prevalence of Entamoeba histolytica (23.74%), followed by Flagella (28.79%) represented by: Giardia intestinalis (22.71%), Trichomonas intestinalis (5.49%) and Chilomastix mesnilii (0.60%). Helminthes were less found. Ascaris lumbricoides was frequent among helminthes (11.87%), followed by Trichuris trichiura (5.64%), Hymenolepis nana (2.68%), Enterobius vermicularis (2.08%), Taenia saginata (0.75%) and Stronyloides stercoralis (0.45%). The clinical symptoms were observed in 110 subjects with parasites (110/606 or 18.15%) characterized by abdominal pain (75 cases) and association diarrhea more abdominal pain (35 cases). The relationship between the infestation index calculed, sex, age, the annual and seasonal changes, polyparasitism and intestinal parasitic infection is discussed.

[Sleep apnea syndrome]. / Le syndrome des apnees du sommeil.

Sleep Apnea Syndrome is an understimated disease. We describe its diagnostic criterion and principal epidemiologic data. After a brief rememory about sleep and respiration, its physiopathologic consequences (especially respiratory, cardiovascular and cerebral) were detailed. The diagnostic of its different clinical presentations is suspected clinically but confirmed by polysomnography. His treatment, usually based on the CPAP, permits to prevent its complications.

[Prevalence of intestinal parasitic disease in three provinces in Morocco]. / Prévalence des parasitoses intestinales au niveau de trois provinces au Maroc.

A study of intestinal parasites was carried out in Taounate, Béni Mellal and Tizinit provinces in Morocco on a sample of 1682 individuals who were representative of the urban and rural area population. For each stool specimen, three microscopic examinations and a Kato test were performed. In the three provinces, about two-thirds of the study participants from rural areas and around 50% of those from urban areas had parasites. The reproducibility of the prevalence figures allowed the study results be generalized to the other provinces of the country. Among the parasite groups encountered, amoebas were the most frequent, followed by flagellates and helminths. Concerning pathogenic species, Entamoeba histolytica, in the amoebic group, was the most commonly found. All the positive cases were treated by specific medication.

[Emphysematous cystitis: apropos of 2 cases]. / Cystite emphysémateuse: à propos de 2 cas.

Emphysematous cystitis is a rare infectious disease of the lower urinary tract. Its reputedly serious prognosis is related to treatment failures revealing ignorance concerning its pathophysiological mechanisms. Two cases of this disease were seen in our department, both in diabetic men over the age of 70 years with a history of prostatism. They presented to the emergency department with complete urinary retention and alteration of the general state and fever. Urine culture isolated Klebsiella pneumoniae in both cases. Treatment consisted of bladder drainage associated with adapted antibiotic therapy and control of diabetes. A suprapubic prostatectomy was subsequently performed in one case and transurethral prostatic resection was performed in the other case. The prognosis of this disease depends on early diagnosis and rapid introduction of effective treatment.

[Reduction of lipoproteins with apoAI but without apoAII (LpAI) in non-insulin-dependent diabetic patients]. / Réduction des lipoprotéines avec apoAI mais sans apoAII (LpAI) chez les diabétiques non insulino-dépendants.

Recent data suggest the existence of a relationship between ischemic heart diseases and apolipoprotein A-I containing lipoproteins. The latter and other classic lipid-lipo-protein-apoprotein parameters were quantified in 25 non-insulin-dependent diabetics and 26 normoglycemic normolipidemic subjects. Compared to a control group, non-insulin-dependent diabetics have higher levels of plasma cholesterol (p < 0.05), triacylglycerol, apolipoprotein B (p < 0.001). In contrast, their lipoprotein particles containing only apolipoprotein AI without apolipoprotein AII and apoAI/apoB ratio were lowered (p < 0.001). In our diabetics, apolipoprotein AI was found at normal level but its distribution between high density lipoproteins ('HDL') and 'non-HDL' was abnormal. Also, the distribution of particles containing apolipoprotein A-I without apolipoprotein A-II in non-insulin-dependent diabetics was found abnormal. A higher proportion of both apoAI and LpAI were found in the 'non-HDL' fraction. These data show that lipoprotein metabolism is affected in non-insulin-dependent diabete mellitus. The disease is associated to a lipoprotein profile which is in favour of the atherogenic process.

Vaginal leiomyoma: the female prostate.

We report one case of vaginal leiomyoma revealed by dysuria operated with success. Our observation are discussed with the review of the literature data.

[Retrocaval ureter. Apropos of 6 cases]. / L'uretère rétro-cave. A propos de 6 cas.

The authors report six cases of retrocaval ureter discovered in quite various circumstances. A genital malformation associated to the retrocaval ureter was found in only one case. Five of our six patients were operated. Four of them underwent uncrossing of the ureter relative to the vena cava, and a patient underwent nephrectomy because her kidney was destroyed. The sixth patient was not operated because there was no impact on the excretory cavities of the kidney. This series and the review of the literature allow specifying the course of action for this pathology.

Thrombin cleavage of apolipoprotein Bh of rabbit LDL: structural comparisons with human apolipoprotein B-100.

Rabbit plasma low density lipoprotein (LDL) contains one major apolipoprotein of apparent molecular weight of 320 kDa, designated apolipoprotein (apo) Bh, while another component termed apoB1 of apparent molecular weight of 220 kDa is found in chylomicrons. The fragments generated by thrombin digestion of the protein moieties of rabbit and human LDL were separated by polyacrylamide gradient gel electrophoresis and compared. As in the human species, the enzyme produced limited cleavage patterns of rabbit LDL apoB. Within the first 2 h, two fragments (Tr1 and Tr2, with apparent molecular weights 280,000 and 44,000, respectively) appeared. Longer incubations led to the production of two additional peptides, Tr3 and Tr4 (apparent molecular weights 180,000 and 96,000, respectively). Ten monoclonal antibodies, developed against rabbit LDL and designated P01 to P10, were found to react with rabbit apoB. Some also cross-reacted with human apoB. Epitope mapping, performed with these antibodies, showed that Tr3 and Tr4 were derived from the further degradation of Tr1. The rabbit is one of the most frequently used animals in atherosclerosis research. Its LDL receptor has been characterized and there exists a strain of homozygous LDL receptor-deficient rabbits referred to as WHHL rabbits. Despite this, little has been done to characterize the structure of rabbit apoB; only a short region has been sequenced and shown to be the carboxyl-terminal region, the rabbit apoB1. The molecular weight of human apoB (550,000) is much larger than rabbit apoBh. In both species, a primary and secondary thrombin cleavage occur, but the size of the fragments produced is very different between the two species. Identification of the thrombolytic fragments of the rabbit apoB have afforded the opportunity to compare the structures of both apoB species.

Differential role of apolipoprotein AI-containing particles in cholesterol efflux from adipose cells.

Cholesterol efflux was studied in cultured Ob1771 adipose cells after preloading with LDL cholesterol. Exposure to particles containing apo AII (LpAI) and particles containing apo AI and apo AII (LpAI:AII) isolated from native human plasma, and from HDL2 or HDL3, showed that only LpAI were able to promote cholesterol efflux, despite the fact that both kinds of particles were able to bind to receptor sites within the same range of concentrations (apparent Kd values between 10 and 25 micrograms/ml). During this long-term exposure, LpAI:AII demonstrated a concentration-dependent inhibition (10-60 micrograms/ml) of LpAI-mediated cholesterol efflux from adipose cells under conditions where LpAI:AII did not deliver cholesterol to the cells and where no net change in the distribution of apo AI between LpAI and LpAI:AII was observed. The antagonizing and modulating role of LpAI:AII in preventing cholesterol efflux mediated by LpAI appears not to be related to the lipid composition and cholesterol content of the particles but, rather, appears dependent upon the presence of apo AI in LpAI particles and apo AII in LpAI:AII particles. The actual concentrations of these particles in the interstitial fluid bathing peripheral cells might be critical for the in vivo occurrence of cholesterol efflux.

Apolipoprotein A-I-containing lipoproteins in human umbilical cord blood. Relation to proapolipoprotein A-I and lecithin:cholesterol acyltransferase.

Lipids, apolipoproteins, lipoproteins, as well as lipoproteins containing both apo A-I and apo A-II (Lp A-I:A-II) or apo A-I but no apo A-II (Lp A-I), proapolipoprotein (proapo) A-I and the activity of lecithin:cholesterol acyltransferase (LCAT), were investigated in umbilical cord sera of 67 term human neonates (30 females and 37 males). Lp A-I and Lp A-I:A-II were present in umbilical cord sera with levels of 0.26 +/- 0.1 and 0.33 +/- 0.15 g/l, respectively. Furthermore, the absolute amount of proapo A-I was lower in cord blood than in adult plasma, but in view of the lower apo A-I levels in umbilical cord sera it comprised 10.48 +/- 3.86% of total apo A-I and was thus significantly higher than in adult plasma (7.1 +/- 0.9%). Proapo A-I was highly correlated with HDL cholesterol and apo A-I. Total serum LCAT activity was about 50% of adult plasma and was highly correlated with Lp A-I, but not with Lp A-I:A-II. We conclude that human umbilical cord serum contains both Lp A-I and Lp A-I:A-II particles and that the LCAT activity is predominantly related with the Lp A-I subfraction. The higher percentage in umbilical cord sera of proapo A-I may indicate a higher turnover of apo A-I or a lower activity of the proapo A-I cleaving enzyme which is still not identified.

[Is sucrose a risk factor in calculus formation?]. / Le saccharose est-il un facteur de risque de la lithogenèse?

The addition of sucrose to drinking water of rats at the rate of 2.5 or 5 grams per 100 ml, for one month, induced hypercalciuria which appeared to be dependent on the degree of supplementation. In spite of these disorders, calcium deposits were not observed in treated animals. This protection against renal calculi was probably due to high urinary excretions of magnesium, phosphorus, zinc and copper. These lithogenesis inhibitors varied, like oxaluria and calciuria, in parallel with dietary sucrose intake.

[What do we know about lipoproteins containing apo A-I?]. / Que savons-nous des lipoprotéines contenant l'apo A-I?

Since the Alaupovic's original concept, the lipoproteins were more and more classified according to their biochemical composition. Between the different and well identified lipoproteins particles, those containing apo A-I were particularly studied. These particles had a very great heterogeneity with respect to both their physicochemical properties and their apolipoproteins composition especially if they had or not the apo A-II. This criterion was frequently used for their classification in two different populations: the lipoproteins which contained both apo A-I and apo A-II (Lp A-I:A-II) and the other lipoproteins which contained apo A-I but no apo A-II (Lp A-I). All the two lipoprotein populations could be divided in several subpopulations. Among the two categories of lipoprotein particles, those devoid of apo A-II were described as the actual anti-atherogenic ones. Indeed, the Lp A-I population appeared as the only lipoproteins which decreased in serum during an atherosclerotic affection, this phenomenon being related to the favourable role of the Lp A-I population in the normal metabolism of lipids. Only the Lp A-I were demonstrated be able to induce and enhance the cholesterol efflux from culture cells. The Lp A-I:A-II function remained unknown, but the hypothesis is raised of a possible regulatory role which could be related to the high concentration of LpA-I in the cholesterol reverse transport.

[Ectopic implantation of the ureter. Apropos of 2 cases]. / L'abouchement ectopique de l'uretère. A propos de deux cas.

We report two cases of urinary incontinence secondary to ectopic ureteral implantation with pyeloureteral duplication in a 14 and 18 year-old girls. Our observations are discussed with the review of the world publication about this data.