Meteorological factors and climate change impact on asthma: a systematic review of epidemiological evidence.

OBJECTIVE: This systematic review aimed to investigate the epidemiological data about meteorological factors and climate change (CC) impact on asthma. DATA SOURCES: A search was performed using three databases (Web of Science, Science Direct, and MEDLINE) for all relevant studies published from January 1, 2018, to December 31, 2022. STUDY SELECTIONS: This systematic review complied with the PRISMA document's requirements, including studies related to meteorological factors and CC impact on asthma. The search included studies published in English or French language, and was based on title, abstract, and complete text. Documents not meeting inclusion requirements were excluded. RESULTS: We identified 18 studies published in the last five years that were eligible for inclusion in this review. We found that these studies concerned European, Asian, American, and Oceanic cities. Extreme variations in temperature, humidity, wind speed, exceptional incidents like hurricanes, cold and heat waves, and seasonal shifts were strongly correlated with the worsening of asthmatic symptoms, particularly in childhood. In addition, excessive concentrations of air pollutants and aeroallergens were linked to pediatric asthma emergency hospital admissions. CONCLUSIONS: A significant association between the consequences of CC and asthma in adults particularly in children has been demonstrated. Future research should quantify the impact of global change in climate regarding the aeroallergens' distribution in terms of geography and time. It is also necessary to research the impact of air pollution on asthmatic health, like sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and particles having an aerodynamic diameter lower than 2.5 µm (PM2.5).

Comparative study of the severity of Covid-19 infection between female and male patients.

Background: Different studies have identified the prognostic factors of COVID-19 infection. These studies have revealed that COVID-19 infection is more severe in males than in females. The aim of our study was to compare the severity of COVID-19 infection between males and females in terms of clinical, biological, radiological, and evolutionary aspects. Methodology: This is a cross-sectional observational study conducted in patients hospitalized with COVID-19 infection over a 6-month period from 1 August 2021 to 1 February 2022. Results: The comparison of clinical, biological, radiological, and evolutionary severity factors of covid-19 infection between the two sexes revealed that this infection was more severe in males. Statistically significant differences were noted for the rate of high dimers (p =0.01) and for lung involvement greater than 25% on chest CT (Computed tomography) (p =0.008). Conclusion: The severity of covid-19 infection in men is due to biological differences between men and women in the renin-angiotensin system, the immune system, genetics, and sex hormones. Further research into the pathophysiological mechanisms behind this finding is needed.

Pleuropulmonary nocardiosis, an unusual radiological presentation: Case report.

Nocardiosis is caused by strict aerobic filamentous bacteria of the genus Nocardia belonging to the order Actinomycetales with Actinomyces, Streptomyces and Mycobacterium. The radio-clinical presentation in the chest is often misleading. We report a case of pulmonary nocardiosis with an unusual radiological presentation. A 54-year-old patient, chronic smoker, never treated for pulmonary tuberculosis, who presented with a chronic cough complicated by moderate hemoptysis, all evolving in a context of altered general condition and feverish sensations. The radiological aspect was in favor of a hydro-pneumothorax, the pleural puncture brought back a chocolate colored purulent liquid with the presence of numerous yellow grains and the direct examination showed numerous branched gram-positive bacilli. The bacteriological study allowed to retain the presumptive diagnosis of nocardiosis, the patient was put under antibiotic treatment with a clear clinical and radiological improvement. This observation illustrates the diagnostic difficulty of pulmonary nocardiosis and emphasizes the importance of thinking about nocardiosis in front of any dark thoracic syndrome.

Knowledge of the Companions of Tuberculosis Patients Hospitalized in The Pneumology Department of The Hassan II Hospital Agadir About the Disease.

Background: Tuberculosis is a major public health problem worldwide, and in Morocco, it is the leading cause of hospitalization in the Pneumology department. Hospitalized patients are often accompanied by family members who primarily act as caregivers. This study aimed to describe the knowledge related to the disease among the companions of tuberculosis patients hospitalized in the pneumology department of Hassan II Hospital in Agadir, Morocco. Methodology: We conducted a cross-sectional observational study with the objective of evaluating the knowledge of the companions of tuberculosis patients. Results: One hundred companions participated in this study, with an average age of 33.8 +/- 10.1. The male-to-female sex ratio was 1.5. More than half of our participants had a low socio-economic level, and over a third were illiterate. Knowledge was assessed through questions related to the disease. Results showed that 82.0% of participants declared that they were aware of the disease called "tuberculosis," and 46.0% knew about its infectious origin. Almost all of them were aware of the contagious nature of the disease and its airborne transmission. Schooling was found to be associated with knowledge of the disease, its infectious nature, contagiousness, and free treatment. The associations were statistically significant with p-values of <0.001, 0.004, <0.001, and 0.002, respectively. Conclusion: The low level of schooling appears to be a hindrance to TB education. This observation could explain the very poor level of knowledge found in our study, despite the efforts made by various programs.

Isolated Endobronchial Metastasis of Breast Cancer Successfully Managed With Multimodal Treatment.

Isolated endobronchial metastases of breast cancers, without other visceral metastatic involvement, are exceptional. We report here an observation of isolated endobronchial metastasis discovered 18 months after complete treatment of breast carcinoma. The endobronchial metastasis was revealed by an incoercible cough and hemoptysis. A bronchoscopy revealed a budding tumor process obstructing the right stem bronchus and a biopsy was performed. The anatomopathological and immunohistochemical analysis confirmed the metastatic nature of the endobronchial tumor. The patient received treatment with palbociclib and aromatase inhibitors. Two years after radiotherapy and under hormone treatment, the patient is in complete remission of her breast cancer and endobronchial metastasis. Emerging research suggests that oligometastatic breast cancer carries a superior prognosis. We believe that patients with oligometastatic breast cancer should be treated with curative intent, including ablative therapy to all sites of disease if it can be safely accomplished. This approach may offer an additional chance for prolonged survival.

Tracheobronchomegaly (Mounier-Kuhn Syndrome) with CT and bronchoscopic correlation: A case report.

Tracheobronchomegaly, or Mounier-Kuhn syndrome, is a clinical and radiological entity characterized by marked dilatation of the trachea and bronchi as a result of severe atrophy of the elastic fibers, with thinning of the muscularis, and the formation of diverticula between the cartilaginous rings. The etiopathogenesis is uncertain and may be congenital or acquired. The clinical signs are not specific and are frequently revealed by recurrent respiratory infections and chronic cough. The diagnosis of Mounier-Kuhn syndrome is based on well-documented measurements of the trachea and main bronchi performed on a chest computed tomography scan. The management of patients is based on symptomatic treatment and may require, in severe cases, the use of endoscopic treatment by stent placement or surgical tracheobronchoplasty. We present a case of a 59yearold patient with recurrent respiratory infections that required several hospitalizations. Diagnosed with Mounier Kuhn syndrome, the thoracic computed tomography scan demonstrated a dilated trachea until the bifurcation and focal points of bronchial dilatation. Bronchoscopic examination showed a dilated and deformed trachea with the presence of diverticula on the tracheal anterior wall. The diameter of the trachea was reduced by more than 50% during expiration and coughing. For this reason, Mounier-Kuhn syndrome should be considered in cases of recurrent respiratory infection or persistent respiratory symptoms.

F-FDG18PET/CT incidental detection of tumor-to-tumor metastasis in patients investigated for squamous cell lung cancer.

Tumor-to-tumor metastasis (TTM) is a well-known entity, although this is still an extremely rare phenomenon. The lung cancers are considered the most frequent metastatic donors while kidney cancers are the most common recipient. The finding of TTM is often incidental during a biopsy of metastases or on surgical specimens but never suspected on radiological assessment of tumor extension. The finding of an unexpected region of Fluorodeoxyglucose (FDG) uptake can occur when performing whole body Positron Emission Tomography/computed tomography (PET/CT) scan and potentially raises the possibility of a second primary tumor. However, PET/CT scan incidental detection of tumor-to-tumor metastasis has never been reported in English literature. We report here a case of clear cell renal carcinoma, receptor of metastases originating from an oligometastatic squamous cell lung cancer detected on the PET/CT scan performed as part of the extension workup. Morphological and immunohistochemical analysis of a percutaneous biopsy of the renal mass were consistent with the diagnosis of a metastasis of lung cancer into renal cell carcinoma. This is the first case of oligometastatic lung cancer with the occurrence of TTM suspected in PET/CT scan. Although this is a rare setting, it should be considered in daily practice, as it could potentially modify the oncological management offered to the patients.

[Tracheal stenosis revealing systemic lupus erythematosus]. / Sténose trachéale révélant un lupus érythémateux systémique.

Systemic Lupus Erythematosus (SLE) with respiratory involvement is less well known than cutaneous, articular and renal involvement. Clinical course is quite variable and dominated by pleural involvements. Tracheal stenosis is unusual, if not exceptional in patients with this disease. We here report a quite particular case of systemic lupus erythematosus revealed by tracheal stenosis with dry eye-buccal syndrome.

Endobronchial localization of Hodgkin's disease.

The endobronchial localization of Hodgkin's disease is a rare entity which is often confused with endobronchial tuberculosis in our setting. We report the case of a 16 years old female who presented with 6 months history of dry cough, hemoptysis, dyspnea, dysphagia and dysphonia. The chest radiography showed a mediastinal and pulmonary opacity. The chest CT scan found enlarged mediastinal lymph nodes. The bronchial biopsy and peripheral lymph node biopsy confirmed Hodgkin's disease with endobronchial localization. The patient received chemotherapy (ABVD protocol) and radiotherapy with a favorable follow up.

[Unusual location of multiple hydatidosis, pancreatic and pelvic: about a case]. / Hydatidose multiple à localisation inhabituelle, pancréatique et pelvienne : à propos d'un cas.

Hydatid cyst is an infectious disease which is quite frequent in Morocco. Pelvic and pancreatic locations of this parasitic infection are rare, namely exceptional. We report the case of a 66-year old patient who was operated for liver hydatic cyst 6 years before, presenting for chest pain associated with hydatidoptysis. Chest X-ray objectified left hydropneumothorax. Thoraco-abdominopelvic CT showed mediastinal liquid mass as well as multiple hepatic, pancreatic (isthmus), pelvic and left under diaphragmatic cystic lesions. Hydatid serology was positive. Treatment involved thoracotomy associated with medical treatment.

[Pleuropulmonary metastases originating from extra-thoracic neoplasia]. / Métastases pleuro-pulmonaires des néoplasies extra-thoraciques.

The lungs receive the entire venous drainage of the body. This explains the high incidence of pleuropulmonary metastases originating from several cancers. The goal of this is to study the clinical manifestations of pleuro-pulmonary metastases originating from extra-thoracic cancers. We conducted a retrospective study of patients with pleuro-pulmonary metastasis whose data were collected in our department between January 2006 and december 2014. 76 patient medical records were studied. The average age was 50 years (aged 21-89 years) with a male predominance in 57.8% of cases. Clinical symptoms were mainly cough (32.8% of cases), dyspnea (23.7% of cases) and hemoptysis (11.2%). Primary cancers responsible for various pleuro-pulmonary metastases found in our case series were dominated by breast cancers in 27.6% of cases, gastro-intestinal cancers in 15.8% of cases, genital cancers in 9, 2% of cases, sarcomas in 7.8% of cases, renal cancers in 5.2% of cases, bladder cancers in 5.2% of cases, prostate cancers in 3.9% cases, ENT cancers in 3.9% of cases, thyroid cancers in 3.9% of cases, skin cancers in 2.6% of cases and cancers of unknown primary origin in 14.4% of cases respectively. Several radiologic features of pleuro-pulmonary metastases have been found in our case series; they can be isolated or combined. The most common radiologic aspect was multiple pulmonary nodules in 52.6% of cases, followed by pleurisies in 34.2% of cases, diffuse micronodules in 23.6% of cases and a solitary nodule in 3.94% of cases. Secondary pleuropulmonary cancers are frequent. They come in 3rd place after lymph nodes and liver metastases and are found in 30% of autopsies of patients with neoplasia.

Prevalence of Skin Sensitization to Pollen of Date Palm in Marrakesh, Morocco.

Background. Date palm's pollen has been identified as a source of allergy; the rate of sensitization of this pollen is between 6 and 29%. Objective. To determine the prevalence of sensitization to date palm in Marrakesh and to identify the clinical profile. Patients and Methods. This study is based on a questionnaire and the prick test on 7 allergens, in population aged 5 years and above with clinical symptoms suggesting allergic diseases, from November 2012 to February 2013 in Marrakech. Results. We included 468 patients (women: 79.5%). The prick tests were considered interpretable in 467 cases. The prevalence of skin sensitization to pollen of date palm was 6.6%. The 31 cases of sensitization to date palm involved 7 men and 24 women with an average age of 37.5 years. Cutaneous monosensitization to date palm's pollen was observed in 2 cases. Asthma, rhinitis, and conjunctivitis were recorded, respectively, in 48.4%, 93.5%, and 67.7%. Conclusion. Skin sensitization to pollen of date palm does not seem unusual among allergic patients in Marrakech and is comparable to that found in Casablanca (7%), Barcelona (6.6%), and Cartagena (6.1%).

[Spontaneous pneumothorax: unusual manifestation of pulmonary hamartochondroma]. / Pneumothorax spontané: mode de révélation inhabituel d'un hamartochondrome pulmonaire.

Hamartochondroma is a benign tumor of the tracheobronchial tree, often found incidentally and rarely symptomatic. It is more common in men than in women. Its radiological aspect is often evocative. Surgery is indicated for large and/or symptomatic tumors. Histological diagnosis usually poses no difficulty We report the case of a 30-year-old young patient with no particular past medical history and with spontaneous pneumothorax revealing a large sized hamartochondroma. This rare association could be explained by the fact that tumors of fairly anarchic composition may contain cyst formations that may rupture into the pleura causing effusions.

[Eosinophilic pneumonia revealing B-cell non-Hodgkin lymphoma]. / Pneumopathie à éosinophile révélant un lymphome non hodgkinien de type B.

The diagnosis of eosinophilic pneumonia is rare and malignant etiology remains exceptional. Eosinophilic pneumonia etiology varies and is mainly dominated by allergic and drug causes. We report the case of a 61-year-old patient with B-cell non-Hodgkin lymphoma revealed by eosinophilic pneumonia. The diagnosis of eosinophilic pneumonia was confirmed by eosinophil count of 56% in bronchoalveolar lavage. Immunohistochemical examination of bone marrow biopsy revealed malignant Small B cells non-Hodgkin lymphoma.

[Pulmonary Langerhans' cell histiocytosis (PLCH) revealed by pneumothorax: about a case]. / Histiocytose langerhansienne pulmonaire révélée par un pneumothorax: à propos d'un cas.

Langerhans cell histiocytosis is a rare disease of unknown etiology characterized by the infiltration of Langerhans cells in one or more organs. It has a polymorphic clinical presentation. We report the case of Mr R.Y, age 22, with 8 pack year history of smoking, admitted to hospital with complete spontaneous right-sided pneumothorax. Chest drainage was performed with good evolution. Control chest CT scan showed multiple diffuse cyst formations, predominant in the upper lobes. Lab and imaging tests were performed in order to detect systemic histiocytosis with negative results. Patient's evolution was marked by pneumothorax recurrence; pleurodesis and lung biopsy were performed which confirmed the diagnosis. The diagnosis of Langerhans cell histiocytosis should be evoked in front of pneumothorax associated with lung cystic. The diagnosis is easy in front of a suggestive clinical and radiological picture. Nevertheless, therapeutic options are limited and pneumothorax recurrence is common.

[Spontaneous hemothorax revealing Wegener's vasculitis in a pregnant woman]. / Hémothorax spontané révélant une vascularite de Wegener chez une femme enceinte.

Spontaneous hemothorax is a rare condition. Its causes are multiple but sometimes they remain unknown. In some patients, thoracotomy may be the only means to determine hemothorax origin. Vasculitis have not been reported as a common cause of spontaneous hemothorax. Pregnancy does not appear to have causal or aggravating effect on spontaneous hemothorax or on vasculitis. We here report the peculiar case of a young patient presenting during pregnancy with spontaneous hemothorax secondary to Wegener's vasculitis. The latter was diagnosed by pleural biopsy performed during exploratory thoracotomy and confirmed by ANCA assays.

[Pulmonary hydatid cyst: unusual double apical location. About a case]. / Kyste hydatique pulmonaire: double localisation pulmonaire apicale inhabituelle. A propos d'un cas.

Hydatid cyst (KH) is still endemic in several areas of Morocco. Pulmonary involvement is a consequence of liver disease. Hydatid cyst is characterized by diverse anatomical and clinical presentations and by the possibility of multiple locations within the lung parenchyma, predominantly involving pulmonary bases. We report the case of Mr J. M, 54 years old, admitted with suspected pulmonary hydatid cyst based on chest pain lasting for six months and an episode of hydatidoptysis. Chest x-ray objectified a double apical location suggesting different stages of evolution for pulmonary hydatid cyst. The diagnosis was confirmed by thoracic CTscan and hydatid serology. Multiple pulmonary hydatid cyst is not rare in areas in which hydatid disease is highly endemic. Our study reports an unusual double apical location of hydatid cyst at various stages of evolution.