[Seroprevalence of pandemic influenza A (H1N1)pdm09 in two regions in Morocco following the 2010-2011 influenza season]. / Séroprévalence de la grippe pandémique A(H1N1)pdm09 dans deux régions du Maroc après la saison grippale 2010-2011.

PURPOSES: To study and to compare the prevalence of infection with the virus A(H1N1)pdm 2009 in the population of two regions of Morocco compared to preexisting antibody levels. PATIENTS AND METHODS: A total of 300 and 200 serum samples were collected in the region of Rabat and Meknes respectively. Samples were collected during March to April 2011. One hundred and fifty sera, collected in 2007 from blood donors, were recovered from the blood center. The research for antibodies to influenza A(H1N1)pdm09 was performed by hemagglutination inhibition assay. RESULTS: The overall prevalence of antibodies inhibiting hemagglutination at the Rabat region (67%) is significantly higher than that of Meknes (53%) while the rate of cross-reactive antibodies was 7.3%. The subjects under 25 years from the Rabat region have infection rates as high with an odds ratio of 2.45. Individuals with comorbidities have the lowest prevalence with an odds ratio of 0.61. The rate of influenza A(H1N1)pdm09 vaccination in the Rabat region is 7%. CONCLUSIONS: Immunization rates of the Moroccan population will prevent the occurrence of large outbreaks in the year 2011 to 2012 but the persistence of a naive population justifies the continuation of vaccination against A(H1N1)pdm09.

[Mixed cryoglobulinemia with monoclonal IgA and biclonal IgM during hepatitis C virus infection]. / Cryoglobuline mixte à IgA monoclonale et IgM biclonale au cours d'une hépatite C.

Cryoglobulins are immunoglobulins that precipitate at low temperature and dissolve when warmed. According to Brouet, their classification relies upon the immunochemical study: type I comprises monoclonal immunoglobulins (IGG), when types II and III include both monoclonal and polyclonal components. During C hepatitis, the presence of a cryoglobulin, essentially made of mixed G-IGG and M-IGG, is a common feature with a prevalence of 40 to 80%. The authors report a case of a 63-year patient who presented with a vascular purpura and a peripheral polyneuropathy in a context of C hepatitis infection. The cryoglobulin found was composed of a monoclonal kappa A-IgG associated with a biclonal kappa and lambda M-IgG. No decrease of normal IgGs was found. This type of cryoglobulin does not belong to Brouet's classification, and argues for a new and more pertinent classification to be proposed.

[Predictive factors of atrial fibrillation in mitral stenosis. Clinical and echocardiographic study]. / Facteurs prédictifs de la fibrillation auriculaire dans le rétrécissement mitral. Etude clinique et échocardiographique.

The objective of this study was to define the predictive factors of atrial fibrillation in pure or very predominant mitral stenosis in a series of 472 consecutive patients divided into 2 groups according to the presence (group I: n = 113) or absence (group II: n = 359) of permanent atrial fibrillation. Univariate analysis showed that predictive factors for atrial fibrillation in mitral stenosis are age (40.3 +/- 9 years vs 31.4 +/- 9.5, p < 0.0001), history of commissurotomy or mitral angioplasty (13 cases vs 10, p < 0.01), functional class III or IV (36 cases vs 43, p < 0.01), history of valvular heart disease (8.4 +/- 7.3 years vs 6.4 +/- 9.2, p < 0.05), left atrial diameter (53.3 +/- 10.3 mm vs 46.5 +/- 8.5, p < 0.0001) and mitral surface area (1.1 +/- 0.4 cm2 vs 1.3 +/- 0.4, p < 0.0001). On multivariate analysis, age and left atrial dilatation were independent predictive factors of atrial fibrillation in mitral stenosis.