Post-tuberculosis fibrosing mediastinitis: A report of 3 cases.

Fibrosing mediastinitis is a rare entity generally caused by granulomatous disease. Most cases develop as a complication of histoplasmosis. Association with tuberculosis has been rarely documented. We report the case of 3 young patients who presented with superior vena cava syndrome several years after treated tuberculosis. Biological, radiological, and histological investigations led to the diagnosis of fibrosing mediastinitis.

Pseudotumor pulmonary sarcoidosis: A case report.

Sarcoidosis is a benign multisystem granulomatosis of unknown etiology. The mediastino-hilar sphere is a preferred site for the disease. It can sometimes reveal a confusing pseudotumoral presentation, constituting a diagnostic trap to be considered. We report the case of a 56-year-old woman whose lesional process rapidly resolved after 2 months of corticosteroid therapy.

Anxiety and Depression in Patients With Chronic Respiratory Diseases in the Fès-Meknès Region of Morocco.

Background Chronic respiratory diseases (CRDs) are a major public health problem in Morocco. Several studies have shown that anxiety and depression are important comorbidities of CRDs and are often associated with CRDs. This study aimed to estimate the prevalence of depression and anxiety and identify their determinants in patients with CRDs. Methodology A cross-sectional study was conducted in the Pneumology Department at the Hassan II University Hospital in Fez in 2021. An anonymous questionnaire was used to collect sociodemographic, clinical, and therapeutic data. The Moroccan version of the Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. A descriptive analysis was performed, followed by a bivariate analysis to investigate the association between anxiety and depression and other factors using tests appropriate to the types of variables studied. A p-value ≤0.05 was considered significant. Data entry was performed in Excel 2013 (Microsoft Corp., Redmond, WA, USA), and data analysis was done using SPSS software version 26 (IBM Corp., Armonk, NY, USA). Results The study included 209 patients, 50.7% (n = 106) of whom were female, with an average age of 57.84 ± 15.36 years. Chronic obstructive bronchopneumopathy was the most represented CRD (43.1%; n = 90), followed by asthma (32.2%; n = 67). The prevalence of depression and anxiety was 46.4% (n = 97) (95% confidence interval (CI) = 39.2-52.8) and 57.4 % (n = 120) (95% CI = 50.3-63.7), respectively. In the univariate analysis, depression was associated with the presence of dyspnea (51.3% vs. 32.7%; p = 0.018), the presence of asthenia (56.5% vs. 38.5%; p = 0.009), the use of oxygen therapy (66.7% vs. 42.7%; p = 0.015), and a higher number of hospitalizations (76.9% vs. 44.4%; p = 0.023). Moreover, 87.6% of patients with depression also had anxiety (p < 0.001). Anxiety was associated with a history of surgery (37.2% vs. 62.4%; p = 0.003) and with the presence of chronic obstructive pulmonary disease (66.7% vs. 50.4%; p = 0.019). Conclusions The results reveal the importance of screening for anxiety-depressive disorders in patients with CRDs and taking into account psychological aspects in the management of the disease to improve quality of life.

Thirteen Cases of Pulmonary Pneumocystis in HIV-Negative Patients.

We report 13 cases of pulmonary pneumocystis (PCP) in human immunodeficiency virus (HIV)-uninfected patients. Of eight males and five females, with a mean age of 55 years, one had breast neoplasia, two had common variable immunodeficiency (CVID), one had an autoimmune disease "Goodpasture's syndrome", and one had idiopathic fibrosis (nonspecific interstitial pneumonia/fibrosis (NIP)) undergoing prolonged corticosteroid therapy for two years, with no known immunosuppression in the remaining cases. The clinical picture was characterized by constant dyspnea and severe hypoxia in 11 cases. Lymphopenia was present in nine cases with an average rate of 920.76 elements/mm3. The diagnosis was confirmed by isolation of Pneumocystis jirovecii (PCJ) from induced sputum, except in two cases where analysis of bronchoalveolar lavage (BAL) fluid was required. With trimethoprim/sulfamethoxazole (TMP/SMX) and corticosteroid therapy, the course was favorable in all cases. Prophylactic treatment was indicated in three cases.

Association between obesity and chronic obstructive pulmonary disease in Moroccan adults: Evidence from the BOLD study.

OBJECTIVE: The Moroccan cross-sectional study aimed to investigate obesity in association to chronic obstructive pulmonary disease in Fez city. METHODS: A cross-sectional survey was carried out in Moroccan adults. Anthropometric and spirometry measurements were performed using standardized guidelines. RESULTS: Among the 744 participants, 53.9% of were women, with a mean age of 55.27 years (SD = 10.29). Nearly all women declared themselves to be never smokers, while 21% of men were current smokers. Overall, chronic obstructive pulmonary disease prevalence decreased with body mass index (p = 0.01) and waist circumference (p < 0.001). The same trends were also observed in women. The adjusted regression analysis showed a significant independent association between chronic obstructive pulmonary disease and decreasing overweight (ORa: 0.66; CI95% (0.40-0.98)), obesity (ORa: 0.66 CI95%: (0.36-0.89)), and a decreasing waist circumference-abdominal obesity (ORa: 0.58 CI95%: (0.34-0.99)) in the whole population. The same association remains significant in women for overweight (ORa: 0.18 CI95%: (0.06-0.54)) and for waist circumference-abdominal obesity (ORa: 0.40 CI95%: (0.19-0.85)). All these associations disappeared for men. CONCLUSION: Chronic obstructive pulmonary disease decreases with the increase in body mass index and waist circumference. The effect of waist circumference on the chronic obstructive pulmonary disease was greater among women, regardless of the tobacco factor. A multicenter study would help to confirm the accuracy of these findings in a larger sample of the Moroccan population. Developed lifestyle programs in patients with chronic obstructive pulmonary disease should be considered.

Risk factors and prevalence of use of different tobacco products among school adolescents in the North Central region of Morocco: a cross-sectional study.

INTRODUCTION: The rising number of youth smokers is a major concern to public health in Morocco. The implementation of appropriate preventive measures would require information about the prevalence and determinants of tobacco use. Data on tobacco consumption among adolescents in the North Center of Morocco are scarce. Therefore, the current study aims at investigating the risk factors of smoking and the prevalence of the use of different forms of tobacco among school teenagers in the North-Centre region of Morocco. METHODS: A cross-sectional study was conducted in North Central Region of Morocco among students in public secondary schools selected by stratified cluster random sampling. The statistical unit devised was a school class from the seventh to the twelfth grade of the Moroccan educational system. RESULTS: A total of 3020 students (53% were males) and an average age = 16 ± 2.1 years were included in the study. The prevalence of the use of cigarettes was 16.1% (95% CI: 14.8% - 17.4%).For other tobacco types such as hookah, snuff and tobacco chewing, the prevalence was respectively 70.6%, 42.8% and 35.0% for cigarettes smokers. The level of current tobacco use was noticeably higher among boys (15.0% vs. 2.5%, p < 0,001) and high school students in comparison to middle school pupils (21.2% versus 11.9%; p < 0,001). CONCLUSION: Among young people, all types of smoking are growing increasingly in our Moroccan society; this alarming result can contribute to help the decision-makers to make decisions and force us obviously to take preventive measures rapidly.

Adaptation and validation of a food frequency questionnaire (FFQ) to assess dietary intake in Moroccan adults.

BACKGROUND: To date, no culture-specific food frequency questionnaires (FFQ) are available in North Africa. The aim of this study was to adapt and examine the reproducibility and validity of an FFQ or use in the Moroccan population. METHODS: The European Global Asthma and Allergy Network (GA2LEN) FFQ was used to assess its applicability in Morocco. The GA2LEN FFQ is comprised of 32 food sections and 200 food items. Using scientific published literature, as well as local resources, we identified and added foods that were representative of the Moroccan diet. Translation of the FFQ into Moroccan Arabic was carried out following the World Health Organization (WHO) standard operational procedure. To test the validity and the reproducibility of the FFQ, 105 healthy adults working at Hassan II University Hospital Center of Fez were invited to answer the adapted FFQ in two occasions, 1 month apart, and to complete three 24-h dietary recall questionnaires during this period. Pearson correlation, and Bland-Altman plots were used to assess validity of nutrient intakes. The reproducibility between nutrient intakes as reported from the first and second FFQ were calculated using intra-class correlation coefficient (ICC). All nutrients were log-transformed to improve normality and were adjusted using the residual method. RESULTS: The adapted FFQ was comprised of 255 items that included traditional Moroccan foods. Eighty-seven adults (mean age 27.3 ± 5.7 years) completed all the questionnaires. For energy and nutrients, the intakes reported in the FFQ1 were higher than the mean intakes reported by the 24-h recall questionnaires. The Pearson correlation coefficients between the first FFQ and the mean of three 24-h recall questionnaires were statistically significant. For validity, de-attenuated correlations were all positive, statistically significant and ranging from 0.24 (fiber) to 0.93 (total MUFA). For reproducibility, the ICCs were statistically significant and ranged between 0.69 for fat and 0.84 for Vitamin A. CONCLUSION: This adapted FFQ is an acceptable tool to assess usual dietary intake in Moroccan adults. Given its representativeness of local food intake, it can be used as an instrument to investigate the role of diet on health and disease outcomes.

Prevalence and demographic factors of smoking in Morocco.

OBJECTIVES: To study the prevalence and determinants of cigarette smoking in Morocco. METHODS: A sample of 9,195 individuals aged 15-90 years, were randomly selected, using a stratified cluster sampling technique. A cross-sectional, household, community-based survey was conducted using a tested questionnaire. The interview covered personal, social and educational characteristics of the respondents and their smoking status. The association between current smoking and sociodemographic variables was estimated. RESULTS: The overall prevalence of current smoking was 31.5% for males and 3.1% for females. In men, smoking was associated with lower educational level. In women, it was associated with higher educational level and social class. CONCLUSION: Cigarette smoking remains an important public health problem in Morocco. A comprehensive strategy for tobacco control is needed.