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Vaccination is considered the most promising approach to ending or containing the 2019 coronavirus (COVID-19) pandemic. Available vaccines have proven to be very safe and effective. Nevertheless, post vaccination complications have been described. We report the case of a 26-year-old female patient admitted for management of severe viral pneumonitis due to SARS COV2, 15 days after the 1st dose of the vaccine, whose investigations suggest a macrophagic activation syndrome or vaccine-induced immune thrombocytopenia syndrome (VITT) Macrophagic activation syndrome (MAS) is observed in a multitude of clinical situations encountered in adults. It is characterized by a series of non-specific clinical and biological signs, the combination of which should raise the suspicion of the diagnosis and lead to a cytological or histological examination to confirm it. Its occurrence requires a fairly exhaustive etiological work-up. It is a serious pathology, with a severe prognosis and a poorly codified treatment [1, 2].The objective of our work is to report a case of MAS strongly suspected following an infection due to COVID in a young 26 year old patient, 15 days after the 1st dose of the vaccine, a Vaccine-induced Thrombotic Thrombocytopenia (VITT) not to be eliminated either.

BACKGROUND: Meeting physical activity (PA) guidelines and decreasing sedentary time (SED-time) are cornerstones in the management of diabetes. OBJECTIVE: This study aims to assess the level of PA, SED-time, and related factors among Moroccan diabetes patients. METHODS: From February to June 2019, 1143 patients with type 2 diabetes took part in a cross-sectional survey. PA and SED-time were assessed through a face-to-face interview using International PA Questionnaire. RESULTS: The PA recommendations were achieved by 77.7% of participants and they were significantly higher in males using oral antidiabetic alone, in normal and overweight participants, and in those with duration less than 7 years. While in females, this level was significantly higher only in participants with a family history of diabetes. The mean SED-time was high (35.66±16.88 hours/week) and increased with age, BMI, duration of diabetes, among widowers and divorced, illiterate and among those with low level of PA. CONCLUSIONS: The PA level and SED-time were high. Furthermore, participants with high SED-time have low levels of PA, which represents a combined risk of sitting and inactivity in this subgroup. As a result, patients should be encouraged to participate regularly in PA and also to minimize their SED-time.

Forest tree species mapping became easier due to the global availability of high spatio-temporal resolution images acquired from multiple sensors. Such data can lead to better forest resources management. Machine-learning pixel based analysis was performed to multi-spectral Sentinel-2 and Synthetic Aperture Radar Sentinel-1 time series integrated with Digital Elevation Model acquired over Argan forest of Essaouira province, Morocco. The argan tree constitutes a fundamental resource for the populations of this arid area of Morocco. This research aims to use the potential of the combination of multi-sensor data to detect, map and identify argan tree from other forest species using three Machine Learning algorithms: Support Vector Machine (SVM), Maximum Likelihood (ML) and Artificial Neural Networks (ANN). The exploited datasets included Sentinel-1 (S1), Sentinel-2 (S2) time series, Shuttle Radar Topographic Missing Digital Elevation Model (DEM) layer and Ground truth data. We tested several sets of scenarios, including single S1 derived features, single S2 time series and combined S1 and S2 derived layers with DEM scene acquisition. The best results (overall accuracy OA and Kappa coefficient K) obtained from time series of optical data (NDVI): OA = 86.87%, K = 0.84, from time series of SAR data (VV+VH/VV): OA = 45.90%, K = 0.36, from the combination of optical and SAR time series (NDVI+VH+DEM): OA = 93.01%, K = 0.914, and from the fusion of optical time series and DEM layer (NDVI+DEM): OA = 93.25%, K = 0.91. These results indicate that single-sensor (S2) integrated with the DEM layer led us to obtain the highest classification results.

[eng] Background: Anxiety is a common and difficult sensation whose source is often non-specific with deleterious effects on anesthetic management and postoperative outcomes. To effectively prevent and treat preoperative anxiety, patients’ anxiety levels must be assessed using reliable measuring instruments. One of these tools is the Amsterdam Preoperative Anxiety and Information Scale (APAIS), which does not yet have a validated Moroccan version. Although the extent and consequences of preoperative anxiety are well documented in the developed world, there are few studies in Morocco. Objectives: This study aimed to adapt APAIS to measure preoperative anxiety in adult Moroccan patients undergoing surgery. Methods: We produced an Arabic version of APAIS and administered it to a sample of 100 adult patients. A forward/backward translation was carried out to ensure a reliable Moroccan cultural adaptation. A pre-test was conducted and the final dialectal Arabic version of APAIS was administered to a sample undergoing elective surgery at the regional hospital of SoussMassa in Agadir. We explored its reliability through Cronbach’s alpha and analyzed its validity. Results: The reliability of the Moroccan APAIS was high with internal consistency and a Cronbach’s alpha coefficient is 0.738. The Intraclass correlation coefficient (ICC) for this score is 0.880 (CI95%: 0.817 to 0.928), which corresponds to a good fidelity. Conclusion: This version of APAIS is valid and can be used reliably in Morocco to appreciate the preoperative anxiety and the desire for information felt by future surgeons. It is a useful screening tool for anxiety and the need for information in clinical practice, particularly because of its brevity and simplicity., [spa] Antecedentes: La ansiedad es una sensación común y difícil cuyo origen es a menudo inespecífico con efectos deletéreos sobre el manejo anestésico y los resultados postoperatorios. Para prevenir y tratar eficazmente la ansiedad preoperatoria, los niveles de ansiedad de los pacientes deben evaluarse mediante instrumentos de medición fiables. Uno de estos instrumentos es la Escala de Ansiedad e Información Preoperatoria de Ámsterdam (APAIS), que aún no cuenta con una versión validada en Marruecos. Aunque el alcance y las consecuencias de la ansiedad preoperatoria están bien documentados en el mundo desarrollado, hay pocos estudios en Marruecos. Objetivos: Este estudio tenía como objetivo adaptar la APAIS para medir la ansiedad preoperatoria en pacientes adultos marroquíes sometidos a cirugía. Métodos: Se elaboró una versión en árabe del APAIS y se administró a una muestra de 100 pacientes adultos. Se realizó una traducción hacia adelante/atrás para garantizar una adaptación cultural marroquí fiable. Se realizó un pre-test y se administró la versión final en árabe dialectal del APAIS a una muestra sometida a cirugía electiva en el hospital regional de SoussMassa en Agadir. Se exploró su fiabilidad mediante el alfa de Cronbach y se analizó su validez. Resultados: La fiabilidad del APAIS marroquí fue alta, con una consistencia interna y un coeficiente alfa de Cronbach de 0,738. El coeficiente de correlación intraclase (CCI) para esta puntuación es de 0,880 (IC95%: 0,817 a 0,928), lo que corresponde a una buena fidelidad. Conclusión: Esta versión del APAIS es válida y puede utilizarse de forma fiable en Marruecos para apreciar la ansiedad preoperatoria y el deseo de información que sienten los futuros cirujanos. Se trata de un instrumento útil de cribado de la ansiedad y la necesidad de información en la práctica clínica, sobre todo por su brevedad y sencillez.

Vaccination is considered the most promising approach to ending or containing the 2019 coronavirus (COVID-19) pandemic. Available vaccines have proven to be very safe and effective. Nevertheless, post vaccination complications have been described. We report the case of a 26-year-old female patient admitted for management of severe viral pneumonitis due to SARS COV2, 15 days after the 1st dose of the vaccine, whose investigations suggest a macrophagic activation syndrome or vaccine-induced immune thrombocytopenia syndrome (VITT) Macrophagic activation syndrome (MAS) is observed in a multitude of clinical situations encountered in adults. It is characterized by a series of non-specific clinical and biological signs, the combination of which should raise the suspicion of the diagnosis and lead to a cytological or histological examination to confirm it. Its occurrence requires a fairly exhaustive etiological work-up. It is a serious pathology, with a severe prognosis and a poorly codified treatment [1, 2].The objective of our work is to report a case of MAS strongly suspected following an infection due to COVID in a young 26 year old patient, 15 days after the 1st dose of the vaccine, a Vaccine-induced Thrombotic Thrombocytopenia (VITT) not to be eliminated either.

Analyzing the dynamics of Sars-Cov-2 spread in the Lebanese society is what this article mainly aspires and points to, where the study was predicated on a compartmental model, namely SIR, the widely known model in epidemiology. SIR. (Susceptible-Infected-Recovered) materializes a basic conceptional structure for theoretically investigating the virus spread and its dynamics within a community, through focusing on the interaction and communication between infected and recovered people. Consequently, providing the necessary attempts to overcome the epidemic, and diminishes its expansion to rescue lives. In which, limiting contact absolutely reduces the possibility of transmitting or contracting an infection. This investigation on a representative sample of the Lebanese population highlights the various drivers and dynamics of this proliferation. These drivers or factors clarify the behavior of the population (wearing a mask, washing their hands) in experiencing the epidemic crisis and their abuse for measures (safety distance, closures) adopted by the authorities to combat the epidemic. So, it turns out that the careless and incautious attitude of the Lebanese population, besides the unsatisfactory control to fulfill the government rules against the dynamics of virus spread was shown by the modeling of Sars-Cov-2 dynamics through the SIR model.

L’objectif de cette etude etait d’evaluer la prevalence de l’hypertension gestationnelle et determiner ses predicteurs parmi les femmes enceintes frequentant les etablissements de soins de sante primaires de la ville de Beni Mellal au Maroc. La prevalence de l’hypertension gestationnelle etait de 18,7 %. Le faible revenu mensuel du menage (ORA (odds ratio ajuste) = 7,874 ; IC 95 % = [1,788–34,67]), l’âge gestationnel de moins de 37 semaines (ORA = 6,860 ; IC 95 % = [1,285–36,626]), les connaissances limitees sur l’hypertension gestationnelle (ORA = 12,719 ; IC 95 % = [3,386–47,785]) et la primigravidite (ORA = 9,047 ; IC 95 % = [(1,595–51,324]) etaient significativement associees a l’hypertension gestationnelle.

The incidence of purulent pleurisy is on the rise in several series in the literature. It is a significant cause of morbidity in pediatrics. The main objective of our study is to analyze the epidemiological characteristics and the prognosis of purulent pleurisy of the child.

تهدف هذه الدراسة الى تحليل سلوك زوار المتنزهات والحدائق الترفيهية بمدينة وجدة في شمال شرق المغرب، من أجل مساعدة المتدخلين على وضع خطط التنمية الحضرية. وقد تضمنت البيانات المتعلقة بالدراسة، التي جمعت من خلال استبيان، ثلاث مجموعات من المتغيرات: الخصائص السوسيومهنية للزوار، السلوكات الاجتماعية وأهم المشاكل التي تعيق زيارة المنتزهات والحدائق بالمدينة. وقد بينت النتائج أن زيارة المنتزهات والحدائق أصبحت سلوكا اعتياديا، مطبوعا بالرغبة في التفاعل والتواصل مع مختلف أفراد المجتمع، من مقربين وأصدقاء وغرباء ليتعزز بذلك سلوك الجمعنة بين الزوار. وقد أفادت نتائج الاستبيان أن ضعف التجهيزات الترفيهية داخل المنتزهات والحدائق، وانتشار مظاهر الانحراف والتلوث تعد من المشاكل المنفرة للزوار., Revue des Etudes Multidisciplinaires en Sciences Economiques et Sociales, Vol. 7, No 1 (2022)

Background Diabetes remains poorly controlled in a high proportion of diabetes patients. This study examines the prevalence of poor glycaemic control and associated factors in type 2 diabetes patients in the Beni-Mellal Khenifra region in Morocco. Methods A cross-sectional survey was conducted in 2017 among 1456 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews using structured and pre-tested questionnaires. Anthropometric measurements, including body weight, height and waist circumference were taken using standardized techniques and calibrated equipment. Glycaemic control was assessed in terms of the glycated haemoglobin (HbA1c) level and poor glycaemic control was defined as HbA1c ≥7% and a level Results Of the total participants, 66.3% had poor glycaemic control. Bivariate analysis showed that sex (p=0.010), education level (p=0.013), body mass index (p=0.048), duration of diabetes (p Conclusions Despite the particularities of the region, the findings about glycaemic control and its cross-sectionally associated factors are in line with findings from other regions of Morocco. In this subgroup, the longer duration of diabetes and insulin treatment could constitute a cause leading to poor glycaemic control. However, inverse causality cannot be excluded.

This work presents an electronic structure study employing multireference configuration interaction MRCI calculations with Davidson correction (+Q) of the ytterbium monobromide YbBr molecule. Adiabatic potential energy curves (PECs), dipole moment curves, and spectroscopic constants (such as Re, ωe, Be, De, Te, and μe) of the low-lying bound electronic states are determined. The ionic character of the YbBr molecule at the equilibrium position is also discussed. With spin–orbit effects, 30 low-lying states in Ω = 1/2, 3/2, 5/2, 7/2 representation are probed. The electronic transition dipole moment is calculated between the investigated states and then used to determine transition coefficients, for example, the Einstein coefficient of spontaneous emission Aij and emission oscillator strength fij. Vibrational parameters such as Eν, Bν, Dν, Rmin, and Rmax of the low vibrational levels of different bound states in both Λ and Ω representations are also calculated. Upon calculating the Franck–Condon factors, they are found to be perfectly diagonal between three couples of low-lying excited states. Vibrational Einstein coefficients and radiative lifetimes are computed as well for the lowest vibrational transitions. Most of the data reported in this work are presented here for the first time in the literature. Very good accordance is obtained in comparison with the previously reported constants by means of experimental methods.

Background: Obesity constitutes a major risk factor for the development of diabetes, and has been linked with poor gly- caemic control among type 2 diabetic patients. Aims: This study examines the prevalence of overweight/obesity and associated factors in type 2 diabetic patients in the Beni-Mellal Khenifra region in Morocco. Methods: A questionnaire-based cross-sectional study was conducted in 2017 among 975 diabetes patients attending pri- mary health centres. Demographic and clinical data were collected through face-to-face interviews. Anthropometric meas- urements, including body weight, height and waist circumference, were taken using standardized techniques and calibrated equipment. Results: The prevalence of overweight was 40.4%, the general obesity was 28.8% and the abdominal obesity was 73.7%. Using multivariate analysis, we noted that the general obesity was associated with female sex (AOR= 3,004, 95% CI: 1.761- 5.104, P

L´hyperplasie macronodulaire bilatérale des surrénales (HMBS) est une cause rare de syndrome de Cushing d´origine surrénalienne, représentant moins de 1% des cas. Nous rapportons le cas d´un patient âgé de 48 ans, diabétique et hypertendu. Présentant un syndrome de Cushing clinique. Le bilan étiologique a permis de retenir le diagnostic d´hypercorticisme «Adrenocorticotropic hormone» (ACTH) indépendant en rapport avec une HMBS. Le choix thérapeutique était en faveur d´une surrénalectomie unilatérale gauche orientée par la scintigraphie au noriodocholestérol, avec une bonne évolution. Cependant, vu le risque de récidive et de complications cardiovasculaires, une surveillance au long cours a été programmée.

The feasibility of the thallium monofluoride TlF+ molecular ion towards laser cooling is brought into focus through an electronic structure study. Ab initio calculations are carried out to investigate the four lowest-lying electronic states, X2Σ+, (1)2Π, (2)2Σ+ and (2)2Π, including the spin-orbit coupling effect by employing the Complete Active Space Self Consistent Field (CASSCF) method at the Multireference Configuration Interaction (MRCI) level of theory while invoking Davidson correction (+Q). Potential energy and permanent dipole moment curves are used to determine the corresponding spectroscopic constants and some other equilibrium parameters. Vibrational parameters of vibrational states and transition dipole moments between possible transitions are computed. The calculated parameters are then used to conduct a theoretical study focusing on the potential possibility of TlF+ ionic molecule to be laser cooled on the (2)2Π1/2(ν')-X2Σ+1/2(ν'') transition based on Di Rosa's criteria. With the results obtained being promising, a laser cooling optical cycling scheme is proposed to illustrate the number of pump lasers needed with the corresponding wavelengths that were found to lie within the ranges covered by a specific scientific laser.

Bilateral macronodular adrenal hyperplasia (BMAH) is a rare cause of adrenal Cushing's syndrome, accounting for less than 1% of cases. We here report the case of a 48-year-old patient with diabetes and hypertension presenting with clinical signs of Cushing's syndrome. Etiological assessment enabled clinicians to retain the diagnosis of Adrenocorticotropic hormone (ACTH)-independent hypercortisolism associated with BMAH. Unilateral left adrenalectomy was performed based on noriodocholesterol scintigraphy results, with good outcome. However, given the risk of recurrence and cardiovascular complications, long-term monitoring was scheduled.

[EN] Phenomenology in recent years has gained throttle in the philosophical domain; more specifically, the phenomenological methodology had its most significant impact on architectural interpretation and understanding. It is unusual how the phenomenological discourse appeared in the architectural prospect on the decays of structuralism and semiotics. On the other hand, in humanities and philosophy, the growth of structuralism happened only after the decline of phenomenology. These paradoxical conditions are explained due to the translation delay of philosophical ideas and their implementation in architecture. In this research, we dig into the essential question of architectural experience by studying architecture through its phenomenological significance as a dwelling attitude to its inhabitants. The study is on dwellings in the eastern Bekaa region -Lebanon, on houses built between two significant eras, a time frame that shows the essential difference between two construction methods and the transitional phase in-between. Showing case the different typologies that generated in the same area, comparing the area's vernacular architecture and sustainable designs, addressing whether these typologies had any effect on the dweller's socio-cultural and socio-economical dynamics. The area of study is still virgin to different phenomenological interpretation, as the drastic change of typologies occurred in the past 50 years. Dwellers just recently overcame the transitional phase, from applying vernacular construction means, to applying new construction technologies with globalized materials. The area permits us to question the primary existential question of being-in-world, and how citizens coped with their environment in order to sustain their existential being through architectural means. We examine the following phenomenon by learning from dwelling theorists and phenomenologists, focusing on phenomenologists such as Martin Heidegger, Merleau-ponty, and Christian Norberg-Schulz in an attempt to correlate phenomenology with sustainability. Additionally, interpreting architecture hermeneutically through the Arabic parables to comprehend it better in concern with its cultural context., [ES] El papel de la fenomenología ha sido clave en el terreno filosófico. La metodología fenomenológica ha tenido un impacto significativo en la interpretación y comprensión arquitectónica. Puede parecer absurdo cómo el discurso fenomenológico aterriza en la arquitectura a partir de la desintegración del estructuralismo y la semiótica, mientras que en el campo de las humanidades, y concretamente en el ámbito filosófico, el estructuralismo se desarrolla, precisamente, a partir del declive de la fenomenología. Esta situación paradójica se explica a raíz de la demora en la traducción de las ideas filosóficas y su implementación en la arquitectura. En esta investigación se pretende profundizar en la cuestión esencial de la experiencia arquitectónica a partir de la comprensión de los modos de habitar. El estudio se desarrolla en el conjunto de viviendas de la región oriental de Bekaa (Líbano), a partir de casas construidas en dos periodos significativos, periodos que permiten distinguir entre dos modos de construir contrastados, con una fase de transición intermedia. Se muestran las diferentes tipologías que proliferaron en una misma área, permitiendo comparar las arquitecturas vernáculas y los diseños sostenibles, planteando a su vez si estas tipologías tuvieron algún efecto en la dinámica sociocultural y socioeconómica de sus habitantes. El interés del área de estudio radica en considerarse un terreno virgen para abordar diferentes interpretaciones fenomenológicas, ya que el cambio drástico de tipologías ocurrió en los últimos 50 años. Los habitantes superaron la fase de transición recientemente, partiendo de la aplicación de medios de construcción vernáculos hasta la aplicación de nuevas tecnologías de construcción con materiales globalizados. El área nos permite cuestionar la cuestión existencial primaria del ser-en-el mundo, y cómo los ciudadanos cooperaron con su entorno para mantener su ser existencial a través de medios arquitectónicos. Examinamos el siguiente fenómeno aprendiendo de los teóricos de la vivienda y los fenomenólogos, centrándonos en fenomenólogos como Martin Heidegger, Merleau-Ponty y Christian Norberg-Schulz. Además, interpretando la arquitectura hermenéuticamente a través de las parábolas árabes para comprenderla mejor en relación con su contexto cultural., [CA] El paper de la fenomenologia ha sigut clau al terreny filosòfic. La metodologia fenomenològica ha tingut un impacte significatiu a la interpretació i comprensió arquitectònica. Pot semblar absurd com el discurs fenomenològic aterra a l'arquitectura arran la desintegració de l'estructuralisme i la semiòtica, mentre que al camp de les humanitats, i concretament a l'àmbit filosòfic, l'estructuralisme es desenvolupa precisament partint del declivi de la fenomenologia. Aquesta situació paradoxal s'explica arran el retard a la traducció de les idees filosòfiques i la seua implementació a l'arquitectura. A aquesta investigació es pretén aprofundir a la qüestió essencial de l'experiència arquitectònica partint de la comprensió de les maneres d'habitar. L'estudi es desenvolupa al conjunt d'habitatges de la regió oriental de Bekaa (Líban), partint de cases construïdes a dos períodes significatius, períodes que permeten distingir entre dos maneres de construir contrastades, amb una fase de transició intermèdia. Es mostren les diferents tipologies que van proliferar a una mateixa àrea, permetent comparar les arquitectures vernacles i els dissenys sostenibles, plantejant a l'hora si aquestes tipologies van tindre cap efecte a la dinàmica sociocultural i socioeconòmica dels seus habitants. L'interès de l'àrea d'estudi radica en considerar-se un terreny verge per enllestir diferents interpretacions fenomenològiques, ja que el canvi dràstic de tipologies va ocórrer als darrers 50 anys. Els habitants van superar la fase de transició recentment, partint de l'aplicació de mitjans de construcció amb materials globalitzats. L'àrea ens permet qüestionar la qüestió essencial primària de l'ésser-al-món i cóm els ciutadans van cooperar amb el seu entorn per mantenir el seu esser existencial per mitjan de mitjans arquitectònics. Examinem el següent fenomen aprenent dels teòrics de l'habitatge i els fenomenòlegs, centrant-nos en fenomenòlegs com Martin Heidegger, Merleau-Ponty y Christian Norberg- Schulz. A més, interpretant l'arquitectura hermenèuticament mitjançant les paràboles àrabs per comprendre-la millor en relació amb el seu context cultural.

Background & objective Mathematical modeling is the most scientific technique to understand the evolution of natural phenomena, including the spread of infectious diseases. Therefore, these modeling tools have been widely used in epidemiology for predicting risks and decision-making processes. The purpose of this paper is to provide an effective mathematical model for predicting the spread of Covid-19 pandemic. Methods Our mathematical model is performed according to a SIDR model for infectious diseases. Epidemiological data from four countries; Belgium, Morocco, Netherlands and Russia, are used to validate this model. Also, we have evaluated the efficiency of Morocco’s Covid-19 countermeasures and simulated the different relaxation plans in order to predict the effects of relaxation countermeasures. Results and conclusions In this paper, we developed and validated a new way of data aggregation, modeling and interpretation to predict the spread of Covid-19, evaluate the efficiency of countermeasures and suggest potential scenarios. Our results will be used to keep the spread of Covid-19 under control in the world.

Hypertension is a major public health concern worldwide and non-controlling it can lead to various cardiovascular complications. Controlling blood pressure and reducing overall cardiovascular risk are two main goals of treatment. Thus, this study aimed to determine the proportion and factors associated with uncontrolled hypertension in hypertensive patients living in the Beni Mellal city.The cross-sectional survey took place between June and March 2019. It involved 580 hypertensive patients attending the primary health care facilities in Beni Mellal city, using systematic sampling.A total of 580 hypertensive patients were recruited, with a mean age of 55.78 (± 10.82 years) and of which 66.89% were female. The proportion of poor blood pressure control was 74.1% and was associated in multivariate analysis with a family history of hypertension(OR = 1.60; 95% CI = [1.02-2.50]), dyslipidemia (OR = 2.05; 95% CI = [1.32 -3.20]), non-adherence to a regular BP measurement (OR = 4.13; 95% CI = [2.49 -6.86]), to treatment (OR = 3.64; 95% CI = [2.34-5.65]) and regular biological monitoring (OR = 2.45; 95% CI = [1.46-4.08]).Despite the free and available of treatment, the proportion of uncontrolled hypertension was high. This might be linked to a lack of awareness and education concerning disease self-management.

Les questions liées à la responsabilité sociale des entreprises (RSE) ont fait l’objet d’un débat croissant dans un éventail de plus en plus large de disciplines en sciences sociales et en études commerciales et de gestion. L’entreprise a été confrontée à une pression croissante pour prendre au sérieux les questions de RSE, en particulier en ce qui concerne les questions environnementales et les normes du travail. Cependant, les problèmes liés à la RSE et à la gestion des ressources humaines (GRH) restent sous-explorés. Cet article traite des pratiques de gestion des ressources humaines dans la promotion et le développement de la RSE au sein des organisations, tout en examinant une question centrale : comment la responsabilité sociale des entreprises (RSE) affecte les activités des RH? S'appuyant sur une étude qualitative des managers dans une entreprise marocaine de boissons gazeuses et ses filiales déclarant un engagement explicite à la RSE, les preuves montrent que leur engagement a tendance à se concentrer sur la formation, la santé, la sécurité et la promotion des employés, ainsi que l'appropriation du développement par les employés.

This paper presents the design and test of a single phase and thermoelectric cooling Micro-Inverter using a DC-DC interleaved isolated boost. It focuses on the optimization of (DC-DC and DC-AC) converters performances and its physical dimensions, and presents an efficient method to track the maximum power point and the load regulation. For this purpose, a specific architecture and design of a high-reliable, robust, stable and miniaturized system are proposed.

International audience; This paper concerns the mathematical modeling of the motion of a crowd in a non connected bounded domain, based on kinetic and stochastic game theories. The proposed model is a mesoscopic probabilistic approach that retains features obtained from both micro-and macro-scale representations; pedestrian interactions with various obstacles being managed from a probabilistic perspective. A proof of the existence and uniqueness of the proposed mathematical model's solution is given for large times. A numerical resolution scheme based on the splitting method is implemented and then applied to crowd evacuation in a non connected bounded domain with one rectangular obstacle. The evacuation time of the room is then calculated by our technique, according to the dimensions and position of a square-shaped obstacle, and finally compared to the time obtained by a deterministic approach by means of randomly varying some of its parameters.

With the lack of evitable data about the electronic structure of the low-lying states of the HgF molecule unlike its counter parts of mercury monohalides, spectroscopic study of eighteen low-lying doublet and quartet electronic states in the representation 2s+1Λ(+\-) of this molecule is conducted. Adiabatic potential energy curves of those states are investigated using the complete active space self consistent field (CASSCF) calculation with multi-reference configuration interaction (MRCI) method including single and double excitations with Davidson correction (+Q). The spectroscopic constants as Re, ωe, ωexe, Be, αe, Te and μe are calculated for the bound states. The dissociation energy D 0 0 and the percentage ionic character fionic are also computed. The transition dipole moment μTDM between some doublet low-lying states is studied and some emission coefficients as the Einstein spontaneous coefficients A21, the spontaneous radiative lifetime τspon, and the oscillator strength f21 are thus determined. A rovibrational study has been done to investigate the vibrational levels of the low-lying bound states and the vibrational constants Ev, Bv, Dv, Rmin and Rmax are reported. The Franck–Condon factors have also been calculated for the most probable transitions between the excited states and the ground state. The comparison between the values of the present work and those short information available in the literature shows good accordance.

In this paper, we have realized and experimented a box-type solar cooker that is powered by photovoltaic energy. Under an illumination of 770 W / m2, an ambient temperature of 18°C and electrical power of 340 W, the results show, on the one hand, a temperature of the thermal resistance which heats the cooker equal to 686°C, and, on the other hand, a temperature and a thermal efficiency of the cooker worth 200°C and 77%, respectively. Heating one liter of water yields a boiling time of 50 minutes, and the time needing for complete evaporation is of the order of 3 hours. In addition, the results show very significant improvements compared to thermal cookers operating directly to the sun, namely 53% increase of the heating temperature and 60 % decrease on its heating duration. All the results and performances obtained in this work demonstrate the feasibility of box-type solar cookers, powered by photovoltaic energy inside homes.

In This paper, we propose an effective and online technique for modeling nd State of Charge (SoC) estimation of Lithium-Ion (Li-Ion) batteries using Feed Forward Neural Networks(FFNN) and Nonlinear Auto Regressive model with eXogenous input(NARX). The both Artificial Neural Network (ANN) are rained using the data collected from the batterycharging and discharging pro ess. The NARX network finds the needed battery model, where the input ariables are the battery terminal voltage, SoC at the previous sample, and the urrent, temperature at the present sample. The proposed method is imple mented on a Li-Ion battery cell to estimate online SoC. Simulation results show good estimation of theSoC.

HIV persistence despite therapy contributes to chronic immune activation and inflammation, increasing the risk of aging-associated events in HIV-infected individuals. We sought here to better understand the complex link between clinical and treatment features and HIV persistence despite therapy. A total of 11,045 samples from 1,160 individuals under combination antiretroviral therapy (cART) with an unquantifiable viral load (VL; limit of quantification, 20 copies/ml) were categorized as detectable or undetectable depending on the detection of a PCR signal using a commercially available assay. Generalized estimating equation (GEE) regression was used to model viral load detectability and to assess the determinants of residual viremia (RV; VL detected below 20 copies/ml) despite therapy. A high VL zenith was associated with a higher probability to have a detectable viremia under cART. Conversely, the probability to have a detectable viral load below 20 copies/ml decreased with time under therapy. Of therapy regimens, protease inhibitor (PI)-based cART was associated with a significantly higher probability of detectable RV compared to nonnucleoside transcriptase inhibitor- or integrase inhibitor-based cART. We found that a PI-based treatment regimen is highly associated with an increased frequency of RV, supporting previous evidence suggesting that PI-based cART regimens could favor ongoing viral replication in some individuals.

In this paper, we propose an effective technique for modeling of Lithium Ion (Li-Ion) batteries using Nonlinear Auto Regressive model with eXogenous input (NARX). The Artificial Neural Network (ANN) are trained employing the data collected from the battery testing process. The NARX network find the request battery model, where the input variables are the battery terminal voltage, SoC at the previous sample, and the current, temperature at the present sample. The proposed model is implemented on a Li-Ion battery cell. Simulation of this model in Matlab/Simulink show a good accuracy of proposed model.

In this paper, an intelligent control strategy for a microgrid system consisting of Photovoltaic panels, grid-connected, and li-ion battery energy storage systems proposed. The energy management based on the managing of battery charging and discharging by integration of a smart controller for DC/DC bidirectional converter. The main novelty of this solution are the integration of artificial neural network (ANN) for the estimation of the battery state of charge (SOC) and for the control of bidirectional converter. The simulation results obtained in the MATLAB/Simulink environment explain the performance and the robust of the proposed control technique.

Adiabatic potential energy curves of the 28 low-lying doublet and quartet electronic states in the representation 2s+1Λ(±) of the zinc monofluoride molecule are investigated using the complete active space self-consistent field (CASSCF) with multi-reference configuration interaction (MRCI) method including single and double excitations with the Davidson correction (+Q). The internuclear distance Re, the harmonic frequency ωe, the static and transition dipole moment μ, the rotational constant Be, and the electronic transition energy with respect to the ground state Te are calculated for the bound states. The transition dipole moment between some doublet states is used to determine the Einstein spontaneous A21 and induced emission [Formula: see text] coefficients, as well as the spontaneous radiative lifetime τspon, emission wavelength λ21, and oscillator strength f21. The ground state ionicity qionicity and equilibrium dissociation energy DE,e are also computed. The comparison between the values of the present work and those available in the literature for several electronic states shows very good agreement. Twenty-three new electronic states have been studied in the present work for the first time.

In this study, we investigated for the first time the antihyperlipidemic ef-fects of crude extract of stigmas from Crocus sativus (saffron) against hyperlipidemia induced by tartrazine (synthetic dye) in normal male rats. Thirty adult male albino rats weighing about 150 - 200 g, were divided into 5 groups (n = 6) and daily treatment was given orally. Clinical biochemis-try and metabolic parameters were evaluated at the end of the experiment and after 105 days. (n=6, for all groups). Our data revealed that the meta-bolic parameters like consumption of food and water, pH and urine vol-ume have not been affected; also the difference between liver, right kid-ney and heart weight was not significant. The levels of cholesterol and triglyceride were significantly increased in group 2 and group 3 compared to control group. There was no significant difference in the level of cholesterol and triglyceride in group 4. Treatment with saffron alone did not have any significant effects on the level of fat compared to control group. The oral administration of the crude extract of saffron revealed good hypolipidemic effects in adult male albino rats. These results suggest that aqueous saffron extract reduced plasma cholesterol and decreased triglyceride. Therefore, it could conceivably lead to suitable changes in blood lipid profiles. [J Med Allied Sci 2017; 7(1.000): 20-25]

Resume Introduction L’insuffisance renale chronique est un facteur de risque cardiovasculaire. Son association avec l’atherosclerose carotidienne demeure controversee. L’objectif de notre etude etait de rechercher les facteurs associes a l’atherosclerose carotidienne chez le patient diabetique et plus particulierement les marqueurs de la maladie renale chronique. Methodes Etude transversale incluant les patients diabetiques de type 1 ou de type 2 hospitalises dans le service d’endocrinologie et de diabetologie de l’hopital militaire de Rabat et repartis en 2 groupes selon la presence ou l’absence d’une atherosclerose carotidienne sur l’echographie doppler des troncs supra-aortiques. La fonction renale a ete evaluee par la mesure de l’excretion urinaire d’albumine sur un recueil des urines de 24 heures et par l’estimation de la clairance de la creatinine par la formule modification of diet in renal disease (MDRD) simplifiee. Une regression logistique multiple a ete realisee pour etudier les facteurs associes a l’atherosclerose carotidienne chez ces patients. Resultats Cent six patients diabetiques ont ete inclus dont 96 diabetiques de type 2. L’âge (p Conclusion Nos resultats suggerent que l’insuffisance renale chronique est associee a l’atherosclerose carotidienne chez le patient diabetique independamment des facteurs de risque cardiovasculaire classiques.

Based on the complete active space self consistent field (CASSCF) method with multi-reference configuration interaction MRCI calculations including single and double excitations with Davidson correction (+Q), twenty three low lying electronic states in the 2s+1Λ(±) representation of the zinc monochloride ZnCl molecule are investigated considering 7 and 9 valence electrons. The internuclear distance Re, the harmonic frequency ωe, the permanent dipole moment μ, the rotational constant Be and the electronic transition energy with respect to the ground state Te are calculated for the bound states. The transition dipole moment between some doublet states is used to determine the Einstein spontaneous A 21 and induced emission B 21 ω coefficients, the spontaneous radiative lifetime τ spon , the emission wavelength λ 21 , the oscillator strength f 21 and the line strength S 21 . The fraction of the ground state ionic character f and equilibrium dissociation energy DE,e are also computed. Using the canonical function approach, the eigenvalues Ev, the rotational constants Bv, the centrifugal distortion constants Dv and the abscissas of the turning points Rmin and Rmax of the zinc monohalide molecules ZnX (X: F, Cl, Br, I) are calculated. The comparison between the values of the present work and those available in the literature for several electronic states shows good accordance.

Multiferroic BiFeO3 (BFO) and BiFe0.5Mn0.5O3 (BFMO) ceramics have been elaborated using conventional solid state method. X-ray diffraction with Rietveld refinement revealed the existence of rhombohedrally R3c symmetry in BFMO with traces of secondary phase and decrease in structural parameters. From the optical and dielectric study, narrower band gap and a significant increase in the dielectric permittivity was shown in BFMO, compared to BFO. Magnetic measurement at room temperature of BFMO showed weak ferromagnetic hysteresis behavior. Also, a significant increase of magnetization has been detected with Mn ion substitution. These findings encourage a further thorough investigation of the prepared (BFMO) ceramic for enhancing multifunctional applications.

This work focuses on the electronic structure of the low-lying states of the heavy polar diatomic molecule HgCl. Ab-initio calculations are performed at complete active-space self-consistent field (CASSCF) method followed by multireference configuration interaction (MRCI) method and by invoking Davidson correction (+Q). The potential energy and dipole moment curves are investigated in two stages of calculations; 18 states while neglecting the spin-orbit coupling effect and 36 states considering this effect. Spectroscopic constants are computed for bound states. Vibrational levels, transition dipole moments, Einstein coefficients, radiative lifetimes and other constants are investigated. Comparison with data available in literature demonstrated significant agreements.

Resume Introduction Le syndrome de Cushing paraneoplasique est une cause rare d’hypercorticisme endogene. Il est du a une secretion ectopique d’ACTH par une tumeur endocrine non hypophysaire. Les donnees biologiques et radiologiques a visee etiologique sont souvent non concluantes posant un probleme de diagnostic differentiel avec la maladie de Cushing. En outre, ces tumeurs sont souvent de petite taille et leur siege est extremement variable d’ou les difficultes de localisation imposant le recours a des techniques d’imagerie moderne notamment la tomographie par emission de positons au 18-fluoro-desoxyglucose (TEP-18FDG) ou au 18-fluoro-dihydroxyphenylalanine (TEP au 18FDOPA). Observation Nous rapportons l’observation d’un homme âge de 50 ans presentant un syndrome de cushing severe et rapidement evolutif, en rapport avec un hypercorticisme par secretion ectopique d’ACTH. Devant la severite du tableau clinique, la resistance au traitement par ketoconazole et l’impossibilite de localiser la tumeur causale par les techniques d’imagerie conventionnelle, une surrenalectomie bilaterale de sauvetage etait realisee. Deux ans plus tard, la tomodensitometrie thoracique objectivait un nodule de 11 mm isole au niveau du lobe inferieur gauche, la TEP au 18FDG retrouvait un hypermetabolisme discret du nodule pulmonaire sans specificite, et la TEP au 18FDOPA confirmait la nature hyperfixante de ce nodule en faveur d’un carcinome endocrine. L’examen anatomopathologique etait en faveur d’une tumeur carcinoide typique et le complement immuno-histochimique montrait une positivite des cellules tumorales pour l’ACTH, le CD56, la chromogranine et la synaptophysine. Conclusion Cette observation illustre le dilemme entre la necessite de localiser la secretion ectopique de l’ACTH et le controle d’un syndrome de Cushing agressif et menacant. Le recours precoce a la TEP au 18FDG ou au 18FDOPA doit etre envisage si le diagnostic topographique de la tumeur causale ne peut etre fait par les techniques d’imageries conventionnelles.

Adiabatic potential energy curves of 19 low-lying doublet and quartet electronic states in the representation 2s+1 Λ (±) of the zinc mono-bromide molecule ZnBr are investigated using high correlated ab initio calculations. For the bound states, the equilibrium internuclear distance R e , the harmonic frequency ω e , the rotational constant B e and the electronic transition energy with respect to the ground state T e have been calculated at the multireference configuration interaction (MRCI) level including single and double excitations with Davidson correction (+Q). Sixteen low-lying states are presented here for the first time. The ground state dissociation energy is also calculated. The comparison between the values of the present work are in agreement with those available in the literature.

The potential energy curves of the low-lying 26 doublet and quartet electronic states in the representation 2 s +1 Λ (+/−) of the ZnI molecule have been investigated using the Complete Active Space Self Consistent Field (CASSCF) with Multi-Reference Configuration Interaction (single and double excitation with Davidson correction) MRCI+ Q method and the second order multi-reference Rayleigh Schrodinger perturbation theory RSPT2-RS2 method. The harmonic frequency ω e , the internuclear distance R e , the static dipole moment, and the electronic energy with respect to the ground state T e have been calculated for the considered bound electronic states. The comparison between the values of the present work and those available in the literature shows a good agreement. Twenty-three electronic states are studied here for the first time.

Resume La metformine est un antidiabetique oral de la famille des biguanides. La peau represente un site commun des effets indesirables dus aux differentes classes medicamenteuses. La litterature rapporte l’apparition d’eruptions cutanees lors de l’utilisation des sulfonylurees. Les effets cutanes de la metformine sont rares, voire exceptionnels. Nous rapportons le cas d’un patient diabetique de type 2, âge de 61 ans, sans antecedents particuliers, qui a developpe une eruption psoriasiforme generalisee, 5 mois apres la mise sous metformine chlorhydrate. Les donnees cliniques et biologiques ont exclu la presence de maladies systemiques. Les lesions cutanees ont disparu 4 mois apres l’arret de la metformine, mais la reintroduction de ce medicament a fait reapparaitre la meme symptomatologie. Notre observation discute un cas d’eruptions psoriasiformes apparues apres la mise sous metformine pour un diabete de type 2 recemment diagnostique, elle souligne la necessite de considerer les effets indesirables comme diagnostic differentiel afin de reduire les erreurs medicales et les bilans inutilement couteux.

La Presse Medicale - In Press.Proof corrected by the author Available online since lundi 9 mai 2016

La Presse Medicale - In Press.Proof corrected by the author Available online since lundi 22 fevrier 2016

The purpose of this work is to study the properties of elementary excitations in a magnetic super lattice [Fe/GaAs]. The study is obtained in framework of the ferromagnetic Heisenberg system where the exchange and the dipolar interactions, the magneto-crystalline and surface anisotropies are all taking into account. The corresponding Hamiltonian is treated by the Green's function method. The analytical expressions of the excitation spectrum and the magnetization per spin are obtained when the exchange is present alone. A good adjustment of calculated magnetization with the experimental results is obtained for various magnetic layer thickness ( t F e ) . The deduced exchange integrals are in agreement with previous studies. The combined effect of dipolar interactions and surface anisotropy is studied numerically.

Chronic kidney failure is an independent risk factor of cardiovascular disease. Its association with carotid atherosclerosis remains controversial. The purpose of our study was to assess the factors associated with carotid atherosclerosis specially the components of chronic kidney disease.In a cross-sectional study, we enrolled type 1 or type 2 diabetic patients from the endocrinology an diabetology department of the military hospital of Rabat assigned in two groups according to the presence or absence of carotid atherosclerosis. Kidney function was assessed based on albuminuria and the estimated glomerular filtration rate calculated using the "modification of diet in renal disease" equation. A multiple logistic regression analysis was performed to identify independent factors associated with carotid atherosclerosis.One hundred and six diabetic patients were enrolled including 96 type 2 diabetic patients. Age (P0.001), diabetes duration (P=0.04), hypertension (P=0.002), peripheral arterial disease (P0.001) and chronic kidney failure (P=0.001) were significantly associated with carotid atherosclerosis. After adjusting for age, hypertension, diabetes duration and peripheral arterial disease, chronic kidney failure was an independent factor associated with carotid atherosclerosis (OR: 5.46; 95%IC: 1.29-23.01; P=0.021).Our data suggest that chronic kidney failure is associated with carotid atherosclerosis in diabetic patients independently of the common cardiovascular risk factors.

Autoimmune hypothyroidism is a common medical condition. Its revelation by thyrotrophic hyperplasia is an unusual and may be misdiagnosed as a pituitary adenoma. A 35-year-old man is referred to us for endocrinological assessment before surgery of a pituitary macroadenoma with bitemporal hemianopsia. Biological data reveal profound primary hypothyroidism. With thyroid hormone substitution, the thyroid function was normalized. Follow-up magnetic resonance imaging, showed the complete shrinkage of the pituitary mass attesting of a thyrotrophic pituitary hyperplasia. This case highlights the importance of a multidisciplinary assessment of pituitary masses to avoid unnecessary surgery and to prevent consequences of sellar masses.

The seasonal regime associated with the eastern part of the cyclonic tropical gyre in the North Atlantic is studied using a high-resolution model. The model reproduces a vertical water mass transition (between South and North Atlantic Central Water) previously observed near σ 0 = 26.8 , which approximately coincides with the base of the North Equatorial Undercurrent (NEUC). The same density may be taken as the lower limit of the large-scale cyclonic flow. The gyre southern flank is formed of the North Equatorial Countercurrent (NECC) in the near-surface layer, and of the NEUC and deep NECC (when this current is developed) in the Central Water. Its poleward limb is made up from the Ekman drift of the trade winds, a northeastward extension of the NEUC/deep NECC, and reinforced by an extension of the Guinea undercurrent along the African continental slope. Model experiments with two different wind forcings were carried out to estimate the transports across 12°N, an approximate gyre central latitude. The time-averaged transport for densities lower than σ 1 = 32.3 and to the east of 35°W is around 4 Sv northward, about one-third of the basin-wide net value which measures the Meridional Overturning Circulation. The near-surface layer accounts for about 3 Sv, and the Central Water for more than 1 Sv, in keeping with the presence of South Atlantic Central Water in the tropical eastern basin. The eastern basin near-surface flow is lowest in summer, when the trade winds nearly vanish at this latitude. In this season the NECC, though having entered its phase of intensification, leaves the region of positive wind stress curl, and temporarily does not act as the tropical gyre southern limb. At the subsurface, most of the NEUC folds up westward at ∼10°N in winter, thus forming an inner circulation of the basin-wide gyre, previously reported from observations. The cyclonic flow associated with the Guinea Dome is another inner circulation, which the model found to be permanent below the surface down to 400–500 m, but masked in the Ekman layer, except in summer.

Amorphous Co80 − xDyxB20 alloys have been prepared by melt spinning technique and their magnetic properties have been studied. The mean field theory has been used to explain the temperature dependence of the magnetization. High-field magnetization studies performed at 4.2 K in magnetic fields up to 38 T have revealed, for samples with stoichiometry close to that of a compensated ferrimagnet, a magnetic behavior that is characteristic of a non-collinear magnetic structure of the Dy and Co sublattices. From the non-collinear regime the exchange interactions between the Co and Dy magnetic sublattices and the magnetic anisotropy constants have been evaluated.

Introduction Plusieurs etudes epidemiologiques suggerent une association entre l'obesite et l'augmentation du risque de cancers thyroidiens. Cependant les mecanismes physiopathologiques a l'origine de cette association ainsi que son impact sur les caracteristiques anatomopathologique et le profil evolutif de la tumeur restent mal connus. L'objectif de notre etude etait d'evaluer l'association entre l'obesite et les aspects clinico-pathologiques des cancers thyroidiens differencies de souche folliculaire. Patients et Methodes Il s'agit d'une etude retrospective menee au sein du service d'endocrinologie incluant les patients suivis pour un cancer thyroidien differencie de souche folliculaire entre janvier 2008 et decembre 2014. Les patients ont ete repartis en 2 groupes selon la presence ou l'absence d'une obesite. On a compare les caracteristiques cliniques, histologiques et le profil evolutif entre les 2 groupes. Resultats 54 patients ont ete inclus dans notre etude. L'âge moyen de nos patients etait de 45,2±9,6 ans avec une predominance feminine (85,2 %). Le carcinome papillaire etait le type histologique le plus frequent (87 %). Il n'y avait pas d'association statistiquement significative entre l'obesite et la multifocalite tumorale, la presence d'une histologie defavorable, de metastases ganglionnaires ou a distance. Il n'y avait pas de correlation significative entre l'indice de masse corporelle et la taille tumorale (r=+ 0,052 ; p =0,72). Par contre les emboles vasculaires tumorales etaient significativement plus frequentes chez les patients obeses (25 % vs 4,2 % ; p =0,041). Sur le plan evolutif, il n'y avait pas de difference significative de la frequence de la remission entre les 2 groupes. Discussions Notre etude montre une association statistiquement significative entre l'obesite et la presence d'emboles vasculaires tumorales ce qui suggere que l'obesite pourrait etre associee a un caractere plus agressif des cancers thyroidiens differencies de souche folliculaire.

The matrix therapy by RGTA opens new perspectives in regenerative medicine. Its application in wound healing is very promising, the first targets being the diabetic foot, pressure ulcers and venous ulcers. This is a 77 years old woman followed by type 2 diabetes recently discovered, uncomplicated, well balanced with insulin. The patient developed necrotizing fasciitis of the internal face of the left thigh in a secondary pruritus. She received a flat surgical and antibiotic treatment for three weeks. The wound remained open due to the high risk of infection, was clean, without fibrinous debris, 20 cm high, 10 cm wide, with circumferential separation of the banks and the presence of two pockets, one down near the perineal area, and the other to the upper portion of the inguinal region (Figure 1A and 1B). Treatment by RGTA was performed at a rate of 02 applications per week to obtain a controlled healing, fast and good quality. After 11 weeks of treatment, we obtained almost total closure of the two banks with the disappearance of the two pockets (Figure 1 C). In addition to the promising result for our case, we know that diabetic foot represents the leading cause of non-traumatic amputation. The foot injuries that can affect people with diabetes are numerous, often unknown and can promote the emergence of infected wounds. It is in this context that the application of the RGTA represents an excellent therapeutic alternative for patients at risk of amputation because it quickly improves the healing process (Figure 1D)

Introduction L’association d’une thyroidite lymphocytaire et une granulomatose est bien decrite dans la litterature, mais la coexistence de ces deux atteintes avec un carcinome thyroidien semble etre une entite rare. Nous rapportons une observation illustrant cette association. Observation Il s’agit d’un homme âge de 46 ans, sans antecedents pathologiques particuliers, qui subissait une thyroidectomie totale pour un goitre multinodulaire dont l’etude histologique montrait un carcinome vesiculaire, une thyroidite lymphocytaire et une adenite granulomateuse non necrosante de type dysimmunitaire. Le bilan physiologique etait negatif, le diagnostic de sarcoidose etait retenu devant l’anergie tuberculinique, l’elevation de l’enzyme de conversion de l’angiotensine, une atteinte ganglionnaire mediastinale, une alveolite lymphocytaire au lavage bronchoalveolaire et un granulome epithelio-giganto cellulaire sans necrose caseeuse a la biopsie bronchique. Le bilan lesionnel de la sarcoidose etait negatif. Le patient etait traite par hormonotherapie substitutive avec une evolution favorable, une surveillance sur le plan fonctionnel respiratoire est prevue chez lui. Discussion L’association entre la sarcoidose et la thyroidite lymphocytaire pourrait etre expliquee par des phenomenes dysimmunitaire mais leur association avec un carcinome vesiculaire de la thyroide est controversee. Les cas rapportes dans la litterature sont peu frequents pour etablir une correlation entre ces trois pathologies.

Paraneoplastic Cushing's syndrome is a rare cause of endogenous hypercortisolism attributable to ectopic ACTH secretion by non-pituitary tumors. Imaging and biochemical results are often inconclusive and differential diagnosis with Cushing's disease can then be challenging. Moreover, these tumors may be occult and difficult to find and thus the need of new imaging tools such as (18)FDG-PET scan and (18)DOPA-PET scan.We report a 50-year-old man who presented with very aggressive clinical features related to Cushing's syndrome. Biological work-up confirmed the hypercortisolism and was consistent with an ectopic ACTH secretion. Conventional localization techniques failed to show any tumor and bilateral adrenalectomy was performed because of life-threatening complications. Two years later, thoracic computed tomography reveals an 11 mm mass in the left lower pulmonary lobe, (18)FDG-PET scan found a non-specific mild hypermetabolism of the lung nodule, and the (18)DOPA-PET scan confirmed the high uptake of this nodule suggesting an endocrine carcinoma. Histology confirmed a typical carcinoid tumor. The tumor cells stained positive for ACTH, CD56, chromogranin and synaptophysin.This case illustrates the dilemma between the need for morphological diagnosis of the ectopic ACTH source and control of the life-threatening hypercortisolism. (18)FDG-PET scan and (18)DOPA-PET scan should be considered early as a secondary diagnostic tool when conventional imagery fails to show any tumor.

Introduction La puberte precoce est l’apparition des caracteres sexuels secondaires avant l’âge de 9 ans chez le garcon. Les pubertes precoces centrales liees a un kyste arachnoidien, constituent des entites rares, dont le diagnostic est clinico-biologique et neuroradiologique. Observation Nous rapportons le cas d’un enfant âge de 8 ans et 2 mois, presentant un developpement precoce des caracteres sexuels secondaires, une avance staturale > 3DS, l’âge osseux est estime a 12 ans selon l’atlas de Grewliche et Pyle. L’exporation hormonale revele une testosteronemie elevee a 3,4 ng/mL, le test au LH-RH a confirme l’origine centrale de cette puberte precoce, le reste du bilan hormonal est normal. L’IRM hypothalamo-hypophysaire a montre un kyste arachnoidien suprasellaire de 25 mm avec dilatation triventriculaire. Un traitement a base des analogues de LH-RH a ete instaure, avec surveillance trimestrielle. L’evolution a ete marquee par la stabilisation clinique, morphologique et la normalisation du bilan hormonal. Discussion Les kystes arachnoidiens sont des collections du liquide cephalo-rachidien dans les espaces sous arachnoidiens, ce sont des malformations qui se manifestent dans 2 % des cas par une puberte precoce chez le garcon. Toute puberte precoce centrale (PPC) doit faire l’objet d’une exploration neuroradiologique de la region hypothalamo-hypophysaire et des voies optiques, ceci releve l’importance de l’IRM hypophysaire avec coupes fines sagittales et coronales. La prise en charge de la PPC peut etre lourde ; les aspects psychologiques lies a la precocite pubertaire devront aussi etre pris en consideration.