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Abstract: Mucocele of the appendix secondary to appendicular carcinoid tumour is a rare entity. It occurs exceptionally during pregnancy. The interaction between carcinoid tumour or mucocele of the appendix and pregnancy is not yet elucidated. Prognosis depends on the size of the carcinoid tumour and its regional invasion. We report a case of appendicular mucocele caused by a carcinoid tumour in a 36-year-old pregnant woman who had been admitted because of acute appendicitis. Pathological examination of the appendicectomy specimen revealed a carcinoid tumour measuring 2 cm. Right hemicolectomy was performed two weeks after delivery with good evolution. According to this case and depending on the literature, the authors discuss the diagnosis and the therapeutic modalities proposed for this rare entity. [Copyright &y& Elsevier]

Abstract: Purpose. – The purpose of this study was to debate the epidemiologic and clinical features of primitive biliary peritonitis (PBP) as much as a rare pathology; and especially to obtain a more comprehensive view of factors associated with a severe prognosis. Method. – It is a retrospective survey of 15 patients, collected from 2000 to 2003. Only primitive biliary peritonitis has been included. Result. – It is a series of 15 patients, 6 men and 9 women, with a mean age of 62 years. Biliary lithiasis was incriminated in 14 cases. Clinical picture was an acute peritonitis in every case. Six patients were operated on by median incision, the others by costal one. The death rate is of 26,6%, all death were a direct complication of PBP. Factors associated with a higher mortality are an IGS II score superior or equal than 31 and a number of organ failures superior or equal to 3. Conclusion. – PBP is a rare and severe pathology that concerns aged women. Biliary lithiasis is the main etiology. Treatment is essentially surgical, in association with active per-operative resuscitation. [Copyright &y& Elsevier]

Abstract: Actinomycosis is a chronic granulomatosis infection caused by a Gram positive anaerobic bacteria, Actinomyces. Abdominal localizations are rare and simulated a malignant process. The difficulties of diagnosis are usually leading to surgical resection. We report a colonic actinomycosis case of a 62-year-old woman with a abdominal tumor and diagnosed after surgical resection. [Copyright &y& Elsevier]

Background: Progressive multifocal leukoencephalopathy, a rare disease of the CNS caused by JC virus and occurring in immunosuppressed people, is typically fatal unless adaptive immunity is restored. JC virus is a member of the human polyomavirus family and is closely related to the BK virus. We hypothesised that use of partly HLA-matched donor-derived BK virus-specific T cells for immunotherapy in progressive multifocal leukoencephalopathy would be feasible and safe.Methods: We did an open-label, single-cohort pilot study in patients (aged 18 years or older) with clinically definite progressive multifocal leukoencephalopathy and disease progression in the previous month at the National Institutes of Health (NIH) Clinical Center (Bethesda, MD, USA). Overlapping peptide libraries derived from large T antigen and major capsid protein VP1 of BK virus with high sequence homology to JC virus counterparts were used to generate polyomavirus-specific T cells cross-recognising JC virus antigens. Polyomavirus-specific T cells were manufactured from peripheral blood mononuclear cells of first-degree relative donors aged 18 years or older. These cells were administered to patients by intravenous infusion at 1 × 106 polyomavirus-specific T cells per kg, followed by up to two additional infusions at 2 × 106 polyomavirus-specific T cells per kg. The primary endpoints were feasibility (no manufacturing failure based on meeting release criteria, achieving adequate numbers of cell product for clinical use, and showing measurable antiviral activity) and safety in all patients. The safety monitoring period was 28 days after each infusion. Patients were followed up with serial MRI for up to 12 months after the final infusion. This trial is registered at ClinicalTrials.gov, NCT02694783.Findings: Between April 7, 2016, and Oct 19, 2018, 26 patients were screened, of whom 12 were confirmed eligible and received treatment derived from 14 matched donors. All administered polyomavirus-specific T cells met the release criteria and recognised cognate antigens in vitro. 12 patients received at least one infusion, ten received at least two, and seven received a total of three infusions. The median on-study follow-up was 109·5 days (range 23-699). All infusions were tolerated well, and no serious treatment-related adverse events were observed. Seven patients survived progressive multifocal leukoencephalopathy for longer than 1 year after the first infusion, whereas five died of progressive multifocal leukoencephalopathy within 3 months.Interpretation: We showed that generation of polyomavirus-specific T cells from healthy related donors is feasible, and these cells can be safely used as an infusion for adoptive immunotherapy of progressive multifocal leukoencephalopathy. Although not powered to assess efficacy, our data provide additional support for this strategy as a potential life-saving therapy for some patients.Funding: Intramural Research Program of the National Institute of Neurological Disorders and Stroke of the NIH. [ABSTRACT FROM AUTHOR]

Abstract: A 48-year-old male patient was admitted to suffering from hydatid disease located in the gall bladder. Although Morocco remains an endemic area for echinococcosis, this presentation of the disease was rare. The pericyst was tightly attached to the liver. Complete pericystectomy with cholecystectomy was done. Histopathology confirmed the presence of a calcified hydatid cyst of the gall bladder. Perioperative adjuvant medical therapy with albendazole was administered. After a 2-year follow-up, no recurrence occurred. [Copyright &y& Elsevier]

The emergence and the rapid spread of Pseudomonas aeruginosa carrying carbapenemases represent a serious threat to public health due to their delicate therapy. This work was performed to establish the resistance profile and to detect carbapenemases producing in 123 P. aeruginosa isolates. Among these 55 are environmental isolates and 68 are from the two major hospitals of Meknes-Tafilalet region in Morocco. All strains were tested against 14 antipseudomonal drugs by disc diffusion method. On carbapenem resistant strains minimum inhibitory concentrations of imipenem were determined by the E-test method. The modified Hodge test and EDTA tests were used for the detection of carbapenemases and metallo-β-lactamases (MBLs), respectively. PCR and DNA sequencing were conducted to detect carbapenemase-encoding genes and the enzyme types. 12% of isolates was susceptible to all antibiotics tested and Carbapenem resistance was observed in 33 P. aeruginosa isolates, 33.3% of them were multi-drug resistant. Among carbapenem resistant strains only two (6.1%) were positive for carbapenemases and also for MBLs. In addition to their resistance to almost all β-lactams tested, the MBLs producing strains were resistant to aminoglycosides. Molecular biology techniques confirmed the phenotypic results obtained for the two strains carbapenemase producers and demonstrated that each one of them carried bla VIM-2 . The present study reports the first isolation of bla VIM genes in clinical isolates of P. aeruginosa in Morocco. Such isolates represent a serious emerging threat requiring strict hygiene measures to better control their spread. [ABSTRACT FROM AUTHOR]

Résumé: La gangrène périnéoscrotale est une affection aiguë, rare et grave du périnée, dont l’évolution est imprévisible et rapidement extensive. Le diagnostic est clinique, les examens paracliniques permettent un diagnostic précoce et une évaluation des retentissements anatomiques et biologiques. Nous avons mené une étude rétrospective portant sur 45 malades sur une période de six ans, de décembre 2003 à décembre 2009, faisant intervenir une équipe multidisciplinaire rassemblant trois spécialistes (urologues, viscéralistes, plasticiens). La moyenne d’âge est de 52ans. Le sexe masculin dominait largement notre série. La gangrène de Fournier était l’étiologie la plus fréquente. Nous avons noté cinq décès en phase aiguë (11 %), dont quatre secondaires à un choc septique et un à une défaillance multiviscérale. L’évolution était favorable chez les 40 autres patients de la série, ayant nécessité une prise en charge initiale en milieu de réanimation, et un traitement chirurgical. La durée moyenne d’hospitalisation était de 17jours. Après la phase aiguë, tous nos malades ont bénéficié d’une chirurgie réparatrice pour la couverture cutanée, allant de la cicatrisation dirigée (deux patients) au lambeau musculocutané du gracilis (six patients) en passant par la suture secondaire (quatre patients), l’enfouissement des testicules (18 patients) et la greffe de peau semi épaisse, avec un résultat fonctionnel et esthétique acceptable, et des séquelles minimes. Les facteurs pronostics les plus prédictifs dans notre série seraient le retard de prise en charge, le sepsis à l’admission et les tares associées. [ABSTRACT FROM AUTHOR]

Abstract: Sigmoid volvulus complicating pregnancy is a rare complication with less than 80 cases reported in literature. We report the case of a young pregnant woman, admitted for sigmoid volvulus. The sigmoid volvulus was resected and Bouilly-Volkmann''s colostomy was performed. According to this case and depending on the literature, the authors discuss the diagnostic and therapeutic modalities proposed for this rare entity. [Copyright &y& Elsevier]