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Le leïomyosarcome prostatique est une tumeur très rare de l'adulte. Il est souvent diagnostiqué à un stade avancé, à cause de la non spécificité clinique et radiologique. Son pronostic demeure très sombre. L'objectif de notre travail est d'illustrer le rôle incontournable de l'imagerie, représentée par la TDM et surtout l'IRM dans le bilan d'extension et le suivi post-thérapeutique de cette tumeur. Nous rapportons l'observation d'un patient âgé de 49 ans, admis pour des troubles mictionnels évoluant depuis 6 mois dans un contexte d'altération de l’état général. A l'examen clinique, la prostate était augmentée de volume, nodulaire, faisant corps avec la base vésicale. Un bilan radiologique fait d’échographie, de TDM et d'IRM abdomino-pelviennes a été réalisé. Il a mis en évidence une prostate hypertrophiée, hétérogène, infiltrant la graisse de voisinage et les méats urétéraux, avec importante urétéro-hydronéphrose bilatérale d'amont. On a noté également la présence de nodules hépatiques d'allure suspecte. Une biopsie prostatique trans-périnéale a été réalisée, a conclu à un leïomyosarcome prostatique. Devant l'altération de l’état général et l'importance de l'extension locale et à distance de la tumeur prostatique, une résection trans-urétérale a été réalisée, associée à une chimiothérapie adjuvante. Les suites opératoires ont été marquées par le décès du patient après sa deuxième cure de chimiothérapie. La TDM et surtout l'IRM jouent un rôle primordial dans le bilan d'extension locale et à distance du léïomyosarcome prostatique et le seul moyen pour affirmer le diagnostic est l'histologie complétée par une étude immuno-histochimique. Leur prise en charge thérapeutique n'est pas codifiée à l'heure actuelle et leur pronostic reste très sombre.

Abstract Introduction Malignant schwannoma is a malignant tumor of differentiation of Schwann cells or perineural cells. Observation The patient was a 74-year-old woman with no particular pathological history. She presented swallowing difficulty of solids and odynophagia, evolving for 1 year. Physical examination revealed a budding tumor of the left palatine tonsil without cervical adenopathy. The CT scan confirmed the lesions and the absence of tumor extensions. Histological and immunohistochemical examination of the biopsy sample of the tonsil tumor concluded to be a malignant schwannoma. The patient underwent a tonsillectomy with postoperative follow-up. Discussion Malignant schwannomas are aggressive tumors. They usually occur in young adults. They mainly affect nerves and soft tissues. Occurrence in the amygdala is rare. Conclusion The association of malignant schwannoma of the palatine tonsil and advanced age is rare.

Background: The aim of this study was to evaluate the prevalence of active tuberculosis (TB) infection in Moroccan patients with rheumatic diseases under biologic therapy, and to describe the demographic characteristics of these patients as well as to explore potential risk factors. Methods: This 14-year nationally representative multicenter study enrolled Moroccan patients with rheumatic diseases who had been treated with biologic therapy. Patient medical records were reviewed retrospectively for demographic characteristics, underlying rheumatic diseases, associated comorbidities, and TB-related data. Results: In total, 1407 eligible patients were studied, detailed records were obtained for only 130 patients; 33 cases with active TB were identified at an estimated prevalence rate of 2.3%. The mean age was 42.9 ± 12 years and 75.8% were males. Ankylosing spondylitis accounted for 84.8% of active TB cases, and the majority of the cases (31/33) occurred among antitumor necrosis factor-alpha (TNF-α) users. A total of 8 out of 33 patients were positive at initial latent TB infection (LTBI) screening by tuberculin skin test and/or interferon-gamma release assay. Consumption of unpasteurized dairy products (odds ratio [OR], 34.841; 95% confidence interval [CI], 3.1–389.7; P = 0.04), diabetes (OR, 38.468; 95% CI, 1.6–878.3; P = 0,022), smoking (OR, 3.941; 95% CI, 1–159.9; P = 0.047), and long biologic therapy duration (OR, 1.991; 95% CI, 1.4–16.3; P = 0.001) were identified as risk factors for developing active TB. Conclusion: Moroccan patients with rheumatic diseases under anti-TNF-α agents are at an increased TB risk, especially when risk factors are present. Strict initial screening and regular monitoring of LTBI is recommended for patients living in high TB prevalence areas.

Aim or Purpose: The study was performed to investigate the prevalence of dental anomalies in Moroccan patients with cleft lip and palate. Materials and Methods: Ninety-six cleft patients referring to the dental care center of Casablanca (CCTD) and the Operation Smile Morocco center were included in this cross-sectional study. Ethical clearance for the study was obtained from Institutional Review Committee. Demographic data were collected and radiographs were evaluated for possible dental anomalies. We managed to compare dental anomaly traits based on gender. Data were analyzed using SPSS version 16.0. The differences in dental anomalies were compared using the Chi-square test. Results: The most frequent cleft type was left unilateral cleft lip and palate (42,7%) and male predominance (55,2%) was observed. The most common anomaly was dental agenesis especially of the maxillary lateral incisor (24.7%). Regarding other types of dental anomalies, the microdontia and the amelogenesis imperfecta were the most frequent anomalies with significant differences between the two sexes (P

Objective:Dentofacial deformities can affect patient “quality of life” (QoL), and orthognathic surgery can improve this QoL. The aim of the present study is to assess changes in QoL in Moroccan adult patients with dentofacial deformities undergoing orthodontic surgical treatment.Methods:32 patients (21 females and 11 males; mean age 27±5.96 years) completed a specific questionnaire of QoL once the surgical phase is completed. The questionnaire includes 22 questions marked on a 4-point scale depending on how much the question covered by the statement disturbs the respondent. The 22 questions contribute to four aspects: social aspects of dentofacial deformities, facial aesthetic, oral function, and awareness of dentofacial aesthetics.Results:A significant difference in QoL was observed before surgery between men and women. On the other hand, 73.6% stated of patients said that they were uncomfortable by their dentofacial appearance before surgery, and almost half of the patients have made functional limitations before surgery. After surgery, 85.42% of patients reported a positive change in their QoL. Class III patients reported greater pre-surgical aesthetic and functional restrictions than Class II skeletal patients. In post-surgery, patients in both skeletal classes showed significant improvement in their QoL, so improving the aesthetics, oral functions and self-confidence are the main motivators to seek orthognathic treatment for our patients.Conclusion:Improving the aesthetics, oral functions and self-confidence are the main motivators to seek orthognathic treatment for Moroccan patients.

Objective: Clinical practice guidelines (CPGs) exist to present recommendations and policies aimed at optimizing the oral health of children and adolescents born with cleft lip and/or palate. The aim of this review is to identify and assess the scope, quality, adequacy, and consistency of CPGs related to oral health in children and adolescents with clefts, along with reporting any differences and shortcomings. Methods: A systematic review of the literature of CPGs following Preferred Reporting Items for Systematic Reviews guidelines was conducted. Assessment of selected CPGs was performed using the Appraisal of Guidelines for Research & Evaluation II methodological quality instrument. Results: Only 7 CPGs fulfilled the criteria. Of these, 4 were from the American Cleft Palate-Craniofacial Association, and 1 each from the American Academy of Pediatrics, the Academy of Breastfeeding Medicine, and the American Academy of Pediatric Dentistry. The lowest overall mean scores were in the domain "Rigor of Development" (mean 29.58%, SD 17.11), revealing lower quality in methodology of the guideline. The domain "Clarity of Presentation" (mean 73.80%, SD 7.87) revealed the best score. Conclusions: Our review results reveal a lack of integrated high-quality CPGs that can be used as universal guidelines by health workers in a range of disciplines for improving oral health in children and adolescents with cleft problems. [ABSTRACT FROM AUTHOR]