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The objective of this research is to describe the clinical and radiological aspects of cervical spine involvement in Juvenile Idiopathic Arthritis (JIA). Patients fulfilled the ILAR (International League Against Rheumatism) criteria for the diagnosis of the JIA. The diagnosis of JIA course types were used in this study. In all patients conventional X-rays of the cervical spine were obtained and the relationship between clinical status (neck pain, limitation of neck motion and neurological complications) and radiographs findings were studied. Cervical spine disease was assessed according clinical parameters related to JIA. 120 patients were included, mean age 22 years ± 10 [5-49], disease duration of JIA was 12 years ± 9.6 [2-35]. Thirty cases of neck pain were found, 18 patients had an inflammatory cervical pain. Neurological complications(tetraparesia in one case and one case of pyramidal irritation) were noted. In our series no cervical spine surgery was performed. In 27 cases (22.5 %), radiological inflammatory abnormalities were detected in the cervical spine: Apophyseal joint ankylosis was noted in 14 patients, anterior atlantoaxial subluxation in 6 and cervical syndesmophytosis in 5 cases. Cervical spine involvement was more frequent in polyarticular and spondylarthropathy subtypes (p=0.01). Cervical spine changes were common in patients with long lasting (p < 0.001) and severe JIA (p= 0.04). In our series, the most frequent inflammatory change was apophyseal joint ankylosis and anterior atlantoaxial subluxation. Cervical spine changes are common in patients with long lasting JIA.

International audience; Various puncture routes, veins, arteries, heart, are used to take blood in animals. For anatomical reasons, differences in blood composition are expected among puncture sites. However, this issue has been rarely assessed and contrasted results have been reported: strong effects of puncture site versus a lack of effect. We captured free-ranging freshwater turtles from different locations to compare the mean concentrations of 12 blood parameters (metabolites, hormone, ions, and enzyme) among three puncture sites: (1) a lateral branch of the jugular vein, (2) a dorsal subcarapacial cervical plexus (sometimes incorrectly referred as the ‘cervical sinus’ in the literature), and (3) a caudal plexus site (sometimes incorrectly referred as the ‘caudal sinus’). Because we used very small syringes (27–30G), we were able to separate lymph, blood, or blood–lymph mixtures. Our results show very strong effects of puncture site and of mixture level (mean maximal difference between sites was 250 %). We also found strong sex and geographical effects. Typically, there were differences in concentrations of blood solutes sampled from the lateral jugular vein and subcarapacial plexus, mainly due to sampling a mixture of blood and lymph from the ‘blood’ at the subcarapacial site and pure blood from the lateral jugular site, and likewise, samples from the caudal site were highly variable due to often sampling a mixture of blood and lymph. These results have technical and fundamental implications, especially when performing comparative analyses. Further, by selecting precise puncture sites, physiological differences between lymph and blood compartments could be investigated.

We studied the effect of Ramadan fasting on calcium intake in 2 groups of 500 healthy subjects from Marrakesh using the colloquial Arabic version of the Fardellone questionnaire. The first group was investigated 5 months before Ramadan and the second during Ramadan. No significant difference was observed between the 2 groups. However, comparison of the pre-Ramadan and Ramadan periods for each age group showed a significant increase in calcium intake in subjects over 60 years. During Ramadan, consumption of milk was significantly higher, while consumption of other dairy products was not different. Overall, no significant difference in calcium intake was noted between pre-Ramadan and Ramadan periods.

Objectives The aim of our work is to evaluate the calcium intake in population of Marrakesh and its region by the translated version in Moroccan Arabic dialect of Fardellone questionnaire. Subjects and methods The version translated into Arabic dialect Fardellone questionnaire is tested on a sample of 1000 subjects. The subjects aged less than 15 years accounted for 30.9% (n = 309), those aged 15 to 59 62% (n = 620) and those aged over 60 years 7.1% (n = 71). The distribution by age group is calculated on the distribution of the Moroccan population. Results The study population includes 60.6% women (n = 606), 39.4% of men (n = 394). The mean calcium intake was respectively 5875 mg by week (that means 839 mg/day), 4899 mg by week (that means 699 mg/day), 3053 mg by week (that means 436 mg/day), in subjects aged less than 15, those aged 15 to 59, and those aged over 60 years. The average consumption of calcium per day is significantly lower than the recommended daily amount for the three age groups. Patients aged over 60 years is the age group most under nourished calcium. The comparison of both gender found a deficit higher among women than among men. Conclusion Evaluation of the calcium intake is an essential tool for better management of metabolic bone diseases.

Introduction La faiblesse musculaire dans la BPCO represente un enjeu clinique majeur. Les recommandations actuelles preconisent une evaluation systematique de la force, souvent difficile a mettre en place car necessitant une evaluation complementaire. La faiblesse musculaire reste alors sous-diagnostiquee. L’enjeu de ce projet etait de trouver une alternative pour le depistage des patients faibles sans envisager de test complementaire. Sachant qu’il existe une correlation positive entre vitesse de marche (VM) et faiblesse musculaire chez les sujets âges et vitesse de marche et pronostic vital chez les BPCO, nous avons cherche a definir 1) la formule de calcul de la VM au cours du test de marche de 6 minutes (TDM6) la plus precise pour depister les patients presentant une faiblesse musculaire par 2) la determination d’une valeur seuil de vitesse de marche. Methodes Au total, 48 patients BPCO ont realise une mesure de la Force maximale isometrique volontaire (FMIV) et un TDM6. A partir de la FMIV et de l’equation predictive de Seymour (2010), les patients etaient definis comme faible ou non faible. Lors du TDM6, nous avons calcule la VM selon differentes formules : sur 4 m et sur 10 m depart arrete, sur 4 m depart lance, vitesse moyenne d’un tour, et enfin vitesse moyenne du test moins les temps d’arrets. Nous avons ensuite eu recours au modele des « courbes ROC » (Receiver Operating Characteristic). A partir de cette methode, la determination des aires sous la courbe, nous a permis de comparer les performances diagnostiques des formules de determination de la VM precitees a notre methode de reference. Pour la formule la plus performante (ie donnant la plus grande aire sous la courbe), nous avons defini la valeur seuil de VM la plus discriminante (valeur definie comme le meilleur compromis entre la specificite et la sensibilite du test). Resultats L’aire sous la courbe la plus grande correspondait a la formule de VM moyenne moins les temps d’arret. La valeur seuil associee etait de 1,0167 m.s−1 ( Figure 1 ). Conclusion La determination de la VM au cours du TDM6 (et plus precisement une VM > a 1,0167 m.s−1) represente une alternative interessante a l’evaluation de la FMIV pour depister la faiblesse musculaire des patients BPCO.

Resume Objectif Etudier l’apport des criteres doigts-orteils de Fournie dans le diagnostic precoce du rhumatisme psoriasique. Materiels et methodes A partir de 47 observations de rhumatisme psoriasique, les auteurs etudient les particularites des signes cliniques et radiologiques au niveau des articulations des mains. Une analyse des radiographies est effectuee, en utilisant les criteres diagnostiques doigts- orteils de Fournie. Resultats Concernant les caracteristiques cliniques, la moitie des patients ont une atteinte des mains, de caractere asymetrique dans 76 % des cas. L’arthrite erosive des interphalangiennes distales est observee dans 60 % des cas. Un aspect en « de a coudre » et/ou une hyperkeratose ungueale sont notes chez 11 malades. L’arthrite a 3 etages est retrouvee chez 3 patients. Sur le plan radiographique, 8 malades ont une arthrite erosive des interphalangiennes distales. L’ankylose d’une inter phalangienne est retrouvee chez 7 patients. L’osteolyse avec pseudo — elargissement d’une interphalangienne est constatee chez 3 malades. La resorption des houppes phalangiennes est observee dans 3 cas. Conclusion L’atteinte des mains est frequente au cours du rhumatisme psoriasique. Le caractere asymetrique et la localisation aux interphalangiennes distale sont caracteristiques. Les criteres radiologiques doigts — orteils constituent un outil simple et fiable qui permet de poser un diagnostic precoce.

Resume But de l’etude L’objectif de ce travail etait d’evaluer les risques professionnels respiratoires chez 346 puisatiers a Agadir et dans sa region. Methode L’enquete epidemiologique transversale comprenait une etude des conditions de travail avec une analyse physico-chimique du sol et un bilan medical (questionnaire, examen clinique, spirometrie et radiographie pulmonaire). Resultats Les puisatiers etaient exclusivement de sexe masculin, avec un âge moyen de 42,8 ans ± 10,5 et une anciennete d’exposition moyenne de 14,5 ans ± 6,9. Les symptomes respiratoires etaient notes chez 50 % des sujets et domines par la dyspnee (43,1 %) et la toux (35 %). La spirometrie etait anormale chez 64,2 % ; les anomalies portaient aussi bien sur les debits que sur les volumes. Les radiographies pulmonaires avaient revele 32,9 % d’images thoraciques anormales dont 78,9 % etaient des petites opacites, et 21,1 % de grandes opacites parenchymateuses. Les symptomes cliniques et fonctionnels respiratoires et les anomalies radiologiques apparaissaient precocement et leurs prevalences augmentaient avec l’anciennete de l’exposition. Il n’a pas ete observe de correlation entre les anomalies spirometriques et les images radiologiques. Discussion Peu d’etudes ont ete consacrees au risque professionnel respiratoire chez les puisatiers. A. Holanda avait mis en evidence chez ces derniers une relation significative entre l’indice d’exposition a la poussiere et l’apparition des opacites parenchymateuses et leur profusion. La valeur mediane de l’indice pour l’apparition des lesions radiologiques etait de 391 jours. Conclusion Le travail de puisatier apparait tres silicogene, l’instauration d’une surveillance medicale speciale et d’une prevention technique adequate sont necessaires pour reduire ce risque respiratoire tres invalidant.

Resume Introduction Les formes familiales de la sarcoidose sont rares. Nous avons revu de facon retrospective 147 cas de sarcoidose, toutes localisations confondues, observes au CHU Rabat-Sale durant une periode de 10 ans (1983–1993). Parmi ces cas, nous rapportons les observations de trois patients appartenant a une meme famille et a trois generations successives. Observations. - Cas 1 la grand-mere avait une sarcoidose a localisation pulmonaire. Cas 2: la fille presentait des localisations cutanees, articulaires et osseuses. Cas 3: la petite-fille avait une sarcoidose cutanee et pulmonaire. Discussion La frequence reelle de la sarcoidose familiale est probablement sous-estimee du fait du grand nombre des formes latentes. Une revue de la litterature nous a permis d'etudier 43 familles. Il n'existe pas de difference clinique entre la sarcoidose familiale et les autres formes. Nos trois observations vont dans ce sens. La preponderance a l'interieur d'une famille de sujets de meme sexe et de filiation mere-fille est decrite par la majorite des auteurs, elle laisse supposer l'existence d'un facteur genetique. Or, ni cette theorie ni celle evoquant la possibilite d'agent etiologique atteignant preferentiellement les sujets de la meme famille ne sont actuellement demontrables. Il n'existe pas d'association forte reconnue avec un groupe HLA dans la sarcoidose familiale. Conclusion La rarete des formes familiales rend tres difficile l'enoncee de theories pouvant expliquer la predisposition familiale

The aim of our work is to evaluate the calcium intake in population of Marrakesh and its region by the translated version in Moroccan Arabic dialect of Fardellone questionnaire.The version translated into Arabic dialect Fardellone questionnaire is tested on a sample of 1000 subjects. The subjects aged less than 15 years accounted for 30.9% (n=309), those aged 15 to 59 62% (n=620) and those aged over 60 years 7.1% (n=71). The distribution by age group is calculated on the distribution of the Moroccan population.The study population includes 60.6% women (n=606), 39.4% of men (n=394). The mean calcium intake was respectively 5875 mg by week (that means 839 mg/day), 4899 mg by week (that means 699 mg/day), 3053 mg by week (that means 436 mg/day), in subjects aged less than 15, those aged 15 to 59, and those aged over 60 years. The average consumption of calcium per day is significantly lower than the recommended daily amount for the three age groups. Patients aged over 60 years is the age group most under nourished calcium. The comparison of both gender found a deficit higher among women than among men.Evaluation of the calcium intake is an essential tool for better management of metabolic bone diseases.

Hypertrophic osteoarthropathy is a rare syndrome characterized by dysacromelia and periostosis with digital clubbing. Primary form is called pachydermoperiostosis. A case of a primary hypertrophic osteoarthropathy without pachydermia is reported in a 13-year-old boy, which was born of a consanguineous marriage. This case suggested an incomplete form of pachydermoperiostosis with a recessive inheritance. Pachydermoperiostosis is often familial and occurs predominantly in men. This affection is believed to be inherited in an autosomal dominant pattern but some autosomal recessive forms have also been reported.

To assess the value of Fournie's radiological criteria "fingers and toes" in the early diagnosis of psoriatic arthritis.47 patients with psoriatic arthritis were studied retrospectively. Clinical and radiological features at the hands and fingers were assessed. Radiographic analysis was performed using Fournie's criteria.Of 47 patients studied, 25 patients developed hand and finger involvement. Asymmetrical joint distribution was observed in 76% of cases. Distal interphalangeal arthritis was noted in 60% of cases. Nail lesions were present in 11 cases and dactylitis in 3 cases. Eight patients had erosions of the distal interphalangeal joints. Osteolysis with pencil-in-cup deformity was noted in 3 cases. Ankylosis of interphalangeal joints was found in 7 cases and acro-osteolysis in 3 cases.Psoriatic arthritis frequently affects the small joints of the hands and fingers. Asymmetrical and distal interphalangeal joint involvement are a characteristic feature of this arthropathy. Some radiological lesions are suggestive and contribute to the early diagnosis of psoriatic arthritis.

Familial sarcoidosis is rare. We reviewed 147 cases of sarcoidosis, whatever their localization, diagnosed at Rabat-Salé University Hospital, during a period of 10 years (1983-1993). Among these cases, we report those of three patients with sarcoidosis, in a same family. The observations concern three generations.Observation 1: the grandmother presented with pulmonary sarcoidosis. Observation 2: the mother presented with sarcoidosis of the skin, joint and lung. Observation 3: the daughter had cutaneous and pulmonary localizations.The real frequency of familial sarcoidosis is probably underestimated because of the big number of latent forms. A review of the literature allowed us to find 43 families with sarcoidosis. There is no clinical difference between familial sarcoidosis and usual forms of the disease, as confirmed by our findings. The preponderance of patients of the same sex in the same family, like our mother-daughter filiation is, described by the majority of the authors. This leads to suppose the existence of genetic factors. Neither this theory nor the one suggesting the possibility for etiologic agent that could perhaps affect the same persons in the same family can be currently demonstrated. Any association with an HLA group in the familial cases of sarcoidosis is unlikely.The rarity of familial sarcoidosis forms makes very difficult to establish theories regarding the familial predisposition.

Data suggestive of a neuromuscular disorder responsive to neostigmine was uncovered in the course of electrophysiological testing of Iraqi patients poisoned by methylmercury. Subsequent neostigmine therapy produced a remarkable clinical improvement of the patients. Placebo substitution resulted in a substantial loss of testable strength that was restored when drug therapy was resumed.

Data suggestive of a neuromuscular disorder responsive to neostigmine was uncovered in the course of electrophysiological testing of Iraqi patients poisoned by methylmercury. Subsequent neostigmine therapy produced a remarkable clinical improvement of the patients. Placebo substitution resulted in a substantial loss of testable strength that was restored when drug therapy was resumed.