Sedentarity and Colorectal Cancer in Morocco

Background: The colorectal cancer (CRC) ranks third among the most nationally prevalent cancers. Several factors including lifestyle modifications are interacting for the emergency of this disease. Morocco has experienced an epidemiologic transition accompanied by the adoption of an unhealthy lifestyle and the physical activity and the sedentary behavior changes. Aim: This study aimed to identify the association between sedentary lifestyle and the onset risk of CRC in Morocco. Methods: This is a national multicenter study of cases/controls which were matched on the sex, age and the recruiting center. All data are collected through a retrospective questionnaire including socio-demographic characters and the lifestyle behaviors (physical activity and sedentary). A sedentary person is defined as being more than 4 hours in a sitting or lying position, at work, at home, during travel, excluding time spent on sleep. Conditional logistic regression was performed to assess the association between sedentary behavior and CRC risk taking into account confounders. Data entry and data analyses were performed by SPSS software 20. Results: In total, 1453 couples (case/control) have been included in this study. 50.2% had colon cancer and 49.8% had rectal cancer. The average age were respectively 56.45 ± 13.95 years and 55.50 ± 13.70 years. For the sex, there were 49.3% male and 50.7% female in each group (case/control). The majority of the cases and controls fall into the poor class. The majority of the cases (43.7%) are overweight with a BMI between 25 and 29.9, 38.7% have a normal weight with a BMI between 18.5 and 24.9. For controls, patients with normal weight (45.6%) and those with overweight (43%) represent the majority. With regard to sedentary behavior, we note that cases are more sedentary (as being >4 hours in a sitting or lying position, at work, at home, during travel, excluding time spent on sleep) than controls with a percentage of 40.5% cases vs 36.2% of controls and a significant difference between cases and controls with OR = 1.19 (1.03-1.39), P = 10−3. Conclusion: The results of this study indicate that sedentary lifestyle is an overall risk factor for CRC. The issue of sedentary life is a major public health issue. Efforts must be made to address this sedentary problem, which will become an even more important health problem in the age of technology, with the massive use of activities that further entrap sedentary life such as social networks.

The allele 4 of neck region liver-lymph node-specific ICAM-3-grabbing integrin variant is associated with spontaneous clearance of hepatitis C virus and decrease of viral loads

L‐SIGN is a C‐type lectin expressed on liver sinusoidal endothelial cells involved in the capture of hepatitis C virus and trans‐infection of adjacent hepatocyte cells. The neck region of L‐SIGN is highly polymorphic, with three to nine tandem repeats of 23 residues. This polymorphism is associated with a number of infectious diseases, but has not been explored in HCV. We therefore investigated the impact of L‐SIGN neck region length variation on the outcome of HCV infection. We studied 322 subjects, 150 patients with persistent HCV infection, 63 individuals with spontaneous clearance and 109 healthy controls. In healthy subjects, we found a total of nine genotypes, with the 7/7 genotype being the most frequent (33%) followed by the 7/6 (22.9%) and the 7/5 (18.3%). The frequencies of the alleles were as follows: 7‐LSIGN (56.4%), 6‐LSIGN (20.2%), 5‐L‐SIGN (18.3%) and 4‐L‐SIGN (5%). The frequency of the 7/4 genotype was higher in spontaneous resolvers (14.3%) as compared with the persistent group (4%) (OR = 0.25, 95% CI = 0.07–0.82, p 0.022). In addition, we found that 4‐L‐SIGN was associated with spontaneous resolution of HCV infection (OR = 0.30, 95%CI, 0.12–0.74, p 0.005). Interestingly, patients with 4‐L‐SIGN had lower viral loads when compared with carriers of the 5 (p 0.001), 6 (p 0.021) and 7‐alleles (p 0.048). The results indicate that neck region polymorphism of L‐SIGN can influence the outcome of HCV infection and the four‐tandem repeat is associated with clearance of HCV infection.

Neuropathies périphériques sans cryoglobulinémie révélatrices de l’hépatite virale C

INTRODUCTION

Peripheral neuropathies are the most common neurological complication of viral hepatitis C infection with mixed cryoglobulinemia.

CASES REPORT

We report five cases (three men, two women) of peripheral neuropathies revealing viral hepatitis C infection without cryoglobulinemia; the patients' mean age was 56 years. Paresthesias were the most frequent symptom. Electroneuromyographic examination found one case of polyneuropathy and four cases of multiplex mononeuropathies; the complement level was normal in all patients and the rheumatoid factor positive in two cases. Etiological investigations for peripheral neuropathy remained negative. Treatment and outcome were variable.

DISCUSSION

Negative cryoglobulinemia in cases of VHC infection with neurological features has been described in the last few years, suggesting the possibility of other mechanisms such as direct action of the virus on the nervous system. There is no consensus on the treatment and outcome is variable.

CONCLUSION

Peripheral neuropathy may reveal VHC infection, underscoring the need for VHC serology testing in etiological investigations for peripheral neuropathies.

[Cancer of the rectum in young adults. Apropos of 38 cases]

This retrospective study is based upon 38 cases of rectal carcinomas occurring in young individuals aged under 25, collected during the 15 year period from January 1978 to December 1993. The mean age of the patients was 23 (range: 14 to 25), with a gender ratio of 2.1. Histology revealed a well differentiated adenocarcinoma in 12 cases, a moderately or slightly differentiated and undifferentiated carcinoma in 14 cases, a colloid carcinoma in 10 cases and a villous tumor with malignant change in 2 cases. Curative surgical excision was possible in only 11 patients. Sixteen patients underwent a palliative procedure, while 12 refused surgery. No treatment was proposed to 3 patients with visceral metastases. Only 11 patients could be followed up, with a mean 5-year survival rate of 10%. The prognosis of rectal carcinoma in young individuals is poor because of late diagnosis at an advanced stage and the aggressive histologic forms encountered.

[Tuberculous abscess of the liver. Apropos of 2 cases]

The authors report two cases of tuberculous liver abscess. They stress the rarity of this site, and differential diagnostic difficulties with other types of infection and liver tumors, notably amebiasis, hydatid cyst and carcinoma. Echo- or Scan-guided needle biopsy is useful for diagnosis and, in some cases, treatment by drainage of the purulent cavity.

[Tuberculous anal fistulas. 13 cases]

Our retrospective study concerns 13 cases of anal tuberculosis fistulas, studied over a period of 12 years, between January 1980 and December 1991. The mean age of our patients was 24 years and they were predominantly male. The diagnosis, which was suspected clinically, was confirmed histologically, either by ridge biopsies of the external orifice of the fistula or by surgical removal of the fistular passage in patients having undergone an initial surgical intervention. In 5 cases, we noted an associated pulmonary tuberculosis involvement. The treatment comprised 2 phases: an antibacillary medical treatment in all cases and a surgical treatment depending on whether the diagnosis was initially based on the ridge biopsies of the external orifice--6 cases (46.15%)--or after removal of the fistular passage--7 cases (53.85%). The outcome was good in all cases.

[Tuberculosis of the transverse colon. Apropos of 2 cases]

The authors report two cases of primitive tuberculosis of the transverse colon. Its rare occurrence and the importance of endoscopy are pointed out. A therapeutic test is often justified. Surgery is needed in case of acute complications or stenosis, and when a malignant lesion cannot be ruled out.