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.

An unusual lethal gunshot wound to the head

Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet. Potentially lethal, craniocerebral gunshot injuries are a common occurrence in developing countries even in non-conflict areas, with very bad outcomes even when treated aggressively in specialized neurosurgical facilities. The authors briefly discuss similar cases and opinions in the relevant literature, emphasizing the importance of a rational approach during the reconstruction of the crime scene.

[Saccharomyces cerevisiae invasive infection: The first reported case in Morocco]

Saccharomyces cerevisiae is a cosmopolitan yeast, widely used in agro-alimentary and pharmaceutical industry. Its impact in human pathology is rare, but maybe still underestimated compared to the real situation. This yeast is currently considered as an emerging and opportunistic pathogen. Risk factors are immunosuppression and intravascular device carrying. Fungemias are the most frequent clinical forms. We report the first case of S. cerevisiae invasive infection described in Morocco, and to propose a review of the literature cases of S. cerevisiae infections described worldwide. A 77-year-old patient, with no notable medical history, who was hospitalized for a upper gastrointestinal stenosis secondary to impassable metastatic gastric tumor. Its history was marked by the onset of septic shock, with S. cerevisiae in his urine and in his blood, with arguments for confirmation of invasion: the presence of several risk factors in the patient, positive direct microbiological examination, abundant and exclusive culture of S. cerevisiae from clinical samples. Species identification was confirmed by the study of biochemical characteristics of the isolated yeast. Confirmation of S. cerevisiae infection requires a clinical suspicion in patients with risk factors, but also a correct microbiological diagnosis.

Osteological proofs of torture and cruelty: forensic findings form a secret cemetery in Tirana, Albania

Two decades after the fall of the communism in Albania, documenting the human rights violations and proving torture and cruelties suffered from ex-politically persecuted and dissidents of the regime, is still a societal priority. Due to several reasons, the judicial way toward redressing the historical injustices has been slowed down. This is mainly because of the lack of proper documentation of torture, mass executions and extrajudicial ill-treatment. Several governmental and civil society organizations have tried to define the issue, but perpetrators have rarely, if ever, been brought to court. Secret cemeteries and mass graves have recently been found in different zones of Albania, and victims exhumed; thus proofs of torture and ill-treatments are being made widely known, potentially creating the necessary legal conditions for punishing the perpetrators and for identifying victims. In the present paper, authors describe osteological forensic findings from Linza secret cemetery in Tirana, where several ante mortem fractures prove the severe and cruel ill-treatment the victims suffered before the execution that was usually by bullet shot in the posterior region of the skull.

Fatal basilar thrombosis possibly related to minor cervical trauma: a case report

Background. Basilar thrombosis is a potentially fatal event, whose traumatic etiology has been repeatedly stated. Methods. We performed the autopsy and the microscopic examination of the brain stem structures from an individual, whose sudden death raised logical suspicions regarding the causative factor. Results. The brain was swollen and clearly hyperemic; a massive basilar thrombus with complete occlusion of the median segment of the basilar artery was macroscopically seen. The brainstem showed an infarcted zone in the pons, with secondary hemorrhagic changes, mainly in the form of multiple petechial hemorrhages. Pontine arteries showed extensive alterations, mainly in the form of severed endothelium, which suggested a thrombotic-traumatic mechanism as the main etiological factor. Conclusions. Minor injuries, such as slight whiplashes, abrupt neck movements, neck trauma related to the slowing down of the vehicles, and critical neck positioning, can all of them explain a thrombotic event in the basilar artery, leading to a fatal occurrence. Other risk factors may obviously concur, but their importance seems unclear.

[Vascular epulis or lobular capillary hemangioma]

Vascular epulide or Lobular capillary hemangioma is a form of epulide which is marked by an inflammatory infiltrate rich of blood vessels. Angiogenic factors seem to be responsible of the important vascular proliferation. Therapeutic implications include cautions toward hemorrhagic risk. Complete ablation is also required to avoid the risk of high recurrence.

Association between sharing of toothbrushes, eating and drinking habits and the presence of Actinobacillus actinomycetemcomitans in Moroccan adolescents

BACKGROUND/AIMS

Actinobacillus actinomycetemcomitans is frequently detected in dental plaque collected from Moroccan adolescents, and has been shown to be associated with clinical attachment loss in this population. The aim of this study was to assess whether behaviors such as the sharing of toothbrushes, and eating and drinking habits were associated with the presence of A. actinomycetemcomitans in Moroccan adolescents.

MATERIALS AND METHODS

A total of 121 adolescents were clinically examined. Interviews regarding sharing of toothbrushes, eating and drinking habits were performed, and plaque samples were collected and analyzed for A. actinomycetemcomitans with different leukotoxin promoter types by polymerase chain reaction. Based on eating and drinking habits, the study population was divided in a low risk behavior group (LRB) and a high risk behavior group (HRB).

RESULTS

No association was found between the sharing of toothbrushes and the presence of A. actinomycetemcomitans. The odds ratios between the HRB and LRB group for being positive for the JP2 type, for non-JP2 types, and for any type of A. actinomycetemcomitans were 4.74 (95% CI 0.55; 40.71), 2.49 (95% CI 1.03; 5.97), and 2.97 (95% CI 1.28; 6.91), respectively. The difference in the mean number of teeth with a clinical attachment loss of > or = 3 mm between the HRB and the LRB group was 0.91(95% CI 0.09; 1.72).

CONCLUSION

Sharing of toothbrushes does not seem to be associated with the presence of A. actinomycetemcomitans in young Moroccans. Eating and drinking habits conducive to exchange of saliva are positively associated with presence of A. actinomycetemcomitans, and with a higher level of clinical attachment loss.