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L’étrange syndrome de l’odeur du poisson pourri 1019

Le syndrome de l’odeur du poisson pourri, appelé la triméthylaminurie, est un désordre métabolique rare où l’organisme est incapable de transformer une substance volatile mal odorante (la triméthylamine) en une autre sans odeur (oxyde de triméthylamine). Cette pathologie est connue en anglais sous le nom de Fish odor syndrome » (FOS) La triméthylamine (TMA) provient de certains aliments notamment les poissons de mer, les cacahuètes, les œufs et certains légumes. En l’absence de sa dégradation, elle s’accumule dans l'organisme et s’évapore par la sueur, l'urine et l'expiration, avec une forte odeur de poisson. LES CAUSES C’est une défaillance génétique de l’enzyme qui dégrade la TMA produite elle-même de la dégradation bactérienne intestinale d’aliments riches en ses précurseurs (choline, lécithine et carnitine). La TMA ainsi produite dans l’intestin sera rapidement transformée dans le foie et éliminée dans les urines sous forme d’oxyde de TMA. L’enzyme peut être totalement absente et la maladie s’exprime alors chez les enfants dès la diversification alimentaire. Si cette absence est partielle, les mauvaises odeurs sont intermittentes. Les personnes atteintes ont deux copies du gène défectueux . Les parents eux-mêmes peuvent n'avoir qu'une seule copie du gène défectueux et la pathologie sera transmise uniquement si les deux parents sont tous les deux porteurs d’une ou deux copies du gène défectueux ; ce qui signifie qu'une personne atteinte ne transmettra la maladie que si son partenaire est porteur. LES SIGNES Une odeur corporelle de poisson extrêmement désagréable que le corps dégage par la sueur, l’urine, la salive et l’haleine et même l’air expiré. L’intensité de cette odeur est variable d’une personne à l’autre et avec le temps. Ces symptômes difficiles à vivre peuvent entraîner un isolement, de l’anxiété et la dépression. On estime que plus de 200 personnes en seraient touchées dans le monde. LE TRAITEMENT DE CE SYNDROME Il n’existe actuellement aucun traitement curatif de la maladie. Les symptômes peuvent être fortement atténués par l’éviction de certains produits riches en TMA et ses précurseurs. Certains antibiotiques sont utiles en cures courtes pour réduire l’activité microbienne intestinale. Se laver fréquemment avec un savon acide et faire des exercices intenses avec sudation suivis par un lavage permet aussi une réduction des odeurs. Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie, Présidente de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Présidente de l’Alliance Maladies Rares au Maroc (AMRM) اختصاصية في الطب الباطني و أمراض الشيخوخة رئيسة الجمعية المغربية لأمراض المناعة الذاتية و والجهازية , رئيسة ائتلاف الأمراض النادرة المغرب BIBLIOGRAPHIE - S. Nicolas and al, Le « Fish odor syndrome » : une maladie socialement invalidante - Fish odor syndrome : A socially disabling disorder, La Revue de Médecine Interne Volume 43, Issue 3, March 2022, Pages 178-180 https://doi.org/10.1016/j.revmed.2021.12.010 - Qu’est-ce que le syndrome de l’odeur du poisson ? Fréquence Médicale https://www.frequencemedicale.com/oncothoracique/patient/25623-Qu-est-ce-que-le-syndrome-de-l-odeur-du-poisson - Messenger J, Clark S, Massick S, Bechtel M. A review of trimethylaminuria: (fish odor syndrome). J Clin Aesthet Dermatol. 2013 Nov;6(11):45-8. PMID: 24307925; PMCID: PMC3848652. OVERVIEW Trimethylaminuria, or fish odor syndrome (FOS), is a condition characterized by the presence of trimethylamine (TMA)—a tertiary amine whose odor is described as resembling that of rotting fish—in the urine, sweat, and expired air. POUR EN SAVOIR PLUS, D’AUTRES EXEMPLES DE MALADIES TRES RARES On estime qu’une maladie est rare lorsqu’elle touche une faible fraction de la population. En Europe, le seuil est fixé à moins d’une personne sur 2 000. Certaines de ces pathologies ne peuvent concerner que quelques centaines de personnes dans le monde. Ainsi à titre d’exemple : Progéria La progéria, est une maladie génétique extrêmement rare qui accélère le vieillissement des nouveau-nés. Sa prévalence est exceptionnellement faible : 1 nouveau-né sur 7 000 000. Il n’y a pas de remède pour cette maladie génétique et la plupart des patients décèdent avant l’âge de 13 ans, atteignant exceptionnellement l’âge de 20 ans. Atrophie hémifaciale progressive Cette maladie affecte la peau, les muscles faciaux et les structures osseuses du visage. Elle n’implique généralement qu’un seul des plans de la tête (d’où son nom, hémifacial). L’atrophie unilatérale donne au patient un aspect très étrange, comme si la moitié de son visage était en train de se décomposer. Il n’y a pas de traitement pour cette affection, mais on emploie souvent la chirurgie esthétique pour en réduire le phénomène L'ostéogenèse imparfaite L’ostéogenèse imparfaite, ou maladie « des os de verre », est une affection génétique, caractérisée par une fragilité osseuse et une faible masse osseuse à l’origine de fractures à répétition, survenant à la suite de traumatismes bénins L'on compte environ un malade pour 10 000 à 20 000 personnes et elle ne peut donc être considérée comme "très rare" L’ostéogenèse imparfaite chez l'enfant ainsi que ces troubles annexes peuvent être traitées par différents traitements médicaux et chirurgicaux : traitement des fractures : en évitant les immobilisations trop rigides et trop prolongées, lutte contre la douleur des fractures du tassement vertébral par des médications ou par des contentions, apport régulier de vitamine D avec des ajouts de calcium si besoin… L’ALLIANCE DES MALADIES RARES AU MAROC (AMRM) Depuis sa création en 2017, l’ALLIANCE travaille au quotidien avec beaucoup d’associations marocaines spécifiques pour une maladie donnée. Elle a d'ailleurs déjà signé des conventions de partenariat « stratégiques » avec 12 associations de patients : 1/Association de syndrome de Rett (AMSR) , 2/ Association de Solidarité avec les Enfants de la Lune au Maroc (A.S.E.L.M.) , 3/ Association de l’amyotrophie spinale (SMA) , 4 / association SOS Pku , 5/ association marocaine des malades d’angioedème héréditaire (AMMAO) , 6/ Association Marocaine pour la Santé de l’Enfant et de la Mère (AMSEM) , 7/ Association S.O.S Marfantime (S.O.S.M.) , 8/Association Prader Willi Maroc (P.W.M.) , 9/ Association Flamme d'Espoir pour les Autistes et les Patients atteints de la PKU , 10/ Association marocaine pour les enfants souffrant d’ostéoporose (Ostéogenèse imparfaite) A.M.E.O.S , 11/ Association Marocaine de Mucoviscidose (AMM) , 12/ Association Fragile X Maroc (FxMa) . Au sein du bureau de l’Alliance, la présidente est entourée notamment du : Dr Fouzia Chraibi, ,Vice –Présidente , Dr Mounir Filali, Secrétaire général, M Mohammed Elaidi, Secrétaire général adjoint, Mme Najat Kababi, Trésorière et de Mme Fatima Lahouiry, Trésorière adjointe
Dr Moussayer khadija

Dr Moussayer khadija

Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie en libéral à Casablanca. Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM)


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Violence in stadiums: a highly complex social phenomenon... 459

Violence in stadiums and their surroundings is not solely a matter of sports passion. It reflects deep social tensions, individual vulnerabilities, and possibly institutional dysfunctions. Understanding this phenomenon implicitly requires an analysis of all the personal, social, and organizational factors that foster these all-too-frequent outbreaks. The majority of young people involved in such violence, especially during football matches, often come from precarious backgrounds, marked by fragile family structures and a strong sense of social, cultural, and economic exclusion. The need for recognition drives some of them to join radical supporter groups, where violence becomes a way to assert their identity, gain notoriety, and earn respect. Clashes before, during, and after matches are opportunities to establish this recognition, assert a certain popularity, or even consolidate leadership. The identification and sanctioning of troublemakers, which are obviously limited, reinforce the feeling of impunity and even superiority over the law and law enforcement. Anonymity in the crowd and insufficient controls facilitate violent acts, often orchestrated by leaders who quickly step back. Family instability, school failure, emotional immaturity, adolescent impulsiveness, and difficulties managing emotions add to educational and psychological deficiencies, encouraging violent behavior. Cognitive vulnerabilities, attention disorders, or below-average IQ, as well as the absence of effective integration programs, further complicate social and academic inclusion, increasing the risk of marginalization. Structural and institutional causes also play a decisive role. Sports clubs, often little involved in the educational and social management of their supporters, shift responsibility onto security services. This opaque and poorly coordinated management among stakeholders makes matches increasingly costly in terms of security and image. Young people left to themselves, without prospects, are easy targets for criminal or extremist groups that exploit sports passion to spread violent and increasingly political messages. The lack of sports and cultural infrastructure in disadvantaged neighborhoods drives these youths to find an outlet for their frustrations in supporter groups. Social networks amplify the spread of tensions and hateful discourse, exacerbating violence. The deterioration of public health, the decline of education, the increase in social inequalities, and the feeling of injustice feed this endemic violence. In Morocco, for example, 1.7 million young people aged 15 to 24 are NEET (not in education, employment, or training), and nearly 280,000 students leave the education system each year without qualifications, fostering marginalization and adherence to violent groups. Today, such groups orbit almost all football teams, regardless of the level of competition, results, or geographic location of the club. This is not just an observation. Violence surrounding sport is not inevitable. Civic education, abandoned in favor of proven ineffective school methods and content, must be reintroduced with a strong emphasis on respect for others and common goods, tolerance, and fair play, starting at a young age through ongoing awareness campaigns in schools and sports clubs. Strengthening judicial authority, with rapid, exemplary, and systematic sanctions, including family responsibility for those under 16, is necessary. The development of local infrastructure with free access and supervised activities must continue. Local authorities have a duty to get involved by recruiting educational staff to supervise young people in neighborhoods and offering extracurricular programs, educational workshops, sports activities, and second-chance schools. Sports clubs must assume their responsibility through greater transparency, adopting an ethical charter for spectator management, training supervisors, engaging in dialogue with supporters, and directly managing matches. They must openly condemn and distance themselves from violent groups and no longer tolerate them. Better collaboration between schools, families, clubs, and authorities is essential for comprehensive youth supervision. European examples, such as Eurofan in Belgium, the European Convention on Violence in Stadiums, or educational programs in Germany and the UK, demonstrate the effectiveness of prevention, dialogue, mediation, and advanced technologies (video surveillance, facial recognition). Violence in stadiums reflects social fractures, exclusion, and a lack of guidance. The solution lies in a comprehensive approach: prevention, education, social integration, professional club management, and institutional cooperation. Sport must once again become a vector of integration, respect, and social cohesion: a notably collective responsibility.

The Africa Atlantic Gas Pipeline: A Strategic Project at the Heart of Regional Rivalriy. 490

While Algerian media persist in disparaging the Nigeria-Morocco gas pipeline project, also known as the Atlantic Africa Gas Pipeline (AAGP), this large-scale transcontinental megaproject paradoxically generates growing interest and increasing international support. More than just a pipeline, the AAGP embodies an ambitious vision of South-South cooperation, regional integration, and sustainable development, crossing often landlocked and fragile countries, and offering a credible complement or alternative source of gas for Europe. The AAGP aims to transport up to 30 billion cubic meters of gas per year from Nigeria’s rich gas fields, passing through about fifteen West African countries, reaching Morocco, and then onward to Europe via the Strait of Gibraltar. This significant capacity will not only diversify Europe’s energy supply sources but, above all, meet the growing energy needs of West African countries. Unlike the Algerian Trans-Saharan gas pipeline project, which is about 1,500 km shorter but costly (nearly USD 20 billion) and passes through an unstable region, the AAGP stands out for its inclusive approach. It is not merely a transit conduit to Europe but a regional energy network that will supply bordering countries, allowing producers to inject their gas locally and others to fuel their industrial, agricultural, and urban development. The AAGP is based on a logic of South-South cooperation, founded on solidarity, sharing expertise, and economic complementarity. By crossing often landlocked countries, the pipeline will help reduce their energy isolation, strengthen their infrastructure, and stimulate their economic growth. The choice of a predominantly offshore route up to Dakhla, then onshore along Morocco’s Atlantic coast, illustrates the desire to fully integrate the Sahel-Saharan region into a modern energy corridor. Dakhla, which will become a major port, industrial, and logistics hub, is set to play a central role in this dynamic, promoting job creation, industrial growth, and economic diversification-key strengths and major assets of the Moroccan vision. Algeria, for its part, perceives it as a direct threat to its dominant position in the regional energy sector. Its shorter Trans-Saharan pipeline project is limited to a simple transit role for Nigerian gas to Europe, without real impact on the development of the territories it crosses. In contrast, the Moroccan AAGP proposes a more ambitious vision, integrating a regional network that will benefit all partners and their increasingly demanding populations. Algerian hostility manifests in an intense media campaign aimed at downplaying the feasibility of the Moroccan project. Beyond the media, Algeria is multiplying diplomatic efforts to strengthen ties with Nigeria and accelerate its own project. Official delegations follow one another, while on social networks, relentless, likely orchestrated smear campaigns seek to discredit the AAGP. This antagonism fits into a broader political logic, with Morocco as the "classic enemy" to weaken. Ideological stubbornness leads to ridiculous choices that paradoxically harm Algeria’s own economic and social interests. The artificial conflict over Western Sahara remains a backdrop; the survival of the Polisario Front has mobilized a large share of Algeria’s resources, efforts, and attention for 50 years. Contrary to Algerian claims, the AAGP enjoys solid support from financial institutions and major investors. The United Arab Emirates (25 billion USD), the Islamic Development Bank, the European Investment Bank, the OPEC Fund for International Development, as well as the USA, have expressed interest and commitment to the project. On the industrial front, the Chinese group Jingye Steel has already won the contract to supply the metal pipes, demonstrating the project’s international and industrial dimension. This involvement of global players strengthens the technical and financial credibility of the AAGP and consolidates adherence to the goal of making the region a development hub rather than a source of migration and forced population displacements. The Moroccan project is divided into several phases, with feasibility, basic engineering, and environmental studies already completed or underway. A call for tenders is planned to accelerate construction, with the commissioning of the first sections envisaged as early as 2029. Beyond energy issues, the AAGP is part of a broader strategy of sustainable development, reducing energy poverty and poverty in general, and strengthening regional stability. By promoting economic integration and complementarity among West African countries, the project will help create an environment conducive to investment, job creation, inclusive growth, and prosperity. This was recently reinforced in the PRAI declaration at the 5th meeting of the African Atlantic States Process (AASP). This approach strongly contrasts with Algeria’s strategy, which remains focused on political and ideological confrontation, to the detriment of economic and social opportunities for its own populations. Algeria even refuses to acknowledge the emergence of new gas producers, notably Senegal and Mauritania, who actively participate in the Moroccan project. These countries adopt a pragmatic logic, favoring economic development and regional cooperation over ideological rivalries. The first section of the AAGP precisely includes these states, illustrating a dynamic of openness and partnership that could reshape West Africa’s energy map. The Atlantic Africa Gas Pipeline is more than just an infrastructure project: it embodies an ambitious vision of cooperation, integration, and sustainable development for West Africa that the affected populations fully understand. Faced with this dynamic, Algeria seems trapped in its chronic confrontational stance, hindering its own development and, regrettably, that of the region. At a time when energy, economic, and geopolitical challenges are multiplying, the AAGP is a model for the future, based on complementarity, solidarity, and innovation. Its success could open the way to a new era of shared prosperity and stability for West Africa and its international partners, much to the dismay of those who oppose it, refuse to admit it, or simply fail to understand it.

The Kabbalah 513

Kabbalah is a mystical tradition within Judaism that seeks to understand the hidden dimensions of the divine, the universe, and the soul. While its formal development emerged in medieval Europe—especially in 12th-century Provence and 13th-century Spain—its roots stretch back to earlier biblical, rabbinic, and merkavah (chariot) mysticism traditions. It offers a symbolic and metaphysical framework for understanding reality and our role within it. At its core, Kabbalah teaches about Ein Sof (“the Infinite”), the boundless aspect of God that lies beyond all human comprehension. From this ineffable source emanates all of creation, unfolding through a dynamic process depicted in the Tree of Life (Etz Chaim), a symbolic diagram composed of ten interconnected spheres called sefirot. These sefirot represent divine attributes or channels through which the Infinite expresses itself, shaping both the spiritual and material realms. At the top is Keter, the crown, symbolizing divine will and pure potential. From Keter flows Chokhmah, the spark of wisdom and intuitive insight, which is then given form and structure by Binah, representing understanding and deep contemplation. Below them, Chesed embodies expansive love, generosity, and mercy, while Gevurah introduces strength, discipline, and the power of judgment. Between these opposing forces lies Tiphereth, the sphere of beauty, harmony, and compassion, which mediates and integrates mercy with severity. Continuing downward, Netzach expresses endurance, initiative, and the force of expansion, while Hod represents humility, introspection, and the power of communication and symbolism. These two channels converge into Yesod, the foundation, which synthesizes and transmits all previous energies into Malkuth, the kingdom—the material world, where divine intention is finally manifested. These ten sefirot are arranged along three vertical pillars—right, left, and center—symbolizing the principles of expansion, restraint, and balance. Together, they form a dynamic spiritual system that mirrors both the structure of the universe and the inner architecture of the human soul. One of the most influential Kabbalistic texts is the Zohar, a mystical commentary on the Torah, which uses allegory, symbolic interpretation, and esoteric language to uncover hidden spiritual meanings in the biblical text. Another foundational work is Sefer Yetzirah ("The Book of Creation"), which presents a cosmology based on the mystical properties of the Hebrew alphabet and the ten sefirot. It teaches that the world was created through 32 paths of wisdom—ten sefirot and 22 Hebrew letters—laying the groundwork for later Kabbalistic systems. A major development in Kabbalah came with Isaac Luria (1534–1572), known as Ha'ari, who introduced Lurianic Kabbalah. He offered new doctrines such as Tzimtzum (the divine contraction that made space for creation), Shevirat ha-Kelim (the breaking of the vessels), and Tikkun (restoration or repair). These concepts explain why evil exists and how humanity participates in the healing of cosmic fractures through spiritual acts. Kabbalistic practice involves more than intellectual study—it includes meditative techniques, letter permutations, sacred chanting, visualization, and deep contemplation on the divine names. Gematria, the system of interpreting Hebrew words through their numerical values, plays a central role in uncovering hidden connections between words and ideas. Another important concept is Sitra Achra, the "Other Side"—a realm of impurity and spiritual blockage that opposes holiness and reflects the duality within creation. Kabbalists explore how spiritual elevation occurs when divine sparks trapped in the material world are liberated through righteous actions, prayer, and intentional living. In more practical or applied Kabbalah, practitioners also work with Divine Names (such as the 72 Names of God), angels, and astrological correspondences, viewing them as symbolic tools to aid in spiritual elevation and unity with divine purpose. The four worlds (Atzilut, Beriah, Yetzirah, and Assiah) represent stages of emanation from the divine to the material realm, showing the hierarchical structure of existence. Although once restricted to mature Jewish scholars, Kabbalah has increasingly influenced broader spirituality, from Hasidic Judaism to Christian mysticism, Western esotericism, and even contemporary self-help movements. However, traditional Kabbalists emphasize that its study demands humility, ethical refinement, and a strong foundation in Torah and Jewish law. Ultimately, Kabbalah is not just a metaphysical system but a transformational path. It invites seekers to draw closer to the Divine, to bring balance to the soul, and to repair the world by restoring harmony between the spiritual and physical realms.