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L’étrange syndrome de l’odeur du poisson pourri 3449

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

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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Football: When Passion Kills the Game in Impunity and Tolerance.. 385

Football (Soccer for Americans) is first and foremost a matter of emotions. By its very essence, it is an open-air theater where human passions play out in their rawest, most primal form. It generates joy, anger, pride, humiliation, and a sense of belonging. From the stands of Camp Nou to those of the Diego Armando Maradona Stadium, through the fervor of the Mohamed V sport Complex in Casablanca, the vibrant enclosures of Stade Léopold Sédar Senghor in Dakar, or even the Parc des Princes in Paris, the Vélodrome In Marseille, and the Bernabeu In Madrid, football transcends the mere framework of the game to become a total social phenomenon. But this emotional intensity, which makes football's beauty, also constitutes its danger. For without rigorous regulation, it quickly tips into excess, then into violence. Today, it must be acknowledged that the rules exist, but they are too often circumvented, stripped of their substance, or applied with disconcerting leniency. On the pitches as in the stands, excesses are multiplying: insults toward referees, provocations between players, systematic challenges, physical violence, projectile throwing, pitch invasions, xenophobic remarks, racist offenses. What was once the exception is tending to become a tolerated norm. Astonishingly, we are starting to get used to it. Recent examples are telling. In Spain, in stadiums renowned for their football culture, racist chants continue to be belted out without shame, targeting players like Vinícius Júnior. Most recently, it was the Muslim community that was insulted. And yet, Spain's current football prodigy is Muslim. An overheated crowd that has doubtless forgotten it wasn't so long ago that it was Muslim itself. Among those chanting these remarks, and without a doubt, some still carry the genes of that recent past... In Dakar, just a few days ago, clashes escalated, turning a sports celebration into a scene of chaos. In Italy, incidents involving supporters who invaded the pitch, during a friendly match, no less, endangered players and officials, recalling the dark hours of European hooliganism in the 1980s. These episodes are not isolated; they reflect a worrying normalization of violence in and around stadiums. Even at the highest level of African football, behavioral excesses are becoming problematic. The 2025 Africa Cup of Nations final left a bitter taste. What should have been a moment of celebration for continental football was marred by behaviors contrary to sporting ethics. Pressures on refereeing, excessive challenges, and game interruptions have become commonplace. When a coach manipulates a match's rhythm to influence a refereeing decision, it is no longer strategy but a challenge to the very foundations of the sport. Despite international outrage, the sanctions imposed on teams, clubs, or players involved remain often symbolic, insufficient to eradicate these behaviors. A very surprising phenomenon: rarely have clubs or federations clearly distanced themselves from such crowds. They accommodate them, and when they condemn them, it is half-heartedly, in a muffled, timid tone with no effect. The problem is twofold. On one hand, disciplinary regulations exist but lack firmness. On the other, their application suffers from a lack of consistency and political courage. Bodies like FIFA, continental confederations, and national federations hesitate to impose truly dissuasive sanctions such as point deductions, prolonged closed-door matches, competition exclusions, or even administrative relegations. Yet without fear of sanction, the rule loses all effectiveness. It suffices to compare with other sports to measure the gap. In rugby, for example, respect for the referee is a cardinal value. The slightest challenge is immediately sanctioned. In athletics, a false start leads to immediate disqualification, no discussion. Football, meanwhile, still tolerates too many behaviors that should be unacceptable. This permissiveness has a cost. It undermines football's image, discourages some families from attending stadiums, and endangers the safety of the game's actors. More gravely, it paves the way for future tragedies. History has already taught us, through catastrophes like the Heysel Stadium disaster, that violence in stadiums can have tragic consequences. It is therefore urgent to react. Regulating football does not mean killing its soul, but rather preserving it. It is not about extinguishing passions, but channeling them. This requires strong measures, exemplary sanctions against offending clubs and players, accountability for national federations, increased use of technology to identify troublemakers, and above all, a clear political will from national and international governing bodies. Football cannot continue to be this "market of emotion" left to its own devices. For by tolerating the intolerable, it risks losing what makes its greatness and its ability to unite rather than divide. If FIFA does not decide to act firmly, the danger is real: that of seeing football sink into a spiral where violence triumphs over the game, and where, one day, tragedies exceed the mere framework of sport. The long-awaited decision of the Court of Arbitration for Sport (CAS) in the 2025 AFCON final case should confirm rigor and integrity in the application of rules, at least at this level, thereby strengthening the credibility of the pan-African competition and football in general.

April 2026 or the Certain Confirmation of the Moroccan Victory... 592

We are entering a decisive month of April. The international dynamic is shifting even further in Morocco's favor on the Sahara issue. April once again promises to be a pivotal moment in the international handling of the Moroccan Sahara question. This structuring diplomatic ritual corresponds to the presentation of the annual report by the UN Secretary-General's Personal Envoy to the Security Council. But this year, the context is profoundly different. The lines have shifted, balances have been redrawn, and a new dynamic is taking hold, clearly favorable to Morocco, a logical follow-up to the adoption of Resolution 2797, with strong structuring potential. The adoption of this resolution marks an essential milestone. It goes beyond simply renewing the existing framework. It consolidates a political direction initiated over several years, by enshrining the preeminence of a realistic, pragmatic, and sustainable political solution, centered exclusively on the Moroccan autonomy initiative. This resolution fits into a strategic continuity that progressively marginalizes unrealistic options, those that long relied on outdated or inapplicable references in the current geopolitical context. It also increases pressure on the parties to engage in a credible political process under the exclusive auspices of the United Nations, but in reality under strong American pressure. The United States has directly engaged in favor of the Kingdom, with the return of roundtables in Madrid and then Washington as key pivots. These meetings have confirmed a diplomatic reality that is now hard to contest. The format of the gatherings, including Morocco, Mauritania, the Polisario Front, and Algeria despite itself, is the only relevant framework for progress. It implicitly enshrines Algeria's central role, long eager to present itself as a mere observer. Its active participation, even forced, places it at the heart of the dispute, profoundly altering the reading of the conflict and redistributing political responsibilities. Madrid and Washington are not insignificant venues. They reflect the growing involvement of Western powers in seeking a resolution, with increasing convergence around the Moroccan proposal. One of the expected developments this month concerns the future of MINURSO. The time has come to redefine the mission. From its inception, it has never fulfilled the role for which it was established. A major evolution is likely emerging in support of implementing autonomy in the southern provinces within the framework of the Kingdom's sovereignty. Long confined to monitoring the ceasefire, the mission will see its name change and its mandate evolve to adapt to on-the-ground realities and the demands of a renewed political process. Such a change would be highly significant. It would mark the end of UN inertia and reflect the international community's will to move from managing the status quo to an active and definitive resolution logic. Much to the dismay of those who, for 50 years, have done everything to perpetuate the conflict through their proxy; the latter is increasingly suffering from the shifting landscape. Washington has toughened its tone and put the Polisario in its sights. Algeria is evidently feeling the effects. The introduction in the US Congress of a proposal to designate the Polisario as a terrorist organization represents a potentially major turning point. If successful, such a designation would have considerable political, financial, and diplomatic consequences. It would further isolate the movement, weaken its supporters, and reshape the balance of power. Above all, it would reinforce the security reading of the dossier, in a Sahel-Saharan context marked by rising transnational threats. This adds to a Security Council increasingly aligned with the Moroccan position. The Council's current composition clearly leans in favor of Moroccan positions. Several influential members explicitly or implicitly support the autonomy initiative, seen as the most serious and credible basis for settlement. This shift is no accident. It results from active, coherent, and consistent Moroccan diplomacy, which has successfully embedded the Sahara issue within logics of regional stability, counter-terrorism, and economic development. Algeria, for its part, faces its contradictions. In this context, the Algerian regime appears increasingly beleaguered. Its positioning, long structured around ideological rhetoric and systematic opposition to Morocco, now seems out of step with international system evolutions. Algiers' relative diplomatic isolation, including in its Sahelian environment, contrasts with its regional ambitions. Internally, economic and social challenges exacerbate tensions in a country with considerable resources but unevenly distributed benefits. Algerian populations suffer from much injustice and lack the essentials. The Sahara issue, instrumentalized for decades as a lever for foreign policy and internal cohesion, thus reveals the limits of a politically exhausted model. The trend thus confirms a historic turning point depriving the Algerian regime of its artificial political rent. All elements converge toward one conclusion: April 2026 could mark a decisive step in the evolution of the Moroccan Sahara dossier. Without prejudging an immediate outcome, current dynamics are progressively narrowing the space for blocking positions. More than ever, resolving this conflict seems to hinge on recognizing geopolitical realities and adhering to a pragmatic political solution. In this perspective, Morocco appears in a position of strength, bolstered by growing legitimacy and increasingly assertive international support. The question remains whether other actors, particularly Algeria, will adapt to this new reality or choose to oppose it at the risk of greater isolation in a world where balances of power evolve rapidly. There will undoubtedly be a before and after April 2026, and above all, the consolidation of a Moroccan position oriented toward further development of the southern provinces. The Security Council's output is awaited in this direction.