Think Forward.

Les particularités de la maladie cœliaque chez l’enfant 2789

Dr Moussayer khadija, 2 y.
- Science - Society - Health -
3.3 min read.
La maladie cœliaque ou intolérance au gluten est une pathologie auto-immune chronique, qui touche les intestins, suite à l'ingestion de gluten. Il s'agit plus précisément d'une intolérance (et non d'une allergie) à un composant du gluten, la gliadine (ensemble de protéines constituant les farines de certaines céréales, dont le blé, le seigle, l'orge, l'avoine). Le diagnostic de ce trouble est souvent difficile et tardif. Il n'existe toujours pas de traitement curatif et sa seule résolution réside dans l'exclusion de tout gluten de l'alimentation générale. Chez les très jeunes enfants (moins de 3 ans), il y a plus souvent présence de diarrhée, de distension abdominale et de retard de croissance. Les enfants plus âgés et les adolescents seraient plus sujets à présenter d’autres symptômes gastro-intestinaux (douleurs abdominales récurrentes, constipation ou vomissements) ou des symptômes extra-intestinaux. LES SYPTOMES DE LA MALADIE COELIAQUE CHEZ L’ENFANT Elle se manifeste essentiellement de deux manières chez les enfants : - la maladie cœliaque avec des manifestations gastro-intestinales impliquant une croissance médiocre, un abdomen distendu, des diarrhées, des vomissements, des troubles de la croissance avec une cassure de la courbe staturo-pondérale. - la maladie cœliaque atypique avec des manifestations peu significatives, des troubles à des organes autres que l’intestin, une croissance médiocre et assez souvent une anémie en fer ou en acide folique . L’enfant peut aussi présenter des manifestations auto-immunes ou être diagnostiqué de ce type de pathologie. Sachant qu'elles peuvent être associées à la maladie cœliaque, il convient alors de faire des examens en procédant à une recherche d'anticorps, notamment chez les enfants atteints de diabète de type1, de thyroïdite ou d'alopécie areata. Cette recherche est nécessaire aussi pour les enfants atteints de maladies rares comme le syndrome de Down ou de Turner. LES TESTS SANGUINS DE DETECTION DE LA PATHOLOGIE Le diagnostic de la maladie cœliaque doit être réalisé avec rigueur selon des protocoles internationaux au moyen de tests sanguins spécifiques et éventuellement par gastroscopie avec prélèvements biopsiques si nécessaire. Le dosage des anticorps anti-transglutaminase spécifiques de la maladie cœliaque, lorsqu'il est détecté avec une valeur élevée, est le test sanguin le plus approprié à réaliser pour le diagnostic suspecté de la maladie cœliaque. Il doit être associé à la détermination des immunoglobulines IGA totales. UNE PREDISPOSITION GENETIQUE La maladie cœliaque est une maladie à forte prédisposition génétique. Elle est en relation avec notre carte d’identité biologique : le système HLA (Human leukocyte Antigen), un ensemble de molécules situées à la surface des cellules pour permettre au système immunitaire de les reconnaitre. La présence de gènes spécifiques HLA DQ2 et DQ8 chez presque tous les cœliaques est un élément nécessaire mais non suffisant pour développer la maladie, puisque qu’on les retrouve aussi en moyenne dans 35% de la population alors que la maladie n’en touche que 1%. LE TRAITEMENT : LE REGIME SANS GLUTEN Le régime sans gluten (RSG) ne doit être mis en place qu'après confirmation du diagnostic, car l'élimination du gluten de l'alimentation de l'enfant entraîne des tests négatifs et la résolution des symptômes, compromettant un diagnostic ultérieur de certitude. Pour le moment, le seul traitement consiste à suivre ce régime alimentaire sans gluten (RSG). Le gluten et les protéines apparentées sont présents dans la majorité des céréales (blé, orge et seigle). Le gluten est présent aussi dans de nombreux produits très divers et souvent insoupçonnés : médicaments, rouge à lèvres, rince-bouche, dentifrice, colle, bonbons, sauce à salade, plats cuisinés… Le patient doit alors se diriger vers des produits de substitution sans gluten comme le riz (blanc, semi-complet, complet), des légumineuses (lentilles, pois chiches, haricots rouges…) ainsi que des céréales non toxiques et pseudo-céréales anciennes ou venues d’autres continents (sarrasin, millet, quinoa ou encore amarante originaire d’Amérique du sud). Au Maroc, la bonne observance du régime sans gluten est compliquée du fait qu’il n’existe pas d’étiquetage obligatoire sur ce sujet L’ASSOCIATION MAROCAINE DES INTOLERANTS ET ALLERGIQUES AU GLUTEN (AMIAG) Fondée en 2013, l’AMIAG a su s’imposer rapidement comme l’association nationale de référence pour la maladie cœliaque au Maroc et est reconnue comme telle par ses partenaires à l’étranger. Elle est présidée par Mme Jamila Cherif Idrissi. Comptant près de 1 000 adhérents, elle a mis en place ou organise : la journée nationale de la maladie cœliaque chaque année en mai ; des ateliers culinaires ; une grande fête annuelle pour les enfants cœliaques ; des conférences scientifiques avec des experts nationaux et internationaux, en particulier lors d’événements des professionnels de santé ; des aides alimentaires et des dons de moulins à céréales aux familles les plus pauvres… . Dr Moussayer khadija, spécialiste en médecine interne et en Gériatrie, vice - présidente de l’association marocaine des intolérants et allergiques au gluten (AMIAG) BIBLIOGRAPHIE - L’effiler D. Celiac disease diagnosis and management. JAMA. 2011;306(14):1582–92 - Ford AC and al. Yield of diagnostic tests for celiac disease in individuals with symp-toms suggestive of irritable bowel syndrome. Arch Intern Med. 2009;169(7):651–8. - Husby S. and al Guidelines for the Diagnosis of Coeliac Disease., for the ESPGHAN Working Group on Coeliac Disease Diagnosis, on behalf of the ESPGHAN Gastroenterology Committee European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. JPGN 2012; 54: 136–160. -Diagnostic de la maladie cœliaque chez l'enfant Diagnosis of celiac disease in children, Elsevier Perfectionnement en Pédiatrie Volume 5, Issue 2, Supplement 1, May 2022, Pages S2-S6 https://doi.org/10.1016/S2588-932X(22)00071- OVERVIEW Celiac disease, defined as permanent intolerance to gluten, is an autoimmune disease, where the immune system attacks, in genetically predisposed individuals, the intestinal villi. The resultant atrophy of the intestinal wall causes malnourishment of nutrients and many other complications. The auto-immune diseases are a broad range of related diseases in which a person’s immune system produces an inappropriate response against its own cells, tissues and/or organs, resulting in inflammation and damage. There are over 100 different autoimmune diseases, and these range from common to very rare diseases. Some of the over 100 autoimmune diseases are lupus, type 1 diabetes, scleroderma, multiple sclerosis, Crohn’s disease, autoimmune hepatitis, rheumatoid arthritis, Graves disease, myasthenia gravis, myositis, antiphospholipid syndrome (APS), Sjogren’s syndrome, uveitis, polymyositis, Raynaud’s phenomenon, and demyelinating neuropathies
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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Agentic AI Beyond Benchmarks: Meta-Agents & the Future of AI Evaluation with Khalil Mrini 281

Tariq Daouda, 1 d.
I recently sat down with Khalil Mrini to talk about his work and international experiences. He has spent time in Marrakech, Switzerland, India, and the United States, each place influencing his perspective in different ways. We also mentioned his visit at the UM6P, his experience of the university, students and innkvative AI curriculum. Khalil presented his new paper on agentic AI. The paper focuses on the use of autonomous agents to evaluate and benchmark other agents: essentially, systems that can test one another’s capabilities. He described how this approach could provide a more dynamic and optimal method for measuring progress in AI research. We ended the conversation by discussing AI ethics. Our exchange raised open questions about responsibility, transparency, and how the field can ensure that increasingly autonomous systems align with human values.
youtu.be/zE7PKRjrid4

A Historical Triptych: How Morocco, Spain, and Portugal are Forging the Success of the 2030 World Cup 390

Imad Khater, 2 d.
The assignment of the 2030 FIFA World Cup hosting rights to the unprecedented trio of Morocco, Portugal, and Spain marks the opening of a new chapter in the history of international and sporting relations. The joint organization of this event confirms an unparalleled dynamic, engaging the three nations in a triangular cooperation whose efficiency will be the decisive marker of this global event's success. This trilateral partnership transcends mere logistical collaboration to become a true lever for strategic development. The question is no longer whether bilateral relations are ready, but how their integration into a strengthened trilateral framework will guarantee the success of a mega-event poised to connect, for the first time, two continents through the medium of sport. Historical ties and geographical proximity provide a fertile ground for a remarkable intensification of relations between these three partners. The announcement of their tripartite bid has, in fact, elevated the need for harmonized coordination in the logistical, economic, and security domains to the level of a strategic imperative. I. The Political and Economic Foundations of Enhanced Cooperation The alignment around the 2030 project is not fortuitous; it is rooted in deep political and economic considerations that mutualize the interests of the three countries. •⁠ ⁠The Imperative of Convergence suffers no ambivalence: Spain and Portugal, while operating within the structural framework of the European Union, recognize Morocco as an essential strategic partner, a genuine gateway and pivot to the African continent. This dynamic is not unilateral; the Kingdom is consolidating its Euro-African anchor with heightened clarity through this same alliance. The World Cup deadline, far from being a simple calendar constraint, acts as a powerful lever, forcing the acceleration—often judged too slow—of regulatory, customs, and security convergence processes among the three capitals. Crucially, the political will displayed at the highest level—symbolized by the direct monitoring of Moroccan commitments by His Majesty King Mohammed VI—stands as a decisive catalyst, ensuring the establishment of a unified and enduring policy line, even in the face of contingencies and fluctuations in political majorities within the allied states. •⁠ ⁠Mutualization of Investments and Benefits: On the economic front, the World Cup represents an unprecedented opportunity to boost trade and investment. The trilateral agreements directly influence the planning of major works: the goal is no longer to build isolated infrastructures, but integrated networks (ports, air links, potential high-speed rail connections) designed for interoperability. The harmonization of tourism offerings and incentivizing fiscal regimes for sponsors and investors is crucial to maximize shared benefits. The success of coordination in the logistical, economic, and security domains will not be merely a performance indicator; it will be the symbol of a collective capacity to manage a complex event on a transcontinental scale. II. Managing Complexities: The Challenges of Co-Development An event of this magnitude, operated by three sovereign states, naturally generates frictions and coordination challenges that require first-rate diplomatic and technical management. •⁠ ⁠The Challenge of Global Security and Integrated Transport: The primary obstacle is the creation of a unified security space for the millions of supporters on the move. This demands real-time information sharing, coordination of law enforcement agencies, and the harmonization of emergency protocols. Concurrently, the transport system must be conceived as a single network. The transit of teams and supporters between Europe and Africa must be fluid, reliable, and ecological, necessitating targeted investments in airport capacity and maritime services. •⁠ ⁠The Cultural and Civilizational Vector: Beyond sport, the World Cup is a diplomatic platform. The secondary, but fundamental, challenge is to move beyond simple technical organization to present an ideal model of intercultural coexistence. Morocco, Spain, and Portugal must invest in promoting their cross-cultural heritages, consolidating the values of peace and mutual respect. This involves qualifying national institutions not only in logistics but also in public management and global media interaction, to avoid the pitfalls of fragmented or sensationalist coverage. III. The Structuring Influence of Bilateral Agreements on Logistics The influence of existing agreements between the three countries is vital for infrastructure development. The current stage is characterized by high anticipation from the private sectors and sports observers, who are watching for the concrete acceleration of construction projects. The overall efficiency of the operation—whether considering the pre-event phase, execution during the tournament, or the post-realization legacy—rests entirely on the solidity of the triangular commitment. The transformation of infrastructures, from stadiums to training centers and reception areas, must be carried out in a spirit of normative alignment. In conclusion, the 2030 World Cup is not merely the sum of three national organizations; it is a project of strategic co-development. The strong historical relations uniting the Kingdom of Morocco, Portugal, and Spain, amplified by a constant and high-level political will, constitute the decisive element for transforming this bid into a resounding success, offering the world a precedent of successful integration between two shores.

Law 30-09: A “Tree with Bitter Fruits” Hindering the Development of Moroccan Sports 392

Imad Khater, 2 d.
- Politics - Society - Sports -
2.5 min read.
While Morocco’s recent performances on the international stage—particularly in football—demonstrate its growing dynamism, the legal framework governing the sports sector seems unable to keep pace with this evolution. Conceived in the wake of the 2008 Royal Letter and enacted in 2010, Law No. 30-09, which was meant to modernize the national sports system, now reveals—fifteen years after its delayed implementation—serious limitations. Marked by internal inconsistencies, deficient enforcement, and pervasive state interference, the law ultimately undermines its original purpose: to professionalize Moroccan sport and align it with international standards. I. Excessive Requirements and Forgotten Sanctions Born from a clear political will to reform Moroccan sport and provide it with a modern legal framework, Law 30-09 has quickly become a rigid and impractical instrument. One of its most emblematic—and controversial—provisions is the obligation imposed on certain sports associations to establish sports corporations (Sociétés Anonymes). While the intent was to ensure sound governance, fiscal transparency, and executive accountability, practice has revealed the limits of this approach. •⁠ ⁠A disproportionate constraint. Most associations lack the financial and organizational capacity to comply with such structural obligations. •⁠ ⁠A flawed and inapplicable framework. The law establishes three non-cumulative conditions triggering the obligation to form a sports company. Only the first has been clarified by regulation, while the other two—relating to turnover and payroll—were never defined by governmental decree. As a result, the rule remains largely inoperative, especially since the penalties for non-compliance are systematically ignored. •⁠ ⁠An unfinished reform. Even among the few clubs that have complied, the parent association still holds the majority of the share capital. This structural lock prevents the opening of capital to private investors, thus maintaining dependency on the old associative model rather than promoting professionalization. II. The Persistent Shadow of the State: An Interference Contrary to Autonomy Principles By its very nature, sport is a sphere of autonomy, an ethos enshrined in the Moroccan Constitution and in the regulations of international organizations such as FIFA. Yet Law 30-09 establishes the supervising ministry as the true guardian of the sector, concentrating significant and often excessive powers: •⁠ ⁠An extensive right of scrutiny. The ministry approves statutes, grants accreditation, and confers authorization to national federations. •⁠ ⁠A pronounced power of interference. The administration may impose standard contracts and, more seriously, revoke authorization or dissolve a federation in the event of a “serious violation.” Such prerogatives contradict the spirit of the Constitution, which reserves this power to the judiciary. •⁠ ⁠Institutional omnipresence. A state representative must sit within the governing bodies of both the national federations and the Moroccan National Olympic Committee (CNOM), reinforcing state oversight at the expense of autonomy. This predominant executive control contradicts the principles of independence that underpin both national constitutional law and the global sports governance model. III. The Ambiguous Status of Athletes: The Law’s Major Omission Beyond institutional deficiencies, Law 30-09 exposes a serious legal vacuum regarding the status of athletes. The professional athlete’s contract is treated as an ordinary employment contract—an assimilation that raises significant difficulties. •⁠ ⁠The legislator had to create several exceptions to the Labour Code (five-year fixed-term contracts, exclusivity clauses, conditions for unilateral termination), resulting in an incoherent hybrid regime. •⁠ ⁠Although classified as “employees,” professional athletes do not enjoy the social protection and retirement benefits normally afforded to workers. •⁠ ⁠As for amateur athletes, their status remains completely unaddressed by the law. The provisions aimed at supporting athlete training and post-career reconversion are equally deficient. They are neither mandatory nor widely implemented, few training centers exist, and many athletes lack the educational background needed to benefit from such programs. IV. The Need for a Moroccan Sports Code Faced with these structural weaknesses, a piecemeal revision of the law is no longer adequate. The codification of sports law—through the adoption of a comprehensive Moroccan Sports Code—is now an imperative step toward supporting the country’s international ambition. Drawing inspiration from the French model, such a reform would serve several key purposes: 1.⁠ ⁠Clarifying and consolidating the dispersed legal texts, regulations, and case law to facilitate specialization among legal practitioners. 2.⁠ ⁠Correcting inconsistencies by redefining the jurisdictional competences of the State and creating a sui generis legal status for professional and amateur athletes. 3.⁠ ⁠Modernizing the legal framework by integrating fiscal and social regimes specific to sports entities and individuals. Despite its initial promise of modernization, Law 30-09 has become a “tree with bitter fruits.” Instead of fostering professionalism, it has constrained the sector and amplified its institutional fragility. Only a complete codification—reflecting Morocco’s socio-economic realities and the principles of good governance—can ensure a coherent, autonomous, and sustainable framework for the country’s sports development.