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1.
Br J Community Nurs ; 26(6): 272-277, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34105361

RESUMO

Intermittent catheterisation (IC) has been in practice for more than 40 years and is considered the gold standard in the management of urinary retention in the neurological bladder. IC has many advantages over indwelling urethral or suprapubic catheterisation, including reducing the risk of infection, protecting the bladder and improving quality of life. However, complications can be caused by the practice of this technique, the most common of which is infection. This review discusses some of the common complications that can occur with the use of intermittent catheterisation, including urinary tract infection (UTIs) and urethral complications. It also highlights the role of the nurse in the management of its complications.


Assuntos
Retenção Urinária , Infecções Urinárias , Cateteres de Demora , Humanos , Qualidade de Vida , Cateterismo Urinário/efeitos adversos , Retenção Urinária/etiologia , Infecções Urinárias/etiologia , Infecções Urinárias/prevenção & controle
2.
BMC Pediatr ; 18(1): 307, 2018 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-30249232

RESUMO

Following publication of the original article [1], one of the authors flagged that the title of the article was submitted (incorrectly) with "Full title:" at the beginning.

3.
Tunis Med ; 96(1): 48-53, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30324992

RESUMO

BACKGROUND: The 2015 WHO classification of primary lung adenocarcinomas idendified not only new subtypes but also new prognostic groups. Solid and micropapillary adenocarcinomas are considered of bad prognosis, lepidici adenocarcinomas are considered of good prognosis and acinary and papillary ones are considered of intermediate prognosis. We aimed to assess the prognostic relevance of this classification through the experience of a specialized Department in Thoracic Oncology. METHODS: We described a survival study about 101 patients presenting primary adenocarcinomas diagnosed between 2008 and 2011. Survival curves were compared using the Log-Rank test. In order to assess the prognostic impact of the classification, 3 groups were formes: group 1 included lepidic adenocarcinomas, le group 2 included acinary and papillary subtypes and group 3 included solid subtype. A univariate analysis was performed to assess the age, sex, size, vascular emboli, lymph nodes, pTNM, histologic subtypes, neoadjuvant treatment and adjuvant treatment. Multivariate analysis using COX model was performed. RESULTS: There was no significant difference between the different subtypes. Besides, the multivariate analysis revealed the pTNM (p=0,02)  stage and the adjuvant treatment (p=0,007) as relevant prognostic factors. CONCLUSION: Our results are discordant with those reported in the literature. It seems that including large series is necessary in order to assess this prognostic classification.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico , Adenocarcinoma de Pulmão/mortalidade , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidade , Adenocarcinoma de Pulmão/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Departamentos Hospitalares , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Estadiamento de Neoplasias/normas , Patologia Clínica/normas , Prognóstico , Pneumologia/normas , Estudos Retrospectivos , Análise de Sobrevida , Tunísia/epidemiologia , Organização Mundial da Saúde
4.
Tunis Med ; 96(3): 172-177, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30325483

RESUMO

BACKGROUND: Studies on parents of children with autistic spectrum disorders' (ASD) quality of life (QOL) agree on its alteration and seek to identify risk factors in order to target interventions. AIMS: To study the QOL of a Tunisian population of parents of children with ASD and to look for risk factors specific to the Tunisian population. METHODS: We conducted a cross-sectional descriptive study of 50 parents of 50 children who met the DSM V criteria for autism spectrum disorder. A pre-established record was used to collect the biographical and clinical data. The severity of autism was determined using CARS. The SF-36, validated in Tunisia, made it possible to assess the QOL of the parents. RESULTS: The proportion of parents with impaired QOL was 64%. The average mental score was lower than the average physical summary score. Aggressiveness was the predominant factor that significantly altered parents' QOL at the total SF-36 score (p=0,03) and 5-dimensional levels (0.006


Assuntos
Transtorno do Espectro Autista , Pais , Qualidade de Vida , Adulto , Idoso , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pais/psicologia , Inquéritos e Questionários , Tunísia/epidemiologia , Adulto Jovem
5.
Tunis Med ; 96(8-9): 501-504, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30430528

RESUMO

OBJECTIVES: To investigate the link between pain sensitivity in autism spectrum disorders (ASD) and self-aggressive behavior. METHODS: we performed a cross-sectional study which involved 50 children fulfilling DSM-V criteria for ASD; confirmed by the Autism Diagnostic Interview Revised. The severity of autism was determined using the Childhood Autism Rating Scale (CARS).The psycho-educational profile (PEP-R) was used to assess the age of development and perception.  Sensitivity to pain was assessed with item IX of the CARS. Self-aggressive behavior was assessed by the Behavior Problems Inventory. RESULTS: Pain sensitivity was lowered in 40% and elevated in 4% of children. In the univariate analysis, no statistically significant association was found between normal sensitivity or hyper sensitivity to pain and the presence of auto-aggressiveness. A significant association was found between the presence of hypo-sensitivity to pain and the following variables: auto-aggression (p = 0.007, OR = 5.8, 95% CI = 1.5-21) , frequency of self-aggression (p = 0.001), intensity of self-aggression (p = 0.05), location of auto-aggressiveness at head and (P = 0.007, OR = 7.6, 95% CI = 1.8-14), higher score at CARS, and lower perception score at PEP-R (p = 0.012). Multiple-varied analysis identified risk factors for hypo-sensitivity to pain: lower perceptual score (p = 0.003, adjusted OR = 4.3, 95% CI = 1.9-54) and location of self-aggression at head and hands (p = 0.001, adjusted OR = 1.09, 95% CI = 1.02-1.09). CONCLUSION: It would be interesting to develop tools allowing a fine and precise evaluation of the painful sensation.


Assuntos
Agressão , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/epidemiologia , Limiar da Dor/fisiologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/etiologia , Agressão/fisiologia , Agressão/psicologia , Transtorno do Espectro Autista/fisiopatologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Dor/diagnóstico , Dor/epidemiologia , Insensibilidade Congênita à Dor/complicações , Insensibilidade Congênita à Dor/epidemiologia , Medição da Dor , Percepção da Dor/fisiologia , Fatores de Risco , Comportamento Autodestrutivo/fisiopatologia
6.
Tunis Med ; 96(2): 129-134, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30324978

RESUMO

OBJECTIVE: In this study, we aimed to analyze the trough plasmatic levels (C0) of the antiepileptic drugs (AED) administered by nasogastric tubes (NGT) in comatose patients and to draw up recommendations for therapeutic drug monitoring (TDM) and for the modalities of AED administration by NGT. METHODS: We conducted a retrospective study on comatose patients addressed over six years and 10 months in Clinical Pharmacology for C0 measurement of AED administered by NGT. RESULTS: In this study, the sex-ratio was 2.38 (44 patients). The patients' median age was 24 years. There was 14.5% of children (≤16 years). Among the 103 samples, C0 measurement concerned valproic acid in 57%, phenobarbital in 28 % and carbamazepine in 15%. Two AED or more were associated in 42% of patients. AED were associated to other drugs in 85% of cases. The AED C0 were subtherapeutic in 71% of cases. C0/Dp lower than recommanded in 65 %. In these samples, 55% presented at least one drug association with the concerned AED. In 45% of the cases, there was no drug association but a non-respect of modalities of AED administration by NGT in patients. CONCLUSION:   The drug monitoring is a useful tool to assess drug-drug interactions and to control modalities of AED administration in comatose patients.


Assuntos
Anticonvulsivantes/uso terapêutico , Coma/tratamento farmacológico , Monitoramento de Medicamentos/métodos , Epilepsia/tratamento farmacológico , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Coma/complicações , Coma/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Epilepsia/complicações , Epilepsia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
7.
BMC Pediatr ; 17(1): 208, 2017 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-29258474

RESUMO

BACKGROUND: Peripheral venous catheterization (PVC) is frequently used in children. This procedure is not free from potential complications. Our purpose was to identify the types and incidences of PVC complications in children and their predisposing factors in a developing country. METHODS: We conducted a prospective observational multicenter study in five pediatric and pediatric surgery departments over a period of 2 months. Two hundred fifteen PVC procedures were conducted in 98 children. The times of insertion and removal and the reasons for termination were noted, and the lifespan was calculated. Descriptive data were expressed as percentages, means, standard deviations, medians and interquartile ranges. The Chi2 test or the Fisher test, with hazard ratios and 95% confidence intervals (CI95%), as well as Student's t test or the Mann-Whitney U test were used to compare categorical and quantitative variables, respectively, in groups with and without complications. The Spearman test was used to determine correlations between the lifespan and the quantitative variables. The Kruskal Wallis test was used to test for differences in the median lifespan within 3 or more subgroups of a variable. Linear regression and logistic binary regression were used for multivariate analysis. A p-value <0.05 was considered significant. RESULTS: The mean lifespan was 68.82 ± 35.71 h. A local complication occurred in 111 PIVC (51.9%) cases. The risk factors identified were a small catheter gauge (24-gauge) (p = 0.023), the use of a volume-controlled burette (p = 0.036), a longer duration of intravenous therapy (p < 0.001), a medical diagnosis of respiratory or infectious disease (p = 0.047), the use of antibiotics (p = 0.005), including cefotaxime (p = 0.024) and vancomycin (p = 0.031), and the use of proton pump inhibitors (p = 0.004).The lifespan of the catheters was reduced with the occurrence of a complication (p < 0.001), including the use of 24-gauge catheters (p = 0.001), the use of an electronic pump or syringe(p = 0.036) and a higher rank of the intravenous device in each patient (p = 0.010). CONCLUSIONS: PVC complications were frequent in our pediatric departments and are often associated with misuse of the device. These results could engender awareness among both doctors and nurses regarding the need for rationalization of the use of PVC and better adherence to the recommendations for the use of each drug and each administration method.


Assuntos
Cateterismo Periférico/efeitos adversos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Lineares , Modelos Logísticos , Masculino , Análise Multivariada , Estudos Prospectivos , Fatores de Risco
8.
Ann Pathol ; 37(6): 467-471, 2017 Dec.
Artigo em Francês | MEDLINE | ID: mdl-29153888

RESUMO

INTRODUCTION: The new classification of lung cancer contains modifications of terminology and a new subdivision of the tumors with the most relevant modifications concerning the group of adenocarcinomas. The latter has been increasing and represents nowadays the most frequent type. Our aim was to assess the reproducibility of the new classification through the experience of a Department of Pathology specialized in thoracic pathology. METHODS: Our study included initially 106 cases diagnosed as adenocarcinomas and reviewed by 2 pathologists and 1 referee. Five cases were ruled out because they corresponded to squamous carcinoma according to the immunohistochemical findings. The same number of slides was reviewed without a limit of time. Statistical analysis was performed using the SPSS software. The Kappa index was estimated and a second coefficient: rho was analyzed. RESULTS: A total concordance was noticed in 82 cases (81.2%) and a discordance was noticed in 19 cases (18.8%). The agreement degree was good with an index Kappa estimated to 0.743 and a rho index reaching 0.763. CONCLUSION: Our study highlights the good reproducibility of the 2015 WHO classification of lung cancer among a trained team. Whereas, in order to improve the reproducibility of such a classification, even in non specialised departments, a training of the pathologists is necessary in order to highlight the prognostic impact of this classification.


Assuntos
Adenocarcinoma de Pulmão/classificação , Neoplasias Pulmonares/classificação , Adenocarcinoma de Pulmão/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Serviço Hospitalar de Patologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tunísia
9.
Tunis Med ; 95(4): 236-241, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29492926

RESUMO

INTRODUCTION: Several theses are supported, every year, in the Faculty of Medicine of Tunis but their scientific become is this day unknown. The most part of specialities have not bibliometric data. OBJECTIVES: This work had for objectives to study the still unknown future of theses of Tunis Faculty of Medecine during 2004-2005, in terms of publication in indexed reviews and to determine the predictive factors of their publication. METHODS: This was a descriptive bibliometric study of theses supported at the Tunis Faculty of Medicine between January 1st, 2004 and december 31st, 2005. The data collected concerned :number of theses, involved specialities, discipline, type of theses, type of study, number of studied cases (<25 ou  25), methodology of the work, identity of the student, the director as well as the number and the rank of one or several directors. The productivity of the various specialities was estimated by two indicators: Ratio thesis-teacher and index of becoming theses. The publication of the theses has been sought in engines "Medline" and "scopus. Predictive factors for publication were sought. RESULTS: Six hundred and thirteen theses were supported, including 57.7% belonged to the medical disciplines. The attributed mention was "very honorable with the congratulations of the jury" in 71,0% of cases and "very honorable with the congratulations of the jury and the proposal at the price of thesis " in 24,0% of the cases. Thirteen comma four pourcent (13.4%) was the rate of publication. These theses were published when the attributed mention was "very honorable with the congratulations of the jury and the proposal at the price of thesis "(p=0.05), when the discipline was community (p <10-3), and when the study was of epidemiological type (p=0.05).The ratio theses-teacher- year was lower than 1 in 70% of cases and the index of becoming theses varied from 0 and 18.7 across all disciplines. The thesis were published in half of the cases in the the review"La Tunisie Médicale". The median of citation was 2 [0-66 citations]. The publication was found thanks to the name of the student which appeared as author in 61.0% of the theses. The student was first author in 12 cases (24.5%). CONCLUSION: The rate of publication of theses of Tunis Faculty of Medecine during 2004-2005 aws little raised by 13.4%. This rate should be considered as a basic figure with regard to wich will be compared the future impact of courses made at present in our Faculty.


Assuntos
Dissertações Acadêmicas como Assunto , Bibliometria , Editoração/estatística & dados numéricos , Faculdades de Medicina , Previsões , Fatores de Tempo , Tunísia
10.
Tunis Med ; 95(6): 422-428, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29512798

RESUMO

OBJECTIVE: Assess Death Certificates accuracy (DCs) issued by a teaching emergency department in Tunis. METHODS: It is a descriptive study. We included all death certificates issued in the Emergency Department of a teaching Hospital in Tunis over 17 months period (October 2013 - March 2014). Twenty-one errors have been predefined and classified as "Editing errors" or "Medical analysis error" then as major or minor errors. RESULTS: 757 certificates were studied; all DCs had at least three errors with an average number of errors of 6.92±1.55.      The mechanism of death was inadequate in 20% of the DCs.  The cause of death was "unacceptable" in 21% of the DCs. CONCLUSION: The results are similar to those reported in international literature. Therefore, it is urgent to start working on further and regular training on how to fulfil a death certificate for undergraduate and postgraduate medical students.


Assuntos
Atestado de Óbito , Serviço Hospitalar de Emergência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Confiabilidade dos Dados , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Tunísia , Adulto Jovem
11.
Tunis Med ; 95(3): 192-195, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29446813

RESUMO

BACKGROUND: Preterm delivery is the major cause of adverse outcomes in twin pregnancy.  A shortened cervix at 20-24 weeks of amenorrhea is a good predictor of preterm birth in asymptomatic patients. However, there are no recommendations for serial cervical length measurements for these high risk pregnancies. OBJECTIVES: To evaluate the benefits from monthly cervical length monitoring in asymptomatic twin pregnancies. METHODS: This was a prospective study. We compared two groups of twin pregnancies (groupe 1: patients with a monthly and systematic transvaginal ultrasound measurement of the cervical length and groupe2 : patients without monitoring of cervical length) in terms of premature labor screening, mean gestational age at the diagnosis of preterm labor, time saved by tocolysis in case of preterm labor and  mean gestational age at delivery. RESULTS: Ninety nine twin pregnancies were included: 35 patients had a systematic, monthly cervical length (group1) and 64 women had a traditional prenatal care without monitoring of cervical length (group2). A significant relationship between a cervical length measured between 22 and 24 weeks of amenorrhea inferior to 30 mm and preterm labor with a high specificity (100%) and a high positive predictive value (100%). The sensitivity remains average (45%).A significant benefit was demonstrated through this systematic ultrasound measurement of cervical length for the screening of preterm labor (p=0.018), the time saved by tocolysis (p=0.023), as well as the medium gestational age at birth (p=0.046). CONCLUSION: Serial cervical length measurements seems to be a significant predictor of early preterm birth in asymptomatic twin pregnancies.


Assuntos
Medida do Comprimento Cervical , Colo do Útero/diagnóstico por imagem , Gravidez de Gêmeos , Adulto , Medida do Comprimento Cervical/métodos , Colo do Útero/fisiologia , Feminino , Humanos , Monitorização Fisiológica/métodos , Valor Preditivo dos Testes , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Gêmeos , Ultrassonografia Pré-Natal
12.
Tunis Med ; 94(2): 167-71, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27532542

RESUMO

BACKGROUND: Medical writing is a coded language; its purpose is to convey a scientific message. In pathology, specialty involving the study of cell and tissue, quantitative and qualitative production of medical doctoral theses and their thematic focus has not been studied. The aim of this study was to analyze the pathology theses on the level of form, the background and methodology. METHODS: Descriptive retrospective study of medical doctoral theses in the specialty "Pathology", listed in the catalog of theses of the library of the Faculty of Medicine of Tunis and supported between 2000 and 2010. Each thesis has been subject of a direct reading, systematic and thorough. RESULTS: The study involved 189 pathology theses. The average overall productivity per academic pathologist was 5.5 theses. Gastrointestinal pathology was the most studied theme (24.9%). Tumor pathology was addressed in 74.1% of the theses. The IMRAD structure was respected in 57.7% of theses; by assistant professor than by associate professor and professor (p = 0.005). The summary was structured in 88.3% of theses, comparably with the grade of the thesis director (p = 0.5) and with the grade of PhD student (p = 0.08). The transcript of references did not meet the recommendations of Vancouver in 87.8% of theses and irrespective of the rank of director of thesis (p = 0.2). CONCLUSION: The pathology theses presented some shortcomings, particularly in the quality of medical writing. To remedy this problem, our faculty should increase efforts to improve the quality of scientific work, in order to have a better view of medical research in Tunisia.

13.
Tunis Med ; 94(3): 172-5, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27575498

RESUMO

BACKGROUND: The thesis is an research work wish must submit to rigorous scientific criteria. However, this research effort remains inaccessible to international scientific communities. The aims of this study were to determinate the publication rates in indexed journals and factors affecting publication. METHODS: This was a retrospective descriptive study of pathology theses listed in the theses catalog of the library medical university of Tunis whose theses were supported between 2000-2010. Publication had been searched in databases "Pub Med". The number of citations received by each published thesis was recorded in www. Scopus.com. RESULTS: Our study concerned 189 theses. Thirty five original articles were derived from 33 theses (17.5%). Eleven medical indexed journals have made the support of articles, dominated by generalist journal (La Tunisie Médicale: 68.6%), specialist journals (Annales de Pathologies, Pathology, Ultrastructural Pathology: 11.4%). The number of article citations had an average of 1. Theses with informative title had been more publication (p=0.005). Theses with structured introduction had been more publication (p=0.002). CONCLUSION: Publication rate of pathology theses in indexed journals are relatively low. This publication rate could be improved by the organization of seminars and workshops on writing articles from theses or by the improvement of these articles in national competitions.


Assuntos
Dissertações Acadêmicas como Assunto , Editoração/estatística & dados numéricos , Indexação e Redação de Resumos , Humanos , Patologia , PubMed , Estudos Retrospectivos , Faculdades de Medicina , Tunísia
14.
Tunis Med ; 94(1): 6-11, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27525598

RESUMO

BACKGROUND:   A polymorphism upstream of interleukin (IL)-28B was recently identified to be associated with a 2-fold difference in sustained virologic response (SVR) to pegylated interferon-alpha and ribavirin therapy in a large cohort of treatment-naive, adherent patients with chronic hepatitis C (CHC) virus genotype 1 (HCV-1) infection. AIM: We sought to confirm the polymorphism's clinical relevance by intention-to-treat analysis evaluating on-treatment virologic response and SVR. METHODS: We perform a prospective study in gastroenterology unitof tunis'military hospital in collaboration with immunology unit, military center of blood transfusion and laboratory of biochemistry of childrens' hospital of Tunis. HCV patients were genotyped as CC, CT or TT at the polymorphic site rs12979860 and TT, TG or GG at the polymorphic site rs8099917. Viral kinetics and rates of rapid virologic response (RVR, week 4) and SVR were compared by IL-28B type in a tunisian population. RESULTS: 154 patients including 80 healthy blood donors(sexratio: 1, mean age: 40.35 ±10.15 years) and 74 patients treated for CHC (39 men and 35 women; mean age = 51.7± 9.4 years) were enrolled. 35.6% of patients were genotyped as CC at the polymorphic site rs12979860 and 69.1% as TT at the polymorphic site rs8099917. The CC IL-28B type at rs12979860 was associated with a greater likelihood of SVR (77% vs 31.9%; p<0.001; OR: 7.11 [2.37-21.35]) compared with CT and TT. The CC IL-28B type at rs12979860 wasn't associated with improved of rapid virologic response (RVR). In a multivariate logistic regression model, the rs12979860 CC genotype predicted SVR (p<0.001; OR: 7.11 IC95% [2.37-21.35]). The TT IL-28B type at rs 8099917 wasn't associated with improved RVR and SVR compared with TG and GG. CONCLUSION: In treatment-naive HCV patients treated with pegylated interferon and ribavirin, a polymorphism upstream CC at the site rs12979860 of IL-28B is associated with increased sustained virologic response and effectively predicts treatment outcome.


Assuntos
Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Interleucinas/genética , Adulto , Quimioterapia Combinada , Feminino , Estudo de Associação Genômica Ampla , Genótipo , Hepacivirus/genética , Humanos , Interferon-alfa/uso terapêutico , Interferons , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Estudos Prospectivos , Ribavirina/uso terapêutico , Tunísia
15.
Tunis Med ; 94(4): 326-331, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27704519

RESUMO

Exertional heat stroke is defined as hyperthermia associated with neurological signs related to intense physical activity performed in a hot environment. This is a medical emergency and life-threatening. In this study, we investigated four cases of exertional heat stroke hospitalized at the military hospital in Tunis (Tunisia) to describe the clinical, therapeutic and preventive characteristics and factors favoring this disease. Four young soldiers, 23 to 44 years older, have developed Exertional heat stroke after Intense and prolonged exercise. Exercises were performed in May and June, in high ambient temperature, high humidity and lack of wind. Three soldiers were in battle dress, a backpack and their weapon. Our four subjects had overweight, were not sufficiently trained and were highly motivated. Insufficient hydration and a diet rich in carbohydrates were noted. Upon hospitalization, patients were febrile and had neurological disorders, neuromuscular disorders, rhabdomyolysis and hemoconcentration. The medical care consisted of a rehydration and oxygen.


Assuntos
Febre/etiologia , Golpe de Calor/etiologia , Militares , Esforço Físico , Adulto , Febre/fisiopatologia , Febre/terapia , Hidratação/métodos , Golpe de Calor/fisiopatologia , Golpe de Calor/terapia , Hospitais Militares , Humanos , Oxigênio/administração & dosagem , Tunísia , Adulto Jovem
16.
Tunis Med ; 93(10): 623-7, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26895125

RESUMO

BACKGROUND: The need for a scientific evaluation of the work life quality has become today evident to all. AIM: This study aims to evaluate the short-term impact of the workload on the quality of life of employed Tunisian women. METHODS: A cross-sectional survey on a representative sample of 394 women working in the sectors of textile, shoe-manufacturing and administration was conducted between 2009 and 2010. The quality of life was assessed using the 36-item Short Form Health Survey questionnaire (SF-36). RESULTS: The overall quality of life score was 67.2 ± 15.2. There was an uneven weathering of the different SF-36 scales. Vitality scale was the most affected with a score below 50. Quality of life of employed women differed significantly depending on the activity sector (p≤ 0.001). The SF-36 score value was lower in the sector of textile. Social load, physical and mental workload significantly influenced the quality of life. CONCLUSION: The quality of life in employed women was correlated with the workload. The use of SF-36 to measure the quality of life is useful for the evaluation of work life quality.

17.
Tunis Med ; 93(11): 668-72, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27126421

RESUMO

BACKGROUND: Endoscopic polypectomy is the technique of choice for resection of colorectal polyps and has a major interest in the prevention of colorectal cancer. The aim of this study was to evaluate the technique, results and tolerance of colonic polypectomy. METHODS: We conducted a retrospective study including 200 consecutive patients with colorectal polyps and who underwent therapeutic endoscopic polypectomy, performed at the endoscopy unit of the Military Hospital in Tunis, between december 2008 and december 2012. RESULTS: Hundred and forty men and 60 women were included. The average age was 58.5 ± 14.5 years. The polyp was unique in more than half of cases. The most frequent location was the sigmoid colon (30.5%). Approximately, » of the polyps was larger than 10 mm. According to the Paris endoscopic classification, 78% of polyps were sessile (Is). Seventy-two percent of polyps were adenomas. Twentyfive per cent of them contained a villous component, 40 % were advanced adenomas and 3% malignant adenomas. Regarding polypectomy, 232 polyps (64%) were treated by the cold forceps, 68 polyps (18.5 %) by the diathermic snare and 63 (17.5 %) by a mucosal resection. Thirty-one percent of polypectomy were fragmented. The evaluation of the efficacy of treatment among adenomas and potentially malignant tumors, had identified 36% of treatment failure. The common independent predictive factor of fragmented resection and treatment failure were the size ≥ 10 mm (p <10-3). Among a total of 363 polypectomies, 23 (6.3%) were complicated, by 11 procedural bleeding, 11 micro-perforations and 1 delayed hemorrhage. The common independent predictive factor of these complications was the size ≥ 10 mm (p <10-3). During following, there were 12 residual polyps (6%), 36 new polyps (18%) and 6 colorectal cancers (3%). The only independent predictive factor of an unfavorable course was the multiplicity of polyps. The colorectal polyps-free survival was 90.2% at 12 months and 88.4% at 24 months. CONCLUSION: The evaluation of colorectal polypectomy in our series had confirmed the effectiveness and the low morbidity of this practice. The polyp size was the only independent predictive factor of both treatment failure and complications.

18.
Tunis Med ; 93(12): 742-5, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27249381

RESUMO

BACKGROUND: In front of the considerable impact of the viral hepatitis C, the prevention is more than ever a priority, based essentially on the screening. AIM: We realized an epidemiological study in a population of young recruits with the aim of considering prevalence of anti-hepatitis C Virus (anti-HCV) antibodies, describing its epidemiological evolution and establishing a cartography of the viral hepatitis C in Tunisia. METHODS: Epidemiological retrospective study of prevalence was realized from the data of the screening of anti-HCV antibodies from 2003 till 2012 of all the young recruits suggested to be incorporated for the national service or suggested to be recruited as career soldier. The study was exhaustive concerning 175 322 young and healthy male adults aged between 20 and 30 years old, originating from all parts of Tunisia. The screening was realized by third and fourth generation ELISA tests then validated by Immunoblot. RESULTS: The prevalence was 0.11% and the confirmed prevalence was 0.07%. The positive subjects were mainly between 20 and 25 years old (82.32%) and 91.05% were detected within the framework of their incorporations to the national service. The lowest prevalence was 0.07% in 2004, and the highest was 0.17% in 2011, without a significant tendency in the increase or in the decrease during the period of study (r = 0.857 ; p = 0.564). The screening of anti-VHC antibodies had an unequal geographical distribution according to a North-South decreasing gradient. The highest proportions were registered in the North-West (23.23%) and the District of Tunis (22.73%), contrary to the South-East which was weakly affected (3.54%). The governorates with the highest proportions were Tunis (19.19%), Bizerte (11.62%) and Jendouba (8.59%), the governorates of Monastir and Tataouine were weakly affected (0.51%). CONCLUSION: Prevalence of anti-HCV antibodies in the young and male Tunisian population was weak, stable without significant tendency in the increase or in the decrease from 2003 till 2012, characterized by an unequal geographical distribution according to a North-South decreasing gradient.

19.
Tunis Med ; 102(4): 212-216, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38746960

RESUMO

INTRODUCTION: The valorisation of thesis through its publication is necessary to enhance its visibility. Few data exist concerning the characteristics of theses defended at the Tunis faculty of medicine. AIM: Examine the publication rate of pediatric theses and identify factors associated with an increased publication rate. METHODS: We conducted a cross-sectional descriptive bibliometric study of pediatric theses defended at the Faculty of Medicine of Tunis over 15 years, from 2006 to 2020. Theses were retrieved from the catalog of the faculty library. Publications had been searched in databases "Pub Med ", and "Google Scholar" until December2021. RESULTS: The study involved 235 pediatric theses. Sixty-eight theses were published, representing 29% of the total. The main topics of published theses were neonatology (16%) and hematology (15%). The language of publication was French and English in 55% and 45% of cases, respectively. All publications in Q1 and Q2 journals were written in English. The only independent factor predicting publication of theses was the very honourable mention with congratulations of the jury and proposal for the thesis prize (p=0,007). CONCLUSION: Additional assessments will be necessary to identify the obstacles to the publication of theses.


Assuntos
Bibliometria , Pediatria , Editoração , Tunísia/epidemiologia , Estudos Transversais , Humanos , Pediatria/estatística & dados numéricos , Pediatria/organização & administração , Editoração/estatística & dados numéricos , Dissertações Acadêmicas como Assunto , Criança , Faculdades de Medicina/estatística & dados numéricos , Docentes de Medicina/estatística & dados numéricos , Publicações/estatística & dados numéricos
20.
Asian Cardiovasc Thorac Ann ; 32(1): 45-65, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38009802

RESUMO

BACKGROUND: The diagnosis of lung cancer is based on the microscopic exam of tissue or liquid. During the recent decade, many biomarkers have been pointed to have a potential diagnostic role. These biomarkers may be assessed in blood, pleural effusion or sputum and they could avoid biopsies or other risky procedures. The authors aimed to assess the diagnostic performances of biomarkers focusing on micro-RNA and metabolites. METHODS: This meta-analysis was conducted under the PRISMA guidelines during a nine-year-period (2013-2022). the Meta-Disc software 5.4 (free version) was used. Q test and I2 statistics were carried out to explore the heterogeneity among studies. Meta-regression was performed in case of significant heterogeneity. Publication bias was assessed using the funnel plot test and the Egger's test (free version JASP). RESULTS: According to our inclusion criteria, 165 studies from 79 articles were included. The pooled SEN, SPE and dOR accounted, respectively, for 0.76, 0.79 and 13.927. The AUC was estimated to 0.859 suggesting a good diagnostic accuracy. The heterogeneity in the pooled SEN and SPE was statistically significant. The meta-regression analysis focusing on the technique used, the sample, the number of biomarkers, the biomarker subtype, the tumor stage and the ethnicity revealed the biomarker number (p = 0.009) and the tumor stage (p = 0.0241) as potential sources of heterogeneity. CONCLUSION: Even if this meta-analysis highlighted the potential diagnostic utility of biomarkers, more prospective studies should be performed, especially to assess the biomarkers' diagnostic potential in early-stage lung cancers.


Assuntos
Neoplasias Pulmonares , MicroRNAs , Humanos , MicroRNAs/genética , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Estudos Prospectivos , Biomarcadores , Biópsia , Biomarcadores Tumorais/genética
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