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1.
Hum Genomics ; 15(1): 63, 2021 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-34657628

RESUMO

BACKGROUND: Mutations in the SLC29A3 gene, which encodes the nucleoside transporter hENT3, have been implicated in syndromic forms of histiocytosis including H syndrome, pigmented hypertrichosis with insulin-dependent diabetes, Faisalabad histiocytosis and Familial Rosai-Dorfman disease (RDD). Herein, we report five new patients from a single family who present with phenotypes that associate features of H syndrome and Familial Rosai-Dorfman disease. METHODS: We investigated the clinical, biochemical, histopathological and molecular findings in five Tunisian family members' diagnosed with Familial RDD and/or H syndrome. The solute carrier family 29 (nucleoside transporters), member 3 (SLC29A3) gene was screened for molecular diagnosis using direct Sanger sequencing. RESULTS: Genetic analysis of all affected individuals revealed a previously reported missense mutation c.1088 G > A [p.Arg363Gln] in exon 6 of the SLC29A3 gene. Four affected members presented with clinical features consistent with the classical H syndrome phenotype. While their cousin's features were in keeping with Familial Rosai-Dorfman disease diagnosis with a previously undescribed cutaneous RDD presenting as erythematous nodular plaques on the face. This report underlines the clinical variability of SLC29A3 disorders even with an identical mutation in the same family. CONCLUSION: We report a rare event of 5 Tunisian family members' found to be homozygous for SLC29A3 gene mutations but showing a different phenotype severity. Our study reveals that despite a single mutation, the clinical expression of the SLC29A3 disorders may be significantly heterogeneous suggesting a poor genotype-phenotype correlation for the disease.

3.
Artigo em Inglês | MEDLINE | ID: mdl-34619764

RESUMO

OBJECTIVE: Patients with prefrontal cortex damage often transgress social rules and show lower accuracy in identifying and explaining inappropriate social behavior. The objective of this study was to examine the relationship between the ability to perceive other unintentional transgressions of social norms and both decision making and emotion recognition as these abilities are critical for appropriate social behavior. METHOD: We examined a group of patients with focal prefrontal cortex damage (N = 28) and a group of matched control participants (N = 28) for their abilities to detect unintentional transgression of social norms using the "Faux-Pas" task of theory of mind, to make advantageous decisions on the Iowa gambling task, and to recognize basic emotions on the Ekman facial affect test. RESULTS: The group of patients with frontal lobe damage was impaired in all of these tasks compared with control participants. Moreover, all the "Faux-Pas", Iowa gambling, and emotion recognition tasks were significantly associated and predicted by executive measures of inhibition, flexibility, or planning. However, only measures from the Iowa gambling task were associated and predicted performance on the "Faux-Pas" task. These tasks were not associated with performance in recognition of basic emotions. These findings suggest that theory of mind, executive functions, and decision-making abilities act in an interdependent way for appropriate social behavior. However, theory of mind and emotion recognition seem to have distinct but additive effects upon social behavior. Results from VLSM analysis also corroborate these data by showing a partially overlapped prefrontal circuitry underlying these cognitive domains.

4.
Soc Neurosci ; : 1-20, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34544320

RESUMO

Despite the key role that decoding of social-perceptual cues from faces plays in interpersonal communication, it is only recently that the potential of prefrontal cortex damage to disrupt this ability has been recognized. In fact, few studies to date had assessed whether the ability to identify the state of mind of others from the whole or part of the face is disrupted after prefrontal cortex damage and whether these two abilities are associated and share overlapped neural systems. In the present study, 30 patients with focal prefrontal lesions and 30 matched control subjects were assessed on their ability to recognize six basic emotions from facial expressions of the whole face and to identify states of mind of others from photographs of only the eyes using the "Reading the Mind in the Eyes Task". Results showed that frontal patients were significantly impaired compared with control subjects on both tasks. Moreover, regression analyses showed that these two abilities are associated and reciprocally predictive of one another. Finally, using voxel-based lesion analysis; we identified a partially common bilaterally distributed prefrontal network in the decoding of both emotional cues from both the whole face and eyes centered within the dorsomedial and ventral regions with extension to the lateral frontal pole.

6.
Artigo em Inglês | MEDLINE | ID: mdl-33871210

RESUMO

Mycoplasma pneumoniae is a well-known cause of community-acquired pneumonia, mostly associated with dermatological manifestations especially with mucosal involvement and targetoid cutaneous lesions. For many years, it was considered among the spectrum of erythema multiforme. Recently, some authors have recommended the creation of a new syndrome called "mycoplasma-induced rash and mucositis." This new syndrome has distinct epidemiological, clinical and histological features making it different from drug-induced Stevens-Johnson syndrome, toxic epidermal necrosis and erythema multiforme. Herein, we report two patients with acute Mycoplasma pneumoniae respiratory tract infection presenting severe mucocutaneous lesions in accordance with this new syndrome.

7.
J Surg Res ; 259: 465-472, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33616077

RESUMO

BACKGROUND: Within the operating rooms (ORs), distractions occur on a regular basis, which affect the surgical workflow and results in the interruption of urgent tasks. This study aimed to observe the occurrence of intraoperative distractions in Tunisian ORs and evaluate associations among distractions, teamwork, workload, and stress. METHODS: This observational cross-sectional study was conducted in four different ORs (orthopedic, urology, emergency, and digestive surgery) of Sahloul University Hospital for a period of 3 mo in 2018. Distractions and teamwork were recorded and rated in real time during the intraoperative phase of each case using validated observation sheets. Besides, at the end of each operation, stress and workload of team members were measured. RESULTS: Altogether, 50 cases were observed and 160 participants were included. Distractions happened in 100% of the included operations. Overall, we recorded 933 distractions that occurred once every 3 min, with a mean frequency of M = 18.66 (standard deviation [SD] = 8.24) per case. It is particularly noticeable that procedural distractions occurred significantly higher during teaching cases compared with nonteaching cases (M = 3.85, M = 0.60, respectively, P < 0.001). The mean global teamwork score was M = 3.85 (SD = 0.67), the mean workload score was M = 58.60 (SD = 24.27), and the mean stress score was M = 15.29 (SD = 4.00). Furthermore, a higher stress level among surgeons was associated with distractions related to equipment failures and people entering or exiting the OR (r = 0.206, P < 0.01 and r = 0.137, P < 0.01, respectively). Similarly, nurses reported a higher workload in the presence of distractions related to the work environment in the OR (r = 0.313, P < 0.05). CONCLUSIONS: This study highlighted a serious problem, which often team members seem to ignore or underestimate. Taking our findings into consideration, we recommend the implementation of the Surgical Checklist and preoperative briefings to reduce the number of surgical distractions. Also, a continuous teamwork training should be adopted to ensure that OR staff can avoid or handle distractions when they happen.


Assuntos
Estresse Ocupacional/epidemiologia , Salas Cirúrgicas/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Cirurgiões/organização & administração , Análise e Desempenho de Tarefas , Comunicação , Estudos Transversais , Feminino , Humanos , Masculino , Estresse Ocupacional/etiologia , Estresse Ocupacional/prevenção & controle , Estresse Ocupacional/psicologia , Salas Cirúrgicas/estatística & dados numéricos , Duração da Cirurgia , Equipe de Assistência ao Paciente/estatística & dados numéricos , Cirurgiões/psicologia , Cirurgiões/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/educação , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Fluxo de Trabalho , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
8.
J Neuropsychol ; 15(3): 533-563, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33595204

RESUMO

Previous studies have shown inconsistent findings regarding the contribution of the different prefrontal regions in emotion recognition. Moreover, the hemispheric lateralization hypothesis posits that the right hemisphere is dominant for processing all emotions regardless of affective valence, whereas the valence specificity hypothesis posits that the left hemisphere is specialized for processing positive emotions while the right hemisphere is specialized for negative emotions. However, recent findings suggest that the evidence for such lateralization has been less consistent. In this study, we investigated emotion recognition of fear, surprise, happiness, sadness, disgust, and anger in 30 patients with focal prefrontal cortex lesions and 30 control subjects. We also examined the impact of lesion laterality on recognition of the six basic emotions. The results showed that compared to control subjects, the frontal subgroups were impaired in recognition of three negative basic emotions of fear, sadness, and anger - regardless of the lesion laterality. Therefore, our findings did not establish that each hemisphere is specialized for processing specific emotions. Moreover, the voxel-based lesion symptom mapping analysis showed that recognition of fear, sadness, and anger draws on a partially common bilaterally distributed prefrontal network.


Assuntos
Reconhecimento Facial , Emoções , Expressão Facial , Humanos , Córtex Pré-Frontal/diagnóstico por imagem , Reconhecimento Psicológico
9.
Aust Crit Care ; 34(4): 363-369, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33121872

RESUMO

INTRODUCTION: Critical care nurses are considered the key to patient safety improvement and play a vital role in enhancing quality of care in intensive care units (ICUs) where adverse events are frequent and have severe consequences. Moreover, there is recognition of the importance of the assessment and the development of patient safety culture (PSC) as a strategic focus for the improvement of patient safety and healthcare quality, notably in critical care settings. OBJECTIVES: This study aimed to assess critical care nurses' perception of PSC and to determine its associated factors. METHODS: This cross-sectional study was conducted among nurses working in the ICUs of the Tunisian centre (six Tunisian governorates). The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture questionnaire, comprising 10 dimensions and a total of 50 items. RESULTS: A total of 249 nurses from 18 ICUs participated in the study, with a participation rate of 87.36%. The dimensions scores ranged between 17.2% for the dimension "frequency of events reported" and 50.1% for the dimension "teamwork within units". Multivariable logistic regression indicated that respondents who worked in private hospitals were five times more likely to have a developed PSC (adjusted odds ratio [AOR]: 5.34; 95% confidence interval [CI], [2.28, 12.51]; p < 10-3). Similarly, participants who worked in a certified hospital were two times more likely to have a more developed PSC than respondents who work in noncertified hospitals (AOR: 2.51; 95% CI, [.92-6.82]; p = 0.041). In addition, an increased nurse-per-patient ratio (i.e., reduced workload) increased PSC (AOR: 1.10; 95% CI, [1.02-1.12]; p = 0.018). CONCLUSION: This study has shown that the state of critical care nurses' PSC is critically low and these baseline results can help to form a plan of actions for improvements.

10.
Psychol Health Med ; 26(2): 212-220, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32835517

RESUMO

Burnout is a major issue among healthcare students and a public health issue in general. Indeed, the consequences of student burnout are as complex as other mental distress factors, such as those concerned with smoking and alcohol consumption, or an unhealthy lifestyle.  This study aimed to determine the prevalence of burnout among health sciences students and to determine its associated factors. This is a cross-sectional descriptive study conducted among 368 students of a Tunisian institution using the French validated version of the MBI-SS. The prevalence of burnout was 64.4%. The presence of a diagnosed health problem, a diagnosed mental disorder or sleep problems were associated with burnout. Students who live alone are significantly the most emotionally exhausted (p=0.010) and the most cynical (p=0.033). Students who had a low socio-economic level are significantly more cynical than those who had a medium or high socio-economic level (p=0.032). Performing leisure activities and practicing physical activities were associated with emotional exhaustion (p=0.007, p= 0.008, respectively).In our study, burnout is prevalent among Tunisian health sciences students. Many factors were found to be associated with this syndrome. These findings reinforce the need to establish early preventive strategies to encounter this problem and its consequent risks.


Assuntos
Esgotamento Psicológico/epidemiologia , Estudantes de Ciências da Saúde/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Estudantes de Ciências da Saúde/estatística & dados numéricos , Tunísia/epidemiologia , Adulto Jovem
11.
Int Emerg Nurs ; 54: 100941, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33341462

RESUMO

BACKGROUND: Emergency departments (EDs) are considered a high-risk environment because of the high frequency of adverse events that occur within. Measuring patient safety culture is an important step that assists healthcare facilities in planning actions to improve the quality of care provided to patients. This study aims to assess patient safety culture within EDs and to determine its associated factors. METHODS: A cross-sectional study conducted among professionals from all the EDs of public and private healthcare institutions in Tunisia. It spread from June to September 2017. We used the validated French version of the Hospital Survey on Patient Safety Culture questionnaire. RESULTS: In total, 11 EDs were included in the study, with 442 participants and a participation rate of 80.35%. All the ten dimensions of patient safety culture were in need of improvement. 'Teamwork within units' scored the highest with 46%, however, the lowest score was attributed to 'the frequency of adverse events reporting' (19.6%). Several factors have been found significantly related to safety culture. Private EDs have shown significantly higher scores regarding nine patient safety culture dimensions. CONCLUSION: This study showed a concerning perception held by participants about the lack of a patient safety culture in their EDs. Also, it provided baseline results giving a clearer vision of the aspects of safety that need improvement.


Assuntos
Serviço Hospitalar de Emergência , Gestão da Segurança , Estudos Transversais , Humanos , Equipe de Assistência ao Paciente/normas , Inquéritos e Questionários , Tunísia
12.
J Egypt Public Health Assoc ; 95(1): 11, 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32813132

RESUMO

BACKGROUND: Hand hygiene (HH) is considered the most important measure to tackle the transmission of healthcare-associated pathogens. However, compliance with recommendations is usually low and effective improvement strategies are needed. We aimed to assess the effectiveness of an intervention targeting hand hygiene promotion among healthcare workers (HCWs). METHODS: We conducted a pre-post interventional study design in the university hospital Sahloul, Sousse, Tunisia, from January 2015 to December 2016. The intervention program consisted of training sessions and distribution of posters of hand hygiene guidelines. To assess the evolution of HH observance at pre- and post-intervention, the same observation form was distributed and collected at healthcare workers' workplace. RESULTS: Of the 1201 and 1057 opportunities for hand hygiene observed among all categories of HCWs, overall compliance enhanced significantly from 32.1 to 39.4% (p < 0.001) respectively at pre- and post-intervention. Nurses were the most compliant with a significant improvement from 34.1 to 45.7% (p < 0.001) respectively at pre- and post-intervention. Furthermore, analysis by department showed significant improvement of compliance in orthopedic department (p < 0.001), maxillofacial-surgery department (p < 0.001), pediatrics department (p = 0.013), and emergencies (p = 0.038). CONCLUSION: This study showed the feasibility and effectiveness of a health-setting-based intervention to enhance hand hygiene observance in the context of a developing country.

13.
J Crit Care ; 56: 208-214, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31952015

RESUMO

PURPOSE: This study aimed to assess patient safety culture (PSC) in intensive care units (ICUs) and to determine the factors affecting it. MATERIALS AND METHODS: This is a cross-sectional study, conducted from October to November 2017 among professionals practicing in the ICUs of the Tunisian center. After obtaining institutional ethics committee's approval and administrative authorizations, an anonymous paper-based questionnaire was distributed to the participants after obtaining their consent to take part in the study. The measuring instrument used is the French validated version of the "Hospital Survey on Patient Safety Culture" questionnaire. RESULTS: A total of 402 professionals, from 18 ICUs and 10 hospitals, participated in the study with a participation rate of 82.37%. All dimensions were to be improved. The most developed dimension was teamwork within the unit (47.87%) and the least developed dimension was the non-punitive response to error (18.6%). Seven dimensions were significantly more developed in private institutions than in public ones. Results also show that when workload is reduced, the PSC was significantly increased. CONCLUSION: This study has shown that the PSC in ICUs needs improvement and provided a baseline results to get a clearer vision of the aspects of security that require special attention.


Assuntos
Cuidados Críticos/organização & administração , Unidades de Terapia Intensiva , Cultura Organizacional , Segurança do Paciente , Gestão da Segurança/organização & administração , Adulto , Estudos Transversais , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Tunísia , Carga de Trabalho , Adulto Jovem
14.
J Med Microbiol ; 68(11): 1686-1693, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31592765

RESUMO

Introduction. Tunisia is an intermediate hepatitis B virus (HBV) endemic country. The vaccination against hepatitis B was introduced in 1995 including four doses with a first dose administrated at birth. Decreasing the level of antibodies against hepatitis B surface antigen (anti-HBs) over time can be alarming. This study was conducted to explore the anti-HBV immune response among children under 6 years old, vaccinated according to the national vaccination schedule, by evaluating the immunological response to primary vaccination and by exploring the anamnestic immune response to a booster dose.Methods. We conducted a cross-sectional prospective study from June 2016 to June 2017 (n=180), based on voluntary participation. Children were recruited from the public pediatric ward sectors in Sahloul University Hospital of Sousse in Central Tunisia. An anti-HB titre was determined based on electro-chemiluminescence micro-particle immunoassay (ECLIA), using Elecsys Anti-HBs II kit, Roche.Results. Mean age at the time of enrollment in the study was 33±14.8 months. The seroprotection rate was 77.2 %. The anti-HB titre differed significantly between the different age groups (P=0.002). The predicting variable for having no seroprotective antibody level was older age. Children with anti-HB levels <10 IU l- 1 were offered an additional dose of HBV vaccine. Anamnestic response 1 month after the challenge dose was observed in 100 % of subjects. The probability of developing a high antibody response, following the booster dose increased in conjunction with an increased pre-booster antibody level.Conclusion. The response to a booster dose suggests the persistence of immune memory in almost all vaccinated individuals. Although a booster dose increases substantially anti-HB titre, the clinical relevance of such an increase remains unknown.


Assuntos
Anticorpos Anti-Hepatite B/imunologia , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/imunologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/administração & dosagem , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Humanos , Memória Imunológica , Lactente , Masculino , Estudos Prospectivos , Tunísia , Vacinação
15.
Clin Med Insights Pediatr ; 13: 1179556519862280, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384137

RESUMO

Purpose: Several studies raised the effects of Ramadan fasting on healthy adults spirometric data, but none was performed in children. The aim of this study was to compare the spirometric data of a group of faster adolescents (n = 26) with an age-matched non-faster one (n = 10). Methods: This comparative quasi-experimental study, including 36 healthy males aged 12 to 15 years, was conducted during the summer 2015 (Ramadan: June 18 to July 16). Three sessions (Before-Ramadan [Before-R], Mid-Ramadan [Mid-R], After-Ramadan [After-R]) were selected for spirometry measurements. Spirometry was performed around 5.5 to 3.5 h before sunset and the spirometric data were expressed as percentages of local spirometric norms. Results: The two groups of fasters and non-fasters had similar ages and weights (13.35 ± 0.79 vs 12.96 ± 0.45 years, 46.8 ± 9.2 vs 41.7 ± 12.6 kg, respectively). There was no effect of Ramadan fasting on forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow, and maximal mid-expiratory flow. For example, during the Before-R, Mid-R, and After-R sessions, there was no significant difference between the fasters and non-fasters mean FVC (101 ± 11 vs 99 ± 14, 101 ± 12 vs 102 ± 14, 103 ± 11 vs 104 ± 13, respectively) or FEV1 (101 ± 13 vs 96 ± 16, 98 ± 11 vs 97 ± 16, 101 ± 10 vs 98 ± 16, respectively). Conclusions: Ramadan fasting had no interaction effect with the spirometric data of Tunisian healthy male adolescents.

16.
J Neuropsychol ; 13(3): 432-461, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-29667317

RESUMO

The results of previous studies are inconsistent in regard to the relationship between the Iowa Gambling Task (IGT), working-memory (WM), and executive tasks, and whether these cognitive processes could be considered as mechanisms underlying a decision-making deficit. Moreover, the relationship between the IGT and executive measures is examined based on a limited number of executive tasks, within different populations showing diffuse damage. In addition, there are fewer studies carried out within control participants, with those studies also being inconclusive. It is also suggested that the association of the IGT performance with executive tasks depends on whether the IGT was running under ambiguity or under risk. In this work, all of these issues are studied. Results showed that both patients with ventromedial (VMPFC, N = 10) and dorsolateral (DLPFC, N = 10) prefrontal cortex lesions are significantly impaired on almost all executive tasks, WM tasks, and the IGT. Furthermore, when the IGT is run under risk, there are significant correlations between executive measures and the IGT for the DLPFC patients and the control participants (N = 34) but not the VMPFC patients. No correlation was found between WM tasks and the IGT for both frontal subgroups and control participants. These findings suggested that the mechanisms underlying the IGT deficit differ according to the lesion locations.


Assuntos
Tomada de Decisões , Função Executiva , Jogo de Azar/psicologia , Memória de Curto Prazo , Testes Neuropsicológicos , Córtex Pré-Frontal/lesões , Adulto , Contusão Encefálica/patologia , Contusão Encefálica/psicologia , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/psicologia , Feminino , Humanos , Hemorragias Intracranianas/patologia , Hemorragias Intracranianas/psicologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/patologia , Desempenho Psicomotor , Adulto Jovem
17.
Tunis Med ; 96(2): 107-112, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30324975

RESUMO

AIMS: The main aim was to compare aerobic performance data, determined before «period1¼ and after «period2¼ cold water immersion in two groups of footballers (CWI and no-CWI groups). METHODS: This is an experimental study with matching and randomization. The 20 male footballers, aged 17 to 20 years, were divided into two groups (n = 10 for each) following a random draw. The two groups were age-, height- and weight matched. 1000-m race was made during the two periods. Heart-rate (HR, % of theoretical maximum HR) and hemoglobin oxygen saturation (Oxy-sat, %) were measured before and after the race, and the time of the race (min) was noted. An Oxy-sat decrease > 4 points retained the diagnosis of exercise-induced desaturation. Eight CWI sessions (one per week), until the hip in a standing position (10 min; temperature: 11-12 °C) were performed. RESULTS: The two groups were age-, height- and weight matched. Comparatively to the race time of «period1¼, this of «period2¼ was decreased in the CWI group (3.21±0.04 vs. 3.15±0.04 min) and was increased in the no-CWI group (3.23±0.05 vs. 3.27±0.07 min). Comparatively to the HRs (before, after the race) of «period1¼, these of «period2¼ were decreased in the CWI group (36±1 vs. 34±1%; 56±3 vs. 44±2%) and were increased in the no-CWI group (35±2 vs. 36±1%; 55±2 vs. 57±2%). Comparatively to the after race Oxy-sat' of the «period1¼, this of «period2¼ was increased in the CWI group (96±1 vs. 98±0%) and was decreased in the no-CWI group (96±1 vs. 95±1%). While in the CWI group, the percent of desaturators was decreased between «period1¼ and «period2¼ (30 vs. 0%), in the no-CWI group, percentages remained similar (50 vs. 90%). CONCLUSION: CWI improves aerobic capacity and muscle strength of young footballers.


Assuntos
Atletas , Temperatura Baixa , Imersão , Força Muscular/fisiologia , Consumo de Oxigênio/fisiologia , Futebol , Adolescente , Adulto , Desempenho Atlético/fisiologia , Crioterapia/métodos , Exercício Físico/fisiologia , Humanos , Medidas de Volume Pulmonar , Masculino , Músculo Esquelético/fisiologia , Recuperação de Função Fisiológica/fisiologia , Futebol/fisiologia , Água/fisiologia , Adulto Jovem
18.
Am J Mens Health ; 12(6): 2089-2103, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30117367

RESUMO

No previous study has evaluated the effects of RF on inflammatory and hematological indices of COPD patients. The main objective of the present pilot study was to assess the effects of RF on some inflammatory and hematological indices measured in male patients with stable COPD. Fifteen COPD patients (mean ± SD of age: 71 ± 6 years) who fasted during Ramadan 2017 volunteered for the study. Three sessions (Before-Ramadan, End-Ramadan and After-Ramadan) were selected. Spirometry tests and blood samples were consistently performed 2.5-4.5 hr before the interruption of the fasting. Assessment sessions comprised: spirometry, inflammatory [erythrocyte sedimentation rate (ESR); C-reactive protein (CRP)] and hematological [red and white blood cells (RBC, WBC); hemoglobin; hematocrit; mean corpuscular volume; mean corpuscular hemoglobin; platelets] indices. Findings were analyzed by applying Friedman ANOVA. The median (lower-upper quartiles) of ESR (Before-Ramadan: 3 (2-9), End-Ramadan: 7 (0-13), After-Ramadan: 9 (5-15) mm/h) and CRP (Before-Ramadan: 20 (11-38), End-Ramadan: 15 (9-34), After-Ramadan: 20 (12-46) mg/L) were not significantly affected by RF. Among all the hematological indices, RF influenced only hemoglobin (Before-Ramadan: 14.4 ± 2.2, End-Ramadan: 13.4 ± 1.3, After-Ramadan: 12.2 ± 0.9 g/dL), hematocrit (Before-Ramadan: 45 ± 7, End-Ramadan: 40 ± 4, After-Ramadan: 39 ± 4%), RBC (Before-Ramadan: 5.1 ± 1.0, End-Ramadan: 4.6 ± 0.7, After-Ramadan: 4.4 ± 0.5 106/mm3) and WBC (Before-Ramadan: 8,673 ± 1,911, End-Ramadan: 7,840 ± 1,526, After-Ramadan: 9,507 ± 2,190/mm3). Compared to the Before-Ramadan session, the End-Ramadan session values for hemoglobin, hematocrit, RBC and WBC were lower. Compared to the After-Ramadan session, the End-Ramadan session values for hemoglobin and WBC were higher and lower, respectively. In conclusion, RF caused significant reduction in hemoglobin, hematocrit, RBC and WBC. However, it did not induce any significant changes in the CRP and ESR indices.


Assuntos
Biomarcadores/sangue , Jejum , Islamismo , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Espirometria , Idoso , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Tunísia
19.
PLoS One ; 12(12): e0189725, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29287082

RESUMO

BACKGROUND: Zoonotic visceral leishmaniasis (ZVL) caused by Leishmania infantum is endemic with an epidemiological profile of a paediatric disease in Tunisia. In the context of a high fatality rate, identifying risk factors for in-hospital mortality in children treated for ZVL is of major epidemiological importance. DESIGN: A retrospective (case-control) study included 230 immuno-competent children diagnosed and confirmed with primary ZVL in the paediatric department of the University Hospital of Kairouan between 2004 and 2014. Forty-seven per cent (47%) were children under 18 months of age, and with a male / female ratio of 1.01:1. RESULTS: The overall case-fatality was 6% (n = 14). The risk factors for in-hospital death identified by a multivariate analysis were: bleeding at admission (OR = 25.5, 95% CI: 2.26-287.4; p = 0.009), white cell count less than 4000/mm3 (OR = 5.66, 95% CI: 1.16-27.6; p = 0.032), cytolysis (OR = 28.13, 95% CI: 4.55-173.6; p < 0.001), and delay between onset of symptoms and admission ≥ 15 days (OR = 11, 95% CI: 1.68-72; p = 0.012). CONCLUSION: The results strongly suggest that paediatric patients admitted 15 days after onset of symptoms, with bleeding, white cell counts below 4,000/mm3, and cytolysis at admission should be considered severe cases and subsequently, they are at high risk of mortality. A better understanding of factors associated with death of children from ZVL may contribute to decrease mortality.


Assuntos
Leishmaniose Visceral/epidemiologia , Zoonoses/epidemiologia , Animais , Feminino , Humanos , Lactente , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/transmissão , Masculino , Fatores de Risco , Tunísia/epidemiologia
20.
Int J Qual Health Care ; 29(2): 176-182, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28073903

RESUMO

Objective: To assess the patient safety culture (PSC) in operating rooms (ORs) and to determine influencing factors. Design: A cross-sectional descriptive multicenter study which was conducted over a period of 7 months (October 2014-April 2015) using the French validated version of the Hospital Survey On Patient Safety Culture questionnaire. Setting: Of the note, 15 ORs of public and private healthcare institutions. Participants: In total, there were 368 participants including surgeons, anesthesiologists, surgical and anesthesia technicians, nurses and caregivers, divided into 316 professionals exercising in public sector and 52 working in private one. Main Outcome Measure(s): A self-administrated questionnaire investigating 10 dimensions of PSC (including 45 items), two items examining the staff perception of patient safety quality and reporting events, and five items regarding demographic characteristics of respondents. Results: The participation rate in the study was 70.8%. All 10 dimensions were to be improved. The overall perception of patient safety had a score of 34.9%. The dimension that had the lowest score (20.5%) was the non-punitive response to error, and the one that had the highest score (41.67%) was teamwork in the ORs. Three dimensions were developed in private sector, and none in public hospitals. Conclusion: This study showed that the level of the PSC needs to be improved not only in public hospitals but also in private ones. The obtained results highlight the importance of implementing quality management systems and developing PSC.


Assuntos
Atitude do Pessoal de Saúde , Salas Cirúrgicas/organização & administração , Cultura Organizacional , Segurança do Paciente/normas , Adulto , Estudos Transversais , Feminino , Hospitais Privados/normas , Hospitais Públicos/normas , Humanos , Masculino , Salas Cirúrgicas/normas , Qualidade da Assistência à Saúde/normas , Gestão da Segurança/organização & administração , Inquéritos e Questionários , Tunísia
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