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1.
Tunis Med ; 97(5): 659-666, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31729737

RESUMO

INTRODUCTION: Cardiovascular diseases (CVD) are a major cause of morbidity and mortality, driven by the epidemiological transition world-wide. AIM: We aimed to describe the epidemiological profile of CVD hospitalizations, to assess their chronological trends and to estimate their future projected trends. METHODS: We retrospectively collected data from the regional morbidity registry of the University Hospital of Sfax, Tunisia, between 2003 and 2016. We included patients with ischemic heart disease (IHD), heart failure (HF) and rhythm and conduction disorder (RCD). RESULTS: The mean age-standardized hospital incidence rate (ASHIR) was 94.8, 20.6 and 14/100000 inhabitants/year for IHD, HF and RCD, respectively. Trends analysis of CVD showed a significant increase in the ASHIR of IHD from 54.3/100000 inhabitants in 2003 to 123/100000 inhabitants in 2016, with an Annual Percentage Change (APC) of 3.59% (95%CI:0.4-6.7%;p<0.001). An upward trend was observed for HF, with ASHIR rising from 8.6/100000 inhabitants in 2003 to 22.6/100000 inhabitants in 2016, with an APC of 8.29% (95%CI:4.1-12;p<0.001). For RCD, no significant change in ASHIR was found. Projections showed that the estimated ASHIR would attend 131 and 36.5/100000 inhabitants for IHD and HF, respectively, while RCD would decline to 19.6/100000 inhabitant in 2026. CONCLUSIONS: IHD and HF were rising at an alarming rate and were expected to continue up to the next 10 years. Therefore, there is an urgent need to emphasize on primordial, primary, and secondary prevention in order to reduce the massive burden of CVD.

2.
Sante Publique ; Vol. 31(3): 433-441, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31640331

RESUMO

OBJECTIVES: Non-communicable diseases (NCDs) represent a major public health problem worldwide. Giving their impact on the morbidity and mortality burden, understanding their chronological trends over time is a priority for epidemiological surveillance. We aimed to determine the epidemiological specificities of NCDs and to study their chronological trends over the period 2010-2015. METHODS: We retrospectively collected data of hospitalized patients from the regional registry of morbidity and mortality in the Southern University Hospital of Tunisia during the period 2010-2015. RESULTS: We included 18,081 patients with NCDs aged ≥ 25 years. The distribution of NCDs was characterized by the predominance of cardiovascular disease (CVD) (10,346 cases, 57.2%). Chronological trends analysis of NCDs showed that NCDs remained globally stable between 2010 and 2015. The same result applied to the group of cancers, chronic respiratory diseases and diabetes mellitus. However, CVD increased significantly between 2010 and 2015 (ρ = 0.84; p = 0.036). The proportion of CVD increased significantly among men (ρ = 0.87; p = 0.019) and elderly (ρ = 0.88; p = 0.019). The hospital mortality rate of NCDs increased significantly (ρ = 0.85; p = 0.031), notably for CVDs (ρ = 0.94; p = 0.005). CONCLUSION: Chronological trends analysis revealed a significant rise in the morbidity and mortality burden of CVDs during the period 2010-2015. It is imperative, therefore, to strengthen health care for these patients and to introduce the concept of integrated NCDs prevention as an essential component of the health system.


Assuntos
Doenças não Transmissíveis/epidemiologia , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/mortalidade , Humanos , Masculino , Morbidade/tendências , Mortalidade/tendências , Doenças não Transmissíveis/mortalidade , Sistema de Registros , Estudos Retrospectivos , Tunísia/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-31100056

RESUMO

Background Body image is considered as central to many aspects of human functioning including emotions, thoughts, behaviors and relationships. Our study aimed to investigate the prevalence of body image distortion and dissatisfaction among adolescents and to assess their main determinants. Methods This was a cross-sectional school-based study conducted among school-adolescents in the south of Tunisia, between October 2017 and February 2018. Results Among 1210 school-adolescents, body image distortion and dissatisfaction prevalence were 44.8% and 42.4%, respectively. Multivariate analysis showed that being in the 16-18 years age group [adjusted odds ratio (AOR) = 1.28, p = 0.046], low family financial situation (AOR = 1.88, p = 0.014), as well as high frequency of eating pasta (AOR = 1.3, p = 0.04) and fast-food consumption (AOR = 1.7, p = 0.042) were independently associated with under-estimated body image. Skipping breakfast (AOR = 1.9, p = 0.017) and having one obese parent (AOR = 1.9, p = 0.01) were independently associated with higher frequency of over-estimated body image. Regarding body image dissatisfaction, independent factors associated with desire to lose weight were: female gender (AOR = 1.53, p = 0.007), high income family financial situation (AOR = 2.1, p = 0.008) and having one parent who is obese (AOR = 2.21, p < 0.001). However, frequent fast-food consumption (AOR = 1.9, p = 0.038) and eating between meals (AOR = 1.57, p = 0.01) were independently associated with a higher desire to gain weight. Conclusions Our study highlighted that the prevalence of body image distortion and dissatisfaction were substantially high among adolescents. Their determinants included socio-demographic factors and lifestyle behaviors. Increased awareness among parents, educators and public health planners may help adolescents improve accuracy of body image attitudes.

4.
J Res Health Sci ; 19(1): e00440, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-31133629

RESUMO

BACKGROUND: Musculoskeletal pain (MSP) is a public health problem among school-adolescents. This study aimed to identify the prevalence, risk factors and consequences of neck, shoulders and low-back pain among school-adolescents. STUDY DESIGN: A cross-sectional study. METHODS: School-adolescents aged from 12 to 18 years between October 2017 and February 2018 in South of Tunisia were recruited. Eligible participants were randomly selected and were asked to respond a four-section questionnaire. Factors independently associated with MSP were determined through multivariate logistic regression analysis. RESULTS: Among 1221 enrolled subjects, shoulders, low-back and neck pain were reported in 43%, 35.8% and 32%, respectively. Multivariate analysis showed that independent risk factors of neck pain were female gender (Adjusted odds ratio AOR=1.55; P=0.002), using computer ≥4 hours/week (AOR=1.50; P=0.010), too low desk (AOR=2.30; P<0.001) and carrying schoolbag ≥60 minutes (AOR=1.58; P=0.008). Female gender (AOR=3.30; P<0.001), BMI ≥25 Kg/m2 (AOR=1.6; P=0.018), playing videogames ≥2 hours/day (AOR=2.37; P<0.001) and schoolbag weight to body weight ≥10% (AOR=1.46; P=0.026) were independently associated with shoulders pain. For low back-pain, independent risk factors were high-school grade (AOR=2.70; P<0.001), playing videogames ≥2 hours/day (AOR=1.83; P<0.001), watching TV≥12 hours/week (AOR=1.5; P=0.016), too low seat backrest (AOR=1.4; P=0.005) and too far seat-to-black (board) distance (AOR=1.5; P=0.041). School-adolescents consumed drugs for MSP in 19.5%, had sleep disturbance in 34% and aggressive behaviors in 22.8%. CONCLUSIONS: The prevalence of MSP was substantially high among school-adolescents and their associated risk factors included sociodemographic factors, leisure activities and classroom furniture. An ergonomic specific and behavior-based school program is urgently needed.


Assuntos
Dor Lombar/etiologia , Dor Musculoesquelética/etiologia , Cervicalgia/etiologia , Instituições Acadêmicas , Dor de Ombro/etiologia , Estudantes , Adolescente , Dorso , Índice de Massa Corporal , Criança , Estudos Transversais , Ergonomia , Feminino , Humanos , Atividades de Lazer , Modelos Logísticos , Dor Lombar/tratamento farmacológico , Dor Lombar/epidemiologia , Masculino , Dor Musculoesquelética/tratamento farmacológico , Dor Musculoesquelética/epidemiologia , Pescoço , Cervicalgia/tratamento farmacológico , Cervicalgia/epidemiologia , Prevalência , Fatores de Risco , Tempo de Tela , Ombro , Dor de Ombro/tratamento farmacológico , Dor de Ombro/epidemiologia , Inquéritos e Questionários , Tunísia/epidemiologia
5.
Am J Infect Control ; 47(8): 945-950, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30777390

RESUMO

BACKGROUND: The aim of this study was to determine the prevalence of health care-associated infections (HAI) in our university hospitals (UH) and to delineate the risk factors associated with HAI. METHODS: We conducted a cross-sectional study in the 2 UH of Sfax, Tunisia on July 2017, including all patients hospitalized for at least 48 hours. It was a 1-day pass per department and a 1-week prevalence survey per UH. RESULTS: Of 752 patients eligible for the study, the total number of HAI was 82, representing an overall prevalence of HAI of 10.9%. Respiratory tract infections were the most prevalent HAI (36.6%). In multivariate analysis, intrinsic risk factors independently associated with HAI were immune-suppression (adjusted odds ratio (AOR) = 2.8; P < .001), diabetes (AOR = 2.2; P = .008), and malnutrition (AOR = 2.2; P = .019). Extrinsic risk factors were endotracheal intubation (AOR = 17; P = .01), transfer to another department (AOR = 9; P = .019), parental feeding (AOR = 7.2; P = .014), tobacco use (AOR = 6.3; P = .004), as well as surgical wound class contaminated or dirty (AOR = 6.3; P = .002), and peripheral venous catheter (AOR = 4.7; P = .006). CONCLUSIONS: Our study highlighted the magnitude of the HAI problem threatening the quality of care in Southern Tunisia. A wise identification of HAI risk factors may help health care workers to ascertain the avoidability of these infections.

6.
Pediatr Int ; 60(1): 76-82, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28891268

RESUMO

BACKGROUND: The aim of this study was to describe the epidemiological profile of childhood respiratory tract diseases (RTD) in the region of Sfax, Tunisia, and to evaluate their trends over a 13 year period. METHODS: We conducted a retrospective study of all children hospitalized with RTD aged under 14 years. We collected data from the regional morbidity register of the university hospital of Sfax from 2003 to 2015. RESULTS: A total of 10 797 RTD patients were enrolled from 49 880 pediatric hospitalizations (21.7%). A male predominance was noted (60%). The median age was 8 months (IQR, 2-36 months). Acute bronchitis (AB) accounted for 53.8%, followed by asthma (15%), pneumonia (14%) and acute upper respiratory infection (AURI; 7.2%). The hospital incidence rate (HIR) of RTD was 34/10 000 inhabitants/year. It was 18.2; 5.07; 4.7 and 2.4/10 000 inhabitants for AB, asthma, pneumonia and AURI, respectively. We noted a significant increase in the HIR of RTD with an annual percentage change (APC) of 10.94% (P < 0.001); in the HIR of AB (APC, 5.27%; P < 0.001); and in asthma HIR (APC, 11.2%; P < 0.001). Otherwise, a significant decrease in AURI HIR was observed (APC, -8.8%; P < 0.001). AB lethality rate increased significantly, with an APC of 7.4% (P < 0.001). Projected trends analysis up to 2024 showed a significant rise in AB and in asthma, while AURI would significantly decrease. CONCLUSIONS: RTD continues to be a serious health problem over time in terms of morbidity and mortality. Preventive and curative strategies are needed urgently.


Assuntos
Doenças Respiratórias/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Hospitalização/tendências , Humanos , Lactente , Recém-Nascido , Masculino , Sistema de Registros , Estudos Retrospectivos , Tunísia/epidemiologia
7.
Tunis Med ; 96(10-11): 688-695, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30746662

RESUMO

BACKGROUND: The aim of screening is to improve individual health through an early detection of diseases at a stage where the prognosis of disease could be significantly. However, this kind of intervention is costly and it's necessary to respect criteria in selection of targeted diseases and screening tests. OBJECTIVE: The objective of this study was to describe public health screening policy in the Maghreb countries in order to identify the main barriers to the development of this type of intervention. METHODOLOGY: This study is a literature review of screening practices and policy in Maghreb countries. For this purpose, we conducted a global search in MEDLINE, as well as in the websites of the Ministries of Health of Maghreb countries; we also asked also key persons in the different countries to provide us useful t information concerning screening in their countries. RESULTS: Antenatal and neonatal screening is generally limited to a few pilot experiments such as screening for congenital hypothyroidism and phenylketonuria and deafness. Regarding school population, screening of certain diseases such as dental disorders, infectious diseases including tuberculosis, overweight and obesity, visual impairment, is carried out during periodic medical visits. Among adults, screening is often opportunist; it is performed in patients who use primary care health centers; the main targeted diseases are cervical, breast cancer and colorectal cancer, pulmonary tuberculosis. Screening coverage, especially for cancers, remains relatively low; for example, in Tunisia, this coverage was 12.7% for at least one cervical smear in the last five years; while for an annual clinical breast examination, this proportion was 33.2%. CONCLUSIONS: It is strongly recommended to improve coverage by screening, especially for cancers through educational actions of the population highlighting the high chances of cure in case of early detection, training of care staff and improvement, access to screening benefits.


Assuntos
Política de Saúde , Programas de Rastreamento/métodos , Serviços Preventivos de Saúde , Adulto , África do Norte/epidemiologia , Criança , Diagnóstico Precoce , Feminino , Política de Saúde/tendências , Humanos , Recém-Nascido , Programas de Rastreamento/organização & administração , Programas de Rastreamento/normas , Programas de Rastreamento/tendências , Triagem Neonatal/métodos , Triagem Neonatal/organização & administração , Triagem Neonatal/normas , Neoplasias/diagnóstico , Gravidez , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/estatística & dados numéricos , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Serviços de Saúde Escolar/organização & administração , Serviços de Saúde Escolar/normas
8.
Tunis Med ; 95(3): 160-167, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29446808

RESUMO

In a context of economic difficulties, the Tunisian government is required to find solutions to meet the expectations of the population. Health sector is one of the critical areas requiring radical reform. The objective of this paper is to find the place of public private partnership project in the harmonious development of both public and private sectors in Tunisia. Indeed, the Tunisian health system consists of two main sectors: the public sector, and the private sector, booming since the 90s. Tunisian infrastructure and staff resources distribution is characterised by a very significant regional disparity, to the detriment of the interior regions, which is more pronounced in the private sector. This area, considered innovative and responsive, captures the local wealthy clientele, and the foreign highly specialized care seekers. It wins over the best healthcare providers, inspite of some reported claims against pricing abuses leading to user's lack of confidence. As for the public sector under funded, handicapped by red tape and some forms of lack of transparency and lobbying, it can not cope with the influx of customers of poor and middle classes. The relationship between the two sectors misses often. The current challenge in the Tunisian health sector is how can public and private sectors combine and harmonize their efforts to achieve common interest objectives. The public-private partnership, is a process helping the state to involve private investors in the realization of public interest projects and develop long term contracts. So, the two sectors will share resources and technical expertise and will access to further advantages. However, it is essential to establish clear and effective legal and institutional frameworks governing private participation in the public sector.


Assuntos
Assistência à Saúde/organização & administração , Parcerias Público-Privadas , Assistência à Saúde/economia , Assistência à Saúde/normas , Assistência à Saúde/tendências , Economia Médica/organização & administração , Economia Médica/tendências , Humanos , Setor Privado/economia , Setor Privado/organização & administração , Setor Privado/tendências , Setor Público/economia , Setor Público/organização & administração , Setor Público/tendências , Parcerias Público-Privadas/economia , Parcerias Público-Privadas/organização & administração , Parcerias Público-Privadas/normas , Parcerias Público-Privadas/tendências , Tunísia/epidemiologia
9.
Soins Pediatr Pueric ; (271): 42-5, 2013.
Artigo em Francês | MEDLINE | ID: mdl-23641627

RESUMO

A descriptive transversal study was carried out by the child psychiatry and neonatology team of Hedi-Chaker General Hospital in Sfax, Tunisia. Its aim was to study the methods and circumstances of the announcement of a disability confirmed during the infant's first days of life. The results of the study show that when the announcement is made by an experienced, trained team, and in favourable conditions, it leads to better acceptance of the disability by the parents.


Assuntos
Comunicação , Anormalidades Congênitas/psicologia , Pais/psicologia , Revelação da Verdade , Adulto , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Masculino
10.
Tunis Med ; 89(10): 745-51, 2011 Oct.
Artigo em Francês | MEDLINE | ID: mdl-22076895

RESUMO

AIM: To study the principal causes of death of the women dead at an âge ranging between 15 and 49 years old and having been hospitalized in a public medical structures of the gouvernorat of Sfax. METHODS: Retrospective study concerning all the included deaths between 1999 and 2007. RESULTS: The study was related to 728 deaths, which correspond to an average of 80.88 deaths FAR per year. Public highway accidents were the major cause of death (83 cases, 11.4 % of the causes of death) followed by the burns (37 cases, 5%) and the cerebral vascular accidents (31 cases, 4.25%). The classification of the causes of death according to groups of pathologies showed the prevalence of the cardio- vascular diseases (18.7%), the external causes of death (18.2%), cancers (11.6%) and the causes related to the pregnancy and the childbirth (8.5%). The maternal death rate was of 56.91 per 100000. The cause of maternal death was directly related to the pregnancy in 67.74 % of the cases. The immediate causes were prevailed by the hemorrhagic causes (27.5%). The death was avoidable in 48.83 % of the cases and the failures were related to the woman in 60% of the cases. CONCLUSION: The prevention of new practices of life (female nicotinism, obesity, bad food habits, lack of vigilance in traffic) and a better practice of the primary and secondary prevention in medicine could decrease the premature death rates in Tunisia.


Assuntos
Causas de Morte/tendências , Acidentes de Trânsito/mortalidade , Adolescente , Adulto , Feminino , Humanos , Mortalidade Materna , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , Tunísia/epidemiologia , Ferimentos e Lesões/mortalidade , Adulto Jovem
11.
Tunis Med ; 88(6): 399-403, 2010 Jun.
Artigo em Francês | MEDLINE | ID: mdl-20517849

RESUMO

BACKGROUND: Adolescents present specific sanitary needs, linked to the physical and psychological mutations that occur during this vulnerable period of life. These needs remain little known in Tunisia. But : To describe epidemiological profile of morbidity of teenagers hospitalized in Hedi Chaker's hospital center of Sfax, during a period of 5 years, between 2003 and 2007. METHODS: Data exploitation of the descriptive survey of morbidity and mortality of hospitalized adolescents. RESULTS: During the study, 2963 adolescents of 10 to 19 years have been hospitalized (5.1 % of total of hospitalizations). Paediatrics received 36.9 % of adolescents. Paediatrics, haematology and infectious diseases's services received 58.5 % of them. According to the groups of diagnosis, genitourinary and endocrine's diseases, dominate for girls, whereas infectious and parasitic diseases and tumors touched more boys. Diabetes, signs and general symptoms, leukaemia and anaemia, were the most frequent pathologies. CONCLUSION: Taking care of teenagers is often parcelled out on several hospitable services. Therefore, the improvement of the greeting services, in order to answer the teenager's relational needs home a temporary solution, while hoping, the setting up of units or specific services of adolescents that showed evidence of their utility for the development of the medicine of the teenagers in the industrialized countries.


Assuntos
Epidemiologia , Hospitalização , Adolescente , Criança , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Tunísia , Adulto Jovem
12.
Urology ; 73(6): 1251-4, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19371931

RESUMO

OBJECTIVES: To investigate, in a prospectively randomized trial, whether preoperative gonadotropin-releasing hormone (GnRH) therapy improves the fertility index in primary cryptorchidism. Cryptorchidism is a common condition with a high risk of infertility. Treatment with GnRH appears to improve fertility later in life by inducing germ cell maturation. METHODS: A total of 24 boys, 12-123 months old (median 34.5), with 24 undescended testes were prospectively assigned to 2 groups during a 24-month period. The patients were randomized to receive either orchiopexy alone (n = 12) or orchiopexy combined with neoadjuvant GnRH therapy (n = 12) as a nasal spray for 4 weeks at 1.2 mg/d. In both groups, testicular biopsies were performed at orchiopexy, and the histopathologic fertility index was determined. RESULTS: The mean fertility index in the group treated with GnRH before surgery was significantly greater (0.88 +/- 0.31) than in the group without hormonal stimulation (0.49 +/- 0.52; P = .02). No significant correlation was found between the fertility index in the GnRH group and the patient's age. CONCLUSIONS: The results of our study have shown that neoadjuvant GnRH treatment improves the fertility index in prepubertal cryptorchidism and, consequently, should improve fertility in adulthood.


Assuntos
Criptorquidismo/cirurgia , Fertilidade , Hormônio Liberador de Gonadotropina/uso terapêutico , Cuidados Pré-Operatórios , Criança , Pré-Escolar , Humanos , Lactente , Masculino , Terapia Neoadjuvante , Estudos Prospectivos
13.
Med Sci Monit ; 15(3): BR71-4, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19247235

RESUMO

BACKGROUND: Hemodynamic manifestations are the leading causes of death after scorpion sting. This study was performed to evaluate the dose-dependent effect of dobutamine on hemodynamic perturbations induced by Buthus occitanus tunetanus (Bot) scorpion venom in rats. MATERIAL/METHODS: Bot venom (850 microg/kg) was administered intravenously. Five minutes later the animals were perfused with vehicle or dobutamine (5, 10, and 20 microg/kg/min). The effects of Bot and dobutamine treatment on systolic arterial pressure (SAP), diastolic arterial pressure (DAP), heart rate (HR), and survival of the rats were examined. RESULTS: Bot venom caused a biphasic variation of SAP and DAP. These parameters reached their maximum values immediately after venom administration, followed by a substantial progressive fall. There was a remarkable decrease in HR, which never returned to its initial value. Dobutamine treatment proved to have significant effects on hemodynamic perturbations only in the group treated at the rate of 20 microg/kg/min. In these animals, the decreases in SAP, DAP, and HR were markedly less important after the 10th min after envenomation (P<0.05 vs. control). Survival rates between the groups showed a statistically significant difference (P<0.01). The rats receiving 20 microg/kg/min dobutamine showed the highest survival rate (P<0.05 vs. control). CONCLUSIONS: Our results indicate that Bot venom (850 microg/kg) causes severe hemodynamic perturbations which were reversed only by high doses of dobutamine (20 microg/kg/min), demonstrating the necessity of adapting the dobutamine dose to the degree of envenomation gravity for optimizing its effect.


Assuntos
Dobutamina/farmacologia , Hemodinâmica/efeitos dos fármacos , Venenos de Escorpião/toxicidade , Animais , Pressão Sanguínea/efeitos dos fármacos , Dobutamina/administração & dosagem , Relação Dose-Resposta a Droga , Masculino , Ratos , Ratos Wistar , Venenos de Escorpião/administração & dosagem , Análise de Sobrevida , Sístole/efeitos dos fármacos
14.
C R Biol ; 330(12): 890-6, 2007 Dec.
Artigo em Francês | MEDLINE | ID: mdl-18068647

RESUMO

Scorpion envenoming is less studied in pregnant victims. In this work, the effect of Buthus occitanus tunetanus on parturition in late pregnancy was studied in an animal model. Four groups of six primigravid female rats, each one at the 22nd day of pregnancy, were used. The first two groups had received an intra-peritoneal injection of 500 microg/kg of Buthus occitanus tunetanus crude venom or a physiological saline solution and left until foetal delivery. Then, the time elapsed until the first pup delivery and that separating the first and latest ones were measured. The other two groups served for the uterine electrophysiological activity exploration. Rats were anaesthetized, artificially ventilated and had received an intraperitoneal injection of 500 microg/kg of Buthus occitanus tunetanus crude venom or a physiological saline solution. Our results showed a significant increase of the latency to foetal delivery, labour time, and uterine contractile activity in envenomed rats compared to controls. Such signs are usually seen in dynamic dystocia. It was concluded that Buthus occitanus tunetanus envenoming might induce a dynamic dystocia, when it occurred in late pregnancy.


Assuntos
Venenos de Escorpião/toxicidade , Animais , Animais Recém-Nascidos , Coito , Feminino , Masculino , Parto/efeitos dos fármacos , Gravidez , Prenhez/efeitos dos fármacos , Ratos , Ratos Wistar , Espermatozoides
15.
Tunis Med ; 85(5): 398-401, 2007 May.
Artigo em Francês | MEDLINE | ID: mdl-17657926

RESUMO

AIM: The objective of this work was to present the main results of this investigation during the year 2002 and to describe the profile of the hospital morbidity. METHODS: In the setting of the epidemiologic supervision, the Community Medicine and Epidemiology service in Sfax leads a continuous descriptive study of the hospital morbidity and mortality. RESULTS: The average age of the hospitalized was 32.10 years. The sex-ratio was estimated at 0.94. The socio-economic level was relatively low. The chronic pathologies come in head and are dominated by: the chronic renal failure, schizophrenia and diabetes. The profile of morbidity reflects an epidemiological transition phenomenon and call to a backing of the ambulatory handling and the development of specific services capable to make decrease the needs of hospitalizations


Assuntos
Indicadores Básicos de Saúde , Mortalidade Hospitalar , Hospitais Universitários/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Bronquiolite/epidemiologia , Pré-Escolar , Diabetes Mellitus/epidemiologia , Estudos Epidemiológicos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Falência Renal Crônica/epidemiologia , Tempo de Internação/estatística & dados numéricos , Leucemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Estudos Retrospectivos , Esquizofrenia/epidemiologia , Fatores Sexuais , Classe Social , Tunísia/epidemiologia
16.
J Trauma ; 57(2): 255-61, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15345970

RESUMO

BACKGROUND: This study aimed to determine predictive factors of mortality after posttraumatic brain injury. METHODS: A retrospective study conducted over a 3-year period (1997-1999) involved 437 adult patients with head injury admitted to the intensive care unit of a university hospital in Sfax, Tunisia. Basic demographic, clinical, biologic, and radiologic data were recorded at admission and during the intensive care unit stay. RESULTS: This study included 393 men (90%) and 44 women with a mean age of 36 +/- 17 years. Traffic accidents were the main cause of trauma (85.6%). In 58% of the cases, the injury was serious (Glasgow Coma Score, <8). The mean simplified acute physiology score was 39 +/- 15, and the mean Injury Severity Score was 34.5 +/- 17. Of the 437 patients, 127 (29.1%) died. According to multivariate analysis, the factors that correlated with a poor prognosis were age older than 40 years (p < 0.01), simplified acute physiology score exceeding 40 (p < 0.001), Glasgow Coma Score lower than 7 (p = 0.03), intracranial mass lesion (p = 0.02), a cerebral herniation (p < 0.001), diabetes insipidus (p < 0.001), and blood sugar level higher than 10 mmol/L (p < 0. 001). CONCLUSIONS: In Tunisia, head injury is a frequent cause of hospitalization, comprising 14.4% of all adult admissions. It is observed most often among young patients involved in traffic accidents. The short-term prognosis is poor, with a high (29%) mortality rate, and determined by demographic, clinical, radiologic, and biologic factors. Prevention is highly advised.


Assuntos
Lesões Encefálicas/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/etiologia , Feminino , Escala de Coma de Glasgow , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Hospitais Universitários , Humanos , Incidência , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Determinação de Necessidades de Cuidados de Saúde , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Tunísia/epidemiologia
17.
Tunis Med ; 81(4): 264-9, 2003 Apr.
Artigo em Francês | MEDLINE | ID: mdl-12848010

RESUMO

The interpretation of biological exam results requires the knowledge of physiological variation factors and reference values for every parameter. Following the preparation and the diffusion by the International Federation of Clinical Chemistry (IFCC) of a new reference material for the dosage of plasmatic proteins (CRM470) and in order to take part in the international effort of standardization of these dosages, we established reference ranges in the tunisian population for 9 plasmatic proteins: the Immunoglobulines G, A and M, complement factors C3 and C4, albumin, transferrin, haptoglobin and the a 1-glycoprotéin acid. Our sample of 211 healthy blood donors aged between 18 and 63 years. Reference limits 0.95 that we obtained are located within variation of most reference values lately found in the literature.


Assuntos
Proteínas Sanguíneas/normas , Adolescente , Adulto , Proteínas Sanguíneas/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Tunísia
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