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1.
J Kidney Cancer VHL ; 8(3): 19-21, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34676153

RESUMO

Adenoid cystic carcinoma (ACC) is a rare malignant cancer that arises from secretory glands. Slow growth, perineural invasion, and late recurrences are the main characteristics of ACC. Only few cases of kidney metastases from ACC have been reported in the literature. We report here the case of a 66-year-old female patient who presented with bilateral renal metastases from ACC of the nasal cavity, detected 14 years after treatment of primary tumor and 6 years after metastasectomy of lung metastases. Histological examination confirmed diagnosis and the patient was treated with systemic chemotherapy. Radiological evaluation showed stability of the disease. However, a progression with occurrence of metastases in other sites (lung and bones) has been observed after 7 months. She is still receiving second-line chemotherapy. To the best of our knowledge, this is the second case of kidney metastases from ACC of the nasal cavity.

2.
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
3.
J Spec Pediatr Nurs ; 26(2): e12324, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33421315

RESUMO

PURPOSE: In pediatric asthma, family empowerment education has been beneficial for the quality of life, pulmonary function, and family functioning. Few studies addressed the impact of a family empowerment program on asthma symptom control, acute healthcare use (AHCU), and medication use in children with asthma. This study aimed to assess the effect of a family empowerment intervention on asthma symptom control, AHCU, inhaler technique, and controller adherence in children with asthma. DESIGN AND METHODS: A single-center study using a randomized controlled design was conducted in a university hospital in the center of Tunisia from May 2018 to September 2019. Eighty-two families were randomly assigned to the intervention group (n = 41) of 8 weeks of group training sessions, or to the control group (n = 41) of usual care education. Thirty-seven families in the intervention group and 39 families in the control group received allocated intervention at baseline. Thirty-four families in each group completed the study at the 12-month follow-up. RESULTS: At baseline, the intervention and control groups were statistically comparable (p > .05). At follow-up, there were significant differences between the intervention and the control group in asthma symptom control, χ2 (1, N = 34) = 9.950, p = .002, and inhalation technique, χ2 (1, N = 34) = 5.916, p = .01. For AHCU and adherence to asthma controller, there was no significant difference between groups, χ2 (1, N = 34) = 3.219, p = .07, χ2 (1, N = 34) = 0.541, p = .46, respectively. The difference within time in asthma symptom control and inhalation technique was significant (p = 10-3 , p = .001; respectively). PRACTICE IMPLICATIONS: This study demonstrated that a family empowerment program significantly improved asthma symptom control and inhaler technique in children with asthma aged 7-17 years. This intervention could be clinically useful and time-saving for pediatric nurses.


Assuntos
Asma , Qualidade de Vida , Asma/tratamento farmacológico , Criança , Humanos
4.
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.

5.
Compr Child Adolesc Nurs ; 44(2): 122-133, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32302238

RESUMO

Asthma is a leading cause of acute health care use (AHCU) as defined by hospitalization and emergency department visits (ED). Little was known about factors associated with asthma-related AHCU. This study aimed to identify factors determining AHCU in children and adolescents with asthma. A descriptive study was conducted among children with mild to severe asthma referred to the pediatric outpatient clinic of "Farhat Hached" University Hospital of Sousse (Tunisia) over a period of three months (April-June 2018). We collected data regarding clinical information, the number of hospitalizations and ED visits related to asthma in the past 12 months, asthma management behaviors, and quality of life of children. Multivariable logistic regression was performed using SPSS (20.0). A total of 90 children have participated in the study. The percentage of children aged 7 to 11 years was higher than the percentage of adolescents aged 12 to 17 years (67.8%; 32.2%, respectively). The final logistic regression model demonstrated that asthma severity and inhaler technique increased the odds of AHCU (OR a = 4.6; 95% CI: 1.1-18.1; p = .03, OR a = 2.9; 95% CI: 1.1-7.8; p = .02, respectively). Also, increased quality of life score reduced the odds of AHCU (OR a = 0.6; 95% CI: 0.4-0.9; p = .01). These results suggest that the organization of programs targeting the management of these factors can reduce the workload on hospital services and emergencies.

6.
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
7.
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
8.
East Mediterr Health J ; 26(11): 1347-1354, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33226102

RESUMO

Background: Ensuring patient safety and health-care quality remain priorities and challenges worldwide and the role of nurses is essential to meet these challenges. Developing patient safety culture is a key component to improve patient safety and health-care quality. Aims: To assess nurses' patient safety culture in primary health-care centres in Tunisia and to determine its associated factors. Methods: This was a multicentre, cross-sectional descriptive study conducted across 30 primary health-care centres in Tunisia, using the French validated version of the Hospital Survey on Patient Safety Culture questionnaire. All the nurses working in these centres were invited to participate in the study (n = 158). Results: The response rate for participation in the study was 87.3%. The dimension of "teamwork within units" had the highest score (70.6%). Three safety dimensions had low scores: "frequency of event reporting" (27.6%), "staffing" (34.76%) and "nonpunitive response to errors" (36.5%). Two factors were associated with patient safety culture: participation in risk management committees, and district of the primary care centre. Conclusions: The level of nurses' patient safety culture needs to be improved in primary health-care centres in Tunisia. Strategies to nurture patient safety culture should focus upon building leadership capacity that supports open communication, blame-free environment, teamwork and continuous organizational learning.


Assuntos
Enfermeiras e Enfermeiros , Cultura Organizacional , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Segurança do Paciente , Atenção Primária à Saúde , Gestão da Segurança , Inquéritos e Questionários , Tunísia
9.
J Pediatr Nurs ; 54: e9-e16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32616452

RESUMO

PURPOSE: Patient education is fundamental in asthma management, especially at pediatric age. It is increasingly recognized as effective in reducing the burden of the disease, but is less clear in improving the quality of life of children with asthma and their parents. This study assessed the effect of an asthma therapeutic education program on pulmonary function and quality of life in children with asthma and their parents. DESIGN AND METHODS: A monocentric randomized controlled trial conducted in Farhat Hached University Hospital of Sousse (Tunisia) from May 2018 to September 2019. Thirty-seven families in the experimental group and 39 families in the control group received allocated intervention at baseline. Thirty-four families in each group completed the study at the 12-month follow-up. RESULTS: The intervention significantly improved quality of life scores of children and their parents (all p < 0.05). Children in the experimental group had significantly better forced expiratory maneuver than children in the control group. Nonetheless, the FEV1/FVC ratio did not show any significant difference in the experimental and control group (p = 0.9; p = 0.14, respectively). CONCLUSIONS: This study demonstrated that a long-term family-based asthma education program resulted in better pulmonary function and QOL of children and parents enrolled in the intervention group, particularly children with non-allergic asthma. PRACTICE IMPLICATIONS: Family-based asthma education can reduce the burden of allergic and non-allergic asthma on children and their parents through improving their quality of life. Also, the pulmonary function of children with non-allergic asthma was improved due to My Asthma Therapeutic Education intervention.


Assuntos
Asma , Qualidade de Vida , Asma/terapia , Criança , Humanos , Pais , Tunísia
10.
Compr Child Adolesc Nurs ; : 1-11, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32687718

RESUMO

Chronic childhood asthma is a leading cause of poor quality of life. Factors associated with this major asthma outcome were controversial. The aim of this study is to assess the quality of life of children and adolescents with mild to moderate asthma and to determine the factors associated with quality of life impairment in this population. This was a descriptive study carried out in the pediatric outpatient clinic of a University Hospital in the center of Tunisia over a period of 3 months (April-June 2018). Participants were children with mild to moderate asthma aged 7 to 17 years. The Pediatric Asthma Quality of Life Questionnaire was used to assess quality of life. Binary logistic regression was performed to identify predictors of asthma-related quality of life. A total of 90 children participated in the study. Almost 68% of children were aged 7 to 11, and nearly 32% were adolescents. The mean of PAQLQ total score was 4.7 ± 1.2. The final logistic regression model demonstrated that asthma symptoms control had the greatest impact on quality of life, followed by acute health care use in the past 12 months (p = .007; p = .01, respectively). The child gender and the parent's quality of life were also associated with the child's quality of life (p = .02; p = .008, respectively). This study revealed that children and adolescents with mild to moderate asthma had a moderate quality of life score. Asthma symptoms control, acute health care use, gender, and parent's quality of life determined the quality of life of children with asthma. Family-based asthma training programs that target family functioning and asthma outcomes are required.

11.
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
12.
Libyan J Med ; 13(1): 1419047, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29277142

RESUMO

The pandemic spread of multidrug-resistant (MDR) bacteria (i.e., methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBLPE), vancomycin-resistant enterococci, carbapenemase-producing Enterobacteriaceae (CPE), multiresistant Pseudomonas aeruginosa and multiresistant Acinetobacter baumannii) pose a threat to healthcare Worldwide. We found limited data of MDR bacteria in pediatric patients hospitalized in Tunisian tertiary healthcare.The aim of the study is to evaluate the acquisition rate of MDR acquisition during hospitalization and to explore some of the associated risk factors for both carriage and acquisition at the pediatric department, Sahloul University Hospital. During September and October 2016, newly admitted patients were screened, at admission, during care and at discharge. Risk factors for colonization were explored by multivariate analysis. Of 112 newly admitted patients, 8.92% were colonized with at least one MDR. No risk factor was identified at admission. During hospitalization, five newly acquisition MDR (4.9%) were detected and eight (7.84%) at discharge. The specie most frequently detected on admission was Escherichia coli (50%), whereas, on discharge, Escherichia coli and K. pneumoniae were the species most frequently detected (52.7%). The pediatric intensive care unit (PICU) hospitalization, the length of hospital stay (more than 3days) and age under 2 years were identified as risk factor for acquisition of MDR during hospitalization. We identified several independent risk factors for contracting MDR bacteria during hospitalization in a tertiary pediatric department. The incidence of symptomatic MDR Infection among those colonized should be under close surveillance and long-term screening for those children is required. An institutional screening program for MDR especially in PICU might be discussed in regards to cost effectiveness.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Fatores Etários , Portador Sadio/diagnóstico , Pré-Escolar , Infecção Hospitalar/diagnóstico , Farmacorresistência Bacteriana Múltipla , Escherichia coli , Feminino , Humanos , Unidades de Terapia Intensiva Pediátrica , Klebsiella pneumoniae , Tempo de Internação , Masculino , Nariz/microbiologia , Admissão do Paciente , Alta do Paciente , Prevalência , Estudos Prospectivos , Reto/microbiologia , Fatores de Risco , Centros de Atenção Terciária , Tunísia/epidemiologia
13.
Sante Publique ; 29(1): 71-79, 2017 Mar 06.
Artigo em Francês | MEDLINE | ID: mdl-28737329

RESUMO

Objective: This study was designed to assess the quality of the Gabès (Tunisia) mobile emergency care medical records and propose corrective actions.Materials and methods: A clinical audit was performed at the Gabès mobile emergency care unit (SMUR). Records of day, night and weekend primary and secondary interventions during the first half of 2014 were analysed according to a data collection grid comprising 56 criteria based on the SMUR guidelines and the 2013 French Society of Emergency Medicine evaluation guide. A non-conformance score was calculated for each section.Results: 415 medical records were analysed. The highest non-conformance rates (48.5%) concerned the "specificities of the emergency medical record" section. The lowest non-conformance rates concerned the surveillance data section (23.4%). The non-conformance score for the medical data audit was 24%.Conclusion: This audit identified minor dysfunctions that could be due to the absence of local guidelines concerning medical records in general and more specifically SMUR. Corrective measures were set up in the context of a short-term and intermediate-term action plan.


Assuntos
Ambulâncias , Guias como Assunto , Registros Médicos/normas , Unidades Móveis de Saúde , Humanos , Auditoria Médica , Estudos Retrospectivos , Tunísia
14.
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
15.
Tunis Med ; 95(2): 120-125, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29424871

RESUMO

BACKGROUND: Fetal macrosomia is associated with an increased risk of adverse outcomes to both the mother and the infant. AIM: To determine maternal and neonatal outcomes associated to fetal macrosomia in diabetic and non- diabetic mothers. METHODS: It is a descriptive retrospective study conducted in Tunisia. We included in this study all patients who delivered newborns having a birth weight above 4kg during 2013. Multivariate analysis was performed using binary logistic regression to identify the complications associated to macrosomic pregnancies with diabetes. RESULTS: Among the 10186 deliveries registered during the study period, 821 mothers gave birth to macrosomic newborns. The prevalence of macrosomia was 8.1%, and macrosomic newborns who had a birth weight of 4500 g or greater were 1.06%. Macrosomia was significantly higher in males (p <10-3). The rate of cesarean delivery was 47.9%. The most frequent adverse maternal and neonatal outcomes were perineal tears (3.6%), post-partum hemorrhage (0.6%), shoulder dystocia (4.9%) and neonatal intensive care unit admission (7.6%).The proportion of maternal diabetes was 9.3%. Macrosomic pregnancies with diabetes appear to be significantly associated with cesarean delivery (OR=2.22), postpartum hemorrhage (OR=6.69) and neonatal intensive care unit admission (OR=4.18). CONCLUSION: Macrosomia increases the risk of maternal and perinatal morbidity particularly when it was associated to maternal diabetes.


Assuntos
Macrossomia Fetal/diagnóstico , Macrossomia Fetal/epidemiologia , Resultado da Gravidez/epidemiologia , Gravidez em Diabéticas/epidemiologia , Adolescente , Adulto , Parto Obstétrico/métodos , Parto Obstétrico/estatística & dados numéricos , Distocia/epidemiologia , Distocia/etiologia , Feminino , Macrossomia Fetal/complicações , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/epidemiologia , Doenças do Recém-Nascido/etiologia , Masculino , Pessoa de Meia-Idade , Complicações do Trabalho de Parto/diagnóstico , Complicações do Trabalho de Parto/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/etiologia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/epidemiologia , Gravidez em Diabéticas/diagnóstico , Prevalência , Prognóstico , Estudos Retrospectivos , Tunísia/epidemiologia , Adulto Jovem
16.
Tunis Med ; 95(2): 115-119, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29424870

RESUMO

BACKGROUND: The operating room is a high-risk environment for the patient and the healthcare professional and therefore their safety remains a priority in this unit. The checklist "patient safety in the operating room" showed, through the years, its effectiveness in promoting the quality of care and the patient safety. AIM: To explore the perception of operating theaters professionals on the use of the checklist. METHODS: This is a descriptive cross-sectional study among operating theaters professionals of the university hospitals in Sousse, Tunisia, and this during the period from 15 July 2015 until 15 September 2015. The measuring instrument used is derived from the validated questionnaire and proposed by the National Health Authority "individual questionnaire of opinion on the use of the checklist". RESULTS: 98.1% expressed agreement that the checklist improves safety culture and 97.2% say that it is an opportunity to avoid mistakes. 88.1% think that the checklist is an additional administrative burden. The whole study population (100%) confirms the usefulness of the checklist in improving patient safety in the operating room. CONCLUSION: Professionals operating theaters have expressed a positive attitude towards the checklist, however, its implementation raises some difficulties.


Assuntos
Atitude do Pessoal de Saúde , Cuidadores/estatística & dados numéricos , Lista de Checagem , Salas Cirúrgicas , Percepção , Adulto , Cuidadores/psicologia , Lista de Checagem/normas , Estudos Transversais , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Erros Médicos/prevenção & controle , Erros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Salas Cirúrgicas/normas , Salas Cirúrgicas/estatística & dados numéricos , Segurança do Paciente/normas , Inquéritos e Questionários , Tunísia/epidemiologia , Adulto Jovem
17.
Sante Publique ; 29(5): 685-691, 2017 Dec 05.
Artigo em Francês | MEDLINE | ID: mdl-29384302

RESUMO

AIMS: To assess safety culture in primary healthcare centres and to explore its associated factors. METHODS: This multicentre cross-sectional descriptive study was conducted in the 30 primary healthcare centres in central Tunisia and used the validated French version of the Hospital Survey on Patient Safety Culture questionnaire' (HSOPSC). RESULTS: A total of 214 professionals participated, corresponding to a response rate of 85%. The ?Teamwork within centres? dimension had the highest score (71.5%). However, two safety dimensions had very low scores: ?Frequency of event reporting?, ?Non-punitive response to errors? with percentages of 31.4% and 35.4%, respectively. Among the associated factors, the ?Frequency of reported events? dimension was significantly higher among professionals involved in risk management committees (p = 0.01). CONCLUSION: This study demonstrates that the level of safety culture needs to be improved in primary healthcare centres in Tunisia and also highlights the need to implement a quality management system in primary healthcare centres.


Assuntos
Cultura Organizacional , Segurança do Paciente , Atenção Primária à Saúde , Gestão da Segurança/organização & administração , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Tunísia
18.
Ann Pathol ; 36(5): 355-357, 2016 Oct.
Artigo em Francês | MEDLINE | ID: mdl-27693311

RESUMO

Tubulo-papillary apocrine adenoma (TAA) is a very rare sweat gland tumor. TAA in association with syringocystadenoma papilliferum (SCP) is exceptional. A 2-year-old Tunisian child developed a mixed tumor on the scalp: TAA in association with SCP. Histologically, the tumor consisted of dilated duct-like areas with some apocrine gland-like areas. The superficial part of the tumor was connected to the epidermis and showed the characteristics of SCP. The characteristics and differences in histopathologic and immunohistochemical findings in this mixed tumor are described.


Assuntos
Adenoma de Glândula Sudorípara/patologia , Adenoma/patologia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias Primárias Múltiplas/patologia , Couro Cabeludo/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Adenoma de Glândula Sudorípara/diagnóstico , Pré-Escolar , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico
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