Impact of acetazolamide use in severe exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation.

Purpose: To analyse the impact of acetazolamide (ACET) use in severe acute decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation and intensive care unit (ICU) admission.

Patients And Methods: Retrospective pair-wise, case-control study with 1:1 matching. Patients were defined as cases when they had received acetazolamide (500 mg per day) and as controls when they did not received it.

[Pulmonary thromboembolism: incidence, physiopathology, diagnosis and treatment].

The objective of this work was to review current data about the pathophysiology, clinical features, and treatment of pulmonary thromboembolism. Venous thromboembolism (VTE) remains a major challenge in hospitalised especially the care of critically ill patients. Pulmonary embolism (PE) is the major complication of VTE.

Comparison of two quantitative real time PCR assays for Rickettsia detection in patients from Tunisia.

Background And Objectives: Quantitative real time PCR (qPCR) offers rapid diagnosis of rickettsial infections. Thus, successful treatment could be initiated to avoid unfavorable outcome. Our aim was to compare two qPCR assays for Rickettsia detection and to evaluate their contribution in early diagnosis of rickettsial infection in Tunisian patients.

Incidence and impact outcome of pulmonary embolism in critically ill patients with severe exacerbation of chronic obstructive pulmonary diseases.

Purpose: We aimed to determine the incidence and the prognostic impact [mortality and length of intensive care unit (ICU) stay (LOS)] of pulmonary embolism (PE) in critically ill patients with severe acute exacerbation of chronic obstructive pulmonary disease (COPD).

Methods: This is a retrospective study performed during a 5-year period in the ICU of Habib Bourguiba University Hospital (Sfax, Tunisia). All patients with severe acute exacerbation of COPD were included.

Severe scorpion envenomation among children: does hydrocortisone improve outcome? A case-control study.

Background: To analyse the efficacy and safety of systemic infusion of hydrocortisone hemisuccinate in children admitted to the intensive care unit with severe scorpion envenomation, we assessed the impact on mortality and length of hospital stay.

Method: We conducted a pair-wise, case-control study with 1:1 matching, reviewing records over a 13-year period (1990-2002) for the intensive care unit (ICU) of the Habib Bourguiba University Hospital, Sfax, Tunisia. A total of 184 children were included in the study (92 cases and 92 controls); cases received hydrocortisone hemisuccinate during hospitalization and controls received no steroids.

Impact of hydrocortisone hemisuccinate use on outcome of severe scorpion-envenomed adult patients.

The aim of this study is to analyze if the infusion of hydrocortisone hemisuccinate improve outcome in severe scorpion-envenomated adult patients admitted to intensive care unit (ICU). Pairwise retrospective case-control study with 1:1 matching was designed. Patients were defined as cases when they received hydrocortisone hemisuccinate (as alone steroids) during hospitalization and as controls when they did not received any steroids.

Does change of catecholamine use improve the outcome of patients with shock admitted to intensive care unit?

Up to 2008, dopamine was the catecholamine that was the most recommended in our intensive care unit (ICU) after fluid resuscitation. However, recently, norepinephrine has become the catecholamine that was most recommended in our ICU after fluid resuscitation. The aim of this study was to determine if there was an efficacy or safety benefit to this protocol therapeutic change in patients with shock admitted to our ICU.

Efficacy of corticosteroid therapy in severe decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation.

The purpose of this study was to analyze the efficacy of corticosteroids in severe acute decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation and intensive care unit (ICU) admission. Pairwise retrospective case-control study with 1:1 matching. Patients were defined as cases when they received corticosteroids and as controls when they did not received any steroids.

[Use of catecholamines for shock. A continuous debate!].

Background: Hypotension and shocks are frequently observed in patients requiring admission in ICU. However, the optimal adrenergic support in shock is controversial.

Aim: To perform a descriptive approach of the current use of catecholamine in a medico-surgical ICU in patients with schoks.

Pulmonary edema following scorpion envenomation: mechanisms, clinical manifestations, diagnosis and treatment.

Scorpion envenomation is common in tropical and subtropical regions. Cardio-respiratory manifestations, mainly cardiogenic shock and pulmonary edema, are the leading causes of death after scorpion envenomation. The mechanism of pulmonary edema remains unclear and contradictory conclusions were published.

Post-traumatic pulmonary embolism in the intensive care unit.

Objective: To determine the predictive factors, clinical manifestations, and the outcome of patients with post-traumatic pulmonary embolism (PE) admitted in the intensive care unit (ICU).

Methods: During a four-year prospective study, a medical committee of six ICU physicians prospectively examined all available data for each trauma patient in order to classify patients according to the level of clinical suspicion of pulmonary thromboembolism. During the study period, all trauma patients admitted to our ICU were classified into two groups.

Outcome analysis and outcome predictors of traumatic head injury in childhood: Analysis of 454 observations.

Aim: To determine factors associated with poor outcome in children suffering traumatic head injury (HI).

Materials And Methods: A retrospective study over an 8-year period including 454 children with traumatic HI admitted in the Intensive Care Unit of a university hospital (Sfax-Tunisia). Basic demographic, clinical, biological and radiological data were recorded on admission and during the ICU stay.

Isolated traumatic head injury in children: Analysis of 276 observations.

Background: To determine predictive factors of mortality among children after isolated traumatic brain injury.

Materials And Methods: In this retrospective study, we included all consecutive children with isolated traumatic brain injury admitted to the 22-bed intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Basic demographic, clinical, biochemical, and radiological data were recorded on admission and during ICU stay.

Scorpion envenomation among children: clinical manifestations and outcome (analysis of 685 cases).

Our objective was to characterize both epidemiologically and clinically manifestations after severe scorpion envenomation and to define simple factors indicative of poor prognosis in children. We performed a retrospective study over 13 years (1990-2002) in the medical intensive care unit (ICU) of a university hospital (Sfax-Tunisia). The diagnosis of scorpion envenomation was based on a history of scorpion sting.

Risk factors and outcomes of intensive care unit-acquired infections in a Tunisian ICU.

Background: ICU-acquired infections constitute an important world-wide health problem. Our aim was to determine the incidence, predictive factors and impact of ICU-AIs in ICU patients in Tunisia.

Material/methods: We conducted a prospective observational cohort study over a 3 month period in the medical surgical intensive care unit of Habib Bourguiba University Hospital (Sfax-Tunisia).

Pulmonary embolism in intensive care unit: Predictive factors, clinical manifestations and outcome.

Objective: To determine predictive factors, clinical and demographics characteristics of patients with pulmonary embolism (PE) in ICU, and to identify factors associated with poor outcome in the hospital and in the ICU.

Methods: During a four-year prospective study, a medical committee of six ICU physicians prospectively examined all available data for each patient in order to classify patients according to the level of clinical suspicion of pulmonary thromboembolism. During the study periods, all patients admitted to our ICU were classified into four groups.

Severe head injury among children: prognostic factors and outcome.

Aim: To determine predictive factors of mortality among children after traumatic brain injury.

Methods: A retrospective study over 8 years of 222 children with severe head injury (Glasgow Coma Scale score < or = 8) admitted to a university hospital (Sfax, Tunisia). Basic demographic, clinical, biological and radiological data were recorded on admission and during intensive care unit stay.

Correlation between antibiotic use and changes in susceptibility patterns of Pseudomonas aeruginosa in a medical-surgical intensive care unit.

Context: Multiple surveillance programmes have reported a decline in antibiotic susceptibility of P. aeruginosa.

Aim: Our study aimed to study the relationship between the use of antipseudomonal drugs and the development of resistance of P.

Clinical manifestations of systemic paraphenylene diamine intoxication.

Background: To report clinical symptoms and outcome of systemic paraphenylene diamine (PPD) intoxication.

Methods: Our study was retrospective. It was conducted over 6 yrs (1994-2000) in the medical intensive care unit (ICU) of a university hospital and it concerned 19 patients hospitalized for systemic PPD intoxication.

Evidence of myocardial ischaemia in severe scorpion envenomation. Myocardial perfusion scintigraphy study.

Objective: To explore the myocardial perfusion by thallium-201 scintigraphy for patients with evidence of myocardial damage after scorpion envenomation.

Design: Prospective study over 1-year period.

Setting: Medical intensive care unit of a university hospital (Sfax, Tunisia).