Benefits of the tranexamic acid in head trauma with no extracranial bleeding: a prospective follow-up of 180 patients.

Introduction: Tranexamic acid (TXA) is one of the debated therapies in the management of traumatic brain injury (TBI). We conducted this study to evaluate the benefits of TXA in TBI on the mortality and its safety in these patients.

Methods: This was a prospective randomized open-label trial including all patients, aged at 18 years or older, hospitalized in the emergency room during a 13-month period, for TBI.

Update on the Epidemiology of Scorpion Envenomation in the South of Tunisia.

Introduction: Scorpion envenomation is still a frequent occurance in tropical and subtropical regions. In Tunisia, multiple studies on scorpion envenoming have contributed to an improved understanding of cardiac dysfunction and factors predictive of poor prognosis. These previous studies have contributed to the current standardized management of envenomed patients.

Epidemiological features of stress hyperglycemia in elderly at emergency department.

Unlabelled: Background : Stress hyperglycemia among patients having an acute pathology is frequently described in recent studies.

Aims: The objectives of this work were to describe epidemiologic features of elderly patients hospitalized in the emergency department and having a hyperglycemia due to stress.

Methods: A retrospective chart review identified patients older than 65 years with obtained serum glucose levels.

[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.

Prediction value of the Canadian CT head rule and the New Orleans criteria for positive head CT scan and acute neurosurgical procedures in minor head trauma: a multicenter external validation study.

Study Objective: The New Orleans Criteria and the Canadian CT Head Rule have been developed to decrease the number of normal computed tomography (CT) results in mild head injury. We compare the performance of both decision rules for identifying patients with intracranial traumatic lesions and those who require an urgent neurosurgical intervention after mild head injury.

Methods: This was an observational cohort study performed between 2008 and 2011 on patients with mild head injury who were aged 10 years or older.

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.

Clinical features, complications and mortality in critically ill patients with 2009 influenza A(H1N1) in Sfax,Tunisia.

Purpose: Africa, as the rest of the world, was touched by the 2009 pandemic influenza A(H1N1). In the literature, a few publications covering this subject emerged from this continent. We prospectively describe baseline characteristics, treatment and outcomes of consecutive critically ill patients with confirmed 2009 influenza A(H1N1) in the intensive care unit (ICU) of Sfax hospital.

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.

Microbiological characteristics of catheter-related bacteremia in a Tunisian intensive care unit.

Background: Prevalence of catheter-related bacteremia in intensive care units is increasing as central venous catheters (CVC) are used more frequently. In the most of the published literature, Gram positive cocci are the leading cause of catheter-related bacteremia and the systemic empiric treatment recommended include the administration of glycopeptides.

Aim: To search for the microbiological characteristics of catheter-related bacteremia in a Tunisian ICU.

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).

Intraperitoneal rupture of renal cyst in autosomal dominant polycystic kidney disease.

Context: To report a rare case of spontaneous rupture of an infected renal cyst into the peritoneal cavity.

Case Report: We report a case of 66-year old man with autosomal dominant polycystic kidney disease and kidney dialysis who had suffered from intestinal obstruction and peritoneal syndrome for 2 days associated with purulent urine. An exploratory laparotomy found multiple hepatic cysts and bilaterally enlarged polycystic kidneys.

[Acute fatty liver of pregnancy. "Incidence, pathogenesis, diagnosis, treatment and prognosis"].

Acute fatty liver of pregnancy (AFLP) is a rare, potentially fatal complication that occurs in the third trimester or early postpartum period. It generally appears between weeks 30 and 38. Usually the APLF symptoms start one to two weeks before hospitalization with nausea, emesis, general uneasiness, jaundice, epigastric pain and other symptoms.

Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in South Tunisia: multivariate analysis of 951 cases.

The aim of this retrospective descriptive study was to describe both epidemiologically and clinically manifestations following severe scorpion envenomation and to define simple predictive factors which can be used in routine practice in general Intensive Care Units (ICU) as an indicator of poor prognosis. Cases were collected from hospital patients' files during 13-year (1990-2002) period in the medical Intensive Care Unit of a university hospital (Sfax - Tunisia). The diagnosis of scorpion envenomation was based on a history of scorpion sting.

End-of-life family conferences: rooted in the evidence.

Critical care clinicians no longer consider family members as visitors in the intensive care unit. Family-centered care has emerged from the results of qualitative and quantitative studies evaluating the specific needs of families of patients dying in the intensive care unit. In addition, interventional studies have established that intensive and proactive communication empowers family members of dying patients, helping them to share in discussions and decisions, if they so wish.

Gastrointestinal manifestations in severe scorpion envenomation.

Objectives: To evaluate the type and incidence of gastrointestinal manifestations secondary to scorpion envenomation and their prognostic significance.

Patients And Methods: All patients admitted to our ICU for scorpion envenomation were included in this retrospective chart review of a 13-year period (1990 - 2002).

Results: During the study period, 951 patients were admitted for scorpion envenomation and 72 (7.

The effect of ventilator-associated pneumonia on the prognosis of head trauma patients.

Background: To investigate the effect of ventilator-associated pneumonia (VAP) on the prognosis of head trauma patients.

Methods: We performed a retrospective case-control study in which 57 head trauma patients with VAP were matched to 57 head trauma patients without VAP. Matching criteria were age (+/-5 years), Glasgow Coma Scale score (+/-2), Injury Severity Score (+/-5), Simplified Acute Physiology Score II (+/-5), and duration of exposure to mechanical ventilation.

Impact of tracheotomy on sedative administration, sedation level, and comfort of mechanically ventilated intensive care unit patients.

Objective: To assess the impact of tracheotomy on sedative administration, sedation level, and autonomy of mechanically-ventilated intensive care unit (ICU) patients.

Design, Setting, And Patients: In this observational study, the charts of all consecutive patients undergoing mechanical ventilation requiring tracheotomy over a 14-month period in our 18-bed tertiary care ICU were reviewed retrospectively. Patients' sedation levels (according to the Riker's 7-level sedation-agitation score) and intravenous (fentanyl and midazolam) and oral (clorazepate and haloperidol) sedative administration were measured daily during the 7 days before and after tracheotomy.

Suspected acute interstitial nephritis induced by colistin.

We describe a 35-year-old male admitted to the intensive care unit (ICU) for acute exacerbation of chronic obstructive pulmonary disease (COPD). He developed ventilator-associated pneumonia caused by multidrug-resistant Pseudomonas aeruginosa and was treated with imipenem and colistin without any renal toxicity. The patient was readmitted to the ICU for a 2nd and a 3rd exacerbation of COPD and was again treated with imipenem and colistin.

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.

Neurological complications secondary to severe scorpion envenomation.

Background: The aim was to study the incidence, clinical manifestations, and prognosis of neurological complications secondary to scorpion envenomation.

Material/methods: A retrospective study over a 13-year period including all patients admitted to our ICU for scorpion envenomation.

Results: During the period of study, 951 patients were admitted due to scorpion envenomation.

Prognosis of traumatic head injury in South Tunisia: a multivariate analysis of 437 cases.

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.

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).

[Incidence and prognosis of acute renal failure in the intensive care unit. Retrospective study of 216 cases].

Unlabelled: Our aims to determine the incidence, the causes, the nature and the prognosis of acute renal failure (ARF) in an intensive care unit of Habib Bourguiba's university hospital (Sfax Tunisia).

Patients And Methods: We retrospectively included all patients having ARF during a period of one year. Two hundred sixteen patients developed ARF (17%) During the period of study.