Implementation of simulation training in the Intensive Care Units (ICU) during the COVID-19 pandemic: A scoping review.

Introduction: In response to the important influx of critically ill patients as well as resources limitation, simulation would be a tool ensuring the continuum of medical training.

Aim: To assess the impact of simulation training on both education and performance related to protocol development during COVID-19 pandemic, in critical care.

Methods: This scoping review was written in accordance with the PRISMA Guideline.

Simulation-based echocardiography learning contribution on training of medical residents.

Introduction: Echocardiography is a pivotal exam in critically ill patients, a specific training is crucial. Medical residents often lack echocardiography practice.

Aim: This study aims to evaluate the impact of simulation-based training on medical residents' echocardiography mastery.

Hypereosinophilic syndrome associated with multiple thromboses requiring ICU admission: A case report.

Hypereosinophilic syndrome (HES) is a leucoproliferative disorder, characterized by marked blood eosinophilia and organ damage due to tissue eosinophilia. Pulmonary involvement may lead to life-threatening acute respiratory failure and intensive care unit (ICU) admission. Association between eosinophilia and thromboembolism has been previously described.

Evaluation of stress induced by high-fidelity simulation among anesthesiology and emergency residents: impact of oral debriefing versus video assisted.

Aim: To describe the level of stress in emergency medicine and anesthesia residents during high fidelity simulation sessions and to evaluate the effect of video-assisted debriefing versus no-video assisted debriefing on stress level.

Methods: Prospective randomized study.

Inclusion: emergency medicine and anesthesia residents consenting.

The contribution of simulation in training for funduscopic examination.

Introduction: Simulation is emerging as an essential part of health sciences training programs as it provides safer patient care by reducing the risk of error. In the healthcare environment, simulation continues to spread in emergency specialties, but it is still underdeveloped in ophthalmology and there is a shortage of publications on this subject in Tunisia.

Objective: To evaluate the effectiveness of procedural simulation as a teaching tool for funduscopic examination training.

Simulation Based Learning in internal medicine students.

Introduction: Few experiences have been reported in simulation-based learning (SBL) in internal medicine.

Aim: To assess the SBL impact in internal medicine learning on learners' perception, knowledge acquisition, and cognitive and communication skills evaluation.

Methods: A prospective observational study conducted in the Simulation Center at the Faculty of Medicine of Monastir between November 2018 and March 2019.

High-fidelity simulation versus video-based learning in the management of pediatric septic shock: a pilot study.

High-fidelity simulation (HFS) and video-based learning (VBL) promote competence in acute care in a realistic and safe environment. These two modalities have not been compared in pediatric emergency situations. Interns rotating in the pediatric department were randomized for the two educational methods.

Automatic oxygen administration and weaning in patients following mechanical ventilation.

Purpose: To evaluate efficacy of FreeO2 device in oxygen weaning of patients after being liberated from mechanical ventilation (MV).

Methods: Prospective crossover cohort study in patients admitted to ICU and after MV weaning. FreeO2 curves were recorded during constant flow and FreeO2 modes.

Assessement of stress induced by high-fidelity simulation sessions among medical students.

Introduction: Simulation is a growing pedagogical method in training health professionals. The use of high-fidelity simulators may be associated with significant stress.

Objective: to measure self-assessed intensity of stress before and after a planned simulation training session of a third degree atrio-ventricular block  among  medical students.

[Contribution of high fidelity simulation to training in respiratory medicine].

Introduction: Simulation maintains patient safety by limiting the risk of errors. In the medical field, simulation is a method of learning that is developing more and more in the acute specialties but it is still not widespread in the field of respiratory medicine.

Objective: To evaluate the efficacy of high fidelity simulation as a teaching tool in respiratory medicine.

Prevalence of anxiety and depressive symptoms among medical residents in Tunisia: a cross-sectional survey.

Objective: To assess the prevalence of anxiety and depressive symptoms and the associated risk factors among Tunisian medical residents.

Design: Cross-sectional survey.

Setting: Faculty of Medicine, Tunis.

Inverted Takotsubo syndrome in Androctonus australis scorpion envenomation.

Context: The nature of scorpion-related cardiomyopathy is still a matter of debate where specific toxin-induced cardiomyopathy, ischemic, or catecholaminergic cardiomyopathy is advocated as well. We report two cases of Takotsubo syndrome following envenomation by Androctonus australis, bringing new evidence for the fundamental role of catecholamines in the pathogenesis of this cardiomyopathy. Case 1: A woman aged 36 presented with pulmonary edema and shock following scorpion envenomation.

Noninvasive ventilation with helium-oxygen mixture in hypercapnic COPD exacerbation: aggregate meta-analysis of randomized controlled trials.

When used as a driving gas during NIV in hypercapnic COPD exacerbation, a helium-oxygen (He/O) mixture reduces the work of breathing and gas trapping. The potential for He/O to reduce the rate of NIV failure leading to intubation and invasive mechanical ventilation has been evaluated in several RCTs. The goal of this meta-analysis is to assess the effect of NIV driven by He/O compared to air/O on patient-centered outcomes in hypercapnic COPD exacerbation.

Trends in use and impact on outcome of empiric antibiotic therapy and non-invasive ventilation in COPD patients with acute exacerbation.

Background: Empiric antibiotic therapy is routinely prescribed in patients with acute COPD exacerbations (AECOPD) requiring ventilatory support on the basis of studies including patients conventionally ventilated. Whether this practice remains valid to current management with first-line non-invasive ventilation (NIV) is unclear.

Methods: In a cohort of ICU patients admitted between 2000 and 2012 for AECOPD, we analyzed the trends in empiric antibiotic therapy and in primary ventilatory support strategy, and their respective impact on patients' outcome.

Study of severe scorpion envenoming following subcutaneous venom injection into dogs: Hemodynamic and concentration/effect analysis.

To evaluate the dose-effects of Androctonus australis hector (Aah) venom injected subcutaneously on hemodynamics and neurohormonal secretions, 10 anesthetized and ventilated mongrel dogs, were split in two groups (n = 5/group). Subcutaneous injection was done with either 0.2 mg/kg or 0.

Scorpion-related cardiomyopathy: Clinical characteristics, pathophysiology, and treatment.

Context: Scorpion envenomation is a threat to more than 2 billion people worldwide with an annual sting number exceeding one million. Acute heart failure presenting as cardiogenic shock or pulmonary edema, or both is the most severe presentation of scorpion envenomation accounting for 0.27% lethality rate.

Systemic corticosteroids in acute exacerbation of COPD: a meta-analysis of controlled studies with emphasis on ICU patients.

Guidelines on systemic corticosteroids in chronic obstructive pulmonary disease (COPD) exacerbation rely on studies that excluded patients requiring ventilatory support. Recent publication of studies including ICU patients allows estimation of the level of evidence overall and in patients admitted to the ICU. We included RCTs evaluating the efficacy and safety of systemic corticosteroids in COPD exacerbation, compared to placebo or standard treatment.

Randomized intubation with polyurethane or conical cuffs to prevent pneumonia in ventilated patients.

Rationale: The occurrence of ventilator-associated pneumonia (VAP) is linked to the aspiration of contaminated pharyngeal secretions around the endotracheal tube. Tubes with cuffs made of polyurethane rather than polyvinyl chloride or with a conical rather than a cylindrical shape increase tracheal sealing.

Objectives: To test whether using polyurethane and/or conical cuffs reduces tracheal colonization and VAP in patients with acute respiratory failure.

Family cluster of Middle East respiratory syndrome coronavirus infections, Tunisia, 2013.

In 2013 in Tunisia, 3 persons in 1 family were infected with Middle East respiratory syndrome coronavirus (MERS-CoV). The index case-patient's respiratory tract samples were negative for MERS-CoV by reverse transcription PCR, but diagnosis was retrospectively confirmed by PCR of serum. Sequences clustered with those from Saudi Arabia and United Arab Emirates.

Prednisone in COPD exacerbation requiring ventilatory support: an open-label randomised evaluation.

Recommendation of the use of systemic steroids in chronic obstructive disease (COPD) exacerbation rely on trials that excluded patients requiring ventilatory support. In an open-label, randomised evaluation of oral prednisone administration, 217 patients with acute COPD exacerbation requiring ventilatory support were randomised (with stratification on the type of ventilation) to usual care (n=106) or to receive a daily dose of prednisone (1 mg·kg(-1)) for up to 10 days (n=111). There was no difference regarding the primary end-point, intensive care unit mortality, which was 17 (15.

NT-proBNP levels at spontaneous breathing trial help in the prediction of post-extubation respiratory distress.

Purpose: To evaluate and compare the performance of NT-proBNP levels, plasma protein concentration, hematocrit, and fluid balance for the preceding 24 h in predicting the outcome of the two steps of weaning: (1) spontaneous breathing trial (SBT), (2) extubation.

Methods: This was a prospective observational study of 143 patients who were mechanically ventilated for more than 48 h (55% COPD) and were ready to wean. They underwent an SBT and were extubated when they passed the trial.