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Bahloul M, Makni A, Kharrat S, Alila I, Suissi B, Bouaziz M. A possible cause of cholesterol crystal embolism in a polytrauma patient? J Med Vasc 2023; 48:88-90. [PMID: 37422333 DOI: 10.1016/j.jdmv.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/09/2023] [Indexed: 07/10/2023]
Affiliation(s)
- M Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia.
| | - A Makni
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - S Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - I Alila
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - B Suissi
- Department of Radiology, Habib Bourguiba Hospital, Sfax University, Sfax, Tunisia
| | - M Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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2
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Ben Jemaa A, Bahloul M, Kallel H, Turki O, Dlela M, Bouaziz M. [Inverted Takotsubo Syndrome due to Severe Scorpion Envenomation: Report of one Case]. Med Trop Sante Int 2021; 1:PWX0-M245. [PMID: 35586636 PMCID: PMC9022762 DOI: 10.48327/pwx0-m245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/01/2020] [Indexed: 11/17/2022]
Abstract
Scorpion envenomation (SE) is common in tropical and subtropical regions. Cardio-respiratory manifestations, mainly cardiogenic shock and pulmonary oedema are the leading causes of death after scorpion envenomation. Cardiac failure can be due to massive release of catecholamines, myocardial damage induced by the venom or myocardial ischemia. Although it has been exceptionally reported, Takotsubo syndrome during SE can help to better elucidate the pathophysiology of this cardiomyopathy. We report a case of inverted Takotsubo following a SE in a 26-year-old patient admitted to the Intensive care unit department for severe scorpion envenomation. His evolution was favorable. We concluded that cardiac involvement in this case fulfills all clinical and paraclinical criteria of Takotsubo syndrome emphasizing the importance of catecholaminergic discharge during scorpion envenomation. We discuss again the management of this syndrome in this specific condition.
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Affiliation(s)
- A. Ben Jemaa
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - M. Bahloul
- Faculté de Médecine de Sfax. Université de Sfax, Boulevard Majida Boulila, Sfax 3029, Tunisie,*
| | - H. Kallel
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - O. Turki
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - M. Dlela
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
| | - M. Bouaziz
- Département de soins intensifs, Hôpital universitaire Habib Bourguiba, 3029, Sfax, Tunisie
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Heni S, Ammar R, Barhoumi H, Chtara K, Bahloul M, Bouaziz M. Post-traumatic acute renal failure: The epidemiological, clinical, etiological aspects and the predictive factors for the occurrence of post-traumatic AKI. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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4
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Maaloul I, Ameur SB, Chabchoub I, Kolsi R, Bahloul M, Kamoun T, Bouaziz M, Hachicha M. Fulminant mulch pneumonitis in a previously healthy child. Arch Pediatr 2018; 25:495-496. [PMID: 30340947 DOI: 10.1016/j.arcped.2018.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/09/2018] [Accepted: 09/23/2018] [Indexed: 10/28/2022]
Abstract
Chronic granulomatous disease (CGD) is associated with multiple and recurrent infections. In patients with CGD, invasive pulmonary infection with aspergillus species remains the greatest cause of mortality. Acute fulminant presentations of fungal pneumonia are catastrophic. It is a medical emergency, and currently the treatment is based on association of corticosteroids and antifungal therapy. We describe the case of an 11-year-old boy, with late initial presentation of CGD, which was revealed by fulminant aspergillus pneumonia. He was successfully treated with an association of high doses of steroids and voriconazole.
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Affiliation(s)
- I Maaloul
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia.
| | - S Ben Ameur
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - I Chabchoub
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - R Kolsi
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Bahloul
- Intensive care unit, Sfax Medical School, Habib Bourguiba Hospital, Sfax, Tunisia
| | - T Kamoun
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Bouaziz
- Intensive care unit, Sfax Medical School, Habib Bourguiba Hospital, Sfax, Tunisia
| | - M Hachicha
- Department of pediatrics, Sfax Medical School, Hedi Chaker Hospital, Sfax, Tunisia
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Bahloul M, Chrifi-Alaoui L, Drid S, Souissi M, Chaabane M. Robust sensorless vector control of an induction machine using Multiobjective Adaptive Fuzzy Luenberger Observer. ISA Trans 2018; 74:144-154. [PMID: 29395127 DOI: 10.1016/j.isatra.2018.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 12/17/2017] [Accepted: 01/05/2018] [Indexed: 06/07/2023]
Abstract
This paper presents an inherent speed estimation scheme associated to the Indirect Field Oriented Control in case of Induction motor sensorless control. Indeed, through the design of a Multiobjective Adaptive Fuzzy Luenberger Observer, the speed sensorless control issue even at low speed, the observer poles' assignment issues and the speed estimation's sensitivity to rotor resistance uncertainties issue are treated concurrently. First of all, the structure of the proposed Takagi-Sugeno adaptive observer is described. Secondly, based on Lyapunov theory, observer gains are designed and a fuzzy speed estimation scheme is provided. The design's objectives consist of minimizing the sensitivity of the proposed observer to rotor resistance uncertainties (using the L2 techniques) and to guarantee a specified observer dynamic performances through a D-stability analysis. The design conditions are formulated into Linear Matrix Inequalities terms. Finally, experiments are conducted to demonstrate the effectiveness of the proposed results regardless of uncertainties in the rotor resistance.
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Affiliation(s)
- M Bahloul
- International Energy Research Centre (IERC),Tyndall National Institute, Cork, T12 R5CP, Ireland; Lab-STA Laboratory, National, School of Engineering of Sfax, 3038 Sfax, Tunisia.
| | - L Chrifi-Alaoui
- LTI, University of Picardie Jules Verne, 13 Av. F. Mitterrand, 02880 Cuffies, France.
| | - S Drid
- LSPIE Laboratory, Electrical Engineering Department, University of Batna 2, 05000 Batna, Algeria.
| | - M Souissi
- Lab-STA Laboratory, National, School of Engineering of Sfax, 3038 Sfax, Tunisia.
| | - M Chaabane
- Lab-STA Laboratory, National, School of Engineering of Sfax, 3038 Sfax, Tunisia.
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Chakroun-Walha O, Karray R, Jerbi M, Ben Rebeh A, Jammeli C, Bahloul M, Ammar R, Chabchoub I, Bouaziz M, Nasri A, Rekik N. Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation. Hum Exp Toxicol 2017; 37:580-586. [DOI: 10.1177/0960327117722822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Context: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation. Methods: A retrospective monocentric study including patients admitted in the emergency department for moderate scorpion envenomation with troponin measurement during their early management. On arrival, an electrocardiogram and a chest X-ray were realized for all patients. Results: We enrolled 132 patients with a mean age at 31.3 ± 24.4 years and a 1.35 sex-ratio. All patients had moderate systemic manifestations. There were 28 patients with clinical manifestations of cardiac dysfunction without life-threatening troubles (21.2%). Troponin was undetectable in 69 patients (56%). The mean value of troponin level (pg/ml) was higher in patients with clinical manifestations of left ventricular dysfunction (1.80 ± 3.8 vs. 0.11 ± 0.5; p = 0.02). Troponin levels were significantly higher in patients with positive T wave on electrocardiogram. Conclusion: In patients with moderate scorpion envenomation with positive T wave, high values of troponin suggest the presence of cardiac dysfunction.
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Affiliation(s)
- O Chakroun-Walha
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - R Karray
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - M Jerbi
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - A Ben Rebeh
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - C Jammeli
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - M Bahloul
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - R Ammar
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - I Chabchoub
- Paediatric Department, University Hospital Hedi Chaker Sfax, Sfax, Tunisia
| | - M Bouaziz
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - A Nasri
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - N Rekik
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
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Bahloul M, Regaieg K, Chabchoub I, Kammoun M, Chtara K, Bouaziz M. Severe scorpion envenomation: pathophysiology and the role of inflammation in multiple organ failure. Med Sante Trop 2017; 27:214-221. [PMID: 28655685 DOI: 10.1684/mst.2017.0688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Scorpion stings occur on every continent except Antarctica. The correlation between young age and severity of clinical manifestations after this envenomation is well-established. Several studies have emphasized the relevance of pro-inflammatory mediators in the pathophysiological manifestations of human scorpion envenomation. Moreover, there is a significant association between pro-inflammatory cytokine levels in the blood and the severity of scorpion envenomation. Release of these cytokines increases the severity of the visceral damage induced by the direct action of the venom and the activation of both the sympathetic and parasympathetic nervous systems.
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Affiliation(s)
- M Bahloul
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - K Regaieg
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - I Chabchoub
- Hôpital Hedi Chaker, service de pédiatrie générale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - M Kammoun
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - K Chtara
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - M Bouaziz
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
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Bahloul M, Regaieg K, Chtara K, Turki O, Baccouch N, Chaari A, Bouaziz M. [Posttraumatic thromboembolic complications: Incidence, risk factors, pathophysiology and prevention]. Ann Cardiol Angeiol (Paris) 2017; 66:92-101. [PMID: 28110934 DOI: 10.1016/j.ancard.2016.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 12/08/2016] [Indexed: 06/06/2023]
Abstract
Venous thromboembolism (VTE) remains a major challenge in critically ill patients. Subjects admitted in intensive care unit (ICU), in particular trauma patients, are at high-risk for both deep vein thrombosis (DVT) and pulmonary embolism (PE). The rate of symptomatic PE in injured patients has been reported previously ranging from 1 to 6%. The high incidence of posttraumatic venous thromboembolic events is well known. In fact, major trauma is a hypercoagulable state. Several factors placing the individual patient at a higher risk for the development of DVT and PE have been suggested: high ISS score, meningeal hemorrhage and spinal cord injuries have frequently been reported as a significant risk factor for VTEs after trauma. Posttraumatic pulmonary embolism traditionally occurs after a period of at least 5 days from trauma. The prevention can reduce the incidence and mortality associated with the pulmonary embolism if it is effective. There is no consensus is now available about the prevention of venous thromboembolism in trauma patients.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie.
| | - K Regaieg
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - K Chtara
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - O Turki
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - N Baccouch
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - A Chaari
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - M Bouaziz
- Service de réanimation médicale, hôpital Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
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Regaieg K, Bahloul M, Turki O, Mnif B, Bouaziz M. [The efficacy of the tigecycline-colistin association in the treatment of multi-resistant Acinetobacter baumannii meningitis]. Med Mal Infect 2017; 47:175-177. [PMID: 28215823 DOI: 10.1016/j.medmal.2017.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/18/2017] [Indexed: 02/07/2023]
Affiliation(s)
- K Regaieg
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - M Bahloul
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie.
| | - O Turki
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - B Mnif
- Laboratoire de microbiologie, CHU Habib Bourguiba, Sfax, Tunisie
| | - M Bouaziz
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
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Chaari A, Ghadoun H, Ben Algia N, Bahloul M, Bouaziz M. La mucormycose : une cause rare d’exophtalmie unilatérale. J Mycol Med 2013; 23:140-3. [DOI: 10.1016/j.mycmed.2013.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 03/13/2013] [Accepted: 04/09/2013] [Indexed: 11/26/2022]
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Gevao B, Al-Ghadban AN, Bahloul M, Uddin S, Zafar J. Phthalates in indoor dust in Kuwait: implications for non-dietary human exposure. Indoor Air 2013; 23:126-133. [PMID: 22862295 DOI: 10.1111/ina.12001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 07/24/2012] [Indexed: 06/01/2023]
Abstract
Phthalates are semivolatile organic compounds with a ubiquitous environmental distribution. Their presence in indoor environments is linked to their use in a variety of consumer products such as children's toys, cosmetics, food packaging, flexible PVC flooring among others. The goal of this study was to investigate the occurrence and concentration of phthalates in dust from homes in Kuwait and to assess non-dietary human exposure to these phthalates. Dust samples were randomly collected from 21 homes and analyzed for eight phthalates. The concentrations of total phthalates were log normally distributed and ranged from 470 to 7800 μg/g. Five phthalates [Di(2-ethylhexyl) phthalate (DEHP), Di-n-octyl phthalate (DnOP), Di-n-butyl phthalate (DBP), Benzyl butyl phthalate (BzBP), and Dicyclohexyl phthalate (DcHP)] were routinely detected. The major phthalate compound was DEHP at a geometric mean concentration of 1704 μg/g (median, 2256 μg/g) accounting for 92% of the total phthalates measured. Using the measured concentrations and estimates of dust ingestion rates for children and adults, estimated human non-dietary exposure based on median phthalate concentrations ranged from 938 ng/kg-bd/day for adults to 13362 ng/kg-bd/day for toddlers. The difference in exposure estimates between children and adults in this study supports previous reports that children are at greater risk from pollutants that accumulate indoors.
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Affiliation(s)
- B Gevao
- Department of Environmental Science, Kuwait Institute for Scientific Research, Safat, Kuwait.
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Harbi Y, Bahloul M. Recherche des E. coli O157:H7 producteurs des shiga-toxines dans les denrées alimentaires. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Bahloul M, Chaari A, Dammak H, Medhioub F, Abid L, Chtourou K, Rekik N, Chelly H, Kallel H, Bouaziz M. [Cardiogenic pulmonary edema following β2 agonist infusion for acute, severe asthma]. Ann Cardiol Angeiol (Paris) 2012; 64:305-8. [PMID: 22436636 DOI: 10.1016/j.ancard.2012.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 01/26/2012] [Indexed: 11/17/2022]
Abstract
We report the case of a severe acute pulmonary edema secondary to the administration of salbutamol to a patient admitted for severe asthma. The diagnosis of acute pulmonary edema was suspected on the clinical examination, chest radiography, biological (plasmatic Pro-BNP rate) and echocardiographic findings. Rapid improvement under dobutamine and mechanical ventilation argue in favour of cardiogenic pulmonary edema. The young age of our patient, the absence of history of cardiovascular disease and the chronology of this complication onset regarded to salbutamol infusion could suggest β2 agonist involvement in this event. The improvement of cardiac function on echocardiography and the normal results obtained with myocardial perfusion scintigraphy performed 35 days later show the left ventricular reversible dysfunction.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie.
| | - A Chaari
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - H Dammak
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - F Medhioub
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - L Abid
- Service de cardiologie, CHU Hédi Chaker, Sfax, Tunisie
| | - K Chtourou
- Service de médecine nucléaire, CHU Habib Bourguiba, Sfax, Tunisie
| | - N Rekik
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - H Chelly
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - H Kallel
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
| | - M Bouaziz
- Service de réanimation médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029 Sfax, Tunisie
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Chaari A, Jedidi I, Chelly H, Bahloul M, Bouaziz M. [Haemophagocytic lymphohistiocytosis syndrome: a possible cause of multi-organ failure in severe head trauma?]. ACTA ACUST UNITED AC 2011; 30:844-7. [PMID: 21978480 DOI: 10.1016/j.annfar.2011.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 07/26/2011] [Indexed: 11/17/2022]
Abstract
We report the case of a 26-year-old patient who was victim of severe head trauma following a trafic road accident. Two days after trauma, she had fever, pancytopenia and multi-organ failure. The haemophagocytic lymphohistiocytosis syndrome was suspected. This diagnosis was confirmed by biologic findings (elevated serum levels of ferritin and triglycerid) and histological findings (examination of bone marrow smears showing histiocytes phagocytosing blood cells). The evolution was unfavorable despite of corticotherapy and symptomatic measures.
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Affiliation(s)
- A Chaari
- Service de réanimation médicale, CHU Habib Bourguiba, route El-Ain-Km 1, 3029 Sfax, Tunisie.
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15
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Chaari A, Bahloul M, Bouaziz M, Ben Ameur H, Dabbech C. [Intrathoracic hernia of the liver: an unusual cause of extubation failure in a trauma patient]. Ann Fr Anesth Reanim 2011; 30:165-166. [PMID: 21315549 DOI: 10.1016/j.annfar.2010.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 11/25/2010] [Indexed: 05/30/2023]
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16
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Chaari AN, Bahloul M, Tlijani M, Dammak H, Bouaziz M. [An unusual mode of snake poisoning in Tunisia]. Med Trop (Mars) 2010; 70:201-202. [PMID: 20486364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Snake poisoning constitutes a real public health problem in the North African countries. In Tunisia, snake poisonings are particularly frequent in the sub-Saharan regions (southern areas) with high mortality and possible debilitation in survivors. The most common mode of snake poisoning is biting, particularly on the extremities. The purpose of this report is to describe a case involving a patient who presented authentic systemic signs of a snake poisoning after ingesting a whole raw viper of the Cerastes cerastes species. Local signs as well as coagulation abnormalities often associated with bites by this kind of viper were not observed. The outcome was favorable after three days of hospitalization. Treatment consisted of symptomatic measures and administration of antivenom therapy.
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Bahloul M, Ben Ahmed MN, Laaroussi L, Chtara K, Kallel H, Dammak H, Ksibi H, Samet M, Chelly H, Ben Hamida C, Chaari A, Amouri H, Rekik N, Bouaziz M. [Peripartum cardiomyopathy: incidence, pathogenesis, diagnosis, treatment and prognosis]. ACTA ACUST UNITED AC 2008; 28:44-60. [PMID: 19111432 DOI: 10.1016/j.annfar.2008.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 11/04/2008] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Peripartum cardiomyopathy (PPCM) is a rare and life-threatening disease of unknown aetiology. The primary objective of this review was to analysed aetiopathogeneses, clinical presentation and diagnosis, as well as pharmacological, perioperative and intensive care management and prognosis of this pathology. METHODS We undertook a systematic review of the literature using Medline, Google Scholar and PubMed searches. RESULTS Unlike other parts of the world in which cardiomyopathy are rare, dilated cardiomyopathy is a major cause of heart failure throughout Africa. Its aetiopathogenesis is still poorly understood, but recent evidence supports inflammation, viral infection and autoimmunity as the leading causative hypotheses. This diagnosis should be limited to previously healthy women who present with congestive heart failure (CHF) and decreased left ventricular systolic function in the last month of pregnancy or within 5 months after delivery. Recently, introduction of echocardiography has made diagnosis of PPCM easier and more accurate. Conventional treatment consists of diuretics, vasodilators, and sometimes digoxin and anticoagulants, usually in combination. Patients who fail to recover may require inotropic therapy. In resistant cases, newer therapeutic modalities such as immunomodulation, immunoglobulin and immunosuppression may be considered. Prognosis is highly related to reversal of ventricular dysfunction. Compared to historically higher mortality rates, recent reports describe better outcome, probably because of advances in medical care. Based on current information, future pregnancy is usually not recommended in patients who fail to recover normal heart function. CONCLUSION PPCM is a rare but serious form of cardiac failure affecting women in the last months of pregnancy or early puerperium. Its aetiopathogenesis is still poorly understood. Introduction of echocardiography has made diagnosis of PPCM easier and more accurate. Prognosis is highly related to reversal of ventricular dysfunction.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, CHU Habib Bourguiba, route El Ain Km 1, 3029 Sfax, Tunisie.
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Kallel H, Hergafi L, Bahloul M, Hakim A, Dammak H, Chelly H, Hamida CB, Chaari A, Rekik N, Bouaziz M. Safety and efficacy of colistin compared with imipenem in the treatmentof ventilator-associated pneumonia: a matched case–control study. Intensive Care Med 2007; 33:1162-1167. [PMID: 17530220 DOI: 10.1007/s00134-007-0675-2] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Accepted: 04/23/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Our study aimed to determine the efficacy and safety of colistin in the treatment of ventilator-associated pneumonia (VAP) caused by pan-drug-resistant Pseudomonas aeruginosa or Acinetobacter baumanii. DESIGN Pairwise, retrospective exposed-unexposed study. SETTING Combined medical and surgical intensive care unit of Habib Bourguiba University Hospital (Sfax, Tunisia). PATIENTS Sixty patients with VAP caused by pan-drug-resistant A. baumanii or P. aeruginosa matched to 60 controls with VAP caused by A. baumanii or P. aeruginosa susceptible to imipenem. All patients had normal renal function at the onset of antibiotic therapy. INTERVENTIONS Case patients were treated by colistin intravenously and control patients were treated by imipenem intravenously. MEASUREMENTS AND RESULTS Baseline characteristics were similar between the colistin and imipenem groups. The mean duration of antibiotic therapy for VAP was 9.5+/-3.8 days (range 5-22 days) with colistin and 8.9+/-2.8 days (range 5-20 days) with imipenem (p=0.32). A favorable clinical response to antibiotic therapy for VAP occurred in 45 patients (75%) in the colistin group and in 43 patients (71.7%) in the imipenem group (p=0.68). The time to resolution of infectious parameters after the initiation of antibiotic therapy was not statistically different between the two groups. During the antibiotic course, none of the patients in either group developed renal failure. CONCLUSIONS We conclude that colistin can be a safe and effective option in the treatments of VAP caused by pan-drug-resistant P. aeruginosa or A. baumanii.
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Affiliation(s)
- H Kallel
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia.
| | - L Hergafi
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
| | - M Bahloul
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
| | - A Hakim
- Laboratoire de Pharmacologie, Faculté de Médecine de Sfax, route el Ain Km 1, 3029, Sfax, Tunisia
| | - H Dammak
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
| | - H Chelly
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
| | - C Ben Hamida
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
| | - A Chaari
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
| | - N Rekik
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
| | - M Bouaziz
- Service de Réanimation Médicale, CHU Habib Bourguiba, route el Ain Km 1, 3029, Sfax, Tunisia
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Bahloul M, Dammak H, Kallel H, Khlaf-Bouaziz N, Ben Hamida C, Chaari A, Chelly H, Rekik N, Bouaziz M. [Thrombotic microangiopathies. Incidence, pathogenesis, diagnosis, treatment and prognosis]. J Mal Vasc 2007; 32:75-82. [PMID: 17490838 DOI: 10.1016/j.jmv.2007.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Accepted: 03/05/2007] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The objective of this work was to review current data about the pathophysiology, clinical features, and treatment of thrombotic microangiopathies. CURRENT KNOWLEDGE Thrombotic microangiopathies are microvascular occlusive disorders characterized by systemic or intrarenal aggregation of platelets, thrombocytopenia, and mechanical injury to erythrocytes. In thrombotic thrombocytopenic purpura, systemic microvascular aggregation of platelets causes ischemia in the brain and other organs. In the hemolytic-uremic syndrome, platelet-fibrin thrombi occlude predominantly the renal circulation. Thrombotic microangiopathy is a rare disorder whose varied clinical manifestations result from the formation of platelet-rich thrombi within the microvasculature and consequent tissue ischemia. The clinical features are acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. This diagnosis is of considerable importance because of the possible fulminant clinical course. Some atypical forms may be unrecognized. Plasma exchange is the current reference treatment of thrombotic thrombocytopenic purpura. However, in the light of recent publications, either infusions of concentrates of purified enzyme or more intensive immunosuppressive therapy would be more specific.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, CHU Habib-Bourguiba, route El-Ain-Km 1, 3029 Sfax, Tunisie.
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Bahloul M, Abid D, Ketata H, Kallel H, Dammak H, Chelly H, Ben Hamida C, Mhiri MN, Bouaziz M. [Traumatic unilateral renal artery thrombosis and protein C deficiency. A case report]. ACTA ACUST UNITED AC 2007; 31:277-9. [PMID: 17202980 DOI: 10.1016/s0398-0499(06)76626-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Post traumatic renal artery thrombosis is rarely described in the literature. This pathology can result from stretch injury to inelastic intima of the renal artery, or by the direct flow to the abdomen causing compression injury to the renal artery against the vertebral column. However, the association of this pathology with hematologic diseases (in particular protein C deficit) was never described. We report an observation of a 28-year-old man with an uneventful history who was admitted to the intensive care unit for traumatic head injury associated with post traumatic renal artery thrombosis requiring nephrectomy. The etiologic investigation of this thrombo-embolic complication reveals a protein C deficit. Our patient was improved under treatment. This original observation confirms that post traumatic renal artery thrombosis can be associated with hematologic diseases (in particular protein C deficit).
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Affiliation(s)
- M Bahloul
- Service de Réanimation Médicale, CHU Habib Bourguiba, Route el Ain Km 1, 3029 Sfax, Tunisie.
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Kallel H, Chelly H, Ghorbel M, Bahloul M, Ksibi H, Rekik N, Ben Mansour H, Bouaziz M. La méningite post-traumatique : incidence, microbiologie et pronostic. Neurochirurgie 2006; 52:397-406. [PMID: 17185945 DOI: 10.1016/s0028-3770(06)71238-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The aim of our study was to search for the incidence, the responsible organisms and the favoring causes of death of post-traumatic meningitis (PTM). METHODS This retrospective study was conducted over a seven-year period (January 1st, 1996 - December 31, 2002) in the ICU and the neurosurgery department of the Habib-Bourguiba University Hospital, Sfax, Tunisia. RESULTS Over the study period, 38 patients presented PTM (0.96% of patients hospitalized for head injury), 92% of them had received antibiotic prophylaxis on admission. Mean time between head injury and the diagnosis of PTM was 9+/- 8 days (range: 2-34 days). The most common isolated organisms were multidrug resistant A. baumanii, and K. pneumoniae and reduced susceptibility S. pneumoniae. Factors predictive of prognosis in the 14 days following the diagnosis of meningitis were Glasgow coma score (GCS) on the day of diagnosis of PTM, absence of nuchal rigidity, CSF protein, CSF/blood glucose ratio, and S. pneumoniae as the causal agent of PTM. CONCLUSIONS Antibioprophylaxis in patients with head trauma must be avoided to prevent the emergence of multidrug resistant bacteria when PTM occurs. GCS on the day of diagnosis of PTM, CSF protein concentration, CSF/blood glucose ratio, and S. pneumoniae as the causal agent of PTM are predictive factors of mortality of patients with PTM.
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Affiliation(s)
- H Kallel
- Service de Réanimation Médicale, CHU Habib-Bourguiba, route El-Aïn, km 1, 3029 Sfax, Tunisie.
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Kallel H, Dammak H, Bahloul M, Ben Hamida C, Chelly H, Rekik N, Bouaziz M. A good death: another break in the wall. Intensive Care Med 2006; 32:1915-6. [PMID: 17019551 DOI: 10.1007/s00134-006-0369-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2006] [Indexed: 11/26/2022]
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Bahloul M, Ben Hamida C, Dammak H, Chaari L, Kallel H, Chelly H, Rekik N, Bouaziz M. Les microangiopathies thrombotiques en réanimation. ACTA ACUST UNITED AC 2006; 25:820-7. [PMID: 16859885 DOI: 10.1016/j.annfar.2006.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Accepted: 04/12/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To analyze the clinico-biological manifestations, identify the causes and evaluate the outcome of patients with severe thrombotic microangiopathies admitted in a Tunisian intensive care unit. METHODS Retrospective study over a period of 10 years (1995-2004) in an intensive care unit. RESULTS Were included in this study 9 cases with a mean age of 29.2+/-9 years (range 15-44 years). Fever was observed in 5 patients, neurological impairment in 5 and digestive manifestations in 6. Haemolytic anaemia, thrombocytopenia and acute renal failure were observed in 100% of the cases. In our study, the aetiologies of thrombotic microangiopathies were: complicated pregnancy in 6 cases, systemic lupus erythematosus in 1 case. In contrast, no aetiology was found in 2 patients. Plasma exchange was performed in 5 patients, while 4 patients received only plasma infusion. After an average stay of 18+/-12.5 days, evolution was marked by the death 3 patients. CONCLUSION The incidence of severe thrombotic microangiopathies is rare in Tunisian ICU. The clinical manifestations are not specific. Despite the improvement in the outcome by exogenous plasma supply, thrombotic microangiopathies with severe organ dysfunctions leading to hospitalization in the intensive care unit are associated with a high mortality rate.
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MESH Headings
- Acute Kidney Injury/complications
- Adolescent
- Adult
- Algeria/epidemiology
- Anemia, Hemolytic/complications
- Anemia, Hemolytic/diagnosis
- Cardiopulmonary Resuscitation
- Female
- Fever/etiology
- Humans
- Intensive Care Units
- Lupus Erythematosus, Systemic/complications
- Male
- Nervous System Diseases/etiology
- Nervous System Diseases/physiopathology
- Peripheral Vascular Diseases/epidemiology
- Peripheral Vascular Diseases/etiology
- Peripheral Vascular Diseases/therapy
- Plasma Exchange
- Pregnancy
- Pregnancy Complications, Cardiovascular/physiopathology
- Purpura, Thrombocytopenic, Idiopathic/complications
- Purpura, Thrombocytopenic, Idiopathic/epidemiology
- Purpura, Thrombocytopenic, Idiopathic/therapy
- Retrospective Studies
- Treatment Outcome
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Affiliation(s)
- M Bahloul
- ICU, Centre Hospitalier H.-Bourguiba, route El-Ain, Km 0,5, 3029 Sfax, Tunisie.
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Bahloul M, Dammak H, Khlaf-Bouaziz N, Trabelsi K, Khabir A, Ben Hamida C, Kallel H, Ksibi H, Chelly H, Chaari A, Rekik N, Bouaziz M. Stéatose hépatique aiguë gravidique. À propos de 22 cas. ACTA ACUST UNITED AC 2006; 34:597-606. [PMID: 16822693 DOI: 10.1016/j.gyobfe.2006.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2005] [Accepted: 05/24/2006] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To report the clinical experience, biochemical findings, complications and maternal outcome in patients with acute fatty liver of pregnancy (AFLP). PATIENTS AND METHODS Retrospective study over a period of 11 years (1993-2003). The diagnosis of AFLP was confirmed by liver biopsy in 15 women. However, in 7 women a medical committee that took into account clinical symptoms, and laboratory findings assessed the diagnosis. RESULTS Were included in this study, 22 women with a mean age of 30+/-5.4 years. Only 22.7% of cases were primigravid. The mean gestational age was 36+/-2.76 weeks (range 31-41 weeks). The fetus was a male infant in 75% of cases. Ten women were admitted in the hospital without jaundice. However 15 women had developed an icterus since their hospital admission or during ICU stay. The mean SAPS II on the ICU admission was of 24.86+/-11.2 points. Biological disturbances observed were mainly: liver cytolysis in 91% of cases, a trend to hypoglycaemia in 86%, a hypoprotidemia in 66.7% and CIVD in 32%. During their ICU stay, 19 women (86.4%) developed one or several organ failures associated to the hepatic failure and 18 women required blood transfusion. After an average stay of 7.5 days, evolution was marked by the death of seven patients (31.8%). Factors correlated with a poor prognosis were: the delay of medical consultation, the development of jaundice, the development of encephalopathy, respiratory or a circulatory failure. DISCUSSION AND CONCLUSION AFLP is a rare but life-threatening complication. Furthermore AFLP shares features with other more common and less perilous illnesses. An early diagnosis and appropriate therapy of this pathology should improve the poor prognosis in our country.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, CHU Habib-Bourguiba, route El Ain, 3029 Sfax, Tunisie.
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Sellami A, Sellami H, Makni F, Bahloul M, Cheikh-Rouhou F, Bouaziz M, Ayadi A. [Candiduria in intensive care unit: significance and value of yeast numeration in urine]. ACTA ACUST UNITED AC 2006; 25:584-8. [PMID: 16626924 DOI: 10.1016/j.annfar.2006.02.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Accepted: 02/17/2006] [Indexed: 11/25/2022]
Abstract
JUSTIFICATION Candiduria is increasingly frequent among patients admitted to intensive care units but its significance remains unclear. OBJECTIVES Search for eventual correlation between quantitative candiduria and known risk factors for invasive candidiasis. STUDY DESIGN Prospective. PATIENTS AND METHODS A four-month study was conducted in 162 patients hospitalized in the intensive care unit for more than 72 hours. All patients underwent a weekly research of candiduria added to sampling from different body sites to determine the Pittet Candida colonization index. RESULTS Candiduria has been proved in 56 cases (34%). It was superior or equal to 10(4) UFC/ml among 28 patients (50%). Candida tropicalis, Candida glabrata and Candida albicans has been isolated in 41, 22 and 20% respectively. All patients had at least one major and two minor risk factors for Candida infection. Six patients (10%) developed invasive candidiasis. The global mortality rate was at 52%. Pittet colonization index was significantly different between patients with candiduria and those with invasive candidiasis (p=0.01). There was a statistically significant correlation between candiduria superior or equal to 10(4) UFC/ml and Pittet colonization index superior or equal to 0.5 (p=0.01). CONCLUSION Candiduria superior or equal to 10(4) UFC/ml associated with risk factors may predict invasive candidiasis in critically ill patients.
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Affiliation(s)
- A Sellami
- Laboratoire de Parasitologie-Mycologie, Faculté de Médecine, Sfax, Tunisie
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Kallel H, Dammak H, Mahjoubi F, Bahloul M, Turki E, Chelly H, Rekik N, Hammami A, Bouaziz M. [Contamination of blood cultures drawn from central vein catheter and peripheral venipuncture. Prospective study of 75 pairs]. ACTA ACUST UNITED AC 2006; 54:44-8. [PMID: 16376178 DOI: 10.1016/j.patbio.2005.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2004] [Accepted: 02/09/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the frequency of contamination, the sensitivity, specificity, and predictive values of cultures done with blood drawn through a central venous catheter or peripheral venipuncture. DESIGN Prospective cohort study of critical ill medical surgical intensive care patients in whom samples for paired culture were drawn through a central venous catheter or peripheral venipuncture during a period of 8 months (from August 1st 2001 to Mars 31st 2002). RESULTS During the study period, 75-paired cultures were studied. Fifteen peripheral blood cultures (20%) and 27 central blood cultures (36%) were positive and 6 peripheral blood cultures (8%) and 15 central blood cultures (20%) were contaminated (P=0.034). The organism most commonly responsible for contamination was Coagulase Negative Staphylococcus (16% of central blood cultures and 6.7% of peripheral blood cultures). The frequency of contamination was of 42.9% for blood cultures drawn through a femoral central venous catheter, of 10% for jugular, and of 19% for subclavian central venous catheter (P=0.22). For catheter draws compared with peripheral venipuncture, sensitivity was 100 and 75%, specificity was 76.2 and 90.5%, positive predictive value was 44.4 and 60% and negative predictive value was 100 and 95%. CONCLUSION Cultures of blood drawn through a catheter are more sensible and less specific than those obtained from a peripheral venipuncture and the organism most commonly responsible for contamination of blood cultures is Coagulase Negative Staphylococcus.
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Affiliation(s)
- H Kallel
- Service de réanimation médicale, CHU Habib Bourguiba, route El-Ain, km 1, 3029 Sfax, Tunisie.
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Bahloul M, Chaari A, Khlaf-Bouaziz N, Kallel H, Chaari L, Ben Hamida C, Chelly H, Rekik N, Bouaziz M. Maladie cœliaque, thrombose veineuse cérébrale et déficit en protéine S, Une association fortuite ? ACTA ACUST UNITED AC 2005; 30:228-30. [PMID: 16292200 DOI: 10.1016/s0398-0499(05)88207-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Celiac disease is a pathology which is rarely associated with thrombosis complications. Cerebral vascular thrombosis has never been described in patients with a celiac disease. OBSERVATION We report an observation of a 21-year-old girl with a history of celiac disease who was hospitalized in the intensive care unit for convulsive status epilepticus secondary to a cerebral venous thrombosis. The etiologic investigation of this thrombo-embolic complication revealed protein S deficit. Our patient improved under symptomatic treatment. COMMENT This original observation confirms that celiac disease can be associated with cerebral venous thrombosis.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, CHU Habib Bourguiba, Route el Ain Km 1, 3029 Sfax, Tunisie.
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Kallel H, Dammak H, Mahjoubi F, Bahloul M, Chelly H, Chaari A, Rekik N, Hammami A, Bouaziz M. [Predictive value of pericatheter skin cultures in detecting catheter-related infections in a medical-surgical intensive care unit]. ACTA ACUST UNITED AC 2005; 24:1343-8. [PMID: 16099126 DOI: 10.1016/j.annfar.2005.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2004] [Accepted: 06/20/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the predictive value of pericatheter skin cultures in detecting catheter-related infections in critically-ill patients. STUDY DESIGN Prospective study. PATIENTS AND METHODS Over a 5 months period (from August 1(st) 2001 to December 31 2001), 500 patients were hospitalised, and 108 central venous catheters were prospectively examined. For each catheter, blood cultures, pericatheter skin cultures and semiquantitative culture of the catheter tip were performed. RESULTS The median duration of catheterization was 8 days (interquartile: 8 days). Catheter was removed because of suspected infection in 54 cases (50%). Systemic catheter-related infection was found in 12 cases (11%) and the responsible organism was a gram-negative rod in 11 cases (92%). The negative predictive values of pericatheter skin cultures in the diagnosis of catheter-related infections and in case of suspected catheter-related infection were 89 and 86%, respectively. CONCLUSION These results indicate that the pericatheter skin cultures are not an effective procedure for the conservative diagnosis of catheter-related infections and that the skin-insertion wound is not the major source of catheter-contamination in our unit.
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Affiliation(s)
- H Kallel
- Service de réanimation médicale, CHU Habib-Bourguiba, Sfax, Tunisie.
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Kallel H, Hedi C, Maaloul I, Bahloul M, Ksibi H, Khémakhem B, Ben Hamida C, Rekik N, Jarraya A, Hammami A, Ben Jemâa M, Bouaziz M. [Evaluation of the antibiotics consumption in a Tunisian university hospital]. Tunis Med 2005; 83:110-3. [PMID: 15969234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE To estimate the consumption of antibiotics in our hospital and to determine the points at which will be targeted the recommendations of good practice of antibiotherapy. PATIENTS AND METHODS Our study is a one day prevalence study where antibiotic's prescriptions are analyzed by a group of 6 doctors referents in antibiotherapy. RESULTS During the study day, 443 patients were studied. Means age was 44.2 +/- 23.3 years (range: 1 and 102 years). 101 infections were diagnosed in 48 patients (10.8%). 192 patients (43.3%) received antibiotics. Antibiotherapy was curative in 44% of cases. The most prescribed antibiotics were gentamicin (85.2 DDD/1000 patients), metronidazole (79 DDD/1000 patients), and cefotaxime (73.9 DDD/1000 patients). According to the evaluation group, 30.7% of the antibiotic's prescription was considered unjustified. The antibioprophylaxis represents the category most often unjustified (49%). The molecules in which prescription was frequently considered unjustified are the ciprofloxacin (67%), the amoxicilline-clavulanate (40%) and the cefotaxime (40%). CONCLUSION Our results suggest that an action of good practice should be targeted at the antibioprophylaxis and should concern especially molecules in which prescription was frequently unjustified.
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Affiliation(s)
- H Kallel
- Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie
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Asnafi V, Beldjord K, Garand R, Millien C, Bahloul M, LeTutour P, Douay L, Valensi F, Macintyre E. IgH DJ rearrangements within T-ALL correlate with cCD79a expression, an immature/TCRγδ phenotype and absence of IL7Rα/CD127 expression. Leukemia 2004; 18:1997-2001. [PMID: 15483677 DOI: 10.1038/sj.leu.2403531] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
cCD79a and IgH VDJ/DJ rearrangements are considered to be relatively specific for B lymphoid precursors. We looked for both in cCD3+, CD7+, CD19- T-ALLs classified by TCR status into alphabeta or gammadelta/immature (IM) lineages, with individualization of HOX11L2+ T-ALLs since they represent an intermediate alphabeta/gammadelta category. cCD79a was expressed at low levels in 47% of T-ALL and was most frequent in IMgamma T-ALLs. IgH rearrangements were common in gammadelta/IM (45%) and HOX11L2+ (35%) T-ALLs compared to HOX11L2-negative cases (3%; P<0.001). CD127 (IL7Ralpha) expression was also more common in the gammadelta/IM lineage but its expression was virtually mutually exclusive of IgH rearrangement. Low-level cCD79a expression alone should therefore not be interpreted as evidence of B lineage affiliation in immature leukemias. gammadelta/IM lineage T-ALLs potentially include two distinct categories: predominantly IgH+, cCD79a+, CD127- cases which retain gammadelta and B lymphoid potential and IgH-, cCD79a-, CD127+ cases with restricted T lineage potential.
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MESH Headings
- Antigens, CD/metabolism
- CD79 Antigens
- Cell Lineage
- Gene Rearrangement, B-Lymphocyte
- Gene Rearrangement, T-Lymphocyte
- Gene Rearrangement, delta-Chain T-Cell Antigen Receptor/genetics
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin J-Chains/genetics
- Leukemia-Lymphoma, Adult T-Cell/genetics
- Leukemia-Lymphoma, Adult T-Cell/metabolism
- Phenotype
- Receptors, Antigen, B-Cell/metabolism
- Receptors, Antigen, T-Cell, gamma-delta/metabolism
- Receptors, Interleukin-7/metabolism
- Tumor Cells, Cultured
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Affiliation(s)
- V Asnafi
- Biological Hematology, Assistance Publique, Hopitaux de Paris, Necker-Enfants-Malades, France
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31
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Bahloul M, Ayedi M, Dammak H, Trabelsi K, Bouaziz M. Pancréatite aiguë nécrotico-hémorragique secondaire à une hypertension artérielle gravidique. ACTA ACUST UNITED AC 2004; 23:157-9. [PMID: 15030867 DOI: 10.1016/j.annfar.2003.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2003] [Revised: 11/13/2003] [Accepted: 11/13/2003] [Indexed: 11/23/2022]
Abstract
The acute pancreatitis is a rare complication during the pregnancy. Causes are dominated by the gallstones and hyperlipidemia. This case report describes a 35-year-old pregnant woman who developed acute pancreatitis while suffering from a severe pre-eclampsia syndrome. Since she had no gallstones or other known aetiological factors of acute pancreatitis, the possibility of an etiologic role of pancreatic ischaemic changes associated with eclampsia is discussed. Evolution was marked with multi-organ system failure and poor outcome. Our experience and the previously reported case suggest that pre-eclampsia could be added to the list of causes of the acute pancreatitis.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale, CHU Habib-Bourguiba, Sfax, Tunisie.
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32
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Bahloul M, Ben Hmida M, Belhoul W, Ksibi H, Kallel H, Ben Hamida C, Chaari A, Chelly H, Rekik N, Bouaziz M. [Hemolytic-uremic syndrome secondary to scorpion envenomation (apropos of 2 cases)]. Nephrologie 2004; 25:49-51. [PMID: 15119220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
HUS was recently described following scorpion sting. We report 2 cases of HUS in the intensive care unit of a university hospital. Two children aged respectively 10 months and 1 year were admitted in the ICU after severe scorpion envenomation (with coma and pulmonary oedema) having required dobutamine and mechanical ventilation. Evolution was marked with acute anaemia without bleeding requiring blood transfusion, acute renal failure, low platelets and signs of haemolysis. Our experience and the previously reported case suggest that scorpion sting could be added to the list of causes of the HUS.
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Affiliation(s)
- M Bahloul
- Service de réanimation médicale CHU Habib Bourguiba, Sfax.
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33
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al-Yakoob S, Bou-Olayan AH, Bahloul M. Trace metals in gills of fish from the Arabian Gulf. Bull Environ Contam Toxicol 1994; 53:718-725. [PMID: 7833609 DOI: 10.1007/bf00196945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- S al-Yakoob
- Environmental Sciences Department, Kuwait Institute of Scientific Research, Safat
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