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  1. Article ; Online: Hemodynamic profile of pulmonary arterial hypertension in a Tunisian center.

    Jamoussi, Amira / Ben Mrad, Nacef / Rachdi, Emna / Jarraya, Fatma / Zairi, Sarra / Ben Romdhane, Kais / Besbes, Mohamed / Ayed, Samia / Ben Khelil, Jalila

    La Tunisie medicale

    2023  Volume 101, Issue 10, Page(s) 751–755

    Abstract: Introduction: Pulmonary hypertension (PH) management can only be conceived in a specialized center. We aimed to report the experience of a Tunisian ICU about PH invasive hemodynamic exploration and to describe consequent therapeutic decisions.: ... ...

    Abstract Introduction: Pulmonary hypertension (PH) management can only be conceived in a specialized center. We aimed to report the experience of a Tunisian ICU about PH invasive hemodynamic exploration and to describe consequent therapeutic decisions.
    Methods: Retrospective descriptive study including all patients admitted to the medical ICU of Abderrahmen Mami Hospital for right heart catheterization (RHC), between 2005 and 2019 as part of the investigation of PH. Patients' characteristics, procedure safety and arising therapeutic decisions were then reported.
    Results: Forty patients were admitted for hemodynamic evaluation. RHC confirmed PH in 31 patients and exploration was then completed with NO reactivity test. Mean age was 41.3±15 years, gender ratio M/F was 1.06. PH was classified into: group 1 (n=13), group 2 (n=14), group 4 (n=2) and group 5 (n=2). NO vasoreactivity test was positive in 50% of post-capillary PH and in 28% of pre-capillary PH. The therapeutic decision following the reversibility test was: prescription of calcium channel blockers (n=5), a specific pulmonary vasodilator (n=10), operability (n=6), heart-lung transplant (n=3) and therapeutic abstention (n=7). Two minor complications were reported.
    Conclusion: The medical ICU in Abderrahmen Mami Hospital represents an experienced team in hemodynamic investigations despite low annual RHC number. NO reactivity test is an indispensable tool that enables important decisions during PH management.
    MeSH term(s) Humans ; Adult ; Middle Aged ; Pulmonary Arterial Hypertension/complications ; Retrospective Studies ; Hemodynamics ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/epidemiology ; Hypertension, Pulmonary/therapy ; Cardiac Catheterization/adverse effects ; Hypertension/complications
    Language English
    Publishing date 2023-10-05
    Publishing country Tunisia
    Document type Journal Article
    ZDB-ID 128627-4
    ISSN 2724-7031 ; 0041-4131
    ISSN (online) 2724-7031
    ISSN 0041-4131
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Beneficial of adding Tocilizumab to standard care in critical forms of Covid-19 pneumonia: Study on paired series.

    Trifi, Ahlem / Abdennebi, Cyrine / Mehdi, Asma / Ben Romdhane, Kais / Blel, Youssef / Daly, Foued / Zakhama, Boubaker / Mestiri, Taher / Abdellatif, Sami / Ben Lakhal, Salah

    La Tunisie medicale

    2022  Volume 100, Issue 4, Page(s) 309–312

    Abstract: Introduction: Tocilizumab (TCZ), a humanized monoclonal antibody directed against interleukin-6 (IL-6) receptors, has been tried in various studies as a Covid-19 therapy with controversial results.: Aim: To evaluate the effectiveness of adding TCZ to ...

    Abstract Introduction: Tocilizumab (TCZ), a humanized monoclonal antibody directed against interleukin-6 (IL-6) receptors, has been tried in various studies as a Covid-19 therapy with controversial results.
    Aim: To evaluate the effectiveness of adding TCZ to standard care (SC) in critical Covid-19 patients.
    Methods: it was designed retrospectively as a comparative study on two paired series of critical patients affected with Covid-19: the 1st group received TCZ plus SC versus a 2nd group which received only SC. The matching criteria were age, sex and severity score and the matching was based on the propensity score matching (PSM) by the nearest neighbor. Outcomes were: survival, mechanical ventilation (MV) and nosocomial infections.
    Results: Ninety patients were included by pairing estimated successful (PSM > 0.5 in more than 50% in each group for all matching criteria). 55.5% of SC group progressed to stage 3-acute respiratory distress syndrome (ARDS) versus 31% of TCZ+SC patients (p=0.03). No effect of TCZ was found on mortality (49% in each group, p=1) nor on MV use (p=0.67). ICU stay was more prolonged in TCZ+SC group (16 versus 8 days, p<10-3). The administration of TCZ induced a significant decrease in CRP but not changed the IL-6 dosage. Nosocomial infections occurred in 18 (40%) of TCZ+SC group comparatively to 15 (33,5%) of SC group, p=0.66.
    Conclusion: Tocilizumab reduced the risk of progression to severe ARDS probably due to its immune-modulating properties. But no beneficial effect was found on survival or on the use of ventilation.
    MeSH term(s) Antibodies, Monoclonal, Humanized/therapeutic use ; COVID-19/drug therapy ; Cross Infection ; Humans ; Interleukin-6 ; Receptors, Interleukin-6 ; Respiratory Distress Syndrome ; Retrospective Studies ; SARS-CoV-2
    Chemical Substances Antibodies, Monoclonal, Humanized ; Interleukin-6 ; Receptors, Interleukin-6 ; tocilizumab (I031V2H011)
    Language English
    Publishing date 2022-09-19
    Publishing country Tunisia
    Document type Journal Article
    ZDB-ID 128627-4
    ISSN 2724-7031 ; 0041-4131
    ISSN (online) 2724-7031
    ISSN 0041-4131
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Severe pneumococcal community-acquired pneumonia admitted to medical Tunisian ICU.

    Belkhouja, Khairallah / Ben Romdhane, Kaïs / Ghariani, Asma / Hammami, Afef / M'hiri, Emna / Slim-Saidi, Leila / Ben Khelil, Jalila / Besbes, Mohamed

    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy

    2011  Volume 18, Issue 3, Page(s) 324–331

    Abstract: Streptococcus pneumoniae is the most common cause of community-acquired pneumonia (CAP). There are no available data about this disease in Tunisian intensive care patients. The objective of this study is to describe the clinical and microbiological ... ...

    Abstract Streptococcus pneumoniae is the most common cause of community-acquired pneumonia (CAP). There are no available data about this disease in Tunisian intensive care patients. The objective of this study is to describe the clinical and microbiological features of pneumococcal CAP and determine the prognostic factors. This is a retrospective cohort study of all pneumococcal CAP cases hospitalized in the medical intensive care unit (ICU) of Hospital A. Mami of Ariana (Tunisia) between January 1999 and August 2008. Included were 132 patients (mean age, 49.5 years; 82.6% males); 30 patients had received antimicrobial treatment before hospital admission. The mean of the Simplified Acute Physiology Score II was 32.9. All patients had an acute respiratory failure; 34 patients (25.8%) had pneumococcal bacteremic CAP. Among the isolated strains, 125 antimicrobial susceptibility tests were performed. The use of the new Clinical and Laboratory Standards Institute breakpoints for susceptibility when testing penicillin against S. pneumoniae showed that all isolated strains were susceptible to penicillin. The mortality rate was 25%. The need of mechanical ventilation at admission [odds ratio (OR), 3.4; 95% confidence interval (CI), 1.67-6.94; P = 0.001), Sepsis-related Organ Failure Assessment (SOFA) score at admission ≥4 (OR, 3.1; 95% CI, 1.56-6.13; P = 0.001), and serum creatinine at admission ≥102 μmol/l (OR, 1.8; 95% CI, 1.02-3.17; P = 0.043) were independent factors related to ICU mortality. In conclusion, pneumococcal CAP requiring hospitalization in the ICU is associated with high mortality. All isolated stains were susceptible to penicillin.
    MeSH term(s) Adult ; Aged ; Analysis of Variance ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Community-Acquired Infections/drug therapy ; Community-Acquired Infections/epidemiology ; Community-Acquired Infections/microbiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Penicillins/pharmacology ; Penicillins/therapeutic use ; Pneumonia, Pneumococcal/drug therapy ; Pneumonia, Pneumococcal/epidemiology ; Pneumonia, Pneumococcal/microbiology ; Prognosis ; Retrospective Studies ; Streptococcus pneumoniae/drug effects ; Streptococcus pneumoniae/isolation & purification ; Treatment Outcome ; Tunisia/epidemiology
    Chemical Substances Anti-Bacterial Agents ; Penicillins
    Keywords covid19
    Language English
    Publishing date 2011-11-02
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1355399-9
    ISSN 1437-7780 ; 1341-321X
    ISSN (online) 1437-7780
    ISSN 1341-321X
    DOI 10.1007/s10156-011-0337-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Acute pulmonary embolism: epidemiologic and tomodensitometric study.

    Hantous-Zannad, Saoussen / Esseghaier, Sonia / Ridène, Imène / Zidi, Asma / Ben Romdhane, Kais / Baccouche, Inès / Ben Khelil, Jalila / Besbes, Mohamed / Ben Miled-M'rad, Khaoula

    La Tunisie medicale

    2010  Volume 88, Issue 12, Page(s) 880–884

    Abstract: Background: Acute pulmonary embolism is a common disease with substantial morbidity and mortality in untreated patients. It requires an urgent positive diagnosis.: Aim: To assess the prevalence of acute pulmonary embolism and calculate the ... ...

    Abstract Background: Acute pulmonary embolism is a common disease with substantial morbidity and mortality in untreated patients. It requires an urgent positive diagnosis.
    Aim: To assess the prevalence of acute pulmonary embolism and calculate the sensitivity and specificity of multidetector CT for the diagnosis of acute pulmonary embolism in a hospital specialized in cardio-thoracic diseases.
    Methods: This is a prospective study conducted at Abderrahmen Mami Hospital, which included 200 consecutive patients suspected of acute pulmonary embolism and explored by a multidetector CT pulmonary angiography (16 slices).
    Results: Prevalence of acute pulmonary embolism was calculated at 37.5%. The multidetector CT has enabled an alternative diagnosis in 46 patients (40%). The sensitivity and specificity of multidetector CT were calculated respectively 89.6% and 100%.
    Conclusion: The prevalence of acute pulmonary embolism, in a hospital specialized in cardio-thoracic diseases, is higher than that found in general hospitals. High sensitivity and specificity of multidetector CT makes it the gold standard for the diagnosis of pulmonary embolism.
    MeSH term(s) Acute Disease ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/epidemiology ; Tomography, X-Ray Computed ; Tunisia/epidemiology
    Language English
    Publishing date 2010-12
    Publishing country Tunisia
    Document type Journal Article
    ZDB-ID 128627-4
    ISSN 0041-4131
    ISSN 0041-4131
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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