Mabrouk Bahloul

University of Sfax | US · ICU

Myocardial ischemia after severe scorpion envenomation is rarely reported. The aim of this review was to elaborate on a review of myocardial ischemia after severe scorpion envenomation and to detail the mechanism of this myocardial hypoperfusion. We used the PubMed database and entered the following keywords in MeSH research: scorpion envenomation,...

One of the most important components of sepsis management is hemodynamic restoration. If the target mean arterial pressure (MAP) is not obtained, the first recommendation is for volume expansion, and the second is for norepinephrine (NE). We describe the methodology of a randomized multicenter trial aiming to assess the hypothesis that low-dose NE...

Despite significant progress in the past decades, sepsis still lacks a specific treatment. Under normal conditions, leucocytes play a critical role in controlling infection and it is suggested that their activity is impaired during sepsis which contribute to the dysregulation of immune reactions. Indeed, in response to infection, several intracellu...

Background Scorpion envenomation is associated with several complications. One of the most serious complications is the cardiac involvement in the form of myocarditis that remains the main reason for mortalities associated with scorpion envenomation. The present review aims to elucidate clinical and paraclinical findings associated with scorpion-re...

Post-traumatic cerebral venous sinus thrombosis is one of the several causes of cerebral venous thrombosis, but its early diagnosis and management are still difficult in this traumatic context. Our objective is to describe clinical and radiological presentations and to report specific management and outcomes of this rare post-traumatic complication...

Abstract Objectives: This study aims to describe the epidemiological features of headaches in patients with COVID-19 infection. Methods: This is a cross-sectional study. Patients older than eighteen and diagnosed with a COVID-19 infection were included. We excluded patients aged less than eighteen, those whose headache could not be assessed, thos...

Objective To compare Decompressive hemicraniectomy (DHC) versus medical treatment alone for malignant middle Cerebral Artery infarction (MMCAI) and to define factors associated with mortality in the surgery group. Methods We conducted a monocenter retrospective study over 11 years including patients with MMCAI. We compared the surgery group versus...

We evaluated the prognostic value of serum cholinesterase (SChE) levels in SARS-CoV-2–infected patients requiring intensive care unit (ICU) admission. This is a retrospective study of severe, critically ill, adult COVID-19 patients, all of whom had a confirmed SARS-CoV-2 infection and were admitted into the ICU of a university hospital. We included...

Au cours de la maladie de Behçet, l'atteinte artérielle anévrysmale est beaucoup moins fréquente que l'atteinte veineuse. Elle touche le plus souvent l'aorte abdominale. Même après traitement, les complications demeurent graves et sont dominées par les récidives et les faux anévrysmes anastomotiques. Les fistules prothétodigestives sont parmi les c...

Objective To analyze clinical, epidemiological, radiological characteristics and outcome of patients undergoing decompressive craniectomy (DC) after traumatic brain injury (TBI) and to identity predictive factors associated with poor prognosis. Methods Demographic, clinical, and radiologic data from a retrospective study on unilateral or bilateral...

Background: Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods: We conducted a retrospective study of critically ill adult COVID-19 patients-all of whom had a confirmed severe acute respiratory syndrome...

Background: In this study, we explored whether early application of the prone position (PP) can improve severe hypoxemia and respiratory failure in coronavirus disease 2019 (COVID-19) patients with spontaneous breathing. Methods: This is a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive...

Introduction: In this study, we aim to explore the value of procalcitonin (PCT), C-reactive protein (CRP), and serum cholinesterase (SChE) activity kinetics as useful predictors of mortality in patients with septic shock admitted to the intensive care unit (ICU). Material and methods: We conducted a prospective single-blinded study in the ICU of...

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. Althou...

Background: Venous thromboembolism (VTE) is a well-established complication of trauma. So far, the factors that are related to early post-traumatic pulmonary embolism (PE) occurrence have been given little attention. Aims: We have conducted this literature review in order to analyze the incidence and the physiopathology of post-traumatic PE amon...

Introduction The occurrence of acute kidney injury (AKI) in patients with multiple traumas is a serious complication, which can be fatal. The objective of our study was to precise the epidemiological, clinical, etiological aspects and the predictive factors for the occurrence of post-traumatic AKI. Description/Methods A cohort study has been condu...

Background: Venous thromboembolism (VTE) is a well-established complication of trauma. Recent studies suggest that pulmonary embolism (PE) may occur very early, and even immediately, after injury. The aim of this study is to analyze the incidence, risk factors and prognosis of early PE among ICU trauma patients. Patients and methods: We conducte...

Pulmonary capillary leak syndrome secondary to influenza SARS‐CoV‐2virus infection was not previously reported. We report 2 cases. The diagnosis of non‐cardiogenic pulmonary edema due to pulmonary capillary leak syndrome SARS‐CoV‐2 virus infection was obtained by a medical committee of 6 physicians. The diagnosis of COVID‐19 infection is confirmed...

Scorpion envenoming is a frequent and deadly event in Tunisia. It is caused mainly by Androctonus australis and Buthus occitanus. Pulmonary edema and shock following scorpion envenoming are related to adrenergic cardiomyopathy, and are the main symptoms leading to death. Our aim was to search for the effect of dobutamine on “scorpion myocardiopathy...

Acute pancreatitis (AP) is a real clinical challenge. Acute pancreatitis remains a common cause of emergency department consultations and a major cause for hospitalization. Gallstones and drinking a lot of alcohol are the most frequent causes of AP. Moreover, AP can be induced by diabetic ketoacidosis (DKA) complicated by hypertriglyceridemia. We r...

Purpose: to evaluate the current rate of PE in our medico-surgical ICU, to identify risk factors, and to determine the outcome of PE in ICU. Methods: We performed a prospective cohort study of consecutive patients requiring intensive care admission during a one-year period. We included, in this prospective study, all the patients with confirmed...

Background: The aim of the present study is to analyze the clinical and epidemiological characteristics of Traumatic Brain Injury (TBI) following Road Traffic Accidents (RTAs). Moreover, we aim to evaluate the outcome of the TBI victims referred to our medico-surgical Intensive Care Unit (ICU), and to define predictive factors associated with poor...

Malaria is a worldwide problem. Infection with Plasmodium. falciparum that may cause a multi-organ-failure, especially if the diagnose wasn't at time. Macrophage activation syndrome is a clinical and biological syndrome caused by an excessive proliferation of T lymphocytes. Plasmodium falciparum infection was rarely reported as a cause of this synd...

Background: Severe scorpion envenomation can lead to severe neurological manifestations, which are an indicator of the severity of the scorpion sting. The direct action of scorpion venom on the central nervous system can explain partly these neurological disorders. Methods and findings: We report a case of severe scorpion envenomation in 16-mont...

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 associat...

La péritonite secondaire est fréquemment rapportée dans la littérature. Les causes sont multiples. Nous rapportons un cas d'une perforation iléale par une cause exceptionnelle. Il s'agit d'une perforation iléale par un corps étranger lors de la réduction d'une hernie inguinale, responsable d'une péritonite grave avec tableau de défaillance multivis...

Hyperglycaemia is often observed in severe scorpion-envenomed patients. It is due to a severe autonomic storm with a massive release of catecholamines, increased glucagon levels, cortisol levels, and either decreased insulin levels or insulin resistance. The presence of hyperglycaemia is an indicator of severity in this specific condition. Indeed,...

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 b...

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 e...

Candida lipolytica (actuellement connu sous le nom de Yarrowia lipolytica) est une levure émergente omniprésente dans l’environnement. Elle peut être responsable d’infections invasives nosocomiales humaines, en particulier les septicémies associées aux cathéters, chez les patients à risque. Les objectifs de notre travail ont été d’analyser les cond...

Résumé Introduction L’embolie pulmonaire est une complication classique des patients en réanimation. Le retentissement gazométrique de l’embolie pulmonaire est complexe et caractérisé par une hypoxémie secondaire aux perturbations des rapports ventilation/perfusion. Nous rapportons un cas d’embolie pulmonaire proximale et bilatérale sans hypoxémie...

Résumé Les accidents thromboemboliques sont fréquents chez les polytraumatisés. L’incidence de l’embolie pulmonaire post-traumatique varie entre 1 et 6 %. Certains facteurs sont reconnus comme étant particulièrement associés à un risque accru : l’âge > 55 ans, le traumatisme sévère et la nature de la lésion traumatique initiale. En effet, les traum...

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 proinflammatory mediators in the pathophysiological manifestations of human scorpion envenomation. Moreover, there is a si...

Viper envenomation is common in North Africa. Cardiac complications are not common features of snakebites, the clinical picture of which is usually dominated by toxin-associated neurological, hematological, and vascular damage. There are rare reports of acute myocardial infarction and/or ischemia caused by snakebites, while myocarditis after enveno...

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...

Le tétanos est une maladie caractérisée par une paralysie spastique et des spasmes. C’est une pathologie grave. Elle nécessite une prise en charge en milieu de réanimation. La mortalité est essentiellement liée aux complications neurovégétatives et infectieuses. Les complications thromboemboliques sont exceptionnelles au cours de cette maladie. A n...

Sepsis is a heterogeneous disease caused by an infection stimulus that triggers several complex local and systemic immuno-inflammatory reactions, which results in multiple organ dysfunction and significant morbidity and mortality. The diagnosis of sepsis is challenging because there is no gold standard for diagnosis. As a result, the clinical diagn...

Purpose: The aim of the study was to identify factors predicting lung contusion in trauma children. Methods: Retrospective study conducted for a period of 8 years (January 01, 2005-December 31, 2012) in a medical surgical intensive care unit. All trauma patients younger than 15 years were included. Two groups were compared: those with lung contu...

Table of contents: PHYSICIANS ABSTRACTSO1 Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: a multicenter randomized controlled study (BEST CUFF)Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacor...

Résumé Les accidents vasculaires ischémiques du tronc cérébral sont caractérisés par des manifestations cliniques aspécifiques. Une autre difficulté diagnostique est l’habituelle normalité de la tomodensitométrie. L’imagerie par résonance magnétique est l’examen de référence par excellence. Cependant, cette dernière exploration peut être non dispon...

Background: We aimed to investigate whether serum cholinesterase (SChE) activity can be helpful for the diagnosis of septic shock and to evaluate its usefulness in comparison with procalcitonin (PCT) and C-reactive protein (CRP). Methods: A prospective single-blinded study conducted in an intensive care unit of university hospital. Patients were...

Background: Amniotic fluid embolism is always a severe complication and generally occurs during labour or immediately after childbirth. Clinical features: We report the case of a patient falling victim to amniotic fluid embolism after the medical termination of her pregnancy at 24 weeks of amenorrhea following the discovery of a teratoma-carryin...

HELLP syndrome is an acronym for Hemolysis, Elevated Liver enzymes and Low Platelets. It is generally considered in the literature as a particular clinical form of pre-eclampsia, a severe complication of the second half of pregnancy. However, this syndrome can occur in isolation in the absence of pre-eclampsia symptoms. Its pathophysiology remains...

Context: Kinetics of SChE activity analyses, in our knowledge, was not previously studied in the prediction of prognosis of patients with septic shock. Objective: We aimed to analyse kinetics of SChE activity in 4 patients with septic shock. Materials and methods: Prospective study. Results: The kinetics analyses of SChE activity showed that SChE a...

Le kyste hydatique du foie (KHF) est une maladie assez répandue dans les pays nord-africains. La rupture post-traumatique ou spontanée du kyste compliquée d'un choc anaphylactique et d'un AVC ischémique a été exceptionnellement rapportée. Nous rapportons un cas d'un kyste hydatique du foie (KHF) fissuré et compliqué d'un choc anaphylactique et d'un...

Résumé Les manifestations neurologiques périphériques au cours de la rectocolite hémorragique (RCH) sont rares, dominées par les polyradiculonévrites chroniques et les mononeuropathies multiples ; les polyradiculonévrites aiguës restent exceptionnelles. Nous rapportons l’observation d’une femme de 37 ans, suivie pour RCH ayant développé une tétrapa...

Résumé Évaluer l’intérêt pronostique des scores Simplified Acute Physiology Score (SAPS II), Acute Physiology And Chronic Health Evaluation (APACHE II), Mortality Predicting Model (MPM II0 et MPM II24) et Organ Dysfunctions and/or Infection (ODIN) chez les patientes obstétricales en réanimation. Étude rétrospective menée au service de réanimation d...

The clinical presentation of varicella in adults is frequently associated with complications, particularly varicella pneumonia. Most cases occur in immunocompromised adults but immunocompetent can have serious pulmonary compromise. We report the case of an immunocompetent patient admitted to the intensive care unit with dyspnea and an exanthematous...

Here we discuss the efficacy of colistin-tigecycline combination in the treatment of multidrug-resistant (MDR) Klebsiella pneumoniae infective endocarditis (IE). We report a case of a 67-year-old head-injured patient who developed a carbapenem-resistant K. pneumoniae IE. The patient was treated with colistin-tigecycline combination, with a favourab...

Objective: To determine predictive factors of early mortality among severe traumatic brain injury in emergency department. Methods: This study is based on a retrospective analysis of 198 admitted in emergency depatment with severe head injury (Glasgow coma scale score ≤8) of an university hospital (Sfax, Tunisia). Basic demographic, clinical, biolo...

To analyse the impact of acetazolamide (ACET) use in severe acute decompensation of chronic obstructive pulmonary disease requiring mechanical ventilation and intensive care unit (ICU) admission. Retrospective pair-wise, case-control study with 1:1 matching. Patients were defined as cases when they had received acetazolamide (500 mg per day) and as...

Neurogenic pulmonary edema (NPE) is a possible complication of severe central nervous system insult. Its physiopathology is still debated. We report a fatal case of a 55-year-old man who was admitted because of severe head injury. The diagnosis of NPE was considered according to clinical and radiologic findings. Transpulmonary thermodilution study...

Aim: 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. By occluding the pulmon...

PurposeWe aimed to determine the incidence and the prognostic impact (mortality and length of ICU stay (LOS)) of pulmonary embolism (PE) in critically-ill patients with severe acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods This is a retrospective study performed during a 5-year period in the intensive care unit of the H...