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5. Predicting outcome after traumatic brain injury: Practical prognostic models based on large cohort of international patients

Author

Perel, P. A., Olldashi, F., Muzha, I., Filipi, N., Lede, R., Copertari, P., Traverso, C., Copertari, A., Vergara, E. A., Montenegro, C., De Huidobro, R. R., Saladino, P., Surt, K., Cialzeta, J., Lazzeri, S., Pinero, G., Ciccioli, F., Videtta, W., Barboza, M. F., Svampa, S., Sciuto, V., Domeniconi, G., Bustamante, M., Waschbusch, M., Gullo, M. P., Drago, D. A., Linares, J. C. A., Camputaro, L., Troccoli, G., Galimberti, H., Tallott, M., Eybner, C., Buchinger, W., Fitzal, S., Mazairac, G., Oleffe, V., Grollinger, T., Delvaux, P., Carlier, L., Braet, V., Jacques, J. -M., De Knoop, D., Nasi, L., Choi, H. K., Schmitt, M., Gentil, A., Nacul, F., Barrios, P. B., Xinkang, C., Hua, L. S., Tian, H. H., Xiaodong, C., Gualteros, W., Otero, A. A., Arango, M., Ciro, J., Jaramillo, H., Gonzalez, I., Gomez, C., Arias, A., Fonseca, M., Mora, C., Cabrera, E. G. L., Betancurth, J. L., Munoz, P., Quinonez, J. A., Castillo, M. E. G., Lopez, O., Yepes, R. P., Cuellar, D. L., Paez, G., Chaves, H. D., Ordonez, P. E., Plata, Riccardo, Pineda, M., Pulido, L. E., Jaramillo, J. S. V., Rebolledo, C., Palma, O., Soler, C., Pastrana, I., Falero, R., Perera, M. D., Garcia, A. A., Oliva, R., Delgado, H. L., Carnero, A. M., Lopez, B. L., Gallardo, A. L., Morales, A. O., Lezcano, H., Ferrer, M. I., Bess, I. Z., Canino, G. R., Ruiz, E. M. P., Cruz, O. G., Svoboda, P., Kantorova, I., Ochmann, J., Scheer, P., Kozumplik, L., Marsova, J., Edelmann, K., Chytra, I., Bosman, R., Andrejsova, H., Pachl, J., Burger, J., Kramar, F., Ulloa, M. I., Gonzalez, L., Daccach, A., Ortega, A., Cevallos, S., Cueva, B. Z., Ochoa, M., Tapia, J. V., Hurtado, J., Wong, M. C. S., Santos, R., Khamis, H., Abaza, A. H., Fekry, A., El Kordy, S., Shawky, T., El-Sayed, H., Khalil, N., Negm, N., Fisal, S., Alamin, M., Shokry, H., Elhusseny, A. Y., Radwan, A., Rashid, M., Gogichaisvili, T., Ingorokva, G., Gongadze, N., Otarashvili, A., Kleist, W., Kalkum, M., Ulrich, P., Andrews, N., Nakos, G., Karavelis, A., Archontakis, G., Myrianthefs, P., Yadav, Y., Yadav, S., Khatri, R., Baghel, A., Husain, M., Jha, D., Chhang, W. H., Dhandhania, M., Fonning, C., Iyengar, S. N., Gupta, S., Ravi, R. R., Bopiah, K. S., Herur, A., Venkataramana, N. K., Satish, A., Bhavadasan, K., Morris, R., Ramesh, S., Dewan, Y., Singh, Y., Bhagchandani, R., Bhagchandani, S., Sethurayar, V. U., Ipe, S., Sreekumar, G., Panigrahi, M., Reddy, A., Khosla, V., Pillay, H., Thomas, N., Sridhar, K., Jose, B., Kurian, N., Praharaj, S., Pillai, S., Ramana, Kiyawat, D., Maheshwari, K., Panikar, D., Chawla, J., Shenoy, S., Raja, A., Rupayana, Y., Reddy, S., Mohan, N., Kelkar, S., Johri, M., Golden, N., Maliawan, S., Fauzi, A., Farouk, U., Fakharian, E., Aramesh, A., Eghtedari, M., Ahmadzadeh, F., Gholami, A., Plunkett, P., Redican, C., Mcmahon, G., Annetta, Maria Giuseppina, Mouchaty, H., Bruzzone, E., Harding, B., Qureshi, M., Idris, Z., Jafri Abdullah, N. C., Ghazali, G., Ghani, A. R. I., Cheah, F., Cabrera, A., Gonzalez, J. L. M., Loria-Castellanos, J., Jackson, S., Hutchinson, R., Komolafe, E., Adeolu, A., Komolafe, M., Adeyemi-Doro, O., Bankole, F., Shehu, B., Danlami, V., Odebode, O., Oluwadiya, K., Sanni, A., Giebel, H., Kumar, S., Jooma, R., Mezquita, J. E., Ovelar, C. O., Portillo, M. G., Rodriguez, D., Balica, L., Oprita, B., Sklerniacof, M., Steflea, L., Bandut, L., Danil, A., Iliescu, R., Ciurea, J., El-Dawlatly, A., Alwatidy, S., Al-Yafi, W., El-Dawlatly, M., Krunic-Protic, R., Janosevic, V., Tan, J., Seah, C., Trenkler, S., Humenansky, M., Stajancova, T., Schwendt, I., Laincz, A., Julius, Z., Maros, S., Firment, J., Cifranicova, M., Saniova, B., Kalig, K., Medekova, S., Wiszt, R., Macuga, I., Hartzenberg, B., Du Plessis, G., Houlie, Z., Nathoo, N., Khumalo, S., Tracey, R., Munoz-Sanchez, A., Francisco Murillo-Cabezas, N. C., Flores-Cordero, J., Rincon- Ferrari, D., Rubi, M., Caler, L., Del Campo, M. M., Laguna, L. B., Nava, J. M., Minguillon, M. A., Lopez, A. M., Ramos-Gomez, L., De La Torre-Prados, V., Pellejero, R., Laloe, V., Mandrella, B., Suganthan, Perera, S., Mahendran, K., Stocker, R., Ludwig, S., Zimmermann, H., Denzler, U., Yutthakasemsunt, S., Kittiwattanagul, W., Piyavechvirat, P., Tapsai, P., Namuang-Jan, A., Chantapimpa, U., Watanachai, C., Subsompon, P., Pussanakawatin, W., Khunjan, P., Tangchitvittaya, S., Nilapong, S., Klangsang, T., Taechakosol, W., Srinat, A., Jerbi, Z., Borsali- Falfoul, N., Rezgui, M., Cakar, N., Ssenyonjo, H., Kobusingye, O., Lomas, G., Yates, D., Lecky, F., Bleetman, A., Baldwin, A., Jenkinson, E., Pantrini, S., Stewart, J., Contractor, N., Roberts, T., Butler, J., Pinto, A., Lee, D., Brayley, N., Robbshaw, K., Dix, C., Graham, S., Pye, S., Green, M., Kellins, A., Moulton, C., Fogg, B., Cottingham, R., Funnell, S., Shanker, U., Summers, C., Malek, L., Ashcroft, C., Powell, J., Moore, S., Buckley, S., Grocutt, M., Chambers, S., Morrice, A., Marshall, H., Harris, J., Matthews, W., Tippet, J., Mardell, S., Macmillan, F., Shaw, A., Luthra, P., Dixon, G., Ahmed, M., Young, M., Mason, S., Loveday, I., Clark, C., Taylor, S., Wilson, P., Ali, K., Greenwood, S., White, M., Perez, R., Eljamel, S., Wasserberg, J., Shale, H., Read, C., Mccarron, J., Pennell, A., Ray, G., Thurston, J., Brown, E., Jaffey, L., Graves, M., Bailey, R., Loveridge, N., Evans, G., Hughes, S., Ahmed, M. K., Richardson, J., Gallagher, C., Odedun, T., Lees, K., Foley, D., Payne, N., Pennycook, A., Griffiths, C., Moore, D., Byrne, D., Dasan, S., Banerjee, Abhishek, Mcguinness, S., Chikhani, C., Zoltie, N., Barlow, I., Stell, I., Hulse, W., Crossley, J., Watkins, L., Dorani, B., Van Viet, T., Plata R., Annetta M. G. (ORCID:0000-0001-7574-1311), Banerjee A., Perel, P. A., Olldashi, F., Muzha, I., Filipi, N., Lede, R., Copertari, P., Traverso, C., Copertari, A., Vergara, E. A., Montenegro, C., De Huidobro, R. R., Saladino, P., Surt, K., Cialzeta, J., Lazzeri, S., Pinero, G., Ciccioli, F., Videtta, W., Barboza, M. F., Svampa, S., Sciuto, V., Domeniconi, G., Bustamante, M., Waschbusch, M., Gullo, M. P., Drago, D. A., Linares, J. C. A., Camputaro, L., Troccoli, G., Galimberti, H., Tallott, M., Eybner, C., Buchinger, W., Fitzal, S., Mazairac, G., Oleffe, V., Grollinger, T., Delvaux, P., Carlier, L., Braet, V., Jacques, J. -M., De Knoop, D., Nasi, L., Choi, H. K., Schmitt, M., Gentil, A., Nacul, F., Barrios, P. B., Xinkang, C., Hua, L. S., Tian, H. H., Xiaodong, C., Gualteros, W., Otero, A. A., Arango, M., Ciro, J., Jaramillo, H., Gonzalez, I., Gomez, C., Arias, A., Fonseca, M., Mora, C., Cabrera, E. G. L., Betancurth, J. L., Munoz, P., Quinonez, J. A., Castillo, M. E. G., Lopez, O., Yepes, R. P., Cuellar, D. L., Paez, G., Chaves, H. D., Ordonez, P. E., Plata, Riccardo, Pineda, M., Pulido, L. E., Jaramillo, J. S. V., Rebolledo, C., Palma, O., Soler, C., Pastrana, I., Falero, R., Perera, M. D., Garcia, A. A., Oliva, R., Delgado, H. L., Carnero, A. M., Lopez, B. L., Gallardo, A. L., Morales, A. O., Lezcano, H., Ferrer, M. I., Bess, I. Z., Canino, G. R., Ruiz, E. M. P., Cruz, O. G., Svoboda, P., Kantorova, I., Ochmann, J., Scheer, P., Kozumplik, L., Marsova, J., Edelmann, K., Chytra, I., Bosman, R., Andrejsova, H., Pachl, J., Burger, J., Kramar, F., Ulloa, M. I., Gonzalez, L., Daccach, A., Ortega, A., Cevallos, S., Cueva, B. Z., Ochoa, M., Tapia, J. V., Hurtado, J., Wong, M. C. S., Santos, R., Khamis, H., Abaza, A. H., Fekry, A., El Kordy, S., Shawky, T., El-Sayed, H., Khalil, N., Negm, N., Fisal, S., Alamin, M., Shokry, H., Elhusseny, A. Y., Radwan, A., Rashid, M., Gogichaisvili, T., Ingorokva, G., Gongadze, N., Otarashvili, A., Kleist, W., Kalkum, M., Ulrich, P., Andrews, N., Nakos, G., Karavelis, A., Archontakis, G., Myrianthefs, P., Yadav, Y., Yadav, S., Khatri, R., Baghel, A., Husain, M., Jha, D., Chhang, W. H., Dhandhania, M., Fonning, C., Iyengar, S. N., Gupta, S., Ravi, R. R., Bopiah, K. S., Herur, A., Venkataramana, N. K., Satish, A., Bhavadasan, K., Morris, R., Ramesh, S., Dewan, Y., Singh, Y., Bhagchandani, R., Bhagchandani, S., Sethurayar, V. U., Ipe, S., Sreekumar, G., Panigrahi, M., Reddy, A., Khosla, V., Pillay, H., Thomas, N., Sridhar, K., Jose, B., Kurian, N., Praharaj, S., Pillai, S., Ramana, Kiyawat, D., Maheshwari, K., Panikar, D., Chawla, J., Shenoy, S., Raja, A., Rupayana, Y., Reddy, S., Mohan, N., Kelkar, S., Johri, M., Golden, N., Maliawan, S., Fauzi, A., Farouk, U., Fakharian, E., Aramesh, A., Eghtedari, M., Ahmadzadeh, F., Gholami, A., Plunkett, P., Redican, C., Mcmahon, G., Annetta, Maria Giuseppina, Mouchaty, H., Bruzzone, E., Harding, B., Qureshi, M., Idris, Z., Jafri Abdullah, N. C., Ghazali, G., Ghani, A. R. I., Cheah, F., Cabrera, A., Gonzalez, J. L. M., Loria-Castellanos, J., Jackson, S., Hutchinson, R., Komolafe, E., Adeolu, A., Komolafe, M., Adeyemi-Doro, O., Bankole, F., Shehu, B., Danlami, V., Odebode, O., Oluwadiya, K., Sanni, A., Giebel, H., Kumar, S., Jooma, R., Mezquita, J. E., Ovelar, C. O., Portillo, M. G., Rodriguez, D., Balica, L., Oprita, B., Sklerniacof, M., Steflea, L., Bandut, L., Danil, A., Iliescu, R., Ciurea, J., El-Dawlatly, A., Alwatidy, S., Al-Yafi, W., El-Dawlatly, M., Krunic-Protic, R., Janosevic, V., Tan, J., Seah, C., Trenkler, S., Humenansky, M., Stajancova, T., Schwendt, I., Laincz, A., Julius, Z., Maros, S., Firment, J., Cifranicova, M., Saniova, B., Kalig, K., Medekova, S., Wiszt, R., Macuga, I., Hartzenberg, B., Du Plessis, G., Houlie, Z., Nathoo, N., Khumalo, S., Tracey, R., Munoz-Sanchez, A., Francisco Murillo-Cabezas, N. C., Flores-Cordero, J., Rincon- Ferrari, D., Rubi, M., Caler, L., Del Campo, M. M., Laguna, L. B., Nava, J. M., Minguillon, M. A., Lopez, A. M., Ramos-Gomez, L., De La Torre-Prados, V., Pellejero, R., Laloe, V., Mandrella, B., Suganthan, Perera, S., Mahendran, K., Stocker, R., Ludwig, S., Zimmermann, H., Denzler, U., Yutthakasemsunt, S., Kittiwattanagul, W., Piyavechvirat, P., Tapsai, P., Namuang-Jan, A., Chantapimpa, U., Watanachai, C., Subsompon, P., Pussanakawatin, W., Khunjan, P., Tangchitvittaya, S., Nilapong, S., Klangsang, T., Taechakosol, W., Srinat, A., Jerbi, Z., Borsali- Falfoul, N., Rezgui, M., Cakar, N., Ssenyonjo, H., Kobusingye, O., Lomas, G., Yates, D., Lecky, F., Bleetman, A., Baldwin, A., Jenkinson, E., Pantrini, S., Stewart, J., Contractor, N., Roberts, T., Butler, J., Pinto, A., Lee, D., Brayley, N., Robbshaw, K., Dix, C., Graham, S., Pye, S., Green, M., Kellins, A., Moulton, C., Fogg, B., Cottingham, R., Funnell, S., Shanker, U., Summers, C., Malek, L., Ashcroft, C., Powell, J., Moore, S., Buckley, S., Grocutt, M., Chambers, S., Morrice, A., Marshall, H., Harris, J., Matthews, W., Tippet, J., Mardell, S., Macmillan, F., Shaw, A., Luthra, P., Dixon, G., Ahmed, M., Young, M., Mason, S., Loveday, I., Clark, C., Taylor, S., Wilson, P., Ali, K., Greenwood, S., White, M., Perez, R., Eljamel, S., Wasserberg, J., Shale, H., Read, C., Mccarron, J., Pennell, A., Ray, G., Thurston, J., Brown, E., Jaffey, L., Graves, M., Bailey, R., Loveridge, N., Evans, G., Hughes, S., Ahmed, M. K., Richardson, J., Gallagher, C., Odedun, T., Lees, K., Foley, D., Payne, N., Pennycook, A., Griffiths, C., Moore, D., Byrne, D., Dasan, S., Banerjee, Abhishek, Mcguinness, S., Chikhani, C., Zoltie, N., Barlow, I., Stell, I., Hulse, W., Crossley, J., Watkins, L., Dorani, B., Van Viet, T., Plata R., Annetta M. G. (ORCID:0000-0001-7574-1311), and Banerjee A.

Abstract

Objective: To develop and validate practical prognostic models for death at 14 days and for death or severe disability six months after traumatic brain injury. Design: Multivariable logistic regression to select variables that were independently associated with two patient outcomes. Two models designed: "basic" model (demographic and clinical variables only) and "CT" model (basic model plus results of computed tomography). The models were subsequently developed for high and low-middle income countries separately. Setting: Medical Research Council (MRC) CRASH Trial. Subjects: 10 008 patients with traumatic brain injury. Models externally validated in a cohort of 8509. Results: The basic model included four predictors: age, Glasgow coma scale, pupil reactivity, and the presence of major extracranial injury. The CT model also included the presence of petechial haemorrhages, obliteration of the third ventricle or basal cisterns, subarachnoid bleeding, midline shift, and non-evacuated haematoma. In the derivation sample the models showed excellent discrimination (C statistic above 0.80). The models showed good calibration graphically. The Hosmer-Lemeshow test also indicated good calibration, except for the CT model in low-middle income countries. External validation for unfavourable outcome at six months in high income countries showed that basic and CT models had good discrimination (C statistic 0.77 for both models) but poorer calibration. Conclusion: Simple prognostic models can be used to obtain valid predictions of relevant outcomes in patients with traumatic brain injury.

Published
2008

7. 365 Contribution and comparison of the wells score with the Geneva score and revised Geneva score for assessing pretest probability of pulmonary embolism in emergency department: Tunisian experience

Author

Longo, Salma, primary, Frikha, Zied, additional, Saidi, H., additional, Baha, Elhabil, additional, Zairi, Ihsen, additional, Kammoun, Sofien, additional, Fennira, Sana, additional, Falfoul, N., additional, Jerbi, Z., additional, and Kraim, Sondos, additional

Published
2012
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10. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): Randomised placebo-controlled trial

Author

Olldashi, F., Muzha, I., Filipi, N., Lede, R., Copertari, P., Traverso, C., Copertari, A., Vergara, E. A., Montenegro, C., De Huidobro, R. R., Surt, K., Cialzeta, J., Lazzeri, S., Pinero, G., Ciccioli, F., Videtta, W., Barboza, M. F., Svampa, S., Sciuto, V., Domeniconi, G., Bustamante, M., Waschbusch, M., Gullo, M. P., Drago, D. A., Linares, J. C. A., Camputaro, L., Troccoli, G., Galimberti, H., Tallott, M., Eybner, C., Buchinger, W., Fitzal, S., Mazairac, G., Oleffe, V., Grollinger, T., Delvaux, P., Carlier, L., Braet, V., Jacques, J. -M., De Knoop, D., Nasi, L., Choi, H. K., Schmitt, M., Gentil, A., Nacul, F., Barrios, P. B., Xinkang, C., Hua, L. S., Tian, H. H., Xiaodong, C., Gualteros, W., Otero, A. A., Arango, M., Ciro, J., Jaramillo, H., Garcia, G., Gonzalez, I., Gomez, C., Arias, A., Fonseca, M., Mora, C., Cabrera, E. G. L., Betancurth, J. L., Munoz, P., Quinonez, J. A., Castillo, M. E. G., Lopez, O., Yepes, R. P., Cuellar, D. L., Paez, G., Chaves, H. D., Ordonez, P. E., Plata, Riccardo, Pineda, M., Pulido, L. E., Jaramillo, J. S. V., Rebolledo, C., Palma, O., Soler, C., Pastrana, I., Falero, R., Perera, M. D., Garcia, A. A., Oliva, R., Delgado, H. L., Carnero, A. M., Lopez, B. L., Gallardo, A. L., Morales, A. O., Lezcano, H., Ferrer, M. I., Bess, I. Z., Canino, G. R., Ruiz, E. M. P., Cruz, O. G., Svoboda, P., Kantorova, I., Ochmann, J., Scheer, P., Kozumplik, L., Marsova, J., Edelmann, K., Chytra, I., Bosman, R., Andrejsova, H., Pachl, J., Burger, J., Kramar, F., Ulloa, M. I., Gonzalez, L., Daccach, A., Ortega, A., Cevallos, S., Cueva, B. Z., Ochoa, M., Tapia, J. V., Hurtado, J., Wong, M. C. S., Santos, R., Khamis, H., Abaza, A. H., Fekry, A., El Kordy, S., Shawky, T., El-Sayed, H., Khalil, N., Negm, N., Fisal, S., Shokry, H., Alamin, M., Elhusseny, A. Y., Radwan, A., Rashid, M., Gogichaisvili, T., Ingorokva, G., Gongadze, N., Otarashvili, A., Kleist, W., Kalkum, M., Ulrich, P., Andrews, N., Nakos, G., Karavelis, A., Archontakis, G., Myrianthefs, P., Yadav, Y., Yadav, S., Khatri, R., Baghel, A., Husain, M., Jha, D., Hoong Chhang, W., Dhandhania, M., Fonning, C., Iyengar, S. N., Gupta, S., Ravi, R. R., Bopiah, K. S., Herur, A., Venkataramana, N. K., Satish, A., Bhavadasan, K., Morris, R., Ramesh, S., Dewan, Y., Singh, Y., Bhagchandani, R., Bhagchandani, S., Sethurayar, V., Ipe, S., Sreekumar, G., Panigrahi, M., Reddy, A., Khosla, V., Pillay, H., Thomas, N., Sridhar, K., Jose, B., Kurian, N., Praharaj, S., Pillai, S., Ramana, Kiyawat, D., Maheshwari, K., Panikar, D., Chawla, J., Shenoy, S., Raja, A., Rupayana, Y., Reddy, S., Mohan, N., Kelkar, S., Johri, M., Golden, N., Maliawan, S., Fauzi, A., Farouk, U., Fakharian, E., Aramesh, A., Eghtedari, M., Ahmadzadeh, F., Gholami, A., Plunkett, P., Redican, C., Mcmahon, G., Annetta, Maria Giuseppina, Mouchaty, H., Bruzzone, E., Harding, B., Qureshi, M., Idris, Z., Abdullah, J., Ghazali, G., Ghani, A., Cheah, F., Gonzalez, J., Loria-Castellanos, J., Jackson, S., Hutchinson, R., Komolafe, E., Adeolu, A., Komolafe, M., Adeyemi-Doro, O., Bankole, F., Shehu, B., Danlami, V., Odebode, O., Oluwadiya, K., Sanni, A., Giebel, H., Kumar, S., Jooma, R., Mezquita, J., Ortiz Ovelar, C., Gonzales-Portillo, M., Rodriguez, D., Balica, L., Oprita, B., Sklerniacof, M., Steflea, L., Bandut, L., Danil, A., Iliescu, R., Ciurea, J., El-Dawlatly, A., Alwatidy, S., Al-Yafi, W., El-Dawlatly, M., Krunic-Protic, R., Janosevic, V., Tan, J., Seah, C., Trenkler, S., Humenansky, M., Stajancova, T., Schwendt, I., Laincz, A., Julius, Z., Maros, S., Firment, J., Cifranicova, M., Saniova, B., Kalig, K., Medekova, S., Wiszt, R., Macsuga, I., Hartzenberg, B., Du Plessis, G., Houlie, Z., Nathoo, N., Khumalo, S., Tracey, R., Munoz-Sanchez, A., Murillo-Cabezas, F., Flores-Cordero, J., Rincon-Ferrari, D., Rubi, M., Caler, L., Del Campo, M., Laguna, L., Manuel Nava, J., Minguillon, M., Lopez, A., Ramos-Gomez, L., De La Torre-Prados, V., Pellejero, R., Laloe, V., Mandrella, B., Suganthan, Perera, S., Mahendran, K., Stocker, R., Ludwig, S., Zimmermann, H., Denzler, U., Yutthakasemsunt, S., Kittiwattanagul, W., Watanachai, C., Subsompon, P., Pussanakawatin, W., Khunjan, P., Tangchitvittaya, S., Nilapong, S., Klangsang, T., Taechakosol, W., Srinat, A., Jerbi, Z., Borsali-Falfoul, N., Rezgui, M., Cakar, N., Ssenyonjo, H., Kobusingye, O., Lomas, G., Yates, D., Lecky, F., Bleetman, A., Baldwin, A., Jenkinson, E., Pantrini, S., Stewart, J., Contractor, N., Roberts, T., Butler, J., Pinto, A., Lee, D., Brayley, N., Robbshaw, K., Dix, C., Graham, S., Pye, S., Green, M., Kellins, A., Moulton, C., Fogg, B., Cottingham, R., Funnell, S., Shanker, U., Summers, C., Malek, L., Ashcroft, C., Powell, J., Moore, S., Buckley, S., Grocutt, M., Chambers, S., Morrice, A., Marshall, H., Harris, J., Matthews, W., Tippet, J., Mardell, S., Macmillan, F., Shaw, A., Luthra, P., Dixon, G., Ahmed, M., Young, M., Mason, S., Loveday, I., Clark, C., Taylor, S., Wilson, P., Ali, K., Greenwood, S., White, M., Perez, R., Eljamel, S., Wasserberg, J., Shale, H., Read, C., Mccarron, J., Pennell, A., Ray, G., Thurston, J., Brown, E., Jaffey, L., Graves, M., Bailey, R., Loveridge, N., Evans, G., Hughes, S., Richardson, J., Gallagher, C., Odedun, T., Lees, K., Foley, D., Payne, N., Pennycook, A., Griffiths, C., Moore, D., Byrne, D., Dasan, S., Banerjee, Abhishek, Mcguinness, S., Chikhani, C., Zoltie, N., Barlow, I., Stell, I., Hulse, W., Crossley, J., Watkins, L., Dorani, B., Vanviet, T., Saladino, P., Cabrera, A., Baigent, C., Bracken, M., Chadwick, D., Curley, K., Duley, L., Farrell, B., Haegi, M., Nickson, G., Peto, R., Pickard, J., Roberts, I., Sandercock, P., Teasdale, G., Collins, R., Haines, S., Macmahon, S., Warlow, C., Edwards, P., Ritchie, N., Shakur, H., Ramos, M., Barnetson, L., Fernandes, J., Tooth, D., Free, C., Narayanan, L., Collander, J., Abernethy, J., Bardswell, J., Mashru, R., Godward, C., Afolabi, L., Ritchie, A., Hosford, T., Collingwood, A., Massey, S., Plata R., Annetta M. (ORCID:0000-0001-7574-1311), Banerjee A., Olldashi, F., Muzha, I., Filipi, N., Lede, R., Copertari, P., Traverso, C., Copertari, A., Vergara, E. A., Montenegro, C., De Huidobro, R. R., Surt, K., Cialzeta, J., Lazzeri, S., Pinero, G., Ciccioli, F., Videtta, W., Barboza, M. F., Svampa, S., Sciuto, V., Domeniconi, G., Bustamante, M., Waschbusch, M., Gullo, M. P., Drago, D. A., Linares, J. C. A., Camputaro, L., Troccoli, G., Galimberti, H., Tallott, M., Eybner, C., Buchinger, W., Fitzal, S., Mazairac, G., Oleffe, V., Grollinger, T., Delvaux, P., Carlier, L., Braet, V., Jacques, J. -M., De Knoop, D., Nasi, L., Choi, H. K., Schmitt, M., Gentil, A., Nacul, F., Barrios, P. B., Xinkang, C., Hua, L. S., Tian, H. H., Xiaodong, C., Gualteros, W., Otero, A. A., Arango, M., Ciro, J., Jaramillo, H., Garcia, G., Gonzalez, I., Gomez, C., Arias, A., Fonseca, M., Mora, C., Cabrera, E. G. L., Betancurth, J. L., Munoz, P., Quinonez, J. A., Castillo, M. E. G., Lopez, O., Yepes, R. P., Cuellar, D. L., Paez, G., Chaves, H. D., Ordonez, P. E., Plata, Riccardo, Pineda, M., Pulido, L. E., Jaramillo, J. S. V., Rebolledo, C., Palma, O., Soler, C., Pastrana, I., Falero, R., Perera, M. D., Garcia, A. A., Oliva, R., Delgado, H. L., Carnero, A. M., Lopez, B. L., Gallardo, A. L., Morales, A. O., Lezcano, H., Ferrer, M. I., Bess, I. Z., Canino, G. R., Ruiz, E. M. P., Cruz, O. G., Svoboda, P., Kantorova, I., Ochmann, J., Scheer, P., Kozumplik, L., Marsova, J., Edelmann, K., Chytra, I., Bosman, R., Andrejsova, H., Pachl, J., Burger, J., Kramar, F., Ulloa, M. I., Gonzalez, L., Daccach, A., Ortega, A., Cevallos, S., Cueva, B. Z., Ochoa, M., Tapia, J. V., Hurtado, J., Wong, M. C. S., Santos, R., Khamis, H., Abaza, A. H., Fekry, A., El Kordy, S., Shawky, T., El-Sayed, H., Khalil, N., Negm, N., Fisal, S., Shokry, H., Alamin, M., Elhusseny, A. Y., Radwan, A., Rashid, M., Gogichaisvili, T., Ingorokva, G., Gongadze, N., Otarashvili, A., Kleist, W., Kalkum, M., Ulrich, P., Andrews, N., Nakos, G., Karavelis, A., Archontakis, G., Myrianthefs, P., Yadav, Y., Yadav, S., Khatri, R., Baghel, A., Husain, M., Jha, D., Hoong Chhang, W., Dhandhania, M., Fonning, C., Iyengar, S. N., Gupta, S., Ravi, R. R., Bopiah, K. S., Herur, A., Venkataramana, N. K., Satish, A., Bhavadasan, K., Morris, R., Ramesh, S., Dewan, Y., Singh, Y., Bhagchandani, R., Bhagchandani, S., Sethurayar, V., Ipe, S., Sreekumar, G., Panigrahi, M., Reddy, A., Khosla, V., Pillay, H., Thomas, N., Sridhar, K., Jose, B., Kurian, N., Praharaj, S., Pillai, S., Ramana, Kiyawat, D., Maheshwari, K., Panikar, D., Chawla, J., Shenoy, S., Raja, A., Rupayana, Y., Reddy, S., Mohan, N., Kelkar, S., Johri, M., Golden, N., Maliawan, S., Fauzi, A., Farouk, U., Fakharian, E., Aramesh, A., Eghtedari, M., Ahmadzadeh, F., Gholami, A., Plunkett, P., Redican, C., Mcmahon, G., Annetta, Maria Giuseppina, Mouchaty, H., Bruzzone, E., Harding, B., Qureshi, M., Idris, Z., Abdullah, J., Ghazali, G., Ghani, A., Cheah, F., Gonzalez, J., Loria-Castellanos, J., Jackson, S., Hutchinson, R., Komolafe, E., Adeolu, A., Komolafe, M., Adeyemi-Doro, O., Bankole, F., Shehu, B., Danlami, V., Odebode, O., Oluwadiya, K., Sanni, A., Giebel, H., Kumar, S., Jooma, R., Mezquita, J., Ortiz Ovelar, C., Gonzales-Portillo, M., Rodriguez, D., Balica, L., Oprita, B., Sklerniacof, M., Steflea, L., Bandut, L., Danil, A., Iliescu, R., Ciurea, J., El-Dawlatly, A., Alwatidy, S., Al-Yafi, W., El-Dawlatly, M., Krunic-Protic, R., Janosevic, V., Tan, J., Seah, C., Trenkler, S., Humenansky, M., Stajancova, T., Schwendt, I., Laincz, A., Julius, Z., Maros, S., Firment, J., Cifranicova, M., Saniova, B., Kalig, K., Medekova, S., Wiszt, R., Macsuga, I., Hartzenberg, B., Du Plessis, G., Houlie, Z., Nathoo, N., Khumalo, S., Tracey, R., Munoz-Sanchez, A., Murillo-Cabezas, F., Flores-Cordero, J., Rincon-Ferrari, D., Rubi, M., Caler, L., Del Campo, M., Laguna, L., Manuel Nava, J., Minguillon, M., Lopez, A., Ramos-Gomez, L., De La Torre-Prados, V., Pellejero, R., Laloe, V., Mandrella, B., Suganthan, Perera, S., Mahendran, K., Stocker, R., Ludwig, S., Zimmermann, H., Denzler, U., Yutthakasemsunt, S., Kittiwattanagul, W., Watanachai, C., Subsompon, P., Pussanakawatin, W., Khunjan, P., Tangchitvittaya, S., Nilapong, S., Klangsang, T., Taechakosol, W., Srinat, A., Jerbi, Z., Borsali-Falfoul, N., Rezgui, M., Cakar, N., Ssenyonjo, H., Kobusingye, O., Lomas, G., Yates, D., Lecky, F., Bleetman, A., Baldwin, A., Jenkinson, E., Pantrini, S., Stewart, J., Contractor, N., Roberts, T., Butler, J., Pinto, A., Lee, D., Brayley, N., Robbshaw, K., Dix, C., Graham, S., Pye, S., Green, M., Kellins, A., Moulton, C., Fogg, B., Cottingham, R., Funnell, S., Shanker, U., Summers, C., Malek, L., Ashcroft, C., Powell, J., Moore, S., Buckley, S., Grocutt, M., Chambers, S., Morrice, A., Marshall, H., Harris, J., Matthews, W., Tippet, J., Mardell, S., Macmillan, F., Shaw, A., Luthra, P., Dixon, G., Ahmed, M., Young, M., Mason, S., Loveday, I., Clark, C., Taylor, S., Wilson, P., Ali, K., Greenwood, S., White, M., Perez, R., Eljamel, S., Wasserberg, J., Shale, H., Read, C., Mccarron, J., Pennell, A., Ray, G., Thurston, J., Brown, E., Jaffey, L., Graves, M., Bailey, R., Loveridge, N., Evans, G., Hughes, S., Richardson, J., Gallagher, C., Odedun, T., Lees, K., Foley, D., Payne, N., Pennycook, A., Griffiths, C., Moore, D., Byrne, D., Dasan, S., Banerjee, Abhishek, Mcguinness, S., Chikhani, C., Zoltie, N., Barlow, I., Stell, I., Hulse, W., Crossley, J., Watkins, L., Dorani, B., Vanviet, T., Saladino, P., Cabrera, A., Baigent, C., Bracken, M., Chadwick, D., Curley, K., Duley, L., Farrell, B., Haegi, M., Nickson, G., Peto, R., Pickard, J., Roberts, I., Sandercock, P., Teasdale, G., Collins, R., Haines, S., Macmahon, S., Warlow, C., Edwards, P., Ritchie, N., Shakur, H., Ramos, M., Barnetson, L., Fernandes, J., Tooth, D., Free, C., Narayanan, L., Collander, J., Abernethy, J., Bardswell, J., Mashru, R., Godward, C., Afolabi, L., Ritchie, A., Hosford, T., Collingwood, A., Massey, S., Plata R., Annetta M. (ORCID:0000-0001-7574-1311), and Banerjee A.

Abstract

Background Corticosteroids have been used to treat head injuries for more than 30 years. In 1997, findings of a systematic review suggested that these drugs reduce risk of death by 1-2%. The CRASH trial—a multicentre international collaboration—aimed to confirm or refute such an effect by recruiting 20 000 patients. In May, 2004, the data monitoring committee disclosed the unmasked results to the steering committee, which stopped recruitment. Methods 10 008 adults with head injury and a Glasgow coma score (GCS) of 14 or less within 8 h of injury were randomly allocated 48 h infusion of corticosteroids (methylprednisolone) or placebo. Primary outcomes were death within 2 weeks of injury and death or disability at 6 months. Prespecified subgroup analyses were based on injury severity (GCS) at randomisation and on time from injury to randomisation. Analysis was by intention to treat. Effects on outcomes within 2 weeks of randomisation are presented in this report. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN74459797. Findings Compared with placebo, the risk of death from all causes within 2 weeks was higher in the group allocated corticosteroids (1052 [21·1%] vs 893 [17·9%] deaths; relative risk 1·18 [95% CI 1·09-1·27]; p=0·0001). The relative increase in deaths due to corticosteroids did not differ by injury severity (p=0·22) or time since injury (p=0·05). Interpretation Our results show there is no reduction in mortality with methylprednisolone in the 2 weeks after head injury. The cause of the rise in risk of death within 2 weeks is unclear.

Published
2004

11. Update on progress in the international, multicenter, randomized, controlled trial of corticosteroids after significant head injury (Medical Research Council CRASH Trial)

Author

Lede, R., Hickling, K., Mazairac, G., Nasi, L. A., Xinkang, C., Arango, M. F., Rodriguez, O. P., Soler, C., Svoboda, P., El-Sayed, H., Khamis, H., Plunkett, P., Gaab, M. R., Nakos, G., Annetta, Maria Giuseppina, Abdullah, J., Idris, Z., Jackson, S., Adeyemi-Doro, H. O., Batica, L., Oprita, B., Tan, J. S. H., Trenkler, S., Hartzenberg, B., Munoz Sanchez, M. D. L. A., Laloe, V., Mandrella, B., Ludwig, S., Jerbi, Z., Cakar, N., Kobusingye, O., Massey, S., Fernandes, J., Mashru, R., Annetta M. G. (ORCID:0000-0001-7574-1311), Lede, R., Hickling, K., Mazairac, G., Nasi, L. A., Xinkang, C., Arango, M. F., Rodriguez, O. P., Soler, C., Svoboda, P., El-Sayed, H., Khamis, H., Plunkett, P., Gaab, M. R., Nakos, G., Annetta, Maria Giuseppina, Abdullah, J., Idris, Z., Jackson, S., Adeyemi-Doro, H. O., Batica, L., Oprita, B., Tan, J. S. H., Trenkler, S., Hartzenberg, B., Munoz Sanchez, M. D. L. A., Laloe, V., Mandrella, B., Ludwig, S., Jerbi, Z., Cakar, N., Kobusingye, O., Massey, S., Fernandes, J., Mashru, R., and Annetta M. G. (ORCID:0000-0001-7574-1311)

Abstract

Purpose of review: To provide an update on the progress of the multicenter, randomized, controlled trial of corticosteroids after significant head injury (CRASH). Recent findings: After a successful pilot phase, the main phase of the CRASH Trial began in March 2001. By June 2002, 107 hospitals from 31 countries were participating in the trial, and together had recruited 3000 patients. Nine hundred patients (30%) had mild head injury, 885 (30%) had moderate head injury, and 1215 (40%) had severe head injury. A total of 1941 (65%) patients were randomized within 3 hours of injury. Outcome at 2 weeks from injury was known for 2933 (98%) patients, of whom 557 (19%) died. At the time of writing, 6-month follow-up for the first 1500 patients was nearly complete. Vital status was known for 1429 (95%) of the 1500 patients, of whom 313 (22%) had died. Functional status based on the Glasgow Outcome Scale was known for 1391 (93%) of the 1500 patients: 22% were dead, 16% were severely disabled, 23% were moderately disabled, and 39% had made a good recovery. Summary: The CRASH Trial is a randomized, placebo-controlled, multicenter trial of a 48-hour corticosteroid infusion after significant head injury and is now the largest head injury trial ever conducted. The efforts of the national coordinators have shown that it is possible to enroll and follow up very large numbers of head-injured patients.

Published
2003

18. Intoxication au bromure de méthyle

Author

Hamouda, C, primary, Ghorbal, H, additional, Hédhili, A, additional, Amamou, M, additional, Ben Lakhal, S, additional, Jerbi, Z, additional, Ben Salah, N, additional, and Yacoub, M, additional

Published
1998
Full Text
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19. [Hemiplegia during carbon monoxide poisoning revealing multiple cerebral artery abnormalities including the hypoglossal artery]

Author

Goulon M, Oútin H, Beydon L, Gajdos P, yves samson, and Jerbi Z

Subjects
Adult, Male, Carbon Monoxide Poisoning, Carotid Arteries, Basilar Artery, Humans, Abnormalities, Multiple, Electroencephalography, Hemiplegia, Cerebral Arteries, Carotid Artery, Internal, Cerebral Angiography
Abstract

Hemiplegia after carbon monoxide (CO) poisoning is rare since only 9 such lesions have been reported from among 1480 cases of poisoning. The patient reported was a 43 year-old man with a left hemiplegia with coma following CO poisoning. Right carotid angiography demonstrated a hypoglossal artery supplying both posterior cerebral arteries. Left carotid angiography showed a dolichocarotid artery supplying the territories of the anterior and middle cerebral arteries on both sides. Complete regression of the hemiplegia occurred after 2 months following rapid administration of hyperbaric oxygen. Normal CT scan images and cerebral blood flow rates on follow-up examination suggest that the left hemiplegia was due to the combined effects of arterial anomalies and CO poisoning.

Published
1984

20. The prevalence of healthcare-associated infection in medical intensive care units in Tunisia. Results of the multi-centre nosorea1 study,Prévalence des infections associées aux soins en réanimation médicale en Tunisie. Résultats de l’étude multicentrique nosorea1

Author

Jamoussi, A., Ayed, S., Ben Ismail, K., kamilia CHTARA, Bouaziz, M., Mokline, A., Messaadi, A., Merhebene, T., Tilouche, N., El Atrous, S., Boussarsar, M., Daly, F., Benlakhel, S., Fathallal, I., Kouraichi, N., El Hechmi, Y. Z., Jerbi, Z., Attigue, R., Hamouda, H., Ghadhoun, H., El Ghord, H., Ben Romdhane, K., Khedher, S., Allala, R., Mateur, H., Brahmi, N., Ben Khelil, J., and Besbes, M.

21. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2) a randomised, placebo-controlled trial

Author

Olldashi, F., Kerçi, M., Zhurda, T., Ruçi, K., Banushi, A., Traverso, M. S., Jiménez, J., Balbi, J., Dellera, C., Svampa, S., Quintana, G., Piñero, G., Teves, J., Seppelt, I., Mountain, D., Balogh, Z., Zaman, M., Druwé, P., Rutsaert, R., Mazairac, G., Pascal, F., Yvette, Z., Chancellin, D., Okwen, P., Djokam-Liapoe, J., Jangwa, E., Mbuagbaw, L., Fointama, N., Pascal, N., Baillie, F., Jiang, J. -Y, Gao, G. -Y, Bao, Y. -H, Morales, C., Sierra, J., Naranjo, S., Correa, C., Gómez, C., Herrera, J., Caicedo, L., Rojas, A., Pastas, H., Miranda, H., Constaín, A., Perdomo, M., Muñoz, D., Duarte, Á, Vásquez, E., Ortiz, C., Ayala, B., Delgado, H., Benavides, G., Rosero, L., Mejía-Mantilla, J., Varela, A., Calle, M., Castillo, J., García, A., Ciro, J., Villa, C., Panesso, R., Flórez, L., Gallego, A., Puentes-Manosalva, F., Medina, L., Márquez, K., Romero, A. R., Hernández, R., Martínez, J., Gualteros, W., Urbina, Z., Velandia, J., Benítez, F., Trochez, A., Villarreal, A., Pabón, P., López, H., Quintero, L., Rubiano, A., Tamayo, J., Piñera, M., Navarro, Z., Rondón, D., Bujan, B., Palacios, L., Martínez, D., Hernández, Y., Fernández, Y., Casola, E., Delgado, R., Herrera, C., Arbolaéz, M., Domínguez, M., Iraola, M., Rojas, O., Enseñat, A., Pastrana, I., Rodríguez, D., La Campa, S. Á, Fortún, T., Larrea, M., Aragón, L., Madrazo, A., Svoboda, P., Izurieta, M., Daccach, A., Altamirano, M., Ortega, A., Cárdenas, B., González, L., Ochoa, M., Ortega, F., Quichimbo, F., Guiñanzaca, J., Zavala, I., Segura, S., Jerez, J., Acosta, D., Yánez, F., Camacho, R., Khamis, H., Shafei, H., Kheidr, A., Nasr, H., Mosaad, M., Rizk, S., El Sayed, H., Moati, T., Hokkam, E., Amin, M., Lowis, H., Fawzy, M., Bedir, N., Aldars, M., Rodríguez, V., Tobar, J., Alvarenga, J., Shalamberidze, B., Demuria, E., Rtveliashvili, N., Chutkerashvili, G., Dotiashvili, D., Gogichaishvili, T., Ingorokva, G., Kazaishvili, D., Melikidze, B., Iashvili, N., Tomadze, G., Chkhikvadze, M., Khurtsidze, L., Lomidze, Z., Dzagania, D., Kvachadze, N., Gotsadze, G., Kaloiani, V., Kajaia, N., Dakubo, J., Naaeder, S., Sowah, P., Yusuf, A., Ishak, A., Selasi-Sefenu, P., Sibiri, B., Sarpong-Peprah, S., Boro, T., Bopaiah, K., Shetty, K., Subbiah, R., Mulla, L., Doshi, A., Dewan, Y., Grewal, S., Tripathy, P., Mathew, J., Gupta, B., Lal, A., Choudhury, M., Gupta, S., Chug, A., Pamidimukkala, V., Jagannath, P., Maharaj, M., Vommi, R., Gudipati, N., Chhang, W. H., Patel, P., Suthar, N., Banker, D., Patel, J., Dharap, S., Kamble, R., Patkar, S., Lohiya, S., Saraf, R., Kumar, D., Parihar, S., Gupta, R., Mangual, R., Alagumuthu, Kooper, D., Mohapatra, C., David, S., Rajaleelan, W., Pangi, A., Saraf, V., Chikareddy, S., Mankar, S., Golhar, A., Sakhare, R., Wagh, N., Hazarika, D., Chaudhuri, P., Ketan, P., Purohit, G., Purohit, Y., Pandya, M., Kiran, S., Walia, S., Goyal, S., Attri, A., Sharma, R., Oberai, A., Oberai, M., Oberoi, S., Tripathi, G. K., Peettakkandy, V., Karuthillath, P., Vadakammuriyil, P., Pol, J., Pol, S., Saste, M., Raul, S., Tiwari, S., Nelly, N., Chidambaram, M., Kollengode, V., Thampan, S., Rajan, S., Raju, S., Babu, S. V., Sumathi, C., Chatterjee, P., Agarwal, A., Magar, H., Magar, M., Singh, M., Gupta, D., Haloi, K., Sagdeo, V., Giri, P., Verma, N., Jariwala, R., Goti, A., Prabhu-Gaonkar, A., Utagi, S., Joshi, M., Agrawal, R., Sharma, G., Saini, G., Tewari, V., Yadav, Y., Parihar, V., Venkataramana, N., Rao, S., Reddy, N., Chander, S. G., Hathila, V., Das, V., Agaja, K., Purohit, A., Lahari, A., Bhagchandani, R., Vidyasagar, B., Sachan, P. K., Das, T., Vyas, S., Bhattacharjee, S., Sancheti, P., Manoj, T., Moideen, M., Pansey, K., Chandrasekaran, V. P., Saikia, K., Tata, H., Vhora, S., Shah, A., Rangad, G., Rajasekaran, S., Shankarlal, S. T., Devadoss, S., Saleem, M., Pillay, H., Hazarika, Z., Deshmukh, P., Murugappan, S. P., Jaiswal, A., Vangani, D., Modha, P., Chonzik, C., Praveen, M., Sethurayar, V., Ipe, S., Shetty, N., Gupta, R. P., Jain, V., Shah, K., Dwikoryanto, M., Golden, N., Atmadjaya, K., Wiargitha, K., Sudiasa, K., Suwedagatha, G., Bal Afif, F., Budipramana, V., Tabrani, Lemuel, A., Chandra, S., Ama, F., Sherafatkazemzadeh, E., Moradi, E., Sheikhi, A., Ziaee, A., Fanaei, A., Hajinasrollah, E., Amini, A., Mohammad, B., Hadi, N., Perone, G., Peri, E., Volpi, A., Johnson, J., Abe, M., Mutiso, V., Okanga, B., Ojuka, D., Abdullah, B., Rahman, H., Noh, Y., Jamaluddin, S., Dawal, H., Roslani, A., Law, C. -W, Devashanti, P., Wahab, Y., Velaiutham, S., Dato, R., Loría, J., Montes, E., Gómez, E., Cazales, V., Bautista, P., Bautista, R., Ahumada, D., Hernández, E., Velásquez, G., Ortega, P., Lira, G., Estrada, F., Casasola, J., Olaomi, O., Abubakar, Y., Apollo, K., Badejo, O., Ihekire, O., Iribhogbe, P., Oludiran, O., Obeta, E., Okojie, C., Udefiagbon, E., Komolafe, E., Olaleye, P., Uzochukwu, T., Onakpoya, U., Dongo, A., Uhunmwagho, O., Eighemerio, E., Morgan, E., Thanni, L., Afolabi, A., Akinola, T., Ademola, A., Akute, O., Khalid, L., Abubakar, L., Aminu, M., Ogirima, M., Attansey, A., Michael, D., Aremu, O., Olugbenga, O., Ukpong, U., Salman, Y., Obianyo, N., Ani, C., Ezeadawi, R., Kehinde, O., Olaide, A., Jogo, A., Bitto, T., Anyanwu, S., Mbonu, O., Oludara, M., Somoye, M., Shehu, B., Ismail, N., Katchy, A., Ndoma-Egba, R., Grace-Inah, N., Songden, Z., Abdulraheem, A., Otu, A., Nottidge, T., Inyang, D., Idiapho, D., Giebel, H., Hassan, R., Adisa, A., Akinkuolie, A., Okam, K., Musa, A., Falope, I., Eze, J., Caballero, J., Azabache, W., Salirrosas, O., Soto, A., Torres, E., Ramírez, G., Malca, C., Velez, J., Yepez, R., Yupanqui, H., Lagos, P., Rodriguez, D., Flores, J., Moya, A., Barrionuevo, A., Gonzales-Portillo, M., Nunez, E., Eldawlatly, A., Al Naami, M., Delvi, B., Khalid, K., Alyafi, W., Djurovic, B., Ng, I., Yaghi, A., Laincz, A., Trenkler, S., Valky, J., Modiba, M., Legodi, P., Rangaka, T., Wallis, L., Muñoz, Á, Serrano, A., Misis, M., Rubi, M., La Torre, V., Ellawala, R., Wijeratna, S., Gunaratna, L., Wijayanayaka, C., Nungu, K., Billy Haonga, Mtapa, G., Yutthakasemsunt, S., Kittiwattanagul, W., Piyavechvirat, P., Impool, T., Thummaraj, S., Salaeh, R., Tangchitvittaya, S., Wattanakrai, K., Soonthornthum, C., Jiravongbunrod, T., Meephant, S., Subsompon, P., Pensuwan, P., Chamnongwit, W., Jerbi, Z., Cherif, A., Nash, M., Harris, T., Banerjee, J., Freij, R., Kendall, J., Moore, S., Townend, W., Cottingham, R., Becker, D., Lloyd, S., Burdett-Smith, P., Mirza, K., Webster, A., Brady, S., Grocutt, A., Thurston, J., Lecky, F., Goodacre, S., Mulla, Y., Sakala, D., and Chengo, C.

22. The prevalence of healthcare-associated infection in medical intensive care units in Tunisia. Results of the multi-centre nosorea1 study.

Author

Jamoussi A, Ayed S, Ben Ismail K, Chtara K, Bouaziz M, Mokline A, Messaadi A, Merhebene T, Tilouche N, El Atrous S, Boussarsar M, Daly F, Benlakhel S, Fathallal I, Kouraichi N, El Hechmi YZ, Jerbi Z, Attigue R, Hamouda H, Ghadhoun H, El Ghord H, Ben Romdhane K, Khedher S, Allala R, Mateur H, Brahmi N, Ben Khelil J, and Besbes M

Subjects
Adult, Aged, Bacterial Infections epidemiology, Catheter-Related Infections epidemiology, Catheter-Related Infections microbiology, Comorbidity, Critical Care statistics & numerical data, Cross Infection microbiology, Female, Humans, Iatrogenic Disease epidemiology, Male, Middle Aged, Prevalence, Risk Factors, Tunisia epidemiology, Cross Infection epidemiology, Intensive Care Units statistics & numerical data
Abstract

Objectives: To determine the prevalence of Healthcare-Associated Infection (HAI) in medical Intensive Care Unit (ICU), risk factors for these infections and identify the predominant infecting organisms., Methods: A 1-day point-prevalence study within all medical ICUs in Tunisia, all patients occupying an ICU bed over a 48-hour period were included. Rates of HAI, resistance patterns of microbiological isolates and potential risk factors for HAI were recorded., Results: One hundred and three patients were collected from 15 Tunisian medical ICUs. HAI prevalence was 25.2% CI 95% [15-35].The most frequent HAIs were hospital acquired pneumonia in 19 cases (59%) and catheter related infection in 5 cases (15%). Independent factors associated with HAI occurrence were SAPSII score ≥ 33 with OR 1.047; CI 95% [1.015-1.077], p=0.003 and recent hospitalization with OR 4.14 CI 95% [1.235-13.889], p=0.021. Non-fermenting pathogens were the most frequent microorganisms reported in ICUs ecology, prior colonization and HAIs of the screened patients., Conclusion: HAIs are frequent in medical ICUs in Tunisia, which emphasize the importance of specific measures for surveillance and infection control in critically ill patients. Implementing a national monitoring system of HAI should be a major priority of public health in Tunisia.

Published
2018

23. Prognostic Value of Serum C-Reactive Protein in Spontaneous Intracerebral Hemorrhage: When Should We Take the Sample?

Author

Elhechmi YZ, Hassouna M, Chérif MA, Ben Kaddour R, Sedghiani I, and Jerbi Z

Subjects
Aged, Aged, 80 and over, Biomarkers blood, Cerebral Hemorrhage diagnosis, Cerebral Hemorrhage mortality, Female, Hospital Mortality, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Factors, Time Factors, C-Reactive Protein metabolism, Cerebral Hemorrhage blood
Abstract

Background: Several studies showed a correlation between C-reactive protein and mortality in spontaneous intracerebral hemorrhage. However, the best time to measure C-reactive protein to assess prognosis is not yet clear. The purpose of this study was to determine if initial or H24-C-reactive protein is independently associated with 30-day mortality in intracerebral hemorrhage., Methods: This is a retrospective study done within years 2010-2015. All intracerebral hemorrhage cases with missing data or with autoimmune disease or neoplasm were excluded. Univariate and multivariate analyses were assessed for initial C-reactive protein, H24-C-reactive protein, and confounding factors., Results: Of 122 patients, 91 were selected. Only H24-C-reactive protein, hematoma volume, and infratentorial origin were independently associated with 30-day mortality in intracerebral hemorrhage. When adjusted with intracerebral hemorrhage score, H24-C-reactive protein with a cutoff value of 30 mg/L independently predicted 30-day mortality., Conclusions: This study suggests that H24-C-reactive protein may be a more reliable marker than initial C-reactive protein in the prediction of mortality in intracerebral hemorrhage. A large multicentric study is necessary to confirm the interest of including H24-C-reactive protein to a modified intracerebral hemorrhage score for the prediction of 30-day mortality., (Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Published
2017
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24. Hemorrhagic Shock as Complication of Intramural Intestinal Bleeding.

Author

Ben Ali A, Cherif MA, Mhajba W, Doghri HH, Hassouna M, Hechmi YZ, Jerbi Z, Ben Hassen I, and Daghfous MH

Abstract

Introduction . Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. Results . We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma. Medical treatment was sufficient and there was no need for surgery. Conclusion . Gastrointestinal bleeding associated with shock in patients treated by oral anticoagulant should alert physicians to research a probable MIH. Urgent diagnosis and appropriate medical treatment can avoid surgical interventions., Competing Interests: The authors declare that there is no conflict of interests regarding the publication of this paper.

Published
2017
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25. Venous thromboembolism risk and prophylaxis in the acute hospital care setting-results of the Endorse study in Tunisia.

Author

Jerbi Z, Houman MH, Ghedira H, Kamoun S, and Ben Salah A

Subjects
Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Risk Assessment, Risk Factors, Tunisia, Hospitalization, Venous Thromboembolism etiology, Venous Thromboembolism prevention & control
Abstract

Background: There are not information about the risk of venous thromboembolism (VTE) and its prophylaxis in Tunisia., Aim: To report the Tunisian results of a multinational crosssectional study, designed to assess the prevalence of VTE risk in the acute hospital care setting and to determine the proportion of at risk patients who receive effective prophylaxis., Methods: All hospital inpatients aged 40 years or over admitted to a medical ward or these aged 18 years or over admitted to surgical ward, in 5 Tunisian hospitals were assessed for risk of VTE on the basis of hospital chart review. The 2004 American College of chest physicians (ACCP) evidence based consensus guidelines were used to assess VTE risk and to determine whether patients were received recommended prophylaxis., Results: 885 were enrolled, 212 (24%) were surgical and 673 (76%) were medical. 408 (44, 9%) judged to be at risk, 95 (44, 8%) are surgical and 313 (46, 5%) are medical. LWMH are the most used. Mechanical prophylaxis was never used., Conclusion: The percentage of at risk patient in Tunisia is comparable to these of other countries. The majority of at risk patient are medical. The prophylaxis was under used. Hospital strategies to assess patient VTE risk and implementation of prophylaxis protocols are needed.

Published
2011

27. Incidence of deep venous thrombosis in patients with erysipelas of the leg: prospective study of 30 cases in an emergency department.

Author

Zaghdoudi I, Rezgui M, Zouaoui W, Marhbene T, Jendoubi A, El Fatimi R, Borsali-Falfoul N, Daghfous MH, and Jerbi Z

Subjects
Aged, Emergency Service, Hospital, Erysipelas diagnostic imaging, Female, Humans, Incidence, Leg blood supply, Leg diagnostic imaging, Leg pathology, Male, Middle Aged, Probability, Prospective Studies, Ultrasonography, Doppler, Duplex, Venous Thrombosis diagnostic imaging, Erysipelas complications, Venous Thrombosis etiology
Abstract

The treatment of lower limb erysipelas is based on anti-streptococcal antibiotherapy. The indication of adjuvant anticoagulant therapy is not clear because of the lack of data about the incidence of deep venous thrombosis (DVT) in these patients. We performed a prospective study using a colour Doppler vein exploration combined with ultrasonography within the first 48 h, with evaluation of clinical probability of DVT according to the Wells score to assess the incidence of DVT in patients with erysipelas of the lower limb. Of 30 patients studied, 3 DVT were diagnosed: 2 distal DVT (posterior tibial vein) and 1 proximal DVT (superficial femoral vein) in patients having a clinical score > or = 3. Pulmonary embolism was diagnosed in 2 cases. The incidence of DVTin our study was 10%.DVT should be considered in patients with erysipelas of the lower limb having a high pretest clinical probability., (Copyright 2009 S. Karger AG, Basel.)

Published
2008
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28. [Functioning of a university hospital emergency department].

Author

Borsal-Falfoul N, Rezgui M, Kefi M, Zaghdoudi I, Asta L, and Jerbi Z

Subjects
Humans, Length of Stay, Retrospective Studies, Transportation of Patients, Triage, Tunisia, Emergency Service, Hospital organization & administration, Emergency Service, Hospital statistics & numerical data, Hospitals, University
Abstract

Background: The emergency department is the part of the hospital where patients with undifferentiated emergencies are triaged and receive their initial resuscitation and treatment. It provides a 24/7 service with doctors and nurses trained in emergency medicine., Aim: We describe our emergency department and its activity to emphasize the difficulties and try to suggest a better emergency department organization., Methods: descriptive retrospective study of an emergency department and its activity during the year 2004., Results: the department has two units: a reception unit with a resuscitation room,a trauma room, an ambulatory emergencies room, and an observation unit. There is an average of 89 patients a day with peaks in july and august, wednesday and Thursday and between 7.00 and 2.00 pm and even between 5.00 and 9.00 pm. 86.6% of patients have medical pathologies, 60% are graded CCMU II and 11% are admitted in the hospital, half of whom in the emergency observation unit with a 28 hours mean stay., Conclusion: emergency department organization must be fit to local requirements. Improvement of emergency functioning requires radiological and biological departments reinforcement and medical seniorisation; which may also reduce medical cost.

Published
2007

29. [The C677T polymorphism in the methylene tetrahydrofolate reductase gene among Tunisian population].

Author

Jerbi Z, Abdennebi M, Douik H, Ben Romdhane H, Harzallah L, Guemira F, and Ghanem A

Subjects
Adult, Aged, Cytosine, Female, Gene Frequency, Genetics, Population, Humans, Male, Middle Aged, Polymerase Chain Reaction, Polymorphism, Restriction Fragment Length, Reference Values, Restriction Mapping, Thymine, Tunisia, Methylenetetrahydrofolate Reductase (NADPH2) genetics, Polymorphism, Single Nucleotide
Abstract

The 5,10 methylene tetrahydrofolate reductase (MTHFR) is an enzyme that catalyzes the irreversible reduction of 5,10 methylene tetrahydrofolate into 5 methyl tetrahydrofolate. It is coded by a gene where several polymorphisms have been identified. The most common is the C677T polymorphism described as presenting an heterogeneous worldwide distribution and associated with different disorders such as cardiovascular and cancerous diseases. The aim of this work was to determine the allelic and genotypic frequencies of the C677T polymorphism among a Tunisian healthy population. The study concerned 185 subjects apparently healthy. It was carried out by the PCR/RFLP method, using the restriction enzyme Hinf I. The results has showed an allelic frequency of 17.8% with a genotype frequency of 5.4%. These values are intermediate between those observed in Africa and those observed in Western countries. They must be considered in the evaluation of the clinic significance of a predisposition to diseases.

Published
2005

30. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months.

Author

Edwards P, Arango M, Balica L, Cottingham R, El-Sayed H, Farrell B, Fernandes J, Gogichaisvili T, Golden N, Hartzenberg B, Husain M, Ulloa MI, Jerbi Z, Khamis H, Komolafe E, Laloë V, Lomas G, Ludwig S, Mazairac G, Muñoz Sanchéz Mde L, Nasi L, Olldashi F, Plunkett P, Roberts I, Sandercock P, Shakur H, Soler C, Stocker R, Svoboda P, Trenkler S, Venkataramana NK, Wasserberg J, Yates D, and Yutthakasemsunt S

Subjects
Craniocerebral Trauma mortality, Follow-Up Studies, Humans, Infusions, Intravenous, Risk Factors, Treatment Outcome, Craniocerebral Trauma drug therapy, Glucocorticoids administration & dosage, Methylprednisolone administration & dosage
Abstract

MRC CRASH is a randomised controlled trial (ISRCTN74459797) of the effect of corticosteroids on death and disability after head injury. We randomly allocated 10,008 adults with head injury and a Glasgow Coma Scale score of 14 or less, within 8 h of injury, to a 48-h infusion of corticosteroid (methylprednisolone) or placebo. Data at 6 months were obtained for 9673 (96.7%) patients. The risk of death was higher in the corticosteroid group than in the placebo group (1248 [25.7%] vs 1075 [22.3%] deaths; relative risk 1.15, 95% CI 1.07-1.24; p=0.0001), as was the risk of death or severe disability (1828 [38.1%] vs 1728 [36.3%] dead or severely disabled; 1.05, 0.99-1.10; p=0.079). There was no evidence that the effect of corticosteroids differed by injury severity or time since injury. These results lend support to our earlier conclusion that corticosteroids should not be used routinely in the treatment of head injury.

Published
2005
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32. [Secondary prevention of ischemic cerebrovascular accidents].

Author

Jerbi Z, Borsali-Falfoul N, Touir F, Hachicha Y, and Chergui A

Subjects
Anticoagulants therapeutic use, Brain Ischemia complications, Drug Monitoring, Humans, Hyperhomocysteinemia complications, Hyperhomocysteinemia prevention & control, Hyperlipidemias complications, Hyperlipidemias prevention & control, Hypertension complications, Hypertension prevention & control, Patient Selection, Platelet Aggregation Inhibitors therapeutic use, Risk Factors, Stroke etiology, Brain Ischemia prevention & control, Stroke prevention & control
Published
2002

34. [Resuscitation of drowning patients].

Author

Metahni MK, Bouhaja B, Ben Lakhal S, Jerbi Z, Ben Salah N, Amamou M, and Yacoub M

Subjects
Adolescent, Adult, Aged, Child, Emergency Service, Hospital, Female, Humans, Male, Middle Aged, Near Drowning classification, Near Drowning mortality, Prognosis, Resuscitation standards, Retrospective Studies, Severity of Illness Index, Tunisia epidemiology, Near Drowning therapy, Resuscitation methods
Published
1991

39. [Severe meningitis in an intensive care unit].

Author

Jerbi Z, Ben Lakhal S, Metahni MK, Bouhaja B, Slim L, Amamou M, Ben Salah N, and Yacoub M

Subjects
Adolescent, Adult, Aged, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, Female, Humans, Intensive Care Units, Male, Meningitis diagnosis, Meningitis mortality, Middle Aged, Prognosis, Respiration, Artificial, Tomography, X-Ray Computed, Meningitis therapy
Published
1989

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