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Biomedical subjects

M Amamou

Publications and source records attributed to M Amamou.

At least 19 recordsLinked to original sources
PubMed2006

[Impact of antibiotic use and prescribing policy in a Tunisian intensive care unit].

OBJECTIVE: The aim of this study was to assess the efficacy of local antibiotic policy in a Tunisian ICU. The predefined primary efficacy objectives were the decrease of antibiotic consumption, reduction of inappropriate antibiotic (ATB) use and antimicrobial resistance. DESIGN: This prospective intervention study lasted from January 2002 to December 2004. In the first study period or the baseline phase (from January to December 2002) we focused on physician education for ATB prescription practice. The second period concerned intervention (control of all ATB use). RESULTS: The number of infection episodes significantly decreased from 2002 to 2004; 198 infection episodes in 2002 (1.63+/-1.15 episodes/patient) versus 124 in 2003 (1.22+/-0.93) (P<0.0008) versus 121 in 2004 (1.23+/-0.8) (P1<0.0008). The number of ATB/prescription also significantly decreased from 1.85+/-1.3 in 2002 to 1.5+/-0.9 in 2003 (P=0.02) and 1.5+/-1.4 in 2004 (P1=0.05). Appropriateness of antibiotherapy improved during the intervention period: 65% in 2002 versus 86% in 2003 (P=0.0003) and 81% in 2004 (P1=0.02). The length of antibiotherapy in survivors was considerably reduced: 14.1+/-2.9 days in 2002 versus 11.9+/-1.2 days in 2003 (P<10(-5)) and 10.9+/-2.5 days in 2004 (P1<10(-5)) with a significant reduction of antibiotherapy cost and length of stay (20.4+/-9 days in 2002 versus 18.3+/-6 days in 2003 and 16.9+/-8 days in 2004; P=0.05; P1=0.02). There was a significant decrease of carbapenem resistant Enterobacteriaceae esbeta, Pseudomonas aeruginosa and Acinetobacter baumannii.

Adult↗
PubMed2004

A review of acute poisoning from Atractylis gummifera L.

Atractylis gummifera is a poisonous plant widely found in North Africa. The thistle grows commonly in dry areas, and the juice of the rhizome is poisonous. It provokes frequent poisoning, especially of children. Toxic glucosides have been isolated and their identified as atractyloside and carboxyatractyloside. Tissues of high metabolic activity are the main target organs. Atractylis gummifera glucosides cause a severe hepatitis with fatal liver failure common. The plant's poisonous compounds interact with detoxication and/or transformation systems in the liver even at doses not likely to induce cytolysis by blocking ADP-ATP conversion through inhibition of P450 cytochrome. Clinical manifestations are related to an induced hypoglycemia and neurovegetative disorders or subsequent renal failure. Liver transplantation or immunotherapy may improve the often fatal prognosis.

Acute Disease↗
PubMed2004

Extrapyramidal syndrome as a delayed and reversible complication of acute dichlorvos organophosphate poisoning.

We describe 4 cases of delayed extrapyramidal disorder following acute dichlorvos poisonings. All patients were seriously poisoned since all exhibited profound coma and respiratory failure, and they were all tracheally intubated and mechanically ventilated. On admission, plasma cholinesterase activity was greaty decreased, < 10 micromol/ml/h at 37 C in all patients (< 10% of normal for our laboratory). Extrapyramidal symptoms occurred between 5 and 15 d and were characterized by dystonia of arms and legs, resting tremor, cogwheel rigidity, and hypereflexia. With bromocriptine therapy the features of extrapyramidal syndrome disappeared progressively with complete recovery in all patients. Our observations suggest a delayed extrapyramidal syndrome should be taken into account during the course of acute dichlorvos organophosphate poisonings.

Acute Disease↗
PubMed2003

Use of plants to induce chemical submission in Tunisia.

Induced chemical submission is the administration or instigation of consumption of one or more substances to an individual without their knowledge to alter attentiveness and make the person vulnerable to abuse. Specific experiences in managing victims of induced submission from plant materials at a poison control center are presented.

Adolescent↗
PubMed2002

Metformin associated acute pancreatitis.

Metformin poisoning is not common and is usually associated with lactic acidosis and acute hepatitis. A case of metformin-poisoning associated with acute pancreatitis is reported here for the first time.

Acute Disease↗
PubMed2002

Acute iron poisoning.

Intoxications with ferrous compounds are uncommon but ferrous sulphate is most frequently involved. Ferrous fumarate is less toxic than ferrous sulphate. Two cases of ferrous fumarate poisoning that resulted in digestive mucosal lesions are reported.

Acute Disease↗
PubMed2000

[Septic shock complicating amniocentesis].

Amniocentesis is a routine technique for prenatal diagnosis. The incidence of severe intra-amniotic infection is very low. We report a case of septic shock following an amniocentesis in a 34-year-old women. Patient admitted in intensive care unit and need mechanical ventilation and vasoactives drugs to control hemodynamic pertubation. Bacteriological data showed positive polymicrobial blood cultures to Klebsiella pneumoniae and Enterobacter. The patient gradually improved, however her renal function was still impaired and she was discharged three months after admission.

Adult↗
PubMed2000

Plant poisonings from herbal medication admitted to a Tunisian toxicologic intensive care unit, 1983-1998.

To collect data on Tunisian herbal toxicity we analysed 56 medical records of patients admitted to the toxicological intensive care unit from 1983 to 1998 following the ingestion of plants. The sex ratio of patients was 1:2, the mean age of patients was 26y (2 to 75y) and II species of plants were involved with Atractylis gummifera (32%), Datura stramonium (25%), Ricinus communis (9%), Nerium oleander (7%) and Peganum harmala (7%) most commonly infested. Poisonings involved neurological (91%), gastrointestinal (73%) and cardiovascular systems (18%). Treatment was mainly symptomatic. The only lethal cases of liver failure involved 16 Atractylis gummifera poisonings.

Adolescent↗
PubMed1999

[Acute self-induced poisoning with carbamazepine].

OBJECTIVE: We report the epidemiological, clinical, toxicological and therapeutic aspects of acute voluntary intoxication with carbamazepine. PATIENTS AND METHODS: The study included 17 cases of acute carbamazepine intoxication in patients hospitalized in our toxicology unit. RESULTS: Neurological signs predominated at admission, mainly agitation or coma associated with seizures. Mydriasis and cardiovascular signs were frequent. Blood chemistry most frequently showed hyponatremia. Mean serum carbamazepine level admission was 24 mg/l (range 4 ñ 12 mg/l). Ten patient required respiratory assistance for 28 +/- 17 hours. Symptomatic treatment and gastric lavage (+activated carbon) provided favorable outcome. CONCLUSION: Acute carbamazepine intoxication is seen with increasing frequency. Severity is related to the degree and duration of the coma, respiratory depression, seizures, cardiovascular disorders, and metabolic abnormalities. Symptomatic and specific treatment with activated carbon are required.

Acute Disease↗
PubMed1999

Datura stramonium poisonings in humans.

Datura stramonium is a hallucinogenic plant which causes serious poisoning. Clinical symptoms are those of atropinic intoxication with psychiatric manifestations of dryness of mouth, mydriasis, tachycardia and hallucinations. Diagnosis is essentially clinical. Treatment is symptomatic and suppurative; prognosis is usually favorable.

Adolescent↗
PubMed1996

[Eikenella corrodens pleuro-pulmonary infection. Apropos of a case].

A case of single bacteria pleuropulmonary infection was observed in a 21-year-old patient with heterozygous sicle-cell amenia. The role of this bacteria in pleuropulmonary suppuration, the pathophysiology and secondary lesions are discussed together with therapeutic modalities.

Adult↗