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Epidemiology of Occupational Asthma in Tunisia: Results of a First National Study

Occupational Diseases and Environmental Medicine 2016年第2期4卷 27-36页

作者： Maoua Maher el maalel olfa Boughattas Wided Chatti Souhail Gharbi Ezzeddine Kammoun Houda Kalboussi Houda Mlaouah Jabrane Abbassi Ammar Brahem Aicha Loukil Mouna Haj Salah Habib Ben Khdimallah Khaled Masmoudi Tasnim Benzarti Mohamed Debbabi Faten Mrizak Néjib Occupational Medicine and Professional Pathologies Department Faculty of Medicine of Sousse Sousse Tunisia University of Sousse Sousse Tunisia CNAM Regional Centers of Sousse Tunis and Sfax Tunisia English Department Faculty of Medicine of Sousse Sousse Tunisia Forensic Medicine Department Faculty of Medicine of Sousse Sousse Tunisia Department of Pneumology and Allergology Farhat Hached Teaching Hospital Sousse Tunisia

Introduction: Apart from its increasingly important frequency, occupational asthma (OA) has become the most important cause of occupational respiratory disorders in developed countries. The number of etiological agents continues to grow following the constant introduction of new harmful substances in industry. Objectives: Determine the prevalence and incidence of OA in our country, the socio-occupational characteristics of asthmatics, and study the forensic and social impact of such pathology. Material and Methods: An exhaustive retrospective epidemiological study was conducted in Tunisia about charts of occupational asthma cases recognized by the competent commissions of the National Medical Care Fund (CNAM) during the period ranging from January 1st 2000 to December 31st 2008. Results: 361 occupational asthma cases, accounting for a prevalence of 7.17% of all occupational diseases, were recognized during the period of the study. Occupational asthma annual incidence was estimated to be 24.42 cases per 1000000 workers. Our study population was mainly women with a sex ratio of 0.86. More than a half (57.6%) of recognized OA cases were working in the textile industry sector. Concerning the asthmatics’ professional career, most of recognized OA cases (n = 225 i.e. 70.6% of cases) kept their jobs, whereas 58 patients did not. The professional career was linked to gender with a job loss that is 1.79 time more important in asthmatic women. Conclusion: The incidence of occupational asthma in Tunisia is comparable with that found in other Mediterranean countries. A rigorous and adequate prevention is necessary and allows reducing the importance of this occupational pathology and its serious consequences.

关键词： Epidemiology Occupational Asthma Pneumology Allergology Tunisia

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Low Back Pain among Nurses: Prevalence, and Occupational Risk Factors

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Occupational Diseases and Environmental Medicine 2017年第1期5卷 26-37页

作者： Wided Boughattas olfa el maalel Maher Maoua Iheb Bougmiza Houda Kalboussi Aicha Brahem Souhaiel Chatti Fethi Mahjoub Néjib Mrizak Department of Occupational Medicine Faculty of Medicine Ibn El Jazzar Sousse Tunisia Department of Community Health Faculty of Medicine Ibn El Jazzar Sousse Tunisia

Objectives: Low back pain is a major occupational problem especially among nursing staff. The objectives of our study are to evaluate the prevalence of low back pain among nurses and to look for physical and psychosocial risk factors. Methods: It is a cross-sectional study based on a self-administered questionnaire destined for all nurses working in Farhat Hached Teaching hospital of Sousse (Tunisia). Results: Our study included 203 nurses with an average age of 39.8 years. The prevalence of low back pain over the last twelve months was 58.1%. The factors that are significantly associated to low back pain were: high BMI, number of pregnancies, arthritis, poor physical condition, daily frequency of inappropriate posture for the activity being performed, and the layout of materials in the workplace. Conclusion: Our study evidenced the high prevalence of LBP among nurses and allowed bringing to light the role of individual and ergonomic physical factors in the genesis of LBP. Such identification permits to undertake targeted preventive actions. The association between psychosocial factors and LBP was not emphasized.

关键词： Low Back Pain Prevalence Nurses Physical Factors Psychosocial Factors

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Occupational Allergic Contact Dermatitis in Tunisia: Epidemiology and Occupational Outcome

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Occupational Diseases and Environmental Medicine 2018年第3期6卷 107-117页

作者： Asma Aloui Maher Maoua Houda Kalboussi Imène Kacem Sana el Guedri Aicha Brahem olfa el maalel Faten Debbabi Souhaiel Chatti Néjib Mrizak Department of Occupational Medicine Faculty of Medicine of Sousse University of Sousse Farhat Hached Teaching Hospital Sousse Tunisia

Background: Occupational allergic contact dermatitis (ACD) is one of the most frequent diseases on the workplace worldwide. Its national incidence and prevalence were not previously studied in Tunisia. Objective: To assess incidence of occupational allergic contact dermatitis and its occupational outcome in Tunisia. Methods: Descriptive epidemiological study of all cases of occupational allergic contact dermatitis reported from 2002 to 2012 in Tunisia and recognized by the medical commissions of the National Health Insurance Fund. Results: 315 cases of occupational ACD were collected representing an annual incidence of 31.65 cases/100.000 workers in the private sector in Tunisia. The mean age of our population was 42.70 ± 9.02 years with a male predominance (sex ratio 3.03). The most affected sectors were the clothing sector (14.3% of cases) and the cement industry (13.7% of cases). Patch tests were positive in 188 patients (59.67%). The most frequently positive allergen was potassium dichromate in 27.3% of the cases. Overall, 25.4% of patients had lost their jobs. After multiple binary logistic regression, job loss had a statistically significant relationship with localization of lesions on the face and on dominant hand. Conclusion: Occupational ACD is frequent in Tunisia and is responsible for an important rate of job loss. Preventive measures must be reinforced, especially the wearing of protective gloves.

关键词： Epidemiology Occupational Disease Allergic Contact Dermatitis Job Loss Tunisia

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Hospital Night Shift and Its Effects on the Quality of Sleep, the Quality of Life, and Vigilance Troubles among Nurses

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International Journal of Clinical Medicine 2014年第10期5卷 572-583页

作者： Wided Boughattas olfa el maalel Ridha Ben Chikh Maher Maoua Kalboussi Houda Aicha Braham Houssem Rhif Souheil Chatti Faten Debbabi Mohamed Dogui Nejib Mrizak Neurophysiology Department Sahloul Teaching Hospital Sousse Tunisia Occupational Medicine and Professional Pathologies Department Medicine Faculty of Sousse Sousse Tunisia

Introduction: The exposure to shift works, and especially to night shift, goes against the circadian rythmicity of the social man, which brings about a multitude of disruptive effects on health. In a hospital environment, such night shift is necessary so as to ensure the continuity of care. Sleep and vigilance disorders related to this work mode are frequent and often pose adaptation problems. The objective of this study is to detect the harmful effects of night shift on sleep, vigilance and the quality of life of nurses in Farhat Hached Teaching Hospital in Sousse. Material and Methods: It is a cross-sectional study carried out among two groups of nurses: one group performing a fixed night work and the other one working permanently during the day at Farhat Hached Teaching Hospital in Sousse. Data collection is mainly based on validated questionnaires evaluating sleep quality (Pittsburg sleep quality index), daytime sleepiness (Epworth sleepiness scale), sleep typology (Horne and Ostberg questionnaire), and the quality of life (SF-12). An objective evaluation of vigilance was realized by the study of reaction time and error rates to different tasks of “Super lab” software. Results: 50 night and 50 day nurses have been colligated. Both groups were age- and gender-matched. Sleep quality mean index was significantly higher among night nurses in comparison with day nurses (10.2 ± 5.9 versus 6.76 ± 5.16). After multivariate analysis, sleep quality was significantly correlated to age, department, schedule and the choice of schedule. Night shift was not related to daytime sleepiness. The objective analysis of vigilance showed that the reaction time to different tasks exploring the attentional mechanisms, as well as errors rate, were significantly more important among the night group. The mental score of the quality of life was significantly higher among day nurses. However, such difference was not significant with regard to physical score. Conclusion: The findings of our s

关键词： Night Shift Nurse Quality of Life Sleep Vigilance

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Extraprofessional and Occupational Risk Factors for Colorectal Cancer

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Journal of Life Sciences 2012年第8期6卷 848-857页

作者： olfa el maalel Wided Boughattas Maher Maoua Houda Kalboussi Iheb Bougmiza Houssem Rhif Souhaiel Chatti Kader N'Daye Faten Debbabi Ali Mtiraoui Noejib Mrizak Department of Occupational Medicine Teaching Hospital Farhat Hached of Sousse Avenue Ibn El Jazzar 4000 Tunisia Department of Communal Medicine Medicine University Avenue Mohamed Karoui Sousse 4002 Tunisia

Colorectal cancers （CRC） account for frequent and serious cancers which result from the interaction between individual genetic factors and environmental factors, and in particular widely studied nutritional ones. The role of other occupational factors remains a controversial subject. The objective of this study is to evaluate the possible impact of occupational factors on the risk of developing CRC. Materials and Methods： This is a retrospective case-control study. The cases and the control group were enlisted in the general surgical ward of Farhat Hached Teaching Hospital of Sousse （Tunisia） during the period extending from 2004 to 2008, and they were age and gender-matched. The data were analyzed using SPSS 11.0 software with a signification threshold fixed at 5%. A univariate analysis was carried out as well as a multiple binary logistical regression. Results： During the period of the study, 40 cases of colorectal cancers have been colligated including 28 men and 12 women with a sex ratio of 0.43. The average age of the cases was 61.55 ± 13.3 years and 60.40 ± 12.84 years for the control group, with a non significant difference （P = 0.69）. The univariate analysis has objectivized significant associations between colorectal cancer and the housing conditions, the neoplastic and digestive family history, the occupational activity sector, exposure to pesticides, and lack of periodic medical supervision. After logistical regression, the occurrence risk of CRC was significantly associated with： alcohol and smoking （ORa = 3.43; Pa = 0.05）, meat consumption （ORa = 3.34; Pa = 0.03）, exposure to pesticides （ORa = 20.44; Pa = 0.012） and lack of periodic medical supervision （OR = 7.45; P = 0.004）. Conclusion： The occupational risk factors might play a role in the etiopathogenesis of colorectal cancers. With regard to our study, pesticides seem to be most implicated and necessitate suitable preventive measures. Nevertheless, it seems useful to multiply the studies to a much l

关键词： Colorectal cancer occupational risk factors extraprofessional factors epidemiology.

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Erratum to:A Donsker Delta Functional Approach to Optimal Insider Control and Applications to Finance

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Communications in Mathematics and Statistics 2015年第3期3卷 535-540页

作者： olfa Draouil BerntФksendal Department of Mathematics University of Tunis El ManarTunisTunisia Department of Mathematics University of OsloP.O.Box 1053Blindern0316 OsloNorway Norwegian School of Economics(NHH) Helleveien 305045 BergenNorway

Erratum to:***.(2015)3:365-421 DOI 10.1007/s40304-015-0065-y Unfortunately,in the original publication of the article some equations appeared *** corrected equations are given below:•In(1.1)it should be added that the... 详细信息

关键词： assumed Optimal equations

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Buerger’s Disease and Fitness for Work in a Flight Personnel: A Case Report

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Occupational Diseases and Environmental Medicine 2022年第2期10卷 71-77页

作者： Imen Jammeli Asma Aloui Malek Ben Abdelkader Zeineb Athimni Marwa Bouhoula Chouchene Asma Imen Kacem Maher Maoua Aicha Brahem Houda Kalboussi olfa el maalel Souhaiel Chatti Nejib Mrizak University Hospital Farhat Hached Sousse Tunisia Department of Occupational Medicine University Hospital Ibnou El Jazzar Faculty of Medicine of Sousse University of Sousse Sousse Tunisia

Buerger’s disease, also called thromboangiitis obliterans (TAO), is an inflammatory disease affecting small and medium size blood vessels of the limbs. Several risk factors are strongly associated with this disease. In fact, heavy smokers represent 99% of patients diagnosed with Buerger’s disease and smoking cessation can slow down the progression of the pathology. Ulcers and gangrene are very common complications and TAO may also cause a vasculitis as well as ischemic damage to the distal part of the limbs that can eventually lead to limb amputation. Here, we report the case of a 43 years old patient, a flight personnel working in a Tunisian airline company who consults for a lesion of the left toe that appeared 2 weeks ago. He is a chronic inveterate smoker with 36 pack-years. The diagnosis of TAO was made based on the clinical presentation and the results of the Doppler Ultrasound of the left toe. This disease has a major impact on the quality of life due to the risk of necrotic ulcers and amputation. Navigation is a profession that requires a high level of physical and mental fitness. According to the international and Tunisian standards, the applicant or the holder of medical certificate must not have a cardiovascular condition that may affect the safety of the exercise.

关键词： Buerger’s Disease Flight Personnel Medical Fitness

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Healing Humor: The Use of Humor in the Nurse-Patient Relationship

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Occupational Diseases and Environmental Medicine 2022年第3期10卷 217-231页

作者： Farah Chelly Imène Kacem Amen Moussa Amal Ghenim Imen Krifa Feriel Methamem Asma Chouachane Asma Aloui Aicha Brahem Houda Kalboussi olfa el maalel Souhail Chatti Maher Maoua Sameh Bannanou Nejib Mrizak Université de Sousse Faculty of Medicine of Sousse Sousse Tunisia Department of Occupational Medicine Farhat Hached Academic Hospital Sousse Tunisia University of Sciences Arts and Techniques of Sousse Sousse Tunisia

Objective: To identify the importance of using humor in patient/nurse relationship, its factors, its conditions and the barriers that might limit its use. Methods: We systematically searched PubMed, Science Direct and Google Scholar, for relevant articles published in English between 2010 and 2019. We included the studies that investigated humor between nurses and their patient’s relationship. Results: From the initial 287 articles found, 15 were included for final revision. Data allowed retrieving information on humor definition;its applicability as a nursing intervention;humor as a tool to improve nurse-patient communication and relationship;influencing factors;humor benefits in health care context and the limits that come against its use. Conclusion: Humor is considered a powerful communication tool, it promotes well-being, relieves anxiety and stress, helps deal with stressful situations but it should be used cautiously in order to prevent undesired consequences.

关键词： Humor Patient/Nurse Relationship Communication

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Characterization of <i>Lactobacillus</i>Strains Isolated from Bovine Raw Milk for Probiotic and Technological Properties

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Advances in Microbiology 2018年第9期8卷 719-733页

作者： Imen Mahmoudi olfa Ben Moussa Tedj el Moulouk Khaldi Yves Le Roux Mnasser Hassouna Unité de Recherche “Bioconservation et Valorisation des Produits Agro-Alimentaires” (UR 13AGR 02) école Supérieure des Industries Alimentaires de Tunis (ESIAT) El Khadhra Tunis Tunisia Université de Lorraine Unité de Recherche “Animal et Fonctionnalités des Produits Animaux” (UR AFPA) équipe “Protéolyse & Biofonctionnalités des Protéines & des Peptides” (PB2P) Vandoeuvre-lès-Nancy France INRA Unité de Recherche “Animal et Fonctionnalités des Produits Animaux” (UR AFPA) Unité Sous Contrat 340 Vandoeuvre-lès-Nancy France

One hundred strains isolated from bovine raw milk, obtained from different farms, were subjected to different in vitro stress typical of gastrointestinal tract. Twelve strains were able to tolerate pepsin at pH 2, pancreatin and bile salts (0.3%). These bacteria were identified using 16S rRNA gene sequencing. Eight isolates were Lactobacillus plantarum and four were Lactobacillus fermentum. They were not able to degrade mucin and they were γ-haemolytic. All strains had antibacterial activity against Staphylococcus aureus, Listeria monocytogenes and Salmonella thyphimirium. However, only six strains inhibited Escherchia coli. All these showed ability for autoaggregation and/or hydrophobicity properties. They were also characterized in respect to their technological properties. Important acidification and low proteolytic and lipolytic capacities were detected for all strains. In addition, they were able to produce exopolysaccharides and grow at hot and cold temperatures. These bacteria may be used further for manufacturing of functional foods and confirming their suitability as probiotic starter cultures.

关键词： Bovine Raw Milk Lactobacillus plantarum Lactobacillus fermentum Probiotic Functional Foods

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First multicenter study for risk factors for hepatocellular carcinoma development in North Africa

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World Journal of Hepatology 2011年第1期3卷 24-30页

作者： olfa Bahri Sayeh Ezzikouri Nissaf Ben Alaya-Bouafif Fella Iguer Abdallah Essaid el Feydi Hafedh Mestiri Moustapha Benazzouz Tahar Khalfallah Rajaa Afifi Latifa elkihal Salah Berkane Agnes Marchio Nabil Debzi Anne Dejean Pascal Pineau Hinda Triki Soumaya Benjelloun Laboratory of Clinical Virology Institut Pasteur of Tunis Laboratory of Viral Hepatitis Institut Pasteur of Casablanca Laboratory of Epidemiology Institut Pasteur of Tunis Laboratory of Viral Hepatitis Institut Pasteur of Algiers Department of Medicine C Ibn-Sina University Hospital Department of General Surgery Mongi Slim Hospital Department of Gastroenterology Bologhine University Hospital Bologhine 16090AlgiersAlgeria Nuclear Organization and Oncogenesis Unit INSERM U993Institut Pasteur of Paris Department of Gastroenterology Mustapha University Hospital

AIM:To assess the role of the major risk factors for hepatocellular carcinoma(HCC) development in the western part of North ***:A multicenter case control study was conducted in Tunisia,Morocco and Algeria in collaboration with Pasteur Institutes in these countries.A total of 164 patients with HCC and 250 control subjects without hepatic diseases were *** of HBsAg,anti-hepatitis C virus(HCV)and diabetes were *** and HBV genotyping were performed for anti-HCV and HBsAg positive ***:The mean age of patients was 62±10 years old for a 1.5 M:F sex *** percent of HCC patients were positive for anti-HCV and 17.9% for *** was detected in 18% of *** ratio(OR)and 95% confidence intervals(CI) were 32.0(15.8-65.0),7.2(3.2-16.1) and 8.0(3.1 -20.0)for anti-HCV,HBsAg and diabetes *** analysis indicated that the three studied factors were independent.1b HCV genotype and D HBV genotype were predominant in HCC *** was the only risk factor significantly associated with an excess of cirrhosis(90% vs 68% for all other risk factors collectively,P=0.00168).Excessive alcohol consumption was reliably established for 19(17.6%) cases among the 108 HCC patients for whom data is ***:HCV and HBV infections and diabetes are the main determinants of HCC development in North *** active surveillance and secondary prevention programs for patients with chronic hepatitis and nutrition-associated metabolic liver diseases are the most important steps to reduce the risk of HCC in the *** Berkane,Department of Gastroenterology BologhineUniversity Hospital,Bologhine 16090,Algiers。

关键词： Hepatocellular carcinoma Hepatitis B virus Hepatitis C virus Non-insulin-dependent diabetes mellitus North Africa

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