INTRODUCTION: Intensive care unit (ICU) beds are a scarce resource, and admissions may require prioritization when demand exceeds supply. However, there are few data regarding both outcomes of admitted patients to intensive care unit (ICU) in comparison with outcomes of not admitted patients. The aim of this study was to assess reasons and factors associated to refusal of admission to ICU as well as the impact on mortality at 28 days and patients' outcomes. METHODS: single-center, cross-sectional descriptive study conducted in 8-bed Medical ICU at a Tunisian University hospital. All consecutive adult patients referred for admission to ICU during 6 months were included. We collected demographic data, ICU admission/refusal reasons, co-morbidity and diagnosis at time of admission, mortality probability model (MPMII0) score, day and time of admission, request for admission and mortality at 28 days. RESULTS: 327 patients were evaluated for ICU admission and 260 were refused to ICU (79.5%). Patients refused because of unavailability of beds represented 50% and patients considered

Predictors of health-related quality of life (HRQL) were controversial in the literature. To this end, we conducted a review to describe predictors of HRQL in patients with chronic obstructive pulmonary disease. The search comprised all the articles published until the end of 2016, which are consistent with our inclusion criteria. These factors could be structured into 5 groups: demographic factors, comorbidity, factors related to the disease, psychological factors, and other factors. The most common predictors of HRQL of chronic obstructive pulmonary disease patients were age, severity stage of the disease, dyspnea grade, and the number of exacerbations. Other determining factors include comorbidity, sex, body mass index, socioeconomic status, and educational level. This review of sparse and well-designed literature gives a current state-of-the-art that might be useful for future research.

Chronic childhood asthma is a leading cause of poor quality of life. Factors associated with this major asthma outcome were controversial. The aim of this study is to assess the quality of life of children and adolescents with mild to moderate asthma and to determine the factors associated with quality of life impairment in this population. This was a descriptive study carried out in the pediatric outpatient clinic of a University Hospital in the center of Tunisia over a period of 3 months (April–June 2018). Participants were children with mild to moderate asthma aged 7 to 17 years. The Pediatric Asthma Quality of Life Questionnaire was used to assess quality of life. Binary logistic regression was performed to identify predictors of asthma-related quality of life. A total of 90 children participated in the study. Almost 68% of children were aged 7 to 11, and nearly 32% were adolescents. The mean of PAQLQ total score was 4.7 ± 1.2. The final logistic regression model demonstrated that asthma symptoms control had the greatest impact on quality of life, followed by acute health care use in the past 12 months (p = .007; p = .01, respectively). The child gender and the parent’s quality of life were also associated with the child’s quality of life (p = .02; p = .008, respectively). This study revealed that children and adolescents with mild to moderate asthma had a moderate quality of life score. Asthma symptoms control, acute health care use, gender, and parent’s quality of life determined the quality of life of children with asthma. Family-based asthma training programs that target family functioning and asthma outcomes are required.

Antibiotic resistance (AMR) is a growing global public health threat. In food-producing animals, antibiotic overuse and misuse play a key role in its emerg