Biomedical subjects
A Thebaud-Mony
Publications and source records attributed to A Thebaud-Mony.
[Doctors and injectable contraception. Analysis of the logistics of prescribing in accordance with the views expressed by doctors].
Injectable contraception (IC) using medroxyprogesterone acetate (Depoprovera) and norethisterone enanthate (Noristerat) has been discussed in numbers of publications since the Food and Drug Administration (FDA) of the USA have refused to authorize the use of Depoprovera as a contraceptive in America. This has provoked a large number of publications in the international literature. The refusal was based on the potential oncogenic risk of the molecule. The distribution of this product as a contraceptive in developing countries and its restricted authorisation in many industrialised countries including France has brought about contradictory debates about the assessment of this method (secondary effects, risks of developing cancer and teratogenesis). In 1986 we started a research using close collaboration between the health teams of Seine-Saint-Denis (which control clinics, family planning clinics and hospitals) in order to try to find some solution to this problem "for or against IC". The object of this research was to find out how acceptable this method was as compared with other contraceptive methods. The fact that many disciplines were involved (gynaecologists, sociologists, epidemiologists and pharmacologists) in this work made it possible first to find out the conditions under which IC was prescribed (by sociological analysis and discussions with doctors). And the socio-cultural features in which the doctors who prescribed this method of contraception were situated also came into play. The criteria under which ICs are prescribed are not mainly medical but are narrowly linked to socio-cultural factors and the socio-economic factors of the women for whom it is prescribed: and this is in comparison with other methods of contraception. Prescribing this substance has a degree of urgency about it.
[Respiratory tuberculosis in Seine-Saint-Denis. Results of treatment].
A study was carried out in 1984-1986 in Seine-Saint-Denis on the clinical management of tuberculous cases. It was possible to observe in routine practice the nature, duration and results of treatment in 336 adult cases suffering for the first time from respiratory tuberculosis. The recommendations of the French Society of Pneumology were taken as a reference. A minority of patients (22%) were treated entirely at home. The others were admitted to hospital then treated at home (33%) or had a stay in a sanatorium (45%). The mean duration of stay in institutions was five months for those patients staying in a sanatorium. The most common therapeutic regime in the initial phase consisted of rifampicin and isoniazid, with additional ethambutol alone (60%) or ethambutol in combination with pyrazinamide (15%). The mean duration of treatment was 10.5 months, without any difference between those regimes consisting of three or four drugs. At the end of the period of treatment 85% of patients were considered to be cured; 16 patients (or 5%) had died and 18 patients (6%) were lost to follow up before the end of treatment. There were 15 patients (or 4%) who showed no significant change between the beginning and the end of the study.
[Health care channels for new cases of respiratory tuberculosis in Seine Saint-Denis in 1984-1986].
The purpose of this study was to observe routine practice in the care of tuberculosis cases treated in the Seine Saint-Denis department in 1984, with reference to the recent recommendations of the French Pneumology Society. The pathway of each patient through the care network was established for 336 adult cases being treated for respiratory tuberculosis for the first time. The social and economic cost of each pathway was evaluated. The results show the multiplicity of health services intervening in the care of these patients, the persistence of hospitalization, sanatorium care, and long sick-leaves from work, together with major differences in the care pathways according to the nationality, sex, and socio-economic group of the patients. The cost of tuberculosis treatment is shown to be high for both patients and the community.
[Tuberculosis in the Department of Seine-Saint Denis. I. Cases under treatment in 1984].
A prospective study of notified cases of tuberculosis started on treatment during 1984 in the department of Seine-Saint-Denis situated in the northern suburb of Paris was undertaken with the help of the Ministry of Health, and the National Committee for the Prevention of Tuberculosis. Fifty-seven hospitals were involved as were 42 sanatoria, 19 clinics and private hospitals and 157 doctors enabled 578 cases of tuberculosis to be registered. For these 578 cases there were 884 notifications coming principally from the control services of the Social Security and public hospitals. Although several sources of notification had declared the same patient, no source had registered all the patients of whom they had knowledge. The notifications made on 12 different forms were often incomplete and sometimes erroneous. Of the 578 patients declared there were 34 different nationalities, of whom 190 were French, approximately 33%; 87 were Algerian, or 15%; 83 came from Mali, or 14%. The study compared the level of notification of tuberculosis in the French, Algerians and those from Mali and has shown that they are six times higher amongst Algerians than the French population and 39 times higher in those from Mali than in the French population. The proportion of patients already treated were 11% and those patients suffering from exclusively extra-respiratory tuberculosis was 16%. A bacteriological and/or histological confirmation was obtained in 70% of cases. The study of the socio-demographic characteristics of the patients has enabled a portrayal of the representation of unskilled workers and the unemployed in comparison to the general population of the department.(ABSTRACT TRUNCATED AT 250 WORDS)
Salud Ocupacional.
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