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D Fassin

Publications and source records attributed to D Fassin.

33 records · Page 2Linked to original sources
PubMed1986

[Illicit sales of drugs in Senegal. Consequences for community health].

The relatively recent development of parallel drug markets in the Third World has not yet been specifically studied. A research on illicit drug sale was carried out in Pikine, a 600,000 people suburb of Dakar: all items provided by all sellers observed on the markets of the town were inventoried; their indications and posologies were given by a sample of 20 among the 100 identified sellers; complementary information was obtained from the official structures of drug distribution. The list of all medications available shows 23 items--12 directed at [symptoms], and 11 at [causes]. The indications and posologies are remarkably similar for the 20 sellers, whose training was done in well-structured channels outside the official network. Evaluation of the potential consequences of these parallel markets for community health shows: 1) a probably beneficial impact of some medications, such as analgesics, antimalarials, antibiotic eye ointment; 2) exposure to individual risks (tetracyclines, sulfamids) and collective risks (antibiotics, not widespread yet, but capable of selecting resistant germs). Moreover, this illicit sale must be understood in its social context where buying drugs on the markets is the least expensive and most accessible solution for underprivileged people, because of scarcity of resources in the dispensaries. Thus, rather than to automatically condemn illicit drug sale, it seems more appropriate and urgent to evaluate the risks of medications available in each of the countries involved, to develop health information in the population, and meanwhile to make access to drugs in primary health care structures easier.

Costs and Cost Analysis↗
PubMed1986

[Caval thromboses and systemic diseases].

Sixty-five patients presenting with a vena cava syndrome have been examined over a 7 years period; incidence of systemic diseases as an etiologic factor has thus been studied. A systemic disease was diagnosed in 17 cases, that is 25 p. 100 of cases. This incidence is higher in inferior vena cava syndromes (15 cases out of 45). Two diseases appear as the main factors: on one hand, Behçet disease, liable for 8 vena cava thrombosis, 7 inferior and 8 superior thrombosis; on the other hand, severe disseminated erythematous lupus liable for 5 cases of inferior vena cava thrombosis. Other etiologies are mentioned such as: Churg and Strauss disease (1 case), Horton disease (1 case) and hemorrhagic rectocolitis (1 case). In the patients presenting with lupus, two died from various pulmonary embolisms; a vena cava clip was required in 3 cases. As for lupus, the immuno-hepatologic exploration did demonstrate a thrombopenia in 5 cases, an hemolytic anemia with a positive Coombs test in 2 cases, and a circulating anti-coagulant (antiprothrombinase type) in one case. Though high frequency of systemic diseases in this series may depend on the patients' recruitment, systemic lupus as well as Behçet diseases are to be researched in case of vena cava thrombosis, above all if diagnosed in a young patient and failing to be explained by a congenital abnormality of hemostasis.

Adult↗
PubMed1985

[Superior caval syndrome. Diagnostic and therapeutic management. Apropos of 20 cases].

Superior vena cava obstruction (SVCO) is an infrequent syndrome. Clinical diagnosis is often late. 20 cases of SVCO collected in 7 years are being reported. In 17 cases, SVCO revealed the underlying disease. It was mostly neoplastic (12 times), especially pulmonary cancers (5 times) and lymphomas (twice). Among benign causes (5 times), mediastinal fibrosis was the most often recognized (twice). Prognosis depended on etiology: when it was malignant, mortality rate was 50 p. cent (actuarial survival rate after one year: 40 p. 100); when it was benign, there was no mortality (follow-up: 21 months). Thrombo-embolic complications (25 p. 100) were seen during the end-stage of neoplasms and were responsible in 4 out of 7 deaths. Surgery was interesting for diagnosis (histology) and treatment (bypass surgery, the result of which was good only in the 3 operated benign causes). A simple model is proposed for treatment.

Adult↗
PubMed1984

[Inferior caval syndromes. Apropos of 45 cases].

The authors report their experience with 45 cases of inferior vena cava thrombosis. Diagnosis was delayed for an average of 55 days. One-third of cases were revealed by an embolic complication. Inflammatory diseases were the most common causes (Behcet disease: seven cases, systemic lupus erythematosus: 5 cases). Malignancies accounted for 20% of cases. Abnormalities of coagulation were uncommon: antithrombin III deficiency in one patient and protein C deficiency in another. Estrogen-progestogen combinations could be incriminated in 4 cases. Outcome was fatal in 20% of cases, usually as a result of the underlying disease. Functional status was good in two-thirds of patients without malignancy followed up for an average of 27 months. In 14 patients a clip was inserted to ensure total (3 cases) or partial (11 cases) interruption of vena cava blood flow because of a free thrombus and/or recurrent pulmonary embolism. Three patients had thrombectomy. After clip insertion two embolisms were recorded, one of which occurred in the immediate post-operative period.

Adolescent↗
PubMed1984

[A sociologic study of health care accessibility in an urban milieu in Tunis].

In developing countries, the study of access to medical care reveals the inequality of health coverage. In rural areas, the two main limiting factors are the lack of health services and the difficulty of access, especially distance. But the relevant factors in urban areas have been little studied. In Mellassine, which is the largest slum of Tunis, we studied the behaviour of 400 under-4 children's mothers in relation to health care. The following factors proved relevant: sex of the child, size of the family, father's profession, level of education, material resources; distance, cost and quality of reception of health services; finally the cultural pattern, particularly the representation of children disease by the mothers. Such an approach allows a reflection to reduce the inequality of access to medical care.

Child Health Services↗
PubMed1984

[Systemic disease and thrombosis of the major vessels].

Etiologic research into caval syndromes enables distinction to be made between superior caval thrombosis, when there is generally a local cause, and inferior caval lesions that are usually of a general origin. Acute disseminated lupus erythematosus and Behçet's disease should be investigated for, particularly in young patients, when an inflammatory syndrome is detected, and when the thrombus lies in the inferior cava territory.

Adult↗