ABSTRACT
Malaria is assimilated with its cardinal symptom, i.e., fever. Treatment of fever with antimalarial drugs is crucial to the prevention of malaria-related death in Senegal. The objective of this study was to analyze fever-treatment practices as a basis for making realistic recommendations for self-treatment in the northern health district of Dakar, Senegal. This cross-sectional study was conducted from March 1 to April 30, 2003. The population included all patients with body temperature higher or equal to 37.5 degrees C (99.5 degrees F) associated with at least one of the following symptoms: headache, shivering, vomiting and diarrhoea. Study endpoints included demographic data and fever treatment modalities including the nature, dosage, and duration of the drugs used. Malaria was suspected in 180 of the 271 patients enrolled in the study. Treatment had already been undertaken in 134 patients including 108 (81%) who had initiated self-treatment. Drugs included antipyretics, antibiotics, and/or antimalarials. Antimalarial drug dosage was incorrect in 84% of those who initiated self-treatment. Dosage errors involved number of daily doses (55%), duration of treatment (13%), or both (32%). Only 45% of patients fully completed treatment. Medical advice was sought in 30% of the cases and drugs were obtained over the counter in pharmacies in 59%. Patients under the age of 15 years were significantly more likely to initiate self-treatment (p=6.10-6), to treat symptoms early, and to use an antimalarial (p=4.10-6). Although self-treatment shortened the delay between onset of symptoms and initiation of treatment, it is likely that indiscriminate and incomplete treatment is responsible for development of resistance to chloroquine in the northern health district of Dakar. Strategies must be adapted to numerous local factors influencing self-treatment including the availability of health-care services and drugs of quality. Special attention must be given to the improvement of antimalarial drug packaging and of the awareness of people that provide self-treatment drugs.
Subject(s)
Fever/drug therapy , Malaria/diagnosis , Malaria/drug therapy , Self Medication/statistics & numerical data , Adolescent , Adult , Antimalarials/administration & dosage , Antimalarials/therapeutic use , Child , Child, Preschool , Chloroquine/administration & dosage , Cross-Sectional Studies , Drug Resistance , Female , Humans , Infant , Malaria/mortality , Male , Middle Aged , SenegalABSTRACT
Le paludisme est assimile a son signe majeur; la fievre; dont le traitement avec un antipaludique est le moyen de prevention de la letalite au Senegal. L'objectif de cette etude est d'analyser les pratiques de traitement de la fievre en vue de formuler des recommandations realistes en matiere d'automedication dans le district nord de Dakar. Cette etude transversale a ete menee du 1er mars au 30 avril 2003. etaient inclus tous les patients qui ont consulte pour une fievre et qui presentaient une temperature corporelle superieure ou egale a 37;5oC associee au moins a l'un des symptomes suivants : cephalees; frissons; vomissements; diarrhee. Les variables etudiees portaient sur les caracteristiques individuelles; les demarches observees; la nature des medicaments utilises; et la conduite therapeutique. Sur 271 patients inclus; 180 ont ete suspects de paludisme. Un traitement avait deja ete entame pour 134 patients dont 108 (81) par automedication. Les medicaments utilises etaient un antipyretique; un antibiotique; et/ou un antipaludique. Le dosage a ete incorrect pour 84de ceux qui ont pris un antipaludique en automedication. Les erreurs de prise portaient sur la dose journaliere (55); la duree (13) ou sur les deux (32). La totalite des comprimes a ete prise par 45des clients. Le conseil etait obtenu du milieu sanitaire dans 30des cas; et les medicaments de la pharmacie dans 59. L'automedication a ete significativement plus frequente parmi les patients ages de moins de 15 ans (p=6;10-6) tout comme la precocite du traitement parmi ceux qui ont fait une automedication et; dans ce groupe; parmi ceux qui ont pris un antipaludique (p=4;10-6). Dans le district nord de Dakar; l'automedication de la fievre augmente la rapidite du traitement; mais sa mauvaise pratique pourrait etre responsable de pharmaco-resistance a la chloroquine. Les strategies doivent etre adoptees aux nombreux facteurs locaux qui peuvent influencer l'automedication; y compris l'acces aux services de sante; la disponibilite des medicaments de qualite; mais surtout le pre-conditionnement des antipaludiques et la sensibilisation des prescripteurs d'automedication
Subject(s)
Fever , Malaria , Self MedicationABSTRACT
More than 30 years after the legalization of contraception in France (Neuwirth law) it was interesting to access the sexual behavior and the practice of contraception of French female teenagers. It is with this purpose that this survey has been done in the city of Nantes in Loire Atlantique. 467 female teenagers, 13 to 21 years old, were concerned. Results point out that more of 75% of young girls who replied to this survey used one contraceptive method during the first sexual intercourse and condom is predominantly used. A few ambivalences stake out this life period, so preventive strategies have to be very specific in order to fight sexual transmitted diseases (STD) and AIDS.
Subject(s)
Contraception , Sexual Behavior , Adolescent , Adult , Contraception/psychology , Female , Humans , Sexual Behavior/psychologyABSTRACT
Scintigraphic images are subject to two forms of imperfection: blurring due to the components of the detector (collimator, photomultiplier, analog processing devices) and noise resulting from radioactive disintegration. We use Wiener filters operating within a limited area of the spatial domain in processing these images. After defining statistical models of ideal image and degrading processes, we study the effects of parameters on filter features. Finally, we present examples demonstrating filter performance.
Subject(s)
Radiographic Image Enhancement/instrumentation , Radionuclide Imaging/instrumentation , Background Radiation , Humans , Mathematics , Technology, RadiologicABSTRACT
Scintigraphy of salivary glands might appear to be a relatively minor test in the study of the morphology of the salivary glands and especially tumours. However, with recent technical progress, it is an extremely useful test in th study of the function of the principal salivary glands. Changes in salivary secretion in certain severe facial paralyses could become an interesting prognostic test; on this subject, the simultaneous abnormalities in sub-maxillary and parotid salivary secretion in these cases of paralyses poses a physiological problem. The study of salivary junction is indispensable in the exploration of aptyalia (in particular in the Sjögren's syndrome), and in sialosis.
Subject(s)
Otorhinolaryngologic Diseases/diagnostic imaging , Salivary Glands/diagnostic imaging , Adolescent , Chorda Tympani Nerve/surgery , Facial Paralysis/diagnostic imaging , Female , Humans , Male , Parotid Gland/surgery , Parotid Neoplasms/diagnostic imaging , Postoperative Period , Prognosis , Radionuclide Imaging , Salivary Gland Neoplasms/diagnostic imaging , Salivary Glands/metabolism , Sialadenitis/diagnostic imaging , Sjogren's Syndrome/diagnostic imaging , Xerostomia/diagnostic imagingSubject(s)
Angiocardiography/methods , Cardiomyopathy, Hypertrophic/diagnostic imaging , Heart Ventricles/diagnostic imaging , Myocardial Contraction , Adult , Cardiomyopathy, Hypertrophic/physiopathology , Evaluation Studies as Topic , Female , Heart Ventricles/physiopathology , Hemodynamics , Humans , Male , Middle AgedABSTRACT
The authors report 92 cases of trauma of the liver which survived initial operation and study the special problems linked to hepatic sequestration. They analyse the factors which favour the appearance of these sequestra and the methods of diagnosis using clinical, laboratory, arteriographic and scintigraphic data. Relatively frequent (8,4 p. 100), these complications require fairly early surgical treatment. They are commonly localised to the dome of the liver and this renders their approach difficult. A low postero-lateral thoracotomy with resection of the 10 th or 11 th rib, followed by sequestrectomy and drainage, seems to them ideal approach. The pleuropulmonary sequelae are minimal.
