Médecine tropicale : revue du Corps de santé colonial
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The implementation of essential drugs policies and widespread use of generic products in humanitarian programs has ensured access to medication for poverty-stricken populations. However rigorous drug selection according to origin is necessary to guarantee quality. ⋯ An obvious danger for drugs such as antibiotics is that use of poor quality products producing insufficient bioavailability will promote development of microbial resistance. This could become a worldwide public health problem with particularly dramatic consequences for the treatment of tuberculosis and retroviruses.
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French Guiana is a French Overseas Department in South America. Ninety-five percent of the territory is a tropical rainforest. Its rich fauna includes seven families of snakes but only 3 are potentially venomous. ⋯ Crotalus durissus, a rattlesnake living in coastal savannah, or Micrurus sp cause neuromuscular poisoning. Coral snakes are encountered throughout French Guiana, but envenomation is very rare. Antivenom therapy must be administered by the intravenous route in association with symptomatic treatment and, if necessary, resuscitation in a specialized care unit.
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The purpose of this retrospective study was to determine the profile of medical emergencies and their management in a university hospital center in a tropical area. Between July 1 and December 31, 2001, all patients examined in a medical and surgical emergency room were included. Obstetrical emergencies, pediatric emergencies, emergencies admitted directly to the cardiology, ORL emergencies and urologic emergencies were not included. ⋯ Gastrointestinal events accounted for 20.23% of cases, cardiovascular events for 9.12%, respiratory events of 8.56%, metabolic events for 1.78%, trauma for 48.20% and infectious disease for 12.09%. Surgical mortality was 2.41%. Most problems facing the intensivist treating medical emergencies in a tropical setting involved resuscitation.
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Comparative Study
[Emergency care in tropical areas: status report based on surgical emergencies in Senegal].
Management of surgical emergencies in Senegal is characterized by a mismatch between supply of facilities and demand for care. The situation has been complicated by runaway urban growth. Two situations can be distinguished in rural zones and in the major city of Dakar. ⋯ The main differences between urban and rural areas involve the volume and type of surgical emergencies with a constantly increasing number of trauma emergencies in cities. Solving these problems will require a specific national plan to develop emergency care services in general. This plan will require coordination of funding, re-organisation of hospital facilities, and hiring and training of qualified personnel (surgeons and paramedical staff).
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[Are health care facilities in Cameroon compatible with rational management of emergency patients?].
The aim of this month-long cross sectional study was to evaluate the preparedness of health care institutions in Cameroon to provide rational management of emergency patients. During January 2002 a survey was carried out to list all health care institutions offering emergency care services and to determine their other departments and available equipment and staff. A total of 144 institutions with emergency care facilities were found including 12 central reference hospitals and 123 district hospitals equipped to provide primary emergency care. ⋯ This ratio was 10 times higher than in France in 1994. Almost all major equipment and trained personnel for emergency care medicine were concentrated at the central reference hospitals but these resources were insufficient to organize round-the-clock services except at a single site. The findings of this survey indicate that the distribution of health care facilities in Cameroon was relatively adequate in relation to population density but that equipment and human resources were still insufficient to provide rational management of emergency patients.