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Biomedical subjects

J Vallin

Publications and source records attributed to J Vallin.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Intestinal lymphangiectasis secondary to cicatricial fibrosis of mesenteric nodes: a nosologic entity?].

Exsudative enteropathy was suspected in a 27-year-old man with lower limb edema, hypoprotidemia and hypoalbuminemia. Gastrointestinal mucosa, kidney, liver, and heart were normal. Laparoscopy showed diffuse small intestine lymphangiectasia. This diagnosis was confirmed by the microscopic examination of several biopsies obtained at laparotomy. Pathological examination of peritoneal, lymph nodes, and liver biopsies showed fibrous thickening of the peritoneum and fibrosis of the lymph nodes. Our patient has been followed for 16 years. Substantial improvement of clinical symptoms was obtained by following a special salt-free diet containing short-chain triglycerides. However biochemical abnormalities have persisted. Exsudative enteropathy due to intestinal lymphangiectasia may be observed in heart and liver diseases as well as in malignant affections of mesenteric lymph nodes. If these conditions are excluded, intestinal lymphangiectasia may be considered as a primitive lymph vessel malformation. The discovery of primitive intestinal lymphangiectasia in an adult cannot be attributed to congenital abnormalities alone. Fibrosis encountered in some cases suggests that an inflammatory process of unknown origin may trigger the onset of intestinal lymphangiectasia.

Adult↗
PubMed1989

[Not Available].

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Demography↗
PubMed1985

[Not Available].

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Demography↗
PubMed1980

Socio-economic determinants of mortality in industrialized countries.

In the early 1950s, it was generally considered that social mortality differentials appeared during the 1st stages of industrialization and would be resolved with the socialization of health services. Admittedly, at that time, the spectacular progress achieved through antibiotics encouraged the belief that health was merely a matter of medicine and that the institution of a social security scheme would suffice for minimizing the risks of death that were not directly involved in the natural differences between individuals. 30 years have passed and the expectation of life has lengthened (although less than anticipated), but the social differences remain. They are, in fact, by no means attributable to lack of medical science. The elimination of the most discriminating causes of death (alcoholism, accidents, suicide, tuberculosis, etc.) is less dependent on further scientific progress than on a complete change in living conditions and behavior. The reduction in the excess mortality of the poorer classes from other causes (cancer, cardiovascular diseases, etc.) again calls more for a thorough cultural transformation of the least privileged social categories than for the discovery of new therapies or increased expenditure on hospitals. Faced with a mortality that is already very unequal (selection, differential risks), the various social categories behave in basically different ways, which, while aggravating the real inequities, lead to an apparent morbidity that is inversely proportional to true morbidity and to a more prompt and frequent use of medical care among the social categories in which true morbidity is lowest. Inequality with respect to death is only 1 dimension of social inequality. It was an illusion to imagine that 1 could be eliminated without the other. Today that illusion has been destroyed. That does not mean that the present situation must be accepted. Inequality with respect of death is still 1 of the most disgraceful consequences of social inequality and its abolition must still be our aim. Obviously, however, this aim cannot be achieved through the health services alone.

Americas↗
PubMed1976

[World trends in infant mortality since 1950].

Despite the considerable progress made in recent decades, and perhaps even partly because of the very uneven distribution of this progress, infant mortality is still very high in some regions, whereas in other regions it is tending, if not disappear completely, at least to become numerically negligible even though remaining a matter of social concern. Whereas in tropical Africa almost one child in five dies before its first birthday, in Japan or Scandinavia it is one child in a hundred. Infant mortality rate varies between these two extremes, but there is a substantial gulf between the "most developed" regions which are all below 30% and the "least developed" regions which fall into three categories: 65-100% (Latin America, Eastern Asia except Japan), around 140% (Northern Africa, South Asia, Melanesia), and about 200% (topical Africa). These inequalities between countries overlap with inequalities between social groupings by urbanization, social/occupational level, education and income, are all variables that are correlated with infant mortality to a greater or lesser degree. The pace of the progress achieved since 1950 seems to be independent of the starting level. Contrary to the development of mortality at other ages, it is not in the countries with high mortality that infant mortality has decreased most. The pace of reduction divides the most developed regions into three distinct groups: very rapid reduction (Japan), rapid reduction (Scandinavia, Western Europe, Southern Europe and Eastern Europe), and slower reduction (British Isles, Northern America and Australia/New Zealand). Thus Japan rapidly caught up with Western Europe and the English-speaking countries and has now reached the same level as Scandinavia. On the other hand, the English-speaking countries have fallen behind the Scandinavian countries and are now at par with Western Europe. The reduction of infant mortality mainly concerned deaths of children over one month of age or even over one week of age and otherwise is due to reduction of infectious diseases. Consequently, in the most developed regions mortality is highly concentrated in the first week of life and is mainly attributable to the "causes of perinatal mortality" and the "congenital" anomalies". In the least developed regions, on the other hand, the infectious or parasitic diseases are still of decisive importance and the risk of death remains very high throughout the first year of life and even beyond. The risk may be even higher during the second year, when weaning takes place abruptly and results in serious difficulties in feeding.

Age Factors↗