Biomedical subjects
Publications and source records attributed to S Resnikoff.
A new simple method, which allows rapid access to the ventricular system to monitor intracranial pressure, is described. One of the lateral ventricles is punctured percutaneously, with a hand drill operated by a flash-light battery, and a lumbar puncture needle (20 gauge) attached to a water manometer or to a strain gauge connected to a venous pressure monitor.
Interhemispheric subdural empyema, secondary to frontal sinusitis in two girls is described. Headache, hemiparesis more marked in the lower extremity, fever, focal seizures, stupor and stiff neck were the principal features of the clinical course. The angiographic appearance of the lesion was the key to the preoperative diagnosis. Surgical evacuation of the purulent collection resulted in complete cure in both cases.
A new, safe, simple technique for percutaneous ventriculocentesis has been devised and used in 15 consecutive patients with excellent results and no complications. This method allows rapid access to the ventricular system for diagnostic and therapeutic purposes.
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Explore the source record for details and available documents.
Cataract remains a major cause of blindness in sub-Sahara and a major public health problem. Blindness prevalence in Togo is equal to 1%, more than half of it is due to cataract, while the number of cataract surgeries is low because of the lack of resources. We assessed the eye healthcare in Togo by cataract surgery. The aim was to estimate the number of cataract surgeries and the Cataract Surgery Rate (CSR) in the administrative regions. The demographic data (denominator) was collected from the Demography and Health Survey (1998) while the number of cataract surgeries (numerator) was obtained from medical registers. The Cataract Surgery Rate (CSR, operated cataracts per million) was assessed from 1995 to 2001. From 1995 to 2001, 3,885 cataract surgeries were performed. Public services predominated with 53.03% (n=2061) of the cataracts operated followed by confessional hospitals with 37.1% (n=1443) and private clinics 3.4% (n=143). Decentralised eye healthcares provided 241 cataract extractions. The University hospital centre of Lome Tokoin was the leader, with 32.5% (n=1,262) of operated cataracts followed by the confessional hospital of Glei, 27.2% (n=1,058). The average per centre per year was 43 cataract surgeries. The mean CSR was 126 and varied from 52 to 163 cataract surgeries per million people per year. There was an important concentration of cataract services in Lome where 41% (n=1,586) of cataracts were operated and the CSR was 334. The unequal distribution of cataract services (41% in Lome) leaves many regions without any resources. Since 1999, the CSR increased by 37% in 2000 and 14% in 2001. The Togolese eye healthcare system is poor and substantial further efforts are necessary to make it accessible and affordable to all those in need. This may be the way to reduce cataract surgery barriers and the unacceptable high prevalence of operable cataract blindness.
An epidemiologic survey by random cluster sampling was carried out in Chad. Its purpose was to evaluate the importance of xerophthalmia. 3.002 children under 10 years of age were surveyed for two different periods: in 1984 after the drought striking the Sahelian zone and in 1985 after a normal crop. Computerization of the results according to nutritional circumstances and geographical distribution demonstrated that avitaminosis is a true Public Health problem, whatever climatic zones, food products and nutritional conditions are. However situation worsens during a drought and calls for an emergency distribution of vitamin A to the most-in-need populations.
Volunteers are instructed during one month: they receive some basic training in hygiene, infectious diseases, and primary therapy using the few drugs which should exist in each family. A two years experience has given encouraging results with, among others, an increase in the number of pulmonary tuberculosis cases detected, and of the population attending vaccinations.
Data and comments from a survey conducted in Atar town with 3.534 individuals controlled. In children, kwashiorkor is rare but malnutrition is observed mainly in female babies between 1 and 3 years. It is caused by on the one hand a too late and too rapid weaning, and on the other hand to ancestral habits giving priority care to male babies. In adult populations, the main fact observed is an over-weight in women, with subsequently, a higher rate of blood hypertension and cerebro-vascular accidents than in men. This over-weight is a symbol of wealthiness and resorts to a traditional pattern of feminine beauty. Public health service and nutrition education can promote the use of a larger variety of foods which has little possibility of changing quickly an esthetic mode. But this concept will slowly recess, according to new ways of life.
In developing countries, vitamin A deficiency (VAD) is a major contributor to child blindness and is associated with increased mortality. We assessed the vitamin A status of a Sahelien population and evaluated the correlation between the various criteria used to score xerophthalmia. The survey was carried out between June 1992 (the end of the dry season) using a representative sample of 906 children between the ages of 3 and 7 years in the district of Douentza. The population sample was selected by a two stage cluster sampling method (villages and then households). Vitamin A status was evaluated using clinical, histological and nutritional criteria. Clinical examination included testing for night blindness (XN), Bitot's spots (X1B) and corneal scars (XS). The Impression Cytology with Transfer (ICT) test described by Amedee-Manesme was used for histological analysis. Cases of follicular trachoma were recorded because of the possible influence of active trachoma on the findings of the ICT test. Nutritional status was determined by measuring the height for weight ratio according to the National Center for Health Statistics criteria. The prevalence of XN was 2.7% (1.6-3.7), significantly higher than the WHO threshold for a public health problem. The prevalence of X1B was 0.5% (0.1-1.2), and no corneal scars were detected. 31.7% of the children were suffering from malnutrition, but malnutrition did not correlate with any of the ophthalmological indicators of a public health problem. Among the 842 readable ICT tests, 265 were abnormal (31.4% of the total, 28.2-34.5). This incidence of abnormal results was unexpectedly low, in the light of the clinical results, and well below the threshold value of 50% suggested by Carlier.(ABSTRACT TRUNCATED AT 250 WORDS)
In developing countries, cataracts are a serious public health problem. There are a large number of patients, an estimated 3 millions in Africa alone, awaiting operations. However, the number of surgical interventions is small for a variety of reasons, including the cost. To try to reduce the cost of surgery, we analysed the various elements involved at the African Institute of Tropical Ophthalmology (AITO) in Bamako (Mali). The route followed by the patient, from contact with the health service through to post-operative health care was analysed in terms of individual jobs, supplies and equipment required. The unit cost of each of these elements was assessed using an adapted calculation method. The results show that the cost of the removal of the lens at the AITO is 15,200 FCFA (or $56). Installing an intra-ocular lens significantly improves the outcome for a similar cost (16,500 FCFA or $60). The relative costs of various elements were as follows: food, 32%, the suture, 12%; and equipment only 13%. Thus, to reduce the overall cost of surgery for cataracts, ambulatory surgery should be organised, with efforts to reduce the costs of suture. High quality equipment should be used, because its life-span is such that it can be amortised over a long period.