Description and evaluation of cocaine body-packers management in French Guiana (2016–2019)

Frémery, Alexis; Piriou, Vincent; Bonnefoy, C.; Hamiche, Karim; Kallel, Hatem; Pujo, Jean Marc; Bonifay, Timothée

doi:10.1016/j.jflm.2023.102500

Cited by 4 publications

(5 citation statements)

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“…French Guiana presents a higher number of violent acts and a higher overall crime rate than the rest of France, which, in certain circumstances, requires a local adaptation of care regarding our health network. 8 , 9 French Guiana is a French overseas territory located in South America between Brazil and Suriname. Its population consists of 276,128 inhabitants, including 144,501 for the main city of Cayenne.…”

Section: Introductionmentioning

confidence: 99%

An Observational Study of Sexual Assaults in French Guiana During 2019–2020

Menseau,

Charbonnier,

Franchi

et al. 2024

OAEM

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Introduction Sexual violence is a major public health issue, including in French Guiana. The feeling of insecurity is significant in this part of France. Sexual violence is an important reason for consultation in forensic and emergency medicine. The challenge is to provide care within the first 72 hours, particularly in medicolegal terms and for infectious disease management. The objectives of our study were, firstly, to establish the epidemiology of sexual assaults at Cayenne General Hospital (CGH), and secondly, to evaluate the management of these victims. Materials and Methods From January 1st, 2019 to December 31st, 2020, we conducted a single-center retrospective descriptive study including patients who were consulted for sexual assaults in the Forensic medicine and the Emergency departments of CGH. Results Over this period, 400 sexual assault victims were consulted. Most of them, were women (87%) with a median age of 13 years-old [8; 17.5]. The aggressor was mostly male (99%) frequently known by the victim (87%) and from her family (39%). Suspected assaults represented 19% of consultations. The most frequent assault on women was penile-vaginal penetration (82%) and penile-anal penetration (77%) on men. The delay of consultation was superior to 72 hours in 60% of the cases. A psychological follow-up was recommended for 62% of these victims. Conclusion This work allowed to identify a young and female population at risk, most often assaulted by a male known to her. Most of the patients consulted more than 72 hours after the assault. Our study highlights the need for prevention actions in French Guiana focusing on this population at risk.

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Section: Introductionmentioning

confidence: 99%

An Observational Study of Sexual Assaults in French Guiana During 2019–2020

Menseau,

Charbonnier,

Franchi

et al. 2024

OAEM

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“…Over the years, the transportation of narcotics has evolved, and body-packing changed towards a micro-industrial manufacturing process, which is probably responsible for the reduced risk of breakage of these so-called 'type 3' pellets [6]. This observation has enabled teams of Cayenne General Hospital to adapt their management and integrate the use of laxatives (polyethylene glycol) as a standard of care, as well as endoscopy in case of pellet stagnation in the digestive tract [3,4]. As Dufayet et al noticed, this approach is discussed in the literature [7,8], but up to now we have not recorded any complications associated with it.…”

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confidence: 99%

“…Domínguez-Rodríguez et al's secondary analysis of the MIMO trial suggested that the reduced risk of serious adverse events in the midazolam group compared to morphine is similar in patients with and without AF [3]. Llauger et al demonstrated that a decline in creatinine from baseline detected on arrival to ED was associated with increased mortality and prolonged hospitalization [4]. These papers underscore the prognostic importance of accurate detection and timely management of AHF in ED.…”

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confidence: 99%

“…According to the court of Cayenne, in the last 9 months, nearly 6000 ‘mules’ have been arrested at Cayenne airport (Unpublished data). Each year, 150 body-packers are managed in the hospital of Cayenne since 2015 [ 3 , 4 ]. This highly lucrative and flourishing market forced health professionals in French Guiana’s medical and emergency services to adapt their care management, with its risk of lethal evolution [ 3 ].…”

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“…In our experience, the risk of death from massive cocaine intoxication is a major issue [ 5 ] but remains extremely rare during the management of these patients. The main complications we have been able to report in our 10 years of experience are mostly related to pellet stagnation in the digestive tract [ 3 , 4 ]. Over the years, the transportation of narcotics has evolved, and body-packing changed towards a micro-industrial manufacturing process, which is probably responsible for the reduced risk of breakage of these so-called ‘type 3’ pellets [ 6 ].…”

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Body-packing, a public health issue requiring more researches

Fremery,

Pujo,

Aboikoni

et al. 2024

European Journal of Emergency Medicine

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Epidemiologic analysis and mortality outcome of firearm injuries in French Guiana (2016–2019)

Fremery,

Beguinot,

Franchi

et al. 2024

Eur J Trauma Emerg Surg

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Background French Guiana (FG) is a French territory located in South America with the highest rate of armed assaults. FG presents a poorly developed road system and a young and precarious population that makes the geographical and socio-demographic characteristics specific. No data concerning the firearm injury management are available in this country. Studying thesis trauma could permit to improve the management of victims. The objective of this study is to investigate the epidemiology of firearm injuries in FG, to define characteristics of the victims, and to assess factors associated with death. These identified factors could enable target primary prevention and intensification of medical management. Methods From January 2016 to December 2019, we conducted a retrospective study at the Cayenne General Hospital (CGH), including all patients admitted for firearm injuries in the emergency department, the medical emergency and resuscitation service, and the forensic service. A bivariate analysis was performed to assess relevant clinical data that were entered into a logistic regression model to assess factors associated with death. Results A total of 871 files were analyzed concerning 340 patients included after cross-checking. Victims were mainly males (90%) and young (30 ± 11 years old). The injury occurred mainly at night (60%), in a context of assaults (83%) and with long-barreled guns (82%). Among the 290 patients managed at the CGH, 60% were hospitalized including 12% that were in the intensive care unit, 41% that required surgical treatment, and 7% that died in hospital. The overall average length of stay was 10 ± 18 days. Overall mortality (n = 71, 21%) is statistically associated with male gender (p = 0.007) and suicide context (p < 0.001). In multivariate analysis, the sites of wounds (head and neck, thorax; p < 0.001) as well as induced organ injuries (neurological, respiratory, and vascular; p < 0.005) were independent factors associated to mortality. Conclusions This work underlines the high incidence of ballistic trauma in FG. This mainly involves a young and male population linked to the use of long arms and assaults. Despite the geographical difficulties of the territory and the technical platform deficits (no neurosurgery, no cardiothoracic surgery, no interventional radiology), the mortality is comparable to other studies, but remains more than twice as high as in mainland France. Finally, despite a change in legislation restricting access to firearms, our results show that gunshot firearm injuries remain a major public health concern requiring greater political actions.

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Description and evaluation of cocaine body-packers management in French Guiana (2016–2019)

Cited by 4 publications

References 15 publications

An Observational Study of Sexual Assaults in French Guiana During 2019–2020

An Observational Study of Sexual Assaults in French Guiana During 2019–2020

Body-packing, a public health issue requiring more researches

Epidemiologic analysis and mortality outcome of firearm injuries in French Guiana (2016–2019)

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