[Lower limb peripheral arterial disease in 268 patients in Guadeloupe]. / L'artériopathie oblitérante des membres inférieurs d'origine athéromateuse en Guadeloupe : à propos de 268 patients.

UNLABELLED: Peripheral arterial disease of the lower limbs is a serious condition because of its local and general prognosis. OBJECTIVES: To identify the localization of peripheral arterial disease, associated risk factors, topography and features of the disease in Guadeloupe. PATIENTS AND METHODS: A descriptive non-interventional study was performed in Guadeloupe located in French West Indies from March to June 2014. Data for all patients, who underwent Doppler ultrasound of the lower limb in a vascular outpatient clinic and in the University Hospital in Guadeloupe for known or suspected peripheral arterial disease were included. RESULTS: The study included 268 patients. Localizations were: infrapopliteal (n=227 patients), popliteal (n=148), femoral (n=185) and aorto-iliac (n=115). Smoking was associated with aorto-iliac (16 patients; P<0.05) and femoral (27 patients; P<0.05) localizations. Diabetes was associated with infrapopliteal localizations (133 patients; P<0.05), and high blood pressure was associated with infrapopliteal, popliteal and femoral localizations. Mean age was 73.1±10.8 years; half of patients (51 %) were women. Peripheral arterial disease was known for 52 % of the population; 147 patients were asymptomatic. Associated factors were high blood pressure (88 %), diabetes (63 %), dyslipidemia (45 %), and smoking (7 %). Ischemic heart disease was found in 14 % of patients, cerebrovascular disease in 18 % and all three localizations in 4 %. A history of amputation, bypass or endovascular treatment was found in 11 %, 20 % and 32 % of patients respectively. CONCLUSION: In our population, an infrapopliteal site was more often found than a proximal site. Distal localization was associated with diabetes, and proximal localization with smoking. Cardiovascular risk factors exhibited an atypical pattern with a large majority of patients (88 %) having high blood pressure, two-thirds diabetes, but with very few (7 %) smokers. Peripheral arterial disease was more often associated with a history of stroke than with ischemic heart disease.

[Epidemiology of Ciguatera in the Iles Saintes (Guadeloupe)]. / Epidémiologie de la Ciguatera aux Iles Saintes (Guadeloupe).

A 1981 retrospective study in the Iles Saintes (Guadeloupe) points to an estimated average number of cases per year of 30 +/- 25 par 10,000 inhabitants, involving 2.6 +/- 1.6 outbreaks per year of this endemic disease. The infection is most common from August to October. The attack rate is 87%. The symptoms, as described by 112 former patients, include the usual digestive and neurological signs, with oculonasal symptoms being particularly frequent. Only in half the cases does the disease require medical care (doctor, dispensary, hospital). The median duration of the illness is 3 weeks. Two patients out of 3 are bedridden. More than one-third present sequelae. Three families of fish are responsible for these cases of food poisoning: the Carangidae, Sphyraenidae, and Muraenidae. The microphagous herbivora species are not incriminated. The results are compared to other series of data published for the Antilles and for the Pacific.