[Antibiotic resistance of Helicobacter pylori in Reunion Island: therapeutic consequences]. / Résistance aux antibiotiques de Helicobacter pylori à l'île de La Réunion: conséquences thérapeutiques.

The aims of this paper were to assess resistance of Helicobacter pylori to antibiotics included in the so-called French triple regimens and to identify the possible causes of therapeutic failure in Reunion island. Antibiotic resistance was determined for 109 strains. All the strains were sensitive to amoxicillin and tetracycline, 93.6% were sensitive to ciprofloxacin, 92.7% to erythromycin and 60.6% to metronidazole. Fifty three patients who had previously tested positive for H. pylori received for one week regimen of amoxicillin (1 g bd), clarithromycin (0.5 g bd) and omeprazole (20 mg bd). Eradication rate after therapy was of 73.6%. Therapeutic failure was analysed for 9 patients using random amplified polymorphic DNA and the presence or not of antibiotic resistance. One cause of failure is clarithromycin resistance. These data show that triple therapy can be used in Reunion Island. In case of failure, sensitivity must be detected because the rate of resistance to metronidazole is over 30%.

[Seasonal trends of respiratory syncytial virus infections on Réunion Island gathering data among hospitalized children]. / Répartition saisonnière des infections dues au virus respiratoire syncytial à l'île de La Réunion à partir de données recueillies auprès d'enfants hospitalisés.

Little is known about the epidemiology of respiratory syncytial virus (RSV) infections in tropical countries and in particular in tropical islands of the Indian Ocean. Our study reviewed all cases of RSV infections diagnosed among hospitalized children in the Hospital de Saint Pierre de la Réunion, from January 1993 to December 1999. 849 cases were identified of which 67.7% were infants under 6 months old. Most cases occurred from December to May (89% of all cases), showing a significant correlation with the hot and rainy season. These data confirm the previous studies and support the existence of seasonal trends of RSV infections in the tropics.

Comparison of three non-nested RT-PCR for the detection of influenza A viruses.

BACKGROUND: The viral isolation technique (VIT) is largely used as a gold standard for the detection of influenza A and B viruses in respiratory samples. Some recent studies have pointed out that the polymerase chain reaction (PCR) assays allow sensitive and rapid detection of influenza viruses, also providing excellent correlation with traditional methods. OBJECTIVES AND DESIGN STUDY: The aim of this study was to evaluate the efficiency of three non-nested PCR, two PCR-hybridization assays using primers defined in M and NS genes, and one PCR which uses primers defined in NP, NS and HA genes and combines the detection of H3N2 and H1N1 hemagglutinin genes using defined primers in NP, NS and HA genes (PCR3), in comparison with an IF assay (IFA) and viral isolation technique (VIT). The study was carried out on 244 nasal samples collected mainly by practitioners of the GROG surveillance network during winter 1998-1999 for the detection of influenza A virus. RESULTS: Overall influenza viruses were detected more frequently by PCR techniques in 157 (64.3%), 147 (60.2%), 110 (45%) cases for PCR1, PCR2, PCR3, respectively, than by VIT or IFA, in 100 (40.9%) and 74 (30.3%) cases, respectively. Taking the positive culture samples as a reference, 100 (41.8%) samples were found to be positive for influenza A, and the sensitivity of IFA, PCR 1, PCR 2 and PCR3 techniques were 70, 100, 99, and 90%, respectively as compared with viral isolation cultures. On the other hand, as 86.5% of positive samples were positive with at least two different techniques, the sensitivity, specificity, VPP and VPN of each technique were recalculated taking into account a further criterion defining a positive sample: positivity with two techniques. We observe that techniques PCR 2 and particularly PCR 1 have very good sensitivity, respectively 98.6 and 100%, far better than the traditional techniques, IFA and culture, whilst maintaining acceptable specificity: 94.1 and 86.1%, respectively. In both cases they enable 141 (57.7%) A-positive influenza samples to be detected instead of the 100 (40.9%) obtained when culture is the reference test. IFA, culture and PCR 3 are highly specific (VPP=100%), but in comparison with PCR 1 and 2 their sensitivity, respectively 51.7, 69. 9, 77.6%, and negative predictive value are unsatisfactory. PCR 1 and 2 are superior to the other techniques to a statistically highly significant degree in terms of sensitivity, but the difference between the two is not significant.

[Clinical study of white atrophy: the viewpoint of the phlebologist]. / Etude clinique de l'atrophie blanche: le point de vue du phlébologue.

After giving a clinical description of Millian's white atrophy, its preferred locations and the area in which it develops (post-phlebitic or non-post-phlebitic chronic venous deficiency), the author distinguishes: a benign, non-evolutive form; forms of pseudo white atrophy, of identical morphology, of different development in which a tableau of acute inflamed hypodermititis develops towards hyperalgic ulceration; intermediate forms of more chronic development; non-evolutive forms, such as certain ulcer scars. If it is impossible to predict the developmental capacity of a plaque of white atrophy, it is nevertheless crucial to prescribe in all cases a well adapted elastic support, as this is the only way to avoid the majority of complications and, sometimes, to obtain a certain degree of reversibility.

[Classical treatment of trophic disorders in the postphlebitic syndrome]. / Traitement classique des troubles trophiques du syndrome post-phlébitique.

The author emphasizes firstly the primordial importance of prevention at each stage of thromboembolic illness, before, during, and after phlebitis; he also emphasizes the necessity of the most rigorous possible treatment of the acute phase (elastic support, ambulation, sufficiently prolonged anticoagulation, early thermal cure). Next the author explains the classical treatment of trophic complications (oedema, hypodermitites, dermoepidermic lesions, ulcers) which must be implemented according to a rational plan, and particularly with regard to leg-ulcers, for which the elastic support plays a leading part. Finally, the regulation of hygiene and regular checking should limit to the maximum the extent and worsening of the complications.

[Notes on the phlebologic work of Jean-Daniel Martinet]. / Apercus de l'oeuvre phlébologique de Jean-Daniel Martinet.

In homage to J.D. Martinet, the author, who was his collaborator for more than 25 years, surveys his phlebological work, so diverse and so multiple that it embraces all subjects of the venous pathology of the lower limbs. He cites 3 representative examples on different levels: the information and practical conclusions provided by phlebological investigations, especially retrograde; the classification of phlebitis migrans according to its course; the various problems presented by the surgery of varicose veins. Finally he emphasizes Martinet's qualities of loyalty and intellectual honesty, as well as his role as creator and director of a team (Broca, and later Epee de Bois).