High prevalence of closely-related Acinetobacter baumannii in pets according to a multicentre study in veterinary clinics, Reunion Island.

Our objective was to study the carriage of Acinetobacter baumannii (AB) in pets in Reunion Island (RI), a French territory in Indian Ocean. Overall, 138 pets were sampled (rectum, mouth, wounds if applicable) in 9 veterinary clinics (VC). The prevalence of AB carriage was 6.5% (95%CI; 2.4, 10.6) and 9 carriers were identified from 4 VC. Hospitalization in a VC and antimicrobial treatment administered within the 15 preceding days were significantly associated with AB carriage (P<0.01 and P<0.05, respectively). Despite the VC in which animals have been sampled were located all around RI, most isolates (8/9) were closely-related (>90% similarity by pulsed-field gel electrophoresis). Additional studies are needed to improve the understanding about interactions between the different reservoirs of AB in RI.

[Paraquat poisoning. Prognostic and therapeutic evaluation in 28 cases]. / Intoxication par le paraquat. Evaluation du pronostic et du traitement à partir de 28 cas.

Since a mouthfull of the herbicidal compound Paraquat usually results in death from caustic burns, renal tubular necrosis, circulatory failure of pulmonary fibrosis, the fact that 11 out of 28 people poisoned in the period 1972-1980 survived deserves consideration. The most significant prognostic factors appear to be: (1) the mode of penetration: all 4 patients poisoned through the skin and/or the respiratory tract survived; (2) the volume of Paraquat absorbed: death from circulatory failure occurs within less than 72 hours with more than 50 mg/kg, while 35 to 50 mg/kg produce progressive pulmonary fibrosis; (3) the content of the stomach at the time of ingestion: food can neutralize the compound; (4) the finding of gastric lesions on early endoscopy; (5) evidence of acute renal failure; finally and mostly (6) Paraquat blood levels during the first 24 hours, as measured by radioimmune assays; lethal levels are 2.0, 0.6, 0.3, 0.16 and 0.10 mg/l at 4, 6, 10, 16, and 24 hours respectively. There is no overlapping between values obtained in patients who died and survivors. In this series, the course of the intoxication, as predicted from the initial prognostic factors, was unmodified by the treatments applied (Fuller's earth, dialysis, charcoal haemoperfusion, furosemide, immediate hypooxygenation). The survival of two patients with restrictive respiratory pathology seems to be ascribable to the circumstances of poisoning rather than to the treatment.

[Environmental etiological factors in atshma in adults (author's transl)]. / La recherche des facteurs étiologiques de l'environnement dans l'asthme de l'adulte.

Clinical, immunological, and functional investigations were conducted to study possible specific factors involved in the etiology of asthma in adults. The authors emphasize the frequency of positive skin, radio-immunologic and bronchial provocation tests for domestic pneumallergens in patients with common asthma, even those over 40 years of age. These cases improve in a protected environment and may benefit from immunotherapy. In patients with clinical manifestations suggesting possible occupational etiological factors the same tests can be used to diagnose the presence of a wide variety of vegetable or animal allergens. Tests involving exposing the bronchi to various chemical compounds used during working conditions (antibiotics, plastic precursors, metals, hair preparations) show that there exists a wide variety of causes. Systematic search for etiological factors is essential when investigating asthma in adults.

[Periarteritis nodosa in an addict with a hepatitis B injection (author's transl)]. / Périartérite noueuse chez un toxicomane atteint d'hépatite B.

The authors describe a case of a drug addict with a hepatitis B who was found to have periarteritis nodosa and a nephrotic syndrome. The course was rapidly fatal and autopsy confirmed the diagnosis. This new case questions the hypothesis suggested of possible toxicity of hard drugs (especially the amphetamines) as being an etiological factor for periarteritis nodosa observed in addicts. Hepatitis B virus, which is involved in the etiology of periarteritis nodosa and some nephrotic syndromes (also reported in addicts) is, in fact, very prevalent in users of hard drugs by the parenteral route.

[Electroencephalogram recordings during eserine treatment for overdosage with anticholinergics (author's transl)]. / L'électroncéphalographie au cours du traitement par ésérine des intoxications anticholinergiques.

The value of electroencephalographic recordings during eserine treatment for overdosage with anticholinergics is discussed, based on the results obtained in 6 cases. The results were spectacular in three cases, and a partial improvement was noted in one other case (suicide attempts with overdoses of atropine compounds), but only a slight effect was observed in two patients (with overdose of neuroleptics). Three points have to be underlined concerning the E.E.G. recordings: --eserine did not cause supplementary E.E.G. changes;--with eserine, the paroxystic abnormalities observed during overdoses of atropine compounds and amitriptyline rapidly disappear;--with mixed overdoses (atropine, barbiturates, or minor tranquillizers), eserine has no effect against non-anticholinergic products. Therapy with eserine, however, is still limited in its indications because of its short period of activity, its side-effects, and the possible risks of cardiac or convulsant complications.

[Acute poisoning by Gyromitra esculenta (author's transl)]. / L'intoxication par Gyromitra esculenta.

This kind of poisoning is scarce in France, on the contrary it is most frequent in Eastern Europe. Clinical picture associating cytolytic hepatitis, seizures, and hemolysis reminds us intoxication by hydrazine. In fact there is some evidence that the toxin of this mushroom--called gyromitrin--is transformed in the stomach in methylhydrazine. The mechanism of hepatotoxicity of the later can be compared with that of the metabolites of isoniazid.

Blood cadmium level and hypertension in humans.

Blood cadmium level was determined in 29 nontreated hypertensive male subjects and 29 controls. All were individually matched for sex, age, and smoking habits. No differences were found between hypertensives (3.3 +/- 0.4 ng/ml) and normotensives (2.6 +/- 0.4 ng/ml).

[Multi-focal tuberculosis]. / Tuberculoses multi-focales.

The authors present 16 cases of multifocal tuberculosis observed over a period of five years on a general medical unit. These cases almost all occurred in immigrants. (14 out of 16) with at least 2 localisations in 9 of them and sometimes 3 or more. The viscera usually affected were, in order, the liver, the lymph nodes, the lungs and pleura, the joints. They emphasise the mildness of the clinical symptoms, the rareness of lung involvement and, on the contrary, the constancy of hepatic involvement so that needle biopsy of the liver is essential in diagnosis.