Search

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%.

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.

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.

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.

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).