[Acid suppression therapy is not required after one-week anti-Helicobacter pylori triple therapy for duodenal ulcer healing]. / La poursuite du traitement antisécrétoire après trithérapie d'éradication de Helicobacter pylori n'est pas nécessaire pour obtenir la cicatrisation des ulcères duodénaux.

AIM: To compare healing of Helicobacter pylori-related non complicated duodenal ulcer after one-week eradication triple therapy alone and after triple therapy with further 3-weeks antisecretory treatment with ranitidine. METHODS: Three hundred and forty three patients with symptomatic H. pylori positive duodenal ulcer were included in this randomized double-blind placebo controlled study. H. pylori infection was established by rapid urease test and histopathology of antral biopsies. All patients were treated for one week with ranitidine 300 mg b.i.d., amoxicillin 1 g b.i.d., clarithromycin 500 mg b.i.d., and then randomly treated for the following 3 weeks either with ranitidine 300 mg once daily (triple therapy + ranitidine, n =180) or placebo (triple therapy alone, n =163). Ulcer healing was assessed by endoscopy 4 weeks after inclusion. H. pylori eradication was established by (13) C-urea breath testing 5 weeks after the end of triple therapy. RESULTS: In intention to treat, duodenal ulcer healed at 4 weeks in 86 % of patients treated with triple therapy + ranitidine and in 83 % of patients treated with triple therapy alone (equivalence: 90 % CI [-3. 8 %; 9.2 %]). The H. pylori eradication rates were 67 % and 69 % respectively. Ulcer healed in 88 % of patients in whom H. pylori eradication was achieved and in 77 % of patients in whom eradication failed. CONCLUSION: These results demonstrate that one-week triple therapy alone is highly effective in healing non complicated H. pylori associated duodenal ulcer without additional antisecretory treatment.

[The value of needle biopsy of the liver in the differential diagnosis of cholestatic jaundice. A clinico-pathologic study of 101 cases (author's transl)]. / Valeur de la ponction-biopsie hépatique dans le diagnostic étiologique des ictères cholestatiques. Etude anatomo-clinique de 101 observations.

The examination of needle biopsy of the liver has permitted the identification of the aetiology of cholestatic jaundice in eighty five cases out of a series of one hundred-and-one patients, leaving eight without definite diagnosis and eight false diagnosis. The characteristic histopathologic lesions of lobular hepatitis and of obstructive jaundice are reviewed. The problems of identification of particular microscopic forms (obstructive jaundice with minimal portal tracts alterations, residual stage of hepatitis, cholangiolitic and hypercholestatic forms of hepatitis) are discussed.

[Comparison of the effects of Rocgel and anti-H2 on the symptomatology of gastroesophageal reflux without esophagitis]. / Comparaison du Rocgel et d'un anti-h2 sur la symptomatologie du reflux gastro-oesophagien sans oesophagite.

The efficacy of boehmite (Rocgel) and of ranitidine was compared in a randomized, double-blind 4-week trial in patients with symptomatic, endoscopically free macroscopic reflux oesophagitis. Of the 64 patients who completed the study 33 received boehmite and 31 ranitidine. Significant symptomatic improvement occurred in both treatment groups (global clinical score and self evaluation by patients) (p < 0.001). Disappearance of heartburn was 52 per cent (15/29) with boehmite and 53 per cent (16/30) with ranitidine. Disappearance of regurgitation was 48 per cent (10/21) with both treatments. 33% of the patients became totally symptom-free. Our results indicate that boehmite seems to be at least as effective as ranitidine in relieving symptoms. Cost of treatment with boehmite, on the other hand is cheaper than ranitidine. As a safe, locally active mucosal protecting agent and antacid, boehmite is an effective drug for the treatment of reflux oesophagitis without macroscopic lesions.