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Biomedical subjects

S Resnikoff

Publications and source records attributed to S Resnikoff.

At least 19 recordsLinked to original sources
PubMed1997

Ganciclovir ophthalmic gel (Virgan; 0.15%) in the treatment of herpes simplex keratitis.

PURPOSE: Ganciclovir is a broad-spectrum virustatic agent. Its efficacy and safety after ocular application have been demonstrated in studies of herpetic keratitis in rabbits. Two strengths of ganciclovir gel (0.05 and 0.15%) were compared with 3% acyclovir ointment in the treatment of superficial herpes simplex keratitis in humans. METHODS: Two multicenter randomized clinical trials were carried out in Africa (Trial 1) and Europe (Trial 2). Sixty-seven patients (Trial 1) and 37 patients (Trial 2) from herpetic ulceration were recruited. RESULTS: The results showed no statistically significant difference between the treatment groups, although the healing rates tended to be better in the group receiving 0.15% ganciclovir gel, with healing rates of 85% (Trial 1) and 83% (Trial 2) as compared with 72% (Trial 1) and 71% (Trial 2) in the group receiving acyclovir ointment. Local tolerance was found to be superior with the gel formulation of ganciclovir with fewer complaints of discomfort (stinging, burning) or blurred vision after application of the drug. Systemic absorption of the drug was low. No hematologic changes were detected. CONCLUSIONS: These findings support the efficacy of ganciclovir gel in the treatment of ulcerative herpes simplex keratitis and demonstrate its superior local tolerance when compared with acyclovir ointment.

Acyclovir↗
PubMed1996

[Ophthalmologic complications due to human immunodeficiency virus infection at Bamako (Mali)].

AIDS ocular complications have been researched in 70 hospitalised patients in the two main hospitals of Bamako (Mali) during one year (1992-1993). Men were predominant (sex ratio 1.6). HIV1 infections (67%) were most frequent than HIV1 + HIV2 (21.4%) or HIV2 infections (11.4%). Most of the patients were on the WHO's clinical stage III; 34% of them had ocular complications, quite often non infectious: cotonous nodules (10%), vascularitis (5.7%) and retineous haemorrhages (4.3%). Ocular opportunistic infections were rare: only one case of toxoplasmic chorio-retinitis was reported. Ocular complications were observed with all types of HIV. Vascular abnormalities were observed in the stage II or IV of AIDS and seemed, in Bamako, as a serious sign during the AIDS course.

Adolescent↗
PubMed1995

Health education and antibiotic therapy in trachoma control.

The objective of this study was to confirm whether the combination of a health education programme with a mass treatment campaign was able to improve the effectiveness of trachoma control. An open controlled clinical trial with a 2 x 2 factorial design was carried out. Four villages, matched for size and epidemiological, economic and social conditions, were included in the study. The first village received mass treatment with 1% oxytetracycline eye drops combined with a specific health education programme. The second village received only a health education programme. The third village received only mass treatment and the fourth village did not receive any intervention during the study (control village). 1810 subjects were enrolled of whom 76% were successfully followed for 6 months. The incidence of new cases ranged between 1.6% and 14.2%. In this study the combination of a health education programme with mass treatment failed to increase the cure rate. There was even a negative interaction (P = 0.03). The best results were obtained in the village where antibiotic treatment was used alone, both in terms of cure rate (82%) and reduction of C trachomatis transmission. These results suggest that the addition of a health education programme does not systematically improve the performances of a mass treatment campaign. The efficacy of this combination depends essentially on the capacity of the community to modify its hygiene behaviour.

Anti-Bacterial Agents↗
PubMed1994

[Course of trachoma under treatment with 1% oxytetracycline ophthalmic solution].

PURPOSE: In order to optimize the trachoma treatment duration, we carried out a prospective study to observe the disease course over a long period of treatment by a 1% oxytetracycline (chlorhydrate) suspension. METHODS: The study involved 50 children between 2 and 12 years living in three Malian villages. The existence of an active trachoma was clinically characterized by the presence of at least 5 follicles associated with a papillary hypertrophy of the upper tarsal conjunctiva. The treatment was administered daily 4 times a day, for two months. All patients were examined before being treated, then on the 15th, 30th and 60th day. The presence and the importance of the follicles, papillae and trachomatous scarring were scored. During treatment, no patient manifested a case of follicular score aggravation. The moderate cases reacted more rapidly than the severe ones. In most cases the reduction in the number of follicles became evident only after two weeks of treatment. On the other hand, the inflammatory hyperplasia diminished rapidly from the 15th day. The cicatricial score was constant and pre-existing scars were not aggravated. After treatment, 33 patients out of 50 (66%) could be considered cured. CONCLUSION: The analysis of data suggests that a longer period of treatment would have led to a higher healing percentage. In fact, all forms of intense trachomatous inflammation, likely to cause blindness, diminished before the end of the control period.

Child↗
PubMed1994

[Effect of water supply on the incidence of trachoma: preliminary results of a prospective study in Mali].

This prospective study (January 1993-January 1994) was carried out in two groups of villages of the district of Ouelessebougou (Mali). The objective of the study was to assess the impact of installing water supply boreholes on the incidence of trachoma. A prospective group of 4 villages, where boreholes were sunk at the beginning of the study, was compared to a control group of 4 villages where there are no boreholes. The examination concerned children below the age of 10 years (N = 700) and was carried out using binocular loupes, according to the simplified procedure for trachoma grading proposed by the WHO. Our results show that in the prospective group, the annual rate of incidence of inflammatory trachoma was 8% (cl: 5.8-10.7) while in the control group it was 14% (cl: 9.6-10.9). RR: 0.58 (0.37-0.90). Likewise the rate of spontaneous healing was 12% (Cl: 9.1-14.9) in the prospective group and 5% (cl: 2.4-9) in the control group. Relative Risk was 2.60 (1.36-4.9). These statistically significant results show that the risk of contracting trachoma is reduced by half in the villages where a borehole has been sunk.

Child↗
PubMed1992

Impression Cytology with Transfer in xerophthalmia and conjunctival diseases.

During a countrywide survey, we assessed the prevalence of clinical signs of xerophthalmia and of major conjunctival diseases in a randomized sample of 2,445 subjects representative of the population of the Republic of Djibouti. On a part of this sample, conjunctival Impression Cytology with Transfer (ICT) test and a plasma retinol determination were performed. Xerophthalmia as a public health problem was displayed by clinical signs (Bitot's spots, corneal scars among preschool children), low plasma retinol levels and ICT test results: 9.3% with deficient cytology in the rural area and 12.3% in the urban one (age-standardized rates). Results of ICT were related to age (p < 0.00001). Vitamin A deficiency was prevalent not only in preschool children but also up to 15 years. Moreover, ICT results are influenced by conjunctival diseases: compared to age-matched controls, there were more abnormal cytologies among patients with trachomatous inflammation (p = 0.025), conjunctivitis (p = 0.024) or Limbal Vernal Keratoconjunctivitis (p = 0.015). Thus ICT shouldn't be performed among children with conjunctival diseases. In the region under study conjunctival diseases had high rates of prevalence: 16.4% of trachomatous scarrings in the urban area (standardized rate), 8% of conjunctivitis among rural preschool children, and 5% of Limbal Vernal Keratoconjunctivitis among children between 5 and 14 years in both areas.

Adolescent↗
PubMed1992

Assessment of vitamin A deficiency in a rural area in Mali. Estimation of sample size for the impression cytology test.

The prevalence of vitamin A deficiency among two to ten years old children in a rural area of Mali was assessed by ophthalmic examination, determination of plasma retinol levels and impression cytology with transfer tests. A Public Health problem of vitamin A deficiency was identified in this rural area by: the prevalence of nightblindness significantly (p < 0.001) above the cut-off (1%) defined by the World Health Organization (WHO); the prevalence of corneal scarring significantly (p < 0.001) above the WHO's cut-off (0.05%); the percentage of subjects with plasma retinol levels below 0.35 mumol/l (10 micrograms/dl) significantly (p < 0.001) higher than the WHO's threshold (5%); and 52.8 +/- 8.2% children with "Abnormal" impression cytology as determined by the impression cytology test (IC). This preliminary survey confirmed widespread vitamin A deficiency in Mali. The minimum sample size required for a study using the impression cytology test to determinate a Public Health problem in a population was calculated for different situations. Ophthalmic examination indicated a very high rate of active trachoma (29.6 +/- 7.0%), and a relationship between active trachoma and impression cytology results was identified.

Child↗
PubMed1992

Assessment of vitamin A deficiency in the Republic of Djibouti.

In a countrywide survey, we assessed the prevalence of vitamin A deficiency by clinical examination and impression cytology with transfer method (ICT) in a randomized sample of 2445 subjects representative of the population of the Republic of Djibouti. A plasma retinol determination was made on a part of this sample. Results lead to believe that serious vitamin A deficiency may periodically occur in Republic of Djibouti when nutritional conditions become poor. Meanwhile a large number of children, mostly in the rural area, have a marginal vitamin A status and are exposed to a high level of risk.

Adolescent↗
PubMed1991

Climatic droplet keratopathy, exfoliation syndrome, and cataract.

During a countrywide survey we assessed the prevalence of climatic droplet keratopathy (CDK) in a randomised sample of 2446 subjects representative of the population of the Republic of Djibouti. The investigation of the relationship between CDK and two diseases considered to be related to exposure to ultra-violet light--namely, exfoliation syndrome and cataract--was planned as a case control study. In the rural area prevalence of CDK was five times higher than in the urban one (2.8% vs 0.5%) and varied according to districts. The highest rates were observed where the inhabitants' activities were related to the sea. The case control study revealed that the opacification of the lens was about three times commoner in patients with CDK than in patients without CDK (p = 0.03) and that the exfoliation syndrome was about six times commoner in patients with CDK than in controls of similar age, sex, climatic conditions, and lens status (p = 0.02). Moreover, we noticed that the sequelae of corneal perforations were about 30 times commoner in patients with CDK than in controls of similar age (p less than 0.00001).

Adult↗
PubMed1991

[Tropical conjunctivitis: infectious etiology and validation of its clinical features].

173 nontrachomatous conjunctivitis studied at the I.O.T.A. in Bamako, Mali, have shown a majority of bacterial aetiology, especially gram-negative. 1 out of 10 conjunctivitis was due to virus, mostly to adenovirus. 4% of the cases were due to Chlamydia Trachomatis. The try of validation of the clinical characters in comparison with the etiology has shown that Chemosis was an indicator of a bacterial conjunctivitis (OR = 2.4) and that the lack of purulent discharge was in connexion with the presence of a keratitis (OR = 7.7). On the one hand the frequency of gram-negative bacteria, on the other hand the potential gravity of the conjunctivitis in tropical area, would justify the use of gentamycin at first in nontrachomatous conjunctivitis.

Adenoviridae Infections↗
PubMed1991

[Trachoma and the conjunctival impression test].

The Transferred Conjunctival Impression test (test d'Impression Conjonctivale Transférée) is a simple, sensitive and non-invasive method enabling populations at risk from Xerophthalmia to be identified. Nevertheless, the results of the test do seem to be influenced by the conjunctival pathology, trachomatous in particular. It appears that conjunctival deficit is noticeably more frequent in trachomatous than non-trachomatous subjects. The trial, involving a random sample of 450, four- to six-year-old children living in the Sahelian zone, enabled us to confirm and quantify this relation. In terms of relative risk, with age, place of residence and nutritional state all being equal, the rate of abnormal TCI tests was 1.7 times higher in trachomatous than non-trachomatous children. Using the Transferred Conjunctival Impression test is thus especially indicated in zones with a low prevalence of trachoma. When high, an eye examination must be carried out during the trial in order to present the results in two categories: trachomatous and non-trachomatous. Failing this, estimates may be obtained using the formulae put forward by the authors.

Alcian Blue↗
PubMed1991

[Retino-vitreous hemorrhage in hemoglobinopathies].

During 15 months all the patients with retinal or vitreous hemorrhages diagnosed in departments of ophthalmology or internal medicine in Bamako (Mali) were submitted to an aetiological assessment. Only patients with hemorrhages caused by a general aetiology were included in the study. 64 cases were selected according to these criteria. Hemoglobinopathies were involved in 14.1% of cases, high blood pressure in 31.8%, diabetes mellitus in 10.9% and miscellaneous causes in 15.6%. In 26.6% of cases an association between several of these aetiologies was observed. SC hemoglobin was the most frequent and the most serious. AS and AC traits were involved in 2 retinal hemorrhages' cases. AS and AC traits' responsibility in ocular hemorrhages associated with diabetes mellitus or high blood pressure was doubtful. A frequent association of sickle cell trait and high blood pressure was noticed. One case of Eales syndrome is reported during a diabetes mellitus-AS trait. All the patients were submitted to a treatment by pentoxifylline. Moreover 5 patients were treated by a laser coagulation and 2 patients by cryoapplication. The interest of the hemoglobin electrophoresis for the aetiologic assessment of retinal and vitreous hemorrhages is stressed.

Adolescent↗
PubMed1990

[Corneal complications of climatic keratopathy].

The "keratopathie de Bietti" or climatic droplet keratopathy or keratopathie climatique (KC) is a degenerative disease of the cornea which is probably due to the exposure to ultraviolet rays. Usually the evolution is a progressive invasion of cornea by amber nodules which lift up the corneal epithelium. We observed that numerous patients suffered from severe corneal ulcerations which appeared to be spontaneous and which evolution was frequently disastrous. The aim of this work was to pick up epidemiologic data on KC in order to check the following hypothesis: the corneal opaquenesses, due to non traumatic perforations, would be more frequent among patients suffering from KC than among the rest of population. The study, carried out in Republic of Djibouti, dealed with two groups of people: an hospitable group of 217 patients suffering from a KC and a random sample of 2,446 persons among Djibouti people, from which a study ill-healthy was carried out among people from 40 years old. The mistakes were controled by adjustment on age and climatic conditions. The result is that corneal blindnesses which seemed to be spontaneous were more frequent in a significative way among people suffering from KC than among healthy people as old as ill people and living in the same conditions (12% against 0.7%; p = 0.003; Odds ratio adjusted on age: 31.8 IC: 8.8-115.20). On the etiopathogenic point of view the bacterial, fungal and deficiency causes could scarcely be accepted. The unfavourable evolution, resisting to all the treatments, drove to several hypothesis among them is responsibility of free amoebas as acanthamoeba.

Blindness↗
PubMed1989

[Epidemiological course of trachoma in Djibouti].

A survey on a representative sample of population showed that inflammatory trachoma is rare in Republic of Djibouti. However, it is significatively more frequent in rural surroundings (0.4%, standard rates) than in urban surroundings (0.4%, standard rates) where it affects particularly people recently coming from border countries. In rural surroundings the frequency changes according to the distances from capital (p = 0.01). On the contrary, cicatricial trachoma is more frequent in the city (16.4%) than in rural surroundings (8.2%--Standard rates). The blindnesses caused by trachoma are relatively rare (0.1%) when entropiontrichiasis appear especially in urban surroundings (0.7%) where people from Arab Peninsula are the most affected (p = 0.008). When comparing with the 1968 situation, we notice a perceptible decrease of the prevalence of trachoma and also the disappearing of ethnic differences which existed at that time concerning the illness active forms. This good evolution is probably due to the effects of several mass campaigns added to an improvement of accessibility to medical care.

Djibouti↗