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T Hoang-Xuan

Publications and source records attributed to T Hoang-Xuan.

At least 19 recordsLinked to original sources
PubMed2001

Characteristics of patients with herpes zoster on presentation to practitioners in France.

There have been many epidemiological studies of chickenpox but only a few of herpes zoster. We report data from an observational study, conducted in France during a 1-year period, of 9038 patients who presented with acute herpes zoster (n = 8103) or postherpetic neuralgia (PHN; n = 935) at the office practices of 4635 general practitioners or dermatologists. The incidence of herpes zoster in France was found to be similar to that in the literature: from 1.4 to 4.8 cases per 1000 population per year. The patient profiles and clinical patterns were delineated, as well as the management decisions made according to the type of treating physician. The impact of herpes zoster on quality of life was evaluated on the basis of the Medical Outcome Study Short Form 36 (MOS SF 36) scale, which is widely used for assessing quality of life in the field of health. This study provides reference data on the substantial deterioration in quality of life associated with herpes zoster and PHN.

Acute Disease↗
PubMed2001

Treatment of ocular cicatricial pemphigoid with sulfasalazine.

PURPOSE: To assess the outcome of patients with ocular cicatricial pemphigoid (OCP) treated with sulfasalazine as an alternative to dapsone. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Nine patients with biopsy-proven OCP and previous dapsone-related adverse effects (hemolysis and gastrointestinal disturbances) treated with oral sulfasalazine. METHODS: Clinical data were abstracted from patients' medical records. MAIN OUTCOME MEASURES: Patients' symptoms, ocular inflammation, conjunctival scarring, complete blood cell count (including reticulocyte count). RESULTS: At the initiation of sulfasalazine therapy, ocular inflammation was controlled in all patients but one. Mean follow-up was 12 months (range, 2-35 months). Median oral sulfasalazine dosage was 3 g (range, 1-4 g). The disease remained controlled with sulfasalazine alone in four patients (45%). Two patients (22%) required adjunctive oral cyclophosphamide. Adverse effects necessitating drug withdrawal occurred in three patients (33%): hemolysis in two and gastrointestinal disturbances in one. CONCLUSIONS: Sulfasalazine may be useful in OCP patients with previous dapsone-related adverse effects.

Administration, Oral↗
PubMed2001

Chronic cicatrizing conjunctivitis.

Conjunctival fibrosis may result from chronic inflammation and may lead to alterations of conjunctival architecture. This results in ocular dryness, entropion and trichiasis, and corneal complications. Causes of conjunctival cicatrization are not limited to autoimmune diseases, such as ocular cicatricial pemphigoid, a severe disease associated with poor ocular prognosis. Other well-known causes include thermal and chemical burns, postinfectious conjunctivitis, and Stevens-Johnson syndrome. Ocular rosacea and atopic keratoconjunctivitis often are underdiagnosed causes of conjunctival fibrosis. Medical history, physical exam, and laboratory tests often allow for diagnosis of the underlying disease. Medical management varies according to specific causes, and many surgical strategies are available to restore corneal transparency and normal palpebral architecture.

Animals↗
PubMed2001

Determination of corneal asphericity after myopia surgery with the excimer laser: a mathematical model.

PURPOSE: To determine the theoretical change of corneal asphericity within the zone of laser ablation after a conventional myopia treatment, which conforms to Munnerlyn's paraxial formula and in which the initial corneal asphericity is not taken into consideration. METHODS: The preoperative corneal shape in cross section was modeled as a conic section of apical radius R(1) and shape factor p(1). A myopia treatment was simulated, and the equation of the postoperative corneal section within the optical zone was calculated by subtracting the ablation profile conforming to a general equation published by Munnerlyn et al. The apical radius of curvature r(2) of the postoperative profile was calculated analytically. The postoperative corneal shape was fitted by a conic section, with an apical radius equal to r(2) and a shape factor p(2) equal to the value that induced the lowest sum of horizontal residuals and the lowest sum of squared residuals. These calculations were repeated for a range of different dioptric treatments, initial shape factor values, and radii of curvature to determine the change of corneal asphericity within the optical zone of treatment. RESULTS: Analytical calculation of r(2) showed it to be independent of the initial preoperative shape factor p(1). The determination of p(2) was unambiguous, because the same value induced both the lowest sum of residuals and the lowest sum of the squared residuals. For corneas initially prolate (p(1) < 1), prolateness increased (p(2) < p(1) < 1), whereas for oblate corneas (p(1) > 1), oblateness increased (p(2) > p(1) > 1) within the treated zone after myopia treatment. This trend increased with the increasing magnitude of treatment and decreased with increasing initial apical radius of curvature R(1). CONCLUSIONS: After conventional myopic excimer laser treatment conforming to Munnerlyn's paraxial formula, the postoperative theoretical corneal asphericity can be accurately approximated by a best-fit conic section. For initially prolate corneas, there is a discrepancy between the clinically reported topographic trend to oblateness after excimer laser surgery for myopia and the results of these theoretical calculations.

Cornea↗
PubMed2000

Comparison of the efficacy and safety of valaciclovir and acyclovir for the treatment of herpes zoster ophthalmicus.

OBJECTIVE: To compare the efficacy and safety of valaciclovir and acyclovir in immunocompetent patients with herpes zoster ophthalmicus. DESIGN: A multicenter, randomized, double-masked study. PARTICIPANTS: One hundred ten immunocompetent patients with herpes zoster ophthalmicus diagnosed within 72 hours of skin eruption were treated; 56 were allocated to the valaciclovir group and 54 to the acyclovir group. METHODS: Patients randomized to the valaciclovir group received two 500-mg tablets of valaciclovir three times daily and one tablet of placebo twice daily. Patients in the acyclovir group received one 800-mg tablet of acyclovir five times daily and one tablet of placebo three times daily for 7 days. MAIN OUTCOME MEASURES: Main outcome measures included the frequency, severity, and duration of ocular complications, patient reports of zoster-associated pain, and the outcome of skin lesions. Tolerance was also assessed on the incidence and types of adverse effects and changes in laboratory parameters. The analysis was mainly descriptive and performed on an intent-to-treat basis. RESULTS: Ocular complications of herpes zoster ophthalmicus were similar in the valaciclovir and acyclovir treatment groups. The main complications were conjunctivitis (54% and 52%, respectively), superficial keratitis (39% and 48%, respectively for punctate keratitis; 11% in each group for dendritic keratitis), stromal keratitis (13% in each group), and uveitis (13% and 17%, respectively). The long-term outcomes of these ocular complications were favorable and similar in both treatment groups. Pain duration and severity and outcome of skin lesions were similar between groups. Most patients reported prodromal pain. After 1 month, 25% of patients in the valaciclovir group and 31% in the acyclovir group still reported pain. The percentage of patients experiencing postherpetic neuralgia decreased during follow-up. The tolerance to acyclovir and valaciclovir was comparable and considered good. The most frequent adverse events were vomiting and edema of the eyelids or face (3%-5%). Three serious adverse events not linked to the study drugs occurred. CONCLUSIONS: Valaciclovir is as effective as acyclovir in preventing ocular complications of herpes zoster ophthalmicus, including conjunctivitis, superficial and stromal keratitis, and pain. Tolerability of the two drugs is similar, but the dosing schedule of valaciclovir is simpler.

Acyclovir↗
PubMed2000

[High-dose intravitreal ganciclovir in CMV retinitis].

PURPOSE: To assess the efficacy and tolerability of high-dose (2000microg) intravitreous ganciclovir in the maintenance therapy of CMV retinitis in AIDS patients. MATERIAL: and methods: Prospective open study in a single center. The maintenance therapy of CMV retinitis consisted of a single high-dose (2000microg) intravitreous injection per week. The evaluation criteria were clinical examinations, and photographs when necessary. RESULTS: Over a 44-week period, twenty-four eyes (15 patients) have been included. The relapse rate evaluated by the survival curves method was 5% at 44 weeks. No ocular toxicity was reported after a follow-up of 24 weeks. CONCLUSION: High-dose intravitreous ganciclovir induces a prolonged remission of CMV retinitis and is well tolerated. Therefore, we recommend the use of the 2000microg dosage per intravitreous injection instead of the classical dosage of 400microg.

AIDS-Related Opportunistic Infections↗
PubMed1999

e-PTFE as scleral buckling episcleral implants: an experimental and histopathologic study.

To investigate the effects of focal implantation of expanded polytetrafluoroethylene (e-PTFE) episcleral implants (i.e., explants or exoplants) on surrounding ocular tissues, an experimental and histopathological study was performed. Twenty-seven Fauve de Bourgogne rabbits eyes were implanted for a period of 3-11 months with oval-shaped e-PTFE episcleral implants. A newly formed capsule constantly encased the implants. Affected by the only two severe complications observed, 2 eyes had an endocapsular acute inflammation and could not be included in the study. Finally, 25 eyes were studied histopathologically. Neither intrusion nor extrusion of episcleral implants was observed. Other changes were related to implant characteristics. The inner surface of the capsule was often covered with numerous giant cells attesting to a foreign-body granuloma developed against the irregular outline of the episcleral implants. The porosity of the material was closely related to its surface irregularity, and also allowed its colonization by a fibrovascular and inflammatory tissue mainly in its peripheral layers. Under episcleral implants, sclera was both thinned and invaginated. Expanded PTFE hydrophobia was the other factor that might have suscitated granuloma. These microscopic changes are in contrast with an overall good apparent experimental tolerance to the material. However, additional studies on the long term behavior of this material would be helpful.

Animals↗
PubMed1999

Immunoelectron microscopic study of the conjunctiva in cicatricial pemphigoid.

BACKGROUND: Immune deposits can be found on the conjunctival basement membrane zone of patients affected by cicatricial pemphigoid using immunofluorescence technique. The purpose of this study was to perform direct immunoelectron microscopy on the conjunctiva of patients with scarring conjunctivitis associated with cicatricial pemphigoid. METHODS: Conjunctival and skin biopsies were performed in six patients who presented with presumed autoimmune cicatrizing conjunctivitis associated with cicatricial pemphigoid. Specimens were processed for direct immunofluorescence and direct immunoelectron microscopy. RESULTS: Direct immunofluorescence was positive in all skin samples and in three of six conjunctival samples. Direct immunoelectron microscopy showed immune deposits in the lamina lucida and the lamina densa of all skin and conjunctival samples. CONCLUSIONS: Direct immunoelectron microscopy can be performed on the conjunctiva. It shows the precise localization of cicatricial pemphigoid target antigens within the conjunctival basement membrane zone.

Aged↗
PubMed1999

Pure ocular cicatricial pemphigoid. A distinct immunopathologic subset of cicatricial pemphigoid.

OBJECTIVE: To determine whether ocular cicatricial pemphigoid (OCP) may represent a distinct immunopathologic disease when it is pure ocular cicatricial pemphigoid (POCP) (e.g., only confined to the conjunctiva) or when it is associated with skin or extraocular mucous membrane lesions or both (OCP+). DESIGN: Prospective, immunologic, and immunopathologic study with special emphasis on direct immunoelectron microscopy. PARTICIPANTS: Six patients with POCP and seven patients with OCP+. INTERVENTION: After informed consent was obtained, a conjunctival biopsy was performed in all patients. Skin and extraocular mucosa biopsy specimens were harvested in selected cases only. MAIN OUTCOME MEASURES: Results of direct immunofluorescence and direct immunoelectron microscopy without freezing on conjunctival and skin biopsy specimens, indirect immunofluorescence, and Western immunoblotting analysis were analyzed. RESULTS: Results of direct immunoelectron microscopic examination of the conjunctiva showed the presence of immune deposits in the upper lamina lucida of the basement membrane zone in the six patients with POCP, whereas the immune reactants were located in the lower part of the lamina lucida and in the lamina densa of the basement membrane zone (conjunctiva, buccal mucosa, and skin) in the seven patients with OCP+. Direct immunofluorescence was positive in the biopsy specimens of three patients with POCP (50%) and the seven patients with OCP+ (100%). Results of indirect immunofluorescence study showed circulating autoantibody levels only in two patients with OCP+, and results of Western immunoblot analysis were negative. CONCLUSIONS: Results of direct immunoelectron microscopic examination of the conjunctiva support the hypothesis that POCP may be a disease entity distinct from mucocutaneous cicatricial pemphigoid.

Aged↗
PubMed1999

Adult-onset angiofibroma and multiple endocrine neoplasia type I.

Multiple endocrine neoplasia type 1 (MEN 1) predisposes affected persons to neoplasms of the parathyroid glands, the endocrine pancreas, the anterior pituitary, and the duodenum. We report the first case of adult-onset multiple angiofibromas of the central face associated with MEN 1. Seven siblings also developed adult-onset angiofibromas, none with evidence of tuberous sclerosis. Basic fibroblast growth factor (BFGF) is elevated in many patients with MEN 1 and may play a pathogenetic role.

Adenoma↗
PubMed1999

Epidemiological considerations about retinal opportunistic infections in HIV-infected patients in France.

PURPOSE: To evaluate the evolution of the epidemiology of retinal opportunistic infections in HIV-infected patients from 1994 to 1997 and to assess the effect of HAART initiated in 1996. MATERIALS AND METHODS: Epidemiological prospective study using the data collected during ocular examinations of HIV-infected patients conducted in a single referral center specialized in HIV infection. RESULTS: From 1995 to 1997, the total number of examined HIV-infected patients and the incidence of retinitis related to CMV, VZV, tuberculosis, and toxoplasmosis decreased. The incidence of CMV retinitis, which was by far the most frequent ocular infection, fell from 6.2% to 1.2%. COMMENTS: The dramatic decrease in retinal opportunistic infections since 1996 may be related to the use of HAART. However, a close follow-up is still justified due to the increasing occurrence of resistance to protease inhibitors.

AIDS-Related Opportunistic Infections↗
PubMed1999

Uveitis in patients treated with intravenous cidofovir.

PURPOSE: To study the characteristics of uveitis occurring during intravenous cidofovir treatment for CMV retinitis in patients with AIDS. PATIENTS AND METHODS: We retrospectively studied ten cases (16 eyes) of uveitis in patients with CMV retinitis treated with intravenous cidofovir. All the patients had ophthalmologic examinations and, if required, fundus angiographies. The median follow-up was eight months. RESULTS: Uveitis occurred after a mean of 8.5 infusions of cidofovir (range 2-17). All ten patients were on protease inhibitors. The mean CD4+ cell count was 92 +/- 51/microl and the median viral load was 3.9 log. All the eyes with uveitis had healed CMV retinitis. The first examination of the involved eyes showed inflammation of the anterior chamber (100%), vitritis (50%), posterior synechiae (75%), and low intraocular pressure (94%). Uveitis did not relapse in the seven patients who stopped cidofovir, whereas it relapsed in two of the three patients who did not stop treatment. At the end of follow-up, permanent posterior synechiae were present in 69% of the involved eyes. COMMENTS: Cidofovir therapy necessitates slit-lamp surveillance, especially in patients on HAART. Cidofovir-related uveitis requires a local steroid treatment, but if possible, cidofovir should be withdrawn.

Adult↗
PubMed1999

[Treatment of ocular cicatricial pemphigoid with sulfasalazine].

PURPOSE: To report on three patients with biopsy-proven ocular cicatricial pemphigoid successfully treated with sulphasalazine. METHODS: Three case reports. RESULTS: A 71-year-old man, treated with dapsone for ocular cicatricial pemphigoid stopped his treatment because of an allergy to this drug. Oral sulphasalazine, 2.5 grams daily was successfully used as an alternative treatment (3 month follow-up). Two patients, aged 71 and 84 year old, were treated with dapsone for ocular cicatricial pemphigoid. Both patients stopped their treatment because of drug induced hemolytic anemia. They then received oral sulphasalazine, 4 grams daily. The disease was successfully controlled. In the first patient, sulphasalazine was discontinued after 13 months; and in the second patient no relapse was seen after a 16 month follow-up period. No adverse side effect of sulphasalazine occurred. CONCLUSION: Sulphasalazine, that has already been proven to be effective for Crohn's disease, also can be used in ocular cicatricial pemphigoid. However, further studies including a larger series of patients along with a longer follow-up are necessary to confirm the efficacy of sulphasalazine in this disease.

Aged↗
PubMed1999

[Ocular rosacea].

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Anti-Bacterial Agents↗