Important prognostic factors for survival in patients with malignant pleural effusion.

BACKGROUND: The approach to palliative treatment of malignant pleural effusion (MPE) should be individualized because these patients generally have poor survival. Our study aimed to develop a model to identify prognostic factors or survival time in patients diagnosed with MPE. METHODS: This is a retrospective, descriptive, observational study to identify prognostic factors related to MPE in patients with a confirmed cancer diagnosis. Cox regression analysis was used to determine significant potential prognostic factors with respect to survival time. Survival time was defined as the time from pathological diagnosis to death. RESULTS: One hundred and sixty-five patients were included; 77 were men (47%) and 88 were women (53%). The median age was 60 years, and all of the patients were pathologically proven to have MPE. Non-small-cell lung cancer (36.0%), breast carcinoma (26%), and lymphoma (13.0%) were the most frequently diagnosed tumors. The median overall survival of patients from the initial diagnosis was 5 months (range: 1.0-96.0 months). Kaplan-Meier univariate analysis showed that survival was significantly related to the following prognostic factors: ECOG PS (hazard ratio [HR] 10.0, 95% confidence interval [95% CI] 5.96 to 18.50, p < 0.0001), primary cancer site (HR 1.99, 95% CI 1.23 to 3.22, p < 0.01), positive pleural cytology (HR 1.25, 95% CI 0.88 to 1.78, p = 0.04), and positive histology (HR 1.33, 95% CI 0.97 to 1.81, p = 0.04). Other potential independent diagnostic factors that were examined did not affect survival. Cox regression analysis showed that only the ECOG PS was highly predictive of survival (HR 73.58, 95% CI 23.44 to 230.95, p < 0.0001). CONCLUSIONS: ECOG PS is an independent predictor of survival in patients with MPE at initial diagnosis. This prognostic factor can help physicians select patients for appropriate palliative treatment of this syndrome.

Newborn screening program for hemoglobinopathies in Rio de Janeiro, Brazil.

BACKGROUND: Newborn screening for hemoglobinopathy in Brazil has been decentralized until 2001 when the Health Ministry of Brazil established the National Newborn Hemoglobinopathy Screening Program. The State of Rio de Janeiro started a program in collaboration with the State Health Department and the Institute of Hematology in Rio (HEMORIO). The goal of this study was to evaluate the effectiveness of the first 10 years of the Newborn Hemoglobinopathy Screening Program in identifying and managing infants with Sickle cell disease (SCD) in the State of Rio de Janeiro. PROCEDURE: Blood samples from 1,217,833 neonates were analyzed by High Performance Liquid Chromatography. Infants with SCD were enrolled in comprehensive treatment programs. RESULTS: Data showed that 4.87% of the newborns were heterozygous for a hemoglobin variant, 0.08% were homozygous or doubly heterozygous for abnormal hemoglobins and 95.02% had normal hemoglobin. All the 912 newborns with SCD were referred for treatment at HEMORIO, 34 (3.7%) of these died due to acute chest syndrome, sepsis or splenic sequestration. Four more children died of unknown causes. The implementation of the Rio de Janeiro Newborn Screening Program gradually increased the area of the State covered by the program. CONCLUSION: Data collected during the 10 years of the program showed reduction in mortality of patients with SCD in comparison to available historical statistical data before the implementation of the national screening program. This 10-year study showed that early diagnosis and treatment of newborns was associated with improved survival and quality of life of Brazilian children with SCD.

The serum D-xylose test as a useful tool to identify malabsorption in rats with antigen specific gut inflammatory reaction.

The inappropriate immune response to foods, such as peanut, wheat and milk may be the basis in the pathogenesis of enteropathies like coeliac and Crohn disease, which present small intestinal malabsorption. A number of recent studies have utilized d-xylose absorption as an investigative tool to study small intestinal function in a variety of clinical settings. Thus, the aim of this experimental study was to evaluate the intestinal absorption of D-xylose in an antigen-specific gut inflammatory reaction rat model. Animals of the experimental group were inoculated with peanut protein extract before their exposure to a challenge diet containing exclusively peanut seeds to induce the gut inflammatory reaction caused by peanut allergy. Our results show that systemic inoculation with peanut protein extract renders significantly higher antibody titres (5.085 +/- 0.126 units) (P < 0.0001) than control rats (0.905 +/- 0.053 units) and that the antibody titres correlate positively to an inflammatory alteration of the gut morphology (P < 0.0001). Animals pertaining to the experimental group showed an intestinal absorption of D-xylose lower than control rats (P < 0.0001). We also observed that D-xylose absorption correlates negatively with IgG titres and positively with morphometric parameters (Pearson correlation). In conclusion, the use of serum D-xylose test was useful to identify the presence of small intestinal malabsorption in our antigen specific gut inflammatory reaction rat model.

Influence of a Scientific Initiation Programme on scientific output of professors on a medical course in Brazil.

BACKGROUND: Scientific Initiation Programmes (SIP) are now considered increasingly important in medical courses, and are now being introduced in many medical courses. The School of Medicine at Universidade Federal Fluminense pioneered on optional SIP in 1995. This study aims to compare scientific output of professors who engaged in SIP disciplines (SIP group) with that of professors who did not (non-SIP group). METHODS: Data on the scientific output of both groups was collected from a period that began 4 years before and ended 4 years after the SIP's inception. The average number of papers published or presented in me di cal meetings in both groups was compared. RESULTS: The scientific output of the SIP group was larger than that of the non SIP group (p = 0.0017), except for M.Sc. professors (p = 0.8362). This result did not change when the scientific production of Ph.D. professors was analysed according to the periods before (p = 0.0003) and after (p = 0.0001) SIP's inception. Scientific output of M.Sc. professors of both group were similar in both periods, i.e., before (p = 1.0) and after (p = 0.67) SIP's inception. When scientific output in the periods before and after SIP's inception is compared, it was found that it increased in both groups, SIP (p = 0.0001) and non SIP (p = 0.0086) alike. CONCLUSIONS: After the inception of SIP, all professors had an increase in their scientific output; however, this occurred independently of their engagement in SIP disciplines.

[Cataract extraction using the phacoemulsification technique in patients with uveitis]. / Extração da catarata pela técnica de facoemulsificação em pacientes com uveíte.

PURPOSE: To report outcomes of cataract extraction by phacoemulsification in patients with uveitis. METHODS: We retrospectively reviewed the charts of 189 patients (242 eyes) with uveitis who underwent cataract extraction by phacoemulsification at the Uveitis and Ocular Immunology Unit of McGill University Health Centre, Montreal, Quebec, Canada. RESULTS: Average follow-up was 46 +/- 31.2 months. Average preoperative visual acuity was 20/100 and average postoperative visual acuity was 20/40. Hundred and forty-six eyes (59.9%) attained visual acuity better than 20/40. Visual loss occurred in 26 eyes. The most common peroperative complication was posterior capsule rupture with vitreous loss seen in 7 eyes (3%). Recurrence of uveitis was the most common postoperative complication seen in 73 eyes (30.16%). Other postoperative complications included iris atrophy (28.51%), ocular hypertension (28.09%), epiretinal membrane (26.44%), posterior capsule opacification (19%), cystoid macular edema (13.63%), ocular hypotony (12.80%), optic disc atrophy (8.67%) and posterior synechiae (6.61%). CONCLUSIONS: Cataract extraction by phacoemulsification is safe in patients with uveitis. Successful visual results are observed in long-term follow-up despite the prevalence of recurrence of uveitis, posterior capsule opacification and macular abnormalities. To the best of our knowledge this is the largest series presented to date.

Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma.

BACKGROUND:: Surgical excision is the treatment of choice for basal cell carcinoma and micrographic surgery considered the gold standard, however not yet used routinely worldwide available, as in Brazil. Considering this, a previously developed treatment guideline, which the majority of tumors were treated by conventional technique (not micrographic) was tested. OBJECTIVE:: To establish the recurrence rate of basal cell carcinomas treated according to this guideline. METHOD:: Between May 2001 and July 2012, 919 basal cell carcinoma lesions in 410 patients were treated according to the proposed guideline. Patients were followed-up and reviewed between September 2013 and February 2014 for clinical, dermatoscopic and histopathologic detection of possible recurrences. RESULTS:: After application of exclusion criteria, 520 lesions were studied, with 88.3% primary and 11.7% recurrent tumors. Histological pattern was indolent in 85.5%, 48.6% were located in high risk areas and 70% small tumors. Only 7.3% were treated by Mohs micrographic surgery. The recurrence rate, in an average follow-up period of 4.37 years, was 1.3% for primary and 1.63% for recurrent tumors. Study limitations: unicenter study, with all patients operated on by the same surgeon. CONCLUSION:: The treatment guideline utilized seems a helpful guide for surgical treatment of basal cell carcinoma, especially if micrographic surgery is not available.

Influence of a scientific program for undergraduated medical students upon the published scientific production of professors.

Medical literature has emphasized the role of scientific research and publications in medical education. This study had the aim to detect the impact of PIC (program of scientific support) upon scientific published production of the professors teaching at Universidade Federal Fluminense. The group comprised 32 professors that participated in the PIC for at least 4 semesters. Each issue published was registered as one "product". Between 1996 and 2003, 8 years were considered for the registration of the "products" by each professor. The mean point of this period was the moment when each professor entered the program. For each professor we counted the products during the 4 years before he entered the program and during the 4 years after this occurred. Finally we summed up the products of all professors for the period before entering the program and had the mean. The same was done for the period after entering the program. Applying the paired t test, two means were reached for the two periods of scientific productivity. The same procedure was followed for two subgroups of professors: masters and doctors. The professors had 25.13 products after and 16.81 before the PIC (P< or =0.001); those with a master degree presented 16.36 products after PIC versus 5.18 before (p< or =0.08); doctors, 29.71 products after versus 22.9 products before PIC (p< or =0.028). The authors concluded that the PIC increased written production of professors, either with degree of master or doctor with relevance for those with degree of master.

Surgical treatment of basal cell carcinoma: an algorithm based on the literature.

Although basal cell carcinoma can be effectively managed through surgical excision, the most suitable surgical margins have not yet been fully determined. Furthermore, micrographic surgery is not readily available in many places around the world. A review of the literature regarding the surgical treatment of basal cell carcinoma was conducted in order to develop an algorithm for the surgical treatment of basal cell carcinoma that could help the choice of surgical technique and safety margins, considering the major factors that affect cure rates. Through this review, it was found that surgical margins of 4mm seem to be suitable for small, primary, well-defined basal cell carcinomas, although some good results can be achieved with smaller margins and the use of margin control surgical techniques. For treatment of high-risk and recurrent tumors, margins of 5-6 mm or margin control of the surgical excision is required. Previous treatment, histological subtype, site and size of the lesion should be considered in surgical planning because these factors have been proven to affect cure rates. Thus, considering these factors, the algorithm can be a useful tool, especially for places where micrographic surgery is not widely available.

Risk Factors of Pulmonary Hypertension in Brazilian Patients with Sickle Cell Anemia.

This study was a prospective cross-sectional cohort study of 125 patients with sickle cell anemia (SS) between the ages of 16 to 60 years. Enrolled patients were followed-up prospectively for 15 months. Demographic, clinical, hematological and routine biochemical data were obtained on all patients. Six-minute walk test and Doppler Echocardiography were performed on all patients. A tricuspid regurgitant jet velocity (TRJV) < 2.5 m/sec was considered normal, 2.5 ≤ TRJV ≤ 3.0 was considered mild-moderate and > 3.0 m/sec, severe. Patients with abnormal TRJV were significantly older and more anemic, had significantly higher lactate dehydrogenase (LDH) levels, reticulocyte count and incidence of death. The logistic multimodal model implemented for the 125 patients indicated that age was the covariate that influenced the outcome of normal or abnormal TRJV with a cutoff age of thirty-two years. The survival rate for the group of patients with creatinine (Cr) > 1.0 mg/dL was lower than the group with Cr ≤ 1 and normal TRJV. A coefficient matrix showed that the LDH values were weakly correlated with the reticulocyte count but strongly correlated with hemoglobin suggesting that the TRJV values were not correlated with the hemolytic rate but with anemia. Ten patients died during the follow-up of whom 7 had TRJV > 2.5 m/sec. Acute chest syndrome was the most common cause of death followed by sepsis. In conclusion, this study shows that patients with SS older than thirty-two years with high LDH, elevated TRJV, severe anemia and Cr > 1 have poor prognosis and may be at risk of having pulmonary hypertension and should undergo RHC.

Combined evaluation of adenosine deaminase level and histopathological findings from pleural biopsy with Cope's needle for the diagnosis of tuberculous pleurisy.

INTRODUCTION: Closed needle pleural biopsy (CNPB) has historically been the gold standard procedure for the diagnosis of pleural tuberculosis. Adenosine deaminase (ADA) is an efficient biomarker for tuberculosis that is measurable in pleural fluids. OBJECTIVE: We compared the diagnostic accuracy of the pleural ADA (P-ADA) level and histopathological findings of CNPB specimens in patients with pleural tuberculosis. METHODS: This prospective study consisted of two groups of examinations with a proven diagnosis of pleural effusion. The P-ADA level was measured in 218 patients with pleural effusion due to a number of causes, and 157 CNPB specimens underwent histopathological analysis. RESULTS: CNPBs were performed in patients with tuberculosis (n=122) and other diseases: adenocarcinoma (n=23), lymphoma (n=5), systemic lupus erythematosus (n=4), squamous cell carcinoma (n=2), and small cell lung cancer (n=1). According to the ROC curve, the optimal cut-off value of the P-ADA level (Giusti and Galanti colorimetric method) was equal to or greater than 40.0 U/L. The diagnostic accuracy of the P-ADA test was 83.0%, and that of histopathological examination of the CNPB tissue, was 78.8% (AUC=0.293, P=0.7695). The association between the P-ADA assay and pleural histopathology was 24.41 (P<0.0001). The tetrachoric correlation coefficient was 0.563 (high correlation). CONCLUSION: In Brazil and other countries with a high incidence of tuberculosis, P-ADA activity is an accurate test for the diagnosis of tuberculous pleural effusions, and its use should be encouraged. The high diagnostic performance of the P-ADA test could to aid the diagnosis of pleural tuberculosis and render CNPB unnecessary.

[Endocrine and metabolic expression in bronchogenic carcinoma]. / Expressão hormonal e metabólica dos carcinomas broncogénicos.

In the present paper, the authors reviews the endocrine and metabolic manifestations in bronchogenic carcinoma. Disorders as paraneoplastic syndromes (hypercalcemia, syndrome of inappropriate antidiuretic hormone, carcinoid and Cushing's syndromes) and others endocrinopathies are discussed. Hypertrophic pulmonary osteoarthropathy is briefly reviewed.

[Endocrine and metabolic manifestations in tuberculosis]. / Manifestações endócrino-metabólicas na tuberculose.

In the present paper, the authors reviews the endocrine and metabolic manifestations in tuberculosis. Disorders as adrenal insufficiency, the syndrome of inappropriate antidiuretic hormone secretion (SIADH), hypercalcemia, endocrine effects of antituberculous drugs, hypopituitarism, tuberculous involvement of the thyroid gland and pancreas and chest radiograph presentation in diabetes mellitus are discussed. In the literature, several reports support the presence of abnormal calcium metabolism in tuberculosis.

[Evaluation of coefficient of variation of age in pleural effusion in António Pedro Hospital, Niterói city, state of Rio de Janeiro, Brazil]. / Avaliação do coeficiente de variação da idade dos pacientes com síndroma de derrame pleural no Hospital Universitário António Pedro, cidade de Niterói, estado do Rio de Janeiro, Brasil.

Pleural effusion is a frequent syndrome in Brazil. Tuberculosis is the most prevalent (P) cause. The coefficient of variation (CV) is a useful single measure of variability. The objective of the present work was to evaluate the coefficient of variation in pleural effusion, having as variable the age. 215 patients had appeared after diagnostic physician and for image of syndrome of pleural effusions. Diagnostic thoracentesis, tests on pleural fluid and others invasive surgical procedures to the approach to a patient with pleural effusion. Tuberculosis (P=56.0%; CV=39,7%), adenocarcinoma (P=11.0%; CV=25.1%), transudates (P=12.0%; CV=19.6%), lymphomas (P=2.0%; CV=34.6%), systemic lupus erythematosus (P=2.0%; CV=38.7%), empyema pleural not tuberculosis (P=5.0%; CV=42.2%), pulmonary infarction (P=4.0 %; CV=30.1%) and parapneumonic (P=4.0 %; CV=38.9%) are the causes more prevalent. The analysis on the date showed that the coefficient of variation of age in pleural effusions was high and very high. The values of the coefficient of variation translate a high degree of dispersion of the age of the patients in each cause of pleural effusion.

[Risk predictive factors for the appearing of a second primary lung neoplasms in 104 patients]. / Fatores preditivos de risco para surgimento de segundo tumor maligno primário no pulmão em 104 casos.

OBJECTIVES: The objective of our study was to identify the risks factors for the de development of a second pulmonary primary cancer. METHODS: It was a primary, observational, multicentric and retrospective study with 104 patients from the Cancer National Institute and the Antonio Pedro Universitary Hospital, in Rio de Janeiro, Brazil. RESULTS: The sites of primary tumors were: head and neck (56.7%); with laryngeal carcinoma (42.4%); lungs (15.5%); bladder (8.6%); uterine cervix (7.6%); stomach (4.8%); others (6.8%). Male patients represented 84.6%. Average age 56.7 +/- 10.7 years, with a coefficient of variation 18.8%. Among the patients 91.4% were smokers and 92.0% were alcohol consumers. Multiple logistic regression model: site of primary tumor (OR:8.22; CI 95% - 2.21 to 30.56; p = 0,0017); specific histologic of primary cancer (OR:0.21; IC 95% : 0.04 to 0.99; p = 0.0498); sex (OR: 0.25; CI 95% : 0.03 to 1.81; p = 0.1711); age (OR: 0.98; CI 95%: 0.92 to 1.04; p = 0.6318); smoking (OR: 2.80; CI 95%: 0.44 to 17.55; p = 0.2711) and alcohol consumption (OR:0.76; CIIC 95%: 0.19 to 2.95; p = 0.6964). Adjusted model: odds ratio of the site of the primary tumor was 4.14, ; CI 95%; from 1.36 and 12.78 and p = 0.0123 (p < 0.05). Accuracy or the model: 82. 69%. CONCLUSION: In this study teh site of the primary tumor was the only predictor of risk for the second pulmonary primary cancer.

[Pulmonary aspects in alpha-1-antitrypsin deficiency]. / Aspectos pulmonares na deficiência de alfa-1-antitripsina.

Alpha-1-antitrypsin deficiency is an autosomal hereditary disorder and the large majority of individuals with severe deficiency are protease inhibitor type ZZ. The disease occurs predominantly in white persons of European origin and its frequency in Europe and North America is comparable to that of cystic fibrosis (1 in 2000 to 1 in 7000). Persons with this deficiency may have no clinical manifestations, but the most prevalent clinical disorder associated, also pointed as the most frequent cause of disability and death, is chronic obstructive pulmonary disease. In those individuals, tobacco smoking is the major risk. The condition appears to be widely underdiagnosed, based on studies. Several strategies have been explored in the treatment of this deficiency.

Prevalence of metabolic syndrome in elderly and agreement among four diagnostic criteria.

BACKGROUND: Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. OBJECTIVE: To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. METHODS: Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. RESULTS: Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. CONCLUSION: Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others.

Evaluation of adenosine deaminase activity for the diagnosis of pleural TB in lymphocytic pleural effusions.

AIM: To evaluate the diagnostic value of pleural adenosine deaminase (P-ADA) as a pleural TB-specific biomarker in lymphocytic pleural effusions. MATERIALS & METHODS: Pleural effusions were classified on the basis of definitive diagnosis. RESULTS: A total of 218 patients (122 tuberculous and 96 nontuberculous) were included in the study. The optimal cut-off value of P-ADA (receiver operating characteristic curve) for the diagnosis of pleural TB was 40.0 U/l (Giusti method). In lymphocytic pleural effusions P-ADA had a sensitivity of 80.3%, a specificity of 96.0% and an accuracy of 86.2%. The positive predictive value was 97.0% and the negative predictive value was 75.0%. The positive likelihood ratio and negative likelihood ratio were 19.8 and 0.2, respectively (p < 0.0001). CONCLUSION: P-ADA activity is recommended for the diagnosis of TB in lymphocytic pleural effusions.

Maternal malnutrition during lactation in Wistar rats: effects on elastic fibers of the extracellular matrix in the trachea of offspring.

OBJECTIVE: To investigate the effects of maternal protein malnutrition during lactation on the elastic fibers in the tracheas of Wistar rat pups. METHODS: At delivery, 12 male pups of two Wistar rat dams were equally divided into two groups: control, in which the dam received water and standard rat chow ad libitum during lactation; and protein-restricted (PR), in which the dam received water ad libitum and an isoenergetic PR diet (8% protein). At 21 days of age, the pups were killed and their tracheas were excised. The elastic fibers were stained with Weigert's resorcin-fuchsin (after oxidation) and evaluated under light microscopy. Morphometric determinations were performed by stereology, with the point-counting method, and expressed as volumetric densities. RESULTS: Elastic fibers, most having a longitudinal distribution, were identified beneath the tracheal mucosa. In addition, well-defined circular layers of elastic fibers were found around the inner and outer surfaces of the cartilaginous ring. There were no differences between the groups regarding the organization and distribution of the elastic fibers. The volumetric density of the elastic fibers of the pups in the control and PR groups was 2.46 ± 0.99% and 3.25 ± 1.13%, respectively (p < 0.01). CONCLUSIONS: The volumetric density of elastic fibers appears to be greater in rat pups breastfed by dams receiving a PR diet than in those breastfed by dams receiving a normal diet.

Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma

Abstract BACKGROUND: Surgical excision is the treatment of choice for basal cell carcinoma and micrographic surgery considered the gold standard, however not yet used routinely worldwide available, as in Brazil. Considering this, a previously developed treatment guideline, which the majority of tumors were treated by conventional technique (not micrographic) was tested. OBJECTIVE: To establish the recurrence rate of basal cell carcinomas treated according to this guideline. METHOD: Between May 2001 and July 2012, 919 basal cell carcinoma lesions in 410 patients were treated according to the proposed guideline. Patients were followed-up and reviewed between September 2013 and February 2014 for clinical, dermatoscopic and histopathologic detection of possible recurrences. RESULTS: After application of exclusion criteria, 520 lesions were studied, with 88.3% primary and 11.7% recurrent tumors. Histological pattern was indolent in 85.5%, 48.6% were located in high risk areas and 70% small tumors. Only 7.3% were treated by Mohs micrographic surgery. The recurrence rate, in an average follow-up period of 4.37 years, was 1.3% for primary and 1.63% for recurrent tumors. Study limitations: unicenter study, with all patients operated on by the same surgeon. CONCLUSION: The treatment guideline utilized seems a helpful guide for surgical treatment of basal cell carcinoma, especially if micrographic surgery is not available.

Ocular pulse amplitude in patients with asymmetric primary open-angle glaucoma.

AIM: To evaluate ocular pulse amplitude (OPA) using the dynamic contour tonometer (DCT) in patients with asymmetric primary open-angle glaucoma (POAG) and asymmetric intra-ocular pressure (IOP). METHODS: The participants consisted of 48 patients (96 eyes) with asymmetric POAG. Three measurements of IOP and OPA were taken using DCT. The diagnosis of asymmetry required a difference of glaucomatous visual field loss greater than 6 dB in the global index MD and a difference of 5 mmHg in IOP measured by Goldmann tonometry between the more affected and the contra-lateral eye. All participants underwent full ophthalmologic clinical assessment including ultrasonic pachymetry and biometric measurements. Exclusion criteria were corneal diseases or scars, topical or systemic glaucomatous medications, and previous ocular surgery. RESULTS: No difference (p = 0.142) was found between the axial length measurements of the better eyes group (22.95 ± 0.91 mm) and worse eyes group (22.85 ± 0.97 mm). There was a statistically significant difference (p = 0.011) between the central corneal thickness values of the better eyes group (537.08 ± 29.54 µm) and worse eyes group (534.40 ± 29.87 µm). The OPA values of the better eyes group (3.32 ± 1.14 mmHg) were significantly lower (p = 0.001) than those obtained in the worse eyes group (3.83 ± 1.27 mmHg). When correcting the OPA readings by the IOP there was no statistical difference between groups (p = 0.996). CONCLUSION: Higher OPA values were found in eyes with higher IOP levels and advanced glaucoma's lesions in asymmetric hypertensive POAG patients. However, after the OPA correction by the IOP levels there was no more statistical difference between eyes.