Efficacy and safety of 0.1% lodoxamide for the long-term treatment of superior limbic keratoconjunctivitis.

PURPOSE: To report the therapeutic efficacy and safety of topical 0.1% lodoxamide in the long-term treatment of superior limbic keratoconjunctivitis. METHODS: Sixty-seven eyes of 34 patients with active SLK were studied. Therapeutic response was analyzed according to modified-Ohashi parameters. All eyes were treated with 0.1% lodoxamide twice daily, and those with moderate or severe inflammation received a short course (7-14 days) of 0.1% fluorometholone acetate at presentation and during a relapse. Patients were evaluated at regular intervals and followed up for ≥3 months on continuous therapy. Primary endpoints included inflammatory response; rates of inflammatory control and remission; relapses while on therapy or on remission; and therapeutic failure rate. RESULTS: The mean follow-up time on lodoxamide therapy was 15.3 months. The majority of eyes (82.0%) achieved control of inflammation in a mean time of 2.2 months. Of these, 42 (76.3%) eyes remained under control while on therapy for 13.8 months. There was a significant improvement of SLK-related signs by the third month on therapy (p < 0.05). A total of 24 (35.8%) eyes achieved remission. Relapses presented in 12 (18.0%) treated eyes and in 4 (16.6%) eyes on remission. Only 5 (7.4%) eyes failed to respond to therapy. In the majority of cases (95.3%), lodoxamide 0.1% was well tolerated and minor adverse effects not requiring stopping the medication were reported in only 4.7% of patients. CONCLUSIONS: Lodoxamide 0.1% is an efficacious therapeutic alternative for the treatment of active and chronic SLK. This medication has proved to be safe and well tolerated.

La demencia del rey Fernando VI y el año sin rey / The dementia of King Ferdinand VI and the year with no king

Introducción. Fernando VI fue rey de España entre 1746 y 1759. Su último año de reinado se conoce como el año sin rey. Durante ese año, el monarca sufrió un rápido empeoramiento de sus condiciones mentales. La enfermedad generalmente ha sido atribuida a una condición psiquiátrica primaria, generalmente por un trastorno bipolar. Desarrollo. Se realiza un estudio de investigación en los archivos documentales españoles y bibliotecas en busca de información clínica sobre la enfermedad de Fernando VI. Se realiza una evaluación y discusión clínica de la enfermedad del rey sobre la base de la información obtenida. Conclusiones. El inicio del empeoramiento clínico del último año de Fernando VI empezó tras la muerte de su amada esposa. Los síntomas iniciales descritos pueden ser similares a los de un episodio depresivo mayor, sin embargo, el monarca sufrió un empeoramiento rápidamente progresivo con alteraciones de la personalidad, conductuales, encamamiento, pérdida de control de esfínteres y crisis epilépticas. Los últimos meses de su vida estuvo en un estado de postración con un estado cognitivo compatible con una demencia grave. Por todo ello, aunque es posible que Fernando VI pudiera padecer previamente algún tipo de trastorno psiquiátrico, la enfermedad que le llevó a su muerte precoz sería compatible con lo que hoy conocemos como una demencia rápidamente progresiva (AU)

Introduction. Ferdinand VI was king of Spain from 1746 until 1759. His last year of reign is known as the year without a king. Over this year the king suffered a rapidly progressive deterioration of his mental health status. The clinical condition has been always attributed to a pure psychiatric disorder, generally a bipolar disorder. Development. We review the sources of information in the Spanish archives and libraries, in order to find clinical information about the illness suffered by the king. We made a clinical evaluation and discussion about the disease of the king according to the information that has been obtained and the different diseases that could have caused the illness. Conclusions. Last year clinical deterioration of Ferdinand VI started with the death of his lovely wife. At first, the symptoms were similar to the symptoms of a mayor depressive disorder. Although the king had a rapidly progressive deterioration with severe changes in behavior and conduct, long stay in bed, loss of sphincters control and seizures. During the last months of his life, the king fell into a state of prostration with a marked cognitive impairment. Although it is possible that Ferdinand VI could have had a previous psychiatric disorder, there is enough information to think about a rapidly progressive dementia as the main cause of his clinical worsening and dead (AU)