[Ocular hypertension in herpes simplex keratouveitis]. / Hipertensiunea intraoculara în keratouveitele date de virusul herpes simplex.

The herpes simplex virus is one of the most common pathogens in humans, who are seropositive for the virus in 90% of the cases at the adult age. It determines reccurent infections in more than a third of the population and these infections depend on the immune response of the host. Ocular infections of newborns are due to the herpes simplex virus type 2, meanwhile type 1 is found predominantly at adults; almost all ocular structures can be affected. HSV-1 in the most frequent etiologic agent in infectious anterior uveitis (with the varicelo-zosterian virus) and it is responsible for 6-10% of all cases of anterior uveitis. More than half of the keratouveitides due to HSV will develop intraocular hypertension and open-angle secondary glaucoma, during reccurences and most of them will resolve after proper control of inflammation.

[Peripheral ulcerative keratitis]. / KERATITA ULCERATIVA PERIFERICA.

Ulcerative keratitis is frequently associated with collagen vascular diseases and presents a predilection for peripheral corneal localization, due to the distinct morphologic and immunologic features of the limbal conjunctiva, which provides access for the circulating immune complexes to the peripheral cornea via the capillary network. Deposition of immune complexes in the terminal ends of limbal vessels initiates an immune-mediated vasculitis process, with inflammatory cells and mediators involvement by alteration of the vascular permeability. Peripheral ulcerative keratitis generally correlates with exacerbations of the background autoimmune systemic disease. Associated sceritis, specially the necrotizing form, is usually observed in severe cases, which may evolve in corneal perforation and loss of vision. Although the first-line of treatment in acute phases is represented by systemic administration of corticosteroids, immunosuppressive and cytotoxic agents are necessary for the treatment of peripheral ulcerative keratitis associated with systemic diseases.

Correlation between left ventricular diastolic function and exercise testing in patients with old myocardial infarction.

There is no correlation between left ventricular (LV) systolic function and effort capacity of the patients with acute or old myocardial infarction (MI). On the other hand, some recent studies suggest such a relationship for LV diastolic function. Twenty-five patients with old MI were submitted to a maximal symptoms limited exercise testing (ET) and to an echo Doppler examination; functional aerobic impairment (FAI), myocardial aerobic impairment (MAI), maximal exercise capacity (METs NYHA class), isovolumic relaxation time (IVRT), E and A wave velocity, E/A rate being calculated. There is a negative significant correlation between MAI and E velocity (r = -0.68), but not between MAI and A velocity or IVRT. The data sustained the correlation between LV diastolic dysfunction and myocardial ischemia, but not with effort capacity of the patients, the last one being determined mainly by other factors. The LV diastolic function indices were modified in anterior but not in inferior MI, in relation with the amount of myocardial necrosis. It is concluded that, like LV systolic function, LV diastolic function does not correlate with the effort capacity of the patients with MI, but it represents a good predictor of the severity of myocardial ischemia mainly in anterior MI.