Dexamethasone/Povidone Eye Drops versus Artificial Tears for Treatment of Presumed Viral Conjunctivitis: A Randomized Clinical Trial.

PURPOSE: To determine whether topical dexamethasone 0.1%/povidone-iodine 0.4% reduces the duration of presumed viral conjunctivitis better than artificial tears and whether the treatment relieves the symptoms of this disease. METHODS: Randomized, masked and controlled trial. One-hundred twenty-two patients with a clinical diagnosis of presumed viral conjunctivitis were randomized to either the treatment group or the control group. Physicians and patients were masked to the treatment. Swabs were taken from the conjunctival fornix for adenovirus PCR analyses. Patients in the treatment group received topical dexamethasone 0.1%/povidone-iodine 0.4% eye drops four times daily, and patients in the placebo group received artificial tears four times daily, both for seven days. Symptoms were recorded on the day of recruitment and at the time of a follow-up examination 5, 10 and 30 d later. The main outcome was duration of the disease. The others outcomes were overall discomfort, itching, foreign body sensation, tearing, redness, eyelid swelling, side effects of the eye drops, intraocular pressure and the incidence of subepithelial corneal infiltrates. RESULTS: There was no statistically significant difference between the treatment group and the control group in terms of the patients' symptoms, intraocular pressure and incidence of subepithelial cornea infiltrates during the entire follow-up period. Patients of the treatment group reported more stinging (p < 0.001) and a shorter conjunctivitis duration (9.4 ± 4.6 d in the dexamethasone 0.1%/povidone-iodine 0.4% group versus 11.8 ± 4.9 d in the artificial tears group, p = 0.009). CONCLUSIONS: The use of topical dexamethasone 0.1%/povidone-iodine 0.4% eye drops four times daily appears to reduce the duration of conjunctivitis, although it causes more stinging than artificial tears.

Tumor carcinóide brônquico em carina secundária / Carcinoid tumor in carina secondary

Tumor carcinóide é um tipo de tumor maligno produtor de serotonina que pertence a uma classe de neoplasias conhecida como tumores neuroendócrinos. Tumores carcinóides do pulmão são muito menos comuns e representam 1% a 2% de todos os cânceres pulmonares. Os carcinóides brônquicos típicos têm crescimento lento e são reconhecidos como tumores neurendócrinos de baixo grau. Os sintomas mais comuns são resultado de compressão local e obstrução da árvore brônquica. O diagnóstico pré-operatório é obtido por biópsia na broncoscopia. Este é um relato de caso de uma mulher com tumor carcinóide em brônquio lobar inferior esquerdo em carina secundária. Tratada com lobectomia inferior esquerda, broncotomia e broncoplastia associada à linfadenectomia. A ressecção cirúrgica completa permanece a única terapia com intento curativo na maioria dos pacientes. A ressecção econômica do parênquima é indicada sempre que possível. Recorrência local pode ser tratada eficazmente com cirurgia, considerando que metástases distantes têm um mau prognóstico até mesmo depois de quimioterapia.

Carcinoid tumor is a serotonin-producing malignant tumor belonging to a class of neoplasms known as the neuroendocrine tumors. Carcinoid tumors of the lung are much less common and represent 1% to 2% of all lung cancers. The current classification of lung tumors recognizes bronchial typical carcinoid as low-grade neuroendocrine tumors. Symptoms are usually related to local compression and obstruction of the bronchial tree. Preoperative diagnosis is usually obtained without bronchoscopic biopsy. The authors report the case of a woman with typical carcinoid tumor in the left lower lobar bronchus, next to the secondary carina. It was treated with bronchoplastic resection, and associated to lymphadenectomy. The complete surgical resection remains the only therapy with curative intent in the majority of patients. Local relapse can be treated successfully with surgery, whereas distant metastases have a poor prognosis even after chemotherapy.