Objective To investigate the effect of l7P-oestradiol ophthalmic drops in comparison with a traditional Design Randomised prospective trial. Setting Menopause clinic.Participants Eighty-four postmenopausal women suffering from keratoconjunctivitis sicca and necessitating a hormone replacement therapy (HRT) for general climacteric symptoms. MethodsThe women were randomised into two groups and were given 17P-oestradiol eye drops (n = 42, group 1) or a tear substitute (n = 42, group 2). Both groups received a systemic HRT.Main outcome measures A Schirmer's test was performed immediately before the beginning of therapy and after four months. In addition, eye symptoms were assessed using a visual analogue scale.Results A comparison of visual analogue scores at four months in the women who received 17p-oestradiol eye drops versus those who received a tear substitute demonstrated a statistically significant difference in all observed ocular symptoms (P < 0.0001) The Schirmer's test revealed a significant difference of results before and after treatment in the oestradiol group (P < 0.000 1) while in group 2 no significant difference was found.Conclusions Our study demonstrates that topical oestrogen is successful in treating keratoconjunctivitis sicca while it seems that the blood-eye barrier prevents systemic oestrogens from acting on the conjunctivae.tear substitute in postmenopausal women with keratoconjunctivitis sicca.

We report on a primigravida, who was admitted in the 14th week of pregnancy because of recurrent vomiting and upper abdominal pain. The diagnosis of a large 20 cm echinococcal cyst of the liver was confirmed by ultrasound and an indirect hemagglutination test (IHA). In the 19th week of pregnancy a subtotal cystectomy was performed under perioperative treatment with the anthelmintic drug Albendazole. The patient delivered a 1420 g, 41 cm premature boy in breech position at 33 weeks. The significance of echinococcal cysts in pregnancy is discussed.

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Aim: To evaluate 14 cases of cystic adenomatoid malformation (CAM) of the lung with regard to antenatal management and fetal outcome. Results: Intrauterine shunts were placed in 3 fetuses to avoid pulmonary hypoplasia. Prenatal sonography showed that the lesions had a tendency to resolve in 4 cases. Of the 9 infants who survived, 5 were treated surgically (lobectomy). Conclusions: The antenatal evolution of these lesions is highly variable; the lesions may even resolve spontaneously, therefore the diagnosis of CAM types II and III should be followed by a period of observation. Intrauterine drainage is recommended in cases of CAM type I if unfavorable prognostic factors are encountered.

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