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Purpose: To determine whether a patient who is non-responder to latanoprost after one month of use should continue using latanoprost or switch to either bimatoprost or travoprost., Patients and Methods: Prospective randomized clinical trial. We recruited new patients who were felt to require intraocular pressure reduction. Patients who had≤20% intraocular pressure reduction after one month of latanoprost treatment were randomly assigned to another month of treatment with latanoprost or a switch to bimatoprost or travoprost for an additional month., Results: Overall, 83 non-responders to latanoprost after one month of treatment were included in the study. Before latanoprost treatment, the mean intraocular pressure was 23.7±4.7mmHg. At randomization on latanoprost, mean intraocular pressure was 21.5±4.5mmHg. One month after the switch of medication, the mean reduction in intraocular pressure was not significantly different between the groups (P=0.148) and was -0.9mmHg, -2.10mmHg and -2.5mmHg, for latanoprost, bimatoprost and travoprost respectively. One month after randomization, 32 (38.5%) of the patients had become responders, with IOP reduction>20%. Of those patients, 9 (31%) were using latanoprost, 13 (41.9%) bimatoprost and 10 (43.5%) travoprost. The number of new responders was similar between the three groups (P=0.584)., Conclusion: There is no added benefit of switching latanoprost to another topical prostaglandin for patients who are initially non-responders. Regression towards the mean and the Hawthorne effect are probably important factors explaining the additional IOP reduction obtained after randomization and explain the result of most switch studies., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

In the treatment of thyroid carcinoma, there is still some discussion about the best operation for a solitary and well encapsulated nodule. 18 years ago, it was decided to treat every case of "cold" thyroid nodule by total lobectomy and isthmectomy. 56 patients were reevaluated 5 to 18 years after such limited operation for malignant nodules. 8 of them died between the 19 th month and the 14 th year after surgery, the death being possibly related to the thyroid cancer in only 4 patients, but without any clinical evidence of local recurrence. Among 50 surviving patients, only one controlateral recurrence was observed, two years after lobectomy; it was treated by surgical totalisation of thyroidectomy, without any new recurrence after 10 more years. These results (although the small number of cases, and too short follow-up exclude definitive conclusions) are comparable to those obtained by a more aggresive surgical approach, but have the great advantage of total absence of any functional sequellae. So are we encouraged to go further in the experience of a rather conservative surgery in the treatment of uninodular thyroid carcinoma.

An unusual of bilateral adrenal benign adenoma with Cushing's syndrome is reported. Nine months after bilateral adrenalectomy, no more sign of hyperadrenocorticism was present. An adenoma was found in each gland with adjacent tissue atrophic. Physiopathology is not clear even if suppression test by dexamethasone and stimulation test by lysin-vasopressin are compatible with a central origin.

Idiopathic arteriovenous fistulae in the renal peduncle are rare. A case was discovered during clinical examination, and was confirmed by total and selective arteriography. A vertebral and dise infection of L3-L4 was also present and blood cultures were positive for enterococcus. This fistula had a high blood-flow rate but it has to be stressed that it was well-tolerated by the cardiovascular system. It was also exceptional in that conservative therapy was possible in this case, which is the eighth reported up to the present time.

The authors report their experience in the surgical correction of aorto-cardiac fistulae. The long term results emphasise the good prognosis in coronaro-cardiac fistulae (13 cases), the problems posed by residual aortic insufficiency in the case of ruptured aneurysms of the sinus of Valsalva (37 cases), the difficulties in diagnosis in the presence of an interventricular communication in association and, finally, the rarity of communications between the aorta and left ventricle (4 cases).