A survey of animal poisonings in New Zealand veterinary practices: perceptions of incidence and frequency of poisoning cases.

AIMS: To survey New Zealand veterinary practices on the incidence and frequency of animal poisonings encountered over a 1-year period. METHODS: A national questionnaire-based cross-sectional online survey was made available to all members of the New Zealand Veterinary Association, active as of 2010, via an email supplying a link to the questionnaire. Veterinary practices listed by the Veterinary Council of New Zealand were also contacted via email or phone. Respondents entered their information on the online survey site or provided a hard copy of their responses, which were then entered by the authors into the database. The questionnaire contained a mixture of tick box options and short answer questions. Responses were analysed using descriptive statistics. RESULTS: Of 463 veterinary practices deemed eligible to complete the survey, 120 (25.9%) responded to the survey. However, only 94 (78.3%) questionnaire entries (78.3%) were deemed adequate for analysis. Veterinary practices (45 mixed practices, 38 companion animal-only practices, nine large animal practices, and two equine-only practices) from 14/16 regions of New Zealand were represented. All respondents affirmed that in the last 12 months, cases of suspected poisoning in animals were attended by veterinarians at their practices and estimated a total of 5,326 poisoning cases. The subcategories most commonly associated with estimated cases of poisoning were pasture mycotoxins (2,133/5,326; 40%), anticoagulant rodenticides (753/5,326; 14.1%), plants (469/5,326; 8.8%), slug/snail baits (305/5,326; 5.7%) and chocolate (221/5,326; 4.1%). Except for anticoagulant rodenticides (once a month), and slug/snail baits, human prescription or over-the-counter drugs, and chocolate (once a year), the majority of respondents reported toxicants caused poisonings seasonally or infrequently. CONCLUSIONS: A variety of poisons were encountered with environmental toxins and household pest control agents being the most common cause of poisoning for animals attended by veterinarians in New Zealand. Most cases of poisoning in animals occurred seasonally or infrequently. Further research is needed to determine the actual number of animals poisoned, the affected species, and the seasons when poisoning occurs in New Zealand. CLINICAL RELEVANCE: : This report provides baseline information on cases of poisoning in animals in New Zealand which could be used for case management, prevention through client education, and poisoning risk assessment.

European Space Agency experiments on thermodiffusion of fluid mixtures in space.

This paper describes the European Space Agency (ESA) experiments devoted to study thermodiffusion of fluid mixtures in microgravity environment, where sedimentation and convection do not affect the mass flow induced by the Soret effect. First, the experiments performed on binary mixtures in the IVIDIL and GRADFLEX experiments are described. Then, further experiments on ternary mixtures and complex fluids performed in DCMIX and planned to be performed in the context of the NEUF-DIX project are presented. Finally, multi-component mixtures studied in the SCCO project are detailed.

Urine retention in cattle putatively associated with injection of an ivermectin and closantel anthelmintic formulation into the ischiorectal fossa.

CASE HISTORY: A group of 39, 19-22-month-old Friesian bulls were administered an ivermectin/closantel anthelmintic via intended S/C injection in the ischiorectal fossa on 15 June 2017 (Day 0). Over the next 50 days, 22 affected bulls presented various degrees of anorexia, abdominal pain and urine dribbling. Seventeen bulls were examined by transrectal ultrasonography which revealed urinary bladder distension in all 17, and peritoneal fluid accumulation in some. Overall, eight bulls died or were subjected to euthanasia. On-farm postmortem examination of three bulls revealed urinary bladder rupture. CLINICAL FINDINGS: On Day 50 one affected live bull was admitted to Massey University for further investigation. This bull continuously dribbled urine and had an overtly distended urinary bladder as determined by rectal palpation and ultrasonography. PATHOLOGICAL FINDINGS: Postmortem examination of this bull revealed a markedly distended urinary bladder, massive subcapsular and pericapsular renal oedema with retroperitoneal fluid accumulation, minimal hydronephrosis and no evidence of mechanical urinary outflow obstruction. The right ischiorectal fossa contained multifocal areas of tissue fibrosis that extended into areas innervated by the distal cutaneous branch of the pudendal nerve and the pelvic nerve. Histopathological changes consisted of extensive fibrosis, myonecrosis and neurodegeneration, and evidence of granulation tissue and inflammation at the putative injection site and in surrounding tissues. DIAGNOSIS: A local inflammatory reaction at the presumed injection site together with localised peripheral neurodegeneration and myelopathy may have led to detrusor-sphincter dyssynergia causing urine retention. CLINICAL RELEVANCE: These cases of urine retention and bladder rupture in cattle were of putative iatrogenic origin. Veterinarians should be aware of this rare complication after S/C injections in the ischiorectal fossa.

Synergistic depression of NMDA receptor-mediated transmission by ketamine, ketoprofen and L-NAME combinations in neonatal rat spinal cords in vitro.

BACKGROUND AND PURPOSE: Spinal N-methyl-D-aspartate (NMDA) receptor/cyclooxygenase (COX) and nitric oxide synthase (NOS) pathways play a major role in nociceptive processing, and influencing them simultaneously may induce synergistic analgesia. This study determined the spinal antinociceptive interactions between ketamine (NMDA receptor channel blocker), ketoprofen (COX inhibitor) and L-NAME (NOS inhibitor) combinations. EXPERIMENTAL APPROACH: Using an in vitro neonatal rat spinal cord preparation, two A-fibre-mediated reflexes, the monosynaptic reflex (MSR) and the low-intensity excitatory postsynaptic potential (epsp), and one C-fibre-mediated reflex, the high-intensity epsp, were evoked electrically. The effect of drugs and drug combinations on these reflexes was assessed and the type of interaction determined by isobolographic analysis. KEY RESULTS: Infusion of ketamine alone decreased all three reflexes. That of ketoprofen decreased both the low and the high-intensity epsp only. Infusion of L-NAME alone produced no significant effects. Co-infusion of fixed ratios of IC(40) fractions of both (ketamine+ketoprofen) and (ketamine+L-NAME) were synergistic for depressing the low and the high-intensity epsps. The interaction was sub-additive for both combinations on the MSR. The only significant effect for the (ketoprofen+L-NAME) combination was synergism on the high-intensity epsp. CONCLUSIONS AND IMPLICATIONS: All three combinations synergistically depressed nociceptive spinal transmission, and both ketamine and ketoprofen and ketamine and L-NAME combinations did so with potentially decreased motor side effects. If such combination profiles also occur in vivo, the present findings raise the possibility of ultimate therapeutic exploitation of increased analgesia with fewer side effects.

Depression of NMDA-receptor-mediated segmental transmission by ketamine and ketoprofen, but not L-NAME, on the in vitro neonatal rat spinal cord preparation.

Activation of spinal N-methyl-D-aspartate (NMDA) receptors and then the nitric oxide and the arachidonic acid pathways is important in pain transmission. This study assessed the effects of the NMDA receptor channel blocker ketamine, the nitric oxide synthase inhibitor L-NAME, and the cyclooxygenase inhibitor ketoprofen in nociceptive transmission using an in vitro neonatal rat spinal cord preparation. Supramaximal electrical stimulation of the dorsal root evoked the A-fibre- and C-fibre-mediated high intensity excitatory postsynaptic potential (EPSP) in the ipsilateral ventral root. Low intensity stimulation evoked the A-fibre-mediated monosynaptic compound action potential (MSR) superimposed on the low intensity EPSP. Both the low intensity EPSP and the high intensity EPSP contain NMDA-receptor-mediated components. Only ketamine and ketoprofen depressed the synaptic responses. Ketamine depressed all three spinal reflexes with IC(50) values (with 95% CI) of 10.80 microM (5.97 to 19.54 microM) for the MSR, 8.29 microM (4.53 to 14.17 microM) for the low intensity EPSP, and 5.35 microM (3.05 to 9.40 microM) for the high intensity EPSP. Ketoprofen depressed the low intensity EPSP and the high intensity EPSP only; IC(50) values (with 95% CI) were 354.5 microM (217.5 to 576.8 microM) and 302.7 microM (174.0 to 526.7 microM), respectively. Reflexes recovered after drug washout. These data demonstrated that ketamine and ketoprofen, but not L-NAME, depressed NMDA-mediated nociceptive transmission in spinal cord preparations from neonatal rats.

Impact of daily number of urgency urinary incontinence episodes on overactive bladder patient reported outcomes.

OBJECTIVE: To explore the impact of urgency urinary incontinence (UUI) on well-being in non-institutionalized patients with overactive bladder (OAB) in a community sample. METHODS: A cross-sectional web-based study was conducted in the general population, including males and females, >18 years of age. Patients with probable OAB were identified using a validated algorithm together with a score ≥8 on the OAB-V8 scale. Presence of coping behavior was considered determinant for the clinical diagnosis of OAB. Individual well-being was determined through a battery of patient-reported outcomes (PRO) measurements including assessment of health-related quality of life (EQ-5D), sleep disturbances (MOS Sleep), and life satisfaction (LISAT-8). Patients were grouped according to the number of daily UUI episodes (UUI severity): 0 (dry OAB),1, 2-3, or ≥4. Multivariate analysis to evaluate factors independently affecting quality of life was undertaken. RESULTS: A total of 396 patients (52.5% women, mean age: 55.3 [11.1] years, OAB-V8 mean score: 14.5 [7.9]) out of 2035 subjects participating from the general population met the criteria for OAB: 203 (51.3%) with 0episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with ≥4 episodes. A statistically significant linear adjusted association was found between number of UUI episodes and PRO scores. Participants with more episodes had poorer health profiles and self-evaluated quality of life, worse life satisfaction, and more sleep disturbances and fewer hours of sleep per night. Number of incontinence episodes was independent factor to affect quality of life using both LISAT-8 and MOS questionnaires. CONCLUSION: Severity of UUI was significantly associated with poorer individual well-being in subjects with OAB in a community sample in Spain.

Sedative and mechanical hypoalgesic effects of butorphanol in xylazine-premedicated donkeys.

REASONS FOR PERFORMING STUDY: Combinations of α2 -adrenoceptor and opioid agonists are commonly used in equids, but little scientific information is available on donkeys. OBJECTIVES: To compare the sedative and hypoalgesic effects of xylazine alone or in combination with different dosages of butorphanol in donkeys. STUDY DESIGN: Placebo-controlled, operator-blinded, randomised, crossover, Latin square study. METHODS: Six donkeys received intravenous normal saline and normal saline (NS-NS); xylazine (0.5 mg/kg bwt) and normal saline (X-NS); xylazine and 10 µg/kg bwt butorphanol (X-B10); xylazine and 20 µg/kg bwt butorphanol (X-B20); xylazine and 30 µg/kg bwt butorphanol (X-B30); and xylazine and 40 µg/kg bwt butorphanol (X-B40). Sedation scores (SS), head height above ground (HHAG) and mechanical nociceptive thresholds (MNT) were assessed before and for 120 min after treatment. Areas under the curve (AUC) values for 0-30, 30-60 and 60-120 min were computed for SS, HHAG and MNT. As appropriate, differences between treatments were analysed using the Friedman test followed by Dunn's test and a repeated measures one-way analysis of variance followed by Tukey's test; significance was set at P<0.05. RESULTS: All treatments apart from NS-NS induced sedation. Butorphanol treatments induced significantly larger SS-AUC0 -30 values than those for NS-NS (P<0.05). Compared to corresponding NS-NS values, HHAG-AUC0 -30 values were significantly smaller for all other treatments (P<0.001) and HHAG-AUC30-60 values were significantly smaller for X-B40 (P<0.05). Compared to NS-NS, all treatments induced mechanical hypoalgesia and yielded significantly larger MNT-AUC0-30 values (P<0.001). Treatment X-NS yielded significantly smaller MNT-AUC0 -30 values than those for X-B30 and X-B40 (P<0.05). Only MNT-AUC30 -60 values for X-B30 and X-B40 were significantly larger than those for NS-NS and X-NS (P<0.05). CONCLUSIONS: Sedation and mechanical hypoalgesia induced by xylazine were enhanced by butorphanol at 40 µg/kg bwt. This drug combination may be suitable for chemical restraint of donkeys undergoing certain clinical procedures.

Effect of butanedione monoxime on the contractility of guinea pig ileum and on the electrophysiological activity of myenteric S-type neurones.

2,3-Butanedione monoxime (BDM) has demonstrated protective effects on isolated cardiac tissues, and on smooth muscle but its mechanism of action is not fully understood. To simultaneously study the effect of BDM on muscle contractility and on neuronal activity, the effect of BDM was tested in the contractile force of myenteric plexus-longitudinal muscle strips and in electrophysiological activity of myenteric S-type neurones of guinea pig ileum. BDM reduces, in a dose-dependent manner, the force of the spontaneous motility and the contractions induced by acetylcholine, bethanechol and electrical stimulation. The same BDM concentrations depolarize the neuronal membrane and reduce the rate of evoked firing. The effect of BDM can be attributed to a direct effect on the smooth muscle and to modifications of the neuronal activity.

Radiohumeral synostosis, femoral bowing, other skeletal anomalies and anal atresia, a variant example of Antley-Bixler syndrome?

We report a newborn with radiohumeral synostosis, femoral bowing, anal atresia, a prominent nose (pear shaped nose), slender ribs, long tapering fingers with distal camptodactyly, genital hypoplasia and a neonatal humeral fracture. Among the possible differential diagnoses a variant example of Antley-Bixler syndrome is considered to be the most likely final diagnosis.

[Stomach content of Spondylus leucacanthus (Bivalvia: Spondylidae) and its relationship with reproduction and phytoplankton in Isla Danzante, Gulf of California]. / Contenido estomacal de Spondylus leucacanthus (Bivalvia: Spondylidae) y su relación con la temporada de reproducción y la abundancia de fitoplancton en Isla Danzante, Golfo de California.

During 1994 we collected specimens of Spondylus leucacanthus near Isla Danzante, Gulf of California. We measured seawater temperature, and sampled stomach contents and phytoplankton. The reproductive season was assessed through the gonadic index. There is a cool season from December to May and a warm season from June to November. The stomach content was composed of detritus (60%), phytoplankton (30%), and unidentified materials (10%). The highest abundance of phytoplankton cells in the bottom water and the stomach content were in March, April, and May, during the seasonal change of temperature. The gonadic index showed a single peak, confirming that the population has an annual pattern of reproduction. The start of gametogenic phase and maturity in the population coincide with the abundance of phytoplankton.

The use of pigment "fingerprints" in the study of harmful algal blooms.

Along the Mexican coast, harmful algae blooms (HAB) have become more frequent, and therefore, there is an urgent need to establish monitoring programs to avoid the undesired consequences of HAB in human and natural ecosystems. In this work, we analyzed the pigment signatures and the species composition from phytoplankton samples to evaluate the utility of the specific pigment "fingerprints" in HAB monitoring programs. Vertical profiles from a coastal lagoon and temporal samples of a red tide occurring in a shrimp-culture pond and in a coastal zone were taken into consideration. Between 76% and 84% of dinoflagellate and diatom cell density was explained by their specific signature variation, in both vertical and temporal samples. Only the variation of zeaxanthin and the cyanobacteria Anabaena sp. showed a poor relationship, probably from difficulties in counting other cyanobacteria present in the samples examined with the microscopic method. These results suggest that inclusion of pigment analysis in the study and monitoring programs dealing with harmful algae would be very useful.

Blooms of Cochlodinium polykrikoides (Gymnodiniaceae) in the Gulf of California, Mexico.

Cochlodinium polykrikoides was the species responsible for the discoloration that occurred between September 15th and 27th, 2000 in a shallow coastal lagoon located in the southern part of the Bahia de La Paz, on the west side of the Gulf of California. Blooms of C. polykrikoides were observed four days after two rainy days with a seawater temperature of 29 to 31 degrees C. Nutrient concentration ranges during the bloom were 0.165-0.897 microM NO2+NO3, 0.16-3.25 microM PO4, and 1.0-35.36 microM SiO4. Abundance of C. polykrikoides ranged from 360 x 10(3) to 7.05 x 10(6)/cells l(-1). Biomass expressed in terms of chlorophyll a was high, ranging from 2.7 to 56.8 mg/m3. A typical dinoflagellate pigment profile (chlorophyll a and c, peridinin, diadinoxantin, and beta-carotene) was recorded. In this study, the red tide occurred in front of several fish and shrimp-culture ponds. No PST toxins were found in the samples. However, 180 fish were found dead in the infected fish-pond; the gills were the most affected part. C. polykrikoides is a cyst-forming species that recurs in this area. New blooms were observed in November 2000 and September-November 2001 in the same area. Anthropogenic activities, such as eutrophication caused by water discharge in this shallow lagoon, and nutrient enrichment in the culture ponds, as well as effects from precipitation and wind stress, could have favored the outbreak of this dinoflagellate.

Paralytic shellfish toxins in the chocolata clam, Megapitaria squalida (Bivalvia: Veneridae), in Bahía de La Paz, Gulf of California.

Occurrence and toxic profiles of paralytic shellfish toxins (PST) in the chocolata clam Megapitaria squalida were investigated. From December 2001 to December 2002, 25 clams were obtained monthly from Bahia de La Paz, Gulf of California. Additionally, net (20 microm) and bottle phytoplankton samples were also collected to identify toxic species. Toxins were analyzed by HPLC with post-column oxidation and fluorescence detection. Toxicity in the clam was low and varied from 0.14 to 5.46 microg/STXeq/100 g. Toxicity was detected in December, March, April, June, and August. Toxin profile was composed mainly by STX, GTX2, GTX3, dcGTX2, dcGTX3, C2, dcSTX and B1. Gymnodinium catenatum was the only PST-producing dinoflagellate identified in the phytoplankton samples throughout the study period. G. catenatum was observed mainly in net samples from December 2001 to December 2002; however, in bottle samples, G. catenatum was only observed in five months. Highest abundance (2600 cells l(-1)) was observed in March and the lowest (160 cells l(-1)) in June. G. catenatum mainly formed two-cell chains and rarely four or eight. The presence of PST in net phytoplankton samples support the fact that G. catenatum is the main source of PST in the clams. This study represents the first report of PST toxins in the chocolata clam from Bahia de La Paz.

Therapeutic benefit in patients switching tolterodine to other novel antimuscarinic agents.

OBJECTIVES: To explore in the daily clinical practice setting that antimuscarinic, Fesoterodine or Solifenacin, provides a greater clinical benefit after changing their prior Overactive Bladder (OAB) therapy with tolterodine extended-release (ER) to other novel antimuscarinic agents. MATERIAL AND METHODS: A post-hoc analysis of data from an observational multicenter, cross-sectional, retrospective study. Adult patients of both sexes, with OAB and OAB-V8 score≥8, who switched to fesoterodine or solifenacin within the 3-4 months before study visit from their prior tolterodine-ER-based therapy due to poor response were included. 92 patients were selected for each treatment group, matched (1:1) according to conditioned probability using the propensity score. Benefit of treatment change perceived by the physician and patient was evaluated by means of the Clinical Global Impression of Improvement subscale (CGI-I) and Treatment Benefit Scale (TBS), respectively. Degree of worry, bother and interference with daily living activities due to urinary symptoms, level of satisfaction, and preference for current treatment were also assessed. RESULTS: Fesoterodine provided a significantly greater improvement than solifenacina in terms of therapeutic benefit perceived by the physician according to ICG-I. 96.7% of the patients on fesoterodine treatment vs. 81.6% of the solifenacin group showed a score of improvement in TBS (P<.05). Fesoterodine was also better rated than solifenacin with regard to satisfaction and preference for the new treatment (93.4 vs. 78.2% P<.05). CONCLUSIONS: In daily clinical practice the switch from tolterodine LP to fesoterodine seems to provide greater benefits both from the physician's and the patient's point of view compared with those provided by solifenacin.

The effect of hyperactive bladder severity on healthcare utilization and labor productivity.

OBJECTIVE: To explore the relationship between the severity of urinary urge incontinence (UUI) on healthcare resources utilization (HRU) and loss of labor productivity of subjects with overactive bladder (OAB) in the general population in Spain. METHODS: Secondary analysis of a cross-sectional web-based study conducted in the general population >18 years, through a battery of HRU questions asked using an online method. Probable OAB subjects were identified using a previously validated algorithm and a score >8 in the OAB-V8 questionnaire. HRU questions included an assessment of concomitant medication used as a consequence of OAB/UUI, pad utilization, and medical office visits. Patients were grouped according to the number of UUI episodes into 0, 1, 2-3 or 4+ episodes. RESULTS: Of a total of 2,035 subjects participating from the general population, 396 patients [52.5% women, mean age: 55.3 (11.1) years, OAB-V8 mean score: 14.5 (7.9)] were analyzed; 203 (51.3%) with 0 episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with 4 or more episodes. A linear and significant adjusted association was observed between the number of UUI episodes and HRU; the higher the number of daily episodes the higher the HRU. Subjects with more episodes had medical visits more frequently at the primary care (P = .001) and specialist (P = .009) level as well. Consumption of day (P < .001) and night (P < .001) urinary absorbents, anxiolytic medicines (P = .021) and antibiotics (P = .05) was higher in patients with more UUI episodes. CONCLUSION: The severity of OAB in terms of frequency of daily urge incontinence episodes was significantly and linearly associated with higher healthcare resources utilization and a decrease in labor productivity in subjects with probable OAB in Spain.

Comparison of the mechanical hypoalgesic effects of five α2-adrenoceptor agonists in donkeys.

Pharmacological pain management is necessary under many clinical situations, but in donkeys little information on analgesic drugs is available. This controlled, randomised, crossover, Latin-square, operator-blinded study aimed to assess and compare the hypoalgesic effects of intravenously administered saline and five α2-adrenoceptor agonists on mechanical nociceptive thresholds (MNT) in donkeys. Areas under the threshold change versus time curve values for 0-30, 30-60, 60-90 and 90-120 minutes postdrug administration were used to compare the effect of treatment. As compared with saline, which did not increase MNT, the overall degree of mechanical hypoalgesia induced by xylazine (1.1 mg/kg), detomidine (20 µg/kg), medetomidine (5 µg/kg) and dexmedetomidine (3.5 µg/kg) was limited to 0-60 minutes, and that of romifidine (100 µg/kg) to 0-120 minutes. Although there were no significant differences between the five α2-adrenoceptor agonists during the first 30 minutes postadministration, hypoalgesia induced by xylazine and dexmedetomidine was significantly less intense than that achieved by detomidine and/or romifidine from 30 to 60 minutes. Differences in the overall degree of hypoalgesia induced by each of the α2-adrenoceptor agonists may influence veterinary surgeons towards choosing a particular drug over others for a particular donkey patient.

Use of analgesic drugs for pain management in sheep.

Awareness of pain and its effects is increasing within the veterinary profession, but pain management in food animals has been neglected. Sheep seldom receive analgesics despite various conditions, husbandry practice and experimental procedures being known to be painful, e.g. footrot, mastitis, vaginal prolapse, castration, vasectomy, penis deviation, and laparoscopy. The evidence supporting use of analgesic drugs in this species is reviewed here. Opioid agonists are of dubious efficacy and are short acting. α2-agonists such as xylazine are good, short-lived analgesics, but induce hypoxaemia. Non-steroidal anti-inflammatory drugs (NSAID) such as ketoprofen provide long-lasting analgesia, but not as marked as that from α2-agonists; they should be more widely used for inflammatory pain. Local anaesthetics reliably block pain signals, but may also induce motor blockade. Balanced analgesia using more than one class of drug, such as an α2 agonist (e.g. medetomidine) and N-methyl-D-aspartate antagonist (e.g. ketamine), with the combination selected for the circumstances, probably provides the best analgesia for severe pain. It should be noted that there are no approved analgesic drugs for use in sheep and therefore the use of such drugs in this species has to be off-label. This information may be useful to veterinary practitioners, biomedical researchers, and regulators in animal welfare to develop rational analgesic regimens which ultimately may improve the health and welfare of sheep in both farming and experimental conditions.

Efficacy of tropicamide, homatropine, cyclopentolate, atropine and hyoscine as mydriatics in Angora goats.

AIM: To document the efficacy of five commercially available mydriatics for their potential for diagnostic and therapeutic use in Angora goats. METHODS: Over 8 weeks, the mydriatic effects of 1% tropicamide, 2% homatropine, 1% cyclopentolate, 1% atropine and 0.25% hyoscine were evaluated. Given as block treatments, drugs were applied randomly to one eye of 10 Angora goats, and the contralateral eye served as a control. Vertical and horizontal pupil diameters were measured to document onset of effect, time to reach a difference of 5 mm in the vertical/horizontal pupil diameter between eyes, time to maximum pupillary dilation, and duration of mydriatic action. RESULTS: Onset of mydriasis for all drugs occurred within 15 minutes. Time to reach a difference of 5 mm in the vertical pupil diameter between eyes was shortest for 1% tropicamide and 0.25% hyoscine (0.5 h), then 2% homatropine and 1% atropine (0.75 h), and longest for 1% cyclopentolate (1.5 h). The maximum vertical pupillary dilation occurred earliest with 1% tropicamide and 1% atropine (2 h), followed by 0.25% hyoscine (3 h), 2% homatropine (4 h), and latest with 1% cyclopentolate (8 h). The duration of vertical dilation of the pupil was shortest with 1% tropicamide (6 h), then 2% homatropine (12 h), 1% cyclopentolate (12 h), 1% atropine (24 h), and longest for 0.25% hyoscine (96 h). The time to reach maximum horizontal dilation of the pupil in treated eyes was shortest with 1% cyclopentolate (1 h), followed by 1% tropicamide (1.5 h), 0.25% hyoscine (3 h), 2% homatropine (3.5 h), and 1% atropine (4 h). The duration of horizontal pupil dilation was shortest with 1% tropicamide (4.5 h), and longest with 0.25% hyoscine (48 h). CONCLUSION: All five mydriatics induced clinical dilation. Tropicamide (1%) had the shortest duration of effect, but gave incomplete dilation. Good dilation was achieved with 1% cyclopentolate and 2% homatropine, but took too long to reach maximum dilation for routine mydriasis. The largest vertical dilation of the pupil was achieved with 1% atropine and 0.25% hyoscine, but pupils remained dilated for more than 24 h. CLINICAL RELEVANCE: For routine mydriasis in goats, it is recommended that 1% tropicamide be used, though there may be incomplete dilation. For a longer duration of mydriasis, such as in the treatment of anterior uveitis, 1% atropine or 0.25% hyoscine would be the drugs of choice.

[Assessment of reasons for overactive bladder treatment change]. / Evaluación de los motivos del cambio de tratamiento para la vejiga hiperactiva.

OBJECTIVES: although efficacious, some patients do not respond optimally to overactive bladder (OAB) treatment. The objective of this study was to identify the reasons why some patients do not respond and to look for reasons for changes in treatment and patient satisfaction with the new treatment. MATERIALS AND METHODS: epidemiological, cross-sectional, non-interventional study to determine the reasons for OAB treatment switching and satisfaction with such OAB treatment switch. OAB patients (OAB-V8≥8), 18 years or more, who had modified their treatment during the previous 3-4 months, were recruited. Demographic data, symptoms, previous, current and concomitant treatments, reasons for treatment switch, clinical global impression (CGI) on disease severity and symptom improvement, Morinsky Green questionnaire, satisfaction with treatment, treatment preference and treatment benefit scale (TBS) were compared. RESULTS: out of 3,365 successive patients, 2,038 (61%) were eligible (61.1±11.2 years; 77% women). The physician decided to switch in 69% of the cases and 31% of patients asked for a change in treatment. Reasons for switching were lack of clinical benefit (60%), side effects (24%), patients' request (8%), non-compliance (6%) and other (2%). 52% of patients complied with new treatment. According to the CGI, 65.4% showed improvement with respect to their previous treatment. 60% were quite/very satisfied with current treatment, 91% preferred it to their previous treatment and 93% reported that their symptoms had improved. CONCLUSIONS: the lack of clinical benefit is the main reason for changing OAB treatment. Most of the patients that switched prefer their new treatment.