RESUMO
Conventional induction protocol (CIP) of calving in buffaloes employs the intramuscular (IM) administration of dexamethasone (40 mg) and cloprostenol sodium (500 µg). If there is no progression in terms of cervical dilatation, then a second dose of cloprostenol sodium (500 µg) is administered intramuscularly. This protocol possesses certain demerits: (1) a wide range of response time intervals, and (2) increased risk of fetal membrane retention. Considering the cervix as a caudal continuation of the myometrium with its own contractile potential, and the limitations of CIP, we developed intracervical (IC) drug administration route in buffaloes. The proposed technique was evaluated for its use in a total of 22 cases of incomplete cervical dilatation in uterine torsion-affected buffaloes (IC-14 and IM-8). In addition to CIP, the IC group received an intracervical injection of cloprostenol sodium (500 µg) at the start of the experiment whereas the IM group received an extra intramuscular dose of cloprostenol sodium (500 µg) either after 24 h or when no progression in cervical dilatation is noticed. Surprisingly, the average response time during the experiment in the IC group was 5.8 h shorter (p < 0.000) than in the IM group (IC-5.7 ± 0.17 h vs. IM-11.9 ± 0.74 h). The duration from calving to fetal membrane expulsion (IC-12.8 ± 0.60 h vs. IM-17.5 ± 1.40 h; p < 0.002) and incidence of retention of fetal membrane were also less in the IC group (57.1% vs. 87.5%). The proposed intracervical drug administration potentiates cervical dilatation and can be regarded as a safe, effective, and feasible technique for attaining reliable results.
Assuntos
Bison , Prostaglandinas , Feminino , Animais , Prostaglandinas/farmacologia , Búfalos/fisiologia , Útero , Colo do Útero , Cloprostenol/uso terapêutico , Cloprostenol/farmacologiaRESUMO
BACKGROUND: Bimatoprost 0.03% is an intraocular pressure (IOP) lowering prostaglandin analog with different adverse side effects such as potential ocular inflammatory effect and ocular hyperemia. CASE PRESENTATION: We report a case of 80-year-old woman diagnosed with bilateral glaucomatous uveitis, and choroidal detachment in the left eye after topical bimatoprost administration. During the patient's hospitalization, Bimatoprost treatment was discontinued and local steroid therapy was administrated. After 1 week we reported a marked improvement of visual acuity, IOP measurement was 12 mmHg in both eyes. Anterior segment examination showed complete resolution of conjunctival and pericheratic hyperemia with significant reduction of endothelial precipitates in both eyes. CONCLUSIONS: In our case, the anterior granulomatous uveitis occurred in both pseudophakic eyes and the choroidal detachment (CD) in the eye that previously had trabeculectomy. Probably the scar tissue of the trabeculectomy allowed a better penetration of the Bimatoprost or a greater sensitivity due to an altered trabecular tissue. This work confirms that the onset physiopathology mechanism of granulomatous uveitis and CD following instillation of Bimatoprost remains uncertain.
Assuntos
Efusões Coroides , Glaucoma , Hiperemia , Uveíte Anterior , Uveíte , Idoso de 80 Anos ou mais , Amidas/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Bimatoprost/efeitos adversos , Cloprostenol/uso terapêutico , Feminino , Glaucoma/induzido quimicamente , Glaucoma/tratamento farmacológico , Humanos , Hiperemia/induzido quimicamente , Pressão Intraocular , Uveíte/induzido quimicamente , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte Anterior/tratamento farmacológicoRESUMO
Cystic endometrial hyperplasia-pyometra complex (CEH/P) is a challenge in canine reproduction. Present study aimed to assess fertility after medical treatment. One-hundred-seventy-four bitches affected by CEH/P received aglepristone on days 1, 2, 8, then every 7 days until blood progesterone < 1.2 ng/mL; cloprostenol was administered on days 3 to 5. Records were grouped according to bodyweight (BW): small (< 10 kg, n = 33), medium (10 ≥ BW < 25 kg, n = 44), large (25 ≥ BW < 40 kg, n = 52), and giant bitches (BW ≥ 40 kg, n = 45). Age; success rate; aglepristone treatments number; relapse, pregnancy rates; diagnosis-relapse, -first, -last litter intervals; litters number after treatment, and LS were analyzed by ANOVA. Overall age was 5.14 ± 1.75 years, without difference among groups. Treatment was 100% successful, without difference in treatments number (4.75 ± 1.18), relapse (15/174, 8.62%) and pregnancy (129/140 litters, 92.14%) rates, intervals diagnosis-relapse (409.63 ± 254.9 days) or -last litter (418.62 ± 129.03 days). The interval diagnosis-first litter was significantly shorter (163.52 ± 51.47 days) and longer (225.17 ± 90.97 days) in small and giant bitches, respectively. Overall, 1.47 ± 0.65 litters were born after treatment. Expected LS was achieved in each group, as shown by ΔLS (actual-expected LS by breed, overall -0.40 ± 1.62) without differences among groups. Concluding, CEH/P affects younger dogs than previously described. Relapses were rarer than previously reported. Medical treatment with aglepristone+cloprostenol is effective and safe, preserving subsequent fertility, as demonstrated by negligible changes in LS.
Assuntos
Doenças do Cão/prevenção & controle , Hiperplasia Endometrial/veterinária , Fertilidade , Tamanho da Ninhada de Vivíparos , Luteolíticos/uso terapêutico , Taxa de Gravidez , Piometra/veterinária , Animais , Cloprostenol/uso terapêutico , Doenças do Cão/fisiopatologia , Cães , Hiperplasia Endometrial/fisiopatologia , Hiperplasia Endometrial/prevenção & controle , Estrenos/uso terapêutico , Feminino , Gravidez , Piometra/fisiopatologia , Piometra/prevenção & controle , RecidivaRESUMO
Twenty-five Thoroughbred jumper geldings suffered back soreness with poor performance, and 5 control horses were assessed by archived computer data, clinical examination, and laboratory analyses of complete blood picture, serum enzymes, and cortisol level, before and after cloprostenol-pharmacopuncture. The 25 diseased horses before therapy showed significant increases in aspartate aminotransferase and creatine phosphokinase with clinical pains scored mild in 15 horses, moderate in 9 horses, and severe in one horse, without changes in the hormonal and hematological data. After therapy, they responded by an increase of heart rate (57.8 ± 4.3 bpm), body temperature (38.5 ± 0.7°C), respiration rate (28.3 ± 2.1 bpm), and capillary refilling time (CRT) (1.0 ± 0.0). On the 2nd day, a significant decrease in the mean levels of aspartate aminotransferase and creatine phosphokinase (P = 0.001) was detected, while on the 4th day, they mimed the level of the 5 controls, and on the 6th day, they showed a significant decrease (P = 0.002). The serum cortisol level showed a significant increase on the 6th day of treatment (P = 0.013). The blood picture showed significant increases in red blood cells, mean corpuscular volume, platelets, white blood cells, hemoglobin, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean platelet volume, platelet distribution width, lymphocytes, plateletcrit, and large platelet concentration ratio (P < 0.05) and nonsignificant changes in hematocrit, granulocytes, and midocytes. The improved blood parameters, enzymes, hormones, and performance progress after cloprostenol-pharmacopuncture proved its effectiveness in treating back soreness in athletic horses.
Assuntos
Pontos de Acupuntura , Terapia por Acupuntura/veterinária , Dor nas Costas , Cloprostenol/uso terapêutico , Doenças dos Cavalos/terapia , Animais , Dor nas Costas/terapia , Dor nas Costas/veterinária , Cavalos , Bexiga Urinária/fisiologiaRESUMO
Previous studies have compared the effectiveness of dinoprost and cloprostenol in cows yielding conflicting results. The aim of our study was to evaluate the efficacy of single treatment with cloprostenol or dinoprost on estrus and reproductive performance in cows with unobserved estrus after service. The study was conducted over four years in two dairy herds of Polish Holstein Frisian cows under a herd health program with an average milk yield per cow over 9000 L. Cows (n=523) diagnosed ultrasonographically as non-pregnant and with a corpus luteum were randomly assigned to be treated with either cloprostenol (n=261) or dinoprost (n=262). The estrus detection rates after administration of cloprostenol or dinoprost were 59.4%, and 57.6%, respectively. The difference between both groups was not statistically significant (p>0.05). Distribution of observed estrus did not differ between cloprostenol and dinoprost. There were no differences (p>0.05) between cloprostenol and dinoprost in conception rate (65.2% vs. 66.2%, respectively) and pregnancy rate (57.5% vs. 54.9%, respectively). Mean days open were similar in cows of both treatments (177.5 ± 74.6 days vs. 175.8 ± 62.6 days, respectively; p>0.05). In conclusion, data from this study showed no significant differences in estrus detection rates and fertility between cows with unobserved estrus after service treated with cloprostenol or dinoprost. Both products are equally useful for the treatment of non-pregnant dairy cows with anestrus after service within a reproductive herd health program.
Assuntos
Cloprostenol , Dinoprosta , Sincronização do Estro , Ocitócicos , Animais , Bovinos , Cloprostenol/uso terapêutico , Dinoprosta/uso terapêutico , Estro , Feminino , Inseminação Artificial , Lactação , Ocitócicos/uso terapêutico , Gravidez , ProgesteronaRESUMO
Hydrometra is characterized by the accumulation of fluid within the uterus due to the persistence of corpus luteum. The diagnosis of this disorder occurs with an ultrasonic exam. This study evaluated uterine drainage and fertility rates in goats after the use of d-cloprostenol in association or not with Gonadotropin-releasing hormone (GnRH) treatment. Twenty Saanen goats, diagnosed with hydrometra, received three 37.5-µg doses of d-cloprostenol laterovulvarly at 10-day intervals. On D5, the goats were assigned into two groups receiving 1 mL of GnRH or saline solution intramuscularly. Ultrasonography (US) was performed from D0 to D25. An US approach was used to rank hydrometra in scores. The pregnancy rate was assessed 45 and 90 days after the end of treatment. The uterine fluid was totally drained after the first and second administration of d-cloprostenol in 50% and 95% of the goats, respectively. In one female, full emptying of the uterus occurred only after D20. US performed at 45 and 90 days after the end of treatment indicated there was a pregnancy rate of 45.0% and 55.0%, respectively. Fertility did not differ between the GnRH-treated and control goats. Those goats not pregnant at 45 days had a follicular cyst, hydrosalpinx or hydrometra. At 90 days, no change was observed in the hydrosalpinx, and four goats had hydrometra. The use of three doses of d-cloprostenol 10 days apart was efficient for induction of draining the contents of the uterus, resulting in a relatively acceptable pregnancy rate. This treatment associated with the US approach can be important when applied in the field.
Assuntos
Cloprostenol/uso terapêutico , Doenças das Cabras/tratamento farmacológico , Ultrassonografia/veterinária , Doenças Uterinas/veterinária , Animais , Dinoprosta , Sincronização do Estro , Feminino , Doenças das Cabras/diagnóstico por imagem , Doenças das Cabras/fisiopatologia , Cabras , Hormônio Liberador de Gonadotropina , Inseminação Artificial , Gravidez , Taxa de Gravidez , Reprodução , Estações do Ano , Ultrassom , Ultrassonografia/métodos , Doenças Uterinas/diagnóstico por imagem , Doenças Uterinas/tratamento farmacológico , Doenças Uterinas/fisiopatologiaRESUMO
Selective laser trabeculoplasty (SLT) is an effective treatment to treat open-angle glaucoma with a low risk of complications. The case is presented of a 73 year-old woman with uncontrolled primary open-angle glaucoma who underwent selective laser trabeculoplasty in both eyes and developed bilateral choroidal effusion.
Assuntos
Doenças da Coroide/etiologia , Terapia a Laser/efeitos adversos , Trabeculectomia/efeitos adversos , Idoso , Amidas/efeitos adversos , Amidas/uso terapêutico , Tartarato de Brimonidina/uso terapêutico , Cloprostenol/efeitos adversos , Cloprostenol/análogos & derivados , Cloprostenol/uso terapêutico , Terapia Combinada , Combinação de Medicamentos , Emergências , Exsudatos e Transudatos , Feminino , Glaucoma de Ângulo Aberto/tratamento farmacológico , Glaucoma de Ângulo Aberto/cirurgia , Humanos , Timolol/efeitos adversos , Timolol/uso terapêuticoRESUMO
AIMS: To investigate the effect of targeted resynchronisation of cows treated for non-observed oestrus before the planned start of mating (PSM), that were not detected in oestrus or pregnant 23 days after treatment (phantom cows), on the proportion pregnant at 42 days after PSM and the end of mating. METHODS: Farm staff from eight herds in two regions of the South Island of New Zealand identified 1,819 cows not showing oestrus by 10 days before PSM. These cows were treated with intravaginal progesterone for 7 days, and I/M gonadorelin 10 days and 1 day before PSM. Three days before PSM they were injected with cloprostenol and equine chorionic gonadotrophin, with fixed time artificial insemination (FTAI) at PSM. By 23 days after PSM, 1,218 cows had not returned to oestrus. Of these, 161 cows confirmed not pregnant by transrectal ultrasonography were randomly assigned to no treatment (control group; n=74) or were resynchronised 25 days after PSM using the same treatment programme as above, with FTAI 35 days after PSM (n=87). All cows that returned to oestrus were artificially inseminated until 42 days after PSM, when natural mating was used. All cows were examined using transrectal ultrasonography 80 to 90 days after PSM to confirm conception dates. RESULTS: Of the 1,819 anoestrous cows treated before PSM, 526 (29 (95% CI=23.1-34.0)%) had not been observed in oestrus by 23 days after PSM and had not conceived, so were diagnosed as phantoms cows. For resynchronised cows, 42/87 (48 (95% CI=37.8-58.8)%) were pregnant by 42 days after PSM compared to 21/74 (28 (95% CI=18.1-38.7)%) control cows (p=0.009). At the end of mating 58/87 (67 (95% CI=56.6-76.7)%) cows in the resynchronised group were pregnant and 46/74 (62 (95% CI=50.9-73.2)%) in the control group (p=0.554). The hazard of conception from 21 to 42 days after PSM was 1.9 (95% CI=1.07-3.12) times greater for resynchronised than control cows (p=0.026). CONCLUSION: In cows not observed in oestrus and treated before PSM, resynchronisation increased the proportion pregnant by 42 days after PSM. CLINICAL RELEVANCE: The benefit of resynchronisation depends on the number of anoestrous cows before PSM and the number of phantom cows after PSM. However at the herd-level it is likely that providing advice to reduce the known risk factors for cows not being observed in oestrus before the PSM may well be more cost effective than identifying and treating a sub-population of phantom cows.
Assuntos
Anestro , Sincronização do Estro/métodos , Administração Intravaginal , Animais , Bovinos , Gonadotropina Coriônica/uso terapêutico , Cloprostenol/administração & dosagem , Cloprostenol/uso terapêutico , Indústria de Laticínios/métodos , Feminino , Hormônio Liberador de Gonadotropina/administração & dosagem , Hormônio Liberador de Gonadotropina/uso terapêutico , Injeções Intramusculares/veterinária , Inseminação Artificial/métodos , Inseminação Artificial/veterinária , Nova Zelândia , Gravidez , Progesterona/administração & dosagem , Progesterona/uso terapêuticoRESUMO
PURPOSE: To assess IOP-lowering efficacy of bimatoprost/timolol fixed combination (Ganfort®) in patients with diabetes mellitus (DM) and uncontrolled secondary neovascular glaucoma (NG). MATERIALS AND METHODS: Fifty patients (51 eyes) with uncontrolled secondary neovascular glaucoma and diabetes mellitus were enrolled in the study. All patients with an uncontrolled IOP have been proposed to switch current IOP-lowering therapy to Ganfort®. In case target IOP level was not reached filtration surgery was recommended. Ganfort® administration - once a day in the morning. RESULTS: IOP-lowering has been observed in all patients when switched to Ganfort®. Mean IOP level was almost 3-x lower versus baseline in 72.5% of patients (37 eyes). The patients achieved target IOP of 15-17 mmHg. As a result, no surgical intervention was required. Significant IOP-lowering has been observed in another group of patients (14 eyes, 27.5 %) nevertheless due to glaucoma progression, these patients are still subjected to surgical treatment. CONCLUSION: IOP-lowering fixed combination Ganfort® (Allergan) can be used in patients with secondary neovascular glaucoma and diabetes mellitus as a drug of choice to control the IOP level. Even in cases when target IOP is not achieved, Ganfort® can be administered in pre-operative period and helps to reduce postoperative complications.
Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Amidas/uso terapêutico , Cloprostenol/análogos & derivados , Angiopatias Diabéticas/tratamento farmacológico , Glaucoma Neovascular/tratamento farmacológico , Pressão Intraocular/efeitos dos fármacos , Timolol/uso terapêutico , Antagonistas Adrenérgicos beta/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Amidas/efeitos adversos , Cloprostenol/efeitos adversos , Cloprostenol/uso terapêutico , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/fisiopatologia , Combinação de Medicamentos , Substituição de Medicamentos , Feminino , Glaucoma Neovascular/diagnóstico , Glaucoma Neovascular/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Timolol/efeitos adversos , Resultado do TratamentoRESUMO
Postpartum endometritis is considered as one of the diseases that lead to a potential profit reduction in dairy cows. The aims of the present study were to promote follicle growth by a previously used controlled internal drug release (CIDR) device and to evaluate its effect on the likelihood of recovery and the reproductive performance of clinical endometritis (CE) cows. Endometritis was diagnosed using ultrasonographic examination at 31 ± 3 (Day 0 of the experiment) days in milk, and CE cows were included in one of the three experimental groups according to the presence of a CL on their ovaries. Cows without CL on their ovaries received a reused CIDR device, which was previously used for 14 days (CIDR-14, n = 108), or PGF2α (PG-1, n = 112) on Day 0. In the third group, those with CL on their ovaries received PGF2α (PG-2, n = 107) at the same time. Ovarian structures, serum estradiol and progesterone concentrations were measured on Days 0, 7, and 14. Controlled internal drug release devices were removed, and response to treatment was evaluated in all treated cows on Day 14. Diameters of ovarian follicles were 11.61 ± 0.50, 12.46 ± 0.25, and 18.36 ± 0.60 mm on Day 7 and 11.63 ± 0.58, 14.35 ± 0.40, and 21.96 ± 0.77 mm on Day 14 in PG-1, PG-2, and CIDR-14 cows, respectively (P < 0.05). Serum estradiol concentrations were higher in CIDR-14 cows (141.17 ± 1.04 pg/mL) than in PG-1 (116.85 ± 1.05 pg/mL) and PG-2 (119.10 ± 1.05 pg/mL) cows on Day 7 (P < 0.05). Higher progesterone concentrations were observed in PG-2 cows than in PG-1 and CIDR-14 cows on Days 0, 7, and 14 (P < 0.001). The likelihood of clinical cure was 54.46%, 62.61%, and 64.81% in PG-1, PG-2, and CIDR-14 cows, respectively (P = 0.11). First-service conception risk, days to the first service, calving to conception interval, proportion of cows bred and pregnant by 120 days in milk did not differ among the treated groups (P > 0.05). The cumulative pregnancy risk was lower in PG-1 (77.67%) cows than in CIDR-14 (87.07%) and PG-2 (87.85%) cows (P = 0.02). In conclusion, reused CIDR would be contributed to the treatment of CE by promotion of follicle growth and induction of sustainable sources of endogenic estrogen secreted by the dominant follicle.
Assuntos
Doenças dos Bovinos/tratamento farmacológico , Preparações de Ação Retardada/uso terapêutico , Endometrite/veterinária , Animais , Bovinos , Doenças dos Bovinos/diagnóstico por imagem , Cloprostenol/administração & dosagem , Cloprostenol/uso terapêutico , Dinoprosta/administração & dosagem , Dinoprosta/uso terapêutico , Endometrite/diagnóstico por imagem , Endometrite/tratamento farmacológico , Estradiol/sangue , Feminino , Modelos Logísticos , Luteolíticos/administração & dosagem , Luteolíticos/uso terapêutico , Folículo Ovariano/diagnóstico por imagem , Folículo Ovariano/efeitos dos fármacos , Progesterona/sangue , UltrassonografiaRESUMO
OBJECTIVE: To determine whether the aqueous levels of matrix metalloproteinases (MMPs) differ between patients with glaucoma treated with topical prostaglandin analogues and normal, nonglaucomatous control patients. Also, to note any difference in MMP levels between latanoprost, travoprost, and bimatoprost that might suggest a difference in efficacy or mechanism of action between these drugs. DESIGN: Prospective, observational study. PARTICIPANTS: Patients who were scheduled to undergo routine intraocular surgery (phacoemulsification or combined phacotrabeculectomy) as part of their standard clinical care were included. Eighteen eyes of 18 patients with glaucoma using any 1 prostaglandin analogue (latanoprost, travoprost, or bimatoprost) were compared with 8 normal control patients. METHODS: This was a multicentre study. Aqueous humour (0.2 mL) was aspirated at the beginning of the intraocular surgery through a clear corneal paracentesis. MMP-2 and -9 were quantified in the aqueous of all participants using enzyme-linked immunosorbent assay. RESULTS: There was no significant difference in the levels of either MMP-2 (p = 0.216) or MMP-9 (p = 0.552) between the control patients and the patients with glaucoma on prostaglandins. There was no difference in the levels of MMP-2 or -9 between the latanoprost, travoprost, or bimatoprost groups. CONCLUSIONS: The levels of MMP-2 and -9 in aqueous of glaucomatous eyes on topical prostaglandin analogues were the same as those of normal age-matched control patients. This could reflect either a return to normal levels with efficacious treatment or a lack of difference between disease and nondisease states.
Assuntos
Anti-Hipertensivos/uso terapêutico , Humor Aquoso/enzimologia , Glaucoma/tratamento farmacológico , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Prostaglandinas F Sintéticas/uso terapêutico , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Amidas/uso terapêutico , Bimatoprost , Cloprostenol/análogos & derivados , Cloprostenol/uso terapêutico , Ensaio de Imunoadsorção Enzimática , Feminino , Glaucoma/enzimologia , Humanos , Latanoprosta , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Estudos Prospectivos , TravoprostRESUMO
IMPORTANCE: Selective laser trabeculoplasty (SLT) should be explored as a therapeutic option in eyes with angle closure. OBJECTIVE: To assess the intraocular pressure (IOP)-lowering efficacy of SLT in eyes with primary angle closure (PAC) and PAC glaucoma (PACG). DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial at tertiary eye care institutions of 100 patients diagnosed as having PAC or PAC glaucoma in which the angles had opened at least 180° (visible posterior trabecular meshwork on gonioscopy) after laser iridotomy. Recruitment and baseline were completed from June 2009 to April 2012 and 6-month follow-up was completed from December 2009 to November 2012. INTERVENTIONS: Eligible patients with a baseline IOP greater than 21 mm Hg were randomized to either SLT or prostaglandin analog (PGA; travoprost, 0.004%). The SLT was repeated if the IOP reduction was less than 20.0% from baseline at the 1- or 3-month follow-up visit. MAIN OUTCOMES AND MEASURES: The primary outcome measure was the change in IOP from baseline to the final follow-up visit (at 6 months). The frequency of additional postoperative treatments and complications were secondary outcomes. RESULTS: Fifty patients (96 eyes) were randomized to SLT and 50 patients (99 eyes) to PGA medical therapy. At 6 months, 49 patients in the SLT group and 47 in the PGA group completed follow-up. Analysis was based on intent to treat. At 6 months, IOP decreased by 4.0 mm Hg (95% CI, 3.2-4.8) in the SLT group (P < .001) and by 4.2 mm Hg (95% CI, 3.5-4.9) in the PGA group (P < .001). There were no differences between the SLT and PGA groups in the absolute mean reduction of IOP (4.0 vs 4.2 mm Hg, respectively; P = .78) or in the percentage of reduction in IOP (16.9% vs 18.5%, respectively; P = .52). Complete success (IOP ≤21 mm Hg without medications) was achieved in 60.0% eyes of the SLT group, compared with 84.0% of eyes in the PGA group (P = .008). No patients required glaucoma surgery. Additional medications were required in 22.0% of patients in the SLT group compared with 8.0% in the PGA group (P = .05). One patient in the SLT group (2.0%) had a transient posttreatment IOP spike greater than 5 mm Hg. The mean endothelial cell count showed a significant decrease from baseline in the SLT arm (4.8% decrease; P = .001). No other events such as persistent uveitis or increase in peripheral anterior synechiae were noted in eyes that underwent SLT. Two patients in the PGA group exited owing to drug-related complications (1 patient with uveitis and 1 with allergic conjunctivitis). CONCLUSIONS AND RELEVANCE: Eyes with PAC or PACG respond to SLT in the short term, but the overall long-term therapeutic effectiveness needs further evaluation. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01004900.
Assuntos
Cloprostenol/análogos & derivados , Procedimentos Cirúrgicos Eletivos/métodos , Glaucoma de Ângulo Fechado/cirurgia , Pressão Intraocular , Terapia a Laser/métodos , Trabeculectomia/métodos , Idoso , Anti-Hipertensivos/uso terapêutico , Cloprostenol/uso terapêutico , Feminino , Seguimentos , Glaucoma de Ângulo Fechado/tratamento farmacológico , Glaucoma de Ângulo Fechado/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Travoprost , Resultado do TratamentoRESUMO
BACKGROUND: The efficacy and safety of bimatoprost ophthalmic solution 0.03% for treating hypotrichosis were shown in a randomized controlled trial and in an open-label study. To date, no data on real-world experience have been published. OBJECTIVE: To evaluate long-term patient satisfaction, usage patterns, and safety of bimatoprost 0.03% in clinical practice. MATERIALS AND METHODS: In this retrospective chart review with a cross-sectional design, adult patients exposed to bimatoprost 0.03% for at least 12 months were randomly sampled from 16 investigational sites. Charts were reviewed for medication usage characteristics and adverse events (AEs). At a study visit, questionnaires eliciting patient-reported outcomes were administered and spontaneously reported AEs were tabulated. RESULTS: Analysis included 585 subjects with a mean (SD) treatment duration of 19.3 (4.3) months. Patient satisfaction with bimatoprost 0.03% was 92.5%; on average, approximately 3 applications per week maintained benefits. Overall, 27.4% of patients spontaneously recalled experiencing AEs while on treatment; however, patient charts showed that only 4 AEs were documented. No instances of iris hyperpigmentation occurred. No serious or severe AEs were noted. CONCLUSION: Treatment with bimatoprost 0.03% for at least 12 months is safe, and long-term use is associated with a high degree of satisfaction.
Assuntos
Amidas/uso terapêutico , Cloprostenol/análogos & derivados , Pestanas , Hipotricose/tratamento farmacológico , Soluções Oftálmicas/uso terapêutico , Satisfação do Paciente , Adulto , Amidas/efeitos adversos , Bimatoprost , Cloprostenol/efeitos adversos , Cloprostenol/uso terapêutico , Estudos Transversais , Eritema/induzido quimicamente , Doenças Palpebrais/induzido quimicamente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/efeitos adversos , Transtornos da Pigmentação/induzido quimicamente , Prurido/induzido quimicamente , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the intraocular pressure (IOP) lowering effect of 2 trabecular microbypass stents and postoperative travoprost in patients with open-angle glaucoma (OAG) not controlled on 2 medications preoperatively. SETTING: S.V. Malayan Ophthalmology Centre, Yerevan, Armenia. DESIGN: Prospective open-label nonrandomized study. METHODS: This prospective pilot study involved 39 qualified phakic patients with OAG, medicated IOP between 18 mm Hg and 30 mm Hg, and unmedicated baseline (after washout) IOP between 22 mm Hg and 38 mm Hg. Patients received 2 stents (iStent) through a clear corneal incision and were prescribed travoprost starting the night of postoperative day 1. Intraocular pressure, complications, and various safety measures were assessed at examinations through 18 months and planned for every 6 months thereafter until month 60. A washout of medications was performed 13 months postoperatively. RESULTS: All patients achieved an IOP reduction of 20% or more from baseline to 12 months with reduction of 1 medication and with IOP 18 mm Hg or less. Follow-up through 18 months showed that medicated IOP decreased from 22.2 mm Hg ± 2.0 (SD) on 2 medications preoperatively to 14 mm Hg or less on 1 medication at the postoperative visits. The mean unmedicated IOP decreased from 25.3 ± 1.8 mm Hg preoperatively to 17.1 ± 2.2 mm Hg 13 months postoperatively. No intraoperative or serious device-related adverse events occurred. CONCLUSIONS: Patients with OAG treated with 2 trabecular microbypass stents and 1 presumptive postoperative medication achieved a significant and sustained reduction in IOP and medication through 18 months. FINANCIAL DISCLOSURE: Dr. Katz served as the medical monitor for this study. All authors are consultants to Glaukos Corp.
Assuntos
Anti-Hipertensivos/uso terapêutico , Cloprostenol/análogos & derivados , Glaucoma de Ângulo Aberto/terapia , Microcirurgia/métodos , Stents , Malha Trabecular/cirurgia , Humor Aquoso/fisiologia , Cloprostenol/uso terapêutico , Terapia Combinada , Paquimetria Corneana , Feminino , Glaucoma de Ângulo Aberto/tratamento farmacológico , Glaucoma de Ângulo Aberto/cirurgia , Humanos , Pressão Intraocular/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Tonometria Ocular , Travoprost , Acuidade Visual/fisiologia , Campos Visuais/fisiologiaRESUMO
The purpose of the present study was to develop and assess a novel sustained-release drug delivery system of Bimatoprost (BIM). Chitosan polymeric inserts were prepared using the solvent casting method and characterized by swelling studies, infrared spectroscopy, differential scanning calorimetry, drug content, scanning electron microscopy and in vitro drug release. Biodistribution of 99mTc-BIM eye drops and 99mTc-BIM-loaded inserts, after ocular administration in Wistar rats, was accessed by ex vivo radiation counting. The inserts were evaluated for their therapeutic efficacy in glaucomatous Wistar rats. Glaucoma was induced by weekly intracameral injection of hyaluronic acid. BIM-loaded inserts (equivalent to 9.0 µg BIM) were administered once into conjunctival sac, after ocular hypertension confirmation. BIM eye drop was topically instilled in a second group of glaucomatous rats for 15 days days, while placebo inserts were administered once in a third group. An untreated glaucomatous group was used as control. Intraocular pressure (IOP) was monitored for four consecutive weeks after treatment began. At the end of the experiment, retinal ganglion cells and optic nerve head cupping were evaluated in the histological eye sections. Characterization results revealed that the drug physically interacted, but did not chemically react with the polymeric matrix. Inserts sustainedly released BIM in vitro during 8 hours. Biodistribution studies showed that the amount of 99mTc-BIM that remained in the eye was significantly lower after eye drop instillation than after chitosan insert implantation. BIM-loaded inserts lowered IOP for 4 weeks, after one application, while IOP values remained significantly high for the placebo and untreated groups. Eye drops were only effective during the daily treatment period. IOP results were reflected in RGC counting and optic nerve head cupping damage. BIM-loaded inserts provided sustained release of BIM and seem to be a promising system for glaucoma management.
Assuntos
Amidas/administração & dosagem , Cloprostenol/análogos & derivados , Glaucoma/tratamento farmacológico , Administração Oftálmica , Amidas/farmacocinética , Amidas/uso terapêutico , Animais , Bimatoprost , Varredura Diferencial de Calorimetria , Cloprostenol/administração & dosagem , Cloprostenol/farmacocinética , Cloprostenol/uso terapêutico , Preparações de Ação Retardada , Sistemas de Liberação de Medicamentos , Glaucoma/fisiopatologia , Humanos , Técnicas In Vitro , Pressão Intraocular , Masculino , Microscopia Eletrônica de Varredura , Ratos , Ratos Wistar , Espectroscopia de Infravermelho com Transformada de Fourier , Distribuição TecidualRESUMO
Treatment with cloprostenol, a prostaglandin synthetic analogue, was evaluated in five queens with open-cervix pyometra. Cloprostenol was administered (5 µg/kg body weight SC) on 3 consecutive days and amoxicillin (20 mg/kg body weight IM) on 7 consecutive days. Transient post-injection reactions caused by cloprostenol administration included diarrhea, vomiting and vocalizations. Reactions began as quickly as 10 mins after cloprostenol administration and lasted as long as 30 mins. All queens improved clinically after cloprostenol treatment and remained healthy until the end of the study, 1 year after treatment. All queens resumed normal estrous cycles without further treatment and two (40%) delivered a normal litter. In conclusion, use of cloprostenol is an acceptable treatment for open-cervix pyometra in queens.
Assuntos
Doenças do Gato/tratamento farmacológico , Cloprostenol/uso terapêutico , Luteolíticos/uso terapêutico , Piometra/veterinária , Amoxicilina/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Gatos , Feminino , Piometra/tratamento farmacológicoRESUMO
The objectives of this study were to evaluate the efficacy of (1) administering ceftiofur hydrochloride in dairy cows with calving-related disorders to prevent metritis and (2) a combination of GnRH and PGF2α for the treatment of clinical endometritis, under Argentinean dairy farming conditions. Cows at high risk (HRC) for metritis (dystocia, RFM >12 h postpartum, hypocalcaemia, twins, or stillbirth) were randomly assigned to receive either 1.1 mg/Kg of ceftiofur hydrochloride on three consecutive days (HRC treated group HRCT, n = 110) or remained untreated (HRC control group HRCC, n = 126). Cows with low risk (LRC, no calving-related disorders, n = 868) did not receive any treatment (LRC group, n = 868). All cows were examined for metritis between days 4 and 10 and for clinical endometritis between 24 and 30 days postpartum. The body condition score (BCS) was recorded at both examinations. Cows with endometritis at days 24 to 30 postpartum received either 1.5 mg of D-cloprostenol (PGF; n = 129) or 100 µg of GnRH followed by D-cloprostenol after 7 days (GnRH+PGF, n = 119). There was no overall effect of treatment on the incidence of metritis or on time to pregnancy. Treatment, however, reduced the incidence of metritis in cows with high BCS (HRCT = 24.0 %, HRCC = 38.5 %) but had no effect in cows with low BCS (HRCT = 38.7 %, HRCC = 37.5 %). The proportion of pregnant cows by days in milk was greater (P < 0.01) in LRC group compared with that of the HRCT and HRCC groups. No significant differences were found between groups PG and PG+GNRH. GnRH+PGF treatment, however, tended (P = 0.06) to increase pregnancy rate in cows with a moderate loss of BCS (76.5 vs 65.2 %) but tended to reduce pregnancy rate (54.5 vs 76.0 %) in cows with a more pronounced loss in BCS (>0.75 points).
Assuntos
Antibacterianos/uso terapêutico , Doenças dos Bovinos/tratamento farmacológico , Cefalosporinas/uso terapêutico , Cloprostenol/uso terapêutico , Endometrite/veterinária , Hormônio Liberador de Gonadotropina/uso terapêutico , Animais , Argentina , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/prevenção & controle , Cloprostenol/administração & dosagem , Endometrite/tratamento farmacológico , Endometrite/prevenção & controle , Feminino , Hormônio Liberador de Gonadotropina/administração & dosagem , Ocitócicos/administração & dosagem , Ocitócicos/uso terapêutico , Gravidez , Reprodução/efeitos dos fármacos , Fatores de RiscoRESUMO
Os objetivos da pesquisa foram caracterizar a ocorrência de infecções uterinas pós-puerperais em vacas leiteiras e avaliara eficiência do cloprostenol sódico para tratamento de infecções uterinas pós-puerperais em vacas leiteiras, sem atividade ovariana luteal. Foram usadas 111 vacas de diferentes rebanhos com infecção uterina, associada ao útero totalmente involuído.O diagnóstico e classificação das endometrites foram baseados na característica da descarga vaginal por vaginoscopia. A mesma medida foi utilizada para avaliação da evolução do processo e eficiência do tratamento. De acordo com o grau de infecção, os animais foram divididos aleatoriamente em quatro grupos e receberam via IM os seguintes tratamentos. T1 (n=15): 2 ml de solução salina; T2 (n=32): uma dose de 0,530mg de Cloprostenol; T3 (n=32): duas doses de 0,530mg de Cloprostenol com 24 horas de intervalo e T4 (n=32) duas doses de 0,530mg de Cloprostenol com 48 horas de intervalo. As vacas foram novamente avaliadas por vaginoscopia 15 a 20 dias mais tarde. A eficiência dos tratamentos foi comparada pelo teste de qui-quadrado (χ2). A eficiência geral dos tratamentos, considerada a cura dos sinais clínicos foi de 6,67; 31,25; 50,00 e 37,50% para os grupos T1, T2, T3 e T4, respectivamente, sendo que todos os tratamentos foram igualmente eficientes (P<0,05) em relação ao controle. Os resultados mostram que o cloprostenol pode ser utilizado no tratamento de infecções uterinas pós-puerperais em vacas sem corpo lúteo,estimulando diretamente a imunidade uterina.
The research aims to characterize the occurrence of uterine post-puerperal infections in dairy cows and evaluate the efficiency ofprotocols of Cloprostenol administration for the treatment of clinical post puerperal uterine infections in dairy cows with and without luteal ovarian activity. 111 cows of different herds were used, all presenting clinical endometritis, associated with an involuted uterus. The diagnosis and classification of the endometritis was based on vaginal discharge characteristic by vaginoscopy. The same measure was used to evaluate the evolution of the process and efficiency of treatment. According to the infection degree the animals had been randomized in four groups, and received IM treatments: T1 (n=15): 2ml of saline solution; T2 (n=32): only onedose of 0.530mg of Cloprostenol; T3 (n=32): 2 doses of 0.530mg of Cloprostenol 24 hours apart and T4 (n=32): 2 doses 0.530mg of Cloprostenol with interval of 48 hours. The cows were evaluated by vaginoscopy 15 to 20 days later. The treatments efficiency was compared by the chi-square test (χ2). The general efficiency of treatments regarded as the healing of clinical signs was 6.67;31.25; 50.00 e 37.50 for groups T1, T2, T3 and T4, respectively. In relation to the Control group T1 (not treated), all groups were more efficient (P<0.05). The Cloprostenol can act in a direct way, in this case of animals without corpora lutea stimulating the uterine immunity. The results demonstrate that cloprostenol can be used in post puerperal uterine infections treatment in cows with absence of corpus luteum, directly stimulating uterine immunity.
Assuntos
Feminino , Animais , Bovinos , Cloprostenol/uso terapêutico , Doenças dos Bovinos , Endometrite/veterinária , Bovinos , Corpo LúteoRESUMO
Few dermatologic conditions carry as much anxiety and emotional distress as hair loss resulting from a disease condition such as alopecia areata or as a result of cytotoxic drug treatment, e.g., after chemotherapy. Bimatoprost 0.03% solution is a Food and Drug Administration-approved prescription product indicated for the treatment of eyelash hypotrichosis. The product was investigated in a double-masked, randomized, and placebo-controlled study in patients who had significant eyelash loss or hypotrichosis as a result of chemotherapy. Once-daily treatment with bimatoprost ophthalmic solution 0.03% to the upper eyelid margin restored eyelash growth and prominence more quickly than the slower, natural course of recovery observed in the vehicle control subjects. The eyelash prominence measured using a validated Global Eyelash Assessment (GEA) scale demonstrated a statistically significant increase over placebo following 6 months of treatment. Efficacy was also demonstrated using a validated objective digital image analysis methodology to show significant increase in eyelash length, thickness/fullness, and darkness in these patients. Bimatoprost was found to be well tolerated over the 1-year treatment period.
Assuntos
Amidas/uso terapêutico , Cloprostenol/análogos & derivados , Fármacos Dermatológicos/uso terapêutico , Hipotricose/tratamento farmacológico , Amidas/efeitos adversos , Antineoplásicos/efeitos adversos , Bimatoprost , Cloprostenol/efeitos adversos , Cloprostenol/uso terapêutico , Fármacos Dermatológicos/efeitos adversos , Método Duplo-Cego , Pestanas , Humanos , Hipotricose/induzido quimicamente , Satisfação do Paciente , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Hypotrichosis of the eyelashes may negatively influence an individual's self-perception and appearance. Assessing the impact of treatment from a patient's perspective may be particularly relevant in trials of aesthetic agents. Once-daily dermal (topically applied) administration of bimatoprost ophthalmic solution 0.03% has been associated with increased eyelash prominence (ie, length, thickness, darkness). OBJECTIVES: The authors assess patient-reported outcomes (PRO) after treatment with bimatoprost for hypotrichosis of the eyelashes. METHODS: In this multicenter, double-masked, randomized, vehicle-controlled, parallel clinical trial, 4 PRO questionnaires were distributed to 278 patients (bimatoprost [n = 137] and vehicle [n = 141]). The primary PRO questionnaire was the 23-item Eyelash Satisfaction Questionnaire (ESQ), which measured satisfaction in 3 domains: length, fullness, and overall satisfaction (LFOS); confidence, attractiveness, and professionalism (CAP); and impact on daily routine (DR). RESULTS: By week 16, the bimatoprost group reported significantly greater improvements from baseline on all ESQ items (P ≤ .0433). These improvements were sustained through the 4-week posttreatment study visit. Patient satisfaction was significantly greater in the bimatoprost group than in the vehicle group for all 3 domains: LFOS (weeks 8-20; P ≤ .0052), CAP (weeks 12-20; P < .0001), and DR (weeks 16 and 20; P ≤ .01). CONCLUSIONS: The bimatoprost group reported significantly greater levels of positive patient outcomes and satisfaction than the vehicle group across all 23 questions and all 3 domains of the primary PRO questionnaire. These results support the effectiveness, as measured by objective measures and PRO, of once-daily bimatoprost ophthalmic solution 0.03% at producing more prominent eyelashes in adults.