Differences in urine volume and supersaturation in 2 physician networks.

PURPOSE: We determined whether a network of practices devoted to a broad range of urological care would achieve a decrease in metabolic stone risk comparable to that achieved by a network of similar practices that emphasized kidney stone management as a distinct specialized interest, provided that each was given equivalent access to high level urine testing and software support. MATERIALS AND METHODS: Pretreatment and treatment 24-hour urine samples were obtained from patients in a large network of practices related by the shared use of lithotripsy facilities and instruments (group 2) and a contrasting network of practices that emphasize stone treatment over other concerns (group 1). All known urine risk factors, including supersaturation, were measured and calculated. RESULTS: Treatment supersaturation values in group 2 exceeded those in group 1. The reason was unpredicted and unexplained but highly consistent lower urine volume in group 2 patients that was present before and persisted during treatment. Group 2 physicians mostly achieved changes in urine volume and stone risk factors equivalent to those of group 1 physicians but began with higher supersaturation due to lower urine volume. CONCLUSIONS: A network of physicians not specialized for stone care may achieve a decreased risk equivalent to that of more specialized physicians. Initial patient characteristics may vary significantly in the groups for reasons that are unknown to date, greatly affecting treatment outcome.

Acepromazine. Effects on intraocular pressure.

We investigated the effects of the topical application of acepromazine maleate on the intraocular pressure (IOP) in 27 adult rhesus monkeys. The monkeys were divided into two groups: group 1 (16 monkeys) had both eyes normal, and group 2 (11 monkeys) had experimental chronic glaucoma in one eye and a normal fellow eye. One drop of 1% acepromazine maleate solution was instilled in one eye of monkeys in group 1 and in the glaucomatous eye of monkeys in group 2; the other eye served as the control. The IOP was measured before drug administration and 1, 4, 8, 24, and 32 hours after, with detailed slit-lamp examination of the anterior segment. Acepromazine produced no change in IOP in eyes in group 1, but it produced a fall in pressure in all eyes with high IOP in group 2, evident 1 hour after instillation, maximal between 4 and 8 hours, and still remaining after 32 hours. The pupil showed no change in size, but a transient ptosis was observed in the treated eye in all monkeys.