Evaluation of Tear Production as Measured by Schirmer Test I in Dogs after Acepromazine and Acepromazine–Methadone Premedication

The purpose of the current study was to investigate the effects of two commonly used sedation protocols in dogs, acepromazine (ACP) and acepromazine–methadone (ACP–MET) combination, on tear production measured by the Schirmer Tear Test (STT) 1. We hypothesized that both sedation protocols cause a reduction in canine tear production for a variable time. Fifteen client-owned dogs were recruited for the study. Each dog was subjected to sedation twice, 2–3 weeks apart, and they were randomly allocated to one of two groups receiving ACP (0.015 mg kg−1) or ACP–MET (0.010 mg kg−1 and 0.2 mg kg−1) intramuscularly. In both eyes, tear production was measured 15 min before sedation (T0) and 20 min (T20 m), 40 min (T40 m), 1 h (T1), 2 h (T2), 4 h (T4) and 8 h (T8), after drug administration. Two-way repeated measures ANOVA, followed by the Bonferroni post hoc test (p < 0.05), showed a significant effect of time (p < 0.0001) and treatment (p < 0.0001). A significant decrease in tear production at T20 m, T40 m, T1 and T2 compared to T0 was observed in the ACP experimental protocol, while in the ACP + MET protocol, this reduction persisted until T8. Comparing the two experimental protocols, no statistically significant differences were observed at T0 or T20 m, and STT 1 values were statistically lower in the ACP + MET than the ACP protocol at the other data points. In the ACP + MET group, at T40 m, 100% of dogs showed STT 1 readings lower than 15 mm/min. This finding is clinically relevant as it can predispose dogs to corneal injuries. The major reduction in tear production due to the ACP + MET protocol proves the need for adequate corneal hydration, particularly to discourage its use in animals with altered tear production. The data obtained provide important information helping clinicians to better manage the drug’s effects on tear production.

Widespread loss of mammalian lineage and dietary diversity in the early Oligocene of Afro-Arabia

Diverse lines of geological and geochemical evidence indicate that the Eocene-Oligocene transition (EOT) marked the onset of a global cooling phase, rapid growth of the Antarctic ice sheet, and a worldwide drop in sea level. Paleontologists have established that shifts in mammalian community structure in Europe and Asia were broadly coincident with these events, but the potential impact of early Oligocene climate change on the mammalian communities of Afro-Arabia has long been unclear. Here we employ dated phylogenies of multiple endemic Afro-Arabian mammal clades (anomaluroid and hystricognath rodents, anthropoid and strepsirrhine primates, and carnivorous hyaenodonts) to investigate lineage diversification and loss since the early Eocene. These analyses provide evidence for widespread mammalian extinction in the early Oligocene of Afro-Arabia, with almost two-thirds of peak late Eocene diversity lost in these clades by ~30 Ma. Using homology-free dental topographic metrics, we further demonstrate that the loss of Afro-Arabian rodent and primate lineages was associated with a major reduction in molar occlusal topographic disparity, suggesting a correlated loss of dietary diversity. These results raise new questions about the relative importance of global versus local influences in shaping the evolutionary trajectories of Afro-Arabia’s endemic mammals during the Oligocene.

Catheter-directed thrombolysis for deep vein thrombosis: 2021 update

Catheter-directed thrombolysis (CDT) has been utilized as an adjunct to anticoagulant therapy in selected patients with deep vein thrombosis (DVT) for approximately 30 years. CDT used to be limited to patients with DVT causing acute limb threat and those exhibiting failure of initial anticoagulation, but has expanded over time. Randomized trials evaluating the first-line use of CDT for proximal DVT have demonstrated that CDT does not produce a major reduction in the occurrence of post-thrombotic syndrome (PTS) and that it is poorly suited for elderly patients and those with limited thrombus extent or major risk factors for bleeding. However, CDT does offer selected patients with acute iliofemoral DVT improvement in reducing early DVT symptoms, in achieving reduction in PTS severity, and in producing an improvement in health-related quality of life (QOL). Clinical practice guidelines from medical and surgical societies are now largely aligned with the randomized trial results. This review offers the reader an update on the results of recently completed clinical trials, and additional guidance on appropriate selection of patients with DVT for catheter-directed thrombolytic therapy.

When usage matters: time-of-use analysis of Cape Town's Day Zero drought response

Poor resource management and infrastructure limitations make the effects of drought worse for cities in developing countries. One way to alleviate the impact without large investments is targeted demand management. This has worked well in studies that focused on some of the recent droughts, including Cape Town's ‘Day Zero’ drought of 2016–2018. Many studies have measured demand response to a drought at a coarse time resolution, but few have measured it at an hourly resolution or compared weekday with weekend use. In this study we evaluated households' hourly time-of-use behaviour in response to the Cape Town drought at two prominent inflection points identified by previous studies: the announcement of the Critical Water Shortages Disaster Plan in October 2017 and the introduction of Level 6B restrictions in February 2018. The first major reduction was caused by residents reducing their usage by about a third in the early morning and evening hours on weekdays, and the second, even larger, reduction was achieved in the mid-morning hours on weekdays when home owners were not at home but ensured that domestic workers used water sparingly.

Extremely Preterm Infant Admissions Within the SafeBoosC-III Consortium During the COVID-19 Lockdown

Objective: To evaluate if the number of admitted extremely preterm (EP) infants (born before 28 weeks of gestational age) differed in the neonatal intensive care units (NICUs) of the SafeBoosC-III consortium during the global lockdown when compared to the corresponding time period in 2019.Design: This is a retrospective, observational study. Forty-six out of 79 NICUs (58%) from 17 countries participated. Principal investigators were asked to report the following information: (1) Total number of EP infant admissions to their NICU in the 3 months where the lockdown restrictions were most rigorous during the first phase of the COVID-19 pandemic, (2) Similar EP infant admissions in the corresponding 3 months of 2019, (3) the level of local restrictions during the lockdown period, and (4) the local impact of the COVID-19 lockdown on the everyday life of a pregnant woman.Results: The number of EP infant admissions during the first wave of the COVID-19 pandemic was 428 compared to 457 in the corresponding 3 months in 2019 (−6.6%, 95% CI −18.2 to +7.1%, p = 0.33). There were no statistically significant differences within individual geographic regions and no significant association between the level of lockdown restrictions and difference in the number of EP infant admissions. A post-hoc analysis based on data from the 46 NICUs found a decrease of 10.3%in the total number of NICU admissions (n = 7,499 in 2020 vs. n = 8,362 in 2019).Conclusion: This ad hoc study did not confirm previous reports of a major reduction in the number of extremely pretermbirths during the first phase of the COVID-19 pandemic.Clinical Trial Registration:ClinicalTrial.gov, identifier: NCT04527601 (registered August 26, 2020), https://clinicaltrials.gov/ct2/show/NCT04527601.

Quantification of anacardic acid, the toxic component in raw and purified samples of Semecarpus anacardium L. by Siddha purification processes

Objectives The knowledge of purification process is unique since it deals with various physical and chemical changes in the inherent toxic properties during the process and it renders a strong support in the art of medicine preparation in Siddha system of medicine. Semecarpus anacardium L. is listed under Schedule e (1) drugs and purification is mandatory before its administration in medicine preparation. The bioactive compounds present in the plant like alkaloids, terpenoids, flavonoids, saponins, glycosides, steroids enhance the medical efficacy and defense mechanisms of the plant. Hence an attempt has been made to reveal the chemical change, occurring during the purification process in Siddha system of medicine by evaluating the phytochemicals and anacardic acid which is responsible for forming blisters and dermatitis. Methods Five common methods were used to purify the Semecarpus anacardium nuts as per the Siddha classical texts. The quantification of phytochemicals and anacardic acid has been done in unpurified, intermediate and purified samples. Results Significant changes were observed in phytochemicals and anacardic acid quantity in unpurified and purified samples. The major reduction of anacardic acid from 5.62 % in S1 to below detectable limit (BDL) in S2, S3, S4, 0.24% in S5 and 3.32% in S6. There is mild to moderate change in the phytochemicals which will support the efficacy of the drug. Conclusions With the results of phytochemicals, though all the purification methods have been evidenced to reduce the toxic nature, among the above five, the process II may be recommended for further research and medicine preparation.

The Influence of Finasteride on the Development of Prostate Cancer

This chapter describes the design, main findings, relevance, and limitations of the landmark Prostate Cancer Prevention Trial (PCPT), which randomized men to finasteride versus placebo and followed them for 7 years. It found a major reduction in prostate cancer incidence but also a higher proportion of high-risk cancer in men diagnosed with prostate cancer. The study did not address the more important oncological outcomes of disease-specific and overall survival. Secondary analyses of PCPT outcomes favored the finasteride arm and suggested that the risk of high-risk cancer is not increased. Linkage analysis of participants from PCPT to Medicare claims data suggested no adverse long-term cardiac, endocrine, or sexual effects.