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A 16-year-old Vietnamese potbellied pig was examined because of recurrent ocular discharge and reduced visual ability. Bilateral upper eyelid entropion and impaired vision secondary to periocular fat deposition were diagnosed. Surgical correction with excision of subdermal fat and redundant skin was performed to address both issues. Surgery restored vision and resolved ocular irritation. More than 1 year following surgical therapy the pig is visual and comfortable with no evidence of recurrent fat deposition or entropion. [ABSTRACT FROM AUTHOR]

A 1-year-old Shar Pei presented for recent-onset exophthalmos and right peri-ocular facial swelling. Physical examination revealed the facial mass was of soft-tissue consistency and nonpainful to the dog. Due to inability to retropulse the globe during ophthalmologic examination, it was suspected the mass had impinged into the orbit, resulting in rostral displacement of the globe. Anatomic location suggested the lesion was probably associated with the zygomatic salivary gland. Fine-needle aspiration and subsequent cytological evaluation of fluid extracted from the facial mass was consistent with a diagnosis of zygomatic mucocele. Computed tomography imaging confirmed a single fluid-filled mass was resulting in both the facial distention and the exophthalmos. A modified, lateral orbitotomy surgical approach was selected for excision of the lesion to provide ventral exposure to the orbit, while minimizing trauma to the globe and supporting structures. Histopathology of the excised lesion confirmed a diagnosis of zygomatic mucocele. This case demonstrates utilization of a modified lateral orbitotomy for effective surgical management of a zygomatic mucocele in a dog, with preservation of vision and absence of any significant postoperative complications. [ABSTRACT FROM AUTHOR]

To evaluate the effects on intraocular pressure (IOP), pupillary diameter (PD), blepharospasm score, conjunctival injection score, and aqueous humor flare score when either 0.03% bimatoprost solution is applied once daily or 0.15% unoprostone isopropyl solution is applied twice daily topically to the eyes of normal cats. The aforementioned parameters were evaluated daily in each of 12 cats throughout the entirety of the study. During an initial 10-day treatment phase a single eye of six of the cats was treated with 0.03% bimatoprost solution while a single eye of the remaining six cats was treated with buffered saline solution (BSS) once daily. During a second 10-day treatment phase a single eye of six of the cats was treated with 0.15% unoprostone isopropyl solution while a single eye of the remaining six cats was treated with BSS twice daily. Contralateral eyes of all cats remained untreated at all time points. Blepharospasm score, conjunctival injection score, and aqueous humor flare score never rose from a value of 0, for any eye of any cat during the study. The mean ± SD of IOP for eyes treated with 0.03% bimatoprost solution and BSS were 16.55 ± 3.06 mmHg and 18.02 ± 3.52 mmHg, respectively. The mean ± of PD for eyes treated with 0.03% bimatoprost solution and BSS were 5.7 ± 1.57 mm and 6.39 ± 1.78 mm, respectively. The mean ± SD of IOP for eyes treated with 0.15% unoprostone isopropyl solution and BSS were 15.7 ± 2.91 mmHg and 17.2 ± 2.9 mmHg, respectively. The mean ± SD of PD for eyes treated with 0.15% unoprostone isopropyl solution and BSS were 5.8 ± 1.43 mm and 6.9 ± 1.37 mm, respectively. There was no significant difference ( P ≥ 0.05) in IOP or PD between eyes treated with 0.03% bimatoprost solution vs. eyes treated with BSS. Similarly, there was no significant difference ( P ≥ 0.05) in IOP or PD between eyes treated with 0.15% unoprostone isopropyl solution vs. eyes treated with BSS. Neither once daily topical administration of 0.03% bimatoprost solution nor twice daily topical administration of 0.15% unoprostone isopropyl solution significantly affect the IOP of normal cats. Both 0.03% bimatoprost solution and 0.15% unoprostone isopropyl solution induced no significant ocular side effects in normal cats when dosed over a 10-day treatment period. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the effects of a novel aldose reductase inhibitor on lens protein kinase Cγ (PKCγ) levels in galactosemic dogs. Six-month old Beagles (12 total; 6 male and 6 female) were made galactosemic by feeding a diet of 40% galactose for 6 weeks. Three dogs per group were fed either control, normal diet, 40% galactose diet, 40% galactose diet with aldose reductase inhibitor at 100 mg/kg body weight per day given orally, or a control diet with aldose reductase inhibitor alone (1-H,7-H-5α,6,8,9-tetrahydro-1-oxopyran[4,3-β]¹ benzopyran, referred to herein as HAR-1). Lenses were removed and analyzed for toxicity by pathological examination. Lens polyol concentrations were determined by GC/MS. PKCγ levels were determined by Western blot and by reverse transcriptase-polymerase chain reaction (RT-PCR). No toxicity was observed from the aldose reductase inhibitor when given at 100 mg/kg body weight per day for 6 weeks. Galactosemic dogs showed deterioration of lens cells. Deterioration included vacuole formation in the lens, cell lysis, and loss of cell nuclei. Galactosemic dogs given the HAR-1 appeared identical to control dogs. Polyol concentrations in the lenses were reduced by 50% in dogs fed the 40% galactose diet with the aldose reductase inhibitor, HAR-1. PKCγ protein levels were reduced in the galactosemic dog lenses, but synthesis of PKCγ was not affected, as measured by RT-PCR. The PKCγ protein levels were similar to controls in dogs given the aldose reductase inhibitor, HAR-1, even when polyol concentrations remained 50% elevated above control levels. HAR-1, when given to control dogs, caused a reduction in the synthesis of PKCγ mRNA but not in total PKCγ protein levels. This study demonstrates the use of a novel aldose reductase inhibitor to control changes in PKCγ in dog lens, a PKC that is known to control gap junction activity. [ABSTRACT FROM AUTHOR]

The trilaminar tear film, composed of the lipid, aqueous and mucin layers, has many functions including defending the ocular surface. The aqueous layer has several soluble antimicrobial factors that protect the ocular surface. Ocular mucins have recently been studied with regard to their role in the defense of the eye as well as in dry eye syndromes. To date, 15 mucin genes have been identified, and six of these mucin genes are localized to or secreted by ocular glands or epithelia. Understanding the production, secretion and function of ocular mucins will aid in the treatment of dry eye syndromes and ocular surface microbial infections. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the impact of managed care on the use of chronic disease medications. Data Source. Claims data from 1997 from two indemnity and three independent practice association (IPA) model managed care insurance plans. Research Design. Cross-sectional analysis of claims data. Data Collection. Adult patients with diabetes mellitus (DM, n=26,444), congestive heart failure (CHF, n=7,978), and asthma (n=9,850) were identified by ICD-9 codes. Chronic disease medication use was defined through pharmacy claims for patients receiving one or more prescriptions for drugs used in treating these conditions. Using multiple logistic regression we adjusted for patient case mix and the number of primary care visits. Principal Findings. With few exceptions, managed care patients were more likely to use chronic disease medications than indemnity patients. In DM, managed care patients were more likely to use sulfonylureas (43 percent versus 39 percent for indemnity), metformin (26 percent versus 18 percent), and troglitazone (8.8 percent versus 6.4 percent), but not insulin. For CHF patients, managed care patients were more likely to use loop diuretics (45 percent versus 41 percent), ACE inhibitors or angiotensin receptor blockers (50 percent versus 41 percent), and beta-blockers (23 percent versus 16 percent), but we found no differences in digoxin use. In asthma, managed care patients were more likely to use inhaled corticosteroids (34 percent versus 30 percent), systemic corticosteroids (18 percent versus 16 percent), short-acting beta-agonists (42 percent versus 33 percent), long-acting beta-agonists (9.9 percent versus 8.6 percent), and leukotriene modifiers (5.4 percent versus 4.1 percent), but not cromolyn or methylxanthines. Statistically significant differences remained after multivariate analysis that controlled for age, gender, and severity. Conclusions. Chronic disease patients in these managed care plans are more likely to receive both inexpensive and expensive medications. Exceptions included older medications partly supplanted by newer therapies. Differences may be explained by the fact that patients in indemnity plans face higher out-of-pocket costs and managed care plans promote more aggressive medication use. The relatively low likelihood of condition-specific medications in both plan types is a matter of concern, however. [ABSTRACT FROM AUTHOR]

Focuses on the policy-relevant evaluation research of New York City's cluster care demonstration. Rare nature of policymakers' utilization of outside evaluations; Association of cluster care with a ten percent reduction in service hours and costs at the intervention sites; Need for policy-driven research in monitoring the effects of changes in health care delivery systems.