Angular limb deformity associated with TSPAN18, NRG3 and NOVA2 in Rambouillet rams

Angular limb deformity (ALD) affects many species of livestock and companion animals. The mechanisms of ALD development are not well understood, but previous research suggests the involvement of genetic risk factors. A case-control genome-wide association study (GWAS) was conducted with 40 ALD-affected and 302 unaffected Rambouillet rams and 40,945 single nucleotide polymorphisms (SNPs). Forelimbs of 6 ALD-affected rams were examined and diagnosed with osteochondrosis. Genome-wide or chromosome-wide significant SNPs were positioned exonic, intronic or within the 3'UTR of genes TSPAN18, NRG3 and NOVA2, respectively. These genes have previously described roles related to angiogenesis and osteoblast, osteoclast and chondrocyte proliferation and differentiation, which suggests the possibility for their involvement in the pathogenesis of osteochondrosis. Functional consequences of SNPs were evaluated through transcription factor binding site analysis, which predicted binding sites for transcription factors of known importance to bone growth, including SOX6, SOX9 and RUNX2. The identification of genetic risk factors for ALD may help to improve animal welfare and production in Rambouillet, a breed known to be at risk for ALD development. This study proposes genes TSPAN18, NRG3 and NOVA2 as targets for further research towards understanding the etiology of ALD in Rambouillet sheep.

Genetic association of wool quality characteristics in United States Rambouillet sheep

Introduction: Fine wool production is an important source of revenue, accounting for up to 13% of total revenue in extensively managed wool sheep production systems of the United States. The Rambouillet are a predominant breed that excels in wool quality characteristics. Understanding the genetic basis of wool quality characteristics would aid in the development of genomic breeding strategies to facilitate genetic improvement. Methods: Wool characteristics and DNA were collected for rams enrolled in the North Dakota State University and University of Wyoming annual central performance ram tests over a three-year period (2019-2021, N = 313). The relationships of wool quality characteristics including grease fleece weight adjusted 365 days (wt. 365 adj.), clean fleece wt. 365 adj., staple length 365 adj., average fiber diameter, face wool cover, amount of skin wrinkles and belly wool were evaluated through genome-wide association studies (GWAS), Pearson correlation and ANOVA. Results: The GWAS identified four genome-wide significant genetic markers (p-value <1.19e-06) and five chromosome-wide significant markers (p-value <1.13e-05) on chromosomes 1, 2, 4, 15, and 19. Significant markers were associated with genes notable for relevant wool biological functions, including the gene ABCC8 which codes for SUR1, an ATP-sensitive potassium channel known to affect hair growth and 60S ribosomal protein L17-like, previously found to be expressed during follicle formation. The strongest Pearson correlation coefficients were identified between clean fleece wt. 365 adj. and grease fleece wt. 365 adj. (r = 0.83) and between clean fleece wt. 365 adj. and staple length 365 adj. (r = 0.53). Additionally, clean fleece wt. 365 adj. was correlated with final body weight (r = 0.35) and scrotal circumference (r = 0.16). Staple length 365 adj. (p-value = 5e-04), average fiber diameter (p-value = .0053) and clean fleece wt. 365 adj. (p-value = .014) were significantly associated with belly wool score. Discussion: The results of this study provide important insight into the relationships between wool quality characteristics and report specific markers that Rambouillet sheep producers may use to help inform selection and breeding decisions for improved wool quality.

22 Young Scholar Talk PHD: Investigating Ovine Mastitis: Microbial Sources and Management Methods to Reduce the Prevalence

Subclinical mastitis, a common intramammary disease in sheep production, can be costly to producers due to compromised performance and decreased longevity. Our research focused on preventative and therapeutic measures on mammary health where the objectives were to identify (1) the impact of Zn supplementation on the milk microbiome and (2) the impact of management practices at lambing and weaning on prevalence and cure rate of subclinical mastitis, the milk microbiome, and levels of antimicrobial resistance in milk bacteria. In study 1, the milk microbiome was characterized during the first 3 wk of lactation and at weaning in ewes divergent in dietary Zn supplementation (1× = CON or 3× recommendations = ZnTRT). Mammary health was assessed using somatic cell count (SCC) class. Amplicon sequencing revealed the presence of Staphylococcus, Mannheimia, Corynebacterium, and Pseudomonas, all major mastitis pathogens. Effects of breed, dietary Zn concentration, and SCC class on diversity were limited to early lactation, where CON milk had greater composition stability than ZnTRT milk (P = 0.02). In study 2, milk bacteria were characterized by culture; Staphylococcus spp. and Streptococcus spp. were tested for antimicrobial susceptibility. Subclinical mastitis prevalence ranged from 22–66% where coagulase-negative staphylococci (CoNS; 59%), bacilli (35%), Mannheimia haemolytica (10%), S. aureus (8%), streptococci (5%), and Corynebacterium spp. (5%) were common. Milk samples were compared by jug bedding treatment: jugs were cleaned and dried with barn lime before adding fresh straw (CLEAN) or fresh straw was added atop soiled bedding (SOILED). Bedding had no effect on subclinical mastitis (P = 0.57), but CoNS had greater sulfadimethoxine resistance in SOILED isolates (P = 0.03). Additional mastitis control methods at weaning were evaluated: penicillin injection (PENN), restricted feed access (FAST), or their combination (COMBO). Weaning treatment did not affect cure rate from weaning to 3-d post- weaning (P = 0.21). Further characterization of these samples via microbial sequencing are underway with source tracking analyses to investigate an exogenous route via retrograde transfer and environmental bacteria or endogenous route via an entero-mammary pathway. Results support that breed, animal husbandry, and mammary health variably affect the milk microbiome and provide novel insight to the impact of management practices in a milk microbiome longitudinal study.

PSXIII-B-20 Variants within Genes Tspan18 and NRG3 Associated with Angular Limb Deformity in Rambouillet Rams

Incidence of angular limb deformities (ALD) have been described in many species of livestock and companion animals. Young, rapidly growing animals are at an increased risk for developing ALD. Although work has been done to identify the casual genetic basis of ALD, bone deformities are likely influenced by the environment, making clear genetic answers challenging to discover. Rambouillet rams from Wyoming, North Dakota and South Dakota annual ram performance tests have been observed to develop limb abnormalities consistent with ALD. Historical incidence of ALD in test rams has ranged from 3 to 18%. A genome-wide association study (GWAS) was conducted with 342 ram-test animals, including 40 ALD-affected rams and 302 unaffected rams collected over three consecutive years. Significant markers were identified within the genes tetraspanin 18 (TSPAN18; p-value = 4.87e-07) and neuregulin 3 (NRG3; p-value = 8.06e-07). In mice, Tspan18 has been proposed as a regulator of endothelial cell Orai1/Ca2+ signaling. Orai1 has also been shown to mediate osteogenic differentiation via the bone morphogenic protein signaling pathway, which suggests the possibility for TSPAN18 involvement in differentiation of chondrocytes and osteocytes. The gene NRG3 is a member of the neuregulin family, which encodes ligands for epidermal growth factor receptors ERBB3 and ERBB4. The epidermal growth factor receptor system has described roles in the regulation of proliferation and differentiation of osteoblast, chondrocyte and osteoclast cells. Identifying genetic risk factors for ALD has the potential to improve animal welfare and animal production in at-risk breeds. This study proposes TSPAN18 and NRG3 as targets for further research towards identifying genetic risk factors for ALD in Rambouillet sheep of the NW United States.

278 Fleece and fiber characteristics of Rambouillet, Targhee, and their reciprocal-crosses at first shearing

Objectives were to evaluate breed, heterosis (HI), and maternal effects on wool production in Rambouillet (R x R), Targhee (T x T), and reciprocal-cross (R x T and T x R) 1-yr-old ewes. Greasy fleece weights (GFW) were obtained at shearing and mid-side, britch, and whole-fleece core wool samples were collected to quantify average (A-FD) and CV of fiber diameter (CV-FD). Laboratory scoured yield (LSY) was quantified on core samples and used to estimate clean fleece weight (CFW). Single-born ewes had greater GFW (3.48 kg), greater CFW (2.11 kg), and lower mid-side CV-FD (17.5%) than multiple-born ewes (3.18 kg, 1.95 kg, and 18.1%, respectively; P &lt; 0.01). Rambouillet-sired ewes had greater LSY than T-sired ewes (60.6 vs. 60.0%; P &lt; 0.01), but no breed effects were detected for GFW or CFW. A sire breed x dam breed interaction effect was detected for A-FD at all locations (P ≤ 0.05). Reciprocal-cross performance indicated unfavorable HI for A-FD within mid-side (+0.34 μm), britch (+0.97 μm), and core samples (+0.42 μm; P ≤ 0.05) compared to purebred average. Greater mid-side and britch A-FD in R x T (22.8 and 25.2 μm) than T x R ewes (21.2 and 23.5 μm; P &lt; 0.01) implied a more favorable additive maternal effect for crossbred ewes gestated and reared by R compared to T dams. Future analyses will consider lifetime lamb and wool production of these breed types to evaluate the utility of finewool crossbred ewes in extensive production systems.

288 Forage mineral and nutrient element concentrations on sheep winter range

Supplementation strategies and nutritional management of ewes during critical production periods of breeding and gestation is an important consideration, particularly when ewes are on winter range. Clinical and subclinical trace mineral deficiencies at these times limit ewe productivity in these extensive environments. The objectives of this study were to (1) quantify mineral element concentrations of common forages on winter range, and (2) evaluate producer supplementation strategies using a survey. We hypothesized that mineral element concentrations in winter forages were inadequate to meet ewe requirements during critical production stages and shrub species would contain higher levels of macro- and micro-mineral element concentrations than grass species. Forage samples were collected from 25 ranches across Wyoming winter range and were compiled by species and analyzed for nutrient and mineral element composition; however, data presented herein represents the first year of data collection (12 of 25 ranches). Nutrient and mineral element concentration results indicated an effect in CP, Ca, P, K, Mg, S, Na, Zn, Cu, Se, Mn, and Mo concentrations between grass and shrub species (P &lt; 0.05). Specifically, Mg and Mo concentrations were higher in grasses while the other mineral element concentrations were higher in shrubs. No effect was observed for Fe and Co concentrations between grass and shrub species (P = 0.37 and P = 0.29). Survey results revealed that 80% of ranches had more than 1000 sheep, and 47% of respondents utilized winter range for 131 to 170 day periods throughout production year. While on winter range the majority of producers (47%) supplement with a protein source. Additionally, 58% do not supplement white salt, while 47% supplement a complete trace mineral mix.

290 Impacts of dietary zinc concentrations on lamb feedlot performance

The objectives of this study were to identify the impacts of Zn concentrations in lamb grower pellet on lamb feedlot performance and natural coccidia infection in terms of fecal Eimeria oocyst excretion. Rambouillet lambs (n = 33; 43.9 ± 1.0 kg) were used in a 63 d feeding trial to assess the effect of a diet fortified with a combination of ZnSO4 (80%) and Zn amino acid complex (20%; ZnAA; Zinpro Corp.; Eden Prairie, MN, USA) at three different dietary Zn concentrations (treatment, TRT) which met or exceeded current recommendations. These levels included 1×NRC requirements (450 mg/kg grower pellet; 1NRC), 2×NRC requirements (900 mg/kg grower pellet; 2NRC), and 3×NRC requirements (1350 mg/kg grower pellet; 3NRC). Lamb performance characteristics, including body weight (BW), average daily gain (ADG), average dry matter intake (DMI), feed efficiency (gain:feed, G:F), and residual feed intake (RFI), were quantified. Fecal samples were collected every 2 wk to assess coccidia infection status via fecal oocyst counts. Treatment × period (d 0–10, 11–42, 42–63) interactions were identified for DMI (P &lt; 0.001). No main effect of TRT was identified for BW, ADG, G:F, or RFI (P &gt; 0.36), but was for DMI (P = 0.02). Ten Eimeria species were detected and summed for total fecal oocyst count, but focus was on the most pathogenic species (E. ahsata, E. bakuensis, E. crandallis, and E. ovinoidalis). A statistical tendency for the interaction between TRT × day was detected for E. bakuensis and E. ovinoidalis (P ≤ 0.08). Transformed counts of E. bakuensis and E. crandallis were lower for 1NRC compared to 2NRC and 3NRC lambs (P &lt; 0.05). Results indicate greater dietary Zn concentrations increased DMI and decreased Eimeria oocysts excreted.

264 Harvest season, carcass weight, and fat measurement effects on lamb carcass characteristics and economic comparison of moderate and heavy weight lamb carcasses in the Western lamb processing industry

Carcass characteristics and economic impact estimates of over-finished lambs on the processing sector were evaluated in two commercial Intermountain West abattoirs. Lamb carcasses were surveyed throughout the year using digital images and imaging software (n = 9,532). Estimations of abattoir costs and returns included loading labor, downtime cost, price of fat, live and carcass trucking costs from the two largest lamb processors in the Intermountain West. Profitability comparisons were made using Monte Carlo simulation models replicating live and carcass prices for distributions based on historical pricing data to assess overall profitability of a carcass in an ideal weight range (29.5 - 39.0 kg) and a carcass that exceeds ideal weight (&gt; 39.0 kg). Overall means show that the average lamb carcass exceeded packer preferred hot carcass weight (40.76 ± 9.29 kg) and industry acceptable 12th rib fat thickness (8.17 ± 3.79 mm). There were seasonal differences in hot carcass weight and fat measurements with carcasses being lighter weight (P = 0.05) and trimmer (P = 0.05) in the summer months. Monte Carlo simulation found that the additional yield from heavier carcasses offset costs of harvesting them. However, factors such as machine wear and increased labor turnover rates should be considered, although difficult to quantify. Collectively, the current study shows that U.S. lamb carcasses are too heavy and excessively fat but have minor effect on processor profitability.

289 Effects of dietary Zn on ewe milk minerals and somatic cell count

The objectives of the current study were to evaluate the effects of dietary Zn fed at approximately 3 times NRC recommendations on milk Zn concentrations and mammary health. Within Rambouillet (WF) and Hampshire (BF) breeds, ewes were ranked by BW and randomly assigned down the rank into 2 treatment groups: Control (n = 45, 37 mg Zn/kg DM) and Zn treatment (n = 44, 113 mg Zn/kg DM). Treatments were delivered via a ZnSO4-fortified alfalfa pellet fed at a rate of 0.45 kg/d DM from a RFID-activated automated feeder from approximately 6 wk before to 4 wk after lambing. Ewe milk was collected twice weekly, and analyzed for mineral content (d 0, 10, and 30 of lactation) and somatic cell count (SCC; d 3–5, 6–9, 10–12, 13–16, 17–19, 20–23, 24–26, 27–29, or 30–32). Single-bearing ewes had greater Ca, Mg, and P (P ≤ 0.04) than multiple-bearing ewes. Day of lactation influenced milk Mg, P, and Zn (P &lt; 0.01), and values generally decreased as lactation progressed. Milk Zn was 1.7-fold greater (P &lt; 0.01) for Zn treatment than Control ewes. Milk Ca, Mg, and P were greater for Control than Zn treatment (P ≤ 0.02) ewes. A breed × litter size effect was detected for LogSCC (P = 0.02). Single-bearing WF ewes had lower LogSCC than multiple-bearing WF ewes (5.36 ± 0.09 vs 5.74 ± 0.07; P &lt; 0.01) but litter size did not affect BF ewe LogSCC (5.80 ± 0.08 vs 5.79 ± 0.09; P = 0.92). Day of lactation impacted ewe SCC (P &lt; 0.01), with peak SCC between d 6 and 9, which began to decline as lactation progressed. In conclusion, dietary Zn above NRC recommendations increased milk Zn.

Zinc AA supplementation alters yearling ram rumen bacterial communities but zinc sulfate supplementation does not

 Despite the body of research into Zn for human and animal health and productivity, very little work has been done to discern whether this benefit is exerted solely on the host organism, or whether there is some effect of dietary Zn upon the gastrointestinal microbiota, particularly in ruminants. We hypothesized that (i) supplementation with Zn would alter the rumen bacterial community in yearling rams, but that (ii) supplementation with either inorganically sourced ZnSO4, or a chelated Zn AA complex, which was more bioavailable, would affect the rumen bacterial community differently. Sixteen purebred Targhee yearling rams were utilized in an 84-d completely randomized design, and allocated to one of three pelleted dietary treatments: control diet without fortified Zn (~1 × NRC), a diet fortified with a Zn AA complex (~2 × NRC), and a diet fortified with ZnSO4 (~2 × NRC). Rumen bacterial community was assessed using Illumina MiSeq of the V4 to V6 region of the 16S rRNA gene. One hundred and eleven OTUs were found with > 1% abundance across all samples. The genera Prevotella, Solobacterium, Ruminococcus, Butyrivibrio, Olsenella, Atopobium, and the candidate genus Saccharimonas were abundant in all samples. Total rumen bacterial evenness and diversity in rams were reduced by supplementation with a Zn AA complex, but not in rams supplemented with an equal concentration of ZnSO4, likely due to differences in bioavailability between organic and inorganically sourced supplement formulations. A number of bacterial genera were altered by Zn supplementation, but only the phylum Tenericutes was significantly reduced by ZnSO4 supplementation, suggesting that either Zn supplementation formulation could be utilized without causing a high-level shift in the rumen bacterial community which could have negative consequences for digestion and animal health.

Effects of feeding ground redberry juniper (Juniperus pinchotii) to gestating ewes on pre- and postpartum performance, serum metabolites and hormones, milk fatty acid composition, and progeny preweaning performance

The objective of this research was to evaluate effects of replacing sorghum × Sudangrass hay with ground juniper in gestating ewe supplements on pre- and postpartum growth performance, serum metabolites and hormonal concentrations, milk fatty acid composition, and progeny preweaning performance. In a completely randomized design, commercial Rambouillet ewes (age = 3 to 5 yr; initial BW = 65.2 ± 1.6 kg) on a base diet of long-stem sorghum × Sudangrass hay were assigned to 1 of 4 dietary supplements in which ground juniper replaced 0% (CNTL), 33% (18JUN), 66% (36JUN), or 100% (54JUN) of the ground sorghum × Sudangrass hay in a pelleted supplement with ground juniper from d 38 ± 4 of gestation to 2 d postpartum. Treatment DM diet intake overall (g/kg BW) in ewes receiving no juniper was similar ( ≥ 0.38) to that of those receiving increasing concentrations of juniper. Changes in ewe BW and BCS were similar ( ≥ 0.24) in ewes throughout gestation. All serum metabolites and hormones were within normal clinical ranges; however, serum IGF-1 decreased linearly ( = 0.003), alanine increased (linear; = 0.003), and serum Na decreased (linear; = 0.049) as the percentage of juniper increased in the diet. Ewe milk fatty acid composition was similar ( > 0.05) for the majority of fatty acids across treatment groups, with the exception of arachidonic acid (C20:4n6) being greater ( < 0.02) in 54JUN vs. CNTL ewe milk. Lamb birth weights were similar ( = 0.13), whereas lamb ADG tended to differ (quadratic; = 0.06) from d 0 to 14, with 18JUN being the least. At weaning, BW tended ( = 0.09) to linearly decrease in lambs born to ewes consuming greater concentrations of juniper but were not different ( = 0.26) between CNTL and 18JUN, 36JUN, and 54JUN. Results indicated that feeding increasing levels of ground juniper in supplements did not negatively alter ewe performance or serum metabolites and hormones measured pre- and postpartum. Lamb birth weight and preweaning performance appeared unaffected by maternal consumption of ground juniper containing supplements. Results also provide novel information regarding the effects of plant secondary compound consumption throughout pregnancy on ewe and progeny performance and health.

Substituting ground woody plants for cottonseed hulls in lamb feedlot diets: Growth performance, blood serum chemistry, and rumen fluid parameters

Effects of using ground woody plants in Rambouillet wether lamb feedlot diets on growth performance, blood serum, and rumen parameters were evaluated. A randomized design study was used with 2 feeding periods (70% concentrate diet from d 0 to 27 [Period 1] and 86% concentrate diet from d 28 to 57 [Period 2]); the concentrate portion of the diets mainly consisted of dried distiller's grains with solubles and sorghum grain. Lambs were individually fed 6 diets that differed only by roughage source ( = 8 animals/treatment; 32.9 ± 3.2 kg initial BW): either cottonseed hulls (CSH; control) or ground wood consisting of redberry juniper (RED), blueberry juniper (BLUE), one-seeded juniper (ONE), or eastern red cedar (ERC) spp. or honey mesquite (MESQ; ). Using ground wood vs. CSH as the roughage source did not affect ( > 0.12) BW. There tended to be a treatment × day interaction ( = 0.07) for lamb DMI, attributed to Period 1 when DMI was greater ( < 0.05) for lambs fed CSH vs. RED, ONE, ERC, or MESQ during the first 14 d and greater ( < 0.05) during d 14 to 28 vs. lambs fed ERC. Overall, ADG was less for lambs fed ERC ( < 0.10) or MESQ ( < 0.05) vs. lambs fed CSH, but G:F was similar ( > 0.10) among all lambs. Dietary treatments did not affect ( > 0.15) ruminal pH, but treatment × day interactions ( < 0.05) were observed for rumen fluid ammonia N or molar proportions of propionate and butyrate; few differences were observed within day. However, overall, lambs fed RED or MESQ had greater ( < 0.05) total rumen VFA than lambs fed CSH. A treatment × day interaction ( = 0.04) was observed for the acetate:propionate ratio, but no differences ( > 0.10) were observed within day. Treatment × day interactions ( < 0.05) were observed for blood serum glucose, γ-glutamyl transferase, the albumin:globulin ratio, total bilirubin, β-hydroxybutyrate, P, Cl, and Mg, with most results being less for lambs fed the wood-based diets than for lambs fed the CSH diets. Results suggested that even though lamb DMI was reduced during the growing period when diets contained 30% ground woody products (RED, ONE, ERC, and MESQ), animal health and rumen fluid parameters were not negatively affected by ground woody plants.

The Efficacy and Safety of Timolol Maleate versus Brinzolamide Each Given Twice Daily Added to Travoprost in Patients with Ocular Hypertension or Primary Open-Angle Glaucoma

PURPOSE

To compare the efficacy and safety of timolol maleate 0.5% versus brinzolamide 1% when added to travoprost 0.004% in patients with ocular hypertension or primary open-angle glaucoma.

DESIGN

A prospective, double-masked, randomized, active-controlled, parallel comparison.

METHODS

Qualified patients at Visit 1 were placed on travoprost dosed every evening for 4 weeks and then were randomized at baseline (Visit 2) to the addition of timolol maleate or brinzolamide each given twice daily. Patients returned to clinic at Week 4 (Visit 3) for a safety visit and Week 12 (Visit 4) for an efficacy visit. At Visits 2 and 4 the intraocular pressure (IOP) was measured at 08:00, 12:00, and 16:00 hours.

RESULTS

Ninety-seven patients on brinzolamide had a baseline diurnal IOP of 21.5+/-2.2 mmHg and 95 on timolol maleate had 21.3+/-2.5 mmHg, each added to travoprost. The diurnal mean IOP at Week 12 was 18.1+/-2.7 mmHg for brinzolamide and 18.1+/-3.0 mmHg for timolol maleate (p=0.96). There was no statistical difference found between treatment groups in the absolute level of pressure, or in the reduction in IOP from baseline, at each time point or for the diurnal curve (p>0.05). There was no significant difference for any adverse event between groups (p>0.05), with the most common side effect being conjunctival hyperemia in 15/97 (16%) brinzolamide and 6/95 (6%) timolol treated patients (p=0.06).

CONCLUSIONS

This study showed that brinzolamide provides similar safety and efficacy compared to timolol maleate when added to travoprost.

Intraocular Pressure, Safety and Quality of Life in Glaucoma Patients Switching to Latanoprost from Adjunctive and Monotherapy Treatments

Purpose

To evaluate efficacy, safety and quality of life in ocular hypertensive or open-angle glaucoma patients changed to latanoprost from previous therapy.

Methods

A prospective, multicenter, active-controlled design in which qualified patients had their previous therapy substituted for latanoprost and were followed for at least thee months.

Results

In 1068 patients, latanoprost was continued 92% throughout the 36-month observation period. Latanoprost treatment reduced the intraocular pressure (IOP)(p < 0.001) when compared to previous monotherapies including: beta-blockers (-4.0 ± 3.7 mmHg, 42%), alpha-antagonists (-3.9 ± 3.0 mmHg, 14%), miotics (-3.8 ± 3.5 mmHg, 2%), or carbonic anhydrase inhibitors (CAI) (-3.8 ± 3.6 mmHg, n = 16%), and adjunctive therapy including: beta-blocker and CAI (-3.7 ± 3.1 mmHg, n = 12%), alpha-agonist (-3.7 ± 3.4 mmHg, n = 5%), or pilocarpine (-3.4 ± 3.7 mmHg, n = 6%), or CAI and alpha-agonist (-4.6 ± 6.4 mm Hg, n = 2%)(p < 0.0017). The most common adverse event with latanoprost was ocular allergy (1.5% incidence). Patients showed a preference for latanoprost for many systemic and ocular quality of life measures on a non-validated questionnaire (p < 0.05).

Conclusions

In a clinical setting, patients who have their mono- and adjunctive therapy treatment substituted for latanoprost may on average experience reduced IOP, deceased side effects and increased quality of life measures.

Presentation and Long-Term follow-up of Exfoliation Glaucoma in Greece, Spain, Russia, and Hungary

Purpose

To evaluate clinical presentation and long-term follow-up of exfoliation glaucoma in separate European population groups.

Methods

A four-center, retrospective, case series analysis in which 200 charts of patients with exfoliation glaucoma or patients with elevated intraocular pressure (IOP) associated with exfoliation syndrome in at least one eye with at least 5 years of follow-up were consecutively reviewed.

Results

This study found an average follow-up time of 6.0±2.1 years. Patients in Hungary and Spain statistically presented at an older age (79 years) than Greek patients (67 years). Patients with exfoliation glaucoma in Greece and Hungary had more glaucomatous damage, had more severe glaucoma, had a higher untreated IOP (31.8 to 32.1 mmHg), and were more difficult to control, showing a greater number of changes in medicines during the follow-up period, a greater number of medicines at the end of the follow-up period, and more progression. On long-term follow-up, Greek, Russian, and Hungarian patients also had the highest mean IOP (18.8 to 20.8 mmHg) and the greatest incidence of progression (approximately 50%). Spanish patients demonstrated the lowest mean IOP (17.6±3.6 mmHg) and the lowest rate of progression (28%) during the follow-up period and the fewest number of medications per patient (0.7) to control the IOP at the end of the follow-up period.

Conclusions

The severity of exfoliation glaucoma presentation and its course may differ within distinct geographic populations in Europe.

Effects of Juniperus species and stage of maturity on nutritional, in vitro digestibility, and plant secondary compound characteristics

Rising feed costs and recurring feed shortages necessitate the investigation into alternative and underutilized feed resources. Nutritional characteristics of species are either unknown or limited to leaves and ground material from small stems. Therefore, the objective was to quantify nutritional characteristics, 48-h true IVDMD (tIVDMD), microbial gas production, and secondary compound characteristics of entire woody plant material of 4 species-, , , and -at immature and mature stages of growth. Immature plants had greater CP concentrations and lower NDF concentrations ( < 0.001) than mature plants regardless of species. Mature plants also had greater ( < 0.001) concentrations of ADF compared with immature plants with the exception of . In general, immature , , and had greater ( < 0.02) tIVDMD and total 48-h and asymptotic gas production than mature plants. Immature and plants were more digested (tIVDMD; < 0.001) than immature and , but tIVDMD did not differ in mature plant material across species. Condensed tannins (CT) were greater ( < 0.001) in immature and than mature plants; differences in CT concentrations among immature species were also detected ( < 0.04). Volatile oil yields were similar across maturity and species with 1 exception: immature yielded more ( < 0.02) volatile oil than mature material. Volatile oil composition across species varied and contained a range of 65 to 70 terpene compounds. The dominant terpenes across species were generally greater ( < 0.05) in immature vs. mature plant material with the exception of . Labdane acids were negligible in , , and and greater in ( < 0.001). Ground material from mature juniper species, although inferior in nutritional quality compared with immature plants, is comparable to traditional low-quality roughage ingredients. Given that has been successfully fed in lamb feedlot diets, the similarities of , and suggest that all three species have potential to be effective roughage ingredients.

Effects of using ground redberry juniper and dried distillers grains with solubles in lamb feedlot diets: growth, blood serum, fecal, and wool characteristics

Effects of using ground redberry juniper and dried distillers grains with solubles (DDGS) in Rambouillet lamb (n = 45) feedlot diets on growth, blood serum, fecal, and wool characteristics were evaluated. In a randomized design study with 2 feeding periods (Period 1 = 64% concentrate diet, 35 d; Period 2 = 85% concentrate diet, 56 d), lambs were individually fed 5 isonitrogenous diets: a control diet (CNTL) that contained oat hay but not DDGS or juniper or DDGS-based diets in which 0 (0JUN), 33 (33JUN), 66 (66JUN), or 100% (100JUN) of the oat hay was replaced by juniper. During Period 1, lambs fed CNTL had greater (P < 0.05) DMI and ADG and tended to have greater (P < 0.10) G:F than lambs fed 0JUN or lambs fed DDGS-based diets. Lamb DMI, ADG, and G:F quadratically increased (P < 0.008) as juniper increased in the DDGS-based diets. During Period 2, lambs fed CNTL had greater (P < 0.05) DMI than lambs fed 0JUN or lambs fed DDGS-based diets, but ADG was similar (P > 0.41). Compared to 0JUN, lambs fed CNTL had similar (P = 0.12) G:F and tended to have less G:F (P = 0.07) than lambs fed DDGS-based diets. Among lambs fed DDGS-based diets, DMI was similar (P > 0.19), ADG increased linearly (P = 0.03), and G:F tended to decrease quadratically (P = 0.06) as juniper increased in the diet. Serum IGF-1, serum urea N (SUN), and fecal N were greater (P < 0.05) and serum Ca and P and fecal P were similar (P > 0.13) for lambs fed CNTL vs. lambs fed DDGS-based diets (CNTL). Within lambs fed DDGS-based diets, SUN increased quadratically (P = 0.01) and fecal N increased linearly (P = 0.004), which can partially be attributed to increased dietary urea and condensed tannin intake. Most wool characteristics were not affected, but wool growth per kilogram of BW decreased quadratically (P = 0.04) as percentage of juniper increased in the DDGS-based diets. When evaluating the entire 91-d feeding trial, results indicated that replacing all of the ground oat hay with ground juniper leaves and stems in lamb growing and finishing diets is not detrimental to animal performance and that DDGS-based diets can reduce total feedlot costs, as compared to sorghum grain and cottonseed meal-based diets. However, compared to using juniper or oat hay as the sole roughage source, using both during the growing period (Period 1) enhanced growth performance and further reduced total feedlot costs.

Organic and inorganic selenium: IV. passive transfer of immunoglobulin from ewe to lamb

Newborn lambs depend on their dams for passive transfer of immunoglobulins, primarily IgG, for protection from harmful pathogens until their own immunological defenses have developed. Previous studies have suggested that supplementation with Se results in a modest increase in IgG concentration in serum of newborn calves and lambs. To evaluate the effect of the Se source and supplementation rate in ewes during pregnancy on passive transfer of IgG to their lambs, 210 Polypay, Suffolk, or Suffolk × Polypay cross ewes were divided into 7 treatment groups (n = 30 each) and drenched weekly with no Se, at the maximum FDA-allowed concentration with inorganic Na-selenite or organic Se-yeast (4.9 mg Se/wk), or with inorganic Na-selenite and organic Se-yeast at supranutritional concentrations (14.7 and 24.5 mg Se/wk). Ewe serum IgG concentrations were measured within 30 d of parturition, ewe colostrum and lamb serum IgG concentrations were measured at parturition before suckling, and lamb serum IgG concentrations were measured again at 48 h postnatal. Ewes receiving 24.5 mg Se/wk tended to have or had, independent of Se source, greater colostral IgG concentrations than ewes receiving 4.9 mg Se/wk overall (81.3 vs. 66.2 mg/mL; P = 0.08) and for Polypay ewes only (90.1 vs. 60.7 mg/mL; P = 0.03). Polypay ewes receiving Se-yeast at 24.5 mg Se/wk transferred a greater calculated total IgG amount to their lambs than Polypay ewes receiving Se-yeast at 4.9 mg Se/wk (15.5 vs. 11.6 g; P = 0.02), whereas the converse was true (interaction between Se source and dose concentration; P = 0.03) for Polypay ewes receiving inorganic Na-selenite at 24.5 mg Se/wk vs. Na-selenite at 4.9 mg/wk (11.6 vs. 15.7 g; P = 0.08). Our results suggest that supranutritional Se supplementation of Polypay ewes during pregnancy increases colostral IgG concentrations but that the optimal supplementation rate for IgG transfer from ewe to lamb may differ for Na-selenite and Se-yeast.

Organic and inorganic selenium: III. Ewe and progeny performance

Selenium is an essential micronutrient in sheep, and deficiency can limit lamb growth and survival. To evaluate how different chemical forms of Se administered to mature ewes at comparative dosages affect ewe and progeny performance, 240 ewes were divided into 8 treatment groups (n = 30 each) and drenched weekly with no Se; at the maximum FDA-allowed concentration with inorganic Na-selenite or organic Se-yeast (4.9 mg Se/wk); with inorganic Na-selenate (8.95 mg Se/wk); or with inorganic Na-selenite and organic Se-yeast at supranutritional concentrations (14.7 and 24.5 mg Se/wk, respectively). The treatment period started approximately 2 wk before breeding and lasted for 62.5 wk. Ewes of the no-Se and Se-yeast groups continued treatments for another 21 to 24 wk through a second lambing season. Chemical form or dosage of Se did not affect ewe reproductive performance based on proportion of ewes lambing in each treatment group, or number of lambs born, nursed, or weaned per ewe (all P > 0.10). Ewes receiving the highest supplementation rate of Se-yeast at 24.5 mg Se/wk had higher BCS (scale 1 to 5) at the end of yr 1 (2.95 vs. 2.66; P = 0.05) than ewes receiving Se-yeast at 4.9 mg Se/wk. Performance was better in lambs from ewes receiving Se-yeast at 24.5 mg Se/wk than in lambs from ewes receiving Se-yeast at 4.9 mg Se/wk or no Se. In yr 1, lambs from ewes receiving Se-yeast at 24.5 vs. 4.9 mg Se/wk were heavier at 120 d of age (37.0 vs. 34.2 kg; P = 0.05). In yr 2, lambs from ewes receiving Se-yeast at 24.5 mg Se/wk were or tended to be heavier at 60 d of age than lambs from ewes receiving no Se (21.2 vs. 19.0 kg; P = 0.04) or lambs from ewes receiving Se-yeast at 4.9 mg Se/wk (19.2 kg; P = 0.09). This effect was more pronounced in ewes raising multiple lambs. We conclude that supranutritional supplementation of ewes with Se-yeast at 24.5 mg Se/wk improves lamb growth and ewe health without negatively affecting reproductive performance.

Organic and inorganic selenium: I. Oral bioavailability in ewes

Although the essentiality of dietary Se for sheep has been known for decades, the chemical source and Se dosage for optimal health remain unclear. In the United States, the Food and Drug Administration (FDA) regulates Se supplementation, regardless of the source of Se, at 0.3 mg of Se/kg of diet (as fed), which is equivalent to 0.7 mg of Se/d or 4.9 mg of Se/wk per sheep. The objectives of this study were to evaluate the effects of Se source (inorganic vs. organic) and supplementation rate (FDA vs. supranutritional rates of 14.7 and 24.5 mg of Se/wk) on whole-blood (WB) and serum-Se concentrations. Mature ewes (n = 240) were randomly assigned to 8 treatment groups (n = 30 each) based on Se supplementation rate (4.9, 14.7, and 24.5 mg of Se•wk(-1)•sheep(-1)) and source [Na-selenite, Na-selenate (4.9 mg/wk only), and organic Se-yeast] with a no-Se control group (0 mg of Se/wk). Treatment groups were balanced for healthy and footrot-affected ewes. For 1 yr, ewes were individually dosed once weekly with 0, 4.9, 14.7, or 24.5 mg of Se, quantities equivalent to their summed daily supplementation rates. Serum- and WB-Se concentrations were measured every 3 mo in all ewes; additionally, WB-Se concentrations were measured once monthly in one-half of the ewes receiving 0 or 4.9 mg of Se/wk. Ewes receiving no Se showed a 78.8 and 58.8% decrease (P < 0.001) in WB- (250 to 53 ng/mL) and serum- (97 to 40 ng/mL) Se concentrations, respectively, over the duration of the study. Whole-blood Se decreased primarily during pregnancy (-57%; 258 to 111 ng/mL) and again during peak lactation (-44%; 109 to 61 ng/mL; P < 0.001). At 4.9 mg of Se/wk, Se-yeast (364 ng/mL, final Se concentration) was more effective than Na-selenite (269 ng/mL) at increasing WB-Se concentrations (P < 0.001). Supranutritional Se-yeast dosages increased WB-Se concentrations in a dose-dependent manner (563 ng/mL, 14.7 mg of Se/wk; 748 ng/mL, 24.5 mg of Se/wk; P < 0.001), whereas WB-Se concentrations were not different for the Na-selenite groups (350 ng/mL, 14.7 mg of Se/wk; 363 ng/mL, 24.5 mg of Se/wk) or the 4.9 mg of Se/wk Se-yeast group (364 ng/mL). In summary, the dose range whereby Se supplementation increased blood Se concentrations was more limited for inorganic Na-selenite than for organic Se-yeast. The smallest rate (FDA-recommended quantity) of organic Se supplementation was equally effective as supranutritional rates of Na-selenite supplementation in increasing WB-Se concentrations, demonstrating the greater oral bioavailability of organic Se.

Investigation of a Q fever outbreak in a Scottish co-located slaughterhouse and cutting plant

Outbreaks of Q fever are rare in the UK. In 2006, the largest outbreak of Q fever in Scotland occurred at a co-located slaughterhouse and cutting plant with 110 cases. Preliminary investigations pointed to the sheep lairage being the potential source of exposure to the infective agent. A retrospective cohort study was carried out among workers along with environmental sampling to guide public health interventions. A total of 179 individuals were interviewed of whom 66 (37%) were migrant workers. Seventy-five (41.9%) were serologically confirmed cases. Passing through a walkway situated next to the sheep lairage, a nearby stores area, and being male were independently associated with being serologically positive for Q fever. The large proportion of migrant workers infected presented a significant logistical problem during outbreak investigation and follow up. The topic of vaccination against Q fever for slaughterhouse workers is contentious out with Australasia, but this outbreak highlights important occupational health issues.

24-hour intraocular pressure and blood pressure levels with latanoprost/timolol fixed combination versus timolol

PURPOSE

To evaluate 24-hr intraocular pressure (IOP) and blood pressure (BP) with timolol or latanoprost/timolol fixed combination (LTFC).

METHODS

Patients with primary open-angle glaucoma or ocular hypertension with normal blood pressure were randomized to LTFC, dosed each evening, or timolol dosed twice daily in a cross-over design for 8 weeks and the opposite medicine for 8 weeks. IOP was measured at 02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours in the sitting position with Goldmann applanation tonometry and BP monitoring every 30 min while awake and every hour while asleep at the end of each 8-week treatment period.

RESULTS

Twenty-nine patients had a 24-hr baseline IOP of 26.3 +/- 2.5 mmHg, systolic BP (SBP) of 121.4 +/- 12.4 mmHg, diastolic BP (DBP) 72.9 +/- 7.1 mmHg, and ocular perfusion pressure (OPP) of 33.9 +/- 5.7 mmHg. No statistical differences were found between untreated and treated 24-hr SBP, DBP, mean BP (MBP), heart rate, or nocturnal BP dipping status with either medication. LTFC lowered IOP more at each timepoint compared to timolol (difference between treatments 2.7 mmHg, p = 0.0002).

CONCLUSIONS

Neither timolol or evening-dosed LTFC reduced SBP, DBP, MBP, OPP, or increased nocturnal dipping. LTFC was more effective than timolol in decreasing IOP.

Twenty-four-hour intraocular pressure control with the travoprost/timolol maleate fixed combination compared with travoprost when both are dosed in the evening in primary open-angle glaucoma

OBJECTIVE

To evaluate the 24 h efficacy and safety of the travoprost/timolol maleate fixed combination (TTFC) versus travoprost when both are dosed in the evening in primary open-angle glaucoma patients.

METHODS

Prospective, double-masked, crossover, active-controlled, randomised 24 h comparison. After a 6 week medicine-free period, patients were randomised to either TTFC or travoprost for 8 weeks and were then switched to the opposite treatment for another 8 weeks. At the end of the washout and treatment periods, a 24 h pressure curve was performed.

RESULTS

Thirty-two patients completed the study. The TTFC group demonstrated a lower absolute intraocular pressure level (2.4 mm Hg) for the 24 h curve and at all time points, compared with travoprost (p</=0.047). The pressure reduction from untreated baseline was significantly different between treatments for all time points (p = 0.018). The mean 24 h pressure fluctuation was lower with TTFC (3.0 mm Hg) compared with travoprost (4.0 mm Hg, p = 0.001). No statistical difference existed between the two treatment groups for any adverse event (p>0.05).

CONCLUSIONS

This study suggests that when both drugs are dosed in the evening the TTFC provides improved intraocular pressure reduction, compared with travoprost, over the 24 h curve and for each individual time point in primary open-angle glaucoma patients.

Second-line therapy with dorzolamide/timolol or latanoprost/timolol fixed combination versus adding dorzolamide/timolol fixed combination to latanoprost monotherapy

OBJECTIVE

To evaluate open-angle glaucoma patients, who were insufficiently controlled on latanoprost monotherapy, to determine the 24 h intraocular pressure (IOP) efficacy and safety when changing them to dorzolamide/timolol (DTFC) or latanoprost/timolol fixed combination (LTFC) or adding DTFC.

METHODS

A prospective, observer-masked, placebo-controlled, crossover, comparison. Consecutive adults with primary open-angle or exfoliative glaucoma who exhibit a mean baseline IOP >21 mm Hg on latanoprost monotherapy were randomised for 3 months to: DTFC, LTFC or DTFC and latanoprost. Patients were then crossed over to the next treatment for periods 2 and 3. At the end of the latanoprost run-in and after each 3-month treatment period, patients underwent 24 h IOP monitoring.

RESULTS

31 patients completed this study. All three adjunctive therapies significantly reduced the IOP at each time point and for the mean 24 h curve, except at 18:00 and 02:00 with DTFC and 02:00 with LTFC. When the three treatments were compared directly, the DTFC and latanoprost therapy demonstrated lower IOPs versus the other treatment groups, including: the mean 24 h pressure, maximum as well as minimum levels and individual time points following a modified Bonferroni correction (p<0.0032).

CONCLUSIONS

This study showed DTFC, LTFC and the addition of DTFC to latanoprost significantly decrease the IOP compared with latanoprost alone, but the latter therapy regime yields the greatest IOP reduction.

Twenty-four-hour intraocular pressure and blood pressure levels with bimatoprost versus latanoprost in patients with normal-tension glaucoma

AIM

To evaluate 24 h intraocular pressure (IOP) and blood pressure (BP) with bimatoprost or latanoprost in patients with normal-tension glaucoma.

DESIGN

Prospective, randomised, crossover, active-controlled, observer-masked study.

METHODS

After a 6-week medicine-free period, we randomised patients to either latanoprost or bimatoprost for 8 weeks and then to the opposite medicine for 8 weeks. At baseline, and at the end of each treatment period, we evaluated IOP and BP at 08:00 and then every 2 h over the 24 h day. Diastolic ocular perfusion pressure (DOPP) was calculated from the above parameters.

RESULTS

Forty completed patients had a 24 h untreated baseline IOP of 15.5 (2.3) mm Hg, and a DOPP of 59.2 (6.1) mm Hg. Both treatments lowered IOP at each time point (p<0.006), and over the 24 h curve (p<0.001, both medicines 13.1 mm Hg, 16% decrease). No difference existed between treatments in absolute IOP, at each time point, and over the 24 h curve (p>or=0.26). Additionally, no differences were found between treated 24 h systolic (p>or=0.29) and diastolic BP (p>or=0.12). The mean 24 h DOPP for latanoprost was increased from baseline (3%, p = 0.031) but not for bimatoprost (2%, p = 0.21). However, no difference in DOPP existed between treatments at any time point or over the 24 h curve (p>or=0.17). No difference was observed between treatments for any adverse event (p>0.05).

CONCLUSIONS

In patients with normal-tension glaucoma, both bimatoprost and latanoprost reduce the 24 h intraocular pressure from untreated baseline to a similar extent. Latanoprost is associated with slightly improved ocular diastolic perfusion pressure over 24 h but similar absolute perfusion levels to that of bimatoprost.

Cost-effectiveness of latanoprost and timolol maleate for the treatment of glaucoma in Scandinavia and the United Kingdom, using a decision-analytic health economic model

PURPOSE

To assess the cost-effectiveness of latanoprost or timolol in glaucoma treatment in Norway, Sweden, Denmark (Scandinavia) and the United Kingdom (UK).

METHODS

A Markov model was constructed to perform a cost-effectiveness analysis. Health states were 'stable' and 'progressed' glaucoma, and transition probabilities for both primary open-angle and exfoliation glaucoma were derived from the medical literature. Practice patterns were obtained from surveys completed by 54 ophthalmologists geographically dispersed throughout each country. Country specific unit costs were used for medications, patient visits, diagnostics, and therapeutic procedures.

RESULTS

Over the life of the model latanoprost was less expensive than timolol by 5.3-7.6% (Scandinavia) and 2.1% (UK). Following adjustments, therapy in the original timolol-treated cohort was slightly more effective in each country with a difference in 0.003-0.015 years to progression of glaucoma existing between latanoprost. This may have resulted from the model design, which reflected that physicians ultimately control most patients' glaucoma over 5 years by adding or changing therapy. The associated incremental cost-effectiveness ratios for latanoprost vs timolol generated by the Scandinavian and the UK models, respectively, were: Norway 351,396 NOK; Sweden 988,985 SEK; Denmark 351,641; and the UK 4751 GBP.

CONCLUSIONS

Over 5 years, in the UK timolol is the cost-effective option, whereas in Scandinavia latanoprost may be the cost-effective alternative to timolol.

Predictive value of the efficacy of glaucoma medications in regulatory trials: Phase I-III to post-marketing studies

PURPOSE

To determine the predictive value of early Phase trials (I-II) for the ocular hypotensive efficacy observed in Phases III and IV.

DESIGN

A review of published literature.

METHODS

This study evaluated 12 medicines in 65 articles in the literature with at least two phases available.

RESULTS

For medicines with Phase I results available (n=3), the average reduction in intraocular pressure (IOP) from untreated baseline was 16%, 26% for Phase II, 26% for Phase III, and 24% for Phase IV. For medicines with Phase II results available (n=6), the average reduction in IOP was 23%, 24% for Phase III, and 23% for Phase IV. For medicines with Phase III results available (n=11), the average reduction in IOP was 25% and 24% for Phase IV.

CONCLUSION

This study indicates that early phase trials usually approximated the results of later regulatory studies and post-commercialization trials.

Twenty-four-hour efficacy of the brimonidine/timolol fixed combination versus therapy with the unfixed components

PURPOSE

To evaluate the 24-h intraocular pressure (IOP) control of brimonidine/timolol fixed combination (BTFC) versusthe unfixed combination of its individual components, each dosed twice daily, in patients with primary open-angle glaucoma or ocular hypertension.

METHODS

An observer-masked, randomized, crossover, active-controlled, two-centre comparison. Following a 6-week medicine-free period, patients were randomized to BTFC or to the unfixed combination of brimonidine and timolol for 3 months. Patients then were crossed over to the opposite treatment for another 3 months. At the end of the medicine-free period, and each treatment period, patients underwent 24-h IOP measurements at 0600, 1000, 1400, 1800, 2200, and 0200 hours.

RESULTS

Twenty-eight patients completed this study. Both BTFC and the unfixed components showed a significant IOP reduction from untreated baseline (P<0.0001), and were statistically equal when compared directly, for each individual time point and for the 24-h IOP curve (P>0.05). The mean 24-h IOP was 24.6+/-1.9 for baseline, 19.2+/-1.9 for BTFC, and 19.2+/-1.6 mmHg for the unfixed components (P=1.0). Four patients were discontinued due to side effects. The most common ocular adverse event was ocular hyperaemia (n=3 with BTFC and n=5 with the unfixed components, P=0.7) and systemic adverse events were rare.

CONCLUSION

This study suggests that both BTFC and the unfixed components of brimonidine and timolol provide a significant 24-h IOP reduction from untreated baseline, and statistically equal control when compared directly, at each time point and for the 24-h pressure curve.

The clinical validity of the treatment satisfaction survey for intraocular pressure in ocular hypertensive and glaucoma patients

PURPOSE

To provide initial validation of the Treatment Satisfaction Survey-Intraocular Pressure (TSS-IOP) quality-of-life survey that analyses specific issues related to side effects, patient satisfaction, and compliance.

METHODS

A prospective, observational cohort of 250 consecutive patients with primary open-angle glaucoma or ocular hypertension was administered the TSS-IOP survey.

RESULTS

Factors that correlated with patient satisfaction included perceived effectiveness of the medicine (F=7.47, P<0.001), ocular irritation (F=6.06, P<0.001), conjunctival hyperaemia (F=4.40, P<0.001), ease of use (F=8.52, P<0.001), and convenience of use (F=6.90, P<0.001). Patient compliance, acceptance of their illness, and knowledge of glaucoma were also related to perceived effectiveness of the medicine (P<0.001), ease of use (P<0.05) and convenience (P<0.001). Physician ratings of patient pressure control, side effects, and instillation problems also were significantly correlated to patient satisfaction (R=0.13-0.26, P=0.05-0.001). The physician ratings of patient compliance, however, were not significantly related to any dimension of patient satisfaction (P>0.05). Among monotherapy prostaglandin treatments, latanoprost demonstrated statistically greater satisfaction than bimatoprost or travoprost regarding conjunctival hyperaemia (P<0.05) and eye irritation (P<0.01).

CONCLUSIONS

This study provides initial evidence that patient satisfaction may be related to compliance, perceived effectiveness of treatment, adverse side effects, ease and convenience of use, acceptance of illness, and knowledge of glaucoma.

Survey of zoonoses recorded in Scotland between 1993 and 2002

All the human and animal laboratory reports of zoonoses sent to Health Protection Scotland between 1993 and 2002 were identified. There were 24,946 reports from veterinary laboratories, and 94,718 (20 per cent) of the 468,214 reports from medical laboratories were considered to be zoonotic. The most common reports of zoonoses from people were Campylobacter, Salmonella, Cryptosporidium and Giardia species and Escherichia coli o157. The most common reports of zoonoses from animals were Salmonella, Cryptosporidium, Chlamydia and Campylobacter species and Mycobacterium avium paratuberculosis. For all the zoonoses in people, the National Health Service Board areas Borders, Dumfries and Galloway, Forth Valley, Grampian, Lanarkshire and Lothian had a higher than expected standardised incidence rate of infection, whereas Ayrshire and Arran, Fife, Greater Glasgow, Shetland, Tayside and Western Isles had a lower than expected rate. The organisms and diseases considered to be new and emerging were Rhodococcus species, Cyclospora cayetanensis, Leishmania species, Pneumocystis carinii (jiroveci) and bovine spongiform encephalopathy/variant Creutzfeldt-Jakob disease.

Safety and efficacy of bimatoprost 0.03% versus timolol maleate 0.5%/dorzolamide 2% fixed combination

PURPOSE

To determine the efficacy and safety of bimatoprost given every evening versus the dorzolamide/timolol fixed combination (DTFC) given twice daily in open-angle glaucoma and ocular hypertensive patients.

METHODS

A double-masked, three-center, prospective, randomized, crossover comparison with two 8-week treatment periods following a 4-week medicine free washout period. Diurnal curve intraocular pressures (IOPs) were taken at 08:00 (trough) and 10:00 and 16:00 hours.

RESULTS

A total of 35 patients were enrolled and 32 completed all evaluations. The diurnal untreated baseline intraocular pressures was 24.8 +/- 2.4 mmHg. On the last day of treatment the mean diurnal intraocular pressures was 17.4 +/- 2.9 for bimatoprost and 18.1 +/- 2.8 mmHg for DTFC (p = 0.35). The individual time points for intraocular pressures were not statistically different between groups. Both groups statistically reduced the intraocular pressures from baseline for each time point and for the diurnal curve (p < 0.05). Regarding ocular safety and tolerability, there was more conjunctival hyperemia with bimatoprost (n = 15) than with DTFC (n = 7, p = 0.013) and more burning and stinging with DTFC (n = 12) than with bimatoprost (n = 0, p = 0.0005). Few systemic adverse events were recorded and there was no statistical difference between groups for any individual event (p > 0.05).

CONCLUSIONS

This study indicates that the intraocular pressures are lowered to a statistically similar amount with DTFC compared to bimatoprost in open-angle glaucoma and ocular hypertensive patients.

Short-term ocular tolerability of dorzolamide 2% and brinzolamide 1% vs placebo in primary open-angle glaucoma and ocular hypertension subjects

PURPOSE

To compare ocular tolerability of dorzolamide 2%, brinzolamide 1%, and placebo given three times daily.

METHODS

A prospective, double-masked, three-centre, crossover comparison in which 25 ocular hypertensive or primary-open angle glaucoma subjects were randomized to receive dorzolamide, brinzolamide, or placebo three times daily for 3 days. Intraocular pressure, visual acuity, a visual analogue scale, and ocular and systemic symptom queries were completed at the end of each period.

RESULTS

After chronic dosing, there was a significant difference in ocular pain on the visual analogue scale among the groups at the 10-s postinstillation time point with dorzolamide having the highest level (22.5+/-28.9) compared to brinzolamide (5.0+/-8.7) or placebo (3.2+/-10.4) (P=0.0006). No differences between groups were observed preinstillation nor following dosing at 3 or 10-min postinstillation. On the initial instillation, the 10-s postinstillation pain was rated as 43.3+/-77.1, which was significantly higher than after chronic dosing (P=0.017). On the ocular symptom query, dorzolamide had the highest incidence of burning/stinging and redness compared to the other groups, but was generally characterized as mild. There were no significant differences in the visual acuity at any time point.

CONCLUSIONS

This study suggests that subjects treated with dorzolamide suffer more ocular pain upon instillation compared to brinzolamide or placebo. However, pain symptoms are fewer following chronic dosing and are generally characterized as mild.

Short term efficacy and safety in glaucoma patients changed to the latanoprost 0.005%/timolol maleate 0.5% fixed combination from monotherapies and adjunctive therapies

AIMS

To evaluate efficacy and safety in patients with ocular hypertension or open angle glaucoma changed to latanoprost/timolol fixed combination (LTFC).

METHODS

A prospective, multicentre, historical control in which qualified patients had their previous therapy substituted by LTFC and were followed for at least 2 months.

RESULTS

In 1676 patients LTFC was continued in 93% throughout the observation period. In all patients LTFC reduced the intraocular pressure (IOP) from 20.6 (SD 3.8) to 17.7 (3.0) mm Hg (p<0.001) compared to previous monotherapies including latanoprost, timolol, alpha agonists or carbonic anhydrase inhibitors (CAI). LTFC provided more efficacy after changing from adjunctive therapies including: a beta blocker added to either CAI, alpha agonist, or pilocarpine, or CAI added to an alpha agonist, or latanoprost added to either CAI, alpha agonist, or beta blocker (unfixed combination), and travoprost added to timolol (p<0.007). LTFC was as effective as latanoprost used with dorzolamide/timolol fixed combination (-0.9 mm Hg, p = 0.1792). The most common reason to discontinue therapy was lack of efficacy (n = 70, 4%) and adverse event (n = 17, 1%).

CONCLUSION

In a clinical setting, patients who have their monotherapy or adjunctive therapy substituted with LTFC may experience reduced IOP, good tolerability, and continuation of therapy for the first 2-3 months of treatment.

Brimonidine purite 0.15% versus dorzolamide 2% each given twice daily to reduce intraocular pressure in subjects with open angle glaucoma or ocular hypertension

BACKGROUND/AIMS

To evaluate the efficacy of brimonidine purite versus dorzolamide given twice daily in primary open angle glaucoma or ocular hypertensive subjects.

METHODS

In this double masked, multicentre, prospective, crossover comparison 33 subjects were randomised to brimonidine purite or dorzolamide for the first 4 week treatment period after a 4 week washout. Subjects began the opposite treatment for the second 4 week period after another 4 week washout. Intraocular pressure (IOP) was measured at 08:00 (trough) and 10:00, 18:00, and 20:00 hours after dosing at each baseline and at the end of each treatment period.

RESULTS

The baseline diurnal IOP was 22.9 (SD 2.8) for brimonidine purite and 22.2 (SD 2.4) mm Hg for dorzolamide. The trough IOP following 4 weeks of therapy was 21.0 (SD 3.7) for brimonidine purite and 21.0 (SD 3.1) mm Hg for dorzolamide (p = 0.90). The mean diurnal IOP was 19.3 (SD 3.1) for brimonidine purite and 19.8 (SD 2.4) mm Hg for dorzolamide (p = 0.46). Dorzolamide caused more ocular stinging upon instillation (n = 8) than brimonidine purite (n = 1) (p = 0.02). No statistical differences existed between groups for systemic adverse events.

CONCLUSIONS

This study suggests that brimonidine purite and dorzolamide each given twice daily have similar efficacy in primary open angle glaucoma or ocular hypertensive subjects. However, a trend was observed at 10:00 of greater brimonidine purite efficacy compared with dorzolamide.

Daytime diurnal curve comparison between the fixed combinations of latanoprost 0.005%/timolol maleate 0.5% and dorzolamide 2%/timolol maleate 0.5%

PURPOSE

The diurnal efficacy and safety of the fixed combinations of latanoprost/timolol given once daily vs dorzolamide/timolol given twice daily in primary open-angle glaucoma or ocular hypertensive patients.

DESIGN

A double-masked, two-centre, crossover comparison.

RESULTS

In 33 patients, the mean diurnal IOP (0800-2000, measured every 2 h) for latanoprost/timolol fixed combination was 17.3+/-2.2 mmHg and for dorzolamide/timolol, the fixed combination was 17.0+/-2.0 mmHg (P = 0.36). Additionally, there was no statistical difference for individual time points following a Bonferroni correction. A bitter taste was found more frequently with the dorzolamide/timolol fixed combination (n = 6) than the latanoprost/timolol fixed combination (n = 0) (P = 0.040), while the latanoprost/timolol fixed combination demonstrated more conjunctival hyperaemia (n = 9) than the dorzolamide/timolol fixed combination (n = 2) (P = 0.045). One patient was discontinued early from the dorzolamide/timolol fixed combination due to elevated IOP.

CONCLUSION

This study suggests that the daytime diurnal IOP is not statistically different between the dorzolamide/timolol fixed combination and latanoprost/timolol fixed combination in primary open-angle glaucoma and ocular hypertensive patients.

Brimonidine 0.2% vs unoprostone 0.15% both added to timolol maleate 0.5% given twice daily to patients with primary open-angle glaucoma or ocular hypertension

PURPOSE

To compare the efficacy and safety of brimonidine 0.2% vs unoprostone 0.15%, both added to timolol maleate 0.5% each given twice daily.

METHODS

In this prospective, multi-centred, double-masked, crossover comparison, patients were randomized to one treatment group for a 6-week treatment period, and then crossed over to the opposite treatment. Measurements were performed at 0800, 1000, 1600, 1800, and 2000 h at baseline and at the end of each treatment period.

RESULTS

In all, 33 patients entered this trial and 29 completed. The baseline trough intraocular pressure (IOP) was 23.3+/-2.4 and the diurnal curve IOP was 22.0+/-1.3 mmHg. For the brimonidine and timolol maleate treatment group, the trough IOP was 21.6+/-3.3 and the diurnal curve IOP was 19.8+/-2.1 mmHg, while the timolol and unoprostone treatment showed a trough IOP of 20.9+/-3.8 and a diurnal curve IOP of 19.3+/-2.4 mmHg. There was no significant difference between treatment groups at any time point for the diurnal curve, or in the reduction from baseline (P>0.05). Both treatments failed to statistically reduce the IOP from baseline at 1800 h. There was no difference between treatment groups regarding ocular and systemic unsolicited adverse events, but patients admitted to more dryness (P=0.02) and burning upon instillation (P<0.0001) with unoprostone by survey.

CONCLUSION

Brimonidine 0.2% or unoprostone 0.15% added to timolol maleate 0.5% provide similar efficacy and safety throughout the daytime diurnal curve.

Efficacy and safety of the latanoprost/timolol maleate fixed combination vs concomitant brimonidine and latanoprost therapy

AIMS

To evaluate the efficacy and safety of latanoprost/timolol maleate fixed combination (LTFC) given once daily vs the concomitant therapy of brimonidine twice daily and latanoprost once daily in primary open-angle glaucoma or ocular hypertensive subjects.

METHODS

A prospective, double-masked, active-controlled comparison in which qualified subjects had all glaucoma medicines discontinued for 1 month and then were randomized to either LTFC or brimonidine and latanoprost concomitant therapy for 6 weeks. They were then switched to the other treatment regimen. The intraocular pressure (IOP) was measured at 0800, 1200, and 1600 h at baseline and at the end of Periods 1 and Period 2.

RESULTS

In 32 subjects, the diurnal curve of the untreated IOP of 26.0+/-3.4 decreased to 17.8+/-2.5 on LTFC and 17.2+/-2.8 mmHg on brimonidine and latanoprost (P=0.31). At 0800 and 1600 h, the IOPs were statistically similar between the groups (P>0.05). At 1200 h the latanoprost and brimonidine treatment IOP was statistically lower (16.2+/-3.2) than LTFC (18.0+/-2.8 mmHg). However, the reduced IOP from untreated baseline was not statistically different at each time point and for the diurnal curve for each therapy (P<0.05). Safety was similar between groups for both solicited and unsolicited side effects (P>0.05).

CONCLUSION

This study suggests that LTFC and concomitant therapy of brimonidine and latanoprost provide statistically similar diurnal IOP reduction from an untreated baseline.

Diurnal intraocular pressure reduction with latanoprost 0.005% compared to timolol maleate 0.5% as monotherapy in subjects with exfoliation glaucoma

AIMS

To compare the diurnal intraocular pressure (IOP) efficacy and safety of timolol vs latanoprost in subjects with exfoliation glaucoma (XFG).

METHODS

A 3-month prospective, single-masked, active-controlled, parallel comparison performed in six centres in Greece that randomized subjects in a 1 : 1 ratio to either latanoprost in the evening (2000 hours) and placebo in the morning (0800 hours), or timolol twice daily (0800 and 2000 hours).

RESULTS

In all, 103 subjects completed the study. After 3 months of chronic dosing, the latanoprost group exhibited a trend to a greater diurnal IOP reduction from an untreated baseline (24.9+/-3.2-17.4+/-2.9) compared with timolol (24.7+/-2.8-18.3+/-1.9 mmHg) (P=0.07). Latanoprost showed a significantly greater IOP reduction at 0800 hours (-8.5 vs -6.0 mm Hg for timolol, P<0.0001) whereas no difference was observed between the two medications at 1000, 1400, and 2000 hours after a Bonferroni Correction. In addition, latanoprost demonstrated a narrower range of diurnal IOP (2.4) than timolol (3.2 mmHg)(P=0.0017). Safety was similar between groups, except there was more conjunctival hyperaemia with latanoprost (n=8) than timolol (n=1)(P=0.01).

CONCLUSIONS

This study suggests that latanoprost provides a statistically lower 08:00-hour IOP and better range of IOP than timolol in the treatment of XFG glaucoma.

Epidemiology of Salmonella enterica serovars Enteritidis and Typhimurium in animals and people in Scotland between 1990 and 2001

Two serovars of salmonella which are currently of particular importance in both human and animal infections are Salmonella enterica serovars Enteritidis phage type 4 (PT4) and Typhimurium definitive type 104 (DT104). This paper describes the trends in the relationships between the levels of infection of people and a range of farm animal species with these two serovars and explores some of the reasons behind them. In 1996, there was a peak of 520 reports of S Typhimurium DT104 infection in people in Scotland, but the number has decreased every year since, to 96 in 2001. In cattle the incidence of S Typhimurium DT104 also peaked in 1996, with 138 incidents, and it has similarly decreased every year to 2001 when there were 10 reported incidents. Similar declines have been observed in its incidence in sheep and pigs. In people the number of reports of S Enteritidis PT4 peaked in 1997 at 1684 and then declined to 457 in 2001. In chickens, the number of reports of S Enteritidis PT4 peaked in 1998 at 34 incidents, but no incidents were reported in the following three years.

The efficacy and safety of the timolol/dorzolamide fixed combination vs latanoprost in exfoliation glaucoma

PURPOSE

To evaluate the safety and efficacy of the timolol/dorzolamide fixed combination vs latanoprost 0.005% in exfoliation glaucoma patients.

METHODS

We randomized in an observer-masked fashion 65 newly diagnosed exfoliation glaucoma patients to either the timolol/dorzolamide twice daily or latanoprost daily treatment for 2 months and then crossed these over to the other treatment.

RESULTS

A total of fifty-four patients completed the study. After 2 months of chronic dosing, the morning intraocular pressure (IOP) (10:00) was reduced from a baseline of 31.2+/-6.5 mmHg to 18.1+/-3.0 with the fixed combination and to 18.9+/-4.1 mmHg with latanoprost (P = 0.21). Six patients were discontinued early from both treatment periods owing to inadequate IOP control and two others were discontinued from latanoprost treatment only. The fixed combination showed a significantly greater incidence of taste perversion (P < 0.001) and stinging upon instillation (P = 0.036), while latanoprost showed a trend for increased conjunctival injection (P = 0.056). However, five patients demonstrated either bradycardia or asthmatic symptoms with initiation of the fixed combination therapy. One patient on latanoprost complained of dizziness. Patient preference was generally given to latanoprost (63 vs 20.3%) mainly because of its once daily dosing (P < 0001).

CONCLUSIONS

This study suggests that both latanoprost and the timolol/dorzolamide fixed combination are efficacious in the treatment of newly diagnosed exfoliation glaucoma.

Effect of timolol 0.5% gel and solution on pulmonary function in older glaucoma patients

PURPOSE

To evaluate the effect of timolol maleate solution or gel forming solution versus placebo on pulmonary function in patients with primary open-angle glaucoma or ocular hypertension without reactive airway disease.

METHODS

After a screening visit, each patient was randomized by a Latin square technique to receive placebo twice daily, 0.5% timolol solution twice daily, or 0.5% timolol gel once a day (placebo given as second dose) to each eye for 2 weeks. Subjects then were crossed over to the two other treatments for 2-week treatment intervals. At each visit, patients were received a dose 15 minutes before pulmonary function testing.

RESULTS

This study began with 25 patients, and 20 finished the trial. There was no difference between treatment groups for the forced expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio (P > 0.1). The mean FEV1 for timolol solution, timolol gel, and placebo was 2.42 L, 2.45 L, and 2.50 L, respectively. The mean FVC for timolol solution, timolol gel, and placebo was 3.33 L, 3.38 L, and 3.44 L, respectively. No difference in intraocular pressure was observed between the timolol solution (17.1 +/- 3.3 mm Hg) and timolol gel (17.1 +/- 3.6 mm Hg) between the treatment periods (P > 0.1). No difference in side effects was observed between treatment groups (P > 0.05).

CONCLUSIONS

In older patients with primary open-angle glaucoma or ocular hypertension without reactive airway disease, nonselective beta-blockers should not worsen pulmonary function.

Brimonidine 0.2% given two or three times daily versus timolol maleate 0.5% in primary open-angle glaucoma

PURPOSE

To evaluate the efficacy and safety of brimonidine 0.2% two or three times daily versus timolol maleate 0.5% solution twice daily.

METHODS

Patients with primary open-angle glaucoma were randomized by Latin square technique to one of the three treatment sequences in this crossover, prospective double-masked trial. Each treatment period consisted of 6 weeks of chronic dosing followed by a diurnal curve for the intraocular pressure measured at 08:00, 10:00, 16:00, 18:00, 20:00, 22:00, and 24:00 hours. Intraocular pressure was measured by applanation tonometry.

RESULTS

Thirty patients completed this trial. The average diurnal intraocular pressures in the trial were measured for timolol maleate (17.7 +/- 2.7 mm Hg), brimonidine given three times daily (18.0 +/- 2.2 mm Hg), and brimonidine given twice daily (19.2 +/- 2.4 mm Hg). There was a statistical difference between groups (P <.005). When groups were compared by pairs, three times daily dosing with brimonidine and timolol maleate both reduced the pressure more than twice daily brimonidine at every time point past 10:00 hours and for the diurnal curve (P <.05). In contrast, three times daily brimonidine and timolol maleate were statistically similar for the diurnal pressure, and each time point, except timolol maleate, decreased the pressure more at 16:00 (P =.042). Safety was similar between groups.

CONCLUSIONS

This study demonstrated that both timolol maleate twice daily and brimonidine three times daily provide a similar intraocular pressure reduction to each other. Timolol maleate twice daily and brimonidine three times daily provide a greater decrease in pressure in the late afternoon and nighttime hours, compared with brimonidine twice daily.

Washout periods for brimonidine 0.2% and latanoprost 0.005%

PURPOSE

To evaluate the intraocular pressure washout time after discontinuing brimonidine 0.2% twice daily and latanoprost 0.005% once every evening.

METHODS

We discontinued brimonidine or latanoprost in a masked fashion from primary open-angle glaucoma or ocular hypertensive patients. The intraocular pressure was measured twice weekly until patients returned to untreated baseline.

RESULTS

In 32 patients, the mean longest eye washout time for brimonidine (n = 15) was 3.3 +/- 3.0 weeks and for latanoprost (n = 17) was 4.4 +/- 3.2 weeks (P =.24). In all but one patient, brimonidine returned to baseline by 5 weeks and latanoprost returned by 8 weeks.

CONCLUSION

After discontinuing latanoprost or brimonidine, a wide variation exists in washout times among individuals, with latanoprost demonstrating a trend to a longer washout period.

Efficacy and safety of bimatoprost in patients with elevated intraocular pressure: a 30-day comparison with latanoprost

PURPOSE

To compare the safety and efficacy of bimatoprost and latanoprost in patients with primary open-angle glaucoma or ocular hypertension.

METHODS

This was a 30-day, multicenter, double-masked, randomized, clinical trial. Patients (n = 64) diagnosed with primary open-angle glaucoma or ocular hypertension were randomly assigned to receive bimatoprost 0.03%, latanoprost 0.005%, or vehicle topically in both eyes once daily, in the evening, for 29 days. The primary endpoint was the reduction in IOP from baseline on day 14 and day 29. Secondary outcome measures included eye examinations and safety parameters.

RESULTS

Bimatoprost and latanoprost significantly lowered IOP from baseline (p <.001). Bimatoprost lowered IOP more than latanoprost at every timepoint measured (bimatoprost: 25-34% reduction, 5.9-8.9 mm Hg; latanoprost: 20-31% reduction, 4.4-7.9 mm Hg), although the between-group differences did not reach statistical significance. Over the 12-hour course of IOP measurements on day 29, bimatoprost provided better diurnal IOP control than latanoprost (p =.0378, area under the curve of diurnal IOP reductions, 1-way ANOVA with pairwise t-test). Both treatment regimens were safe and well tolerated, with no significant between-group differences in reports of specific adverse events. The most common side effect was conjunctival hyperemia, which was similarly apparent in the bimatoprost and latanoprost treatment groups.

CONCLUSIONS

At the end of this 30-day trial, once-daily bimatoprost 0.03% provided better diurnal IOP control than latanoprost and was safe and well tolerated in patients with ocular hypertension and glaucoma.