Serum samples were collected weekly for 3 yr from two female African elephants, for 18 mo from two other female African elephants, and for 2 yr from two female Asian elephants. Animals were not sedated at the time of blood collection. Ovarian cycles, characterized by changes in progesterone and immunoreactive luteinizing hormone (ILH) concentrations, averaged 15.9 +/- 0.6 wk (N = 25) for African females and 14.7 +/- 0.5 wk for Asian females (N = 10). The length of the active luteal phase averaged 10.0 +/- 0.3 wk for African elephants (range 8-14 wk) and 10.6 +/- 0.6 wk for Asian females (range 9-13 wk). Interluteal phases were 5.9 +/- 0.6 wk for African females and 4.2 +/- 0.5 wk for Asian females. One African female (Maliaca) had two extended interluteal phases, both occurring between the months of February and May. Excluding these two periods, there were no differences in the length of the ovarian cycle or the length of the luteal phase between species of elephant. Serum progesterone in both species ranged from less than 50 pg/ml to 933 pg/ml. Average progesterone concentrations during the luteal phase were significantly lower in African elephants compared with Asian elephants (328 +/- 13, N = 30 cycles vs. 456 +/- 23, N = 14 cycles; p less than 0.001). ILH ranged from nondetectable to 11.6 ng/ml. These data suggest that the length of the ovarian cycle in the African elephant is about 16 wk and confirm that the length of the ovarian cycle in the Asian elephant is about 15 wk.
BACKGROUNDBleeding in early pregnancy is strongly associated with pregnancy loss. Progesterone is essential for the maintenance of pregnancy. Several small trials have suggested that progesterone therapy may improve pregnancy outcomes in women who have bleeding in early pregnancy. METHODSWe conducted a multicenter, randomized, double-blind, placebo-controlled trial to evaluate progesterone, as compared with placebo, in women with vaginal bleeding in early pregnancy. Women were randomly assigned to receive vaginal suppositories containing either 400 mg of progesterone or matching placebo twice daily, from the time at which they presented with bleeding through 16 weeks of gestation. The primary outcome was the birth of a live-born baby after at least 34 weeks of gestation. The primary analysis was performed in all participants for whom data on the primary outcome were available. A sensitivity analysis of the primary outcome that included all the participants was performed with the use of multiple imputation to account for missing data. RESULTSA total of 4153 women, recruited at 48 hospitals in the United Kingdom, were randomly assigned to receive progesterone (2079 women) or placebo (2074 women). The percentage of women with available data for the primary outcome was 97% (4038 of 4153 women). The incidence of live births after at least 34 weeks of gestation was 75% (1513 of 2025 women) in the progesterone group and 72% (1459 of 2013 women) in the placebo group (relative rate, 1.03; 95% confidence interval [CI], 1.00 to 1.07; P = 0.08). The sensitivity analysis, in which missing primary outcome data were imputed, resulted in a similar finding (relative rate, 1.03; 95% CI, 1.00 to 1.07; P = 0.08). The incidence of adverse events did not differ significantly between the groups. CONCLUSIONSAmong women with bleeding in early pregnancy, progesterone therapy administered during the first trimester did not result in a significantly higher incidence of live births than placebo.
Anesthesia in the giant anteater (Myrmecophaga tridactyla) may be complicated by apnea. Although emergent orotracheal intubation may be possible in other species, the particular anatomy of the anteater prevents a smooth intubation. A technique, developed on a cadaver model, is described for a surgical approach to the trachea of the giant anteater that may be used to secure an airway in an anesthetized animal under emergent conditions. The approach is complicated by the presence of the large paired submaxillary salivary gland and the relatively deep and caudal position of the larynx relative to the ramus of the mandible. This procedure, however, appears to be a feasible method to achieve endotracheal intubation in the anteater.
This communication reports a partially reversible chemical immobilization protocol used for translocation and veterinary care in giant otter (Pteronura brasiliensis; GO). Six GOs (three males and three females) weighing 24.8 +/- 4.0 kg (mean +/- SD) and ranging in age from 16 to 42 mo old were anesthetized with an i.m. combination of medetomidine (29 +/- 3 microg/kg) and ketamine (3.9 +/- 0.4 mg/kg). To perform all procedures, two otters required an additional dose of ketamine (1.5 mg/kg). Anesthesia was reversed with atipamezole i.m. (147 +/- 14 mg/kg). The mean induction time and recovery times were 12 +/- 5 and 4 min (range, 0-9 min), respectively, with an anesthesia time of 47 +/- 16 min. According to these results, the combination of medetomidine (30 microg/kg i.m.) and ketamine (4 mg/kg i.m.) is a reasonable choice for inducing anesthesia in GOs.
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