No abstract

The aim of this study was to determine whether the magnitude of the intraocular pressure (IOP) lowering response in monkeys to the non-selective prostaglandin (PG)F2a-isopropyl ester (ie) can be reproduced by combining other PG subtype-selective compounds. IOP was lowered by approximately 25% after four to five days of topical administration with latanoprost (FP agonist, 1.5μg, q.d.), bimatoprost (prostamide, whose metabolites have been shown to be FP agonists; 9μg, q.d.), or travoprost (FP agonist, 1.2μg, q.d) or the EP2 agonist butaprost (25μg, b.i.d.). The EP1 agonist, 17-phenyl trinor(PhT)PGE2 b.i.d. and EP3 agonist, sulprostone b.i.d. had no IOP lowering effects. The addition of butaprost, sulprostone (10μg), or 17PhTPGE2 (25μg) to latanoprost did not lower IOP more than latanoprost alone. However, treatment with the combination of latanoprost, 17PhTPGE2, butaprost, and sulprostone produced a similar 50-55% reduction in IOP as did PGF2α-ie (b.i.d.). In conclusion, latanoprost, travoprost and bimatoprost produce similar IOP-lowering responses in normotensive monkeys and are most efficacious when administered q.d. pm compared to b.i.d. The combination of the FP, EP1, EP2, and EP3 agonists used in this study was sufficient to lower IOP by the same magnitude as PGF2α-ie suggesting combining PG-subtype agonists may be a potent anti-glaucoma strategy.

The primary aim of this randomized clinical trial is to investigate the effects of ultrasound-guided transversus abdominis plane (TAP) vs ultrasound-guided trigger point injections (TPIs) on numerical rating scale pain scores at month 3 follow-up in patients with a chronic abdominal wall pain. The primary outcome measure was the difference in mean numeric rating scale pain scores between the TAP and TPI groups at month 3 in an intent-to-treat (ITT) analysis. A total of 60 patients were randomized 1:1 to receive an ultrasound-guided TAP block (n = 30) or an ultrasound-guided TPI (n = 30). No significant group differences in baseline demographic or clinical characteristics were observed. The mean baseline pain score for the TAP and TPI groups was 5.5 and 4.7, respectively. In the ITT analysis at month 3, the between-group difference in pain scores was 1.7 (95% confidence interval, 0.3-3.0) favoring the TPI group. In a secondary per-protocol analysis, the between-group difference in pain scores was 1.8 (95% confidence interval, 0.4-3.2) favoring the TPI group. For the ITT and per-protocol analyses, the group differences in pain scores were consistent with a medium effect size. The main finding of this randomized clinical trial is that adults with chronic abdominal wall pain who received a TPI reported significantly lower pain scores at month 3 follow-up compared with patients who received a TAP block.