Blood gas analyses, ruminal and blood pH, urine and faecal pH in dairy cows during subacute ruminal acidosis

The aim of this study was to investigate the variations of some physiological parameters in dairy cows during subacute ruminal acidosis (SARA), a common important disorder of dairy cows that occurs in early lactation. pH changes in ruminal fluid collected by rumenocentesis were measured at ten farms stationed in different zones in the north of Italy. Additionally, the following parameters were measured: blood pH, faecal pH, urine pH, partial pressure of carbon dioxide oxygen, partial pressure of oxygen, bicarbonate level, base excess of extracellular fluid and oxygen content. Herds were divided into two groups according to their average ruminal pH: group A included farms with average ruminal pH > 5.8 (normal) and group B farms with average ruminal pH < 5.8 (acidosis). Unpaired Student\u2019s t test was used to reveal statistical significances between the two groups. Ruminal pH changes due to pathogenesis can be diagnostic for SARA

Pharmacological Management of Anxiety Disorders in the Elderly

Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction. Those antidepressants with more favorable pharmacokinetic profiles should be considered first-line in the treatment of anxiety. Mirtazapine and vortioxetine are also considered safe treatment options. Buspirone may have benefit, but lacks studies in elderly populations. Although tricyclic/tetracyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) may be effective in the elderly, their side effect and safety profiles are suboptimal and thus are not recommended in late-life. Benzodiazepines and beta blockers should generally be avoided when treating anxiety in the elderly. There is not enough evidence to support the use of antipsychotics or mood stabilizers given their risk of problems in both the long and short term. In addition, antipsychotics have a black box warning for increased mortality in elderly patients with dementia