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Topic:Clinical Findings

Clinical findings in horses encompass a range of observable signs and symptoms identified during veterinary examinations that contribute to diagnosing and managing equine health conditions. These findings can include physical observations, such as changes in behavior, posture, or gait, as well as physiological measurements like heart rate, respiratory rate, and temperature. Diagnostics may also involve laboratory tests, imaging, and other diagnostic procedures to assess organ function and detect abnormalities. Recognizing and interpreting clinical findings are essential components of veterinary practice, aiding in the identification of diseases, monitoring treatment progress, and guiding therapeutic interventions. This page brings together peer-reviewed research studies and scholarly articles that explore the methodologies, interpretations, and implications of clinical findings in the context of equine health care.
Clinical observations and management of a severe equine herpesvirus type 1 outbreak with abortion and encephalomyelitis.
Acta veterinaria Scandinavica    March 5, 2013   Volume 55, Issue 1 19 doi: 10.1186/1751-0147-55-19
Walter J, Seeh C, Fey K, Bleul U, Osterrieder N.Latent equine herpesvirus type 1 (EHV-1) infection is common in horse populations worldwide and estimated to reach a prevalence nearing 90% in some areas. The virus causes acute outbreaks of disease that are characterized by abortion and sporadic cases of myeloencephalopathy (EHM), both severe threats to equine facilities. Different strains vary in their abortigenic and neuropathogenic potential and the simultaneous occurrence of EHM and abortion is rare. In this report, we present clinical observations collected during an EHV-1 outbreak caused by a so-called "neuropathogenic" EHV-1 G(2254)/D(...
Renal replacement therapy in healthy adult horses.
Journal of veterinary internal medicine    March 4, 2013   Volume 27, Issue 2 308-316 doi: 10.1111/jvim.12049
Wong DM, Witty D, Alcott CJ, Sponseller BA, Wang C, Hepworth K.Renal replacement therapy (RRT) has been implemented extensively in people to facilitate recovery from acute renal failure (ARF). RRT has not been explored in horses, but might provide a further treatment option in horses with ARF. Objective: To investigate efficacy and safety of RRT in horses. Methods: Five healthy adult horses. Methods: A prospective study was performed on horses restrained in stocks and intravenously connected to a commercial RRT machine to allow continuous venovenous hemodiafiltration to be performed for 6 hours. The RRT machine was set at the following flow rates: blood ...
Blood lactate concentrations in ponies and miniature horses with gastrointestinal disease.
Equine veterinary journal    March 4, 2013   Volume 45, Issue 6 666-670 doi: 10.1111/evj.12043
Dunkel B, Kapff JE, Naylor RJ, Boston R.Clinical impression suggested that pony and miniature breeds (collectively referred to as ponies) presenting to a referral hospital for investigation of gastrointestinal disease had higher blood lactate concentrations on admission than large breed horses. Objective: The study tested the hypothesis that ponies with gastrointestinal disease had higher blood lactate concentrations on admission than large breed horses with similar disease severity. Methods: Retrospective case-control study. Methods: Medical records from September 2006 to July 2011 were reviewed for ponies with a primary presenting...
Exposure of mares to processionary caterpillars (Ochrogaster lunifer) in early pregnancy: an additional dimension to equine amnionitis and fetal loss.
Equine veterinary journal    March 4, 2013   Volume 45, Issue 6 755-760 doi: 10.1111/evj.12044
Cawdell-Smith AJ, Todhunter KH, Perkins NR, Bryden WL.Equine amnionitis and fetal loss (EAFL) is an unusual form of abortion in mid- to late-gestation mares, first identified in Australia in 2004. It has been shown that both whole processionary caterpillars (Ochrogaster lunifer) and their shed exoskeletons can induce abortion in mares during midgestation. These abortions exhibited gross pathology and bacteriology results consistent with field cases of EAFL. Objective: To determine whether exposure of mares to the shed exoskeletons of processionary caterpillars can induce abortion in the preplacentation (<35 days' gestation) and early plac...
Visual outcome after corneal transplantation for corneal perforation and iris prolapse in 37 horses: 1998-2010.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 115-119 doi: 10.1111/j.2042-3306.2012.00657.x
Henriksen Mde L, Plummer CE, Mangan B, Ben-Shlomo G, Tsujita H, Greenberg S, Toft N, Brooks DE.We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation. Objective: To evaluate the visual outcome of horses with iris prolapse treated with penetrating keratoplasty alone and penetrating keratoplasty in combination with overlying conjunctival or amniotic membrane grafting. Methods: A retrospective medical records study of horses presented to the University of Florida Veterinary Medical Center for iris prolapse and treated with penetrating keratoplasty in the period of 1998-2010. Data collected from the medical records include...
Retrospective study investigating causes of abnormal respiratory noise in horses following prosthetic laryngoplasty.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 27-30 doi: 10.1111/j.2042-3306.2012.00612.x
Compostella F, Tremaine WH, Franklin SH.To investigate causes of respiratory noises in horses following prosthetic laryngoplasty (with or without a ventriculocordectomy) and to examine potential associations between degree of arytenoid abduction and the presence of other upper respiratory tract (URT) abnormalities, including right-sided collapse. Methods: Clinical records and dynamic videoendoscopic recordings were examined from horses presented between 1995 and 2010 for investigation of respiratory noise during exercise, following a prosthetic laryngoplasty (+/- a ventriculocordectomy). Relationships between the degree of left aryt...
Clinical evaluation of a closed, one-stage, stapled, functional, end-to-end jejuno-ileal anastomosis in 5 horses.
The Canadian veterinary journal = La revue veterinaire canadienne    March 2, 2013   Volume 53, Issue 9 987-991 
Anderson SL, Blackford JT, Kelmer SG.This study describes the outcome and complications in horses that had a closed, one-stage, stapled, functional, end-to-end (COSFE) jejuno-ileal anastomosis (JIA) following resection of compromised small intestine. Medical records were reviewed to identify all horses that had a COSFE JIA performed during exploratory laparotomy and to determine post-operative complications and final outcome. All 5 horses that were identified had successful COSFE JIA with resection of various amounts of distal jejunum and proximal ileum. Post-operative ileus occurred in 1 of the 5 horses. All horses survived at l...
Pathological evidence of pancreatitis in 43 horses (1986-2011).
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 45-50 doi: 10.1111/j.2042-3306.2012.00636.x
Yamout SZ, Nieto JE, Anderson J, De Cock HE, Vapniarsky N, Aleman M.Definitive ante mortem diagnosis of pancreatitis in horses is difficult. Reports summarising the most common clinical signs, clinicopathological features and concurrent disorders in horses with a definitive diagnosis of pancreatitis that may aid in the recognition of disease are lacking. Objective: To describe case details, clinical signs, clinicopathological data and necropsy findings in horses with a definitive diagnosis of pancreatitis. Methods: This was a retrospective study (1986-2011) and inclusion criteria consisted of horses with a definitive diagnosis of pancreatitis. A medical record...
Use of a wireless, inertial sensor-based system to objectively evaluate flexion tests in the horse.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 8-11 doi: 10.1111/j.2042-3306.2012.00611.x
Marshall JF, Lund DG, Voute LC.A wireless, inertial sensor-based system has previously been validated for evaluation of equine lameness. However, threshold values have not been determined for the assessment of responses to flexion tests. The aim of this investigation was to evaluate a sensor-based system for objective assessment of the response to flexion. Methods: Healthy adult horses (n = 17) in work were recruited prospectively. Horses were instrumented with sensors on the head (accelerometer), pelvis (accelerometer) and right forelimb (gyroscope), before trotting in a straight line (minimum 25 strides) for 2 consecutive...
Magnetic resonance and radiographic diagnosis of osseous resorption of the flexor surface of the distal phalanx in the horse.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 3-7 doi: 10.1111/j.2042-3306.2012.00675.x
Young AC, Dimock AN, Puchalski SM, Murphy B, Spriet M.Osseous resorption of the flexor surface of the distal phalanx of the horse has been identified previously using magnetic resonance (MR) imaging; however, little is known about the prevalence and characteristics of this lesion. Objective: To establish the MR prevalence of resorptive lesions in the flexor surface of the distal phalanx and identify concurrent lesions associated with this finding and associations between the MR and radiographic findings. Methods: Horses with distal extremity MR and radiographs performed within 2 weeks of each other were included in the study. The flexor surface o...
Acquired equine polyneuropathy in Norway and Sweden: a clinical and epidemiological study.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 36-44 doi: 10.1111/j.2042-3306.2012.00679.x
Gröndahl G, Hanche-Olsen S, Bröjer J, Ihler CF, Jäderlund KH, Egenvall A.Acquired equine polyneuropathy (AEP, also known as 'Scandinavian knuckling syndrome'), is a serious disease of unknown aetiology, which emerged clustering in horse farms in Sweden, Norway and Finland in the 1990s. Clinical and epidemiological data regarding the syndrome are scarce. Objective: To describe the clinical and epidemiological findings and outcome in outbreaks of AEP and compare risk factors in affected and unaffected horses on affected farms in Norway and Sweden during 2007-2009. Methods: Neurological examinations were performed and data collected regarding demography, usage, turnin...
Dose titration of the clinical efficacy of intravenously administered flunixin meglumine in a reversible model of equine foot lameness.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 17-20 doi: 10.1111/j.2042-3306.2012.00655.x
Foreman JH, Bergstrom BE, Golden KS, Roark JJ, Coren DS, Foreman CR, Schumacher SA.There are no refereed controlled documentations of the skeletal analgesic efficacy of different dosages of flunixin meglumine (FM). Objective: The objective of this experiment was to compare the efficacy of various dosages of FM with a negative control. The hypothesis was that higher doses would result in improved efficacy in a dose-dependent manner when tested in a reversible model of foot lameness. Methods: Ten horses shod with adjustable heart bar shoes had weekly modified AAEP grade 4.0/5.0 lameness induced by tightening a set screw against the heart bar. Heart rate (HR) and lameness score...
Influence of head and neck position on radiographic measurement of intervertebral distances between thoracic dorsal spinous processes in clinically sound horses.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 21-26 doi: 10.1111/j.2042-3306.2012.00678.x
Berner D, Winter K, Brehm W, Gerlach K.Reductions in distances between dorsal spinous processes on radiographs are used as criteria for the diagnosis of impingement of the thoracic dorsal spinous processes in horses but are potentially altered by spine motion and different head and neck positions. Objective: To determine the influence of head and neck positions on intervertebral distances between dorsal spinous processes on radiographs of thoracic spines of clinically sound horses. Methods: Lateral-lateral radiographs were obtained from 23 horses in 3 head and neck positions. The width of the thoracic dorsal spinous processes and i...
Long-term maintenance of arytenoid cartilage abduction and stability during exercise after laryngoplasty in 33 horses.
Veterinary surgery : VS    March 1, 2013   Volume 42, Issue 3 291-295 doi: 10.1111/j.1532-950X.2013.01109.x
Barnett TP, O'Leary JM, Parkin TD, Dixon PM, Barakzai SZ.To (1) assess long-term maintenance of arytenoid cartilage abduction (ACA) after laryngoplasty (LP); and (2) correlate the residual grade of ACA and postoperative abductory loss with arytenoid cartilage stability (ACS) during exercise. Methods: Case series. Methods: Horses re-examined after laryngoplasty (n = 33). Methods: Of 89 LP horses (2005-2010), 33 had historic ACA data available and upper airway endoscopy at rest and during over-ground exercise (mean, 33 months; range, 4-71 months) after surgery. ACA grade at 1 and 6 weeks postoperatively were correlated to long-term ACA grade. Effects ...
Non-terminal animal model of post-traumatic osteoarthritis induced by acute joint injury.
Osteoarthritis and cartilage    March 1, 2013   Volume 21, Issue 5 746-755 doi: 10.1016/j.joca.2013.02.653
Boyce MK, Trumble TN, Carlson CS, Groschen DM, Merritt KA, Brown MP.Develop a non-terminal animal model of acute joint injury that demonstrates clinical and morphological evidence of early post-traumatic osteoarthritis (PTOA). Methods: An osteochondral (OC) fragment was created arthroscopically in one metacarpophalangeal (MCP) joint of 11 horses and the contralateral joint was sham operated. Eleven additional horses served as unoperated controls. Every 2 weeks, force plate analysis, flexion response, joint circumference, and synovial effusion scores were recorded. At weeks 0 and 16, radiographs (all horses) and arthroscopic videos (OC injured and sham joints) ...
Vasoconstriction in horses caused by endophyte-infected tall fescue seed is detected with Doppler ultrasonography.
Journal of animal science    February 28, 2013   Volume 91, Issue 4 1677-1684 doi: 10.2527/jas.2012-5852
McDowell KJ, Moore ES, Parks AG, Bush LP, Horohov DW, Lawrence LM.The hypotheses that endophyte (Neotyphodium coenophialum)-infected tall fescue (TF) seed causes vasoconstriction in horses in vivo and that ground seed would cause more pronounced vasoconstriction than whole seed were tested. Ten horses each received 1 of 3 treatments: endophyte-free ground (E-G; n = 4 horses) seed, endophyte-positive whole (E+W; n = 3) seed, or endophyte-positive ground (E+G; n = 3) seed. There were two 14-d periods, P1 and P2. During P1, animals were adapted to a concentrate (0.2% BW, as fed, twice daily) and alfalfa cubes. During P2, the seed was mixed into the concentrate ...
Equine multisystemic eosinophilic epitheliotropic disease: a case report and review of literature.
New Zealand veterinary journal    February 27, 2013   Volume 61, Issue 3 177-182 doi: 10.1080/00480169.2012.753569
Bosseler L, Verryken K, Bauwens C, de Vries C, Deprez P, Ducatelle R, Vandenabeele S.A 2-year-old Standardbred gelding presented with a history of fever over 1 week, anorexia and skin lesions on all four legs. The lesions were associated with severe pruritus and oedema, and there was no response to therapy. Results: The horse was in poor body condition, was lethargic and severely pruritic. Skin lesions consisted of diffuse alopecia and crusting of the distal extremities. Initially it was slightly febrile, but subsequently its temperature increased up to 40°C. Ten days after admission it developed profuse watery diarrhoea and the skin lesions progressed. Skin biopsies revealed...
Normal electrocardiographic QT interval in race-fit Standardbred horses at rest and its rate dependence during exercise.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    February 22, 2013   Volume 15, Issue 1 23-31 doi: 10.1016/j.jvc.2012.08.002
Pedersen PJ, Kanters JK, Buhl R, Klaerke DA.Cardiac repolarization, measured as QT and Tpeak to Tend (TpTe) intervals on the ECG, is important, as irregularities caused by diseases, ventricular hypertrophy, drugs and genetic defects can trigger arrhythmias which predispose human patients to syncope and sudden cardiac death. In horses, repolarization is not well described and therefore QT analysis cannot yet be used diagnostically. Therefore, we sought to describe reference values for the normal QT and TpTe intervals in Standardbreds and to determine the best method for heart rate (HR) correction. Methods: 30 Standardbreds. Methods: QT a...
Nephrectomy via ventral median celiotomy in equids.
Veterinary surgery : VS    February 22, 2013   Volume 42, Issue 3 275-279 doi: 10.1111/j.1532-950X.2013.01095.x
Arnold CE, Taylor T, Chaffin MK, Schott HC, Caron JP.To report technique for, and outcome after, nephrectomy through a ventral median celiotomy in equids. Methods: Case series. Methods: Equids with unilateral renal disease (n = 6), aged 2 months to 18 years, weighing 90-434 kg. Methods: A ventral median celiotomy was used to access the left or right kidney. To facilitate surgical exposure, the small intestine was reflected towards the diaphragm using laparotomy sponges and the ascending colon was exteriorized and in some cases evacuated. The peritoneum over the affected kidney was incised and blunt dissection used to free the kidney from the ret...
Large segmental mandibulectomy for treatment of an undifferentiated sarcoma in a horse.
Veterinary surgery : VS    February 21, 2013   Volume 42, Issue 4 433-439 doi: 10.1111/j.1532-950X.2013.01086.x
Carmalt JL, Linn KA.To describe a large segmental (sub-total) mandibulectomy for removal of an undifferentiated sarcoma in a horse. Methods: Clinical report. Methods: A 10-year-old mare. Methods: A combination of methods including computed tomography (CT) were used to diagnose a large undifferentiated sarcoma of the right mandible. A large segmental mandibulectomy extending from 3 cm below the right temporomandibular joint to immediately caudal to tooth 407 was used to perform an en-bloc resection of the mass under general anesthesia. Results: Surgery time was 11 hours and 35 minutes and total anesthesia time, 12...
Ex vivo comparison of bursting strength of ventral median and right ventral paramedian celiotomies in horses.
Veterinary surgery : VS    February 21, 2013   Volume 42, Issue 4 468-472 doi: 10.1111/j.1532-950X.2013.12003.x
Anderson SL, Bracamonte JL, Hendrick S, Carmalt JL, Wilson DG.To compare bursting strength and failure mode between ventral median (VM) and right ventral paramedian (RVP) celiotomies closed with 1 section of USP 7 braided polydioxanone (7PD). Methods: Ex vivo experimental. Methods: Equine cadavers (n = 12). Methods: A 25 cm VM or RVP (positioned 5 cm lateral to the linea alba) celiotomy was created in fresh equine cadavers. A 200 L polyurethane bladder was inserted into the abdomen. Celiotomies were closed in a simple continuous pattern with 1 section of 7PD. The bladder was inflated with compressed air until construct failure. Horse signalment, body wei...
Ultrasound features of arytenoid chondritis in Thoroughbred horses.
Equine veterinary journal    February 19, 2013   Volume 45, Issue 5 598-603 doi: 10.1111/evj.12037
Garrett KS, Embertson RM, Woodie JB, Cheetham J.Laryngeal ultrasonography can provide valuable information when considering a diagnosis of arytenoid chondritis, but specific ultrasonographic parameters have not been defined. Objective: To compare ultrasonographic findings of the arytenoid cartilages in horses with endoscopically diagnosed arytenoid chondritis with ultrasonographic findings of the arytenoid cartilages in normal horses. Methods: Ultrasound images of the larynx were obtained at the level of the arytenoid cartilages in horses with endoscopically diagnosed arytenoid chondritis and horses with normal arytenoid cartilage structure...
Laparoscopic evaluation of oviductal patency in the standing mare.
Theriogenology    February 18, 2013   Volume 79, Issue 6 905-910 doi: 10.1016/j.theriogenology.2012.12.004
Arnold CE, Love CC.Intraluminal masses in the oviduct might cause infertility and/or subfertility in mares by preventing transport of ova, sperm, or both, to the site of fertilization or the embryo into the uterus. Currently, there is no clinical test for oviductal patency in mares. The objective was to determine if the passage of microspheres from the oviduct to the uterus was associated with the presence or absence of intraluminal masses. In this trial, a standing laparoscopic technique was used to cannulate the oviducts and instill 15-μm fluorescent beads in 16 light-breed mares. At 48 hours after surgery, u...
An unexpected finding after a fall from a horse.
BMJ (Clinical research ed.)    February 12, 2013   Volume 346 f724 doi: 10.1136/bmj.f724
Raby S, Greaves D, Padayatty J, Huntly B.No abstract available
Renin-Angiotensin-aldosterone system and hypothalamic-pituitary-adrenal axis in hospitalized newborn foals.
Journal of veterinary internal medicine    February 11, 2013   Volume 27, Issue 2 331-338 doi: 10.1111/jvim.12043
Dembek KA, Onasch K, Hurcombe SD, MacGillivray KC, Slovis NM, Barr BS, Reed SM, Toribio RE.The renin-angiotensin-aldosterone system (RAAS) and hypothalamic-pituitary-adrenal axis (HPAA) and their interactions during illness and hypoperfusion are important to maintain organ function. HPAA dysfunction and relative adrenal insufficiency (RAI) are common in septic foals. Information is lacking on the RAAS and mineralocorticoid response in the context of RAI in newborn sick foals. Objective: To investigate the RAAS, as well as HPAA factors that interact with the RAAS, in hospitalized foals, and to determine their association with clinical findings. We hypothesized that critical illness i...
Histiocytic sarcoma of the nasal cavity in a horse.
Research in veterinary science    February 8, 2013   Volume 94, Issue 3 648-650 doi: 10.1016/j.rvsc.2013.01.005
Paciello O, Passantino G, Costagliola A, Papparella S, Perillo A.Histiocytic diseases in veterinary medicine have been revised in the last few decades, but these are considered relatively rare in horses. This report describes a 9-year-old female horse, Dutch Warmblood, presented for investigation of severe nasal bleeding. A multinodular bilateral mass of 5 cm, reddish to white in color, that invaded and destroyed the surrounding tissues, was observed during a clinical examination of the nostril The morphological features of the tumor cells were represented by cytologically bizarre, highly phagocytic, multinucleated giant cells. These findings, together with...
Detection of equid herpesviruses 2 and 5 in a herd of 266 Lipizzaners in association with ocular findings.
Veterinary microbiology    February 4, 2013   Volume 164, Issue 1-2 139-144 doi: 10.1016/j.vetmic.2013.01.035
Rushton JO, Kolodziejek J, Tichy A, Nell B, Nowotny N.A herd of Lipizzaners (n=266) in three locations [Federal stud Piber (Styria), Heldenberg (Lower Austria) and the Spanish Riding School Vienna (Vienna)] were examined for ocular diseases and tested for herpesviruses (HVs) in PBMCs, nasal- and conjunctival swabs. In 167 (62.8%) horses equid herpesvirus-2 (EHV-2) nucleic acid was identified in at least one of the investigated samples, and 136 (51.1%) horses were positive for equid herpesvirus-5 (EHV-5) nucleic acid in at least one of the samples. One hundred and five (39.5%) of the horses mentioned above were identified with EHV-2/EHV-5 double i...
Evaluation of pregnancy and foaling rates after reduction of twin pregnancy via transvaginal ultrasound-guided aspiration in mares.
Journal of the American Veterinary Medical Association    February 1, 2013   Volume 242, Issue 4 527-532 doi: 10.2460/javma.242.4.527
Klewitz J, Krekeler N, Ortgies F, Heberling A, Linke C, Sieme H.To assess pregnancy and live foaling rates after reduction of twin pregnancy via transvaginal ultrasound-guided aspiration (TUA) in mares and evaluate effects of gestational period, localization of conceptuses, fluid aspiration volume, and combination of TUA with embryonic or fetal puncture on these outcomes. Methods: Clinical trial. Methods: 44 mares pregnant with twins (25 to 62 days of gestation). Methods: TUA was performed in all mares and combined with embryonic or fetal puncture in 13. Follow-up ultrasonographic examinations were performed by referring veterinarians. Effects of gestation...
Optimal tension, position, and number of prostheses required for maximum rima glottidis area after laryngoplasty.
Veterinary surgery : VS    February 1, 2013   Volume 42, Issue 3 280-285 doi: 10.1111/j.1532-950X.2013.01103.x
Bischofberger AS, Wereszka MM, Hadidane I, Perkins NR, Jeffcott LB, Dart AJ.To evaluate the effect of 3 laryngeal prostheses alone or in combination on rima glottidis area in horses. Methods: Experimental randomized design. Methods: Cadaveric equine larynges (n = 22). Methods: Three prostheses were preplaced in each of 14 larynges. Rima glottidis area was measured after loading each suture in 5 Newton (N) increments from 0 N to 35 N. In 8 larynges, the 3 prostheses were tied alone or in combination at a fixed load of 15 N and rima glottidis area measured. Results: Rima glottidis cross-sectional area increased as the load on each prosthesis increased with maximum area ...
Oleander toxicosis in equids: 30 cases (1995-2010).
Journal of the American Veterinary Medical Association    February 1, 2013   Volume 242, Issue 4 540-549 doi: 10.2460/javma.242.4.540
Renier AC, Kass PH, Magdesian KG, Madigan JE, Aleman M, Pusterla N.To determine clinical, laboratory analysis, and necropsy findings for equids with oleander toxicosis and to identify factors associated with outcome. Methods: Retrospective case series. Methods: 30 equids. Methods: Medical records of equids with detectable concentrations of oleandrin in serum, plasma, urine, or gastrointestinal fluid samples and equids that had not received cardiac glycoside drugs but had detectable concentrations of digoxin in serum were identified via a medical records database search. Descriptive statistics were calculated for medical history, physical examination, laborato...
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