Analyze Diet

Topic:Clinical Study

Clinical studies in equine research involve the systematic investigation of health and disease in horses through structured scientific methods. These studies aim to evaluate the safety and efficacy of treatments, understand disease mechanisms, and improve veterinary care practices. Clinical studies can include randomized controlled trials, observational studies, and case-control studies. They may focus on various aspects such as pharmacokinetics, therapeutic interventions, and diagnostic techniques. This page compiles peer-reviewed research studies and scholarly articles that explore the design, implementation, and findings of clinical studies in equine medicine, providing insights into their impact on horse health and veterinary practices.
Diestrous Ovulations in Pregnant Mares as a Response to Low Early Postovulatory Progestogen Concentration.
Animals : an open access journal from MDPI    November 30, 2020   Volume 10, Issue 12 2249 doi: 10.3390/ani10122249
Okada CTC, Kaps M, Perez Quesada J, Gautier C, Aurich J, Aurich C.Spontaneous prolongation of the luteal phase has been described in horses, but the underlying causes are still unclear. The present study investigated details of gonadotrophin and progestogen secretion in pregnant mares (n = 11) with or without experimentally reduced early postovulatory luteal function. From days 0 to 3 after ovulation, they were treated with the prostaglandin F (PGF) analogue cloprostenol or left untreated. After conceptus collection on day 34, they were assigned to the opposite treatment. Mares were affiliated to the group primary corpus luteum (n = 6) or diestrous corpus lu...
Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis.
Equine veterinary journal    November 30, 2020   Volume 53, Issue 5 895-901 doi: 10.1111/evj.13361
Haseler CJ, Jarvis GE, McGovern KF.Intrasynovial corticosteroid injections are commonly used in the treatment of equine orthopaedic disease, but corticosteroid administration is widely considered a risk factor for the development of laminitis. Despite a list of putative mechanisms and a number of case reports of steroid-induced laminitis, no case-control or cohort studies investigating the association between use of intrasynovial corticosteroids and acute laminitis have been published. Objective: To quantify the risk of laminitis posed by intrasynovial triamcinolone acetonide (TA) administration in a mixed population of horses....
Development and Validation of an Automated Video Tracking Model for Stabled Horses.
Animals : an open access journal from MDPI    November 30, 2020   Volume 10, Issue 12 2258 doi: 10.3390/ani10122258
Kil N, Ertelt K, Auer U.Changes in behaviour are often caused by painful conditions. Therefore, the assessment of behaviour is important for the recognition of pain, but also for the assessment of quality of life. Automated detection of movement and the behaviour of a horse in the box stall should represent a significant advancement. In this study, videos of horses in an animal hospital were recorded using an action camera and a time-lapse mode. These videos were processed using the convolutional neural network Loopy for automated prediction of body parts. Development of the model was carried out in several steps, in...
Investigation of Oral Microbiome in Donkeys and the Effect of Dental Care on Oral Microbial Composition.
Animals : an open access journal from MDPI    November 30, 2020   Volume 10, Issue 12 2245 doi: 10.3390/ani10122245
Zhu Y, Jiang W, Holyoak R, Liu B, Li J.The objective of this study was to investigate the oral microbial composition of the donkey and whether basic dental treatment, such as dental floating, would make a difference to the oral microbial environment in donkeys with dental diseases using high-throughput bacterial 16S rRNA gene sequencing. Oral swab samples were collected from 14 donkeys with various dental abnormalities on day 0 (before treatment) and day 20 (twenty days after treatment). It is the first report focusing on the oral microbiome in donkeys with dental diseases and the impact of common dental procedures thereon. Identif...
Estimation of Nitrite-Nitric Oxide Derivative-In Horses with Intestinal Colic by ESR Spectroscopy.
Veterinary sciences    November 29, 2020   Volume 7, Issue 4 191 doi: 10.3390/vetsci7040191
Borunova SF, Tkachev N, Iolchiev B, Artyushina Z, Abramov P, Nikitina M, Silanteva A, Khusnetdinova N, Serezhenkov V.Diseases of the gastrointestinal tract of horses are caused by many factors and have a complex pathogenesis. Developing effective methods of differential diagnostics is of high fundamental and applied importance. The pathogenesis of diseases of the digestive tract of horses accompanied by the development of inflammation and oxidative stress, can be associated with a lack of the nitrogen monoxide which controls many signaling pathways in the body. The level of the nitric oxide (NO) is involved in the regulation of the immune and nervous systems, the tone of all the blood vessels, and the course...
Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses.
Animals : an open access journal from MDPI    November 29, 2020   Volume 10, Issue 12 doi: 10.3390/ani10122242
Maskato Y, Dugdale AHA, Singer ER, Kelmer G, Sutton GA.Assessment of the severity of pain in colic cases is subjective. The Equine Acute Abdominal Pain Scale (EAAPS), previously validated using film clips of horses with colic, was tested for feasibility and revalidated in both medical and surgical colic cases in Israel and the UK. Feasibility qualities evaluated were quickness and ease-of-use. Pain in 231 horses, presented for colic, was assessed by 35 participants; 26 in the UK and 9 in Israel. Without prior training, participants assessed the severity of pain using two scales; the EAAPS and a visual analogue scale (VAS). Convergent validity comp...
Histologic effects of MicroPulse™ transscleral cyclophotocoagulation in normal equine eyes.
Veterinary ophthalmology    November 29, 2020   Volume 24, Issue 1 59-70 doi: 10.1111/vop.12846
Foote BC, Smith JD, Allbaugh RA, Sebbag L.Determine the immediate post-operative effects of MicroPulse transscleral cyclophotocoagulation (MP-TSCPC) in healthy equine eyes. Methods: Ten adult horses. Methods: MP-TSCPC was performed on sedated horses in 12 eyes (4 groups) using the following parameters (power, duration, duty cycle): (1) 2000 mW, 180 seconds, 31.3%; (2) 3000 mW, 180 seconds, 31.3%; (3) 3000 mW, 270 seconds, 31.3%; and (4) 3000 mW, 270 seconds, 50%. Three additional eyes were left untreated (control). Eyes were monitored clinically until euthanasia (mean = 3 hours post-procedure). Histologic sections were asse...
Echocardiographic assessment of left ventricular size and systolic function in Warmblood horses using linear measurements, area-based indices, and volume estimates: A retrospective database analysis.
Journal of veterinary internal medicine    November 28, 2020   Volume 35, Issue 1 504-520 doi: 10.1111/jvim.15968
Berthoud D, Schwarzwald CC.Echocardiographic assessment of left ventricular (LV) size and function using area-based indices and volumetric estimates is not well established in horses. Objective: To report reference intervals and measurement variability for uni-, 2-, and 3-dimensional echocardiographic indices of LV size and systolic function in Warmblood horses and to provide proof of concept for allometric scaling of variables to body weight. Unidimensional indices were to be compared to area-based indices and LV volume estimates to establish their clinical use. Methods: Thirty healthy Warmblood horses and 70 Warmblood...
Nerve growth factor in the equine joint.
Veterinary journal (London, England : 1997)    November 28, 2020   Volume 267 105579 doi: 10.1016/j.tvjl.2020.105579
Kendall A, Nyström S, Ekman S, Hultén LM, Lindahl A, Hansson E, Skiöldebrand E.Nerve growth factor (NGF) is a neurotrophin with many functions. In humans, it is involved in inflammation, nerve growth, apoptosis and pain signalling. Increased concentrations of NGF in synovial fluid has been shown in humans and dogs with osteoarthritis. Despite osteoarthritis being a common problem in horses, no studies have previously been published on NGF in the equine joint. The aim of this study was to quantify NGF in equine synovial fluid from healthy joints, acutely inflamed septic joints and joints with structural changes associated with osteoarthritis. A secondary aim was to identi...
Cumulative antibiogram and multidrug-resistant organisms in a regional equine referral hospital. Yuen KY, Gibson JS, Hinrichsen S, Medina-Torres CE, Bertin FR, Stewart AJ.Prudent use of antimicrobials is paramount to slow the development of resistance and for successful treatment. The use of cumulative antibiograms will allow evidence-based antimicrobial selection with consideration of local resistance patterns. We generated a "first-isolate-per-patient" cumulative antibiogram for a regional equine referral hospital. Bacterial organisms cultured from horses between 2011 and 2018, sample origin, antimicrobial susceptibilities, and multidrug-resistant (MDR) status were tabulated. Of 1,176 samples, 50% were culture positive. Overall, 93 of 374 (25%) were MDR. Of t...
Characteristics of complete tibial fractures in California racehorses.
Equine veterinary journal    November 27, 2020   Volume 53, Issue 5 911-922 doi: 10.1111/evj.13375
Samol MA, Uzal FA, Hill AE, Arthur RM, Stover SM.Tibial fractures cause ~3% of racehorse deaths. Pre-existing stress fractures have been associated with multiple racing and training fractures, but not complete tibial fractures. Objective: To describe racehorse tibial fractures and compare signalment and exercise histories of affected and control racehorses. Methods: Retrospective analysis of necropsy reports. Methods: Racehorses that had a complete tibial fracture (1990-2018) were retrospectively reviewed. Signalment and exercise histories of affected horses were compared to 1) racehorses that died because of non-tibial musculoskeletal injur...
Characterization of semen collected by pharmacologically induced ejaculation from a stallion with seminal vesiculitis.
Reproduction in domestic animals = Zuchthygiene    November 27, 2020   Volume 55, Issue 12 1808-1811 doi: 10.1111/rda.13860
Cavalero TMS, Segabinazzi LGTM, Scheeren VFDC, Freitas-Dell'Aqua CP, Papa FO.The present study compared the quality of sperm collected by artificial vagina or pharmacologically induced ejaculation from a 10-year-old thoroughbred stallion with seminal vesiculitis. The pharmacological protocol involved intravenous administration of detomidine (0.01 mg/kg) and oxytocin (20 IU) and successfully induced ejaculation in all attempts of semen collection. Sperm motility, plasma membrane and acrosome integrity (PMAI), reactive oxygen species (ROS) levels, polymorphonuclear neutrophil (PMN) percentage, and bacterial profiles of fresh and cooled semen (5°C for 24 hr) were eval...
Expression of Proteinase-Activated Receptor 2 During Colon Volvulus in the Horse.
Frontiers in veterinary science    November 27, 2020   Volume 7 589367 doi: 10.3389/fvets.2020.589367
Lambertini C, Zannoni A, Romagnoli N, Bombardi C, Morini M, Dondi F, Bernardini C, Forni M, Rinnovati R, Spadari A.Large colon volvulus in horses is associated with a poor prognosis, especially when ischemic-reperfusion injury of the affected intestinal tract develops. Proteinase-activated receptor 2 (PAR2) plays an important role in the pathogenesis of inflammation in the gastrointestinal tract. The aim of this study was to evaluate the distribution and expression of PAR2 in colonic pelvic flexure of horses spontaneously affected by large colon volvulus (CVH group). Eight horses admitted for severe abdominal colon volvolus and which underwent surgery were included. Colon samples were collected after enter...
Hastening Time to Ejaculation in Donkey Jacks Treated with the PGF2α Analog, Cloprostenol Sodium.
Animals : an open access journal from MDPI    November 27, 2020   Volume 10, Issue 12 doi: 10.3390/ani10122231
Panzani D, Quaresma M, Fanelli D, Camillo F, Moroni R, Rota A, Martins-Bessa A, Nóvoa M, Catalán J, Canisso IF, Conte G, Mirò J.Due to the long courtship needed to attain excitation and erection, donkey semen collection can take up to 90 min. ProstaglandinF2α (PGF2α) has been reported to hasten the onset of erection and ejaculation in domesticated mammals, presumably by inducing smooth muscle contractions in the internal genitalia. However, while it has been anecdotally used in donkeys, it has yet to be critically evaluated. This study aimed to compare behavioral and semen parameters in Catalan, Balearic, Amiata, and Miranda jacks treated with the PGF2α analogue cloprostenol sodium immediately prior to exposure to a...
Effect of Equine-Assisted Activities on Cardiac Autonomic Function in Children with Cerebral Palsy: A Pilot Randomized-Controlled Trial.
Journal of alternative and complementary medicine (New York, N.Y.)    November 27, 2020   Volume 27, Issue 1 96-102 doi: 10.1089/acm.2020.0346
Park IK, Lee JY, Suk MH, Yoo S, Seo YG, Oh JK, Kwon JY. Children with cerebral palsy (CP) have an impaired cardiac autonomic function. Attenuated heart rate recovery (HRR), which is a valuable prognostic parameter for autonomic nervous system, is known to be associated with an increased risk of cardiovascular events and all-cause mortality. However, only few studies have observed the effects of exercise on the cardiac autonomic function in children with CP. The purpose of this pilot study was to examine the effects of equine-assisted activity (EAA) program on cardiac autonomic function in children with CP. A single-blinded, parallel, two-arm pilo...
Equine seroprevalence of West Nile virus antibodies in the UK in 2019.
Parasites & vectors    November 26, 2020   Volume 13, Issue 1 596 doi: 10.1186/s13071-020-04481-9
Folly AJ, Waller ESL, McCracken F, McElhinney LM, Roberts H, Johnson N.West Nile virus (WNV) is a single-stranded RNA virus that can cause neurological disease in both humans and horses. Due to the movement of competent vectors and viraemic hosts, WNV has repeatedly emerged globally and more recently in western Europe. Within the UK, WNV is a notifiable disease in horses, and vaccines against the virus are commercially available. However, there has been no investigation into the seroprevalence of WNV in the UK equine population to determine the extent of vaccination or to provide evidence of recent infection. Methods: Equine serum samples were obtained from the A...
Pharmacokinetics and pharmacodynamics of meperidine after intramuscular and subcutaneous administration in horses.
Veterinary surgery : VS    November 26, 2020   Volume 50, Issue 2 410-417 doi: 10.1111/vsu.13545
Hanafi AL, Reed RA, Trenholme HN, Sakai DM, Ryan CA, Barletta M, Quandt JE, Knych HK.To describe the pharmacokinetics and pharmacodynamics of meperidine after IM and subcutaneous administration in horses. Methods: prospective, randomized, blinded, crossover trial. Methods: Six adult horses weighing 494 ± 33 kg. Methods: Treatments included meperidine 1 mg/kg IM with saline 6 mL subcutaneously, meperidine 1 mg/kg subcutaneously with saline 6 mL IM, and saline 6 mL subcutaneously and 6 mL IM, with a 7-day washout between treatments. Plasma meperidine concentrations and pharmacodynamic values (thermal and mechanical thresholds, physiological variables, fecal production) were c...
Recovery of Equine Oocytes in Ambulatory Practice and Potential Complications.
Journal of equine veterinary science    November 26, 2020   Volume 98 103324 doi: 10.1016/j.jevs.2020.103324
Rodriguez J, Maserati M, Robilotta T, Augusto G, Alonso MA, Redoan M, Tibary A, Fleury P.Field collection of oocytes in mares using transvaginal follicular aspiration (TVA) for embryo production has the potential to revolutionate the equine industry. Protocols for TVA in specialized laboratory settings have been described in the scientific literature since the early 1980s. The objective of this study was to determine the success rate of TVA oocytes recovery under ambulatory conditions. A secondary goal of this study was to determine if TVA is associated with any health complications when performed by recently trained practitioners in the field. Follicles (n = 296) from 66 adult c...
Changes in Arterial Blood Pressure and Oxygen Tension as a Result of Hoisting in Isoflurane Anesthetized Healthy Adult Horses.
Frontiers in veterinary science    November 25, 2020   Volume 7 601326 doi: 10.3389/fvets.2020.601326
Cerullo M, Driessen B, Douglas H, Hopster K. In anesthetized adult horses, changes in recumbency can influence the cardiovascular system but how arterial blood pressures and oxygen tension change in isoflurane anesthetized animals as a direct result of hoisting has not been investigated. To evaluate effects of hoisting on hemodynamic function and pulmonary gas exchange in isoflurane-anesthetized horses. Prospective, experimental study. Six adult horses were anesthetized three times using isoflurane in pure oxygen (inspired fraction 0.9-1.0), and allowed breathing spontaneously in lateral recumbency. After 45 min horses were hoisted u...
Asymmetric dimethylarginine-A potential cardiac biomarker in horses.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    November 24, 2020   Volume 33 43-51 doi: 10.1016/j.jvc.2020.11.002
Ertelt A, Stumpff F, Merle R, Kuban S, Bollinger L, Liertz S, Gehlen H.Asymmetric dimethylarginine (ADMA) is a cardiac biomarker in humans, symmetric dimethylarginine (SDMA) a renal biomarker in humans, cats, and dogs. The purpose of this prospective study was to investigate if measuring serum ADMA and SDMA concentrations via ELISA allows detection of cardiac disease in horses in a routine laboratory setting. In this context, reference values in horses were established. Methods: Seventy-eight horses with no known medical history were compared to 23 horses with confirmed structural cardiac disease with/or without arrhythmias. Horses underwent physical examination,...
Use of color-coded, three-dimensional-printed equine carpus models is preferred by students but does not result in statistically different academic performance. Johnson KL, Hespel AM, Price JM, de Swarte M.Radiology can be a challenging subject for students and finding new techniques that help improve their understanding could have positive effects in their clinical practice. The purpose of this prospective experimental study was to implement the use of color-coded, three-dimensional-printed, handheld equine carpus models into a radiographic anatomy course and evaluate the impact objectively and subjectively using quizzes and student response surveys. A first-year veterinary class was randomly divided into two similarly sized groups (groups A and B) for an equine normal radiographic anatomy labo...
Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses.
Animals : an open access journal from MDPI    November 24, 2020   Volume 10, Issue 12 doi: 10.3390/ani10122195
Haussler KK.The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until...
Investigation of a 24-Hour Culture Step to Determine the Viability of Streptococcus equi Subspecies equi Via Quantitative Polymerase Chain Reaction in Nasal Secretions From Horses With Suspected Strangles.
Journal of equine veterinary science    November 24, 2020   Volume 97 103328 doi: 10.1016/j.jevs.2020.103328
Pusterla N, Barnum SM, Byrne BA.Polymerase chain reaction (PCR)-based detection assays for Streptococcus equi subspecies equi often overestimate the prevalence of samples containing viable organisms. The objective of this study was to determine if viability could be determined using genome quantitation and detection of messenger RNA (mRNA) transcripts for the SeM gene of S. equi in pre- and post-cultured samples. Nasal secretions collected from 42 horses with suspected strangles were tested by culture and by quantitative PCR (qPCR) before and 24 hours after a culture step. Viable S. equi was determined based on the detecti...
Comparison of the Surface Thermal Patterns of Horses and Donkeys in Infrared Thermography Images.
Animals : an open access journal from MDPI    November 24, 2020   Volume 10, Issue 12 2201 doi: 10.3390/ani10122201
Domino M, Romaszewski M, Jasiński T, Maśko M.Infrared thermography (IRT) is a valuable diagnostic tool in equine veterinary medicine; however, little is known about its application to donkeys. This study aims to find patterns in thermal images of donkeys and horses and determine if these patterns share similarities. The study is carried out on 18 donkeys and 16 horses. All equids undergo thermal imaging with an infrared camera and measurement of the skin thickness and hair coat length. On the class maps of each thermal image, fifteen regions of interest (ROIs) are annotated and then combined into 10 groups of ROIs (GORs). The existence o...
How low can we go? Influence of sample rate on equine pelvic displacement calculated from inertial sensor data.
Equine veterinary journal    November 23, 2020   Volume 53, Issue 5 1075-1081 doi: 10.1111/evj.13371
Pfau T, Reilly P.Low-cost sensor devices are often limited in terms of sample rate. Based on signal periodicity, the Nyquist theorem allows determining the minimum theoretical sample rate required to adequately capture cyclical events, such as pelvic movement in trotting horses. Objective: To quantify the magnitude of errors arising with reduced sample rates when capturing biological signals using the example of pelvic time-displacement series and derived minima and maxima used to quantify movement asymmetry in lame horses. Methods: Data comparison. Methods: Root mean square (RMS) errors between the 'reference...
Monitoring equine ascarid and cyathostomin parasites: Evaluating health parameters under different treatment regimens.
Equine veterinary journal    November 23, 2020   Volume 53, Issue 5 902-910 doi: 10.1111/evj.13374
Nielsen MK, Gee EK, Hansen A, Waghorn T, Bell J, Leathwick DM.Strongylid and ascarid parasites are omnipresent in equine stud farms, and ever-increasing levels of anthelmintic resistance are challenging the industry with finding more sustainable and yet effective parasite control programs. Objective: To evaluate egg count levels, bodyweight and equine health under defined parasite control protocols in foals and mares at two Standardbred and two Thoroughbred stud farms. Methods: Longitudinal randomised field trial. Methods: A total of 93 foals were enrolled and split into two treatment groups, and 99 mares were enrolled and assigned to three treatment gro...
Implantable loop recorders can detect paroxysmal atrial fibrillation in Standardbred racehorses with intermittent poor performance.
Equine veterinary journal    November 23, 2020   Volume 53, Issue 5 955-963 doi: 10.1111/evj.13372
Buhl R, Nissen SD, Winther MLK, Poulsen SK, Hopster-Iversen C, Jespersen T, Sanders P, Carstensen H, Hesselkilde EM.Limited information is available on paroxysmal atrial fibrillation (PAF) in the horse. Indeed, undiagnosed PAF could result in poor performance. Due to the intermittent occurrence, PAF is difficult to diagnose. However, implanting a small ECG device (implantable loop recorder, ILR) subcutaneously, allows the continuous and automatic detection of PAF. Objective: The aim was to investigate the potential of ILRs as a tool for diagnosing PAF in horses with poor performance. Methods: Prospective field study. Methods: Twelve racing Standardbred trotters with intermittent reduced performance (mean ag...
Low dietary silicon supplementation may not affect bone and cartilage in mature, sedentary horses.
Journal of animal science    November 21, 2020   Volume 98, Issue 12 skaa377 doi: 10.1093/jas/skaa377
Pritchard A, Nielsen BD, Robison C, Manfredi JM.As osteoarthritis is a major cause of lameness in horses in the United States, improving collagen health prior to onset and increasing collagen turnover within affected joints could improve health- and welfare-related outcomes. Through its positive effects on bone mineral content and density and its role in increasing collagen synthesis, silicon (Si) may slow the development and progression of osteoarthritis, thereby reducing lameness. This study evaluated the hypothesis that Si supplementation would increase cartilage turnover through increased collagen degradation and formation markers, as w...
Reliable and clinically applicable gait event classification using upper body motion in walking and trotting horses.
Journal of biomechanics    November 21, 2020   Volume 114 110146 doi: 10.1016/j.jbiomech.2020.110146
Roepstorff C, Dittmann MT, Arpagaus S, Serra Bragança FM, Hardeman A, Persson-Sjödin E, Roepstorff L, Gmel AI, Weishaupt MA.Objectively assessing horse movement symmetry as an adjunctive to the routine lameness evaluation is on the rise with several commercially available systems on the market. Prerequisites for quantifying such symmetries include knowledge of the gait and gait events, such as hoof to ground contact patterns over consecutive strides. Extracting this information in a robust and reliable way is essential to accurately calculate many kinematic variables commonly used in the field. In this study, optical motion capture was used to measure 222 horses of various breeds, performing a total of 82 664 steps...
Serum Progesterone and Conception Rates in Acyclic Embryo Recipient Mares Using a Bovine Progesterone-Releasing Intravaginal Device.
Journal of equine veterinary science    November 21, 2020   Volume 97 103325 doi: 10.1016/j.jevs.2020.103325
Rigoleto Júnior WL, Dias de Camargo Neto W, de Paula Nogueira G, Ferrari TA, Bertan Membrive CM, Giometti IC, Castilho C.The objective of this study was to quantify serum progesterone levels, uterine features, and pregnancy rates in acyclic, embryo recipient mares using a bovine progesterone-releasing intravaginal device in a commercial embryo transfer (ET) program. The study included 73 recipient mares of unknown breed, aged 3-10 years, weighing 350-500 kg, and kept under an intensive management system on Tifton 85 (Cynodon spp.) pastures with water and mineral salt ad libitum. The horses were divided into two groups: a group with a progesterone-releasing intravaginal device (1 g progesterone, G-IVP4, n = 24...