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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.
Head and pelvic movement asymmetry during lungeing in horses with symmetrical movement on the straight.
Equine veterinary journal    May 29, 2015   Volume 48, Issue 3 315-320 doi: 10.1111/evj.12446
Rhodin M, Roepstorff L, French A, Keegan KG, Pfau T, Egenvall A.Lungeing is commonly used as part of standard lameness examinations in horses. Knowledge of how lungeing influences motion symmetry in sound horses is needed. Objective: The aim of this study was to objectively evaluate the symmetry of vertical head and pelvic motion during lungeing in a large number of horses with symmetric motion during straight line evaluation. Methods: Cross-sectional prospective study. Methods: A pool of 201 riding horses, all functioning well and considered sound by their owners, were evaluated in trot on a straight line and during lungeing to the left and right. From th...
Evaluation of mean echogenicity of tendons and ligaments of the metacarpal region in neonatal foals: A preliminary study.
Research in veterinary science    May 29, 2015   Volume 101 11-14 doi: 10.1016/j.rvsc.2015.05.011
Spinella G, Loprete G, Castagnetti C, Musella V, Antonelli C, Vilar JM, Britti D, Capitani O, Valentini S.The aims of this research were to evaluate mean echogenicity (ME) of the deep and superficial digital flexor tendons (DDFT and SDFT), the interosseous muscle (IM), and the accessory ligament of the deep digital flexor tendon (ALDDFT) of the metacarpal region in neonatal foals, and determine the effect of sex, side and body weight on this quantitative ultrasonographic evaluation. Thirteen orthopedically sound neonatal foals were examined. Four areas of study (1A, 1B, 2A, 2B) were identified. Transverse scans of the DDFT, SDFT, IM and ALDDFT were obtained, recorded, and analyzed. The most echoge...
[New drugs for horses and production animals in 2014].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    May 27, 2015   Volume 43, Issue 3 154-158 doi: 10.15653/TPG-150250
Emmerich IU.In 2014, no new active pharmaceutical ingredients were released on the German market for horses and food producing animals. One established veterinary active pharmaceutical ingredient is avaibable for an additional species. The analgetic buprenorphine (Buprenodale® Multidose) has additionally been authorized for horses. Furthermore, four new preparations with a new pharmaceutical form, one drug with a new formulation, new galenics and a new indication, respectively, have recently been released to the market. Furthermore, the prostaglandin F2α analoque luprostiol is available again.
Strangles in horses can be caused by vaccination with Pinnacle I. N.
Vaccine    May 27, 2015   Volume 33, Issue 30 3440-3443 doi: 10.1016/j.vaccine.2015.05.009
Cursons R, Patty O, Steward KF, Waller AS.The differentiation of live attenuated vaccine strains from their progenitor and wild-type counterparts is important for ongoing surveillance of product safety and improved guidelines on their use. We utilised a genome sequencing approach to confirm that two cases of strangles in previously healthy horses that had received the Pinnacle I. N. vaccine (Zoetis) were caused by the vaccine strain. Our data shed new light on the safety of this vaccine and suggest that factors beyond the maturity of the animal's immune system influence the development of adverse reactions.
Activity of 10 antimicrobial agents against intracellular Rhodococcus equi.
Veterinary microbiology    May 27, 2015   Volume 178, Issue 3-4 275-278 doi: 10.1016/j.vetmic.2015.05.019
Giguère S, Berghaus LJ, Lee EA.Studies with facultative intracellular bacterial pathogens have shown that evaluation of the bactericidal activity of antimicrobial agents against intracellular bacteria is more closely associated with in vivo efficacy than traditional in vitro susceptibility testing. The objective of this study was to determine the relative activity of 10 antimicrobial agents against intracellular Rhodococcus equi. Equine monocyte-derived macrophages were infected with virulent R. equi and exposed to erythromycin, clarithromycin, azithromycin, rifampin, ceftiofur, gentamicin, enrofloxacin, vancomycin, imipene...
AICAR administration affects glucose metabolism by upregulating the novel glucose transporter, GLUT8, in equine skeletal muscle.
Veterinary journal (London, England : 1997)    May 27, 2015   Volume 205, Issue 3 381-386 doi: 10.1016/j.tvjl.2015.05.018
de Laat MA, Robinson MA, Gruntmeir KJ, Liu Y, Soma LR, Lacombe VA.Equine metabolic syndrome is characterized by obesity and insulin resistance (IR). Currently, there is no effective pharmacological treatment for this insidious disease. Glucose uptake is mediated by a family of glucose transporters (GLUT), and is regulated by insulin-dependent and -independent pathways, including 5-AMP-activated protein kinase (AMPK). Importantly, the activation of AMPK, by 5-aminoimidazole-4-carboxamide-1-D-ribofuranoside (AICAR) stimulates glucose uptake in both healthy and diabetic humans. However, whether AICAR promotes glucose uptake in horses has not been established. I...
Development of a technique for standing hand-assisted laparoscopic splenectomy in five horses.
Australian veterinary journal    May 27, 2015   Volume 93, Issue 6 183-188 doi: 10.1111/avj.12326
Gracia-Calvo LA, Martín-Cuervo M, Jiménez J, Vieítez V, Argüelles D, Durán ME, Ezquerra J.To develop an experimental standing hand-assisted laparoscopic splenectomy (HALS) technique, report the associated peri-operative complications and document the short-term surgical outcomes. Results: Five healthy 300-470 kg horses that underwent standing HALS. Spleens of different weights (2.25-7.0 kg) were removed using this technique. The main complication during surgery was difficulty sectioning the gastrosplenic ligament. The postoperative complications included adhesions of the colon to the nephrosplenic ligament stump and incisional discharge in two horses. Conclusions: Standing HALS...
An abattoir survey of equine dental abnormalities in Queensland, Australia.
Australian veterinary journal    May 27, 2015   Volume 93, Issue 6 189-194 doi: 10.1111/avj.12327
Chinkangsadarn T, Wilson GJ, Greer RM, Pollitt CC, Bird PS.A cadaver study to estimate the prevalence of dental disorders in horses presented at an abattoir in Queensland, Australia. Methods: Cadaver heads at a Queensland abattoir were examined for the presence of dental abnormalities and categorised into age groups. The prevalence of abnormalities was analysed by binomial observation of observed proportion, Pearson's Chi-square test or Fisher's exact correlation test. Strength of association was evaluated using Cramer's V test. Results: Heads from horses (n=400) estimated to be between 1 and 30 years of age were placed into four age groups. The most ...
Diseases of the Equine Urinary System.
The Veterinary clinics of North America. Equine practice    May 26, 2015   Volume 31, Issue 2 377-387 doi: 10.1016/j.cveq.2015.04.005
McLeland S.Uncommon diseases of the equine urinary system span a variety of etiologies and frequently have nonspecific clinical presentations. Because of the infrequency of equine urinary disease and inconsistencies in clinical symptoms, diagnosis and subsequent treatment of urinary disease in this species may be challenging. This article reviews various diseases of the equine urinary system, morphologies, and potential discriminating clinical and clinicopathologic presentations to aid the clinician in determining a definitive diagnosis in practice.
Medial patellar ligament splitting in horses with upward fixation of the patella: A long-term follow-up.
Equine veterinary journal    May 26, 2015   Volume 48, Issue 3 312-314 doi: 10.1111/evj.12435
Andersen C, Tnibar A.Medial patellar ligament splitting (MPLS) has been shown to be a highly effective and minimally invasive treatment for upward fixation of the patella (UFP) in horses. However, long-term follow-up results of this procedure have not previously been reported. Objective: To evaluate the long-term resolution of UFP following MPLS and provide information on complications and recurrence. Methods: Retrospective case series. Methods: Data were collected from horses that underwent MPLS between 1999 and 2013. All cases had a confirmed diagnosis of UFP that had not responded to conservative therapy. Data ...
Rodeo athletes: management of shoulder instability.
The Journal of sports medicine and physical fitness    May 25, 2015   Volume 56, Issue 5 560-564 
Figueiredo EA, Belangero PS, Cohen C, Louchard RL, Terra BB, Pochini AC, Andreoli CV, Cohen M, Ejnisman B.The aim of this study was to describe epidemiological data and evaluate the clinical results of traumatic anterior glenohumeral instability in rodeo athletes. Methods: Thirteen patients, all male, with a mean age of 23.2 (18-31) years old, with anterior glenohumeral instability were include in this study. In 9 patients, the right side was affected. The mean time elapsed between injury and undergoing surgery was 56 months (24-120 months). The surgical technique used (arthroscopic or open bone block procedure) was chosen based on the ISIS (Instability Severity Index Score). Only professional ath...
Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine consensus statement.
Journal of veterinary internal medicine    May 23, 2015   Volume 29, Issue 3 743-758 doi: 10.1111/jvim.12593
Hinchcliff KW, Couetil LL, Knight PK, Morley PS, Robinson NE, Sweeney CR, van Erck E.Published studies of exercise-induced pulmonary hemorrhage (EIPH), when assessed individually, often provide equivocal or conflicting results. Systematic reviews aggregate evidence from individual studies to provide a global assessment of the quality of evidence and to inform recommendations. Objective: Evaluate evidence to determine: if EIPH adversely affects the health, welfare or both of horses; if EIPH affects the athletic capacity of horses; the efficacy of prophylactic interventions for EIPH; and if furosemide affects the athletic capacity of horses. Methods: None. Methods: Systematic re...
Diffusion of mepivacaine to adjacent synovial structures after intrasynovial analgesia of the digital flexor tendon sheath.
Equine veterinary journal    May 23, 2015   Volume 48, Issue 3 326-330 doi: 10.1111/evj.12447
Jordana M, Martens A, Duchateau L, Haspeslagh M, Vanderperren K, Oosterlinck M, Pille F.Controversy exists about the specificity of diagnostic analgesia of the digital flexor tendon sheath (DFTS) in horses. Objective: To evaluate the degree of diffusion of mepivacaine from the equine DFTS to adjacent synovial structures. Methods: Crossover experiment. Methods: Under general anaesthesia, the DFTS of one front and one hindlimb of 8 horses were injected simultaneously with mepivacaine. Synovial fluid samples of the injected DFTS, the adjacent metacarpo-/metatarsophalangeal (MCP/MTP) joint, proximal interphalangeal joint, distal interphalangeal joint, navicular bursa and contralatera...
Evaluation of the ability of a gravitational filtration system to enhance recovery of equine bone marrow elements.
American journal of veterinary research    May 23, 2015   Volume 76, Issue 6 561-569 doi: 10.2460/ajvr.76.6.561
Mundy LN, Ishihara A, Wellman ML, Bertone AL.To assess efficiency of gravity filtration to enhance recovery of equine bone marrow elements including stem and progenitor cells. Methods: 12 healthy adult horses. Methods: Bone marrow aspirates were collected from the fifth sternebral body and filtered by gravitational flow to obtain bone marrow elements. Raw and harvested bone marrow and marrow effluent were evaluated for WBC and platelet counts, automated and cytomorphologic cell differential counts, mesenchymal stem cell CFUs, cell viability, and differentiation capacity. Isolated cells were analyzed for CD90 and major histocompatibility ...
Equivalence between invasive and oscillometric blood pressures at different anatomic locations in healthy normotensive anaesthetised horses.
Equine veterinary journal    May 23, 2015   Volume 48, Issue 3 357-361 doi: 10.1111/evj.12443
Tearney CC, Guedes AG, Brosnan RJ.Accurate blood pressure measurement is essential for effective clinical assessment and appropriate interventions in anaesthetised horses. Information on the accuracy of oscillometry for blood pressure measurement on the appendages of mature horses is limited. Objective: To assess equivalence between invasive and oscillometric blood pressures at different anatomic locations in horses. Methods: Prospective experimental study using 6 healthy mature horses. Methods: Blood pressure was measured invasively in the right transverse facial artery and noninvasively by oscillometry in nondependent limbs ...
Testicular perfusion after standing laparoscopic peritoneal flap hernioplasty in stallions.
Theriogenology    May 22, 2015   Volume 84, Issue 5 797-804 doi: 10.1016/j.theriogenology.2015.05.014
Gracia-Calvo LA, Duque J, Balao da Silva C, Ezquerra J, Ortega-Ferrusola C.Acquired inguinal herniation is a very common condition in stallions, usually leading to unilateral or bilateral castration to prevent future recurrence. Recently, several surgical techniques such as the standing laparoscopic peritoneal flap hernioplasty (SLPFH) have been developed to avoid herniation recurrence and also preserve the breeding activity of high economic value stallions. However, studies on SLPFH lack more comprehensive and systematic data about reproductive-related adverse effects and outcomes. The aim of this study was to evaluate whether SLPFH of the internal inguinal rings pr...
Effect of Presurgical Iodine-Based Disinfection on Bacterial Colonization of the Equine Peripodal Region.
Veterinary surgery : VS    May 22, 2015   Volume 44, Issue 6 756-762 doi: 10.1111/vsu.12338
Johnson J, Messier S, Meulyzer M, Vinardell T, Marcoux M, David F.To compare bacterial colonization after diluted iodine tincture or povidone iodine solution for presurgical disinfection of the equine peripodal region. Methods: Complete block design. Methods: Five horses. Methods: Disinfection protocols using iodine tincture or povidone iodine solutions were tested on 5 pairs (n = 10) equine front feet. Iodine tincture was applied to the left feet and povidone iodine to the right feet. Fixed surfaces of the sole, frog, hoof wall, and peripodal skin were swabbed pre-preparation (T0), after a standard pre-disinfection step (T1), after short disinfection wi...
Knot Security of 5 Metric (USP 2) Sutures: Influence of Knotting Technique, Suture Material, and Incubation Time for 14 and 28 Days in Phosphate Buffered Saline and Inflamed Equine Peritoneal Fluid.
Veterinary surgery : VS    May 22, 2015   Volume 44, Issue 6 723-730 doi: 10.1111/vsu.12333
Sanders RE, Kearney CM, Buckley CT, Jenner F, Brama PA.To evaluate knot security for 3 knot types created in 3 commonly used 5 metric suture materials incubated in physiological and pathological fluids. Methods: In vitro mechanical study. Methods: Knotted suture loops (n = 5/group). Methods: Loops of 3 different suture materials (glycolide/lactide copolymer; polyglactin 910; polydioxanone) were created around a 20 mm rod using 3 knot types (square [SQ], surgeon's [SK], and triple knot [TK]) and were tested to failure in distraction (6 mm/min) after tying (day 0) and after being incubated for 14 and 28 days in phosphate buffered saline (PBS...
Plasma concentrations, analgesic and physiological assessments in horses with chronic laminitis treated with two doses of oral tramadol.
Equine veterinary journal    May 21, 2015   Volume 48, Issue 4 528-531 doi: 10.1111/evj.12448
Guedes A, Knych H, Hood D.Laminitis is a painful disease for which adequate pain management remains a challenging and largely unmet medical need. Objective: To investigate plasma concentrations, analgesic and physiological effects of 2 doses of tramadol in horses with chronic laminitis. Methods: Nonrandomised trial. Methods: Four horses with naturally occurring chronic laminitis received 5 mg/kg bwt and then 10 mg/kg bwt tramadol orally every 12 h for one week with a one-week washout between. Noninvasive arterial blood pressure, heart and respiratory rates, intestinal sounds and forelimb off-loading frequency were ...
Mechanical nociceptive thresholds using four probe configurations in horses.
Veterinary anaesthesia and analgesia    May 21, 2015   Volume 43, Issue 1 99-108 doi: 10.1111/vaa.12274
Taylor PM, Crosignani N, Lopes C, Rosa AC, Luna SP, Puoli Filho JN.To examine the relationship between probe tip size and force readings of mechanical nociceptive thresholds (MTs) to identify appropriate probes for horses. Methods: Randomized, crossover study. Methods: Eight adult, mixed-breed horses aged 5-10 years, weighing 268-460 kg. Methods: Four probe configurations (PCs) were used in random sequence: 1.0 mm diameter (SHARP); 3.2 mm (BLUNT); spring-mounted 1.0 mm (SPRING), and 3 × 2.5 mm (3PIN). A remote-controlled unit on the horse increased force (1.2 N second(-1)) in a pneumatic actuator on the metacarpus. Mean MT for each PC was calculated from 10 ...
Improvement of development of equine preantral follicles after 6 days of in vitro culture with ascorbic acid supplementation.
Theriogenology    May 19, 2015   Volume 84, Issue 5 750-755 doi: 10.1016/j.theriogenology.2015.05.006
Gomes RG, Lisboa LA, Silva CB, Max MC, Marino PC, Oliveira RL, González SM, Barreiros TR, Marinho LS, Seneda MM.The aim of this study was to evaluate the effects of different concentrations of ascorbic acid (25, 50, and 100 μg/mL) in supplemented minimum essential medium (MEM+) on the development of equine preantral follicles that were cultured in vitro for 2 or 6 days. The contralateral ovaries (n = 5) from five mares in seasonal anestrus were collected from a local abattoir. Nine ovarian tissue fragments of approximately 5 × 5 × 1 mm were obtained from each animal. One fragment was immediately fixed and subjected to histologic analysis (control group; Day 0), and the other eight were placed in PBS ...
Intraosseous infusion of the distal phalanx compared to systemic intravenous infusion for marimastat delivery to equine lamellar tissue.
Veterinary journal (London, England : 1997)    May 19, 2015   Volume 205, Issue 3 357-363 doi: 10.1016/j.tvjl.2015.05.010
Underwood C, Collins SN, van Eps AW, Mills PC, Allavena RE, Bailey SR, Medina Torres CE, Meizler A, Pollitt CC.No validated laminitis drug therapy exists, yet pharmaceutical agents with potential for laminitis prevention have been identified. Many of these are impractical for systemic administration but may be effective if administered locally. This study compared intraosseous infusion of the distal phalanx (IOIDP) with systemic intravenous constant rate infusion (CRI) to determine which was more effective for lamellar marimastat delivery. Ultrafiltration probes were placed in both forefeet of five horses to collect lamellar interstitial fluid as lamellar ultrafiltrate (LUF). Marimastat solution (3.5â€...
Pharmacokinetics and bioequivalence testing of five commercial formulations of omeprazole in the horse.
Journal of veterinary pharmacology and therapeutics    May 19, 2015   Volume 39, Issue 1 78-83 doi: 10.1111/jvp.12240
Sykes BW, Underwood C, Greer R, McGowan CM, Mills PC.Omeprazole is widely used in the treatment of equine gastric ulcer syndrome. To date, little is known about the relative pharmacokinetics of the different formulations making comparisons between products difficult. The objectives of the study were to investigate the relative pharmacokinetics of five commercially available formulations of omeprazole in the horse and to test for bioequivalence of four of the formulations using one of the formulations as a reference standard. Twelve mature Thoroughbred horses were fasted for 16 h then administered 2 g of each formulation in a cross-over design. S...
L-Arginine supplementation 0.5% of diet during the last 90 days of gestation and 14 days postpartum reduced uterine fluid accumulation in the broodmare.
Animal reproduction science    May 16, 2015   Volume 159 46-51 doi: 10.1016/j.anireprosci.2015.05.011
Mesa AM, Warren LK, Sheehan JM, Kelley DE, Mortensen CJ.L-Arginine is an essential amino acid in many species that has been shown to influence reproduction. However, in horses a dose of 1% L-arginine of total dietary intake impaired absorption of other amino acids, whereas a dose of 0.5% did not. The objectives of this experiment were to evaluate postpartum parameters on mares supplemented with 0.5% L-arginine through the last 90d of gestation and 14d postpartum. Sixteen light-horse mares were randomly divided in two groups: 8 mares supplemented with 0.5% L-arginine and 8 mares fed an isonitrogenous equivalent. Gestation length, days to uterine cle...
Evaluation of the efficacy of meloxicam for post-operative management of pain and inflammation in horses after orthopaedic surgery in a placebo controlled clinical field trial.
BMC veterinary research    May 15, 2015   Volume 11 113 doi: 10.1186/s12917-015-0427-4
Walliser U, Fenner A, Mohren N, Keefe T, deVries F, Rundfeldt C.The benefit of pre and post-operative administration of non-steroidal anti-inflammatory drugs for the relief of post-operative pain and control of inflammation in horses following orthopaedic surgery has not been previously investigated in controlled clinical field trials, and the utility of such treatment is a matter of ongoing dispute. Recently the utility of post-operative pain management was emphasized. It was therefore our aim to determine the efficacy of meloxicam in horses following partial resection of fractured splint bones. This condition was selected since the limited extent of the ...
Contribution of SRF, Elk-1, and myocardin to airway smooth muscle remodeling in heaves, an asthma-like disease of horses.
American journal of physiology. Lung cellular and molecular physiology    May 15, 2015   Volume 309, Issue 1 L37-L45 doi: 10.1152/ajplung.00050.2015
Chevigny M, Guérin-Montpetit K, Vargas A, Lefebvre-Lavoie J, Lavoie JP.Myocyte hyperplasia and hypertrophy contribute to the increased mass of airway smooth muscle (ASM) in asthma. Serum-response factor (SRF) is a transcription factor that regulates myocyte differentiation in vitro in vascular and intestinal smooth muscles. When SRF is associated with phosphorylated (p)Elk-1, it promotes ASM proliferation while binding to myocardin (MYOCD) leading to the expression of contractile elements in these tissues. The objective of this study was therefore to characterize the expression of SRF, pElk-1, and MYOCD in ASM cells from central and peripheral airways in heaves, ...
Developing a preventive immunization approach against insect bite hypersensitivity using recombinant allergens: A pilot study.
Veterinary immunology and immunopathology    May 15, 2015   Volume 166, Issue 1-2 8-21 doi: 10.1016/j.vetimm.2015.05.002
Jonsdottir S, Hamza E, Janda J, Rhyner C, Meinke A, Marti E, Svansson V, Torsteinsdottir S.Insect bite hypersensitivity (IBH) is an allergic dermatitis of horses caused by bites of midges (Culicoides spp.). IgE-mediated reactions are often involved in the pathogenesis of this disease. IBH does not occur in Iceland due to the absence of Culicoides, but it occurs with a high frequency in Icelandic horses exported to mainland Europe, where Culicoides are present. We hypothesize that immunization with the Culicoides allergens before export could reduce the incidence of IBH in exported Icelandic horses. The aim of the present study was therefore to compare intradermal and intralymphatic ...
Hoof position during limb loading affects dorsoproximal bone strains on the equine proximal phalanx.
Journal of biomechanics    May 14, 2015   Volume 48, Issue 10 1930-1936 doi: 10.1016/j.jbiomech.2015.04.014
Singer E, Garcia T, Stover S.Sagittal fractures of the proximal phalanx (P1) in the racehorse appear to be associated with turf racing surfaces, which are known to restrict forward slide of the foot at impact. We hypothesized that restriction of forward foot slip would result in higher P1 bone strains during metacarpophalangeal joint (MCPJ) hyperextension. Unilateral limbs from six equine cadavers were instrumented with strain gauges and bone reference markers to measure dorsoproximal P1 bone strains and MCPJ extension, collateromotion and axial rotation during in vitro limb loading to 10,500 N. By limiting movement of th...
Local and systemic effect of transfection-reagent formulated DNA vectors on equine melanoma.
BMC veterinary research    May 14, 2015   Volume 11 107 doi: 10.1186/s12917-015-0414-9
Mählmann K, Feige K, Juhls C, Endmann A, Schuberth HJ, Oswald D, Hellige M, Doherr M, Cavalleri JM.Equine melanoma has a high incidence in grey horses. Xenogenic DNA vaccination may represent a promising therapeutic approach against equine melanoma as it successfully induced an immunological response in other species suffering from melanoma and in healthy horses. In a clinical study, twenty-seven, grey, melanoma-bearing, horses were assigned to three groups (n = 9) and vaccinated on days 1, 22, and 78 with DNA vectors encoding for equine (eq) IL-12 and IL-18 alone or in combination with either human glycoprotein (hgp) 100 or human tyrosinase (htyr). Horses were vaccinated intramuscularly, a...
Report of the Havemeyer Foundation Workshop on Equine Implantation: Is early pregnancy loss the only important potential consequence of disturbed preimplantation development?
Equine veterinary journal    May 13, 2015   Volume 47, Issue 4 381-383 doi: 10.1111/evj.12382
Stout TA, Troedsson MH.No abstract available