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.
Investigating the link between particulate exposure and airway inflammation in the horse.
Journal of veterinary internal medicine    October 1, 2014   Volume 28, Issue 6 1653-1665 doi: 10.1111/jvim.12458
Ivester KM, Couëtil LL, Zimmerman NJ.Inhalant exposure to airborne irritants commonly encountered in horse stables is implicated in the pathogenesis of inflammatory airway disease (IAD) and recurrent airway obstruction (RAO), non-infectious, inflammatory pulmonary disorders that impact the health and performance of horses across all equine disciplines. IAD and RAO have overlapping clinical, cytological, and functional manifestations of the pulmonary response to organic dust and noxious gases encountered in the barn environment. Study of these diseases has provided important but incomplete understanding of the effect of air qualit...
Pharmacokinetics of metronidazole in foals: influence of age within the neonatal period.
Journal of veterinary pharmacology and therapeutics    October 1, 2014   Volume 38, Issue 3 227-234 doi: 10.1111/jvp.12164
Swain EA, Magdesian KG, Kass PH, Edman JE, Knych HK.Neonatal foals have unique pharmacokinetics, which may lead to accumulation of certain drugs when adult horse dosage regimens are used. Given its lipophilic nature and requirement for hepatic metabolism, metronidazole may be one of these drugs. The purpose of this study was to determine the pharmacokinetic profiles of metronidazole in twelve healthy foals at 1-2.5 days of age when administered as a single intravenous (IV) and intragastric (IG) dose of 15 mg/kg. Foals in the intravenous group were studied a second time at 10-12 days of age to evaluate the influence of age on pharmacokinetics wi...
Pharmacokinetics of intravenous, plain oral and enteric-coated oral omeprazole in the horse.
Journal of veterinary pharmacology and therapeutics    October 1, 2014   Volume 38, Issue 2 130-136 doi: 10.1111/jvp.12169
Sykes BW, Underwood C, McGowan CM, Mills PC.The objectives were to document the pharmacokinetics of intravenous, enteric-coated oral and plain oral omeprazole in fasted horses and to investigate the impact of feeding on the bioavailability of an enteric-coated omeprazole. Twelve horses received four treatments: intravenous omeprazole (0.5 mg/kg) in the fasted state (IV-Fasted), enteric-coated omeprazole (4 mg/kg) orally in the fasted state (ECO-Fasted), enteric-coated omeprazole (4 mg/kg) orally in the fed state (ECO-Fed) and plain omeprazole (4 mg/kg) orally in the fasted state (PL-Fasted). Plasma omeprazole concentrations were det...
Multiple hypersensitivities including recurrent airway obstruction, insect bite hypersensitivity, and urticaria in 2 warmblood horse populations.
Journal of veterinary internal medicine    September 30, 2014   Volume 29, Issue 1 320-326 doi: 10.1111/jvim.12473
Kehrli D, Jandova V, Fey K, Jahn P, Gerber V.Multiple hypersensitivities (MHS) have been described in humans, cats, and dogs, but not horses. Objective: Horses suffering from recurrent airway obstruction (RAO), insect bite hypersensitivity (IBH), or urticaria (URT) will have an increased risk of also being affected by another one of these hypersensitivities. This predisposition for MHS also will be associated with decreased shedding of strongylid eggs in feces and with a single nucleotide polymorphism (SNP BIEC2-224511), previously shown to be associated with RAO. Methods: The first population (P1) included 119 randomly sampled horses re...
Cytokine concentrations in bronchoalveolar lavage fluid from horses with neutrophilic inflammatory airway disease.
Journal of veterinary internal medicine    September 30, 2014   Volume 28, Issue 6 1838-1844 doi: 10.1111/jvim.12464
Richard EA, Depecker M, Defontis M, Leleu C, Fortier G, Pitel PH, Couroucé-Malblanc A.Multiple cytological patterns occur in bronchoalveolar lavage fluid (BALF) of horses with inflammatory airway disease (IAD). Only few data on BALF cytokine profiles are available for horses with IAD, and are limited to mRNA expression. Objective: Cytological profiles of IAD are associated with different BALF immunological pathways. To investigate BALF cytokine concentrations in a large number of horses with neutrophilic IAD. Methods: One hundred and thirty-eight client-owned Standardbred racehorses in active training. Methods: Prospective observational study. BALF samples were obtained from le...
Effects of age on the pharmacokinetics and selected pharmacodynamics of intravenously administered fentanyl in foals.
Equine veterinary journal    September 30, 2014   Volume 47, Issue 1 72-77 doi: 10.1111/evj.12246
Knych HK, Steffey EP, Mitchell MM, Casbeer HC.The use of fentanyl is limited in adult horses, in part due to potential for central nervous system excitation. The pharmacokinetics and the plasma concentration-related behavioural actions of fentanyl have not been described for young foals. The goal of the present study was to describe the pharmacokinetics and behavioural effects of fentanyl following administration to the same group of foals at 3 different ages. Experimental study in healthy foals. Fentanyl was administered i.v. (4 μg/kg bwt) to a group of 9 foals on 3 separate occasions at 6–8, 20–22 and 41–42 days of age. Blood sam...
Autologous processed plasma: cytokine profile and effects upon injection into healthy equine joints.
Journal of veterinary science    September 30, 2014   Volume 16, Issue 1 47-55 doi: 10.4142/jvs.2015.16.1.47
Moreira JJ, Moraes AP, Brossi PM, Machado TS, Michelacci YM, Massoco CO, Baccarin RY.This experimental controlled study was performed to evaluate the composition of autologous processed plasma (APP), and the effects of APP intra-articular injection into healthy equine metacarpophalangeal joints. The effects on joints were analysed with a short-phase protocol and a prolonged-phase protocol using saline-injected joints as controls. For the short protocol, horses received one intra-articular APP injection. Synovial fluid samples were collected prior to the injection and 3, 6, 24, 48, and 16 h after treatment. For the prolonged protocol, the joints received three weekly injections...
Stem cell therapies for treating osteoarthritis: prescient or premature?
Veterinary journal (London, England : 1997)    September 30, 2014   Volume 202, Issue 3 416-424 doi: 10.1016/j.tvjl.2014.09.024
Whitworth DJ, Banks TA.There has been unprecedented interest in recent years in the use of stem cells as therapy for an array of diseases in companion animals. Stem cells have already been deployed therapeutically in a number of clinical settings, in particular the use of mesenchymal stem cells to treat osteoarthritis in horses and dogs. However, an assessment of the scientific literature highlights a marked disparity between the purported benefits of stem cell therapies and their proven abilities as defined by rigorously controlled scientific studies. Although preliminary data generated from clinical trials in huma...
Comparison of sub-bandage pressures achieved by 3 abdominal bandaging techniques in horses.
Equine veterinary journal    September 29, 2014   Volume 47, Issue 5 599-602 doi: 10.1111/evj.12329
Canada NC, Beard WL, Guyan ME, White BJ.Clinicians frequently place post operative abdominal bandages on horses undergoing laparotomies. Presently, no information exists on the amount of incisional support provided by these bandages. Determination of sub-bandage pressure provides a means of comparing the ability of different bandages to support incisions. Objective: Determination of sub-bandage pressure over a 24 h period using 3 bandaging techniques. Methods: A randomised, crossover design using 9 healthy horses. Methods: Horses were randomly assigned to a treatment regimen consisting of placement of 3 abdominal bandage types, name...
The interrelationship between anti-Müllerian hormone, ovarian follicular populations and age in mares.
Equine veterinary journal    September 29, 2014   Volume 47, Issue 5 537-541 doi: 10.1111/evj.12328
Claes A, Ball BA, Scoggin KE, Esteller-Vico A, Kalmar JJ, Conley AJ, Squires EL, Troedsson MH.Anti-Müllerian hormone (AMH) is a granulosa-cell-derived glycoprotein, which plays an important inhibitory role during folliculogenesis. Concentrations of AMH are highly correlated with antral follicle counts (AFCs) in other species, which in turn are related to follicular reserve. Relatively little is known about AMH and AFC in the mare. Objective: To determine plasma AMH concentrations and AFCs in mares of different ages, to measure the repeatability of AMH concentrations and AFCs within and across oestrous cycles and to assess the relationship between plasma AMH concentrations and AFCs wit...
Pathology of gastric lesions in donkeys: A preliminary study.
Equine veterinary journal    September 29, 2014   Volume 47, Issue 6 684-688 doi: 10.1111/evj.12336
Al-Mokaddem AK, Ahmed KA, Doghaim RE.Donkeys (Equus africanus asinus) are important working animals, particularly in countries where the majority of the population lives below the poverty line. Gastric ulceration has been shown to be common in British donkeys but donkeys from other parts of the world have not been as extensively researched. Objective: This study was performed as a preliminary overview of the severity and distribution of gastric lesions in mature donkeys and to document which parasites were present. Methods: Descriptive study of pathological findings. Methods: Stomachs of 35 mature draught donkeys were examined gr...
Expression of epidermal growth factor receptor and human epidermal growth factor receptor 2 in periocular squamous cell carcinomas of horses.
American journal of veterinary research    September 26, 2014   Volume 75, Issue 10 912-917 doi: 10.2460/ajvr.75.10.912
Hendrix DV, Newkirk KM.To determine whether epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) are expressed in periocular squamous cell carcinomas (SCCs) of horses. Methods: Biopsy specimens of SCCs from 46 horses. Methods: Pathology records were searched retrospectively for biopsy specimens of periocular SCCs obtained from horses. Slides of the specimens were reviewed histologically to confirm the SCC diagnosis and stained for EGFR and HER2 by immunohistochemical methods. For both EGFR and HER2, the immunohistochemical staining intensity and percentage of stain-positive cel...
A specific adenylyl cyclase inhibitor (DDA) and a cyclic AMP-dependent protein kinase inhibitor (H-89) block the action of equine growth hormone on in vitro maturation of equine oocytes.
Zygote (Cambridge, England)    September 26, 2014   Volume 23, Issue 6 795-801 doi: 10.1017/S0967199414000434
Pereira GR, Lorenzo PL, Carneiro GF, Bilodeau-Goeseels S, Kastelic J, Liu IK.The objectives of this study were firstly to determine whether the stimulatory function of equine growth hormone (eGH) on equine oocyte maturation in vitro is mediated via cyclic adenosine monophosphate (cAMP); and secondly if the addition of eGH in vitro influences oocyte nuclear maturation and if this effect is removed when GH inhibitors are added to the culture. Cumulus-oocyte complexes (COCs) were recovered from follicles <25 mm in diameter and randomly allocated as follows: (i) control (no additives); and (ii) 400 ng/ml of eGH. A specific inhibitor against cyclic AMP-dependent protein ...
Flow cytometric detection of circulating platelet-derived microparticles in healthy adult horses.
American journal of veterinary research    September 26, 2014   Volume 75, Issue 10 879-885 doi: 10.2460/ajvr.75.10.879
Springer NL, Smith E, Brooks MB, Stokol T.To develop a flow cytometric assay to quantify platelet-derived microparticles (PMPs) in equine whole blood and plasma. Methods: Citrate-anticoagulated whole blood from 30 healthy adult horses. Methods: Platelet-poor plasma (PPP) was prepared from fresh whole blood by sequential low-speed centrifugation (twice at 2,500 × g). Samples of fresh whole blood and PPP were removed and stored at 4° and 24°C for 24 hours. Platelet-derived microparticles were characterized in fresh and stored samples on the basis of the forward scatter threshold (log forward scatter < 10(1)) and labeling with anne...
Buprenorphine provides better anaesthetic conditions than butorphanol for field castration in ponies: results of a randomised clinical trial.
The Veterinary record    September 26, 2014   Volume 175, Issue 24 623 doi: 10.1136/vr.102729
Rigotti C, De Vries A, Taylor PM.A prospective, randomised, blinded, clinical trial in 47 ponies compared butorphanol and buprenorphine administered intravenously with detomidine prior to castration under anaesthesia. Detomidine 12 μg/kg intravenously was followed by butorphanol 25 μg/kg (BUT) or buprenorphine 5 μg/kg (BUP) before induction of anaesthesia with intravenous ketamine and diazepam. Quality of sedation, induction and recovery from anaesthesia, response to tactile stimulation, and surgical conditions were scored. If anaesthesia was inadequate 'rescue' was given with intravenous ketamine (maximum three dose...
A nonterminal equine mandibular model of bone healing.
Veterinary surgery : VS    September 25, 2014   Volume 44, Issue 3 314-321 doi: 10.1111/j.1532-950X.2014.12279.x
Sarrafian TL, Garcia TC, Dienes EE, Murphy B, Stover SM, Galuppo LD.To develop a nonterminal large animal bone defect model for assessing the efficacy of regenerative and pharmacologic treatments designed to enhance bone healing. Methods: In vivo experimental. Methods: Adult gelding horses (n = 6). Methods: Under general anesthesia, using radiographic guidance, 13.5 mm diameter bilateral, full thickness mandibular defects were created in 6 horses using a custom surgical jig and coring bit. After 16 weeks, under general anesthesia, 23 mm diameter cores that encompassed the original healing defects and surrounding parent bone material were removed for evaluation...
Treatment of osteochondrosis dissecans in the stifle and tarsus of juvenile thoroughbred horses.
Veterinary surgery : VS    September 22, 2014   Volume 44, Issue 3 297-303 doi: 10.1111/j.1532-950X.2014.12277.x
Clarke KL, Reardon R, Russell T.To determine if arthroscopic surgery performed on weanlings/yearlings with trochlear ridge OCD of the femur (stifle OCD), or intermediate ridge of the tibia (tarsal OCD) detected on routine presale radiographs affects future racing performance. Methods: Retrospective case control study. Methods: Thoroughbred weanlings and yearlings. Methods: Stifle (N = 37; 22 male, 15 female) and tarsal (N = 35; 22 male, 13 female) OCD cases were identified. Outcome measures relating to racing performance (number of race starts, wins, places, and prize money earned, from races in their 2- and 3-year-old racin...
Laparoscopic-guided compared to skilled instructor support for student rectal examination training using live horses in the veterinary curriculum.
Veterinary surgery : VS    September 22, 2014   Volume 44, Issue 3 352-358 doi: 10.1111/j.1532-950X.2014.12278.x
Radcliffe RM, Manchester AC, Mohammed HO, Ortved K, Reesink HL, Schnabel LV, Lang HM, Scrivani PV, Fubini SL.To evaluate the veterinary student learning outcome of 2 methods of equine rectal examination training. Methods: Randomized prospective study. Methods: Veterinary students (3rd and 4th year; n = 40) and practicing equine veterinarians (n = 10). Methods: Year 1: Group 1 (n = 11) and Group 2 students (n = 10) received skilled instructor (SI) and laparoscopic-guidance (LG), respectively, during rectal exam instruction. All students were tested on rectal identification of 4 abdominal organs. Year 2: One group of students (n = 19) was trained and subsequently tested using each technique, first SI, ...
Thoroughbred horses in race training have lower levels of subchondral bone remodelling in highly loaded regions of the distal metacarpus compared to horses resting from training.
Veterinary journal (London, England : 1997)    September 21, 2014   Volume 202, Issue 3 443-447 doi: 10.1016/j.tvjl.2014.09.010
Holmes JM, Mirams M, Mackie EJ, Whitton RC.Bone is repaired by remodelling, a process influenced by its loading environment. The aim of this study was to investigate the effect of a change in loading environment on bone remodelling by quantifying bone resorption and formation activity in the metacarpal subchondral bone in Thoroughbred racehorses. Sections of the palmar metacarpal condyles of horses in race training (n = 24) or resting from training (n = 24) were examined with light microscopy and back scattered scanning electron microscopy (BSEM). Bone area fraction, osteoid perimeter and eroded bone surface were measured withi...
Risk of false positive genetic associations in complex traits with underlying population structure: a case study.
Veterinary journal (London, England : 1997)    September 21, 2014   Volume 202, Issue 3 543-549 doi: 10.1016/j.tvjl.2014.09.013
Finno CJ, Aleman M, Higgins RJ, Madigan JE, Bannasch DL.Genome-wide association (GWA) studies are widely used to investigate the genetic etiology of diseases in domestic animals. In the horse, GWA studies using 40-50,000 single nucleotide polymorphisms (SNPs) in sample sizes of 30-40 individuals, consisting of only 6-14 affected horses, have led to the discovery of genetic mutations for simple monogenic traits. Equine neuroaxonal dystrophy is a common inherited neurological disorder characterized by symmetric ataxia. A case-control GWA study was performed using genotypes from 42,819 SNP marker loci distributed across the genome in 99 clinically phe...
The prevalence of abnormal breathing patterns during exercise and associations with dynamic upper respiratory tract obstructions.
Equine veterinary journal    September 21, 2014   Volume 47, Issue 5 553-556 doi: 10.1111/evj.12325
Fitzharris LE, Franklin SH, Allen KJ.There is very limited published information on the prevalence and significance of abnormal breathing patterns adopted during canter/gallop. Objective: The aim of this study was to report the prevalence of abnormal breathing patterns during canter/gallop and to investigate whether these may be associated with dynamic upper respiratory tract (URT) obstructions. Methods: Retrospective analysis of clinical records. Methods: Simultaneous audio and URT videoendoscopy recordings from 365 horses referred for treadmill evaluation were analysed. Results: Thirty percent of horses had an abnormal breathin...
Disposition, behavioural and physiological effects of escalating doses of intravenously administered fentanyl to young foals.
Equine veterinary journal    September 21, 2014   Volume 47, Issue 5 592-598 doi: 10.1111/evj.12318
Knych HK, Steffey EP, Casbeer HC, Mitchell MM.Foal responses to a broader range of plasma fentanyl concentrations than currently reported are desirable to support (or not) clinical use. Objective: To describe fentanyl plasma concentrations following an escalating i.v. fentanyl dosing schedule in foals aged 5-13 days and describe selected, associated dose- and time-related behavioural and physiological responses to plasma fentanyl concentration. Methods: Experimental. Methods: Fentanyl was administered i.v. in an escalating fashion (2, 4, 8, 16 and 32 μg/kg bwt) at 10-min intervals. Blood samples were collected before and at selected time...
Interspecies comparison of subchondral bone properties important for cartilage repair.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society    September 19, 2014   Volume 33, Issue 1 63-70 doi: 10.1002/jor.22740
Chevrier A, Kouao AS, Picard G, Hurtig MB, Buschmann MD.Microfracture repair tissue in young adult humans and in rabbit trochlea is frequently of higher quality than in corresponding ovine or horse models or in the rabbit medial femoral condyle (MFC). This may be related to differences in subchondral properties since repair is initiated from the bone. We tested the hypothesis that subchondral bone from rabbit trochlea and the human MFC are structurally similar. Trochlea and MFC samples from rabbit, sheep, and horse were micro-CT scanned and histoprocessed. Samples were also collected from normal and lesional areas of human MFC. The subchondral bone...
Characterization and outcome following excision of masses in the nictitating membranes of horses: 50 cases (1998-2012).
Journal of the American Veterinary Medical Association    September 18, 2014   Volume 245, Issue 7 812-815 doi: 10.2460/javma.245.7.812
Scherrer NM, Lassaline-Utter M, McKenna BC.To determine the histologic findings associated with masses in the nictitating membranes (third eyelids) of horses and to identify prognostic factors associated with recurrence and the outcome. Methods: Retrospective case series. Methods: 50 horses with masses in a third eyelid. Methods: Medical records of horses with partial or complete excision of a third eyelid and submission for histologic evaluation between September 1998 and November 2012 were reviewed. Horses were included if follow-up information for at least 1 year after surgery was available. Information regarding signalment and trea...
Comparison between the robo-horse and real horse movements for hippotherapy.
Bio-medical materials and engineering    September 18, 2014   Volume 24, Issue 6 2603-2610 doi: 10.3233/BME-141076
Park JH, Shurtleff T, Engsberg J, Rafferty S, You JY, You IY, You SH.While the novel robotic hippotherapy system has gradually gained clinical application for therapeutic intervention on postural and locomotor control in individuals with neurological or musculoskeletal impairments, the system's validity and reliability for the robotic hippotherapy system has not been well established. The objective of the current study was to investigate the validity and test-retest reliability of the robotic hippotherapy system by comparing with real horse movements. The 3-axis accelerometer sensors attached on the robotic and real horse saddles were used to collect 3-dimensio...
Occurrence of Incisional Complications After Closure of Equine Celiotomies With USP 7 Polydioxanone.
Veterinary surgery : VS    September 17, 2014   Volume 44, Issue 4 521-526 doi: 10.1111/j.1532-950X.2014.12275.x
Anderson SL, Devick I, Bracamonte JL, Hendrick S, Barber SM, Carmalt JL, Wilson DG.To report the occurrence of, and risk factors associated with, incisional complications of equine ventral median celiotomies closed with USP 7 polydioxanone (7PD). Methods: Retrospective case series. Methods: Horses (n = 73; 75 celiotomies). Methods: Medical records (2000-2010) were retrieved and reviewed for horses that had a ventral celiotomy closed with 7PD and survived ≥14 days. Follow-up (>1 year) was obtained from the medical record, owner, or referring veterinarian. Independent variables were selected based on risk factors identified in previous studies, perceived clinical relevan...
Detection and pharmacokinetics of salbutamol in thoroughbred racehorses following inhaled administration.
Journal of veterinary pharmacology and therapeutics    September 17, 2014   Volume 38, Issue 1 41-47 doi: 10.1111/jvp.12150
Wieder ME, Paine SW, Hincks PR, Pearce CM, Scarth J, Hillyer L.Salbutamol sulphate (Ventolin Evohaler) was administrated via the inhalation route to six horses at a dose of 0.5 mg every 4 h during the day for 2 days (total dose 4 mg). Urine and blood samples were taken up to 92 h postadministration. Hydrolyzed plasma and urine were extracted using solid phase extraction (SPE). A sensitive tandem mass spectrometric method was developed in this study, achieving a lower limit of quantification (LLOQ) for salbutamol of 10 pg/mL in plasma and urine. The parent drug was identified using UPLC-MS/MS. Most of the determined salbutamol plasma concentrations, post l...
Pathology of Natural Cases of Equine Endocrinopathic Laminitis Associated With Hyperinsulinemia.
Veterinary pathology    September 17, 2014   Volume 52, Issue 5 945-956 doi: 10.1177/0300985814549212
Karikoski NP, McGowan CM, Singer ER, Asplin KE, Tulamo RM, Patterson-Kane JC.Laminitis in equids is a clinical syndrome usually associated with systemic disease. Endocrinopathies recently have been recognized as the most common cause of laminitis, with hyperinsulinemia playing a key role. Descriptions of laminitis-associated lesions have been confusing due to the wide range of experimental models used, failure of adequate clinical documentation for naturally occurring cases, lack of separate analysis of inflammatory and endocrinopathic laminitis, and uncertainty regarding normal morphological variation of lamellae. In this study, lamellar morphology and pathology were ...
Probiotic use in horses – what is the evidence for their clinical efficacy?
Journal of veterinary internal medicine    September 17, 2014   Volume 28, Issue 6 1640-1652 doi: 10.1111/jvim.12451
Schoster A, Weese JS, Guardabassi L.The gastrointestinal microbiota is extremely important for human and animal health. Investigations into the composition of the microbiota and its therapeutic modification have received increasing interest in human and veterinary medicine. Probiotics are a way of modifying the microbiota and have been tested to prevent and treat diseases. Probiotics are proposed to exert their beneficial effects through various pathways. Production of antimicrobial compounds targeting intestinal pathogens, general immune stimulation, and colonization resistance are among these mechanisms. Despite widespread ava...
Diagnostic double-guarded low-volume uterine lavage in mares.
Theriogenology    September 17, 2014   Volume 83, Issue 2 222-227 doi: 10.1016/j.theriogenology.2014.09.008
Christoffersen M, Brandis L, Samuelsson J, Bojesen AM, Troedsson MH, Petersen MR.Endometritis constitutes a major problem in the management of broodmares; hence, diagnostic tests with a high sensitivity and specificity are highly appreciated. The aim of this study was to compare the results from endometrial, cytologic, and bacteriologic examinations obtained by a newly developed, double-guarded, flushing technique versus standard diagnostic tests, the double-guarded swab and biopsy. The described double-guarded flush technique requires the use of a disposable uterine flushing tube, a sanitary sleeve, a sterile steel speculum, and a 250 mL fluid bag. Endometrial biopsies, s...