Analyze Diet

Topic:Disease Treatment

Disease treatment in horses encompasses a range of medical interventions and management strategies aimed at addressing various health conditions affecting equine species. These treatments can include pharmacological approaches, such as the administration of antibiotics, anti-inflammatory drugs, and antiparasitic medications, as well as non-pharmacological methods like physical therapy, dietary adjustments, and surgical procedures. The selection of appropriate treatments depends on the specific disease, its severity, and the individual needs of the horse. This topic brings together peer-reviewed research studies and scholarly articles that explore the efficacy, safety, and advancements in therapeutic options for equine diseases, providing insights into best practices and emerging trends in equine veterinary medicine.
Clinical features and prognostic variables in 109 horses with esophageal obstruction (1992-2009).
Journal of veterinary internal medicine    August 12, 2010   Volume 24, Issue 5 1147-1152 doi: 10.1111/j.1939-1676.2010.0573.x
Chiavaccini L, Hassel DM.Esophageal obstruction is common in horses and can result in life-threatening complications. Previous studies have described clinical findings in horses with esophageal obstruction, but there are no reports that attempt to make correlations of clinical findings with outcome. Objective: Specific clinical features of horses with esophageal obstruction are associated with increased likelihood of complications. Methods: One hundred and nine horses with esophageal obstruction. Methods: Retrospective cross-sectional study. All clinical records of horses admitted between April 1992 and February 2009 ...
First aid for the laminitic foot: therapeutic and mechanical support.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 451-458 doi: 10.1016/j.cveq.2010.06.004
Reilly PT, Dean EK, Orsini JA.The goals of mechanical treatment during the acute phase of laminitis are to preserve the lamellar interface by reducing the forces that are compromising its integrity and to make the horse more comfortable. Early decision making is important in managing acute laminitis. This article helps the practitioner to identify some of the commonly used and accepted methods of protecting the laminitic foot. The materials available and the theories behind their use are also described. The laminitic foot needs to be understood before determining methods for its support. Most treatment options involve shif...
The effect of variable waveform low-intensity pulsed ultrasound in a fourth metacarpal osteotomy gap model in horses.
Ultrasound in medicine & biology    August 10, 2010   Volume 36, Issue 8 1298-1305 doi: 10.1016/j.ultrasmedbio.2010.05.005
McClure SR, Miles K, Vansickle D, South T.The objective of this study was to evaluate the effects of variable waveform low-intensity ultrasound on the healing of a fracture gap of the fourth metacarpal bone in horses. A randomized, blinded, controlled trial was conducted in eight healthy adult horses. In each horse, a 1-cm osteotomy of the fourth metacarpal bone was created. One randomly selected metacarpal gap was treated daily with a 40-min session of ultrasound and the opposite gap was managed similarly with an inactive transducer. The fourth metacarpal bones were radiographed weekly. Fluorescent markers were administered at 14, 28...
Effects of two commercially available immunostimulants on leukocyte function of foals following ex vivo exposure to Rhodococcus equi.
Veterinary immunology and immunopathology    August 6, 2010   Volume 138, Issue 3 198-205 doi: 10.1016/j.vetimm.2010.07.027
Ryan C, Giguère S, Fultz L, Long MT, Crawford PC.The objective of this study was to determine the effect of immunostimulants on neutrophil, macrophage, and lymphocyte function following ex vivo exposure to Rhodococcus equi. Eighteen foals were randomly assigned to one of 3 treatment groups. Treatment consisted of inactivated Propionibacterium acnes (PA), inactivated parapoxvirus ovis (PPVO), or saline (control) administered on days 0 (7 days of age), 2, and 8. Bronchoalveolar lavage (BAL) fluid and blood were collected on days 0 (baseline), 12, 24 and 36. Intracellular replication of R. equi in macrophages, cytokine induction by R. equi-infe...
Clara cell secretory protein increases phagocytic and decreases oxidative activity of neutrophils.
Veterinary immunology and immunopathology    August 6, 2010   Volume 139, Issue 1 1-9 doi: 10.1016/j.vetimm.2010.07.021
Katavolos P, Ackerley CA, Clark ME, Bienzle D.Horses suffer from recurrent airway obstruction, an asthma-like condition induced by repeat inhalation of environmental substances present in barn air. Clara cell secretory protein (CCSP) is much reduced during active inflammation when neutrophils predominate in the airways, and in chronic asthmatics. We sought to investigate morphologic and functional interactions of CCSP with neutrophils. Bronchoalveolar and blood neutrophils from healthy control animals, and from animals with recurrent airway obstruction in remission and exacerbation, were evaluated by immuno-cytochemistry and immuno-electr...
Blood cells RNA biomarkers as a first long-term detection strategy for EPO abuse in horseracing.
Drug testing and analysis    August 6, 2010   Volume 2, Issue 7 339-345 doi: 10.1002/dta.146
Bailly-Chouriberry L, Noguier F, Manchon L, Piquemal D, Garcia P, Popot MA, Bonnaire Y.Recombinant human erythropoietins (rHuEPOs) are glycoproteins drugs, produced by the pharmaceutical industry to restore production of red blood cells by stimulating human bone marrow for which this pathology has been diagnosed. It is suspected that these molecules are diverted as doping agents in horseracing to enhance oxygen transport and aerobic power in racehorses. Although indirect double-blotting or direct liquid chromatography-mass spectrometry (LC-MS) methods have been developed to confirm the presence of rHuEPO in a sample, the short detection time (48 h) is still a problem for doping ...
[The use of a GnRH vaccine in mares and stallions to influence undesirable behavior: a retrospective study of 31 cases].
Schweizer Archiv fur Tierheilkunde    August 5, 2010   Volume 152, Issue 8 373-377 doi: 10.1024/0036-7281/a000085
Wenzinger B, Kähn W, Bleul U.The aim of this study was to investigate the effect of a GnRH vaccine (Equity) on behavior and gonadal function in horses with unwanted behavior. The reason for the treatment was asked using a questionnaire and the findings of physical examination, rectal palpation as well as rectal ultrasonography, were recorded. The results of these examinations and the behavior of 21 mares and 10 stallions before the first and after the second administration of the GnRH vaccine were compared. In 84 % of all cases a decrease of the unwanted behavior could be observed. In the mares the ovaries were significan...
Mycobacterium avium subsp. hominissuis infection in horses.
Emerging infectious diseases    August 4, 2010   Volume 16, Issue 8 1328-1329 doi: 10.3201/eid1608.100097
Kriz P, Jahn P, Bezdekova B, Blahutkova M, Mrlik V, Slana I, Pavlik I.No abstract available
Effects of antifungal drugs and delivery vehicles on morphology and proliferation of equine corneal keratocytes in vitro.
American journal of veterinary research    August 3, 2010   Volume 71, Issue 8 953-959 doi: 10.2460/ajvr.71.8.953
Mathes RL, Reber AJ, Hurley DJ, Dietrich UM.To evaluate the effects of topical antifungal drugs and delivery vehicles on the morphology and proliferation rate of cultured equine keratocytes. Methods: 16 corneas obtained from 8 apparently ophthalmologically normal horses < 0.5 hours after euthanasia for reasons unrelated to the study. Methods: Primary cultures of equine keratocytes were obtained from corneal stroma and were exposed to several concentrations of 3 commonly used, topically applied antifungals: natamycin, itraconazole, and miconazole. In addition, effects of drug delivery vehicles DMSO, benzalkonium chloride, and carboxym...
Standing lateral thoracotomy in horses: indications, complications, and outcomes.
Veterinary surgery : VS    August 3, 2010   Volume 39, Issue 7 847-855 doi: 10.1111/j.1532-950X.2010.00713.x
Hilton H, Aleman M, Madigan J, Nieto J.To describe the indications for, complications arising from, and outcome of horses that had standing lateral thoracotomy for pleural or pericardial disease. Methods: Case series. Methods: Horses (n=16). Methods: Medical records (January 1990-December 2008) of sedated standing horses that had lateral thoracotomy were reviewed. Clinical and surgical findings, perioperative and short-term complications were recorded. Long-term (>6 months) outcome was determined through telephone conversations with owners and veterinarians. Results: Mean (±SD) horse age was 6.6±5.3 years (range, 1-15 years). ...
Expression of inflammation-associated genes in circulating leukocytes collected from horses with gastrointestinal tract disease.
American journal of veterinary research    August 3, 2010   Volume 71, Issue 8 915-924 doi: 10.2460/ajvr.71.8.915
Lopes MA, Salter CE, Vandenplas ML, Berghaus R, Hurley DJ, Moore JN.To investigate whether expression of inflammation-associated genes in leukocytes from horses with gastrointestinal tract (GIT) diseases correlated with the type of disease and outcome. Methods: 10 healthy horses and 50 horses with GIT disease. Methods: A blood sample was collected from each healthy horse or horse with GIT disease (during admission to the hospital). Leukocytes were isolated, diluted to a standard concentration, and frozen until RNA extraction. Expression of 14 genes associated with inflammation was quantified by use of a real-time quantitative reverse transcription PCR assay. R...
Shortened strongyle-type egg reappearance periods in naturally infected horses treated with moxidectin and failure of a larvicidal dose of fenbendazole to reduce fecal egg counts.
Veterinary parasitology    August 2, 2010   Volume 173, Issue 3-4 349-352 doi: 10.1016/j.vetpar.2010.07.001
Rossano MG, Smith AR, Lyons ET.Deworming horses with anthelmintics that have activity against encysted small strongyle larvae (L(3) and L(4)) is a common practice in parasite control programs. The two drugs currently available for this use are moxidectin (MOX) administered in a single dose of 0.4 mg/kg and fenbendazole (FBZ) given at the larvicidal dose (10mg/kg for 5 days). Here, we report the efficacy of MOX and the larvicidal dose of FBZ for reducing counts of strongyle-type eggs per gram of feces in naturally infected horses. Fecal egg counts (FECs) of 15 yearlings were observed following deworming. On day 0, 6 of the 1...
Pemoline and tetramisole ‘positives’ in english racehorses following levamisole administration.
Irish veterinary journal    August 1, 2010   Volume 63, Issue 8 498 doi: 10.1186/2046-0481-63-8-498
Gutierrez J, Eisenberg RL, Koval NJ, Armstrong ER, Tharappel J, Hughes CG, Tobin T.Pemoline is a central nervous system stimulant that has been used to treat attention-deficit hyperactivity disorder and narcolepsy in humans; its identification in horses could be considered evidence of attempts to influence performance. Two recent pemoline 'positives' in English racehorses led us to review the chemical relationships between tetramisole, levamisole, aminorex and pemoline. Pemoline is a simple oxidation product of aminorex, which has been shown in the United States and elsewhere to be an equine metabolite of levamisole. Based on the clear structural relationships between aminor...
Monoclonal antibodies to equine CD14.
Veterinary immunology and immunopathology    July 31, 2010   Volume 138, Issue 1-2 149-153 doi: 10.1016/j.vetimm.2010.07.003
Kabithe E, Hillegas J, Stokol T, Moore J, Wagner B.CD14 is a receptor for the complex of lipopolysaccaride (LPS) and LPS-binding protein. Binding of this complex to CD14 in association with Toll-like receptor 4 provides a major pathway for the initiation of innate immune responses to bacterial pathogens. We used a mammalian expressed extracellular region of equine CD14 (rCD14) derived from an IgG fusion protein to produce monoclonal antibodies (mAbs) to CD14. Eight mAbs were tested by flow cytometric analysis of equine leukocytes and by immunoblotting using rCD14 indicating that the mAbs recognized at least three different epitopes on equine C...
Longitudinal study of Australian stringhalt cases in France.
Journal of animal physiology and animal nutrition    July 29, 2010   Volume 94, Issue 6 712-720 doi: 10.1111/j.1439-0396.2010.01019.x
Domange C, Casteignau A, Collignon G, Pumarola M, Priymenko N.Seventy horses with clinical evidence of Australian stringhalt were studied in France from 2003 to 2008. All horses but one had history of bilateral stringhalt and grazed pastures infested with Hypochoeris radicata (L.). They displayed hind limbs hyperflexion and an abnormal gait because of a distal axonopathy with a skeletal muscle denervation and atrophy. Fifty percentage of them recovered spontaneously in 8 months, and only the more affected horses were unable to recover even if they looked healthy on dry and hot days. Clinical troubles revealed also depression or aggressive behaviour, sugg...
Low-molecular-weight heparin dosage in newborn foals.
Journal of veterinary internal medicine    July 28, 2010   Volume 24, Issue 5 1190-1195 doi: 10.1111/j.1939-1676.2010.0568.x
Armengou L, Monreal L, Delgado MÁ, Ríos J, Cesarini C, Jose-Cunilleras E.Heparin is used in humans as prophylaxis of hypercoagulable states and disseminated intravascular coagulation (DIC). However, babies need a higher heparin dose than do adults. Septic neonate foals are at high risk of hypercoagulable state and DIC, and there is limited objective information about heparin dose for equine neonates. Objective: To assess whether neonate foals require higher dosages of low-molecular-weight heparin (LMWH) than adults. Methods: Eighteen healthy and 11 septic neonate foals. Methods: Experimental and clinical studies. Firstly, healthy foals were randomly distributed in ...
A two-component nonlinear mixed effects model for longitudinal data, with application to gastric emptying studies.
Statistics in medicine    July 27, 2010   Volume 29, Issue 17 1839-1856 doi: 10.1002/sim.3956
Kim I, Cohen ND, Roussel A, Wang N.Gastric emptying studies are of great interest in human and veterinary medical research to evaluate effects of medications or diets for promoting gastrointestinal motility and to examine unintended side-effects of new or existing medications, diets, or procedures. Summarizing gastric emptying data is important to allow easier comparison between treatments or groups of subjects and comparisons of results among studies. The standard method for assessing gastric emptying is by using scintigraphy and summarizing the nonlinear emptying of the radioisotope. A popular model for fitting gastric emptyi...
The effect of a supplement containing sunflower oil, vitamins, amino acids, and peptides on the severity of symptoms in horses suffering insect bite hypersensitivity.
Tijdschrift voor diergeneeskunde    July 24, 2010   Volume 135, Issue 13 520-525 
van den Boom R, Driessen F, Streumer SJ, Sloet van Oldruitenborgh-Oosterbaan MM.Insect bite hypersensitivity (IBH) is most often caused by Culicoides spp., although other insect species are also thought to play a role in causing this disease. The disease has been reported to occur in most countries, with a prevalence of up to 28% in some countries in some breeds. The only truly effective therapy currently available is to prevent horses from coming into contact with Culicoides midges, which can be achieved by stabling horses during certain times of the day or by covering them with insect blankets. The effect of a new dietary supplement containing vitamins, polypeptides, an...
Effects of lidocaine infusion during experimental endotoxemia in horses.
Journal of veterinary internal medicine    July 24, 2010   Volume 24, Issue 4 940-948 doi: 10.1111/j.1939-1676.2010.0555.x
Peiró JR, Barnabé PA, Cadioli FA, Cunha FQ, Lima VM, Mendonça VH, Santana AE, Malheiros EB, Perri SH, Valadão CA.The clinical efficacy of IV infusion of lidocaine for treatment of equine endotoxemia has not been studied. Objective: Lidocaine infusion after exposure to lipopolysaccharide (LPS) will inhibit the inflammatory response and have inhibitory effects on the hemodynamic and cytokine responses to endotoxemia. Methods: Twelve horses. Methods: Two equal groups (n=6): saline (GI) and lidocaine (GII). In all animals, endotoxin (500 ng/kg body weight [BW]) was injected intraperitoneally over 5 minutes. Twenty minutes later, animals received a bolus of GI or GII (1.3 mg/kg BW) over 5 minutes, followed by...
Effects of athletic conditioning on horses with degenerative suspensory ligament desmitis: a preliminary report.
Veterinary journal (London, England : 1997)    July 23, 2010   Volume 189, Issue 1 49-57 doi: 10.1016/j.tvjl.2010.06.010
Xie L, Spencer ND, Beadle RE, Gaschen L, Buchert MR, Lopez MJ.Equine degenerative suspensory ligament desmitis (DSLD) is a debilitating condition that has limited response to rest and stall confinement. This study was designed to test the hypothesis that mild to moderate DSLD is not worsened by consistent exercise. Paso Fino and Peruvian Paso horses (two normal horses and four horses with DSLD) were exercised for 30 min every other day for 8 weeks and then pasture rested for 4 months. Gait analysis, radiographs, ultrasound and serum insulin and glucose concentrations were performed prior to the exercise trial and at each time point. Vertical impulse incr...
Pharmacokinetics of an orally administered methylcellulose formulation of gallium maltolate in neonatal foals.
Journal of veterinary pharmacology and therapeutics    July 22, 2010   Volume 33, Issue 4 376-382 doi: 10.1111/j.1365-2885.2009.01150.x
Chaffin MK, Fajt V, Martens RJ, Arnold CE, Cohen ND, O'Conor M, Taylor RJ, Bernstein LR.Gallium is a trivalent semi-metal with anti-microbial effects because of its incorporation into crucial iron-dependent reproductive enzyme systems. Gallium maltolate (GaM) provides significant gallium bioavailability to people and mice following oral administration and to neonatal foals following intragastric administration. To study the prophylactic and therapeutic effects of GaM against Rhodococcus equi pneumonia in foals, we developed a methylcellulose formulation of GaM (GaM-MCF) for oral administration to neonatal foals. Normal neonatal foals were studied. Six foals received 20 mg/kg and ...
Efficacy of intramuscular polysulfated glycosaminoglycan in a controlled study of equine carpitis.
Journal of veterinary pharmacology and therapeutics    July 22, 2010   Volume 33, Issue 4 357-362 doi: 10.1111/j.1365-2885.2009.01154.x
Verde C, Ferrante M, Simpson MI, Babusci M, Broglia G, Landoni MF.Twelve healthy horses were subject to the monoioidoacetate (MIA) carpitis model, which was allowed to develop for 7 days. The horses were then randomly divided into two groups. Group A (control) received an intramuscular injection of normal saline every 4 days for a total of seven injections while group B received 500 mg of a PSGAG (SYNTEX CSY36) intramuscularly every 4 days for seven treatments. Efficacy of the PSGAG was evaluated by three clinical outcomes: lameness score, carpal circumference and maximum carpal flexion. Clinical outcomes were measured on days -8 (previous to carpitis induct...
Reversal of profound rocuronium block monitored in three muscle groups with sugammadex in ponies.
British journal of anaesthesia    July 21, 2010   Volume 105, Issue 4 480-486 doi: 10.1093/bja/aeq172
Mosing M, Auer U, Bardell D, Jones RS, Hunter JM.This clinical study evaluated the speed of reversal of profound rocuronium block in ponies using sugammadex and investigated the differences in onset and recovery from block in three different muscle groups. Methods: Anaesthesia was induced and maintained with isoflurane in oxygen 100% in eight ponies. Neuromuscular monitoring was performed at each site using acceleromyography: in the extensor muscles of the pelvic limb (peroneal nerve) and thoracic limb (radial nerve), and in the orbicularis oris muscle (OOM; facial nerve). Rocuronium 0.6 mg kg(-1) i.v. was administered, followed 5 min later ...
Tiludronate infusion in the treatment of bone spavin: a double blind placebo-controlled trial.
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 381-387 doi: 10.1111/j.2042-3306.2010.00120.x
Gough MR, Thibaud D, Smith RK.Tiludronate regulates bone remodelling through a decrease of the resorptive process and should therefore ameliorate the remodelling processes active in osteoarthritis of the distal tarsal joints ('bone spavin') and alleviate pain associated with abnormal bone lysis. Objective: To confirm the efficacy of tiludronate, administered as a single infusion at a dose of 1 mg/kg bwt, in the treatment of bone spavin in the horse. Methods: A double blind placebo controlled trial on 108 clinical cases of bone spavin was undertaken. The lameness score of the lamest limb was assessed following distal tarsal...
Intra-articular opioid analgesia is effective in reducing pain and inflammation in an equine LPS induced synovitis model.
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 412-419 doi: 10.1111/j.2042-3306.2010.00077.x
van Loon JP, de Grauw JC, van Dierendonck M, L'ami JJ, Back W, van Weeren PR.Intra-articular administration of morphine as a local analgesic and anti-inflammatory drug is widely used in human medicine. In equids, little is known about its clinical analgesic and anti-inflammatory efficacy. Objective: To use an inflammatory orthopaedic pain model to investigate the analgesic and anti-inflammatory effects of intra-articularly administered morphine as a new treatment modality in horses with acute arthritis. Methods: In a crossover study design, synovitis was induced in the left or right talocrural joint by means of intra-articular injection of 0.5 ng lipopolyssacharide (LP...
A comparison of four systems for scoring recovery quality after general anaesthesia in horses.
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 400-406 doi: 10.1111/j.2042-3306.2010.00093.x
Vettorato E, Chase-Topping ME, Clutton RE.The recovery quality scoring systems (RQSSs) in current use have not been critically reviewed for reliability. Objective: To examine reliability (reproducibility) of 4 RQSSs when applied to a ranked series. Methods: A DVD incorporating the recordings of 9 horses recovering from general anaesthesia was evaluated by final year students over 5 days. On Day 1, each evaluator ranked recoveries from 1-9 (1 = best). Over the following 4 days, each evaluator scored the same recoveries using 4 different RQSSs (3 of them in common usage and previously published) applied in random order. The scores from ...
Practical aspects of equine parasite control: a review based upon a workshop discussion consensus.
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 460-468 doi: 10.1111/j.2042-3306.2010.00065.x
Nielsen MK, Fritzen B, Duncan JL, Guillot J, Eysker M, Dorchies P, Laugier C, Beugnet F, Meana A, Lussot-Kervern I, von Samson-Himmelstjerna G.Development of resistance of several important equine parasites to most of the available anthelmintic drug classes has led to a reconsideration of parasite control strategies in many equine establishments. Routine prophylactic treatments based on simple calendar-based schemes are no longer reliable and veterinary equine clinicians are increasingly seeking advice and guidance on more sustainable approaches to equine parasite control. Most techniques for the detection of equine helminth parasites are based on faecal analysis and very few tests have been developed as diagnostic tests for resistan...
Outcome and long-term follow-up of 20 horses undergoing surgery for caecal impaction: a retrospective study (2000-2008).
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 388-392 doi: 10.1111/j.2042-3306.2010.00087.x
Smith LC, Payne RJ, Boys Smith SJ, Bathe AP, Greet TR.If untreated, caecal impaction may progress to rupture of the caecum and reports of long-term outcome for horses undergoing surgery for caecal impaction are required. Objective: To describe short- and long-term complication rates for horses undergoing surgery for caecal impaction in an otherwise life-threatening gastrointestinal condition. Methods: Case records were reviewed for horses undergoing surgery for caecal impaction. Horses were included in the study if an abnormally large, fluid-distended or feed-impacted caecum was the primary diagnosis at surgery and excluded if the caecum had alre...
Peritoneal concentrations of transforming growth factor beta in horses with colic.
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 451-455 doi: 10.1111/j.2042-3306.2010.00102.x
Argüelles D, Casteljins G, Carmona JU, Armengou L, Climent F, Prades M.In man, peritoneal transforming growth factor beta (TGF-beta) is associated with peritoneal diseases and subsequent adhesion formation. No studies on plasma and peritoneal TGF-beta concentrations in horses with colic are available. Objective: 1) To determine both plasma and peritoneal TGF-beta(1) and TGF-beta(3) concentrations in horses with different types of colic (not previously subjected to abdominal surgery); 2) to compare these concentrations according to the type of peritoneal fluid (transudate, modified transudate and exudate); and 3) to compare and correlate plasma and peritoneal conc...
Risk factors for incisional complications after exploratory celiotomy in horses: do skin staples increase the risk?
Veterinary surgery : VS    July 20, 2010   Volume 39, Issue 5 616-620 doi: 10.1111/j.1532-950X.2009.00636.x
Torfs S, Levet T, Delesalle C, Dewulf J, Vlaminck L, Pille F, Lefere L, Martens A.To assess risk factors for celiotomy incisional infection in horses, especially the use of staples for skin closure. Methods: Case series. Methods: Horses (n=356) that had 1 exploratory celiotomy for colic and survived >2 weeks after surgery between March 1, 2004 and December 31, 2007. Methods: Incisions were classified as "normal" (no complication, only edema, serous drainage lasting <24 hours) or as "surgical site infection (SSI)" (persistent serosanguinous drainage or purulent drainage with or without positive bacterial culture). All possible risk factors, including method o...