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Topic:Equine Medicine

Equine Medicine encompasses the study and application of medical practices specifically related to the health and well-being of horses. This field involves the diagnosis, treatment, and prevention of diseases and disorders affecting equine species. It covers a wide range of topics, including internal medicine, surgery, reproduction, and pharmacology. Research in equine medicine often focuses on understanding the physiological and pathological processes unique to horses, as well as developing effective therapeutic interventions. This page aggregates peer-reviewed research studies and scholarly articles that explore various aspects of equine medicine, providing insights into the latest advancements and methodologies in the care and management of horse health.
Effects of orally administered clioquinol on the fecal microbiome of horses.
Journal of veterinary internal medicine    December 22, 2024   Volume 39, Issue 1 e17276 doi: 10.1111/jvim.17276
Smith MZ, York M, Townsend KS, Martin LM, Gull T, Coghill LM, Ericsson AC, Johnson PJ.Whereas restoration of fecal consistency after treatment with clioquinol for chronic diarrhea and free fecal water syndrome has been attributed to its antiprotozoal properties, actions of clioquinol on the colonic bacterial microbiota have not been investigated. Objective: Characterize the dynamics of fecal microbial diversity before, during, and after PO administration of clioquinol to healthy horses. Methods: Experimental prospective cohort study using a single horse group. Methods: Eight healthy adult horses received PO clioquinol (10 g, daily) for 7 days. Feces were obtained daily for ...
Quantitative DNA metabarcoding reveals species composition of a macrocyclic lactone and pyrantel resistant cyathostomin population in the UK.
International journal for parasitology. Drugs and drug resistance    December 22, 2024   Volume 27 100576 doi: 10.1016/j.ijpddr.2024.100576
Bull KE, Hodgkinson J, Allen K, Poissant J, Peachey LE.Cyathostomins are the most abundant equid endoparasites globally. There are approximately fifty cyathostomin species and, whilst they occupy distinct niches within the large intestine, they are generally considered to share similar characteristics in terms of pathogenicity and response to drug treatment. There are three classes of anthelmintic licensed in the UK to treat cyathostomins (benzimidazoles, tetrahydropyrimidines and macrocyclic lactones) and cases of resistance have been documented for all classes. Previously, faecal egg count reduction tests (FECRT) on four UK Thoroughbred studs re...
Development of an ultrasound-guided proximo-medial approach for injection of the carpal flexor tendon sheath in horses and comparison with the conventional proximo-lateral ´blind` technique.
Journal of equine veterinary science    December 20, 2024   105258 doi: 10.1016/j.jevs.2024.105258
Dörner CA, Vargas V, Castellón CH.The aim of this prospective case-control study was to describe and implement a reliable, accurate, and straightforward ultrasound-guided proximo-medial approach technique for injecting the carpal flexor tendon sheath in horses. The proximo-medial ultrasound-guided approach for intrathecal access to the carpal canal, as described in this study, was firstly developed on ten cadaveric limbs using an undiluted ionic iodinated contrast medium. Landmarks were identified, and the access point was established. Subsequently, the technique was validated in ten horses, and its efficacy was compared with ...
Comparison of end-to-side versus side-to-side jejunocecostomy in horses.
Veterinary surgery : VS    December 19, 2024   Volume 54, Issue 2 410-419 doi: 10.1111/vsu.14200
Moyer EK, Bauck AG, Denagamage T, Freeman DE.To compare end-to-side (ES) and side-to-side (SS) jejunocecostomy (JC) in healthy horses. Methods: Experimental study in vivo. Methods: A total of 14 healthy adult horses underwent ventral midline celiotomy, a resection, and either an ES (n = 7) or stapled SS (n = 7) JC. Methods: Surgical times and the external lengths of completed anastomoses were measured. Physical examinations and pain scoring were performed every 6 h for 5 days, then once daily until euthanasia and necropsy 28 days postoperatively. Results: The anastomosis was completed more rapidly (p < .002) with the SS...
Alcohol-based antisepsis without the use of chlorhexidine for arthroscopy in horses.
Journal of equine veterinary science    December 19, 2024   105257 doi: 10.1016/j.jevs.2024.105257
Nakamae Y, Elce YA, Saab ME, McClure JT, Doyle AJ.Alcohol-based antisepsis has shown experimentally to be as effective as 4% chlorhexidine gluconate (CHG) at reducing bacterial counts (colony forming units; CFU) on equine skin. Our objectives were to determine the immediate and post-surgical reduction in CFU/mL on equine skin prepared with CHG-based or 70% isopropyl alcohol (IPA)-based (without CHG) protocols in a clinical setting with arthroscopic surgery. Our hypotheses were that the logCFU/mL reduction would not significantly differ between protocols immediately after preparation or at the end of surgery. Six horses underwent a 40 min bila...
How to perform a transtracheal aspirate in horses for diagnosis of lower respiratory tract disease.
Journal of the American Veterinary Medical Association    December 18, 2024   1 doi: 10.2460/javma.24.11.0697
Bishop RC, Nobrega AD, Mersich I, Wilkins PA.To describe indications for and demonstrate the technique to perform a transtracheal aspirate in horses. Transtracheal aspirate is indicated to collect samples for cytology and bacteriologic culture in cases of suspected pneumonia or other lower respiratory tract disease. Methods: 1 healthy university-owned horse was used for demonstration purposes. Images of clinical case samples from the University of Illinois Veterinary Teaching Hospital are shown. Methods: The horse is restrained and sedated with detomidine or xylazine to facilitate restraint and butorphanol to minimize coughing. The ventr...
Effect of Bio-Electro-Magnetic-Energy-Regulation (BEMER) Horse Therapy on Cardiopulmonary Function and Recovery Quality After Isoflurane Anesthesia in 100 Horses Subjected to Pars-Plana Vitrectomy: An Investigator-Blinded Clinical Study.
Animals : an open access journal from MDPI    December 18, 2024   Volume 14, Issue 24 3654 doi: 10.3390/ani14243654
Brandenberger O, Kalinovskiy A, Körner J, Genn H, Burger R, Leser S.The use of Bio-Electro-Magnetic-Energy-Regulation (BEMER) therapy during general anesthesia has not previously been reported in horses. This randomized, investigator-blinded, placebo-controlled trial evaluates equine cardiopulmonary function and recovery quality after BEMER therapy application for 15 min in 100 horses during general anesthesia using isoflurane for pars-plana vitrectomy surgery as treatment for recurrent uveitis. Visually identical blankets were used in the two groups (1:1 ratio), one with a functional BEMER module and the other with a placebo module. Arterial blood pressure, b...
Further Investigation Into an Environmental Source for Aminorex.
Drug testing and analysis    December 18, 2024   Volume 17, Issue 8 1357-1367 doi: 10.1002/dta.3820
Brooks L, Ryan M, McCosham E, Loganathan D.In 2009, levamisole was identified as a source for several aminorex positives reported in postrace equine samples in Canada. Since then, unexplained detections of aminorex continue to be identified in equine samples where there is no evidence to link these detections to a levamisole administration. Previous studies identified a compound named barbarin in some species of plants from the Brassicaceae family and suggested that barbarin may be a possible precursor for aminorex. The objectives of this study were to (1) investigate the link between barbarin and aminorex and (2) identify other biomar...
Temporal kinetics of serum amyloid A (SAA) concentration and identification of SAA isoforms in blood and synovial fluid of horses with experimentally induced septic arthritis, non-septic synovitis, and systemic inflammation. Koziy RV, Katselis GS, Yoshimura S, Simko E, Bracamonte JL.Prompt diagnosis of equine septic arthritis is crucial for successful treatment. Serum amyloid A (SAA) has been suggested as a reliable biomarker. However, we previously found that synovial fluid SAA increases in nonaffected joints of horses with septic arthritis. We hypothesized that systemic SAA may leak into the nonaffected joints. If this is the case, we also hypothesized that locally produced joint SAA isoforms may be better candidates for septic arthritis biomarkers. Thus, our objectives were 1) to evaluate the temporal kinetics of systemic and synovial fluid SAA in horses with septic ar...
Clinical application and prognostic value of computed tomography examination in foals diagnosed with osteomyelitis: Forty-four cases. Buyck C, Zani DD, Robert M, Gustafsson K.Computed tomography (CT) is increasingly recognized as superior to conventional imaging methods for diagnosing osteomyelitis in foals. However, comprehensive studies in this area are limited. This study aims to report on clinical cases of osteomyelitis in foals, establishing a relationship between CT findings and survival outcomes. Additionally, it compares CT imaging with conventional methods such as radiography and ultrasound. We hypothesized that CT variables would more accurately predict survival than other clinical factors and provide more detailed information about osteomyelitis lesions....
Analgesic efficacy of tapentadol in chronic joint disorders in horses: plasma serotonin concentration and adrenocortical response as biomarkers of pain-induced stress.
Frontiers in veterinary science    December 17, 2024   Volume 11 1505398 doi: 10.3389/fvets.2024.1505398
Costa GL, Tabbì M, Bruschetta G, Spadola F, Leonardi F, Bruno F, Iannelli NM, Licata P, Macrì F, Passino ES, Macrì D, Interlandi C.The study aimed to evaluate the analgesic efficacy of tapentadol in horses, by determining plasma serotonin concentration and adrenocortical response, as biomarkers of pain stress in chronic joint disorders. Thirty-six horses (20 females and 16 males) were divided into three groups of 12 subjects each: group A, osteoarthritis (OA), grade 3-4 lameness; group B, OA, grade 5 lameness; and group C, no OA, no lameness, were enrolled. The orthopedic examination included flexion tests, and radiological and ultrasound examinations. The degree of lameness has been estimated from 0 to 5 according to the...
The Combined Use of Triamcinolone and Platelet-Rich Plasma in Equine Metacarpophalangeal Joint Osteoarthritis Treatments: An In Vivo and In Vitro Study.
Animals : an open access journal from MDPI    December 17, 2024   Volume 14, Issue 24 doi: 10.3390/ani14243645
Guidoni K, Chiaradia E, Pepe M, Di Meo A, Tognoloni A, Seccaroni M, Beccati F.Intra-articular corticosteroids, such as triamcinolone acetonide (TA), help reduce pain related to osteoarthritis (OA), but they may impair cartilage metabolism. In contrast, platelet-rich plasma (PRP) therapy, a regenerative therapy, has shown potential to promote healing and regeneration of articular cartilage. This study investigates the effects of combining PRP with TA to treat osteoarthritis in racehorses. The study proposes that PRP injection following TA treatment could reduce side effects and improve treatment outcomes. Firstly, in the in vitro study, chondrocytes were exposed to diffe...
The Prevalence of Gastric Ulcer Syndrome in 395 Horses in Jiangyin City, China, Jiangsu Province.
Animals : an open access journal from MDPI    December 17, 2024   Volume 14, Issue 24 doi: 10.3390/ani14243636
Zhou K, Dong Z, Zhou X, Zhai B, Li B, Zhang J, Cheng F.The aim of this study was to determine the prevalence and association of EGUS in horses of different ages, breeds and occupations. Gastroscopies were performed on 395 horses, and gastric ulcers were graded on a scoring system from 0 to 4. The relationship between age, breed, and work, along with the prevalence of gastric ulcers and their influences, were evaluated. The prevalence rate of ulcers in this herd was 78%. Older horses were prone to ulcers in both the glandular and squamous mucosal areas. Across the different jobs surveyed, 60% of the horses had a score of 2 or above. For the horses ...
Showing the unshowable: a new start for rescue horses.
The Veterinary record    December 13, 2024   Volume 195, Issue 12 480-481 doi: 10.1002/vetr.5023
Dahm E.Emma Dahm introduces a new society in the world of showing that aims to give horses that have come back from neglect and abuse a platform to show off their talents and resilience.
Birth of a Healthy Monozygotic Twin Foal with Hydrops and a Dead Co-Twin.
Veterinary sciences    December 13, 2024   Volume 11, Issue 12 649 doi: 10.3390/vetsci11120649
Peere S, Van den Branden E, Broothaers K, Polfliet E, Smits K, Govaere J.Transfer of in vitro-produced (IVP) equine embryos is associated with a higher incidence of monozygotic multiple pregnancies, but this remains a rarity. The outcome of monozygotic twin gestation is poor, and good management techniques are lacking. In addition, hydrops conditions are exceptional in horses, with hydroallantois occurring more frequently than hydramnion. Most hydrops conditions will lead to compromise or death of the foal and mare. A 6-year-old multiparous standardbred recipient mare, 332 days pregnant, diagnosed with a monozygotic twin and hydrops with a dead co-twin, gave birth ...
Assessment of horse behavior using an activity monitoring device used for cats and dogs.
Journal of equine science    December 12, 2024   Volume 35, Issue 4 47-55 doi: 10.1294/jes.35.47
Matsubara T, Fukatsu R, Yamamoto M, Moriya M, Hano K, Nakamura K, Ohba Y, Takasu M.Including Internet of Things (IoT) technology in horse-rearing management can potentially mitigate problems such as human resource shortages and time limitations in performing daily behavior monitoring. In this study, a small and inexpensive activity meter used to monitor dogs and cats (PLUS CYCLE, JARMeC, Kanagawa, Japan) was used to monitor the daily behavior of horses. A study was performed to examine the suitability of the PLUS CYCLE device for monitoring horses and to determine whether it could estimate horse behavior. The device was equipped with an accelerometer and was used to monitor ...
Risk factors for fatality in jump racing Thoroughbreds in Great Britain (2010-2023).
Equine veterinary journal    December 12, 2024   Volume 57, Issue 4 870-877 doi: 10.1111/evj.14450
Allen SE, Taylor S, Given J, Verheyen KL.The British horseracing industry is committed to reducing equine fatalities in jump racing. Race-related fatalities are a major welfare concern and threaten the sport's social licence to operate. Objective: To describe the risk of, and determine risk factors for, fatality in British jump racing. Methods: Retrospective cohort. Methods: Analyses included all starts made in British jump races between January 2010 and April 2023. Available information for each horse, race, racecourse, trainer and jockey was collated and combined with details of all fatalities recorded by official veterinary office...
Pilot study characterizing a single pooled preparation of equine platelet lysate for nebulization in the horse.
Frontiers in veterinary science    December 12, 2024   Volume 11 1488942 doi: 10.3389/fvets.2024.1488942
Egli P, Boone L, Huber L, Higgins C, Gaonkar PP, Arrington J, Naskou MC, Peroni J, Gordon J, Lascola KM.Platelet lysate (PL) demonstrates antimicrobial and anti-inflammatory properties offering potential for treatment of bacterial pneumonia in horses. It remains unknown whether nebulization is suitable for PL administration in horses. This pilot study characterized particle size and flow rate of pooled equine PL (single preparation) nebulized using an equine-specific nebulizer (Flexivent®). Unassigned: Protein composition and antimicrobial activity were compared before and after nebulization. Protein composition was evaluated according to growth factor, antimicrobial peptide and cytokine concen...
Influence of Dietary Cobalt on Fiber Digestibility and Serum Cobalt and Cobalamin Concentrations in Horses.
Animals : an open access journal from MDPI    December 12, 2024   Volume 14, Issue 24 3595 doi: 10.3390/ani14243595
LeCompte Lazić RA, Nielsen BD, Robison CI, Schott HC, Herdt TH, Larson CK.The 2007 Horse NRC reduced cobalt (Co) requirements from 0.1 ppm to 0.05 ppm in dietary dry matter, though preliminary research suggested increasing dietary-Co enhanced fiber digestion in horses. This study aimed to evaluate fiber digestion with varying dietary Co amounts, as well as to compare serum Co concentrations with dietary Co content. Four geldings (mean body weight [BW] 503 ± 37 kg) were studied in a 4 × 4 Latin square design consisting of four 5-week periods, each comprising a 2-week washout phase followed by a 3-week treatment phase. Supplementing 0.0, 5.6, 16.8, or 28.0 mg of Co ...
Evidence of Influenza A(H5N1) Spillover Infections in Horses, Mongolia.
Emerging infectious diseases    December 11, 2024   Volume 31, Issue 1 doi: 10.3201/eid3101.241266
Damdinjav B, Raveendran S, Mojsiejczuk L, Ankhanbaatar U, Yang J, Sadeyen JR, Iqbal M, Perez DR, Rajao DS, Park A, Viana M, Murcia PR.Recent outbreaks of influenza A(H5N1) have affected many mammal species. We report serologic evidence of H5N1 virus infection in horses in Mongolia. Because H3N8 equine influenza virus is endemic in many countries, horses should be monitored to prevent reassortment between equine and avian influenza viruses with unknown consequences.
Detection of Over 110 Anabolic-Androgenic Steroids, Corticosteroids and/or Their Esters in Horse Hair Using Ultra-High-Performance Liquid Chromatography-High-Resolution Mass Spectrometry and Gas Chromatography-Tandem Mass Spectrometry After Solid-Supported Liquid Extraction.
Drug testing and analysis    December 10, 2024   doi: 10.1002/dta.3837
So YM, Kwok WH, Ching CCW, Wong COL, Wan TSM, Ho ENM.Anabolic-androgenic steroids (AAS) are banned substances in both human and equine sports. They are often administered intramuscularly to horses in esterified forms for the purpose of extending their duration of action. As such, the detection of intact esters of endogenous steroids in hair is particularly advantageous, as it can provide unequivocal proof of their external origin. Compared with urine and blood matrices, hair in general allows a longer detection window as long as the administered drug can be incorporated into hair and has not degraded. This can be useful in doping control of equi...
Role of cannabidiolic acid or the combination of cannabigerol/cannabidiol in pain modulation and welfare improvement in horses with chronic osteoarthritis.
Frontiers in veterinary science    December 10, 2024   Volume 11 1496473 doi: 10.3389/fvets.2024.1496473
Aragona F, Tabbì M, Gugliandolo E, Giannetto C, D'Angelo F, Fazio F, Interlandi C.Cannabidiol (CBD) is a non-psychotropic cannabinoid obtained from hemp (Cannabis sativa L.) used for pain management in companion animals including horses. The present study aimed to evaluate the efficacy of cannabidiolic acid (CBDA) and cannabigerol/cannabidiol oil (CBG/CBD) oral administration in alleviating pain in adult horses affected by chronic osteoarthritis (OA). Twenty-four horses (10 geldings and 14 mares), aged between 11 and 18 years old, were equally divided into two groups. One group received CBDA 15% oil and the other group received CBG/CBD oil (CBG20%-CBD10%) for 14 consecuti...
Egg reappearance periods associated with anthelmintic treatments given to horses in winter and summer over two years.
Veterinary parasitology, regional studies and reports    December 9, 2024   Volume 57 101182 doi: 10.1016/j.vprsr.2024.101182
Scott I, Lawrence KE, Gee EK.Shortened egg reappearance periods (ERP) have been seen as an early warning of anthelmintic resistance development in cyathostomins in horses. The hypothesis has been that in these instances, efficacy against egg laying adult cyathostomins remains high, but a decline in activity against later larval stages leads to the earlier resumption of egg shedding after treatment. In this study using a single herd of horses we investigated the ERP of a number of commonly used equine anthelmintics and examined whether ERP might show seasonal variation between winter and summer. Four main Faecal egg count ...
Efficacy of 0.2% povidone-iodine and 0.1% polyhexamethylene biguanide as preoperative antiseptics in equine ophthalmic procedures.
Veterinary ophthalmology    December 8, 2024   doi: 10.1111/vop.13306
Farkas A, Thieme K, Soimala T, Jensen CK, Eule JC.This retrospective study evaluates the efficacy of povidone-iodine (PI) and polyhexamethylene biguanide (PHMB) as preoperative antiseptics in equine ophthalmic procedures. Methods: Horses that underwent routine ophthalmic surgery and procedures. Methods: Data were collected retrospectively from the medical records of equine patients undergoing ophthalmic procedures. Inclusion criteria were sampling for aerobic microbial culture at three different time points (T0: pre-irrigation, T1: post-irrigation, and T2: postoperatively) and T0 showing bacterial growth. Microbiological outcomes were assesse...
Transport-related respiratory pathogens in horses travelling long distances: A prospective study on arrival at the slaughterhouse.
Research in veterinary science    December 7, 2024   Volume 183 105498 doi: 10.1016/j.rvsc.2024.105498
Padalino B, Pellegrini F, Felici M, Zappaterra M, Catella C, Cordisco M, Lorusso E, Cirone F, Pratelli A.Respiratory disorders (RDs) are a common transport-related welfare consequence in horses. This prospective study described the journeys of horses transported to two slaughterhouses in Italy, documented the prevalence of potentially RD-related pathogens, and identified possible predisposing factors. Data were recorded from arrival until 48 h after arrival and included the collection of Deep Nasopharyngeal Swabs (DNS), journey details and welfare assessment of horses (n = 155). PCR was used to quantify the presence of influenza A virus, reovirus, equine herpesvirus type 1 and 4, adenovirus, r...
Effect of a dietary nutraceutical “STRUCTURE-Joint” on response of horses to intra-articular challenge with IL-1: implications for tissue adaptation to stress.
Translational animal science    December 7, 2024   Volume 8 txae172 doi: 10.1093/tas/txae172
Korac L, Golestani N, MacNicol J, Souccar-Young J, Witherspoon S, Wildish A, Topfer S, Pearson W.The purpose was to determine local (articular) and systemic effects of intra-articular interleukin-1 in horses supplemented with a dietary PUFA supplement [STRUCTURE-Joint (ST-J)]. Sixteen (16) healthy, mature, light breed horses were randomly assigned to diets containing 0 or 120 mL (n = 8 per group) of ST-J for 30 d. On days 0 (prior to beginning supplementation) and 27, recombinant equine interleukin-1β (reIL-1 β) (75 ng) was injected into the left or right intercarpal joint to induce mild, transient synovitis. Synovial fluid was obtained by aseptic arthrocentesis at postinjection hou...
Sleeping and Eating Behavior Recognition of Horses Based on an Improved SlowFast Network.
Sensors (Basel, Switzerland)    December 5, 2024   Volume 24, Issue 23 7791 doi: 10.3390/s24237791
Liu Y, Zhou F, Zheng W, Bai T, Chen X, Guo L.The sleeping and eating behaviors of horses are important indicators of their health. With the development of the modern equine industry, timely monitoring and analysis of these behaviors can provide valuable data for assessing the physiological state of horses. To recognize horse behaviors in stalls, this study builds on the SlowFast algorithm, introducing a novel loss function to address data imbalance and integrating an SE attention module in the SlowFast algorithm's slow pathway to enhance behavior recognition accuracy. Additionally, YOLOX is employed to replace the original target detecti...
Ice application without water drainage supports optimal hoof cooling in adult horses.
Journal of equine veterinary science    December 5, 2024   Volume 145 105255 doi: 10.1016/j.jevs.2024.105255
Folk KM, White RR, Gleason CB.Cryotherapy is often used to reduce inflammation in acute equine laminitis cases. Certain hoof temperatures have been suggested as effective in minimizing the inflammatory process; however, there is limited evidence on which methods are best at achieving these temperatures. Our objective was to determine how different methods of cryotherapy influence the rate and extent of cooling for the equine hoof wall. Four horses received three hoof cooling treatments and a control (CON; no treatment application) in a 4 × 4 Latin square design. Treatments included (1) ice surrounding the hoof in a 5 L fl...
Effect of hay nets on subluxations, pain-pressure thresholds, and cervical range of motion in the axial skeleton of adult horses.
Journal of equine veterinary science    December 5, 2024   Volume 145 105256 doi: 10.1016/j.jevs.2024.105256
DeBoer M, Rieck T, Johnson L, Redenius H, Martinson K.Horses have become more intensively managed, including the use of hay nets to increase intake time and reduce hay waste, but their impact on health is not well known. The objectives were to compare changes in subluxations, range of motion, and the pain-pressure threshold in the axial skeleton of horses fed hay with (NET) or without (CON) hay nets. In September 2021, 13 adult horses were blocked by bodyweight (BW) and randomly assigned to the NET or CON treatments for one year. After one year, horses switched treatments and the trial concluded in September 2023. Horses were housed in dry lots w...
Double-blinded, randomized tolerance study of a biologically enhanced Nanogel with endothelin-1 and bradykinin receptor antagonist peptides via intra-articular injection for osteoarthritis treatment in horses.
BMC veterinary research    December 4, 2024   Volume 20, Issue 1 547 doi: 10.1186/s12917-024-04352-w
Terlinden A, Jacquet S, Manivong S, Cullier A, Cassé F, Legendre F, Garcia AA, Roullin G, Moldovan F, Sirois P, Banquy X, Galéra P, Audigié F....Osteoarthritis is a leading cause of pain and retirement in athletic horses. Hydro-expansive functionalized nanogels, acting as Drug Delivery Systems, constitute one of the current therapeutic prospects. These nanogels have the potential to combine mechanical benefits through polymers with the biological effect of prolonged release of bioactive molecules. The purpose of this double-blinded randomized tolerance study versus negative control was to evaluate the response of healthy joints to a single injection of the expected efficient dose (further referred to as the trial dose) and overdose of ...
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