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Topic:Horses

"Horses" is a broad topic that encompasses various aspects of equine biology, behavior, and management. This category includes studies on the anatomy, physiology, and genetics of horses, as well as their behavior, nutrition, and care. Research in this area may also cover the historical and cultural significance of horses, their roles in agriculture, sport, and therapy, and the challenges associated with their conservation and welfare. The page aggregates peer-reviewed research articles and scholarly studies that explore the multifaceted relationships between humans and horses, examining both scientific and socio-economic perspectives.
Comparison of serological and molecular tests for detection of Trypanosoma evansi in domestic animals from Ghardaïa district, South Algeria.
Veterinary parasitology    March 19, 2020   Volume 280 109089 doi: 10.1016/j.vetpar.2020.109089
Benfodil K, Büscher P, Abdelli A, Van Reet N, Mohamed-Herif A, Ansel S, Fettata S, Dehou S, Bebronne N, Geerts M, Balharbi F, Ait-Oudhia K.Trypanosoma evansi (T. evansi) is a hemoflagellate parasite that affects a broad range of mammalian hosts and that causes a disease called surra. Diagnosis of surra based on clinical symptoms alone is inaccurate. Therefore, a variety of serological and molecular diagnostic tests are used to assist in the detection of T. evansi infections. The aim of this study was to compare the diagnostic performance of four serological tests (CATT/T.evansi, immune trypanolysis, ELISA with purified variant surface glycoprotein RoTat 1.2 and with whole cell lysate) and two molecular PCR tests targeting sequenc...
Calcium Electroporation of Equine Sarcoids.
Animals : an open access journal from MDPI    March 19, 2020   Volume 10, Issue 3 doi: 10.3390/ani10030517
Frandsen SK, Gehl J, Tramm T, Thoefner MS.Sarcoids are common equine skin tumors where the risk of recurrence after treatment is high, and better treatment options are warranted. Calcium electroporation is a novel anti-cancer treatment where lethally high calcium concentrations are introduced into the cells by electroporation, a method where short high-voltage pulses induce transient permeabilization of the cell membrane. This study investigated the safety and long-term response of calcium electroporation on sarcoids. Thirty-two sarcoids in eight horses were included. The study suggested that calcium electroporation is a safe and feas...
Evaluation of acquired passive immunity in mule foals up to 60 days of age.
Journal of equine science    March 19, 2020   Volume 31, Issue 1 1-4 doi: 10.1294/jes.31.1
Baptista VDS, Guttmann PM, Rusca AC, Moreira da Silva K, Macieira DB, de Alencar NX, Lessa DAB.Ten mule foals were used to investigate serum IgG concentration. Blood was collected from mares and foals on the day following parturition (D1), at 48 and 72 hr after birth (D2 and D3), and on D7, D14, D21, D28, D35, D42, and D60. Serum IgG concentration was determined by zinc sulfate turbidity test and was above 400 mg/dl at all time points, except for one foal on D2. Mean values were above 800 mg/dl from D1 to D7 and at D60. The difference between mares and foals at each collection time was significant, except at D1. For all other days, foal IgG values were lower than the mare IgG values. Me...
Using Artificial Intelligence to Predict Survivability Likelihood and Need for Surgery in Horses Presented With Acute Abdomen (Colic).
Journal of equine veterinary science    March 19, 2020   Volume 90 102973 doi: 10.1016/j.jevs.2020.102973
Fraiwan MA, Abutarbush SM.Artificial intelligence and machine learning have promising applications in several medical fields of diagnosis, imaging, and laboratory testing procedures. However, the use of this technology in the veterinary medicine field is lagging behind, and there are many areas where it could be used with potentially successful outcomes and results. In this study, two critical predictions were explored in horses presented with acute abdomen (colic) using this technology. Those were the need for surgical intervention and survivability likelihood of affected horses based on clinical data (history, clinic...
Evaluation of the Element point-of-care blood gas analyzer for use in horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    March 18, 2020   Volume 30, Issue 3 279-285 doi: 10.1111/vec.12950
Krueger CR, Hackett ES, Hess AM, Mama KR.To compare the Element point-of-care (POC) portable blood gas analyzer with a laboratory-based bench-top reference analyzer using whole blood samples obtained from horses presenting to a referral center with various disorders in order to determine agreement between these analyzers. Methods: Prospective clinical study. Methods: The study was conducted at a university teaching hospital at moderate altitude. Methods: One hundred paired samples from 80 horses >1 year of age were collected after obtaining informed client consent. Fifty paired samples were from patients admitted for elective pro...
Identification and Quantification of Transient Receptor Potential Vanilloid 1 (TRPV1) in Equine Articular Tissue.
Animals : an open access journal from MDPI    March 18, 2020   Volume 10, Issue 3 506 doi: 10.3390/ani10030506
Braucke AFGV, Frederiksen NL, Berg LC, Aarsvold S, Müller FC, Boesen MP, Lindegaard C.Joint pain and osteoarthritis (OA) are some of the most common causes of lameness in horses, and most of the available treatments focus on symptomatic relief without a disease-modifying effect. TRPV1 is a potential target for treating joint diseases, including OA, and the present study aims to investigate if the TRPV1 receptor is present in equine articular tissue and determine whether the number of receptors is upregulated in joint inflammation. Metacarpo/metatarsophalangeal (MCP/MTP) joints from 15 horses euthanised for reasons unrelated to this study were included. Based on synovial fluid a...
First case of fatal equine meningoencephalitis caused by Halicephalobus gingivalis in Mexico.
Veterinary parasitology, regional studies and reports    March 18, 2020   Volume 20 100399 doi: 10.1016/j.vprsr.2020.100399
Avila VA, López-García Y, Hernández-Castro R, Salas-Garrido CG, Ramírez-Lezama J, Calderón-Villa R, Martínez-Chavarría LC.Aberrant nematode larval migration in the CNS of horses is rare but frequently fatal; one of the main etiological agents involved in this illness is Halicephalobus gingivalis. This soil nematode has been associated with several fatal equine meningoencephalitis reports worldwide; however, it had never been diagnosed in horses of Mexico. A 10 year-old Andalusian horse presented dysphagia, fever, weakness, prostration and ataxia; the patient expired during the medical attention. Post mortem examination was performed and no gross alterations were found. Histopathology revealed meningoencephalitis...
Inflammatory Response of Healthy Horses Subjected to Small Colon Enterotomy and Treated or Not With Heparin.
Journal of equine veterinary science    March 17, 2020   Volume 90 102989 doi: 10.1016/j.jevs.2020.102989
Alonso JM, Schmidt EMS, Eckersall PD, Kjelgaard-Hansen M, Alves ALG, Rodrigues CA, Watanabe MJ, Crescencio AP, Hussni CA.The acute phase response is a response to injury and depends on the severity of the trauma. Heparin is routinely used for postsurgical treatment of horses to prevent abdominal adhesions; however, its effect on inflammation is unknown. This study aimed to assess systemic inflammatory response of horses subjected to small colon enterotomy and to evaluate heparin effects on postsurgical inflammation. Ten adult horses were subjected to small colon enterotomy and were assigned to a control or a treatment group. Both groups received prophylactic antibiotics and flunixin, and the treatment group rece...
Antimicrobial susceptibility patterns of bacterial isolates cultured from synovial fluid samples from horses with suspected septic synovitis: 108 cases (2008-2017).
Journal of the American Veterinary Medical Association    March 17, 2020   Volume 256, Issue 7 800-807 doi: 10.2460/javma.256.7.800
Miagkoff L, Archambault M, Bonilla AG.To describe the antimicrobial susceptibility patterns of the most commonly isolated bacteria cultured from synovial fluid samples from horses with suspected septic synovitis treated at an equine referral hospital between May 1, 2008, and September 24, 2017. Methods: 131 synovial fluid samples from 108 client-owned horses. Methods: A retrospective medical record search was conducted to identify horses with suspected septic synovitis and results of synovial fluid bacterial culture and antimicrobial susceptibility testing. Data collected included signalment, known or suspected origin of synovial ...
The energy requirements of performance horses in training.
Translational animal science    March 17, 2020   Volume 4, Issue 2 txaa032 doi: 10.1093/tas/txaa032
Ebert M, Moore-Colyer MJS.The aim of this study was to estimate the energy requirements of performance horses in active, variable training in the field. Sixty horses in England and Switzerland were measured over 2-wk periods and, for 15 of these, the measurement period was extended, ranging from 21 to 42 wk. Energy intake was estimated by measuring daily feed consumption. Energy output was measured using heart rate (HR) monitors during 608 training sessions, relating HR to volume of oxygen (VO₂) and converting VO₂ to energy. Field maintenance requirements were calculated by deducting the marginal energy cost of tra...
Cryopreservation of equine oocytes: looking into the crystal ball.
Reproduction, fertility, and development    March 17, 2020   Volume 32, Issue 5 453-467 doi: 10.1071/RD19229
De Coster T, Velez DA, Van Soom A, Woelders H, Smits K.Invitro embryo production has evolved rapidly in the horse over the past decade, but blastocyst rates from vitrified equine oocytes remain quite poor and further research is needed to warrant application. Oocyte vitrification is affected by several technical and biological factors. In the horse, short exposure of immature oocytes to the combination of permeating and non-permeating cryoprotective agents has been associated with the best results so far. High cooling and warming rates are also crucial and can be obtained by using minimal volumes and open cryodevices. Vitrification of invivo-matur...
A Comparison of Multiple Allergen Simultaneous Tests Using Allergen-Specific IgE Concentration and Intradermal Skin Tests in Atopic Horses With Pollen Allergy.
Journal of equine veterinary science    March 17, 2020   Volume 90 102992 doi: 10.1016/j.jevs.2020.102992
Wilkołek P, Szczepanik M, Rodzik B, Sitkowski W, Pluta M, Taszkun I, Gołyński M.Intradermal tests (IDTs) and measurement of specific immunoglobulin E class (sIgE) levels in sera are the most common and reliable methods used in allergological clinical practice. The purpose of this study was to explore the sensitization of pollen allergy in atopic horses with pollinosis and to assess the diagnostic value of the multiple allergen simultaneous tests (MASTs) compared with that of the IDT. Twenty-one Malopolski horses with typical skin hypersensitivity symptoms during pollen seasons were enrolled. Intradermal tests were performed, and allergen-specific IgE concentrations in ser...
Complete genome analysis of Glutamicibacter creatinolyticus from mare abscess and comparative genomics provide insight of diversity and adaptation for Glutamicibacter.
Gene    March 17, 2020   Volume 741 144566 doi: 10.1016/j.gene.2020.144566
Santos RG, Hurtado R, Gomes LGR, Profeta R, Rifici C, Attili AR, Spier SJ, Mazzullo G, Morais-Rodrigues F, Gomide ACP, Brenig B, Gala-García A....Bacteria of the genusGlutamicibacterare considered ubiquitous because they can be found in soil, water and air. They have already been isolated from different habitats, including different types of soil, clinical samples, cheese and plants. Glutamicibacter creatinolyticus is a Gram-positive bacterium important to various biotechnological processes, however, as a pathogen it is associated to urinary tract infections and bacteremia. Recently,Glutamicibacter creatinolyticusLGCM 259 was isolated from a mare, which displayed several diffuse subcutaneous nodules with heavy vascularization. In this s...
Speed of in vitro embryo development affects the likelihood of foaling and the foal sex ratio.
Reproduction, fertility, and development    March 17, 2020   Volume 32, Issue 5 468-473 doi: 10.1071/RD19298
Claes A, Cuervo-Arango J, Colleoni S, Lazzari G, Galli C, Stout TA.The success of invitro embryo production (IVEP) in horses has increased considerably during recent years, but little is known about the effect of the speed of invitro embryo development. Blastocysts (n=390) were produced by intracytoplasmic sperm injection of IVM oocytes from warmblood mares, cryopreserved, thawed and transferred into recipient mares on Days 3, 4, 5 or 6 after ovulation. The time required for invitro-produced (IVP) embryos to reach the blastocyst stage was recorded (Day 7 vs Day 8). The likelihood of foaling was affected by the speed of invitro embryo development and recipient...
A Subset of Equine Gastric Squamous Cell Carcinomas Is Associated With Equus Caballus Papillomavirus-2 Infection.
Veterinary pathology    March 17, 2020   Volume 57, Issue 3 427-431 doi: 10.1177/0300985820908797
Alloway E, Linder K, May S, Rose T, DeLay J, Bender S, Tucker A, Luff J.Squamous cell carcinoma (SCC) is the most common neoplasm of the equine stomach. However, the mechanisms underlying malignant transformation are unknown. As papillomavirus-2 (EcPV-2) is a likely cause of some genital SCCs, we hypothesized that EcPV-2 is associated with a subset of equine gastric SCCs. To this aim, we performed polymerase chain reaction (PCR) and in situ hybridization (ISH) for EcPV-2 E6/ E7 oncogenes on 11 gastric SCCs and on gastric samples from 15 control horses with no SCC. PCR for EcPV-2 was positive in 7/11 (64%) gastric SCCs; non-SCC gastric samples were all negative. I...
Detection of intra-articular gene therapy in horses using quantitative real time PCR in synovial fluid and plasma.
Drug testing and analysis    March 16, 2020   Volume 12, Issue 6 743-751 doi: 10.1002/dta.2785
Haughan J, Jiang Z, Stefanovski D, Moss KL, Ortved KF, Robinson MA.Gene therapy promotes the expression of missing or defective genes and can be curative following administration of a single dose. Gene therapy is prohibited in equine athletes by regulatory bodies due to the high potential for abuse and novel analytical methods are needed for detection. The goal of this study was to detect the administration of an experimental gene therapy: a recombinant adeno-associated viral vector (rAAV) carrying a transgene for the anti-inflammatory cytokine IL-10 (rAAV-IL10). Twelve horses were randomly assigned to receive an intra-articular injection of rAAV-IL10 or phos...
Non-invasive evaluation of the equine gastrointestinal mucosal transcriptome.
PloS one    March 16, 2020   Volume 15, Issue 3 e0229797 doi: 10.1371/journal.pone.0229797
Coleman MC, Whitfield-Cargile C, Cohen ND, Goldsby JL, Davidson L, Chamoun-Emanuelli AM, Ivanov I, Eades S, Ing N, Chapkin RS.Evaluating the health and function of the gastrointestinal tract can be challenging in all species, but is especially difficult in horses due to their size and length of the gastrointestinal (GI) tract. Isolation of mRNA of cells exfoliated from the GI mucosa into feces (i.e., the exfoliome) offers a novel means of non-invasively examining the gene expression profile of the GI mucosa. This approach has been utilized in people with colorectal cancer. Moreover, we have utilized this approach in a murine model of GI inflammation and demonstrated that the exfoliome reflects the tissue transcriptom...
Domesticated equine species and their derived hybrids differ in their fecal microbiota.
Animal microbiome    March 16, 2020   Volume 2, Issue 1 8 doi: 10.1186/s42523-020-00027-7
Edwards JE, Schennink A, Burden F, Long S, van Doorn DA, Pellikaan WF, Dijkstra J, Saccenti E, Smidt H.Compared to horses and ponies, donkeys have increased degradation of dietary fiber. The longer total mean retention time of feed in the donkey gut has been proposed to be the basis of this, because of the increased time available for feed to be acted upon by enzymes and the gut microbiota. However, differences in terms of microbial concentrations and/or community composition in the hindgut may also underpin the increased degradation of fiber in donkeys. Therefore, a study was conducted to assess if differences existed between the fecal microbiota of pony, donkey and hybrids derived from them (...
Comparison of a continuous indwelling glucometer with a point-of-care device in healthy adult horses.
The Veterinary record    March 16, 2020   Volume 187, Issue 3 e21 doi: 10.1136/vr.105607
Cunneen A, Wood KA, Mathison K, Herndon AM, Bertin FR.Blood glucose is tightly regulated in horses; however, since hypoglycaemia and hyperglycaemia are associated with poor prognosis, close monitoring is warranted. This study aimed at evaluating a continuous indwelling glucometer (CIG) by comparing performance with a point-of-care glucometer (POC). Ten horses were equipped with CIG and an intravenous catheter. Interstitial glucose concentrations were determined by CIG every 5 min at rest, during insulin-induced hypoglycaemia and dextrose-induced hyperglycaemia, and compared with blood glucose determined by POC. Glucose concentrations were compa...
A Brief Introduction to Equine Influenza and Equine Influenza Viruses.
Methods in molecular biology (Clifton, N.J.)    March 15, 2020   Volume 2123 355-360 doi: 10.1007/978-1-0716-0346-8_26
Chambers TM.Equine influenza virus (EIV) is a common respiratory pathogen of horses and other equids in most parts of the world. EIV are Type A influenza viruses and two subtypes are known: H3N8 and H7N7. Both are believed to have evolved from avian influenza virus ancestors. The H3N8 subtype circulates widely, but the H7N7 subtype is thought to be extinct. The clinical disease in horses, caused by either subtype, is an upper respiratory infection of varying severity depending upon the immune status of the individual animal. It is not normally life-threatening in itself except in very young foals; however...
RNA Extraction from Equine Samples for Equine Influenza Virus.
Methods in molecular biology (Clifton, N.J.)    March 15, 2020   Volume 2123 369-382 doi: 10.1007/978-1-0716-0346-8_28
Balasuriya UBR.The primary goals of this chapter are to discuss common viral RNA isolation and purification methods that are routinely used by various diagnostic laboratories and to highlight the advantages and drawbacks of each method and to identify the most suitable and reliable method to increase the sensitivity and specificity of RT-PCR assays for the detection of equine influenza virus (EIV) in clinical specimens. Our experiences and review of literature show that magnetic bead-based nucleic extraction methods (manual and automatic) work well for isolation and purification of EIV RNA from nasal swab sp...
Equine Influenza Diagnosis: Sample Collection and Transport.
Methods in molecular biology (Clifton, N.J.)    March 15, 2020   Volume 2123 361-367 doi: 10.1007/978-1-0716-0346-8_27
Chambers TM, Reedy SE.In horses, presumptive diagnosis of equine influenza is commonly made on the basis of clinical signs. This alone is insufficient for confirmation of equine influenza, because other equine infectious respiratory diseases can in some degree have similar clinical presentations. Surveillance and control of equine influenza also necessitate detection of subclinical cases. Effective diagnosis of equine influenza virus infection is critically dependent on obtaining adequate specimens of virus-containing respiratory secretions for testing. These specimens are also valuable as sources for isolation of ...
Congenital phimosis causing preputial swelling in a newborn foal.
The Canadian veterinary journal = La revue veterinaire canadienne    March 14, 2020   Volume 61, Issue 3 247-250 
Canisso IF, Ellerbrock RE, Wilkins PA.An 18-hour-old colt was presented for abdominal discomfort, preputial swelling, and frequent posturing to urinate. Examination of the scrotum confirmed 2 testes and no scrotal or inguinal hernia. Transabdominal ultrasound identified a distended bladder and no free fluid in the peritoneal cavity. Inspection of the preputial cavity revealed that the internal lamina of the prepuce was mostly attached to the glans penis. The preputial cavity was lubricated and manual traction was applied to detach the internal lamina of the prepuce from the glans penis. The colt urinated spontaneously 1 hour after...
Scapula fracture secondary to metastatic pulmonary carcinoma in a horse: Clinical, sonographic, radiographic, computed tomographic, and pathologic findings.
The Canadian veterinary journal = La revue veterinaire canadienne    March 14, 2020   Volume 61, Issue 3 251-256 
Pye J, Kilcoyne I, Roy M, Vaughan B, Ormond C, Spriet M.A 20-year-old Quarter horse gelding was referred for evaluation of an acute onset non-weight-bearing right forelimb lameness. Marked soft tissue swelling was apparent over the right scapula and shoulder region; no crepitus was palpable. A complete transverse fracture of the scapular neck was suspected based on ultrasonography and radiographs were obtained to confirm the presumptive diagnosis. A complete, oblique fracture of the right scapular neck with mild cranial and proximal displacement of the distal fragment was detected. Computed tomography of the upper right forelimb was performed post-...
Clinical findings, diagnoses, and outcomes of horses presented for colic to a referral hospital in Atlantic Canada (2000-2015).
The Canadian veterinary journal = La revue veterinaire canadienne    March 14, 2020   Volume 61, Issue 3 281-288 
Kaufman JM, Nekouei O, Doyle AJ, Biermann NM.Medical records of equine patients presented for signs of abdominal pain to the Atlantic Veterinary College Teaching Hospital between 2000 and 2015 were reviewed. A total of 575 patients were enrolled, and the most common clinical findings, diagnoses, and outcomes are described. Potential predictors of survival to discharge were assessed. The most common diagnosis was large colon impaction (18.4%), followed by large colon volvulus (6.2%). Overall survival to discharge was 69%. The survival rates for horses were 82.9% for those with no diagnosis, 74.6% for those with large intestine lesions, an...
Evaluation of Stress Response under a Standard Euthanasia Protocol in Horses Using Analysis of Heart Rate Variability.
Animals : an open access journal from MDPI    March 13, 2020   Volume 10, Issue 3 doi: 10.3390/ani10030485
Gehlen H, Loschelder J, Merle R, Walther M.The effects of a standard protocol for euthanasia on heart rate variability (HRV) as a consequence of stress response were analyzed in this prospective clinical study. The HRV was determined in 40 horses undergoing euthanasia due to various reasons, at different locations, and with/without owner presence. For euthanasia, horses were sedated with xylazine or a combination of xylazine and butorphanol. General anesthesia was induced using diazepam and ketamine. Afterwards, horses were euthanized with pentobarbital. The ECG data were taken by a Telemetric ECG at three time points (sedation, anesth...
Transporting and Exercising Unconditioned Horses: Effects on Microflora Populations.
Journal of equine veterinary science    March 13, 2020   Volume 90 102988 doi: 10.1016/j.jevs.2020.102988
Szemplinski KL, Thompson A, Cherry N, Guay K, Smith WB, Brady J, Jones T.The objective of this study was to determine if transportation and exercise stress in horses affect the microflora populations in the equine hindgut. Four horses were subjected to three transport periods (0, 3, and 6 hours) with a 7-d rest period between each transport. Horses were fed 0.91 kg/day of Purina Impact All Stages 12% and had ad libitum access to Cynodon dactylon (Coastal Bermudagrass) hay. Fecal samples were collected before (0 hours) and after (48 hours) transport. In addition, three horses underwent a different standardized exercise test with a 7-d rest period between each ex...
Use of smartphones to aid the teaching of equine ocular fundus examination.
The Veterinary record    March 13, 2020   Volume 186, Issue 16 532 doi: 10.1136/vr.105544
Shipman E, Burford JH, Bowen M, Duz M.Teaching and learning how to perform examination of the ocular fundus is challenging. Smartphones can support to enhance students' confidence and experience. Following an optional year-4 ophthalmoscopy practical using hand-held ophthalmoscopes, students completed a questionnaire using a visual analogue scale (VAS) investigating if students felt smartphone use aided learning and if student's self-assessed confidence in visualising the ocular fundus had improved. VAS scores were compared using the Wilcoxon signed rank test (significance: P<0.05). All 30 year-4 students attending the practic...
Pharmacokinetics and clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia.
Journal of veterinary pharmacology and therapeutics    March 12, 2020   Volume 43, Issue 4 369-376 doi: 10.1111/jvp.12855
Guedes A, Knych H, Tucker L, Almeida DC, Baldo CF, Wendt-Hornickle E, Allweiler S.This study determined the pharmacokinetics and compared the clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. Six healthy horses aged 8.5 ± 3 years and weighing 462 ± 50 kg were anesthetized with isoflurane for 2 hr under standard conditions on two occasions one-week apart. In recovery, horses received 200 μg/kg xylazine or 0.875 μg/kg dexmedetomidine intravenously and were allowed to recover without assistance. These doses were selected because they have been used for postanesthetic sedation in clinical and research studies. Serial ...
Ex-vivo Mechanical Testing of Novel Laryngeal Clamps Used for Laryngeal Advancement Constructs.
Frontiers in veterinary science    March 12, 2020   Volume 7 139 doi: 10.3389/fvets.2020.00139
Grzeskowiak RM, Schumacher J, Mulon PY, Steiner RC, Cassone L, Anderson DE.Rostral laryngeal advancement, also known as laryngeal tie-forward, is used to treat horses for intermittent dorsal displacement of the soft palate and has a morbidity rate of about 6%. We hypothesized that a novel laryngeal clamp would prevent morbidity associated with the sutures tearing through the thyroid cartilage. Larynges (n = 35 horses) were used for ex vivo testing. For uniaxial testing, 15 equine larynges were tested in one of three laryngeal tie-forward constructs [standard laryngeal tie-forward; modified laryngeal tie-forward using a suture-button; and modified laryngeal tie-forwar...