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Topic:Thoroughbreds

Thoroughbreds are a breed of horse known for their agility, speed, and spirit, often associated with horse racing and equestrian sports. Originating from crossbreeding native English mares with imported Arabian, Barb, and Turkoman stallions, Thoroughbreds have a well-documented pedigree that traces back to the late 17th and early 18th centuries. This breed is characterized by a refined head, deep chest, and long legs, contributing to their athletic capabilities. Thoroughbreds are primarily bred for their performance in racing but are also utilized in other equestrian disciplines. This page compiles peer-reviewed research studies and scholarly articles that explore the genetics, physiology, and performance characteristics of Thoroughbreds, as well as their management and welfare in various equine activities.
Copy number deletion has little impact on gene expression levels in racehorses.
Asian-Australasian journal of animal sciences    September 3, 2014   Volume 27, Issue 9 1345-1354 doi: 10.5713/ajas.2013.13857
Park KD, Kim H, Hwang JY, Lee CK, Do KT, Kim HS, Yang YM, Kwon YJ, Kim J, Kim HJ, Song KD, Oh JD, Kim H, Cho BW, Cho S, Lee HK.Copy number variations (CNVs), important genetic factors for study of human diseases, may have as large of an effect on phenotype as do single nucleotide polymorphisms. Indeed, it is widely accepted that CNVs are associated with differential disease susceptibility. However, the relationships between CNVs and gene expression have not been characterized in the horse. In this study, we investigated the effects of copy number deletion in the blood and muscle transcriptomes of Thoroughbred racing horses. We identified a total of 1,246 CNVs of deletion polymorphisms using DNA re-sequencing data from...
Thoroughbred Horse Single Nucleotide Polymorphism and Expression Database: HSDB.
Asian-Australasian journal of animal sciences    September 3, 2014   Volume 27, Issue 9 1236-1243 doi: 10.5713/ajas.2013.13694
Lee JH, Lee T, Lee HK, Cho BW, Shin DH, Do KT, Sung S, Kwak W, Kim HJ, Kim H, Cho S, Park KD.Genetics is important for breeding and selection of horses but there is a lack of well-established horse-related browsers or databases. In order to better understand horses, more variants and other integrated information are needed. Thus, we construct a horse genomic variants database including expression and other information. Horse Single Nucleotide Polymorphism and Expression Database (HSDB) (http://snugenome2.snu.ac.kr/HSDB) provides the number of unexplored genomic variants still remaining to be identified in the horse genome including rare variants by using population genome sequences of...
What is your diagnosis? CBC and blood film from an Italian thoroughbred gelding. Microfilaremia.
Veterinary clinical pathology    August 28, 2014   Volume 43, Issue 4 609-610 doi: 10.1111/vcp.12186
Zanzani S, Piseddu E, Barelli A, Manfredi MT.No abstract available
Profiles of strongyle EPG values for Thoroughbred mares on 14 farms in Kentucky (2012-2013).
Veterinary parasitology    August 28, 2014   Volume 205, Issue 3-4 646-652 doi: 10.1016/j.vetpar.2014.08.001
Lyons ET, Tolliver SC, Kuzmina TA, Dzeverin II, Nielsen MK, McDowell KJ.The main purpose of the research was to determine if three weekly samplings would produce consistent results for low strongyle egg shedders, generally associated with older horses. Strongyle egg counts per gram of feces (EPG) were done for 661 Thoroughbred mares on 14 farms in 2012-2013 once a week for three consecutive weeks. None of the mares had been treated with ivermectin or moxidectin for more than 90 days and with fenbendazole, oxibendazole, or pyrantel pamoate for more than 60 days. Strongyle EPG count data indicated that 38.3% of the mares were positive at first and second sampling, a...
Haplotype diversity in the equine myostatin gene with focus on variants associated with race distance propensity and muscle fiber type proportions.
Animal genetics    August 26, 2014   Volume 45, Issue 6 827-835 doi: 10.1111/age.12205
Petersen JL, Valberg SJ, Mickelson JR, McCue ME.Two variants in the equine myostatin gene (MSTN), including a T/C SNP in the first intron and a 227-bp SINE insertion in the promoter, are associated with muscle fiber type proportions in the Quarter Horse (QH) and with the prediction of race distance propensity in the Thoroughbred (TB). Genotypes from these loci, along with 18 additional variants surrounding MSTN, were examined in 301 horses of 14 breeds to evaluate haplotype relationships and diversity. The C allele of intron 1 was found in 12 of 14 breeds at a frequency of 0.27; the SINE was observed in five breeds, but common in only the T...
Prevalence of patent Strongyloides westeri infections in Thoroughbred foals in 2014.
Parasitology research    August 23, 2014   Volume 113, Issue 11 4163-4164 doi: 10.1007/s00436-014-4088-1
Lyons ET, Tolliver SC.The prevalence of patent Strongyloides westeri infections was determined by examination for eggs in fecal samples collected from 513 Thoroughbred (TB) foals between February 25 and June 3, 2014. The study was conducted with 244 colts and 269 fillies from 11 well-managed farms in Central Kentucky. Foals ranged from 17 to 117 days of age and had never been dewormed. The mean prevalence of patent S. westeri infection was 30% (156/513 foals). This prevalence was substantially greater than historical reports from the same sampling area during the late 1990s and early 2000s. It is hypothesized that ...
Calcium homeostasis in myogenic differentiation factor 1 (MyoD)-transformed, virally-transduced, skin-derived equine myotubes.
PloS one    August 22, 2014   Volume 9, Issue 8 e105971 doi: 10.1371/journal.pone.0105971
Fernandez-Fuente M, Terracciano CM, Martin-Duque P, Brown SC, Vassaux G, Piercy RJ.Dysfunctional skeletal muscle calcium homeostasis plays a central role in the pathophysiology of several human and animal skeletal muscle disorders, in particular, genetic disorders associated with ryanodine receptor 1 (RYR1) mutations, such as malignant hyperthermia, central core disease, multiminicore disease and certain centronuclear myopathies. In addition, aberrant skeletal muscle calcium handling is believed to play a pivotal role in the highly prevalent disorder of Thoroughbred racehorses, known as Recurrent Exertional Rhabdomyolysis. Traditionally, such defects were studied in human an...
Systemic mycobacteriosis in an aborted thoroughbred fetus in Japan.
The Journal of veterinary medical science    August 21, 2014   Volume 76, Issue 12 1617-1621 doi: 10.1292/jvms.14-0276
Sano Y, Matsuda K, Osaki K, Miyasho T, Tsuda T, Taniyama H.A male Thoroughbred fetus was aborted on day 251 of pregnancy. Gross and histological examinations detected systemic granulomatous lesions in many superficial and visceral lymph nodes and organs including the liver, tonsils, lungs, thymus, spleen, right thyroid gland and gastrointestinal tract, and suppurative placentitis, pyogranulomatous amnionitis and intralesional acid-fast bacilli were also detected. An examination of the DNA base sequence of the β subunit of RNA polymerase demonstrated that Mycobacterium avium strain 104 had infected several organs. To the best of our knowledge, this is...
Changes in plasma leptin concentration during different types of exercises performed by horses.
Animal : an international journal of animal bioscience    August 19, 2014   Volume 8, Issue 9 1456-1461 doi: 10.1017/S1751731114001220
Kędzierski W.Leptin is a tissue-derivative adipokine that regulates appetite, food intake and energy expenditure. It is still not clear how exercise affects plasma leptin concentration in horses. The aim of this study was to evaluate the influence of exercise intensity and duration on plasma leptin levels in working horses. A total of 38 horses were prospectively included in the study and grouped according to the type of exercise they performed: dressage (six stallions, group D), jumping (12 stallions, group J), race (12 Thoroughbred horses, six stallions and six mares, group R) and harness (10 light draft...
Airborne particulates (PM10) and tracheal mucus: A case-control study at an American Thoroughbred racetrack.
Equine veterinary journal    August 15, 2014   Volume 47, Issue 4 410-414 doi: 10.1111/evj.12303
Millerick-May ML, Karmaus W, Derksen FJ, Berthold B, Robinson NE.Particle mapping within stalls has demonstrated a relationship between particulate concentrations and visible accumulations of tracheal mucus. However, measurement of breathing zone particulate concentrations, which is the most accurate way to measure exposure, has not been performed to determine the relationship between exposures and accumulations of tracheal mucus sufficient to affect performance. Objective: To compare breathing zone particulate exposures between horses with tracheal mucus scores (MS) previously demonstrated to affect performance (MS≥2) and those without (MS = 0) visible t...
The effect of the laryngeal tie-forward procedure and soft palate cautery on nasopharyngeal diameter in horses.
The Veterinary record    August 14, 2014   Volume 176, Issue 1 19 doi: 10.1136/vr.102509
Offord S, Tulloch LK, Franklin SH, Tremaine WH, Woodford NS, Allen KJ.The laryngeal tie-forward (LTF) procedure has been shown to move the larynx rostrally and dorsally whilst repositioning the basihyoid bone caudally and dorsally. Other studies have shown that the position of the hyoid bones influences the size of the nasopharynx. The effect of the LTF procedure on the size of the nasopharynx is unknown. It was hypothesised that the LTF procedure would result in a decrease in dorsoventral nasopharyngeal diameter. Twenty-five thoroughbred horses which underwent LTF with or without soft palate cautery (LTF±SPC) for treatment of dorsal displacement of the soft pa...
Diagnosis and treatment of dynamic collapse of the cricotracheal ligament in thoroughbred racehorses.
Veterinary surgery : VS    August 13, 2014   Volume 44, Issue 2 162-167 doi: 10.1111/j.1532-950X.2014.12262.x
Kelly PG, Pollock PJ.To describe (1) diagnosis of dynamic collapse of the cricotracheal ligament in a group of horses and (2) treatment and outcome of affected horses. Methods: Retrospective case series. Methods: Thoroughbred horses (n = 8). Methods: Of 600 over ground dynamic endoscopic examinations performed, 8 Thoroughbred horses had cricotracheal ligament collapse (CTLC); 5 were 2 years old and in early training and 2 were mature horses in full work. CTLC was diagnosed if circumferential collapse of the cricotracheal ligament was identified during exercise. Seven horses had repeat endoscopic examination. T...
Comparison of the effect of two doses of omeprazole on the squamous gastric mucosa in thoroughbred racehorses.
The Veterinary record    August 5, 2014   Volume 175, Issue 10 249 doi: 10.1136/vr.102622
Sykes BW, Sykes K, Hallowell GD.No abstract available
Computed tomographic imaging of subchondral fatigue cracks in the distal end of the third metacarpal bone in the thoroughbred racehorse can predict crack micromotion in an ex-vivo model.
PloS one    July 31, 2014   Volume 9, Issue 7 e101230 doi: 10.1371/journal.pone.0101230
Dubois MS, Morello S, Rayment K, Markel MD, Vanderby R, Kalscheur VL, Hao Z, McCabe RP, Marquis P, Muir P.Articular stress fracture arising from the distal end of the third metacarpal bone (MC3) is a common serious injury in Thoroughbred racehorses. Currently, there is no method for predicting fracture risk clinically. We describe an ex-vivo biomechanical model in which we measured subchondral crack micromotion under compressive loading that modeled high speed running. Using this model, we determined the relationship between subchondral crack dimensions measured using computed tomography (CT) and crack micromotion. Thoracic limbs from 40 Thoroughbred racehorses that had sustained a catastrophic in...
The paradoxical relationship between stallion fertility and oxidative stress.
Biology of reproduction    July 30, 2014   Volume 91, Issue 3 77 doi: 10.1095/biolreprod.114.118539
Gibb Z, Lambourne SR, Aitken RJ.The relationship between stallion fertility and oxidative stress remains poorly understood. The purpose of this study was to identify criteria for thoroughbred fertility assessment by performing a logistical regression analysis using "dismount" sperm parameters as predictors and weekly per-cycle conception rate as the dependent variable. Paradoxically, positive relationships between fertility and oxidative stress were revealed, such that samples that produced pregnancies exhibited higher rates of 8-hydroxy-2'-deoxyguanosine release (1490.2% vs. 705.5 pg/ml/24 h) and lower vitality (60.5% vs. 6...
Concentrations of stromal cell-derived factor-1 in serum, plasma, and synovial fluid of horses with osteochondral injury.
American journal of veterinary research    July 26, 2014   Volume 75, Issue 8 722-730 doi: 10.2460/ajvr.75.8.722
Dymock DC, Brown MP, Merritt KA, Trumble TN.To determine whether stromal cell-derived factor-1 (SDF-1) concentrations in serum, plasma, and synovial fluid differed among untrained, race-trained, and osteochondral-injured Thoroughbred racehorses. Methods: 22 racehorses without osteochondral injury and 37 racehorses with osteochondral injury. Methods: Horses without osteochondral injury were examined before and after 5 to 6 months of race training. Horses with osteochondral injury were undergoing arthroscopic surgery for removal of osteochondral fragments from carpal or metacarpophalangeal or metatarsophalangeal joints (fetlock joints). S...
Genome-wide analysis of DNA methylation patterns in horse.
BMC genomics    July 15, 2014   Volume 15, Issue 1 598 doi: 10.1186/1471-2164-15-598
Lee JR, Hong CP, Moon JW, Jung YD, Kim DS, Kim TH, Gim JA, Bae JH, Choi Y, Eo J, Kwon YJ, Song S, Ko J, Yang YM, Lee HK, Park KD, Ahn K, Do KT, Ha HS....DNA methylation is an epigenetic regulatory mechanism that plays an essential role in mediating biological processes and determining phenotypic plasticity in organisms. Although the horse reference genome and whole transcriptome data are publically available the global DNA methylation data are yet to be known. Results: We report the first genome-wide DNA methylation characteristics data from skeletal muscle, heart, lung, and cerebrum tissues of thoroughbred (TH) and Jeju (JH) horses, an indigenous Korea breed, respectively by methyl-DNA immunoprecipitation sequencing. The analysis of the DNA m...
A preliminary study of silver sodium zirconium phosphate polyurethane foam wound dressing on wounds of the distal aspect of the forelimb in horses.
Veterinary surgery : VS    July 9, 2014   Volume 44, Issue 3 359-365 doi: 10.1111/j.1532-950X.2014.12240.x
Kelleher ME, Kilcoyne I, Dechant JE, Hummer E, Kass PH, Snyder JR.To determine if application of silver sodium zirconium phosphate polyurethane semi-occlusive foam (SPF) dressing would improve measures of wound healing and decrease bacterial contamination compared with a non-adherent, absorbent dressing applied to wounds created on the distal aspect of the equine limb. Methods: Controlled randomized experimental study. Methods: Adult Quarter Horse and Thoroughbred horses (n = 5). Methods: One 6.25 cm(2) wound was created on the dorsomedial aspect of the proximal metacarpus on each forelimb. A SPF dressing was applied to 1 randomly assigned limb as a treatmen...
Effect of pectin, lecithin, and antacid feed supplements (Egusin®) on gastric ulcer scores, gastric fluid pH and blood gas values in horses.
BMC veterinary research    July 7, 2014   Volume 10 Suppl 1, Issue Suppl 1 S4 doi: 10.1186/1746-6148-10-S1-S4
Woodward MC, Huff NK, Garza F, Keowen ML, Kearney MT, Andrews FM.The objectives of this study were to evaluate the effects of two commercial feed supplements, Egusin 250® [E-250] and Egusin SLH® [E-SLH], on gastric ulcer scores, gastric fluid pH, and blood gas values in stall-confined horses undergoing feed-deprivation. Methods: Nine Thoroughbred horses were used in a three-period crossover study. For the three treatment groups, sweet feed was mixed with E-250, E-SLH, or nothing (control group) and fed twice daily. Horses were treated for 21 days, then an additional 7 days while on an alternating feed-deprivation model to induce or worsen ulcers (period o...
Identification, management and outcome of postoperative hemoperitoneum in 23 horses after emergency exploratory celiotomy for gastrointestinal disease.
Veterinary surgery : VS    July 5, 2014   Volume 44, Issue 3 379-385 doi: 10.1111/j.1532-950X.2014.12236.x
Gray SN, Dechant JE, LeJeune SS, Nieto JE.To investigate postoperative hemoperitoneum in a population of horses that had surgery for colic. Methods: Retrospective case series. Methods: Horses (n = 23). Methods: Preoperative, intraoperative, and postoperative information was obtained from medical records (1985-2012) of horses with postoperative hemoperitoneum after emergency exploratory celiotomy. Pre-existing hemoperitoneum during surgery and nonsurgical hemoperitoneum were excluded. Results: Of 4520 horses that had emergency exploratory celiotomy for gastrointestinal disease, 23 horses met inclusion criteria; an incidence of 0.5%. Ho...
Impact of race training on volumetric bone mineral density and its spatial distribution in the distal epiphysis of the third metatarsal bone of 2-year-old horses.
Veterinary journal (London, England : 1997)    July 1, 2014   Volume 201, Issue 3 353-358 doi: 10.1016/j.tvjl.2014.06.018
Bogers SH, Rogers CW, Bolwell CF, Roe WD, Gee EK, McIlwraith CW.The aim of the study was to use spatial and multiple correspondence analysis (MCA) to describe and compare the regional proportion and spatial pattern of volumetric bone mineral density (BMDv) values within loaded regions of the plantar metatarsal epiphysis of young horses in race training. A single 2 mm transverse peripheral quantitative computed tomography 'slice', 10 mm proximal from the distal limit of the sagittal ridge of the distal metatarsal epiphysis was obtained from 14 2-year-old Thoroughbred fillies (7 exercised and 7 controls). Six regions of interest were generated and examin...
Quadricuspid aortic valve and a ventricular septal defect in a horse.
BMC veterinary research    June 30, 2014   Volume 10 142 doi: 10.1186/1746-6148-10-142
Michlik KM, Biazik AK, Henklewski RZ, Szmigielska MA, Nicpoń JM, Pasławska U.Quadricuspid aortic valve (QAV) and ventricular septal defect (VSD) are congenital heart defects and have been described in both human and veterinary medical literature. Methods: A 5-year-old half-bred bay stallion was referred for surgical castration. Cardiac murmurs were heard on the presurgical clinical examination and the cardiac examination revealed subcutaneous oedema, tachycardia with a precodrial thrill and a grade 5/6 pansystolic murmur, which was heard on auscultation of the right and left side of the chest. Examination of the B-mode echocardiograms revealed the presence of a QAV (on...
Handedness of whip use by Australian Jockeys.
Australian veterinary journal    June 27, 2014   Volume 92, Issue 7 231-234 doi: 10.1111/avj.12196
Knight PK, Hamilton NA.To compare handedness of whip use by Australian jockeys in Melbourne (where racing is counterclockwise) and Sydney (where racing is clockwise). Methods: Photographs of finishes of Thoroughbred horse races in Melbourne and Sydney were examined. Where whip use was clearly visible, the venue, the hand in which the whip was held and the names of the jockey and the horse were determined. Comparisons of whip hand use between cities were made using the Chi-squared test. Results: A total of 771 identifications were made, 328 from Melbourne and 443 from Sydney, representing 78 jockeys and 506 horses. R...
Histopathological characteristics of endometrosis in thoroughbred mares in Japan: results from 50 necropsy cases.
Journal of equine science    June 25, 2014   Volume 25, Issue 2 45-52 doi: 10.1294/jes.25.45
Hanada M, Maeda Y, Oikawa MA.Uteri from 50 necropsied nonpregnant Japanese Thoroughbred brood mares (1-30 years of age) were investigated to clarify the histopathological characteristics of endometrosis in Japanese Thoroughbred mares and the distribution pattern of endometrosis lesions in the uterus as a whole. Endometrosis was observed in all animals over 6 years of age and in all of the 21 mares aged over 12 years of age. The affected mares showed elastofibrosis of arteries, veins and lymphatic vessels in the uterine wall, atrophy of the uterine smooth muscle layers and hyperplasia of collagen fibers among the smooth mu...
Anti-inflammatory and Intestinal Barrier-protective Activities of Commensal Lactobacilli and Bifidobacteria in Thoroughbreds: Role of Probiotics in Diarrhea Prevention in Neonatal Thoroughbreds.
Journal of equine science    June 25, 2014   Volume 25, Issue 2 37-43 doi: 10.1294/jes.25.37
Tanabe S, Suzuki T, Wasano Y, Nakajima F, Kawasaki H, Tsuda T, Nagamine N, Tsurumachi T, Sugaya K, Akita H, Takagi M, Takagi K, Inoue Y, Asai Y....We previously isolated the commensal bacteria lactobacilli and bifidobacteria from the Thoroughbred intestine and prepared the horse probiotics LacFi(TM), consisting of Lactobacillus ruminis KK14, L. equi KK 15, L. reuteri KK18, L. johnsonii KK21, and Bifidobacterium boum HU. Here, we found that the five LacFi(TM) constituent strains remarkably suppressed pro-inflammatory interleukin-17 production in mouse splenocytes stimulated with interleukin-6 and transforming growth factor-β. The protective effects of the probiotic on impaired intestinal barrier function were evaluated in Caco-2 cells tr...
An approach of estimating individual growth curves for young thoroughbred horses based on their birthdays.
Journal of equine science    June 25, 2014   Volume 25, Issue 2 29-35 doi: 10.1294/jes.25.29
Onoda T, Yamamoto R, Sawamura K, Murase H, Nambo Y, Inoue Y, Matsui A, Miyake T, Hirai N.We propose an approach of estimating individual growth curves based on the birthday information of Japanese Thoroughbred horses, with considerations of the seasonal compensatory growth that is a typical characteristic of seasonal breeding animals. The compensatory growth patterns appear during only the winter and spring seasons in the life of growing horses, and the meeting point between winter and spring depends on the birthday of each horse. We previously developed new growth curve equations for Japanese Thoroughbreds adjusting for compensatory growth. Based on the equations, a parameter den...
Transcriptional expression changes of glucose metabolism genes after exercise in thoroughbred horses.
Gene    June 24, 2014   Volume 547, Issue 1 152-158 doi: 10.1016/j.gene.2014.06.051
Gim JA, Ayarpadikannan S, Eo J, Kwon YJ, Choi Y, Lee HK, Park KD, Yang YM, Cho BW, Kim HS.Physical exercise induces gene expression changes that trigger glucose metabolism pathways in organisms. In the present study, we monitored the expression levels of LDHA (lactate dehydrogenase) and GYS1 (glycogen synthase 1) in the blood, to confirm the roles of these genes in exercise physiology. LDHA and GYS1 are related to glucose metabolism and fatigue recovery, and these processes could elicit economically important traits in racehorses. We collected blood samples from three retired thoroughbred racehorses, pre-exercise and immediately after 30 min of exercise. We extracted total RNA and ...
Number, causes and destinations of horses leaving the Australian Thoroughbred and Standardbred racing industries.
Australian veterinary journal    June 23, 2014   Volume 92, Issue 8 303-311 doi: 10.1111/avj.12204
Thomson PC, Hayek AR, Jones B, Evans DL, McGreevy PD.Significant proportions of horses leave the Australian Thoroughbred and Standardbred racing industries, which has ramifications for both the economic sustainability and the public perception of racing. The aim of this study was to quantify potential horse wastage, describe the destinations of exiting horses and identify risk factors for horses going to these destinations. Methods: Questionnaires were sent to 1258 selected Thoroughbred and 981 Standardbred trainers, with response rates of 30% and 32%, respectively. The survey investigated the role of various risk factors for wastage, including ...
Post-mortem stability of RNA in skeletal muscle and adipose tissue and the tissue-specific expression of myostatin, perilipin and associated factors in the horse.
PloS one    June 23, 2014   Volume 9, Issue 6 e100810 doi: 10.1371/journal.pone.0100810
Morrison PK, Bing C, Harris PA, Maltin CA, Grove-White D, Argo CM.Obesity, a major concern for equine welfare, is highly prevalent in the leisure horse population. Skeletal-muscle and adipose tissues are important determinants of maintenance energy requirements. The myostatin and perilipin pathways play key roles in the regulation of muscle mass and lipolysis respectively and have both been associated with obesity predisposition in other mammalian species. High quality samples, suitable for molecular biology, are an essential prerequisite for detailed investigations of gene and protein expression. Hence, this study has evaluated a) the post-mortem stability ...
Heritability of epistaxis in the Australian Thoroughbred racehorse population.
Veterinary journal (London, England : 1997)    June 16, 2014   Volume 202, Issue 2 274-278 doi: 10.1016/j.tvjl.2014.06.010
Velie BD, Raadsma HW, Wade CM, Knight PK, Hamilton NA.Post exercise epistaxis, the manifestation of a severe form of exercise-induced pulmonary haemorrhage (EIPH), has been observed in many equine racing populations. Although multiple analyses have suggested that non-genetic factors may lead to the development of this condition, relatively little consensus has been reached regarding its genetic aetiology. The objective of this study was to provide insight into both genetic and non-genetic factors that may contribute to the expression of epistaxis in the Australian Thoroughbred racing population. Racing records and reported epistaxis occurrences w...
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