1
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Bishop RC, Kemper AM, Burges JW, Jandrey KE, Wilkins PA. Preliminary evaluation of reference intervals for a point-of-care viscoelastic coagulation monitor (VCM Vet) in healthy adult horses. J Vet Emerg Crit Care (San Antonio) 2023; 33:540-548. [PMID: 37561043 DOI: 10.1111/vec.13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To evaluate a point-of-care viscoelastic coagulation monitor (VCM Vet) for use in horses by assessing variability between devices and establish reference intervals (RIs) for healthy adult horses. DESIGN Prospective observational study. SETTING Two university teaching hospitals. ANIMALS Healthy adult horses (n = 68). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Blood collected by direct jugular venipuncture was applied directly from the syringe into 2 VCM Vet cassettes to establish coefficients of variation (CVs) and RIs for reported parameters of clotting time (CT), clot formation time (CFT), alpha angle, amplitude at 10 and 20 minutes, maximum clot firmness, and lysis index at 30 and 45 minutes. CVs for each parameter were within clinical tolerance. There was a significant difference in CT between institutions (P < 0.001). Differences in CV were found between institutions for CT (P = 0.003) and CFT (P = 0.01). Healthy horse RIs were calculated for the overall data set and each individual institution. Calculated RIs were as follows: CT, 255.6-1233.9 seconds; CFT, 89.4-581 seconds; alpha angle, 11.4-53.6°; maximum clot firmness, 18-37.7; lysis index at 30 minutes, 97.3%-102.1%; lysis index at 45 minutes, 80.8%-103.3%; amplitude at 10 minutes, 8.7-28.3; and amplitude at 20 minutes, 17.4-35.7. CONCLUSIONS VCM Vet is a repeatable and practical option for rapid point-of-care assessment of hemostasis in horses but has a wide RI and is susceptible to variability. Establishment of institution-specific RIs is recommended.
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Affiliation(s)
- Rebecca C Bishop
- Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Ann M Kemper
- Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Julie W Burges
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Karl E Jandrey
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Pamela A Wilkins
- Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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2
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Honoré ML, Pihl TH, Busk-Anderson TM, Flintrup LL, Nielsen LN. Investigation of two different human d-dimer assays in the horse. BMC Vet Res 2022; 18:227. [PMID: 35705958 PMCID: PMC9199134 DOI: 10.1186/s12917-022-03313-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 05/16/2022] [Indexed: 11/21/2022] Open
Abstract
Background D-dimer has value as a marker of thrombosis in critically ill horses and can provide additional information about prognosis. However, there are currently no equine species-specific d-dimer assays available, nor has there been any formal investigation of the applicability of human d-dimer assays in horses, so it is unknown, which assay performs best in this species. The aim of this study was therefore to evaluate and compare two human d-dimer assays for their applicability in horses. The study included four groups of horses: clinically healthy horses, horses with gastrointestinal (GI) disease and mild systemic inflammation based on low serum amyloid A (SAA) (low SAA group), horses with GI disease and strong systemic inflammation based on high SAA (high SAA group) and, horses with thrombotic GI disease caused by Strongylus vulgaris (also called non-strangulating intestinal infarction (NSII)) (NSII group). The assays evaluated were the STAGO STA-Liatest D-di + (Stago) and NycoCard™ D-dimer (NycoCard). Intra- and inter-coefficients of variation (CV) were assessed on two d-dimer concentrations, and linearity under dilution was evaluated. A group comparison was performed for both assays across the four groups of horses. A Spaghetti plot, Spearman Correlation, Passing Bablok regression and Bland–Altman plot were used to compare methods in terms of agreement. Results Ten horses were included in the clinically healthy group, eight in the low SAA group, eight in the high SAA group, and seven in the NSII group. For the Stago assay, intra- and inter-CVs were below the accepted level except for one inter-CV. The NycoCard assay did not meet the accepted level for any of the CVs. The linearity under dilution was acceptable for both the Stago and NycoCard. In the group comparison, both methods detected a significantly higher d-dimer concentration in the high SAA and NSII groups compared to the clinically healthy group. Method agreement showed slightly higher d-dimer concentrations with NycoCard compared to Stago. The overall agreement was stronger for the lower d-dimer concentrations. Conclusion Both the Stago and the NycoCard were found to be applicable for use in horses but were not directly comparable. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-022-03313-5.
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Affiliation(s)
- Marie Louise Honoré
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Hoejbakkegaard Allé 5a, 2630, Taastrup, Denmark.
| | - Tina H Pihl
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Hoejbakkegaard Allé 5a, 2630, Taastrup, Denmark
| | - Tanne M Busk-Anderson
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Hoejbakkegaard Allé 5a, 2630, Taastrup, Denmark
| | - Laura L Flintrup
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Hoejbakkegaard Allé 5a, 2630, Taastrup, Denmark
| | - Lise N Nielsen
- Section for Internal Medicine, Oncology and Clinical Pathology, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Dyrlaegevej 16, 1870, Frederiksberg C, Denmark
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3
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Lovett AL, Gilliam LL, Sykes BW, McFarlane D. Thromboelastography in obese horses with insulin dysregulation compared to healthy controls. J Vet Intern Med 2022; 36:1131-1138. [PMID: 35429197 PMCID: PMC9151488 DOI: 10.1111/jvim.16421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/13/2022] [Accepted: 03/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Both obesity and metabolic syndrome are associated with hypercoagulability in people, increasing the risk of cardiovascular disease and thromboembolic events. Whether hypercoagulability exists in obese, insulin-dysregulated horses is unknown. HYPOTHESIS/OBJECTIVES To determine if coagulation profiles differ between healthy horses and those with obesity and insulin dysregulation. ANIMALS Fifteen healthy horses (CON) and 15 obese, insulin-dysregulated horses (OBID). Individuals were university or client owned. METHODS Case-control study. Obesity was defined as a body condition score (BCS) ≥7.5/9 (modified Henneke scale). Insulin dysregulation status was assessed by an oral sugar test (OST). Kaolin-thromboelastography and traditional coagulation variables were compared between groups. The direction and strength of the association between coagulation variables and BCS and OST results were determined using Spearman's correlation. RESULTS Thromboelastography variables MA (OBID: 69.5 ± 4.5 mm; CON: 64.8 ± 4.3 mm; P = .007) and G-value (OBID: 11749 ± 2536 dyn/m2 ; CON: 9319 ± 1650 dyn/m2 ; P = .004) were higher in OBID compared to CON. Positive correlations between MA and BCS (R = 0.45, P = .01) and serum insulin (T0 : R = 0.45, P = .01; T60 : R = 0.39, P = .03), and G-value and BCS (R = 0.46, P = .01), and serum insulin (T0 : R = 0.48, P = .007; T60 : R = 0.43, P = .02; T90 : R = 0.38, P = .04) were present. CONCLUSIONS AND CLINICAL IMPORTANCE Obese, insulin-dysregulated horses are hypercoagulable compared to healthy controls.
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Affiliation(s)
- Amy L. Lovett
- Department of Clinical Sciences, College of Veterinary MedicineOklahoma State UniversityStillwaterOklahomaUSA
- Present address:
School of Veterinary SciencesMassey UniversityPalmerston NorthNew Zealand
| | - Lyndi L. Gilliam
- Department of Clinical Sciences, College of Veterinary MedicineOklahoma State UniversityStillwaterOklahomaUSA
| | - Benjamin W. Sykes
- School of Veterinary SciencesMassey UniversityStillwaterPalmerston NorthNew Zealand
| | - Dianne McFarlane
- Department of Clinical Sciences, College of Veterinary MedicineOklahoma State UniversityStillwaterOklahomaUSA
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4
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Dunkel B. Hypercoagulation and thrombosis associated with infection in horses. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. Dunkel
- Department of Veterinary Clinical Sciences The Royal Veterinary College Equine Referral Hospital Hatfield Hertfordshire UK
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5
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A pilot study evaluating the Calibrated Automated Thrombogram assay and application of plasma-thromboelastography for detection of hemostatic aberrations in horses with gastrointestinal disease. BMC Vet Res 2021; 17:346. [PMID: 34749707 PMCID: PMC8573990 DOI: 10.1186/s12917-021-03058-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/19/2021] [Indexed: 01/15/2023] Open
Abstract
Background Critically ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations. Global hemostatic tests examining the initiation of coagulation, clot strength and fibrinolysis, such as the Calibrated Automated Thrombogram (CAT) and plasma-thromboelastography (TEG) have not been evaluated in horses. This study aimed to evaluate CAT and apply plasma-TEG in horses. Test performance of CAT was evaluated on equine platelet poor plasma with intra- and inter-assay variability (CV) and a heparin dilution curve. To examine clinical performance of both tests, group comparisons were assessed comparing healthy horses, horses with mild and severe GI disease with both CAT and plasma-TEG. Results For CAT, intra- and inter-assay CVs were established for lag-time (1.7, 4.7%), endogenous thrombin potential (1.6, 4.6%), peak (2.6, 3.9%) and time to peak (ttPeak) (1.9, 3.4%). Increasing heparin concentrations led to the expected decrease in thrombin generation. In the group comparison analysis, CAT showed significant higher peak (p = 0.04) and ttPeak (p = 0.008) in the severe GI disease group compared to horses with mild GI disease and healthy horses, respectively. Plasma-TEG showed an increased angle (p = 0.032), maximum amplitude (p = 0.017) and shear elastic force (G) (p = 0.017) in the severe GI disease group compared to healthy horses. Conclusions CAT performed well in horses. Both CAT and plasma-TEG identified hemostatic aberrations in horses with severe GI disease compared to healthy horses. Further studies including more horses, are needed to fully appreciate the use of CAT and plasma-TEG in this species. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-03058-7.
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6
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Martín-Cuervo M, Aguirre CN, Gracia LA, Barrera R, Ezquerra LJ, Martinez-Subiela S, Cerón JJ. Usefulness of a Point-of-Care Analyzer to Measure Cardiac Troponin I and D-Dimer Concentrations in Critically Ill Horses With Gastrointestinal Diseases. J Equine Vet Sci 2020; 90:102965. [PMID: 32534789 DOI: 10.1016/j.jevs.2020.102965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 11/19/2022]
Abstract
Point-of-care (POC) systems for the joint measurement of Troponin and D-dimers have not been studied in horses. The aim of this study was to perform the validation of a POC system (AQT90 FLEX) for the measurement of cardiac troponin I (cTnI) and D-dimers in the serum of horses with gastrointestinal diseases. The main objective was to evaluate whether or not this system can distinguish healthy animals from diseased animals. A sample of 33 horses was included in the study: control group (n = 10) and horses with gastrointestinal disorders (n = 21), which were classified according to their outcome in survivors (subgroup A = 9) and nonsurvivors (subgroup B = 12). Considering the diagnosis of the process, ill horses were classified into three groups: inflammatory (I = 7), obstructive (O = 9), and strangulating diseases (S = 5). The clinical usefulness of AQT90 FLEX was validated by the study of linearity, coefficient of variation, and detection limits. Later, concentrations of D-dimers and cTnI were measured. A significant increase in both parameters was detected in ill animals (cTnI: control: 0.014 ± 0.01 μg/mL, survivors: 0.27 ± 0.37 μg/mL, nonsurvivors: 0.60 ± 1.21 μg/mL; D-dimers: control: 104.90 ± 30.82 ng/mL, survivors: 1,217.22 ± 1,213.28 ng/mL, nonsurvivors: 1,613.67 ± 1,426.75 ng/mL), although there were no statistically significant differences in concentrations according to diagnosis and outcome. In conclusion, AQT90 FLEX POC analyzer can be used in horses with gastrointestinal diseases to measure cTnI and D-dimer concentrations. It is a quick, practical, and minimally invasive tool that helps in determining the severity of illness.
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Affiliation(s)
- María Martín-Cuervo
- Animal Medicine Department, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain.
| | - Carla N Aguirre
- Veterinary Teaching Hospital, University of Murcia, Murcia, Spain
| | - Luis Alfonso Gracia
- Animal Medicine Department, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - Rafael Barrera
- Animal Medicine Department, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - Luis Javier Ezquerra
- Animal Medicine Department, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - Silvia Martinez-Subiela
- Department of Animal Pathology, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - José Joaquín Cerón
- Department of Animal Pathology, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
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7
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Abstract
Horses with clinical signs of unprovoked or excessive hemorrhage should be evaluated for underlying platelet defects or coagulopathies. This article provides an overview of preliminary screening and definitive tests to assess coagulation and identify hemostatic defects in horses, as well as a review of the hemostatic disorders most frequently encountered in clinical practice.
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Affiliation(s)
- SallyAnne L DeNotta
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA
| | - Marjory B Brooks
- Comparative Coagulation Laboratory, Animal Health Diagnostic Center, Cornell University, Ithaca, NY 14850, USA.
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8
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Nikvand AA, Jalali SM, Ghadrdan Mashhadi A, Razi Jalali M, Hassanpour Amirabadi S. Clinical, hematologic, hemostatic, and serum biochemical findings related to survival in Arabian horses with colic. Vet Clin Pathol 2019; 48:441-448. [PMID: 31531891 DOI: 10.1111/vcp.12779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/13/2019] [Accepted: 01/18/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The efficacy of clinical examinations, and hematologic, hemostatic, and serum biochemical assessments to determine appropriate early medical or surgical therapy in Arabian horses with colic have not been well-described. OBJECTIVES We aimed to evaluate clinical and hematologic findings, coagulation-fibrinolytic parameters, and organ dysfunction markers in association with survival in horses with colic. METHODS Seventeen Arabian horses with colic and ten healthy horses were enrolled. After clinical examinations, including heart rates (HRs), capillary refill times (CRTs), abdominal sounds, rectal palpations, and nasogastric (NG) reflux assessments in both healthy and diseased horses, blood samples were collected and hematologic parameters, coagulation indices such as the prothrombin time (PT), activated partial thromboplastin time (APTT), plasma d-dimer (PDD), platelet count, fibrinogen, and hepatorenal biomarkers were measured. Based on the outcomes, horses with colic were divided into survival (10) and nonsurvival (7) groups, and all mentioned parameters were compared with the control group horses. RESULTS Unlike HRs, CRTs, and abdominal sounds, rectal palpations (57.1%) and NG reflux (28.6%) findings were least sensitive in being able to determine survival. At least three of the five coagulation indices were significantly abnormal (prolonged PT, increased PDD, and decreased plasma fibrinogen) in 71.4% of the horses in the nonsurvival group compared with the control and survival groups. Significantly increased urea, creatinine, and bilirubin levels, and AST activities were also observed in the survival group compared with the control and nonsurvival groups. CONCLUSIONS The combination of prolonged PT, increased PDD, and hypofibrinogenemia could be a reliable predictor of survival in horses with colic. The significant renal and hepatic dysfunctions in nonsurviving horses with colic appeared to be consistent with disseminated intravascular coagulation (DIC) and a grave prognosis.
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Affiliation(s)
- Ali Abbas Nikvand
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Seyedeh Missagh Jalali
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Alireza Ghadrdan Mashhadi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mohammad Razi Jalali
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Soroush Hassanpour Amirabadi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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9
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Barton AK, Wirth C, Bondzio A, Einspanier R, Gehlen H. Are pulmonary hemostasis and fibrinolysis out of balance in equine chronic pneumopathies? J Vet Sci 2018; 18:349-357. [PMID: 28057902 PMCID: PMC5639088 DOI: 10.4142/jvs.2017.18.3.349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 09/28/2016] [Accepted: 10/21/2016] [Indexed: 11/20/2022] Open
Abstract
Clinical examination, bronchoalveolar lavage fluid (BALF) cytology, acute-phase protein, and pulmonary hemostasis and fibrinolysis marker (fibrinogen, serum amyloid A [SAA], and D-dimer) results were compared between control and respiratory disease-affected horses. Using a clinical scoring system, horses (n = 58) were classified as respiratory disease-free (Controls, n = 15) or with recurrent airway obstruction (RAO; n = 18), inflammatory airway disease (n = 14) or chronic interstitial pneumopathy (n = 11). There were no significant differences in fibrinogen concentrations among groups, but there was a trend toward a lower value in controls (median 0.0024 g/L) than in horses with chronic pneumopathies (median 0.0052 g/L), in particular, those with RAO (median 0.0062 g/L). Fibrinogen concentration was positively correlated with percentage of neutrophils in BALF (rs = 0.377, p = 0.004). SAA concentrations were low; 65.5% of samples were below the detection limit. D-dimer concentrations were also low and quantifiable concentrations were only obtained after ultrafiltration and only in RAO (median 0.1 mg/L). In conclusion, there was limited evidence of increased coagulatory activity in chronic pneumopathies, apart from RAO. It is uncertain whether fibrinogen and D-dimer concentrations increased due to their role as acute-phase proteins or as a misbalance of coagulation and fibrinolysis.
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Affiliation(s)
| | - Caroline Wirth
- Equine Clinic, Freie Universitaet Berlin, 14163 Berlin, Germany
| | - Angelika Bondzio
- Institute of Veterinary Biochemistry, Freie Universitaet Berlin, 14163 Berlin, Germany
| | - Ralf Einspanier
- Institute of Veterinary Biochemistry, Freie Universitaet Berlin, 14163 Berlin, Germany
| | - Heidrun Gehlen
- Equine Clinic, Freie Universitaet Berlin, 14163 Berlin, Germany
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10
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Mackenzie CJ, McGowan CM, Pinchbeck G, Carslake HB. Comparison of two blood sampling techniques for the determination of coagulation parameters in the horse: Jugular venipuncture and indwelling intravenous catheter. Equine Vet J 2017; 50:333-338. [PMID: 28976034 DOI: 10.1111/evj.12764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 09/22/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Evaluation of coagulation status is an important component of critical care. Ongoing monitoring of coagulation status in hospitalised horses has previously been via serial venipuncture due to concerns that sampling directly from the intravenous catheter (IVC) may alter the accuracy of the results. Adverse effects such as patient anxiety and trauma to the sampled vessel could be avoided by the use of an indwelling IVC for repeat blood sampling. OBJECTIVES To compare coagulation parameters from blood obtained by jugular venipuncture with IVC sampling in critically ill horses. STUDY DESIGN Prospective observational study. METHODS A single set of paired blood samples were obtained from horses (n = 55) admitted to an intensive care unit by direct jugular venipuncture and, following removal of a presample, via an indwelling IVC. The following coagulation parameters were measured on venipuncture and IVC samples: whole blood prothrombin time (PT), fresh plasma PT and activated partial thromboplastin time (aPTT) and stored plasma antithrombin activity (AT) and fibrinogen concentration. D-dimer concentration was also measured in some horses (n = 22). Comparison of venipuncture and IVC results was performed using Lin's concordance correlation coefficient. Agreement between paired results was assessed using Bland Altman analysis. RESULTS Correlation was substantial and agreement was good between sample methods for all parameters except AT and D-dimers. MAIN LIMITATIONS Each coagulation parameter was tested using only one assay. Sampling was limited to a convenience sample and timing of sample collection was not standardised in relation to when the catheter was flushed with heparinised saline. CONCLUSIONS With the exception of AT and D-dimers, coagulation parameters measured on blood samples obtained via an IVC have clinically equivalent values to those obtained by jugular venipuncture.
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Affiliation(s)
- C J Mackenzie
- Department of Equine Clinical Science, University of Liverpool, Institute of Veterinary Science, Neston, Cheshire, UK
| | - C M McGowan
- Department of Equine Clinical Science, University of Liverpool, Institute of Veterinary Science, Neston, Cheshire, UK
| | - G Pinchbeck
- Department of Epidemiology and Population Health, University of Liverpool, Institute of Infection and Global Health, Neston, Cheshire, UK
| | - H B Carslake
- Department of Equine Clinical Science, University of Liverpool, Institute of Veterinary Science, Neston, Cheshire, UK
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11
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Pihl TH, Nielsen MK, Jacobsen S. Changes in Hemostatic Indices in Foals Naturally Infected With Strongylus vulgaris. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2017.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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12
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Thane K, Bedenice D, Pacheco A. Operator-based variability of equine thromboelastography. J Vet Emerg Crit Care (San Antonio) 2017; 27:419-424. [PMID: 28520166 DOI: 10.1111/vec.12610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 10/29/2015] [Accepted: 11/18/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the extent of intraoperator (between duplicate samples) and interoperator (between different operators) variability in equine thromboelastography (TEG). DESIGN Kaolin-activated TEG was performed in duplicate by operator-pair A/B or A/C (2 groups of 10 horses) using discrete setups, within 30-45 minutes of vacuum-assisted blood collection. Recorded TEG variables included clot initiation time (R), clot formation time (K), rate of clot formation (α), clot strength (MA), and viscoelastic/shear strength (G). Operators independently determined the clinical coagulation status for each sample. Intra- and interoperator variabilities were reported as coefficients of variation (CV), using descriptive statistics and paired samples t-test or Wilcoxon matched pair signed-rank test (P < 0.05 considered significant). ANIMALS Twenty hospitalized adult horses with no clinical evidence of systemic inflammation. MEASUREMENTS AND MAIN RESULTS Mean intraoperator CVs ranged from 2.6 to 14% (operator A), 2.8 to 13% (operator B) and 1.2 to 18% (operator C). Both intra- and interoperator variabilities were lowest for MA (1.2-3.2%) and G (2.9-7.3%), and highest for K (13-23%). Mean CVs for all TEG parameters were lower when comparing intra- to interoperator variation. Seventy percent of horses had at least 1 TEG variable (out of 4 replicates) outside the established reference intervals. Assessment of coagulation status was conserved between operators in 9/10 and 8/10 horses for A/B and A/C, respectively, with comparable agreement between operator A/B (к = 0.73) and A/C (к = 0.74). CONCLUSIONS TEG measurements of MA and G are more reproducible than assessment of K, within samples and between operators. The highest test variability was thus observed within the early phase of clot formation.
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Affiliation(s)
- Kristen Thane
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536
| | - Daniela Bedenice
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536
| | - Ana Pacheco
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536.,Dr.'s Pacheco current address: Genesee Valley Equine Clinic, Scottsville, NY
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13
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Perez-Ecija A, Mendoza FJ. Characterisation of clotting factors, anticoagulant protein activities and viscoelastic analysis in healthy donkeys. Equine Vet J 2017; 49:734-738. [DOI: 10.1111/evj.12685] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A. Perez-Ecija
- Department of Animal Medicine and Surgery; University of Cordoba; Cordoba Spain
| | - F. J. Mendoza
- Department of Animal Medicine and Surgery; University of Cordoba; Cordoba Spain
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14
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Diseases of the Alimentary Tract. Vet Med (Auckl) 2017. [PMCID: PMC7167529 DOI: 10.1016/b978-0-7020-5246-0.00007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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15
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Junge HK, Ringer SK, Mayer N, Schwarzwald CC. Assessment of method reliability and determination of reference intervals for rotational thromboelastometry in horses. J Vet Emerg Crit Care (San Antonio) 2016; 26:691-703. [DOI: 10.1111/vec.12515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 03/15/2016] [Accepted: 04/07/2016] [Indexed: 01/28/2023]
Affiliation(s)
- Hannah K. Junge
- Clinic for Equine Internal Medicine; University of Zurich; Zurich Switzerland
| | - Simone K. Ringer
- Equine Department, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - Nathalie Mayer
- Equine Department, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
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de Solís CN, Reef VB, Slack J, Jose-Cunilleras E. Evaluation of coagulation and fibrinolysis in horses with atrial fibrillation. J Am Vet Med Assoc 2016; 248:201-6. [DOI: 10.2460/javma.248.2.201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Rossi TM, Smith SA, McMichael MA, Wilkins PA. Evaluation of contact activation of citrated equine whole blood during storage and effects of contact activation on results of recalcification-initiated thromboelastometry. Am J Vet Res 2015; 76:122-8. [DOI: 10.2460/ajvr.76.2.122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cesarini C, Monreal L, Armengou L, Delgado MÁ, Ríos J, Jose-Cunilleras E. Progression of plasma D-dimer concentration and coagulopathies during hospitalization in horses with colic. J Vet Emerg Crit Care (San Antonio) 2014; 24:672-80. [PMID: 25123566 DOI: 10.1111/vec.12211] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 05/17/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess the progression of plasma D-dimer concentrations and coagulation status in horses with different types of colic. DESIGN Prospective clinical observational study performed between March 2004 and September 2008. SETTING Veterinary university teaching hospital. ANIMALS Horses admitted and treated for colic and hospitalized for >48 hours were considered. Animals were classified by diagnosis into medical obstructive conditions (MO), surgical obstructive conditions (SO), inflammatory conditions, and ischemic lesions (IS). INTERVENTIONS Three blood samples were obtained from each horse (admission, at 24-48 h [or after surgery] and upon discharge). For each sample, plasma D-dimer concentration, prothrombin time, activated partial thromboplastin time, antithrombin activity, and the presence of subclinical disseminated intravascular coagulation were determined. MEASUREMENTS AND MAIN RESULTS When median plasma D-dimer concentration values at admission and after 24-48 hours were compared, they were different but stable in horses with MO (1.29-1.95 nmol/L) and inflammatory conditions (5.70-6.69 nmol/L). However, 10-fold and 5-fold increases were observed, respectively, in SO (2.08 to 16.38 nmol/L) and IS (3.08 to 15.91 nmol/L) in the postoperative period. By 24-48 hours, the percentage of horses with coagulopathy increased in most groups (MO, 43 to 58%; SO, 50 to 96%, IS, 53 to 90%). By the time of discharge, 87% of horses with SO problems and 89% of horses with IS still had some form of coagulopathy documented. CONCLUSIONS Throughout hospitalization, horses with MO problems had less severe coagulopathy and lower plasmatic D-dimer concentrations compared to other groups of horses. On admission, most horses with inflammatory conditions presented with coagulopathy. At 24-48 hours of hospitalization and following surgery, the hemostatic profile can differ markedly when compared to admission values.
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Affiliation(s)
- Carla Cesarini
- Servei de Medicina Interna Equina, Fundació Hospital Clínic Veterinari, and Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
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Hanel RM, Chan DL, Conner B, Gauthier V, Holowaychuk M, Istvan S, Walker JM, Wood D, Goggs R, Wiinberg B. Systematic evaluation of evidence on veterinary viscoelastic testing Part 4: Definitions and data reporting. J Vet Emerg Crit Care (San Antonio) 2014; 24:47-56. [DOI: 10.1111/vec.12145] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 11/15/2013] [Indexed: 12/28/2022]
Affiliation(s)
- Rita M. Hanel
- From the Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC 27607
| | - Daniel L. Chan
- Clinical Science and Services; The Royal Veterinary College; University to London; North Mymms; Hertfordshire UK AL9 7TA
| | - Bobbi Conner
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville FL 32608
| | - Vincent Gauthier
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON N1L 1G6
| | - Marie Holowaychuk
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON N1L 1G6
| | | | - Julie M. Walker
- Department of Medical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison WI
| | - Darren Wood
- Department of Pathobiology; Ontario Veterinary College; University of Guelph; Guelph ON N1L 1G6
| | - Robert Goggs
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853
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Flatland B, Koenigshof AM, Rozanski EA, Goggs R, Wiinberg B. Systematic evaluation of evidence on veterinary viscoelastic testing Part 2: Sample acquisition and handling. J Vet Emerg Crit Care (San Antonio) 2014; 24:30-6. [DOI: 10.1111/vec.12142] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 11/15/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Bente Flatland
- From the Department of Biomedical and Diagnostic Sciences; College of Veterinary Medicine; University of Tennessee; Knoxville TN 37996
| | - Amy M. Koenigshof
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine, Michigan State University; East Lansing MI 48824
| | - Elizabeth A. Rozanski
- the Department of Clinical Sciences; Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine; Cornell University; Ithaca NY 14853
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de Laforcade A, Goggs R, Wiinberg B. Systematic evaluation of evidence on veterinary viscoelastic testing Part 3: Assay activation and test protocol. J Vet Emerg Crit Care (San Antonio) 2014; 24:37-46. [DOI: 10.1111/vec.12147] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 11/15/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Armelle de Laforcade
- From the Department of Clinical Sciences; Cummings School of Veterinary Medicine; Tufts University; North Grafton MA
| | - Robert Goggs
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY, 14853
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Goggs R, Brainard B, de Laforcade AM, Flatland B, Hanel R, McMichael M, Wiinberg B. Partnership on Rotational ViscoElastic Test Standardization (PROVETS): Evidence-based guidelines on rotational viscoelastic assays in veterinary medicine. J Vet Emerg Crit Care (San Antonio) 2014; 24:1-22. [DOI: 10.1111/vec.12144] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 11/15/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Robert Goggs
- From the Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853
| | - Benjamin Brainard
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine; University of Georgia; Athens GA 30602
| | - Armelle M. de Laforcade
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton MA 01536
| | - Bente Flatland
- Department of Pathobiology, College of Veterinary Medicine; University of Tennessee; Knoxville TN 37996
| | - Rita Hanel
- Department of Clinical Sciences, College of Veterinary Medicine; NC State University; Raleigh NC 27607
| | - Maureen McMichael
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine; University of Illinois; Urbana IL 61801
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Epstein KL, Brainard BM, Giguere S, Vrono Z, Moore JN. Serial viscoelastic and traditional coagulation testing in horses with gastrointestinal disease. J Vet Emerg Crit Care (San Antonio) 2013; 23:504-16. [PMID: 24028350 DOI: 10.1111/vec.12095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 08/03/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Objectives of this study were to compare the ability of serial thromboelastography, Sonoclot, and traditional coagulation panels to detect coagulopathies associated with disease category, systemic inflammatory response syndrome (SIRS), complications, and nonsurvival in horses with gastrointestinal disease. DESIGN Prospective clinical evaluation. SETTING University referral hospital. ANIMALS One hundred twenty-one horses admitted as emergencies for gastrointestinal disease and 28 healthy adult horses. INTERVENTION Blood samples were collected ≤4 times from emergency horses (admission and if surviving and hospitalized on days 2-4) and once from healthy horses. Thromboelastography (with and without tissue factor activation), Sonoclot, and a traditional coagulation panel were performed on each sample. MEASUREMENTS AND MAIN RESULTS Emergency horses were grouped based on disease category (ie, nonstrangulating medical, nonstrangulating surgical, strangulating, and inflammatory), survival to discharge, SIRS at admission, requirement for exploratory celiotomy, ileus, diarrhea, fever, thrombophlebitis, and laminitis. Changes over time were evaluated individually and compared between disease groups. Horses with gastrointestinal disease had dynamic changes in coagulation and fibrinolysis during the first 4 days of hospitalization that were correlated with disease category, SIRS, complications, and fatality. The multivariate logistic regression model for nonsurvival included activated partial thromboplastin time on day 2 and LY30 on day 3 (overall model significance P < 0.0001). The odds of nonsurvival were 23.75 times higher if activated partial thromboplastin time was >85.6 s on day 2 and 9.38 times higher if LY30 was >1% on day 3. CONCLUSIONS Horses with gastrointestinal disease have activation of coagulation and fibrinolysis. Magnitude of change in these parameters is small and predictive value moderate, making application of these tests to direct therapy in clinical patients difficult. Effect of specific treatments (eg, surgery) on these tests and coagulation has not been determined. Further studies are required to determine if these tests could be used to help monitor response to treatment in individual animals or specific disease states.
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Affiliation(s)
- Kira L Epstein
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
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Affiliation(s)
- B. Dunkel
- Equine Referral Hospital; Department of Veterinary Clinical Sciences; The Royal Veterinary College; North Mymms; Herts; UK
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McGovern K, Lascola K, Smith S, Clark-Price S, Wilkins P, Schaeffer D, Foreman J. The Effects of Hyperglycemia and Endotoxemia on Coagulation Parameters in Healthy Adult Horses. J Vet Intern Med 2013; 27:347-53. [DOI: 10.1111/jvim.12052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 12/17/2012] [Accepted: 01/09/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- K.F. McGovern
- Department of Veterinary Clinical Medicine; University of Illinois; Urbana IL
| | - K.M. Lascola
- Department of Veterinary Clinical Medicine; University of Illinois; Urbana IL
| | - S.A. Smith
- College of Medicine; University of Illinois; Urbana IL
| | - S.C. Clark-Price
- Department of Veterinary Clinical Medicine; University of Illinois; Urbana IL
| | - P.A. Wilkins
- Department of Veterinary Clinical Medicine; University of Illinois; Urbana IL
| | - D.J. Schaeffer
- Department of Biosciences; University of Illinois; Urbana IL
| | - J.H. Foreman
- Department of Veterinary Clinical Medicine; University of Illinois; Urbana IL
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McGovern KF, Lascola KM, Smith SA, Clark-Price SC, McMichael M, Wilkins PA. Assessment of acute moderate hyperglycemia on traditional and thromboelastometry coagulation parameters in healthy adult horses. J Vet Emerg Crit Care (San Antonio) 2012; 22:550-7. [DOI: 10.1111/j.1476-4431.2012.00792.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 07/16/2012] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Stephanie A. Smith
- College of Medicine; University of Illinois; 1008 W Hazelwood Drive; Urbana; IL; 61802
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Mendez-Angulo JL, Mudge MC, Couto CG. Thromboelastography in equine medicine: Technique and use in clinical research. EQUINE VET EDUC 2011. [DOI: 10.1111/j.2042-3292.2011.00338.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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