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Critical appraisal of reports entails 3 fundamental steps: 1) determining if study results are valid; 2) assessing the clinical importance of study findings; and, 3) assessing if the results of valid, clinically important studies are relevant to our patients. A foundation for applying these 3 steps is a hierarchy of study types for EBM, which places a premium on those that are patient-based. Clinical importance has many interpretations, but in terms of quantification it is best assessed in reference to the magnitude of the observed association(s) in a study.

Among equids, R. equi infections occur almost exclusively among foaIs; infected adult horses generally have an underlying immunodeficiency, and human cases of R. equi are most commonly reported among persons infected with HIV or with other forms of immunosuppression such as that induced by drugs in transplant recipients and those receiving chemotherapy.

In horses with primary cecal impactions, there is a gradual onset of abdominal pain similar to the development of a large colon impaction. The typical time course is 5-7-days. During this time, veterinarians may use treatments for impactions, such as intravenous administration of analgesics and nasogastric administration of laxatives such as mineral oil, dioctyl sodium sulfocuccinae (DSS) or magnesium sulphate (Epsom salts).

Although there has been a substantial increase in our understanding of postoperative complications in recent years, the treatments remain very much the same. For ileus, these treatments include decompression of the stomach, replacement of fluid and electrolyte losses with parenteral fluids, and use of a variety of prokinetic agents. For adhesions, treatments include anti-inflammatory medications and antibiotics, although some of the newer physical agents such as carboxymethylcellulose offer new modalities for combating this problem.

The palmar digital nerves are blocked by injecting up to 2 ml of anesthetic over the nerves, along the edge of the DDFT. Much discussion has taken place regarding the proximal to distal level that the injection should occur. The PDN can be blocked anywhere from the proximal margin of the collateral cartilage to the mid pastern region.

The cornea is the front layer of the fibrous tunic of the eye; it is composed of three distinct layers and one distinct membrane. The outer epithelial layer is approximately five to ten cells thick. The middle stromal layer comprises about 95% of the cornea, and the inside layer is the endothelial layer, and its basement membrane is Descemet's membrane.