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1.
Neuroscience ; 322: 251-61, 2016 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-26905952

RESUMEN

Older adults use a different muscle strategy to cope with postural instability, in which they 'co-contract' the muscles around the ankle joint. It has been suggested that this is a compensatory response to age-related proprioceptive decline however this view has never been assessed directly. The current study investigated the association between proprioceptive acuity and muscle co-contraction in older adults. We compared muscle activity, by recording surface electromyography (EMG) from the bilateral tibialis anterior (TA) and gastrocnemius medialis (GM) muscles, in young (aged 18-34) and older adults (aged 65-82) during postural assessment on a fixed and sway-referenced surface at age-equivalent levels of sway. We performed correlations between muscle activity and proprioceptive acuity, which was assessed using an active contralateral matching task. Despite successfully inducing similar levels of sway in the two age groups, older adults still showed higher muscle co-contraction. A stepwise regression analysis showed that proprioceptive acuity measured using variable error was the best predictor of muscle co-contraction in older adults. However, despite suggestions from previous research, proprioceptive error and muscle co-contraction were negatively correlated in older adults, suggesting that better proprioceptive acuity predicts more co-contraction. Overall, these results suggest that although muscle co-contraction may be an age-specific strategy used by older adults, it is not to compensate for age-related proprioceptive deficits.


Asunto(s)
Envejecimiento/fisiología , Pierna/fisiología , Contracción Muscular/fisiología , Músculo Esquelético/fisiología , Equilibrio Postural/fisiología , Propiocepción/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Electromiografía , Femenino , Humanos , Masculino , Postura/fisiología , Análisis de Regresión , Adulto Joven
2.
Neuropsychologia ; 49(9): 2400-9, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21536055

RESUMEN

Depending on task combination, dual-tasking can either be performed successfully or can lead to performance decrements in one or both tasks. Interference is believed to be caused by limitations in central processing, i.e. structural interference between the neural activation patterns associated with each task. In the present study, single- and dual-task effects were addressed in the context of aging. Increasing evidence from research on motor and cognitive tasks has shown that aging is associated with an expansion of brain activation and an increased BOLD-signal. This may result in increased structural interference and higher dual-task interference in older adults. Functional magnetic resonance imaging was used to measure the BOLD-response in 20 old and 20 young healthy adults while performing tasks separately, or combined. Single tasks consisted of mental arithmetic cued by auditory tones, and a visuomotor task, drawing a circular shape with spatiotemporal constraints. Age-related brain activation increases were only apparent during performance of the visuomotor task. Elderly showed higher BOLD-responses in a frontoparietal network, pointing to an increased reliance on sensory feedback processing. However, no increased structural interference was found for the elderly during performance of the dual-task. Region of interest analysis involving a functional cluster within the (pre-) supplementary motor area, active during performance of both single-tasks, revealed that both groups were able to upregulate their brain activity for dual-as compared to single-task performance. We assume that this allowed both groups to maintain performance under dual-task conditions, leading to minimal dual-task interference.


Asunto(s)
Envejecimiento/fisiología , Atención/fisiología , Corteza Cerebral/fisiología , Conceptos Matemáticos , Procesos Mentales/fisiología , Destreza Motora/fisiología , Adulto , Anciano , Análisis de Varianza , Mapeo Encefálico , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Vías Nerviosas/fisiología , Valores de Referencia , Adulto Joven
3.
Neuroimage ; 49(3): 2570-80, 2010 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-19874897

RESUMEN

Functional magnetic resonance imaging was used to reveal the shared neural resources between movements performed with effectors of the left versus right body side. Prior to scanning, subjects extensively practiced a complex coordination pattern involving cyclical motions of the ipsilateral hand and foot according to a 90 degrees out-of-phase coordination mode. Brain activity associated with this (nonpreferred) coordination pattern was contrasted with pre-existing isodirectional (preferred) coordination to extract the learning-related brain networks. To identify the principal candidates for effector-independent movement encoding, the conjunction of training-related activity for left and right limb coordination was determined. A dominantly left-lateralized parietal-to-(pre)motor activation network was identified, with activation in inferior and superior parietal cortex extending into intraparietal sulcus and activation in the premotor areas, including inferior frontal gyrus (pars opercularis). Similar areas were previously identified during observation of complex coordination skills by expert performers. These parietal-premotor areas are principal candidates for abstract (effector-independent) movement encoding, promoting motor equivalence, and they form the highest level in the action representation hierarchy.


Asunto(s)
Mapeo Encefálico , Encéfalo/fisiología , Lateralidad Funcional/fisiología , Desempeño Psicomotor/fisiología , Adulto , Fenómenos Biomecánicos/fisiología , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Imagen por Resonancia Magnética , Masculino , Adulto Joven
4.
Br J Dermatol ; 150(4): 750-2, 2004 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15099373

RESUMEN

BACKGROUND: Female pattern hair loss (FPHL) is the preferred term for androgenetic alopecia in women. FPHL can be a source of considerable distress for affected women. Our hypothesis was that women with FPHL who seek treatment would rate their condition as more severe than would their treating doctors. OBJECTIVES: To identify discrepancies between the severity ratings of the women and their clinicians. METHODS: Participants were 30 women receiving treatment for biopsy-proven FPHL and 44 women on a waiting list to receive treatment for FPHL. Each woman completed a self-report photographic measure of severity of hair loss, specifically developed for the current study. RESULTS: Although no difference was found between the severity ratings of women receiving treatment and their clinicians, it was found that women in the waiting list group underestimated the severity of their hair loss compared with their clinicians' ratings. CONCLUSION: The results indicate that FPHL-affected women who seek treatment for FPHL do not overestimate the severity of the hair loss; in fact, they tend to underestimate. The present findings have implications for the treatment of FPHL.


Asunto(s)
Alopecia/psicología , Adulto , Actitud Frente a la Salud , Femenino , Humanos , Fotograbar , Autoimagen , Autoevaluación (Psicología) , Índice de Severidad de la Enfermedad , Listas de Espera
5.
Hum Mov Sci ; 22(3): 271-83, 2003 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12967758

RESUMEN

Changes in horizontal velocity (HV) are known to influence many biomechanical characteristics of human locomotion. The purpose of the present study was to investigate this phenomenon with respect to the interlimb symmetry of walking in a normal population. Peak and temporal ground reaction force data from both feet of 20 able-bodied males were collected at each of three relative velocity conditions (slow, normal and fast). These data were analyzed using of a series of 2 x 3 repeated measures ANOVAs, which revealed a high degree of interlimb (bilateral) symmetry across HV conditions despite significant intralimb (unilateral) changes. In contrast to this primary finding were two significant interaction effects for the stance time and peak vertical force at push-off measures respectively. These interactions indicated greater asymmetries at the slow HV condition with a trend toward improved symmetry at higher velocities. Although these results may provide some theoretical insight into the underlying nature of symmetry in gait, their overall magnitude does not seem to invalidate the current widespread use of symmetry assumptions in clinical and research settings today.


Asunto(s)
Extremidades/fisiología , Caminata/fisiología , Adulto , Fenómenos Biomecánicos , Humanos , Locomoción/fisiología , Masculino , Equilibrio Postural/fisiología , Factores de Tiempo
6.
Prev Vet Med ; 49(3-4): 209-22, 2001 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-11311954

RESUMEN

Risk factors for equine laminitis were examined in a prospective case-control study of the 258 cases seen at six collaborating veterinary teaching hospitals over a 32-month period. Case-control pairs were matched on institution, clinician, and season of diagnosis. The 90% of case-control pairs (78 acute, 155 chronic) that had complete data for age, gender, and breed were used in separate conditional logistic-regression models for acute and chronic laminitis. There was an increase in risk for horses with acute laminitis from 5 to 7 years of age (OR 4.7, 95% CI 1.3-16) and from 13 to 31 years of age (OR 3.9, 95% CI 1.3-12) (both compared to <5 years); risk was increased for chronic laminitis from 10 to 14 years (OR 3, 95% CI 1.4-6.8) and from 15 to 38 years (OR 2.9, 95% CI 1.4-6.1) (both compared to <6 years). Mares - but not stallions - were more likely than geldings to develop acute laminitis (OR 2.6, 95% CI 1.1-6.2) and chronic laminitis (OR 2.0, 95% CI 1.1-3.6). In the small acute-laminitis data set, the breed variable was collapsed into three categories: Thoroughbred (THB, reference), the Quarter Horse (QH), and other (non-QH-THB). The non-QH-THB group was at increased risk of acute laminitis (OR 3.8, 95% CI 1.2-11.8). For the seven breed-group categories used in the chronic-laminitis model, however, all non-THB breed groups appeared significantly at risk as compared to the THB, with odds ratios ranging from 3.3 (95% CI 1.3-8.30) for the QH to 9.1 (95% CI 2.1-39.3) for ponies.


Asunto(s)
Enfermedades del Pie/veterinaria , Pezuñas y Garras , Enfermedades de los Caballos/epidemiología , Cojera Animal/epidemiología , Enfermedad Aguda , Factores de Edad , Animales , Cruzamiento , Estudios de Casos y Controles , Enfermedad Crónica , Femenino , Enfermedades del Pie/epidemiología , Caballos , Incidencia , Inflamación/epidemiología , Inflamación/veterinaria , Modelos Logísticos , Masculino , Oportunidad Relativa , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales
7.
Am J Vet Res ; 61(8): 862-8, 2000 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10951973

RESUMEN

OBJECTIVE: To measure changes in laminar microvascular blood flow (LMBF) over time in healthy horses and horses in the prodromal stage of black walnut-induced laminitis and to determine the effects of glyceryl trinitrate application on LMBF in horses with acute laminitis. ANIMALS: 10 healthy adult horses. PROCEDURE: Laser Doppler flowmetry was used to measure LMBF Baseline measurements were obtained, horses were given deionized water via a nasogastric tube, and measurements were obtained hourly for 12 hours. Twenty-four hours later, baseline measurements were again obtained, and horses were given black walnut extract. Measurements were obtained hourly for 12 hours or until development of Obel grade-3 laminitis. At this time, 5 horses were treated with phenylbutazone, and the other 5 were treated with phenylbutazone and glyceryl trinitrate, and measurements were obtained hourly for an additional 12 hours. RESULTS: LMBF was significantly decreased 1 and 2 hours after administration of the black walnut extract but then returned to near-baseline values for the next 6 hours. Eight hours after extract administration, there was a second significant decrease in LMBF that persisted until the end of the study. Glyceryl trinitrate had no effect on LMBF. Clinical signs of laminitis developed 8 to 12 hours after extract administration. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in horses with black walnut-induced laminitis, there is an early decrease in LMBF followed by reperfusion prior to onset of clinical signs. Treatment with glyceryl trinitrate after development of clinical signs of laminitis did not have a significant effect on LMBF.


Asunto(s)
Enfermedades del Pie/veterinaria , Miembro Anterior/irrigación sanguínea , Pezuñas y Garras/irrigación sanguínea , Enfermedades de los Caballos/fisiopatología , Huesos Sesamoideos/irrigación sanguínea , Animales , Antiinflamatorios no Esteroideos/uso terapéutico , Presión Sanguínea , Temperatura Corporal , Enfermedades del Pie/etiología , Enfermedades del Pie/fisiopatología , Frecuencia Cardíaca , Enfermedades de los Caballos/etiología , Caballos , Flujometría por Láser-Doppler/veterinaria , Nitroglicerina/uso terapéutico , Nueces/efectos adversos , Nueces/metabolismo , Fenilbutazona/uso terapéutico , Distribución Aleatoria , Vasodilatadores/uso terapéutico
8.
Eur J Surg Oncol ; 22(6): 569-70, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-9005140

RESUMEN

Sixty-seven patients undergoing level three axillary node clearance were studied to ascertain the benefit of collar and cuff shoulder immobilization in reducing the incidence of axillary seroma formation. During this period the patients' views were obtained on this aspect of post-operative care. Although daily drainage volume decreased more rapidly in those patients whose shoulders were immobilized this did not result in a significant decrease in seroma formation following drain removal on the fifth post-operative day (31% vs 43%, P>0.05). Patient interviews revealed that they found the collar and cuff incapacitating, felt it delayed their return to normal activity and made personal hygiene difficult to maintain. In view of these results shoulder immobilization should not be employed in the routine post-operative care of these patients.


Asunto(s)
Neoplasias de la Mama/cirugía , Exudados y Transudados , Inmovilización , Escisión del Ganglio Linfático/efectos adversos , Complicaciones Posoperatorias/prevención & control , Articulación del Hombro , Adulto , Anciano , Axila , Femenino , Humanos , Escisión del Ganglio Linfático/métodos , Persona de Mediana Edad , Cuidados Posoperatorios/métodos , Resultado del Tratamiento
9.
J Nurs Manag ; 4(5): 257-63, 1996 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8954393

RESUMEN

The aim of this study was to explore the perspectives of qualified nurses on the implementation of staff appraisal. The sample consisted of eight nurses, varying in age, professional status and experience, within the clinical area in a hospital located in the South of England. Each participant was interviewed in depth. The unstructured interviews were then transcribed, coded and analysed in line with the strategies of grounded theory. The data yielded several important factors which require consideration by senior nurses and managers if they are to execute appraisals effectively. Contrary to expectations, the majority of participants expected, and even eagerly anticipated, the implementation of appraisals. However, several informants expressed concern that appraisals may be used against them. 'Gaining direction and purpose' was seen by staff as the main benefit of the appraisal from a personal and organizational point of view. Recommendations were made which might facilitate the implementation of future appraisal schemes throughout the organization.


Asunto(s)
Actitud del Personal de Salud , Evaluación del Rendimiento de Empleados/normas , Personal de Enfermería en Hospital/psicología , Humanos , Investigación Metodológica en Enfermería , Supervisión de Enfermería/normas , Encuestas y Cuestionarios
10.
Am J Vet Res ; 55(4): 445-9, 1994 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8017686

RESUMEN

Once daily for 3 days, laser Doppler flowmetry was used in 5 healthy, nonsedated adult horses to evaluate coronary band and laminar microcirculatory blood flow (MBF) in both forelimbs. The coronary band had significantly (P < 0.05) higher MBF than did the laminae on the days evaluated. Significant variation in MBF was not found over the 3-day measurement period in any one site. Significant (P < 0.05) variation was found in coronary band MBF among horses. This variation was not observed in laminar MBF. On occlusion of the digital arteries at the level of the fetlock, marked decrease in coronary band and laminar MBF was observed. Twenty minutes after IV administration of acetylpromazine, marked increase in coronary band and laminar MBF was observed. The technique was easily performed in standing nonsedated horses, did not inflict discomfort, lacked complications, and measurements were repeatable. This technique provides an index of digital MBF, either intermittently or continuously, avoiding introduction of invasive variables associated with other techniques.


Asunto(s)
Circulación Coronaria , Caballos/fisiología , Flujometría por Láser-Doppler/veterinaria , Acepromazina/farmacología , Animales , Velocidad del Flujo Sanguíneo/efectos de los fármacos , Circulación Coronaria/efectos de los fármacos , Estudios de Evaluación como Asunto , Microcirculación/efectos de los fármacos , Valores de Referencia
11.
Vet Clin North Am Equine Pract ; 8(2): 285-302, 1992 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-1643543

RESUMEN

With recent advances in diagnostic techniques associated with equine lameness, there is a tendency to reduce our reliance on the most important part of purchase evaluation of the horse-the hands-on physical examination. This article stresses the importance of the physical examination and advises less dependence on involved diagnostic procedures.


Asunto(s)
Enfermedades de los Caballos/diagnóstico , Caballos/anatomía & histología , Sistema Musculoesquelético/anatomía & histología , Examen Físico/veterinaria , Piel/anatomía & histología , Animales , Marcha , Caballos/fisiología , Cojera Animal/diagnóstico , Movimiento , Fenómenos Fisiológicos Musculoesqueléticos , Palpación/veterinaria , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/veterinaria
12.
Am J Vet Res ; 52(2): 333-6, 1991 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-2012346

RESUMEN

The antebrachiocarpal and tarsocrural joints of 10 adult horses were randomly assigned to 1 of 4 groups. Groups were formulated and were treated as follows: group 1, control (arthrocentesis only); group 2, buffered lactated Ringer solution; group 3, 10% dimethyl sulfoxide (DMSO; w/v) in lactated Ringer solution; and group 4, 30% DMSO (w/v) in lactated Ringer solution. Joints were lavaged once with the respective solution. Prior to lavage and on days 1, 4, and 8 after lavage, all horses were evaluated for lameness and joint effusion; synovial fluid total and differential WBC counts, synovial fluid total protein concentration, and mucin clot quality were determined. Horses were euthanatized on day 8, and joints were evaluated grossly, histologically, and histochemically. Significant difference was not observed in effect of lactated Ringer solution, 10% DMSO, and 30% DMSO on any measured variable. At 24 hours after treatment, significant (P less than 0.05) difference in synovial fluid WBC numbers and total protein concentration was detected between control and treated joints. Eighty percent of lavaged joints had effusion 24 hours after treatment, compared with 30% of control joints. Gross, histopathologic, or histochemical differences were not detected between treated and control joints. Results of the study indicate that buffered lactated Ringer, 10% DMSO, and 30% DMSO solutions induce similar inflammatory changes in articular structures and significantly greater inflammatory reaction than does arthrocentesis alone.


Asunto(s)
Dimetilsulfóxido/farmacología , Líquido Sinovial/química , Irrigación Terapéutica , Animales , Estudios de Evaluación como Asunto , Inyecciones Intraarticulares/veterinaria , Soluciones Isotónicas , Distribución Aleatoria , Solución de Ringer
13.
J Physiol ; 431: 173-85, 1990 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-2100306

RESUMEN

1. To explore how maximum velocity of shortening (Vmax) of fibres varies within one muscle and how Vmax varies with body size, we measured Vmax of muscle fibres from soleus muscle of a large animal, the horse. 2. Vmax was determined by the slack test on skinned single muscle fibres at 15 degrees C during maximal activation (pCa = 5.2). The fibre type was subsequently determined by a combination of single-cell histochemistry and gel electrophoresis of the myosin light chains. 3. Vmax values for the type I, IIA and IIB muscle fibres were 0.33 +/- 0.04 muscle lengths/s (ML/s) (+/- S.E.M., n = 6), 1.33 +/- 0.08 ML/s (n = 7) and 3.20 +/- 0.26 ML/s (n = 6), respectively. It is likely that the large range in Vmax is due to differences observed in the myosin heavy chains and light chains associated with the three fibre types. 4. Comparison of Vmax over a 1200-fold range (450 kg horse vs. 0.38 kg rat) of body mass (Mb) suggests that slow fibres scale more dramatically (Mb-0.18) than do fast glycolytic fibres (Mb-0.07). This difference may enable the slow fibres to work at high efficiencies in the large animal while the fast fibres can still generate a large mechanical power when necessary.


Asunto(s)
Constitución Corporal/fisiología , Caballos/fisiología , Contracción Muscular/fisiología , Músculos/fisiología , Animales , Fenómenos Biomecánicos , Técnicas In Vitro , Contracción Isométrica/fisiología , Factores de Tiempo
14.
Anal Biochem ; 184(2): 381-7, 1990 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-2327580

RESUMEN

A microanalytical gas chromatographic (GC) method for the analysis of nitrate in rat urine is described. The method involves the conversion of nitrate to nitromesitylene and quantitation using 3,4-dimethylnitrobenzene as an internal standard. The nitroaromatics were separated on a wide-bore capillary column and detected with a nitrogen-phosphorus thermionic detector. The method exhibited linearity over the range of 1.0 to 1000 microM nitrate, and the detection limit was 0.5 microM nitrate (200-microliters sample). The coefficient of variation (CV) range for intra-day precision was 2.2 to 5.8% (20 microM level) and 3.1 to 6.5% (200 microM level). Inter-day CVs ranged from 2.0 to 6.1% for the samples tested. The average recovery was 77% (20 microM level) and 80% (20 microM level). The accuracy of the GC method compared favorably with results obtained from a standard colorimetric nitrate assay. Interference by urinary chloride was eliminated by pretreatment of samples with saturated silver acetate. Both processed and unprocessed samples were stable for at least 60 days at -15 degrees C. The procedure was used to measure urinary nitrate in rats fed a custom low-nitrate diet.


Asunto(s)
Cromatografía de Gases/métodos , Nitratos/orina , Animales , Derivados del Benceno , Colorimetría , Masculino , Microquímica , Nitratos/administración & dosificación , Nitrobencenos , Ratas , Ratas Endogámicas
15.
J Histochem Cytochem ; 37(11): 1731-8, 1989 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-2530270

RESUMEN

Until now, there has been no reliable method for histochemical determination of fiber types of single skinned muscle fibers. The major problem arises from the fact that most histochemical techniques use cross-sections of a large group of fibers and compare a given fiber with those surrounding it. This is not possible with a single skinned fiber which has been separated from a bundle to be used for mechanical analysis. A further problem is that the skinning procedure itself may alter the staining pattern. We have developed a procedure by which multiple cross-sections of single skinned fibers can be exposed to various histochemical reactions and the staining patterns compared on the same slide to those of frozen muscle and skinned bundles. By this procedure, three fiber types were distinguished by both Ca2+-ATPase and SDH reactions. The fiber typings determined from both enzyme systems correlated well with each other. Although we were able to differentiate only between slow and fast fibers by SDS-PAGE, these results corroborated the histochemical classification. This procedure will clearly be useful in skinned single muscle fiber mechanics experiments performed to determine functional differences among fiber types.


Asunto(s)
Caballos/anatomía & histología , Músculos/citología , Animales , ATPasas Transportadoras de Calcio/metabolismo , Electroforesis en Gel de Poliacrilamida , Histocitoquímica , Peso Molecular , Músculos/análisis , Músculos/enzimología , Músculos/fisiología , Miosinas/análisis , Succinato Deshidrogenasa/metabolismo
18.
Am J Vet Res ; 40(5): 724-6, 1979 May.
Artículo en Inglés | MEDLINE | ID: mdl-224737

RESUMEN

The plasma concentration of hydrocortisone was determined in mares given either cosyntropin (100 IU, given IV) or corticotropin (200 IU, given IM). Plasma hydrocortisone concentrations of the mares treated with cosyntropin increased by 46%, 57% and 80% at 30, 60, and 120 minutes, respectively, when compared with base-line values; these values returned to base line at 240 minutes. In mares treated with corticotropin, mean plasma hydrocortisone concentrations increased by 42%, 143%, 101% and 155% at 30, 60, 120, and 240 minutes, respectively, when compared with base-line values. Differences in total leukocyte count, total eosinophil count, and plasma concentrations of electrolytes (calcium, sodium, magnesium, potassium) of cosyntropin- and corticotropin-treated mares, and these values in control animals were not significant. Results of the present study indicated that the horse responds to small dosages of cosyntropin (IV) in a prompt and reproducible manner as determined by plasma hydrocortisone values. Response to corticotropin was slow and less consistent. Thus, administration of cosyntropin to the horse, according to test results with paired samples collected (before administration and again at 2 hours after injection), was found to be a prompt and meaningful test of adrenal gland function.


Asunto(s)
Glándulas Suprarrenales/efectos de los fármacos , Hormona Adrenocorticotrópica/análogos & derivados , Hormona Adrenocorticotrópica/farmacología , Cosintropina/farmacología , Caballos/fisiología , Glándulas Suprarrenales/fisiología , Animales , Femenino , Caballos/sangre , Hidrocortisona/sangre , Recuento de Leucocitos
20.
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