Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Maintenance”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1998

Maintenance and recovery characteristics after sevoflurane or propofol during ambulatory surgery in children with epidural blockade.

PURPOSE: To compare the maintenance and recovery characteristics after sevoflurane with those after propofol in children with epidural blockade. METHODS: Fifty unpremedicated, children ASA I-II, 2-8 yr of age, scheduled for elective urological surgery as outpatients, were randomly allocated to receive either: 1) sevoflurane for induction and maintenance of anaesthesia or 2) propofol for induction (2-3 mg.kg-1 i.v.) and for maintenance (5-10 mg.kg-1.hr-1 i.v.). All children received N2O 70% in oxygen before induction and throughout the anaesthetic, rocuronium for neuromuscular blockade and a lumbar or caudal epidural block before incision. Heart rate (HR), systolic blood pressure (SBP), recovery times and all side effects during maintenance and recovery were recorded by a blinded observer. Adverse events during the first 24 hr were also recorded. RESULTS: Mean HR increased 5-10% after induction in both groups reaching a maximum by five minutes. Heart rate returned to baseline by skin incision in the sevoflurane group and by 10 min after induction in the propofol group. During maintenance, HR decreased by 10-20% below baseline values by 20 min in the propofol group only, where it remained for the remainder of the anaesthetic. Similarly, SBP increased by 10% after induction of anaesthesia in both groups, but returned to baseline by 10 min. Light anaesthesia occurred in four (16%) children, all in the propofol group. Emergence and recovery indices were similar in the two groups. DISCUSSION: Sevoflurane and propofol exhibit similar maintenance and recovery profiles when combined with epidural analgesia in children undergoing ambulatory surgery.

Ambulatory Surgical Procedures↗
PubMed1998

Potency and hourly maintenance requirement of combinations of mivacurium and pancuronium in adults.

PURPOSE: To evaluate the dose-response and maintenance requirements of a combination of mivacurium and pancuronium (cMP) in clinical practice. METHODS: In a randomised, open clinical study, 70 patients, 17-50 yr of age, were anaesthetised with propofol, alfentanil and nitrous oxide in oxygen. Thirty patients received mivacurium and 20 patients received pancuronium to establish dose-response curves for these agents. Hourly maintenance requirements of mivacurium and pancuronium to maintain 90-95% neuromuscular blockade (NMB) were determined. Thereafter, 20 additional patients received cMP in incremental doses to establish a cumulative dose-response curve for cMP followed by maintenance doses of cMP. NMB was recorded by adductor pollicis electromyography. RESULTS: The ED95 values for mivacurium and pancuronium were 100 and 66 micrograms.kg-1, respectively; and for the cMP 2:1 (in mg:mg basis), 32 micrograms.kg-1 mivacurium together with 16 micrograms.kg-1 pancuronium. This cMP was 1.8 times more potent than one parent agent (P < 0.0001). When cMP 2:1 was used, 60% of normal maintenance requirement of pancuronium reduced the requirement of mivacurium by > 90%. If cMP 20:1 was used, then 20% of normal maintenance requirement of pancuronium reduced the requirement of mivacurium by > 70%. Neostigmine 35 micrograms.kg-1 given at T1 10% recovery following cMP reversed the NMB to a TOF ratio of 0.70 in 9.5 +/- 3.9 min. CONCLUSION: These results reflect considerable synergism between mivacurium and pancuronium. The cMP is near intermediate-acting and the NMB is easily reversed with neostigmine. By using cMP, it may be possible to save some pharmacological costs during maintenance of anaesthesia.

Adolescent↗
PubMed2002

Oral caffeine maintenance potentiates the reinforcing and stimulant subjective effects of intravenous nicotine in cigarette smokers.

RATIONALE: Epidemiological, clinical and pre-clinical observations suggest that caffeine can potentiate the reinforcing and discriminative effects of nicotine. OBJECTIVE: The present study examined whether chronic exposure to moderate doses of caffeine affects the reinforcing and subjective effects of intravenously administered nicotine. METHODS: The effects of oral caffeine maintenance on the subjective and physiological effects of intravenously administered nicotine and caffeine were examined using double-blind methods in nine volunteers with current use of tobacco, caffeine, and cocaine. Each subject was exposed to two chronic drug phases (200 mg/70 kg oral caffeine t.i.d. and placebo t.i.d.), each of at least 12 days duration. Within each drug phase, the subject received intravenous injections of placebo, nicotine (1.0 and 2.0 mg/70 kg), and caffeine (200 and 400 mg/70 kg) in mixed order. Physiological and subjective data were collected before and repeatedly after drug or placebo injection. RESULTS: Both intravenous nicotine and caffeine produced significant increases in ratings of drug effect, stimulated, rush, and bad effect, with only nicotine significantly increasing ratings of liking and good effect. Caffeine maintenance significantly increased ratings of drug effect and stimulated after the high dose of nicotine, and significantly decreased ratings of bad effect after the low dose of nicotine. Caffeine maintenance also significantly increased the identification of the low dose of nicotine as a stimulant. A drug versus money measure of reinforcement showed that subjects were willing to pay money to receive nicotine injections, but willing to forfeit money to avoid caffeine injections. Furthermore, subjects were willing to pay significantly more money to receive the high dose of nicotine in the caffeine maintenance phase than in the abstinence phase. Both intravenous nicotine and caffeine increased diastolic blood pressure and decreased skin temperature, and nicotine also increased heart rate. These physiological effects of intravenous nicotine and caffeine as well as the subjective effects of intravenous caffeine were not influenced by caffeine maintenance. CONCLUSIONS: The results extend recent clinical and preclinical findings by showing that oral caffeine maintenance can potentiate the reinforcing and stimulant subjective effects of nicotine.

Administration, Oral↗
PubMed1981

Prolonged maintenance interval in hymenoptera venom immunotherapy.

To decrease the cost, inconvenience, and potential side effects of venom immunotherapy we tested whether the interval between the maintenance injections can be increased. In 30 patients who had been given the standard therapy regimen and who had been sting-challenged after 1 and 2 yr of monthly maintenance injections the maintenance interval was increased from 4 to 6 wk. IgG anti-yellow jacket venom antibodies did not change over the next 9 mo. The incidence of local reactions to venom injections did not increase, and there were no systemic reactions during therapy. After 6 to 9 mo 29 of the 30 patients were sting-challenged with one possible reaction. The success rate, 97%, is the same as that observed with monthly maintenance injections. We conclude that the 6-wk maintenance interval is effective in both clinical and immunologic terms after a period of monthly maintenance therapy.

Arthropod Venoms↗
PubMed1992

Selection of Dictyostelium discoideum transformants and analysis of vector maintenance using live bacteria resistant to G418.

A protocol that allows the rapid isolation and growth of large numbers of independent G418-resistant Dictyostelium discoideum transformant colonies on the surface of agar media with live bacteria was developed. Transformants grown under these conditions form normal fruiting bodies. Discovery that aggregation of nontransformants was inhibited at a nonselective level of G418 (25 to 35 micrograms/ml) led to the development of a vector maintenance assay. Using this assay we examined the stability of recombinant plasmids derived from the D. discoideum native plasmids Ddp1 and Ddp2. We conclude that the origin of replication of plasmid Ddp1 does not alone confer stable maintenance and thus, Ddp1 must bear additional sequences required for its own maintenance. Analysis of the maintenance of vectors derived from Ddp2 showed that autonomously replicating shuttle vectors that contained bacterial plasmid DNA and from which one element of the Ddp2 inverted repeat was removed were much less stable than vectors that contained a complete inverted repeat or that did not carry a bacterial plasmid. Sequences between the 3' end of the rep gene and the inverted repeat appear to play a role in plasmid maintenance. An intact rep gene and one copy of the inverted repeat element were required for extrachromosomal replication. Maintenance of extrachromosomal vectors was found to be strain dependent. Four traits distinguishing integrating vectors from those capable of autonomous replication were identified.

Animals↗
PubMed1991

Medical maintenance: the treatment of chronic opiate dependence in general medical practice.

Medical maintenance was created to treat rehabilitated methadone maintenance patients within the context of general medical practice. One hundred methadone patients who met screening criteria were transferred for continuing care from traditional methadone clinics either to the practices of hospital-based physicians or to a health maintenance organization. Patients see their physicians about once per month, submit urine samples at the time of the office visits, drink a dose of methadone in the presence of their doctor or nurse, and receive a 28-day supply of methadone in pill or tablet form. The methadone prescriptions are filled by the hospital pharmacies. Physicians are responsible for the patients' annual physicals and can treat patients for other conditions. In our initial analysis of medical maintenance, 82.5% of the patients remained in good standing and 5% left the program voluntarily in good standing; the remaining 12.5% who were unable to respond favorably were returned to clinic programs. For rehabilitated patients requiring long-term or life-long care, medical maintenance is a viable alternative to traditional clinic programs. With proper policies and procedures, medical maintenance can be implemented in many hospitals.

Aftercare↗
PubMed2006

Pharmaco-economics of community maintenance for opiate dependence: a review of evidence and methodology.

This literature review synthesizes and appraises evidence on the pharmaco-economic value of community maintenance for opiate dependence. Included studies enrolled opiate-dependent subjects aged 18 years or over participating in a community maintenance programme. Cost-effectiveness/cost-utility analyses provided some evidence supporting the value of methadone maintenance in combination with psychosocial services and of heroin co-prescription. Evidence on the pharmaco-economic profile of maintenance with buprenorphine as compared with methadone is mixed. Few studies carried out an economic evaluation alongside a randomised controlled trial and studies adopting a modelling approach suffered from problems with the quality and validity of parameter estimates. Studies were also limited in the range of costs and consequences considered. The cost-benefit literature showed positive net benefits from community maintenance programmes. A longer length of stay of subjects in methadone maintenance was associated with greater reductions in criminal activity. However, measurement of benefits was limited to savings from reduced crime rates. Health benefits were rarely considered. Cost-benefit studies based on a before-and-after comparison were not able to consider the impact of treatment on mortality of opiate-dependent subjects. There is a need for better-designed economic evaluations that examine whether treatment benefits exceed costs, in terms of both financial benefits and health gain.

Buprenorphine↗
PubMed2006

Warfarin maintenance dose adjustment with indirect pharmacodynamic model in rats.

The purpose of the study was to adjust the individual maintenance dose of warfarin with a simple approach based on indirect pharmacodynamic model (IDR). Based on the distinct pharmacokinetic and pharmacodynamic features of warfarin, the relationship between the maintenance dose and the steady-state anticoagulation effect was simplified and an approach for the maintenance dose adjustment was proposed. According to the steady-state anticoagulation effect before and after multiple doses (0.1 mg kg(-1)day(-1)), the optimal maintenance doses were predicted for the target anticoagulation effect (INR(target)=2.5), then the actual anticoagulation effect (prothrombin times, PT) on the 6th (8 pm)\8th (8 am)\10th (2 pm) day after dose adjustment according the present method was compared with the target effects with a view of determination the feasibility and accuracy of the proposed approach. The proposed method was also used to adjust warfarin maintenance doses in the presence of metabolism inhibitor metronidazole. The results suggested that the proposed approach could appropriately achieve the target international normalized ratio (INR(target)) when warfarin used alone or in combination with metronidazole, the actual INR values of three days were 2.69+/-0.18 and 2.52+/-0.22 (mean+/-S.D.), respectively. The method provided a relatively simple and accurate strategy for warfarin maintenance dose adjustment.

Administration, Oral↗
PubMed2005

The role of neurotrophins in the maintenance of the spinal cord motor neurons and the dorsal root ganglia proprioceptive sensory neurons.

The aim of this study was to approach the question of neuronal dependence on neurotrophins during embryonic development in mice in a way other than gene targeting. We employed amyogenic mouse embryos and fetuses that develop without any skeletal myoblasts or skeletal muscle and consequently lose motor and proprioceptive neurons. We hypothesized that if, in spite of the complete inability to maintain motor and proprioceptive neurons, the remaining spinal and dorsal root ganglia tissues of amyogenic fetuses still contain any of the neurotrophins, that particular neurotrophin alone is not sufficient for the maintenance of motor and proprioceptive neurons. Moreover, if the remaining spinal and dorsal root ganglia tissues still contain any of the neurotrophins, that particular neurotrophin alone may be sufficient for the maintenance of the remaining neurons (i.e., mostly non-muscle- and a few muscle-innervating neurons). To test the role of the spinal cord and dorsal root ganglia tissues in the maintenance of its neurons, we performed immunohistochemistry employing double-mutant and control tissues and antibodies against neurotrophins and their receptors. Our data suggested that: (a) during the peak of motor neuron cell death, the spinal cord and dorsal root ganglia distribution of neurotrophins was not altered; (b) the distribution of BDNF, NT-4/5, TrkB and TrkC, and not NT-3, was necessary for the maintenance of the spinal cord motor neurons; (c) the distribution of BDNF, NT-4/5 and TrkC, and not NT-3 and Trk B, was necessary for the maintenance of the DRG proprioceptive neurons; (d) NT-3 was responsible for the maintenance of the remaining neurons and glia in the spinal cord and dorsal root ganglia (possibly via TrkB).

Animals↗
PubMed2006

A kinetic inhibition mechanism for maintenance.

To fulfil their maintenance costs, most species use mobile pools of metabolites (reserve) in favourable conditions, but can also use less mobile pools (structure) under food-limiting conditions. While some empirical models always pay maintenance costs from structure, the presence of reserve inhibits the use of structure for maintenance purposes. The standard dynamic energy budgets (DEB) model captures this by simply supplementing all costs that could not be paid from reserve with structure. This is less realistic at the biochemical level, and involves a sudden use of structure that can complicate the analysis of the model properties. We here propose a new inhibition formulation for the preferential use of reserve above structure in maintenance that avoids sudden changes in the metabolites use. It is based on the application of the theory for synthesizing units, which can easily become rather complex for demand processes, such as the maintenance. We found, however, a simple explicit expression for the use of reserve and structure for maintenance purposes and compared the numerical behaviour with that of a classical model in oscillating conditions, by using parameters values from a fit of the models to data on yeasts in a batch culture. We conclude that our model can better handle variable environments. This new inhibition formulation has a wide applicability in modelling metabolic processes.

Adaptation, Physiological↗
PubMed2006

Tiotropium in COPD patients not previously receiving maintenance respiratory medications.

INTRODUCTION: Use of maintenance bronchodilator therapy is currently recommended in symptomatic patients with Chronic obstructive pulmonary disease (COPD) and in those with Stage II or greater COPD as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Because no prospective data describe when rescue therapy alone is insufficient or the optimal time to start maintenance therapy, it is unclear whether maintenance therapy has benefits in milder disease. To explore potential benefits we asked: Does once-daily tiotropium improve lung function, health status, and/or symptoms in "undertreated" COPD patients (i.e., those who are not receiving maintenance bronchodilator therapy) or patients considered by their health care providers as having milder disease? METHODS: A post-hoc analysis of data from COPD patients participating in two, 1-year, placebo-controlled trials with tiotropium was performed. Patients were defined as "undertreated" if they received no respiratory medication or only as-needed short-acting beta-agonists prior to enrollment. Measures included serial spirometry, Transition Dyspnea Index (TDI), and St. George's Respiratory Questionnaire (SGRQ). RESULTS: Of 921 patients enrolled, 218 (23.7%) were "undertreated": 130 received tiotropium; 88 received placebo. Demographics for the two treatment groups were comparable. Tiotropium-treated patients had significantly improved forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) compared with patients using placebo on all study days. Additionally, TDI and SGRQ scores significantly improved with tiotropium compared with placebo. CONCLUSIONS: Once-daily tiotropium provides significant improvement in lung function, health status, and dyspnea when used as maintenance therapy in undertreated COPD patients who were not previously receiving maintenance bronchodilator therapy.

Aged↗
PubMed2000

Bipolar disorder therapeutics: maintenance treatment.

Although most of the care received by bipolar patients occurs during the maintenance phase, relatively little empirical data is available to guide long-term treatment decisions. We review literature pertaining to key questions related to use of pharmacotherapy in the maintenance phase of bipolar disorder. The few double-blind trials with a reasonable sample size are restricted to bipolar I patients and address a modest range of questions mostly related to use of lithium. One rigorous multicenter trial found valproate to have prophylactic benefit. Other studies with valproate alone and in combination suggest efficacy equivalent to lithium and perhaps greater than carbamazepine. Data available for combination treatment are sparse but moderately encouraging. Maintenance treatment with standard antidepressant medications appears destabilizing for some bipolar patients, particularly following a mixed episode. Although some bipolar patients may benefit from combined treatment with a mood stabilizer and a standard antidepressant medication, current knowledge does not allow confident selection of the bipolar patients who might benefit. Clozapine and perhaps other atypical antipsychotics are promising options for maintenance treatment but have not been evaluated in double-blind trials. The numerous other agents used in maintenance treatment are primarily adjuncts to lithium, valproate, or carbamazepine, and information about them is largely anecdotal and uncontrolled. Study design for maintenance trials remains an imperfect art. Conclusions must be drawn cautiously, given the limited generalizability of study designs that accession samples enriched with presumed treatment responders, randomize patients after brief periods of partial remission, abruptly taper prior treatment, make no attempt to distinguish relapse from recurrence, use no formal outcome assessments, or report hospitalization as the only outcome criterion.

Antidepressive Agents↗
PubMed1998

Implications of failing to achieve successful long-term maintenance treatment of recurrent unipolar major depression.

This is a review article that describes current data, issues, and controversies regarding long-term maintenance treatment of depression. The authors suggest that the issues represent a public health crisis. This paper will identify the need, from both a health-care and economic perspective, for more research on the efficacy of maintenance treatment for this pernicious and lifelong disorder. Data will be reviewed on the natural course of unipolar depression, focusing on clinical predictors that increase the risk of a relapse or recurrence. This review will include new data from the National Institute of Mental Health Collaborative Depression Study. Failing to achieve adequate maintenance treatment for unipolar recurrent major depression has psychopathological and psychosocial consequences, decreasing work productivity and the quality of a person's life. Published double-blind placebo-controlled studies on continuation treatment of major depression will be reviewed. The two competed double-blind placebo-controlled long-term maintenance studies of recurrent unipolar major depression will be discussed in detail. Despite the positive findings from research done to date, there remain many unresolved questions relating to the maintenance treatment of recurrent unipolar major depression, and the need for research in this area is critical. The paper concludes with recommendations for long-term maintenance treatment of unipolar major depression.

Antidepressive Agents↗
PubMed1998

Maintenance therapy after quadruple induction therapy in HIV-1 infected individuals: Amsterdam Duration of Antiretroviral Medication (ADAM) study.

BACKGROUND: Highly active antiretroviral therapy (HAART) has led to health benefits for patients infected with HIV-1. However, long-term use of multidrug regimens is difficult to sustain. Simplifying antiretroviral treatment regimens would increase patients' adherence and minimise toxicity. We investigated the feasibility of a strategy of induction therapy followed by maintenance therapy with HAART in a randomised open-label study. METHODS: From March, 1997, we enrolled patients infected with HIV-1 with at least 200 CD4 cells/microL, at least 1000 HIV-1 RNA copies/mL in plasma, and no previous exposure to antiretroviral drugs. After 26 weeks of induction therapy (stavudine, lamivudine, saquinavir, and nelfinavir) patients were randomly allocated maintenance therapy (either stavudine and nelfinavir or saquinivir and nelfinavir) or prolonged induction therapy (if the plasma HIV-1 RNA concentration at weeks 24 and 25 was <50 copies/mL). FINDINGS: In February, 1998, we discontinued randomisation after an interim analysis. 62 patients had been enrolled. 39 (91%) of the 43 patients who were followed up for at least 26 weeks had an undetectable plasma HIV-1 RNA concentration at week 16. At week 26, 31 patients were randomly allocated treatment. Of these patients 25 had a total follow-up of at least 36 weeks. At week 36, a higher proportion of patients on maintenance therapy (nine [64%] of 14) had a detectable HIV-1 RNA than patients on prolonged induction therapy (one [9%] of 11, p=0.01). The initial virion-clearance rate during induction therapy was higher in five patients on maintenance therapy with a sustained undetectable plasma HIV-1 RNA concentration than in nine patients with recurrence of a detectable plasma HIV-1 RNA concentration at week 36 (0.35 vs 0.19 per day, respectively; p=0.0008). INTERPRETATION: The induction regimen provided a rapid suppression of viral replication to below 50 copies/mL. However, suppression was not sustained in a considerable number of patients who went onto maintenance therapy. It is currently inadvisable to continue attempts at moving from induction to maintenance therapy in day-to-day practice.

Adult↗
PubMed2006

Principles of maintenance therapy.

Although follicular non-Hodgkin's lymphoma may respond well to induction therapy, almost all patients will eventually relapse. To reduce the frequency of relapses and prolong disease-free intervals, maintenance treatment may be given to patients who respond or have stable disease after induction therapy. Maintenance treatment is given at regular intervals over prolonged periods in patients who may be asymptomatic, and so it is important that administration is simple, toxicity is minimal and that there is clear evidence of efficacy. The monoclonal antibody rituximab has many characteristics essential for a maintenance therapy: it is both effective and very well tolerated, and can maintain active concentrations in the blood with intervals of several months between administrations, enabling patients to continue with normal life while on maintenance therapy. Randomized trials of rituximab maintenance therapy have confirmed that remissions can be prolonged, and in one randomized trial, early results suggest a survival benefit. The optimal schedule for maintenance therapy has not yet been defined.

Animals↗
PubMed2006

Safety of rituximab maintenance therapy in follicular lymphomas.

The human/mouse chimeric monoclonal antibody rituximab has been used extensively in treatment of hematologic malignancies, and its efficacy and safety are well established, both as single-agent therapy and when used in combination with chemotherapy. Mild-to-moderate, transient infusion-related reactions are the most common adverse event, and rituximab does not add significantly to the toxicity of chemotherapy. Rituximab maintenance therapy has now emerged as an effective treatment for follicular lymphoma. Patients on rituximab maintenance therapy receive regular doses of rituximab for periods up to 2 years after initial induction therapy and are completely depleted of B-cells throughout this time, although B-cells eventually recover when maintenance treatment is stopped. In randomized trials of rituximab maintenance therapy versus observation after induction with single-agent rituximab, standard chemotherapy or rituximab plus chemotherapy, patients receiving rituximab maintenance therapy did not experience significantly greater toxicity than those in the observation arms, and no cumulative or unexpected toxicities were observed. Findings to date thus indicate that rituximab maintenance therapy is well tolerated, but further assessment of the long-term effects of prolonged B-cell depletion is still required.

Animals↗
PubMed2001

Maintenance desipramine for dysthymia: a placebo-controlled study.

BACKGROUND: This study examines the efficacy of maintenance pharmacotherapy in dysthymia without concurrent major depression, i.e. 'pure dysthymia'. No published data exist on this topic. METHODS: Responders to a 10-week open trial of desipramine (DMI) whose therapeutic response persisted during a 4-month continuation phase were eligible to begin a 2-year placebo-controlled maintenance phase. We analyzed the subgroup with DSM-III-R pure dysthymia (n=27) that entered maintenance. Time to recurrence during maintenance therapy was compared between the two treatment groups. RESULTS: Six of 13 patients receiving placebo and none of 14 patients receiving ongoing DMI experienced a recurrence. Risk of recurrence was significantly greater for placebo patients. Five of six placebo recurrences occurred within the first 6 months of maintenance. LIMITATIONS: Larger replication studies are needed. CONCLUSION: Desipramine was efficacious as a maintenance treatment in patients with pure dysthymia who responded to 7 months of acute and continuation DMI.

Acute Disease↗
PubMed1997

Patterns of health maintenance on Michigan equine operations.

Data from two 12 month prospective monitoring programs that followed management, economics and animal health from randomly-sampled equine operations in Michigan were used to determine patterns of health maintenance. Health maintenance measures were grouped, and average uses per year were computed for the most-common measures reported: respiratory, Potomac Horse Fever, neurological and multiple-system vaccinations, deworming, and general farrier work. Factors examined for potential association with health maintenance measure use were numbers of equids and horse-days on the operation, average age of equids, disease prevention management procedures, and operation and individual equine activities. The most-common vaccinations reported were respiratory vaccines (administered an average of 0.9 times per equid per year, of which 61% were for rhinopneumonitis). Multiple-system, Potomac Horse Fever and neurological vaccines were given on average 0.9, 0.9 and 0.7 times per equid per year, respectively. Deworming treatments were administered approximately 2.7 times per equid per year, of which 64% were ivermectin. Overall farrier work was reported 3.3 times per equid per year, trimming was done 2.9 times and shoeing was done 1.5 times per equid per year. In general, operations with active equids engaged in training, breeding or showing showed increased use of health maintenance measures. Overall use of health maintenance measures in the Michigan equine operations monitored did not appear to reach recommended levels, because many operations reported no use of these measures. However, on operations where health maintenance measures were reported, operators were using these measures at or near recommended levels.

Aging↗