VIVOTIF® Oral Product Information NAME OF THE MEDICINE Oral Typhoid Vaccine DESCRIPTION Vivotif Oral is an oral, live, attenuated typhoid vaccine for active immunization against typhoid and contains Salmonella typhi strain Ty21a. Each enteric coated capsule contains not fewer than 2 x 109 viable organisms. Each capsule also contains the following excipients: ethylene glycol, s
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Microsoft word - csteel-updatebleederseiph-june07-edited.docAn update on “Bleeders” and
that reported in Japan, Britain and
South Africa, and less than that
reported in Singapore, Hong Kong
Defining a “bleeder”.
and the USA.
definition of a “bleeder” in various world. In Australia, bleeding is
defined as the appearance of blood
indicate that some degree of EIPH
at both nostrils, irrespective of the
may occur in up to 75% of runners.
quantity, after exercise, unless in the
opinion of the Stewards such
bleeding was caused by external
trauma (AR53A (1) ). In some racing
bleeding from one nostril after exercise How common is bleeding from the
lungs in racehorses and how is it
What risk factors have been identified
for this condition?
The prevalence of epistaxis is higher in nostrils (referred to as ‘epistaxis’) in racing increases the risk), in hurdle or Victoria, the prevalence of horses
bleeding for the first-time as defined
as the appearance of blood at both
nostrils after exercise is Singapore the prevalence of bleeding
approximately 1.5 per 1000 starters
(epistaxis) is higher on fiber-sand than (or 0.15%). This is comparable to
turf. The effect of ‘going’ is variable identified as a risk in one study but not hemiplegia/‘roaring’) or airway disease potentially at least, contribute further Why do horses bleed from their
the smallest vessels (the capillaries) in unlikely to be central to the problem is capillary stress failure. The interface of Consequences of EIPH
specialized cells lining the respiratory macrophages) that ‘ingest’ blood over cumulative, ultimately
leading to significant decreases in
performance. This is likely because
sample and are called following each episode), red cells are haemosiderophages. The presence and Therefore, EIPH is a serious
Blood in the air spaces is irritant and
condition in racehorses and
stimulates an inflammatory response
prevention or reduction of its
in the lung. In areas where persistent
incidence is an important issue.
The safety and welfare issues and
review of the bleeding rule.
from repeated episodes of several centres in Australia and the haemorrhage and the development of (‘bleeding’), a small percentage are Does EIPH affect performance?
the majority of fatalities are as a result most horses with blood at both
nostrils finish worse than mid-field,
and about half of these horses finish
and stumble before they ‘pull up’ or are likely to be progressive and lung
Rules regarding “bleeders” vary
There is to the author’s knowledge, no world wide from no or limited action
apparent explanation as to the rationale to banning horses from racing after
the second episode. Although
individuals may differ slightly in their opinions, overall, the parties concerned bleeder rules. Also, they appear to vary In South Africa the rule stipulates: 1st for 2 months, or start in any race for 3 training tracks for 2 months or start in a race for 6 months, and only then after is permanently banned if it suffers a 3rd The regulations for bleeders are stricter horses on the ‘bleeder list’ (a list of nostrils or in the trachea on enodscopic If the horse is observed by officials to episode-placed on ‘bleeder list’ and satisfactory gallop of at least 1,000m in If the incidence of a fatal episode of
bleeding is so low, why ban bleeders
Can bleeding be prevented
In 1998-1999 an extensive review of the bleeding rule was under-taken in pathological reactions, it is well worth rule was too harsh in light of ‘softer’ can assist in reducing the severity of
haemorrhage and therefore reduce the
requires collection of a ‘lung wash’ Australian Equine Veterinary (BAL), which is probably best Association provided an extensive scientific and statistical review of this blood and to heal. A minimum time
of 1 month is likely to be needed to
recover from a single acute episode
of EIPH. A longer period is
required in many cases where
chronic lesions are present. Despite
months of rest and treatment, some
horses do continue to bleed when
faster exercise resumes. These horses
should be and usually are retired.
the lung. Because of its diuretic effect, effects on detection of other drugs and, the fact that frusemide is not effective authorities do not allow the use of this Equine Nasal Strips have been shown
consideration of their use in training in is not currently permitted on raceday in ‘treatments’ that claim to treat bleeding alternative drugs will be developed that This article was prepared by Dr Cate
Steel, BVSc FACVSc.
References are available on request
THE SLEEP DISORDERS CLINIC Raymond Gottschalk MB ChB FRCP(C) D.ABSM Medical Director, Quality Advisor 55 FRID STREET, UNIT 7 282 LINWELL ROAD, SUITE 202 HAMILTON, ONTARIO L8P 4M3 ST. CATHARINES, ONTARIO L2N 6N5 TELEPHONE: (905) 529-2259 TELEPHONE: (905) 646-8582 FAX: (905) 529-2262 FAX: (905) 529-2262 WHAT WILL HAPPEN AFTER MY FIRST SLEEP STUDY? 1. I