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Indeed, the California Horse Racing Board has found that pre-existing pathology at the site of a fatal injury "is a reoccurring finding at necropsy, with nearly 90% of musculoskeletal racing and training fatalities showing pre-existing pathology associated with the fatal injury".
From this database, Dr Rick Arthur, the CHRB's equine medical director, has found that between85%and90%90% of all fatal musculoskeletal injuries have pre-existing pathology at the site of the fatal injury.
"If you had a horse with a certain level of pre-existing pathology in a limb, it might do better on synthetic than it would on dirt," Parkin said.
"We, in our very extensive necropsy programme in California, have identified [that] between 85% and 90% of all fatal musculoskeletal injuries have pre-existing pathology at the site of the fatal injury.
Pre-existing pathology was particularly common in the medial and lateral parasagittal grooves of the distal articular surfaces of the third metacarpus/metatarsus.
It is also possible that pre-existing pathology and vascular risk may already be present outweighing any effect related to lipids.
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Data regarding catastrophic injury occurrence in TBR focused on pre-existing pathologies as risk factors for MSI development [ 18].
Racetrack surface [ 2, 3], age [ 1, 3, 6], gender [ 1, 6, 16, 17], season [ 3, 5, 16], trainer [ 4, 5, 15- 17], pre-existing pathologies [ 18- 20], accumulation of exercise at racing speed [ 21, 22], average distance run per week [ 23, 24], laying-up periods [ 2, 22] and inter-race interval [ 2, 22] have all been studied in TBR populations, with contradictory results.
Taken together, and keeping the limitations of murine disease models in mind, our data suggests that DM in humans can accelerate the progression of a pre-existing tau pathology and exacerbate disease in patients that are predisposed to develop tau pathology.
Many of these patients are already compromised due to acquired or pre-existing pulmonary pathology, and clinical respiratory distress may be masked by concomitant respiratory support and sedation.
Even if one-third to a half of IE develop in absence of pre-existing cardiac pathology or prosthetic devices, a high suspicion for IE should be kept for septic patients with prosthetic valves, implantable devices, or known significant native valve pathology, and for ICU bacteriemic patients with unknown septic focus.
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