scholarly journals Increasing Muscle Extensibility: A Matter of Increasing Length or Modifying Sensation?

2010 ◽  
Vol 90 (3) ◽  
pp. 438-449 ◽  
Author(s):  
Cynthia Holzman Weppler ◽  
S. Peter Magnusson
Keyword(s):  
Clinical Practice ◽  
Viscoelastic Properties ◽  
Muscle Length ◽  
Short Term ◽  
Length Increase ◽  
Biomechanical Effect

Various theories have been proposed to explain increases in muscle extensibility observed after intermittent stretching. Most of these theories advocate a mechanical increase in length of the stretched muscle. More recently, a sensory theory has been proposed suggesting instead that increases in muscle extensibility are due to a modification of sensation only. Studies that evaluated the biomechanical effect of stretching showed that muscle length does increase during stretch application due to the viscoelastic properties of muscle. However, this length increase is transient, its magnitude and duration being dependent upon the duration and type of stretching applied. Most of these studies suggest that increases in muscle extensibility observed after a single stretching session and after short-term (3- to 8-week) stretching programs are due to modified sensation. The biomechanical effects of long-term (>8 weeks) and chronic stretching programs have not yet been evaluated. The purposes of this article are to review each of these proposed theories and to discuss the implications for research and clinical practice.

Treatment of Acute Mania

CNS Spectrums ◽  
2003 ◽  
Vol 8 (12) ◽  
pp. 917-928 ◽  
Author(s):  
Paul E. Holtzheimer ◽  
John F. Neumaier
Keyword(s):  
Clinical Practice ◽  
Side Effects ◽  
Drug Administration ◽  
Mood Stabilizers ◽  
Acute Mania ◽  
Treatment Resistant ◽  
Short Term ◽  
The Past ◽  
Term Tolerability

AbstractMood stabilizers have evolved considerably over the past decade. Lithium, divalproex, and olanzapine are currently Food and Drug Administration-approved for the treatment of acute mania. A number of new and traditional medications have also been tested and are commonly used in clinical practice. Several strategies for managing treatment-resistant mania have been suggested, but few have been rigorously tested. Emphases on rapid stabilization and fewer side effects have raised the bar for what is expected from mood stabilizers and the successful treatment of mania involves a delicate balance between swiftness, short-term tolerability, and long-term safety.

Viscoelastic Properties of Semi-Crystalline Thermoplastic Polymers: Dynamic Analysis and Creep

2012 ◽  
Vol 188 ◽  
pp. 211-218 ◽  
Author(s):  
Dan Andrei Serban ◽  
Henry Hanson ◽  
Liviu Marşavina ◽  
Vadim V. Silberschmidt
Keyword(s):  
Viscoelastic Properties ◽  
Polymeric Materials ◽  
Mechanical Analysis ◽  
External Loading ◽  
Thermoplastic Polymer ◽  
Elastic Solids ◽  
Short Term ◽  
Creep Tests ◽  
And Storage

When subjected to external loading, polymeric materials behave in a manner intermediate between elastic solids and viscous fluids. Their mechanical properties depend on a material’s viscous flow, which, in turn, is influenced by (i) temperature, with its different magnitudes determining a ductile or brittle behaviour and (ii) time, through the effect of a deformation rate and long-term relaxation. Short-term viscoelastic properties (loss and storage moduli) of a studied semi-crystalline thermoplastic polymer were obtained using Dynamic Mechanical Analysis, while its long-term viscoelastic properties (compliances) were determined using creep tests.

scholarly journals P629 Long-term effectiveness and safety of ustekinumab (UST) in patients with active Crohn’s disease (CD) in real life: Interim analysis of the SUSTAIN study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S520-S522
Author(s):  
M Chaparro ◽  
S Sulleiro ◽  
I Bastón-Rey ◽  
C Rodríguez ◽  
I García-Tercero ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Adverse Events ◽  
Predictive Factors ◽  
Cumulative Incidence ◽  
Retention Rate ◽  
Previous Surgery ◽  
Short Term ◽  
Term Benefit

Abstract Background Post-marketing data are required to confirm the durability and the long-term benefit and safety of UST in CD in clinical practice. Our aims were: (1) to evaluate the retention rate of UST in CD patients and to identify predictive factors of UST discontinuation; (2) to assess UST short-term effectiveness; (3) to analyse the durability of the response to UST in the long-term; and (4) to evaluate the safety of UST in clinical practice. Methods Retrospective, multicentre study (>60 centres). Patients with active CD [(Harvey–Bradshaw (HBI) >4)] that received at least one dose of UST intravenously before July 2018 were included. Clinical activity plus biochemical parameters were assessed at every UST administration. Clinical remission was defined as HBI score ≤4, and clinical response as a decrease in HBI ≥3 points. Loss of efficacy was defined as reappearance of symptoms that led to intensify the treatment dose, add another medication to control CD, switching or surgery in patients with short-term remission. The retention rate of UST treatment and the cumulative incidence of loss of efficacy were evaluated by survival curves, and predictive factors were assessed by Cox-regression. The short-term response was evaluated at week 8 and after the induction (week 16). Factors associated with short-term remission were assessed by multivariate analysis. Adverse events were recorded. Data quality was assured by remote monitoring. Results 331 CD patients have been included up to date (Table 1). The incidence rate of UST discontinuation was 15% per patient-year of follow-up: 8%, 13% and 20% at 6, 12 and 18 months (Figure 1). Previous surgery was the only factor associated with a higher risk of UST discontinuation [Hazard ratio (HR) = 2.03, 95% confidence interval (CI) = 1.1–3.6]. Short-term efficacy is shown in Figure 2. Previous surgery (OR = 0.3, 95% CI = 0.2–0.6) and higher HBI score at baseline (OR = 0.8, 95% CI=0.8–0.9) were associated with an impaired response to UST at week 16. The cumulative incidence of loss of response was 32% per-patient-year of follow-up (Figure 3); A higher HBI score at baseline was associated with a higher risk of losing response (HR = 1.2, 95% CI = 1.1–1.3). Neither the concomitant treatment with immunosuppressants nor the number of previous biologics were associated with UST short- and long-term benefit. Thirty adverse events were reported in 25 (7%) patients (Table 2). Conclusion Sustain is the largest real clinical practice study of UST to treat CD patients with the longest follow-up reported to date. UST was demonstrated to be effective in real-world use in the short and long run. Safety was consistent with the known profile of UST.

scholarly journals The Extent of Short-Term and Long-Term Compensation to Temperature Shown by Frog and Toad Sartorius Muscle

1984 ◽  
Vol 108 (1) ◽  
pp. 57-75 ◽  
Author(s):  
J. M. RENAUD ◽  
E. D. STEVENS
Keyword(s):  
Muscle Length ◽  
Mechanical Power ◽  
Acclimation Temperature ◽  
Sartorius Muscle ◽  
Short Term ◽  
Shortening Velocity ◽  
The Difference ◽  
Temperature Interaction ◽  
Tetanic Tension

The effect of pH at different temperatures was studied on the force-velocity characteristics of the sartorius muscle to estimate short-term compensation to temperature. The effect of thermal acclimation was also studied in order to estimate long-term compensation. A decrease in either pH or temperature reduced both tetanic tension and shortening velocity. There was a significant pH-temperature interaction for tetanic tension and for maximum mechanical power, but not for Vmax. It is shown that this pH-temperature interaction was large enough to provide a mechanism for short-term compensation only for the maximum strength (tetanic tension) in both species. Shortening velocities at small loads of the sartorius muscle of frogs and toads acclimated to 25 C were faster than those acclimated to 5 C. The difference between the two acclimation groups increased with test temperature and was almost 1 muscle length per second (m.l.s−1) at 25 C for both species. Acclimation temperature had no significant effect on tetanic tension or on maximum mechanical power at any of the test temperatures. It is proposed that the small capacity for long-term compensation in frog and toad sartorius muscles is related to the strategy employed during winter: frogs and toads hibernate.

scholarly journals Short-term weight trajectories and long-term weight outcomes from a lifestyle intervention in real-world clinical practice

2019 ◽  
Author(s):  
Robert J Romanelli ◽  
Sylvia Sudat ◽  
Qiwen Huang ◽  
Jun Ma ◽  
Elizabeth M Venditti ◽  
...  
Keyword(s):  
Weight Loss ◽  
Clinical Practice ◽  
Real World ◽  
Weight Change ◽  
Lifestyle Change ◽  
Weight Changes ◽  
Short Term ◽  
Weight Outcomes ◽  
Weight Trajectories

Abstract Centers for Disease Control and Prevention aligned lifestyle change programs are effective in promoting weight loss among those with elevated cardiometabolic risk; yet, variability in weight outcomes among participants is high. Little is known about heterogeneity of short-term weight changes among participants in real-world clinical practice. We sought to identify short-term weight trajectory clusters among lifestyle change program participants in real-world clinical practice and to examine the relationship between cluster membership and long-term weight outcomes. We identified participants from the electronic health records (2010–2017) with weight measured ≤30 days prior to program initiation (baseline) and in four intervals (3-week segments) in the 12 weeks after baseline. Clustering analysis was performed to identify distinct trajectories in percent weight change over 12 weeks. Cluster-specific differences in weight change at 12 and 52 weeks were assessed. Among 1,148 participants, across 18 clinic sites, three clusters were identified: minimal-to-no weight loss (MWL), delayed-minimal weight loss (DWL), and steady-moderate weight loss (SWL), corresponding to mean weight changes of 0.4%, −2.3%, and −4.8% at 12 weeks follow-up, respectively. Mean weight changes were 0.4%, −1.8%, and −5.1% for MWL, DWL, and SWL clusters, respectively, at 52 weeks follow-up, which correlated in direction and magnitude with short-term weight changes. Clustering analysis reveals heterogeneous, short-term weight trajectories among lifestyle change program participants in real-world clinical practice. Given the relationship between the magnitudes of short- and long-term weight change, individual participant weight trajectories may be useful in identifying potential non-responders in need of adjunctive or alternative therapy.

Re-examining the role of benzodiazepines in the treatment of schizophrenia: A systematic review

2014 ◽  
Vol 29 (2) ◽  
pp. 212-223 ◽  
Author(s):  
Faye Sim ◽  
Isabel Sweetman ◽  
Shitij Kapur ◽  
Maxine X Patel
Keyword(s):  
Clinical Practice ◽  
First Generation ◽  
Outcome Data ◽  
Short Term ◽  
Global Improvement ◽  
Conflicting Evidence ◽  
Randomised Controlled ◽  
Long Term Studies

Background Benzodiazepine prescribing for schizophrenia occurs in clinical practice and antipsychotic trials. This review examined the clinical outcomes for benzodiazepines in schizophrenia. Method A systematic search identified randomised controlled trials that evaluated benzodiazepines in comparison with placebo or antipsychotics, and also as adjuncts to antipsychotics. Relevant clinical outcome data was extracted. Results Twenty six studies were included with some reporting multiple comparisons. Seven short-term studies compared benzodiazepines with placebo: benzodiazepine superiority was found in two out of five studies for global improvements and two out of four studies for psychiatric/behavioural outcomes. Eleven studies compared benzodiazepines with first-generation antipsychotics (FGAs): four out of nine studies (including two long-term studies) reported greater global improvements for antipsychotics; four out of five studies showed no treatment differences for psychiatric/behavioural outcomes. Fourteen studies compared benzodiazepines (as adjunct to antipsychotics) vs antipsychotics alone (mostly FGAs); benzodiazepine superiority was found for global improvement in one out of eight studies and inferiority in two out of eight short-term studies whereas superiority was found for psychiatric/behavioural outcomes in three out of 12 short-term studies and inferiority in three out of 12 studies. Conclusion Benzodiazepine superiority over placebo was found for global, psychiatric and behavioural outcomes, but inferiority to antipsychotics on longer-term global outcomes. Conflicting evidence exists regarding the addition of benzodiazepines to antipsychotics; thus the use of benzodiazepines in clinical practice and antipsychotic trials should be limited.

243Reviewing electronic health records with the use of natural language processing to determine the prognostic impact of AF and anticoagulation therapy in patients undergoing PCI

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
K Dujardin ◽  
W Anne ◽  
P Pollet ◽  
W J Acou ◽  
P Galvao
Keyword(s):  
Natural Language Processing ◽  
Clinical Practice ◽  
Language Processing ◽  
Routine Clinical Practice ◽  
Short Term ◽  
Health Records ◽  
Vital Status ◽  
History Of ◽  
Long Term Mortality

Abstract Introduction Between 10-15% of patients undergoing percutaneous coronary intervention (PCI) have a history of atrial fibrillation (AF), and require both oral anticoagulant (OAC) as well as antiplatelet therapy following PCI.  However this combination puts the patient at a high risk of serious or fatal bleeding complications.  Using big data from electronic health records (EHR) provides the unique opportunity to observe to what extent AF and anticoagulant therapy affect the outcome of patients undergoing PCI in routine clinical practice. Purpose We analysed whether a history of AF and the use of OAC upon discharge was independently associated with short-term, mid-term and long-term mortality in large single institution cohort of patients undergoing PCI. Methods This retrospective EHR study was approved by the institutional review board and data privacy officer.  The study population comprised all patients undergoing either planned or urgent PCI between 2012 and 2018.  SNOMED time coded past and current medical diagnosis, procedures and drug therapy were extracted from the medical correspondence using natural language processing, procedural characteristics were obtained from the PCI database, and hospital admission data, billing cost, length of stay and vital status were added from the hospital administrative software.  Vital status was obtained in all patients. The independent predictors of mortality were analysed using a stepwise multivariate logistic linear regression analysis, with automated forward selection of variables.  For each variable the odds ratio with confidence intervals were derived from the regression model.  The validity of the model was tested with the Hosmer and Lemeshow test. Results During a 6 year period 5223 patients were identified who underwent a total of 6854 PCI’s, of which 74% were men with a median age of 71 years.  At the time of PCI, 256 patients had  AF and were not treated with OAC, 549 patients had AF and were treated with OAC, 284 patients developed AF during follow up and 5765 were in sinus rhythm. Patients with a history of AF or ensuing AF were older, more often had multivessel coronary disease, a history of CABG and MI, renal failure, diabetes mellitus and a lower ejection fraction. AF was found to be a strong independent predictor of mortality at 30 days (OR: 2,8), 120 days (OR: 2), 1 year (OR: 1,9) and 5 years (OR: 1,7) following PCI. By contrast OAC was associated with lower odds ratios of mortality at 30 days (OR: 0,4), 120 days (OR: 0,4), 1 year (OR: 0,7) and 5 years (OR: 0,7).  Also the occurence of AF post PCI was linked with an increased mortality Conclusions In this large data set of patients undergoing PCI in routine clinical practice, a history of AF was independently associated with increased short-term, mid-term and long-term mortality. On the other hand, OAC was associated with improved short-term, mid-term and long-term mortality survival following PCI. Abstract Figure.

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