Lower Extremity Passive Range of Motion in Community-Ambulating Stroke Survivors

Background: Physical therapists may prescribe stretching exercises for individuals with stroke to improve joint integrity and to reduce the risk of secondary musculoskeletal impairment. While deficits in passive range of motion (PROM) exist in stroke survivors with severe hemiparesis and spasticity, the extent to which impaired lower extremity PROM occurs in community-ambulating stroke survivors remains unclear. This study compared lower extremity PROM in able-bodied individuals and independent community-ambulatory stroke survivors with residual stroke-related neuromuscular impairments. Our hypothesis was that the stroke group would show decreased lower extremity PROM in the paretic but not the nonparetic side and that decreased PROM would be associated with increased muscle stiffness and decreased muscle length. Methods: Individuals with chronic poststroke hemiparesis who reported the ability to ambulate independently in the community (n = 17) and age-matched control subjects (n = 15) participated. PROM during slow (5 degrees/sec) hip extension, hip flexion, and ankle dorsiflexion was examined bilaterally using a dynamometer that measured joint position and torque. The maximum angular position of the joint (ANGmax), torque required to achieve ANGmax (Tmax), and mean joint stiffness (K) were measured. Comparisons were made between able-bodied and paretic and able-bodied and nonparetic limbs. Results: Contrary to our expectations, between-group differences in ANGmax were observed only during hip extension in which ANGmax was greater bilaterally in people post-stroke compared to control subjects (P ≤ 0.05; stroke = 13 degrees, able-bodied = −1 degree). Tmax, but not K, was also significantly higher during passive hip extension in paretic and nonparetic limbs compared to control limbs (P ≤ 0.05; stroke = 40 Nm, able-bodied = 29 Nm). Compared to the control group, Tmax was increased during hip flexion in the paretic and nonparetic limbs of post-stroke subjects (P ≤ 0.05, stroke = 25 Nm, able-bodied = 18 Nm). K in the nonparetic leg was also increased during hip flexion (P ≤ 0.05, nonparetic = 0.52 Nm/degree, able-bodied = 0.37 Nm/degree.) Conclusion: This study demonstrates that community-ambulating stroke survivors with residual neuromuscular impairments do not have decreased lower extremity PROM caused by increased muscle stiffness or decreased muscle length. In fact, the population of stroke survivors examined here appears to have more hip extension PROM than age-matched able-bodied individuals. The clinical implications of these data are important and suggest that lower extremity PROM may not interfere with mobility in community-ambulating stroke survivors. Hence, physical therapists may choose to recommend activities other than stretching exercises for stroke survivors who are or will become independent community ambulators

{5-Methyl-1-[8-(trifluoro­meth­yl)quinolin-4-yl]-1H-1,2,3-triazol-4-yl}(morpholino)methanone

In the title mol­ecule, C18H16F3N5O2, the dihedral angle between the pyridine ring and the fused benzene ring is 4.50 (10)°. The triazole ring makes dihedral angles of 54.48 (12) and 57.91 (11)° with the pyridine and benzene rings, respectively. The morpholine ring atoms are disordered over two positions; the site-occupancy factors are ca 0.53 and 0.47. Inter­molecular C—H⋯F hydrogen bonding is found in the crystal structure. Furthermore, C—H⋯O and C—H⋯N intra­molecular contacts are also present

EVALUATION OF METHANOLIC EXTRACT OF EUPHORBIA NERIIFOLIA STEM BARK ON BLOOD SUGAR LEVELS, SERUM AND TISSUE LIPIDS IN A PRECLINICAL MODEL

Objective: The present study is undertaken to evaluate the effect of Euphorbia neriifolia stem bark on blood glucose and lipid levels in experimental diabetic rats. Methods: Methanolic extract of Euphorbia neriifolia stem bark (MEEN) was administered at different doses and its effect on blood glucose, haemoglobin, serum and tissue lipids, hexokinase and glucose-6-phosphatase in streptozotocin-induced diabetic rats were studied. Glibenclamide was used as standard reference drug. Results: Euphorbia neriifolia methanolic extract (MEEN), at doses of 100,200 and 400mg/kg body weight for 30 days, suppressed the elevated blood glucose and lipid levels in diabetic rats. Euphorbia neriifolia at 400mg/kg was found to be comparable to glibenclamide. Conclusion: The study indicates that the Euphorbia neriifolia possess antihyperlipidaemic effect as well as antidiabetic activity.                                 Peer Review History: Received 19 June 2017;   Revised 25 June; Accepted 1 July, Available online 15 July 2017 Academic Editor: Dr. Asia Selman Abdullah, Al-Razi university, Department of Pharmacy, Yemen, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:        Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Dr. Mohamed Derbali, Faculty of Pharmacy, Monastir, Tunisia, [email protected] Dr. Sabah Hussien El-Ghaiesh, Tanta University, Egypt, [email protected] Similar Articles: EVALUATION OF ANTIDIABETIC DRUG ALOGLIPTIN FOR THE TREATMENT OF INFLAMMATION IN RATS IN -VIVO ANTI-DIARRHOEAL ACTIVITY OF METHANOL EXTRACT OF BOMBAX BUONOPOZENSE PHYTOCHEMICAL SCREENING AND IN-VITRO ANTIOXIDANT AND ANTI-INFLAMMATORY POTENTIAL EVALUATIONS OF METHANOLIC EXTRACTS OF COCOS NUCIFERA (L.) LEAVE

The utility of implantable loop recorders in patient management: an age- and indication-stratified study in the outpatient-implant era

INTRODUCTION: Implantable loop recorders (ILR) are now routinely implanted for long-term cardiac monitoring in the clinic setting. This study examined the real-world performance of these devices, focusing on the management decision changes made in response to ILR-recorded data. METHODS AND RESULTS: This was a single centre, prospective observational study of consecutive patients undergoing ILR implantation. All patients who underwent implantation of a Medtronic Reveal LINQ device from September 2017 to June 2019 at Barts Heart Centre were included.501 patients were included. 302 (60%) patients underwent ILR implantation for an indication of pre-syncope/syncope, 96 (19%) for palpitations, 72 (14%) for atrial fibrillation (AF) detection with a history of cryptogenic stroke and 31 (6%) for patients deemed to be high risk of serious cardiac arrhythmia.The primary outcome of this study was that an ILR-derived diagnosis altered management in 110 (22%) of patients. Secondary outcomes concerned sub-group analyses by indication: in patients who presented with syncope/presyncope, a change in management resulting from ILR data was positively associated with age (HR: 1.04 [95%CI 1.02-1.06]; p < 0.001) and negatively associated with a normal ECG at baseline (HR 0.54 [0.31-0.93]; p = 0.03). Few patients (1/57, 2%) aged < 40 years in this group underwent device implantation, compared to 19/62 patients (31%) aged 75 years and over (p = 0.0024). 22/183 (12%) of patients in the 40-74 age range had a device implanted.In patients who underwent ILR insertion following cryptogenic stroke, 13/72 patients (18%) had AF detected leading to a decision to commence anticoagulation. CONCLUSION: These results inform the utility of ILR in the clinical setting. Diagnoses provided by ILR that lead to changes in management are rare in patients under age 40, particularly following syncope, presyncope or palpitations. In older patients new diagnoses are frequently made and trigger important changes in treatment

A simple method for determination of plasma and urinary biotin

Measurement of biotin in plasma and urine has been stimulated by recent descriptions of inborn errors of biotin metabolism and by newly recognized causes of biotin deficiency. Biotin determination in physiologic fluids to document these conditions has been hindered by lack of a widely useable assay. This paper presents a method which employs tritium-labelled biotin, avidin, and nitrocellulose filters to measure urinary and plasma biotin in a rapid and simple manner.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23871/1/0000110.pd