To examine the response of short hamstring muscles to repeated passive stretching.
A repeated measures design.
A university laboratory for human movement analysis in a department of rehabilitation.
...Students (7 men, 10 women) from the Department of Human Movement Sciences.
The lift force, range of motion, pelvic-femoral angle, first sensation of pain, and electromyogram of the hamstrings were measured.
Comparison of the data of the test group (n = 17) after five successive passive stretch tests by means of an instrumental straight-leg raising test showed no significant change of the variables passive muscle stiffness and extensibility (p>.05).
The acute effect of repeated passive stretching of short hamstring muscles is negligible. With an instrumental straight-leg raising test, the relevant muscle variables can be examined noninvasively.
Wernicke encephalopathy can have different clinical outcomes. Although infections may precipitate the encephalopathy itself, it is unknown whether infections also modify the long-term outcome in ...patients developing Korsakoff syndrome.
To determine whether markers of infection, such as white blood cell (WBC) counts and absolute neutrophil counts in the Wernicke phase, are associated with cognitive outcomes in the end-stage Korsakoff syndrome.
Retrospective, descriptive study of patients admitted to Slingedael Korsakoff Center, Rotterdam, The Netherlands. Hospital discharge letters of patients with Wernicke encephalopathy were searched for relevant data on infections present upon hospital admission. Patients were selected for further analysis if data were available on WBC counts in the Wernicke phase and at least 1 of 6 predefined neuropsychological tests on follow-up.
Infections were reported in 35 of 68 patients during the acute phase of Wernicke-Korsakoff syndrome—meningitis (1), pneumonia (14), urinary tract infections (9), acute abdominal infections (4), sepsis (5) empyema, (1) and infection “of unknown origin” (4). The neuropsychological test results showed significant lower scores on the Cambridge Cognitive Examination nonmemory section with increasing white blood cell counts (Spearman rank correlation, ρ = −0.34; 95% CI: −0.57 to −0.06; 44 patients) and on the “key search test” of the behavioral assessment of the dysexecutive syndrome with increasing absolute neutrophil counts (ρ= −0.85; 95% CI: −0.97 to −0.42; 9 patients).
Infections may be the presenting manifestation of thiamine deficiency. Patients with Wernicke-Korsakoff syndrome who suffered from an infection during the acute phase are at risk of worse neuropsychological outcomes on follow-up.
Background: Blood pressure does not reach guideline targets in the majority of hypertensive patients. Longitudinal data from general practice records on trends in hypertension management and the ...influence of guideline changes are lacking. Objective: To describe the longitudinal impact of guideline revisions on the process and outcome of hypertension management in a primary care based database. Methods: We extracted data from the Nijmegen Monitoring Project (NMP), an academic practice-based research network with 50 000 patients listed. Based on the years of publication of the first Dutch guideline on hypertension (1991) and two revisions (1997 and 2003), we formed three cohorts of patients newly diagnosed with hypertension. We compared data such as patient characteristics, 2-year blood pressure course, type of first-choice antihypertensive drugs, and number of medications after 2 years of treatment. Results: Both the mean age at time of diagnosis of hypertension and pulse pressure rose between cohorts. In agreement with revisions in the guidelines, the use of diuretics as first-choice drugs increased significantly from the first to the last cohort. The percentage of patients with three or more antihypertensive drugs remained equal. The relative 2-year systolic blood pressure decline did not differ with clinical relevance between the cohorts.
Conclusion: Our study has demonstrated that general practitioners achieve substantial and prolonged blood pressure reduction. However, guideline revisions do not seem to influence the amount of reduction, despite clear formulation of stricter treatment goals. In addition to qualitative research to identify the causes of this phenomenon, research to evaluate the effect of expert support systems on risk awareness and risk gain by additional treatment is necessary.
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