Adverse events of ECT
Alan Weiss in The Electroconvulsive Therapy Workbook, 2018
It is known that there is a profound physiological effect on the body after the stimulus has been delivered in ECT (Abrams, 2002). Immediately after stimulation there is a marked parasympathetic vagal outflow that can induce bradycardia, hypotension and an electrocardiac pause. It is followed by an intense sympathetic surge during the seizure that results in tachycardia, hypertension and increased myocardial oxygen consumption. Once the seizure has terminated there a rapid drop in heart rate and blood pressure (Abrams, 2002). Careful monitoring by the anaesthetist is required to ensure cardio-respiratory stability during this period. It is not uncommon for the anaesthetist to use anticholinergic agents like glycopyrrolate or atropine or a beta blocker like labetalol or esmolol pre-ECT to minimise this response.
Randomised controlled trials, other study designs and meta-studies
R. Paul Thompson, Ross E.G. Upshur in Philosophy of Medicine, 2017
As this debate illustrates well, randomisation is believed essential because it reduces – ideally eliminates – confounding. It ensures that each experimental group is equally representative of the larger population from which a random sample is drawn. As a result, the only factor that could be responsible for a difference between a group receiving an intervention and the group that is not is the intervention. If there is a third factor, or concatenation of factors, C, its effect will be distributed evenly in both groups and the intervention and control groups will manifest no difference; the intervention will be neutral (i.e. not efficacious). One potential factor believed to be an important confounder is the placebo effect. This describes a situation where experimental subjects seem to benefit from an intervention but the benefit actually derives from psychological expectations; that is, from one’s mind affecting physiological status (including the mind itself). The change in status is what the subject expects and his mind produces the expected physiological effect. Randomisation ensures that the propensity to manifest this effect is distributed equally in the two groups and blinding removes knowledge of which group is the intervention group. Blinding means that the subjects do not know whether they are receiving the intervention or not. Double-blinding means that the experimenter is also blind to which group is the intervention group.
Receptor-Ligand Interactions that are Disaproportionate With Their Physiological Effects
John C. Matthews in Fundamentals of Receptor, Enzyme, and Transport Kinetics, 2017
An often encountered example of such disproportionality is that of spare receptors. Consider a cell membrane that has receptor-gated calcium channels in it. The purpose of these channels is to permit the controlled entry of calcium into the cell cytoplasm from outside the cell. Once inside the cell, the calcium interacts with a variety of calcium receptors to initiate its physiological effect. In order for the calcium to interact with its receptors inside the cell its concentration must be elevated sufficiently to put it in the range where it can have a significant effect on fractional receptor occupancy. Let us suppose that opening half of the calcium channels will permit the entry of enough calcium in a short enough time to saturate all the calcium receptor sites inside the cell. This will produce the maximum obtainable physiological effect. If more of the calcium channels are opened by the addition of more ligand no further effect will be produced. All the receptor-gated calcium channels over 50%, in this example, are spares.
Medical Art Therapy Research Moves Forward: A Review of Clay Manipulation With Parkinson’s Disease
Published in Art Therapy, 2018
Deborah L. Elkis-Abuhoff, Morgan Gaydos
Based on the three aforementioned studies, the medical model has guided our latest research to look at the physiological impact that clay manipulation art therapy has on the brain (Elkis-Abuhoff & Gaydos, 2016). To adopt this perspective, we needed to look at PD from a neurological perspective. Because PD is a neurodegenerative disease, both psychological and physical responses and reactions are interrelated to the physiological responses in the PD brain. With the psychological and emotional impact of a diagnosis such as PD, the physiological effect is directly related to brain function. Neurologically, PD is a disorder that affects the central nervous system and the messages the body receives from the brain. The basal ganglia, consisting of the substantia nigra, which is the structure responsible for facilitating physical movement, is the place where dopamine is produced. As dopamine starts to become depleted, the body follows suit with slowing of movement and miscommunication in messages (Elbaz et al., 2016).
Effects of Citrulline Malate Supplementation on Muscle Strength in Resistance-Trained Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Published in Journal of Dietary Supplements, 2022
Andreo F. Aguiar, Juliano Casonatto
Nitric oxide (NO)-stimulating nutritional supplements are commonly advertised and marketed between athletes and amateur practitioners engaged in high-intensity exercise programs (Bloomer 2010). NO is a gaseous molecule produced at high levels in skeletal muscle (Stamler and Meissner 2001) by neuronal nitric oxide synthase (nNOS) that catalyzes the conversion of L-arginine to L-citrulline and generates the NO (Ckless et al. 2007). The main physiological effect of NO related to physical exercise is vasodilation (Joyner and Dietz 1997; Simmonds et al. 2014) and consequent increases the supply of oxygen and energy substrates to the active muscles (Joyner and Casey 2015), but it also acts in other physiological processes, including mitochondrial respiration (Poderoso et al. 2019), release of calcium from the sarcoplasmic reticulum (Heunks et al. 2001), muscle regeneration and hypertrophy (Smith et al. 2002; Aguiar et al. 2017), glucose uptake (Higaki et al. 2001; Hong et al. 2014), and muscle fatigue (Percival et al. 2010). Given these multiple physiological effects, NO-stimulating dietary supplements (e.g., citrulline and arginine) have been advocated to increase performance in high-intensity exercises (Bailey et al. 2015; Viribay et al. 2020).
Recent advances in freeze-drying: variables, cycle optimization, and innovative techniques
Published in Pharmaceutical Development and Technology, 2022
Mohammed M. Mehanna, Kawthar K. Abla
Freezing-drying is a widely used technique in the manufacturing of pharmaceutical and biomedical products such as nanoparticulate systems, vaccines, and protein formulations. However, it may result in undesired effects, as loss of biological activity or alteration of physical and chemical characteristics of the treated samples. Many variables come into play throughout lyophilization which could adversely affect product stability inducing a complex landscape of interrelated events. Therefore, many variables should be assessed and precisely controlled during the process to obtain an optimal and stable lyophilizate with high quality. These factors include the selection of formulation excipients exemplified by cryopotectants and lyoprotectants, the process and instrumental parameters like the temperature and pressure, as well as the product storage conditions. Furthermore, the attentions have been dedicated nowadays toward novel pharmaceutical FD concept, which makes it possible to move from batch to continuous manufacturing with reduced the process time as well as overall cost.
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