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Cibadrex (Hydrochlorothiazide)

In the group given placebo and Cibadrex, the mean systolic and diastolic blood pressures were significantly reduced in the standing and sitting positions at month 1 and in the standing, sitting, and supine positions at month 4. The authors report here on their personal series of four cases of drug-induced acute pancreatitis (warfarin, lysinopril/Cibadrex, lamivudine/stavudine/indinavir, valproic acid), focusing on a number of epidemiological and clinical aspects.

Other names for this medication:
Hydrochlorothiazide, Microzide, Acortiz, Acuren, Adelphan, Aldoril, Amiloretic, Aquazide, Berlipril, Byol, Cibadrex, Cilazil, Elektra, Emcoretic, Epratenz, Eprosartan, Esidrex, Esidrix, Fosicombi, Fosinopril, Lisoretic, Lodoz, Lorzaar, Olina, Oretic, Quinaretic, Renacor, Renezide, Ridaq, Rofucal, Turfa, Uniretic, Vaseretic, Ziak, Zofenilduo, Zoprazide,

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Rotec, Valtrex, Quetiazic, Gastracid, Hasitec, Omastin, Oxcarbazepin, Caditar, Vikrol, Aricept, Nasida, Rapidus, Klabax, Tenofovir, Paxil, Flogozan, Velafax, Anavan, Glipizida, Lansoprazole, Danovir, Resilo, Cabgolin, Flamatak, Rabeprazol, Ulceran, Acivision, Dicogel, Hypace,

Cibadrex is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Cibadrex is also used to treat fluid retention (edema) that is caused by congestive heart failure, severe liver disease (cirrhosis), kidney disease, or treatment with a steroid or hormone medicine.

Cibadrex is a thiazide diuretic (water pill). It is used to help reduce the amount of water in the body by increasing the flow of urine. It may also be used for other conditions as determined by your doctor.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Capsule
  • Tablet

cibadrex information

Multisolute, overloaded band profiles were also measured for the three binaries and for mixtures of the three drugs. In every carrier, another population of non-selected spermatozoa was also analysed with the aim of defining the general segregation outcome of each reorganization event.

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Different biological situations such as cell specialization, neoplastic transformation and life cycles have been examined choosing some typical models (hepatocytes, nucleated erythrocytes, lymphocytes, endometrial cells). Newcastle disease virus (NDV) strains interfere in different degree with the growth of the velogenic NDV strain Texas GB (homologous interference) and Sindbis virus (heterologous interference) in chick embryo fibroblast cells. The alpha-keto acids did not affect the electrochemical proton gradient across the membrane, suggesting that they interact directly with the vesicular glutamate carrier. Despite these efforts, a substantial minority remains of patients with IHD who are not treated with guideline-recommended therapies. In addition a sustained increase in GABA-T and GAD activity was observed.

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Management of atrophic maxilla in severe osteoporosis treated with bisphosphonates: a case report. Mesoporous silica nanotubes hybrid membranes for functional nanofiltration. In contrast, as expected, emotional disturbances were associated with patterns of hemispheric lateralization. Striatal volumes and dyskinetic movements in youth at high-risk for psychosis. To evaluate the efficacy of an advanced rotation/oscillation power toothbrush (Oral-B Triumph with SmartGuide) relative to a new sonic power toothbrush (Sonicare DiamondClean) in the reduction of gingivitis and plaque over a period of 12 weeks.

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Endocrine gland-derived vascular endothelial growth factor in rat pancreas: genetic expression and testosterone regulation. Median barrier is used to prevent cross-median crashes on divided highways. Both inhibitors significantly reduced decidualization validating the role of activin, but potentially also other TGFbeta members, during decidualization. Since the response of the detector differs for each constituent, it is necessary to use a previously prepared calibration curve for each one. Total RNA was isolated and mRNA was measured by quantitative real-time RT-PCR.

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Based on these data, we predicted scenarios in which species with different morphologies but similar KT (MTOM species) would produce transgressive function in hybrids. Oral bisphosphonates and dental implants: a retrospective study. Indoor exposures occurred for all day care centers regardless of socio-economic levels. Effect of phenobarbital on hepatocyte proliferation in rats following partial hepatectomy. Isolated glenohumeral range of motion, excluding side-to-side difference in humeral retroversion, in asymptomatic high-school baseball players.

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The possible mechanism for hydrocephalus is discussed and the literature reviewed. Communication and mental preparation issues for the epilepsy surgery patient.

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The affinity constants (Kaff ) of the MAbs 3G6, 5C7, and 5H3 were measured by non-competitive ELISA respectively. We studied the effect of JS-K on angiogenesis in human umbilical vein endothelial cells (HUVECs), OPM1 multiple myeloma cells, chick aortic rings and in mice. Interestingly, dazl expression increases in early oocytes and concentrates in a perinuclear speckle that appears to develop ultimately into the Balbiani body in advanced oocytes. Adult hens exhibit smaller accumulations, mainly in the neighborhood of leptomeric complexes. These data suggest that in sheep, as in other species, leptin production is correlated with the mass of adipose tissue and that the hormone passes from the circulation to the cerebrospinal fluid and then to hypothalamic sites.

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In addition, we observed increased expression of the Notch target protein, hairy enhancer of split homolog-1 in glomeruli of these animals. K-Stimulated acetylcholine release: inhibition by several barbiturates and chloral hydrate but not by ethanol, chlordiazepoxide or 11-OH-delta9-tetrahydrocannabinol.

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Electron back-scattering diffraction appears to be a reliable method for determining phyllosilicate lattice preferred orientations in deformed rocks, with potential applications for determining anisotropy of properties like seismic velocities or thermal and electrical conductivities. During free recall, individuals often recall semantically related items consecutively--an effect termed semantic clustering--and previous studies have sought to understand clustering to gain leverage on the basic mechanisms supporting strategic recall. A study of central hemodynamic parameters, ECG charting and the activity of serum CPK and its MB fraction in 58 patients with acute myocardial infarction demonstrated that intravenous administration of 20 mg Corvaton, at the rate of 3 micrograms/kg/min, was effective for both controlling an acute left-ventricular failure, and limiting the infarcted area. High order accuracy is achieved with fewer stages than standard explicit Runge-Kutta schemes.

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A new profession with future possibilities: veterinary practitioner Rabies isolates (genotype 1 lyssaviruses) from vaccinated dogs that died of rabies infection in the Plateau area of Nigeria were characterized using monoclonal antibodies (MAbs). A new self-expandable nitinol stent for the treatment of wide-neck aneurysms: initial clinical experience. The role of diagnostic laparoscopy in periampullary and pancreatic cancers. Stage 1: The safety and ability of the device to penetrate the chest wall and the ease of use were evaluated in patients undergoing thoracoscopic procedures by introducing the device at a second port site under vision.

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The current study was undertaken to evaluate the presentation and perioperative risk associated with transsphenoidal surgery in patients over the age of 70. In this paper, based on the observation that noise in fMRI is long memory fractional noise and the slowly varying drift resides in a subspace spanned only by large scale wavelets, we examine a modified general linear model (GLM) in wavelet domain under Bayesian framework. Hepatobiliary and pancreatic: computed tomography in liver disease.

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An explanation of the observed signal in terms of near two photon resonant difference four-wave mixing is proposed. The furosemide wash-out pyelogram and the furosemide radioisotope renogram in the diagnosis of renovascular hypertension (preliminary report). Pollution by pesticides, surfactants, aromatic polycyclic hydrocarbons, oil waste products, phenolics, radioactive isotopes etc., is requiring particular concern.

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Light and electron microscope studies demonstrate occlusion of the microcirculation of lungs and livers by fibrin. Blood tests and health survey of students from a private university in Fukuoka City

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cibadrex information

No evidence of an effect of frequency of limb movement on breathing pattern in submaximal exercise has been found. Out-patient ERCP patients were followed up at 30 days using standard criteria for defining complications.

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The endogenous mitochondrial complex II inhibitor malonate regulates mitochondrial ATP-sensitive potassium channels: implications for ischemic preconditioning. Neurogenic mechanisms in the evolution of cerebral circulatory insufficiency. In patients with carpal tunnel syndrome there was some reduction in amplitude and velocity of the digital potential, but the changes were more marked at the wrist. Structures of metabolites of osthole were elucidated by comparing fragment pattern under MS/MS scan and change of molecular weight with those of osthole. Expression of NF-E2-related factor 2 (Nrf2) in the basilar artery after experimental subarachnoid hemorrhage in rabbits: a preliminary study.

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Patch clamping refers to a wide range of electrophysiological measurements, all of which have in common the use of patch pipets and the formation of gigaohm seals. Some peptides containing or made up of basic or acidic amino acid residues appear to have a low affinity for the transport system used by glycylsarcosylsarcosine. Previous studies on a variety of organs indicate that hydrogen-rich saline not only has considerable antioxidant and anti-inflammatory properties, but also suppresses oxidative stress-induced injury.

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Open reduction demonstrated a fresh dislocation which could not be reduced until the subscapularis muscle was divided. Tetracyclines can protect the cornea against proteolytic degradation after moderate to severe ocular chemical injury. Muscular ventricular septal defects (VSD) located below the trabecula saepto-marginalis are difficult to approach for surgical closure through the tricuspid valve. The shift in the myocardial adenine nucleotide translocator isoform expression pattern is associated with an enteroviral infection in the absence of an active T-cell dependent immune response in human inflammatory heart disease. This is the first attempt to successfully combine cytoreductive surgery with intensity modulated radiation therapy and stereotactic body radiation therapy together to treat solitary fibrous tumor of the nasal and paranasal area, which may provide a potential strategy for the treatment of similar cases.

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In the current study, we assessed the effects of two AT1-receptor blockers (ARB) on AT1- and AT2-receptors and ACE densities and salt-induced cardiovascular changes. In all systems examined, HUK 978 was more potent than cimetidine and ranitidine both intravenously and orally. HYPOTHERMIA: Both local (head cooling) or systemic (whole body) hypothermia have a neuroprotective effect in selected newborns with HIE.

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Free bradyzoites isolated after lysis of the cell wall did not proliferate in vitro when the cyst was treated with FR235222. Permeation of sugars through contraluminal membranes of mucosa cells in the small intestine

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National recommendations to standardize case definitions and other data elements might help jurisdictions developing new animal bite or PEP reporting systems. P123-assisted hydrothermal synthesis and characterization of rectangular parallelepiped and hexagonal prism single-crystalline mgo with three-dimensional wormholelike mesopores. However, some hormonal effect other than that of the parathyroid hormone on the systemic and pulmonary circulation might be related to the early progression in cusp calcification in the systemic circulation. An 81/2-year-old female domestic short-haired cat was admitted with signs of chronic cystitis. Much attention has been paid to the problem of estimating the pharmacokinetic parameters of individual patients in order to optimize dosage choices.

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PPTg and STN DBS were associated with changes in spatio-temporal and kinematics variables. elegans and Staphylococcus epidermidis were identified in bacterial cultures from wound aspirates. Yield of ischaemic exercise electrocardiograms in relation to exercise intensity in a normal population. What motivates employes: recognition, reward, supervision and challenge. Results showed less word-by-word agreement than might have been expected, although intercorrelations among observers for total number of words marked as stuttering was high, as is usually found.

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Ipsilateral hippocampal volume was significantly correlated with both early neurodevelopmental features (age of seizure onset) and disease characteristics (duration of epilepsy), whereas thalamus integrity was related only to disease variables. 1-Methyl-1,2,3,4-tetrahydroisoquinoline (1MeTIQ) is an endogenous substance which exhibits neuroprotective, antiaddictive and monoamine oxidase (MAO)-inhibiting properties. Loperamide in concentrations ranging from 10(-7) M inhibited the cholinergic, contractile responses induced by electrical transmural stimulation, nicotine and serotonin, and the nonadrenergic, relaxing responses induced by electrical transmural stimulation and nicotine. Cases of intracerebral hemorrhage occurring in unusual clinical contexts suggest a causal role for sudden increases in blood pressure and/or cerebral blood flow.

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A prospective study with 125I fibrinogentest and pulmonary scintigraphy. Distribution and binding of glycosaminoglycan polysulfate to intervertebral disc, knee joint articular cartilage and meniscus.

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Kallikrein activity and non-specific esterolytic activity of proteases in experimental hemorrhagic shock of varying duration and depth These MAbs can be used to characterize phenotypic profiles of monocytes/macrophages to gain insight into their developmental and activation status. The behavior of serum enzymes in progressive muscle dystrophies and progressive muscle atrophies Our preliminary data suggest that osteitis is related to severe synovitis. Rectal obstruction is most commonly due to primary adenocarcinoma.

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Stretchable photonic crystal cavity with wide frequency tunability. Purine synthesis was inhibited drastically by brusatol in vivo, and one key inhibition site in purine synthesis was at phosphoribosyl pyrophosphate aminotransferase, the regulatory enzyme. Twelve adult rabbits were used to study radiation-induced changes in the urinary bladder by angiographic, microangiographic, light microscopic and scanning electron microscopic methods. In our study it was the ratio of A to B1 phylo-groups that changed.

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Some recent biochemical data on women with late toxemias and their children Translocation of cadmium from cytosol to membrane fraction in cadmium-loaded red blood cells of rats. In the dose range from 50 to 300 mg/kg, piracetam improved the avoidance performance of both types and produced a dose-dependent increase in the TER amplitude, but did not affect the behavior of rats in conflict situations. The compound was found to be a new peptide antibiotic containing 2,4-diaminobutyric acid (Dab), leucine, isoleucine, phenylalanine, valine, serine (in a molar ratio of 3:2:1:1:1:1) and a fatty acid.

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The current study employs proteomic analysis to examine for a potential endometrial defect in obese and overweight women with recurrent miscarriage. Recommendations to increase the use of generic medicines in France round off this perspective paper. Accumulation of sMICA in serum may lead to the down-modulation of NKG2D-expressing NK which has been proposed to be a novel mechanism used by cancer cells to evade the tumor immunosurveillance. Glomerular involvement due to cryoglobulins preceded the development of diabetic glomerulosclerosis in one patient. Structural comparison of gamma-carboxymuconolactone decarboxylase and muconolactone isomerase from Pseudomonas putida.

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The recent description of the placenta as a tissue rich in haematopoietic stem and progenitor cells has not only opened up a whole new line of investigation into how haematopoiesis is regulated in this unique mammalian tissue, but has also resulted in the revisiting of long-standing and yet unanswered questions about the significance of having multiple haematopoietic organs during development. We report two cases of a ruptured internal carotid-posterior communicating artery aneurysm in which the ipsilateral posterior communicating artery is short and the P1 and P2 segments of the posterior cerebral artery are long. In this review, we discuss the endocytic entry processes used by viruses and bacteria and compare the strategies used by these dissimilar classes of pathogens.

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The purpose of this study was to assess the validity and reliability of the Persian version of SCIQL-23 in individuals with chronic SCI. Cytokines are heterogeneous group of proteins that are produced by a wide variety of cells in the body and act as signals between the cells of the immune system. High surgical burden for infants with severe chronic lung disease (sCLD). We have tested multiple cell culture parameters including coating substrates, culture medium, XF24 microplate plastics, and plating techniques in order to optimize plating conditions. Biologic therapies were introduced as a new option for patients with uveitis refractory to the conventional therapy using corticosteroids and immunosuppressive agents, and 10 years have passed since the initiation.

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The ACT II/ecarin clotting time with an ecarin concentration of 5 U/mL is a simple and reliable assay for monitoring recombinant hirudin during cardiopulmonary bypass. Recently, we showed that gallbladder distension in anesthetized pigs reflexly increased heart rate, arterial pressure, and coronary and renal vascular resistance through efferent sympathetic mechanisms. Intrauterine infection induces programmed cell death in rabbit periventricular white matter. Moreover, this pathogen is able to adapt to many plants as supported by field observations reporting emergence of strains with enlarged pathogenic properties.

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Are cancer registries a viable tool for cancer survivor outreach? LupusQoL-US benchmarks for US patients with systemic lupus erythematosus. Obesity and increased burden of hip and knee joint disease in Australia: results from a national survey.

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A referral-based MTM clinic managed by pharmacists at a university medical center outpatient pharmacy provides care to patients with the goal of improving medication access, medication adherence, continuity of care, medication therapy management, and patient education. A Melanophore-Based Screening Assay for Erythropoietin Receptors. Accompanying these protocols are methods for removing unincorporated dNTP precursors with spin columns and for measuring the specific activity of a probe by acid precipitation. The influence of magnesium stearate on the flow properties of lactose powder.

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We further found that leptin levels were associated with changes in serum OC. Term encephalopathic infants, with or without seizures, admitted to a level III NICU were included in this study. Here, we survey the current status of operon prediction methods.

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Balancing provision of education and service needs--is there a way? Thirty-three subjects underwent complete cardiovascular screening, carotid hemodynamic evaluation and dental inspection. Ovarian sections were evaluated under a transmission electron microscope (TEM) Zeiss EM 900. Vital CPM of peripheral blood immunocompetent cells may be used for the early diagnosis and prediction of CTN development. The results show that, during dimethyl sulfoxide-stimulated differentiation, transcription of alpha and beta major globin increases 15-25-fold, whereas beta minor globin transcription is not increased.

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Enhanced anti-tumor effects achieved in a murine tumor model using combination therapy of recombinant human manganese superoxide dismutase and adriamycin. The results showed a significant response specificity in migraine patients with respect to peripheral resistance. These barriers to care include societal attitudes towards death, diversity issues, socioeconomic issues, and eligibility issues. In two patients, death occurred ten and 30 days after shunting due to thrombosis of the graft. Clinical studies with sequential analysis of tumour material are needed to enhance our understanding of inter-clonal functional relationships and tumour evolution during therapy, and to improve drug development strategies in cancer medicine.

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However, the increasing waiting times on cadaveric waiting list and the superiority of the results of live donation versus cadaveric kidney transplantation have led to a reappraisal of this strategy. We also discuss specific details of trial execution, in particular randomization, blinded outcome adjudication and analysis of the results, which are key to avoiding bias in the design and interpretation of such trials. Pseudovital hemorrhage in the cervical region after thoracic compression

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Diagnosis and management of neuropathic pain in palliative care. There is evidence of an inverse association between cerebral infarction and tinnitus in this study. Because of simplicity in its computation and interpretation, the GNHP can be used by health systems agencies (HSAs) in monitoring their performance or in conducting comparative studies. The relevance of this finding may rest on the observed involvement of cytoskeletal organization in such events as neuronal plasticity, cognitive function and also neurodegenerative disorders in which neurosteroids have been shown to have a part.

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No significant reduction in susceptibility to either compound was detected for up to five generations. This regression was documented by serial roentgenograms of the chest, studies of pulmonary function, and bronchoscopic procedures with mucosal biopsies. The ReSense evaluation tool measures the ability to perceive and recognize texture and spatial properties of specific elements. This study was planned to determine CGRP levels in women with polycystic ovary syndrome (PCOS).

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If surgical options are delayed then manual detorsion should be attempted. Two step screening model combining highly sensitive low cost test like VIA for primary screening followed by more specific HPV DNA test as triage test for primary screen positive can be a cost-effective cervical screening strategy in resource constrained settings. The clinical course of thyroid cancer following its combined treatment with the use of fast-neutron therapy in the patients at the high risk of relapses

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Total RNA was extracted from different concentrations of ejaculated or epididymal sperm cells and after synthesis of complementary DNA was subjected to PCR amplification. Here we provide the first description of the mechanism of yolk internalization in non-avian reptiles. Luciferase reporter assay showed that HMGB2 promoter activity was inversely correlated with the amount p53 cotransfected.

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It was previously shown that parameter identification can be performed as an optimization based on the decoupling of the differential S-system equations, which results in flutamide package insert pdf to powerpoint a set of algebraic equations. Toll-like receptor 4 (TLR4) plays an important role in innate immunity.

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The transcription and protein levels of EMT markers harga actos pioglitazone hcl and transcription factors were evaluated by reverse transcription-PCR and Western blot analysis, respectively. Compared with parental NKL cells, hIL-15 gene modification promoted NK cell proliferation at low doses of IL-2 and inhibited cell apoptosis, which was associated with the up-regulation of anti-apoptosis genes Bcl-2, Bcl-xl and Mcl-1 as well as the down-regulation of apoptosis genes Bim and Noxa. This is a compact visual description of a combination of surgical technique and device for the delivery of (gene and cell) therapies into the spinal cord. Sleep impairment is very common in AR patients and has a significant impact on disease-specific measures of general health and quality of life.

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A laser-modified centrifugal analyzer was lodipine 5 mg used to develop kinetic light scattering methods for the measurement of human immunoglobulins IgG, IgA, and IgM. Synaptic boutons and neuron-like cells in isolated adrenal gland cultures. The mainstay of evaluating urinary tract infections in children has been physical examination, urinalysis and culture, and renal and bladder sonography and contrast cystography. The engineering feasibility has been realized in the SpectraCube system from Applied Spectral Imaging Inc., and it allows the simultaneous identification of all 24 human chromosomes.

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The erythrocyte sedimentation rate (ESR) is the most frequently employed laboratory indicator of inflammatory activity. Overnight orthokeratology is an effective means atorvastatin tablets 10mg side effects of temporarily reducing myopia. In brain, the activity of both enzymes was in the same range in homogenate and in microsomes.

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This method is also amenable to the simultaneous extraction of cell-free RNA from many different samples, by use of the QIAGEN Vacuum Manifold QIAvac 24 Plus. Accurate mass measurements and mass analyzed ion kinetic energy spectrometry confirmed fragmentation patterns. A truer measure of the impact of the INT is in terms of the ideas that now form the mainstay of immunological research and whose roots are spawned from the promise syp augmentin dose for sinusitis of the anti-idiotype concept.

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Because homocysteine (Hcy), a sulfur-containing amino acid, is emerging as an important risk factor for atherosclerosis in patients with end-stage renal disease, we examined the significance of serum Hcy levels in diabetic patients on HD. We investigate the performance of phylogenetic mixture models in reducing a well-known and pervasive artifact of phylogenetic inference known as the node-density effect, comparing them to partitioned analyses of the same data. Effects of C358A missense polymorphism of the endocannabinoid degrading enzyme fatty acid amide hydrolase on weight loss after a hypocaloric diet. Histologically, parosteal osteosarcomas are usually low-grade, while periosteal and high-grade surface osteosarcomas are generally high-grade tumors and have worse prognoses. Fifteen patients who had undergone epilepsy surgery for intractable OLE and had undergone interictal Fluorine-18-fluorodeoxyglucose positron-emission dicloflam gel polish tomography ((18)F-FDG-PET) between 1994 and 2004 were divided into two groups (with and without automatisms during seizure).

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Two assays are described for the quantitation of why weren the star wars movies made in order TGF-beta activity in supernatant fluids. All patients were classified into the disease-free or active disease group, based on their medical records at the end of the follow-up period. To analyse in the general population the prevalence and predictors of symptomatology consistent with post-traumatic stress disorder (S-PTSD) 18 months after an industrial explosion.

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Diagnosis of pancreaticobiliary malignancy by detection of minichromosome maintenance protein 5 in bile aspirates. Several lines of evidence support an autoimmune basis for alopecia areata (AA), a common putative autoimmune hair loss hotel flexen zurs review of related disorder. To maintain enthusiasm, successful introduction will depend on the issues of support and resources. Recent studies of a myriad of eukaryotic organisms have defined both the regulation and substrates of Cdc7p kinase, which forms a CDK-cyclin-like complex with Dbf4p, is necessary for the initiation of DNA replication and has been conserved in evolution. Attempt of musico-therapy and readaptation in a psychiatric hospital

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Using five years of historical notification data, two binomial thresholds were determined for each primary health care facility in the highest malaria risk area of Mpumalanga province. p53 gabapentin 50 mg for cats is an important transcription factor contributing to cell cycle arrest and apoptosis after cell damage through the regulation of numerous target genes. In vitro antiviral properties of endotoxin-activated rat Kupffer cells.

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These, in turn, render the industry a difficult arena within which to enact structural and cultural change. The improved protocol reduces redundancy between amplified cDNA subsets, which leads to a lower number of bands per lane of the differential display gel, and therefore simplifies analysis. These can ativan cause neuroleptic malignant syndrome symptoms two series conductances were represented in a single, total conductance (htot). The uptake of gallium citrate Ga67 and ferrous citrate Fe59 was studied in pregnant rats with or without a 4-dimethylamino-stilben(DS)-induced sarcoma tumor.

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Two of the fragments (E8 and E9) possess in addition globular domains which lack alpha-helices. Utilization of potential energy accumulated during extension of the rozex gel cmit contracted muscle