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The objective was to investigate the effects of functional (FT) and traditional (TT) training on trunk muscles maximal isometric strength, rate of force development and endurance with trained elderly women. Forty-five elderly women were directed into three groups: FT (n =1 6), TT (n = 14) and Control (n = 15). The FT (multi-planar, and multi-articular movements) and TT (primarily machine-based resistance exercises) performed mobility, muscle strength and power exercises. Both training groups also performed intermittent cardiometabolic activities. The maximum strength and endurance of the trunk muscles were verified, both at baseline and after 12 weeks of training (3xweek for 50 min each). Data were analyzed using a 2-way ANCOVA with contrast of adjusted mean values. FT significantly increased all variables: maximum trunk flexor strength (p = 0.002, 22%); rate of flexor force development (p = 0.001, 84%); trunk extensors maximal strength (p = 0.003, 17%); trunk extensor rate of force development (p = 0.05, 16%); trunk flexors (p = 0.001, 19%) and extensors (p = 0.017, 13%) endurance compared to baseline. TT showed an increase only in RFD of trunk extensors (p = 0.003, 53%), and flexors (p = 0.033, 42%), and trunk flexors endurance (p = 0.008, 11%). However, there was no statistically significant difference between groups. FT promoted improvement in all variables; strength, endurance and rate of force development of the trunk flexors and extensors of the elderly. On the other hand, TT improved only the rate of force development of trunk flexors and extensors and endurance of the trunk flexors. FT is recommended for elderly women as it improves a broader array of physiological parameters.

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CONTEXT: The National Athletic Trainers' Association position statement on acute management of the cervical spine-injured athlete recommended the all-or-nothing endeavor, which involves removing or not removing both helmet and shoulder pads, from equipment-laden American football and ice hockey athletes. However, in supporting research, investigators have not considered alternative protocols. OBJECTIVE: To measure cervical spine movement (head relative to sternum) produced when certified athletic trainers (ATs) use the all-or-nothing endeavor and to compare these findings with the movement produced using an alternative pack-and-fill protocol, which involves packing the area under and around the cervical neck and head with rolled towels. DESIGN: Crossover study. SETTING: Movement analysis laboratory. PATIENTS OR OTHER PARTICIPANTS: Eight male collegiate football players (age = 21.4 ± 1.4 years; height = 1.87 ± 0.02 m; mass = 103.6 ± 12.5 kg). INTERVENTION(S): Four ATs removed equipment under 4 conditions: removal of helmet only followed by placing the head on the ground (H), removal of the helmet only followed by pack-and-fill (HP), removal of the helmet and shoulder pads followed by placing the head on the ground (HS), and removal of the helmet and shoulder pads followed by pack-and-fill (HSP). Motion capture was used to track the movement of the head with respect to the sternum during equipment removal. MAIN OUTCOME MEASURE(S): We measured head movement relative to sternum movement (translations and rotations). We used 4 × 4 analyses of variance with repeated measures to compare discrete motion variables (changes in position and total excursions) among protocols and ATs. RESULTS: Protocol HP resulted in a 0.1 ± 0.6 cm rise in head position compared with a 1.4 ± 0.3 cm drop with protocol HS (P < .001). Protocol HP produced 4.9° less total angular excursion (P < .001) and 2.1 cm less total vertical excursion (P < .001) than protocol HS. CONCLUSIONS: The pack-and-fill protocol was more effective than shoulder pad removal in minimizing cervical spine movement throughout the equipment-removal process. This study provides evidence for including the pack-and-fill protocol in future treatment recommendations when helmet removal is necessary for on-field care.

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La densidad mineral ósea evaluada por DXA predice el riesgo de fractura de cadera. Los pacientes añosos, aún con densitometría normal pueden fracturarse. Esto indica que otras propiedades del hueso, participan en la resistencia ósea, como las características físicas del material y la geometría. Nuestro objetivo fue evaluar mujeres normales de la ciudad de Buenos Aires con las nuevas tecnologías DXA y medir los parámetros geométricos y arquitectónicos. Evaluamos 903 mujeres con equipo GE Lunar Prodigy. La edad media fue 55 ± 7.23 años y la talla 1.60 ± 0.06 m. Esta descendió progresivamente con la edad, siendo 1.54±0.05 m en las mayores de 70a. La DMO media de L1-L4, en mujeres jóvenes fue 1.16 ± 0.12 g/cm2, en cuello femoral, 0.93 ±0.1g/cm2, cuello superior 0.81 ± 0.13 g/cm2 y fémur total 0.95 ± 0.09 g/cm2. Los valores de DMO también descendieron progresivamente. La media de longitud del eje de cadera (HAL) fue 103.12 ±5.71 mm y mostró marcada correlación con la talla y no con edad. El momento de inercia de la sección cruzada (CSMI) correlacionó con la DMO. Las variables geométricas permanecieron estables con el tiempo, demostrando condicionamiento genético, en tanto las arquitectónicas se modificarían por el remodelado durante la vida. Nuestros datos demuestran que la mujer argentina presenta valores arquitectónicos y geométricos en fémur proximal similares a los descriptos en la literatura. La asociación de los mismos permitirá una mejor evaluación de los individuos en riesgo.

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Acute spinal damage forms a small percentage of total trauma injury but it has tremendous significance because of the resultant disability, poor prognosis, economic and social cost and the burden on victims, family, taxpayers and health workers. Of fifty-five patients admitted to the University Hospital of the West Indies (UHWI), Mona, Jamaica, over a seven-year period, forty form the basis of this report. Young males accounted for most victims and 85 percent of the injuries were non-intentional. The cervical spine, most commonly C6, was the region most frequently injured, followed by the lumbar and the thoracic regions. On admission, the mean Glasgow Coma Score was 14.6 and the mean Modified Injury Severity Score 12.7. Five patients were admitted in Frankel Grade A, complete paraplegia. Of eighteen patients treated with steroids, only eleven had methylprednisolone and only six of these appropriately. Nine patients had surgery after a mean time of 10.1 days. The average length of hospital stay was 18.2 days. Of 35 patients whose outcomes were known, eleven improved; two patients died in hospital. With the modernisation of the management of this condition, we recommend that attention be focused on prevention, pre-hospital immobilisation and transport, prompt resuscitation, the standardisation of written protocols and early operative intervention. Also essential is the continuing medical education of all levels of personnel and the formalisation of a well-coordinated and rehearsed Spine team.(Au)

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Acute spinal damage forms a small percentage of total trauma injury but it has tremendous significance because of the resultant disability, poor prognosis, economic and social cost and the burden on victims, family, taxpayers and health workers. Of fifty-five patients admitted to the University Hospital of the West Indies (UHWI), Mona, Jamaica, over a seven-year period, forty form the basis of this report. Young males accounted for most victims and 85 percent of the injuries were non-intentional. The cervical spine, most commonly C6, was the region most frequently injured, followed by the lumbar and the thoracic regions. On admission, the mean Glasgow Coma Score was 14.6 and the mean Modified Injury Severity Score 12.7. Five patients were admitted in Frankel Grade A, complete paraplegia. Of eighteen patients treated with steroids, only eleven had methylprednisolone and only six of these appropriately. Nine patients had surgery after a mean time of 10.1 days. The average length of hospital stay was 18.2 days. Of 35 patients whose outcomes were known, eleven improved; two patients died in hospital. With the modernisation of the management of this condition, we recommend that attention be focused on prevention, pre-hospital immobilisation and transport, prompt resuscitation, the standardisation of written protocols and early operative intervention. Also essential is the continuing medical education of all levels of personnel and the formalisation of a well-coordinated and rehearsed Spine team.

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Raloxifeno é um modulador seletivo do receptor de estrógeno de segunda geração com ação agonista no osso e sistema cardiovascular e ação antagonista na mama e útero. Sua seletividade tecidual ocorre devido a diversos mecanismos como diferentes receptores de estrógenos, distribuição diferencial destes receptores, diferentes co-fatores protéicos transcricionais e diferente conformação do receptor após ligação de raloxifeno. No osso, raloxifeno aumenta a massa óssea na coluna, fêmur, corpo inteiro, é eficaz em prevenir osteoporose em mulheres na pós-menopausa e reduz a incidência de fraturas vertebrais em 50 por cento em mulheres com osteoporose. No sistema cardiovascular, raloxifeno reduz o colesterol total, LDL-colesterol, fibrinogênio e lipoproteína (a), não tendo efeito nos triglicérides e HDL-colesterol total, porém aumento a subfração HDL-C2. Raloxifeno tem atividade antiproliferativa na mama, não induz mastalgia e uma redução na incidência de novos casos de câncer de mama tem sido demonstrada em mulheres em uso de raloxifeno em grandes estudos clínicos para osteoporose. No útero, raloxifeno não estimula o endométrio e não aumenta a incidência de sangramento vaginal ou carcinoma endometrial. O evento adverso mais comum com raloxifeno são ondas de calor e o mais sério é o tromboembolismo venoso com incidência semelhante à terapia de reposição hormonal. Raloxifeno é uma alternativa para o tratamento e preveção de osteoporose em mulheres na pós-menopausa com evidências de efeitos benéficos seletivos em outros órgãos. Outros benefícios potenciais de raloxifeno como proteção cardiovascular e prevenção de câncer de mama estão sendo investigados em grandes estudos clínicos a longo prazo.

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Os trabalhadores de enfermagem estäo sujeitos a lesöes na coluna vertebral, atribuídas a condiçöes ergonômicas e posturais inadequadas. Com o objetivo de auxiliar na reduçäo dessas lesöes, elaborou-se uma proposta educativa específica para o pessoal de enfermagem, cujo planejamento e tópicos constam do presente estudo. A estratégia foi realizada a partir da análise do ambiente de trabalho e das atividades desenvolvidas por esse pessoal, abordando temas relativos à anatomia e biomecânica da coluna vertebral, orientaçöes gerais de postura, aspectos ergonômicos específicos do trabalho da enfermagem e consideraçöes sobre movimentaçäo e transporte de pacientes.

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