Work and Family Support Systems and the Prevalence of Lower Back Problems in a South African Steel Industry

Introduction Back complaints are a common in society. Methods An analytical cross-sectional epidemiological study was carried out among 366 steel plant workers to examine the prevalence and association between lower back problems (LBP) and family and workplace related psychosocial risk factors. Results Using inclusive and stringent definitions for LBP, point prevalence was 35.8% and 15.3%, respectively. Logistic regression analyses indicated significant adjusted odd ratios (OR) for negative perceptions of workplace support (2.32; CI 1.09–4.92), unexpected events (2.58; CI 1.19–5.59) and working under time pressures and deadlines (2.83; CI 1.24–6.48). A significant protective association was found for control over the order and pace of working tasks (OR 0.30; CI 0.14–0.63). A significant univariate association was further found between LBP and negative perceptions of family (1.97; CI 1.06–3.68) support. Conclusion These findings suggest that workers who feel more in control on the job and who have good family and workplace support systems in tact are less likely to experience LBP. Supervisors are therefore encouraged to develop appropriate support and organizational systems which may be an inexpensive, but potentially beneficial, means of reducing worker stress and LBP.     

Effect of phagocytosis on the reduced soluble sulfhydryl content of human granulocytes

The role of reduced glutathione in relation to hexose monophosphate shunt activity and peroxide detoxification has been well established in human erythrocytes. Less is known about the content of reduced glutathione in phagocytic leukocytes and the changes that occur during functional activity. We have measured the reduced sulfhydryl content of normal resting human granulocytes and of cells isolated from a patient with chronic granulomatous disease. Normal cells and those from the patient with chronic granulomatous disease contained similar concentrations of reduced sulfhydryls. Stimulation of a phagocytic response by incubation with opsonized zymosan particles resulted in prompt and nearly complete depletion of intracellular glutathione from normal granulocytes. This fall in reduced glutathione concentration was dependent on the phagocytic load. Exposure of chronic granulomatous disease granulocytes to a similar phagocytic load resulted in a slower and less complete fall in reduced glutathione. In normal cells, those from the chronic granulomatous disease patient, and those from an obligate carrier of the disease, the decrement in reduced glutathione during phagocytosis was correlated with oxidation of 14C-1-glucose and 14C-formate, nitroblue tetrazolium reduction, and the chemiluminescence phenomenon.     

冠心病合并糖尿病患者可降解涂层雷帕霉素洗脱支架置入术后5年随访研究

目的探讨冠心病合并糖尿病患者经皮冠状动脉介入（PCI）置入EXCEL可降解涂层雷帕霉素洗脱支架（SES）治疗的远期疗效。方法回顾性随机入选2007年1月至2007年12月住院期间冠心病合并糖尿病患者行PCI162例,并入选同时期150例无糖尿病的冠心病患者行PCI为对照组。随访5年,随访包括心绞痛复发、死亡、心肌梗死、卒中和再次血运重建的主要不良心脑血管事件。结果两组支架术成功率均为100％。随访率100％,随访5年,糖尿病组与非糖尿病组术后并发症发生率（8．8％、7．0％）、卒中发生率（3．9％、3．0％）、心源性死亡率（0．0％、0．0％）差异无统计学意义（均为P〉0．05）。再次血运重建率（30．4％、14．0％）、心绞痛复发率（42,1％、30．0％）、全因死亡率（9．8％、2．0％）糖尿病组高于非糖尿病组;但心源性病死率均为0．0％。结论选择性冠脉内置入药物洗脱支架安全,成功率高,远期疗效尚好,但糖尿病仍是远期不良预后的独立预测因素。     

Efficacy of A Sports Specific Balance Training Programme on The Incidence of Ankle Sprains in Basketball

The purpose of the study was to determine the efficacy of a 22- week prescribed sports specific balance training programme on the incidence of lateral ankle sprains in basketball players. A controlled clinical trial was set up. In total 54 subjects of six teams participated and were assigned to either an intervention (IG) or a control group (CG). The IG performed a prescribed balance training programme on top of their normal training routine, using balance semi-globes. The programme consisted of 4 basketball skills each session and its difficulty was progressively thought-out. The intervention lasted 22 weeks and was performed 3 times a week for 5 to 10 minutes. Efficacy of the intervention on the incidence of lateral ankle sprains was determined by calculating Relative Risks (RR, including their 95% Confidence Intervals or CI) and incidence rates expressed per 1000h. RR (95% CI) showed a significantly lower incidence of lateral ankle sprains in the IG compared to the CG for the total sample (RR= 0.30 [95% CI: 0.11-0.84]) and in men (RR= 0.29 [95% CI: 0.09-0.93]). The difference in RR was not confirmed when examining the incidence rates and their 95%CI’s, which overlapped. The risk for new or recurrent ankle sprains was slightly lower in the IG (new: RR= 0.76 [95% CI: 0.17-3.40]; re-injury: RR= 0.21 [95% CI: 0.03-1.44]). Based on these pilot results, the use of balance training is recommended as a routine during basketball activities for the prevention of ankle sprains.

Key points

• We could not establish a true preventive effect of the training, most likely due to the low sample size.
• Although not significant, large differences in incidence rates were found between the intervention and control group and relative risks showed a significant difference.
• Our results were in line with previous results and therefore proprioceptive balance training should become a part of the training routine.
• Concerning this study and the literature, proprioceptive balance training should last 5-15 minutes and should be performed 2 to 3 times a week.

Key Words: Injury prevention, sports, proprioceptive training, ankle injury     

Does a period of detraining cause a decrease in serum brain-derived neurotrophic factor?

Brain-derived neurotrophic factor (BDNF) is one of the neurotrophins promoting cognitive function and contributing to neurogenesis and neuroprotection. Available evidence suggests that exercise influences serum BDNF concentrations, but that the effect is transient. The purpose of this study is to determine whether a period of aerobic training, followed by a period of detraining, can influence basal serum BDNF levels in humans. Sixteen young, sedentary subjects were assigned to an experimental group (n = 9) and a control group (n = 7). The experimental group performed an aerobic training program during 8 weeks, followed by 8 weeks of detraining, during which subjects returned to their previous, sedentary activity level. The control group remained physically inactive during 16 weeks. In both groups, performance on short-term (Digit Span test) and mid-term memory (Recall of Images) was assessed. Aerobic training significantly increased the VO₂ peak in the experimental group, and these values returned to baseline after 8 weeks of detraining. Basal serum BDNF was not influenced by 8 weeks of aerobic training and detraining did not seem to have an effect on basal peripheral BDNF concentrations. Both training and detraining did not clearly influence short-term memory performance on the Digit Span test and no differences were present between the experimental and control group on the mid-term memory test. Future studies should focus on patient groups and elderly to further investigate the effect of training and detraining on neurotrophic factors and cognitive function, and on the effects of training and detraining on the BDNF response to acute exercise.     

Alteration in sympathoadrenergic activity at rest and during intense exercise despite normal aerobic fitness in late pubertal adolescent girls with type 1 diabetes

BACKGROUND: An impaired sympathoadrenergic response to hypoglycaemic episodes has been described in young Type 1 diabetic subjects. It is unknown if this altered response occurs with exercise, and if it could influence aerobic power. METHODS: Body composition (skinfold thickness), physical activity (questionnaire) and aerobic power (PWC170 and VO2max) were assessed in 19 post-menarcheal Type 1 diabetic (T1D) girls (13.3-18.2 years) and 19 healthy siblings. At rest and at each stage of the graded exhaustive exercise, plasma glucose, insulin, epinephrine and norepinephrine, were monitored via an intravenous catheter. RESULTS: Only when expressed per kilograms of body weight, was aerobic power impaired in T1D girls compared to controls, probably because they were overweight. Throughout exercise, plasma glucose remained stable while plasma insulin decreased in the healthy girls, whereas glucose diminished significantly with no change in plasma insulin in T1D girls. During exercise catecholamines increased in the same way in both groups. However, at rest and throughout all stages of exercise, norepinephrine levels were significantly lower by a mean difference of 1.2 nmol/L, while epinephrine levels were significantly higher by a mean difference of 0.14 nmol/L, in T1D girls compared to healthy girls. Heart rates of T1D girls were not affected by the sympathoadrenergic alteration. CONCLUSION: T1D adolescent girls display an altered sympathoadrenergic activity at rest and during intense exercise. Their reduced sympathetic activity, albeit probably compensated for by higher adrenomedullary responsiveness or sensitivity, does not affect their heart rate adaptations to exercise.     

Salbutamol for hyperkalaemia in children

Hyperkalaemia is a potentially fatal disorder that demands direct treatment. The efficacy of traditional medical treatment is unpredictable, limited, of short duration or carries the risk of serious adverse events. The administration of salbutamol for hyperkalaemia in children is described in several clinical trials and case reports.

Conclusion: Salbutamol, inhaled or infused, is safe and efficacious and results in a predictable and long-lasting reduction in serum potassium. Salbutamol merits a place as the preferred medication for hyperkalaemia in children without arrhythmias. If follow-up with haemodialysis is required, the administration of salbutamol gives time to make the necessary preparations.     

Long-term results of surgical treatment for pulmonary valve stenosis

109 children who survived surgical treatment for isolated pulmonary valve stenosis were followed for up to 17 years. In all the postoperative status was assessed as satisfactory. Cardiac catheterization repeated in 43 gave a resting valve gradient below 40 mmHg. The 22 children whose pulmonary valves had been excised were as healthy as the 87 who had undergone pulmonary valvotomy. Consideration was given to the desirable length of postoperative review. Except for the few children with symptoms before operation, a postoperative increase in exercise tolerance was not a feature.     

Hormonal responses during prolonged exercise are influenced by a selective DA/NA reuptake inhibitor

OBJECTIVE: A decrease in dopamine activity is thought to lead to a reduction in motivation and arousal and therefore to the "central" component of fatigue. The purpose of the present study was to investigate the effects of a dopamine (DA) noradrenaline (NA) reuptake inhibitor, bupropion (Zyban), on exercise performance and on the hormonal response to exercise. METHODS: Eight healthy well trained male cyclists (Watt(max) 397+/-15 W) participated in the study. Subjects completed one maximal exercise test (to determine maximal power output Watt(max)), and two endurance performance tests (time trials) in a double blind randomised cross-over design. Subjects took either placebo capsules (lactose) or 2 x 300 mg bupropion (BUP). Blood samples were collected for adrenocorticotropin (ACTH), prolactin, cortisol, growth hormone, beta-endorphins, and catecholamines. RESULTS: Performance was not influenced by BUP (placebo: 89+/-1 min; BUP 2 x 300 mg: 89+/-0.7 min). All hormones increased during exercise in all trials. Cortisol plasma concentrations were significantly higher in the BUP trial at rest, at min 60, and at the end of exercise, while beta-endorphins were higher in the BUP trial at the end of exercise and during recovery, and ACTH at the end of exercise. CONCLUSION: From the present results, we can conclude that bupropion had a more marked central noradrenergic effect (compared to dopaminergic) on the hormonal response to exercise, but no effect on the outcome of performance.