The objective of this study was to compare the bone mineral density (BMD) of men with Down syndrome (DS) to otherwise mentally retarded (MR) men and to investigate whether leg muscle strength of these patients is related to BMD. Two groups with MR (with and without DS) participated in the study, having met the following criteria: similar age, moderate to mild mental retardation, Tanner stage V of sexual development, similar age of beginning to walk, and equal motor activities. The DS group consisted of 8 men 23.9 +/- 4.2 years, and the MR group without DS consisted of 8 men 23.5 +/- 3.6 years. The two groups were compared with 10 sedentary students of the same age range (25.9 +/- 2.9 years) attending our University. The BMD of the 2(nd) to 4(th) lumbar vertebrae was measured in the PA projection and the mean density was expressed as g/cm(2). The isokinetic muscle strength of the right quadriceps femoris and hamstrings muscles was measured on a Cybex II isokinetic dynamometer. The value measured was peak torque at angular velocities at 60, 120, and 300 degrees.sec(-1). The results showed that BMD in DS individuals versus young adults (reference group of the scanner) was lower at the 26% level (T-score - 2.66 +/- 0.29) and significantly lower (P = 0.002) than that of the MR group. Significantly different muscle strength was observed between the DS and non-DS MR group (in quadriceps at 300 degrees.s(-1): P < 0.01, at 120 and 60 degrees. s(-1): P < 0.05; in hamstrings at 300 degrees.s(-1): P < 0.05). Higher differences in muscle strength were found between MR and control men, but no significant difference existed in BMD between them. Bivariate correlation showed that quadriceps strength significantly predicted the BMD in the DS patients. Active lifestyle and increased physical exercise to improve muscular strength should be instituted to avoid the development of osteoporosis in DS patients.

No abstract

This study provides an insight into the process of ethical decision-making regarding the initiation or withdrawal of artificial nutritional support of seriously ill patients and explores the nursing involvement in it. Fifteen health carers were recruited from a clinical nutrition unit in the UK and qualitative research methods were used to gather data. The findings of the study indicate that nursing contribution to decision-making appeared to be in the 'back room' as the nurses feel that the decisions about difficult ethical dilemmas are 'out of their hands' because of lack of knowledge, experience and confidence. The medical staff and the clinical nurse specialist appear to be primarily responsible for making important decisions. It is clear from the study that to become more effective in the process, nurses need to enhance their knowledge in nutritional support and to develop their practical skills in ethical decision-making through experience and research.

Implementation of a low-impact exercise training program appears to improve physical fitness of postpartum women, while it does not seem to affect lipid levels and lactation-associated hormone levels. Hence, implementation of an exercise training program combining low-impact dance aerobic, resistance and stretching exercise is feasible in postpartum, primiparous, lactating women.

Antioxidant supplementation has been suggested to prevent exercise-induced muscle injury, but the findings are inconsistent. The objective of this study was to investigate the potential protective role of vitamin E treatment against eccentric exercise-induced muscle injury by examining morphological and functional alterations in rat soleus muscle after downhill running as well as muscle injury markers in the blood. Sixty adult male Wistar rats were randomly assigned to vitamin E-treated or placebo-treated groups studied at rest, immediately post-exercise or 48 h post-exercise (n = 10 per group). Vitamin E was administered by daily intraperitoneal injections of 100 mg/kg body mass of DL: -α-tocopheryl acetate for five consecutive days prior to exercise, resulting in the doubling of its plasma concentration. Downhill running resulted in significant (P < 0.05) changes in all injury markers for the placebo-treated rats at 0 and 48 h post-exercise. However, significantly smaller soleus muscle single-twitch tension (P (t)) and unfused (40 Hz) tetanic force, and greater plasma creatine kinase (CK) and lactate dehydrogenase (LD) activities compared with the control were found only immediately post-exercise for the vitamin E-treated rats (P < 0.05). Maximal tetanic force (P (o)) did not decline significantly compared to sedentary controls at neither time points measured. The vitamin E-treated rats had significantly (P < 0.05) higher soleus muscle P (t) immediately post-exercise than the placebo-treated rats as well as lower plasma CK and LD activity 48 h post-exercise. However, there was no difference in P (o) decline between groups at either time points measured. Vitamin E-treated rats had less pronounced morphological alterations in muscle in the immediate and 48-h post-exercise period. In conclusion, the effect of short-term vitamin E supplementation against eccentric exercise-induced muscle injury did not appear to be physiologically significant, because vitamin E failed to prevent the decline in the functional measure of P (o) compared to the placebo conditions.