5 steps for a pain–free back

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1. Stay fit

Stretching and strengthening both your back and abdominal muscles is important. A stretching and strengthening regimen should target the back, abdominal, and buttock muscles.

Bicycling (either stationary or regular), swimming, and walking lead the list of low-risk, high-benefit activities for most people’s backs. All are low- or minimal-impact exercises that strengthen muscles which support the back. None involve awkward or stressful actions that are detrimental to back muscles.

Sports and activities such as football, tennis, gymnastics, wrestling, weight lifting, rowing (crew), running, aerobic dance, and ballet involve a relatively high risk for back injury because of the extension, lifting, or impacts involved. Other unnatural motions that could induce pain include back arching (during gymnastics and diving), twisting (while hitting a golf ball, swinging at a baseball, or bowling), vertical jolting (while riding a horse), and stretching your legs strenuously (when hiking or when balancing a sailboat during a race).

2. Maintain a healthy weight

The heavier you are, the greater the load your spine must carry. To make matters worse, if the bulk of your weight comes in the form of abdominal fat, rather than muscle, your center of gravity can shift forward — a condition that puts added pressure on your back.

3. Kick the habit

Nicotine in cigarettes contributes to low back pain in two ways. First, nicotine hampers the flow of blood to the vertebrae and disks. This impairs their function and may trigger a bout of back pain. Second, smokers tend to lose bone faster than nonsmokers, putting them at greater risk for osteoporosis, another common cause of back pain.

4. Lighten your load

A survey by the American Academy of Orthopaedic Surgeons found that nearly 60% of the doctors responding had treated school-age patients complaining of back and shoulder pain caused by heavy backpacks.

1.     Use both of the pack’s straps instead of slinging one strap over a shoulder.

2.     Carry only the essentials

3.     Lighten your load whenever possible.

4.     Opt for backpacks that have different-sized compartments to help distribute weight evenly.

5.     Look for wide, padded straps and a padded back.

6.     When carrying a heavy load, put the heaviest items as close as possible to the center of the back

7.     Use the hip strap for support.

8.      For very heavy loads, use a backpack with wheels.

9.     Bend from your knees when picking up your pack.

5. Develop back-healthy habits

  1. While standing to perform ordinary tasks like ironing or folding laundry, keep one foot on a small step stool.
  2. Don’t remain sitting or standing in the same position for too long. Stretch, shift your position, or take a short walk when you can.
  3. When bending from the waist, always use your hands to support yourself.
  4. When sitting, keep your knees a bit higher than your hips and bend them at a 90-degree angle. Sit with your feet comfortably on the floor. If your feet don’t reach the floor, put a book or a small stool under them.
  5. Because vacuuming can take a toll on your back, tackle rooms in chunks, spending no more than five to 10 minutes at a time doing this task.

Last patients on ICU rounds get least time

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Doctors spent significantly less time with intensive care unit patients at the end of rounds as compared with the beginning.

The time decreased by about a minute per patient as clinical staff members made rounds in a 12-bed cardiothoracic intensive care unit (ICU).

Comparison of the first four and last four patients seen on rounds produced a statistically significant difference in the time spent with physicians and other participants in rounds, said Laura Jones, PhD, at the Society of Critical Care Medicine meeting.

To study time distribution during clinical rounds, Jones and colleagues accompanied clinical staff on 20 nonconsecutive weekdays during rounds in a cardiothoracic ICU. All patients had undergone coronary bypass surgery. On any given day, participants in rounds included one or more physicians, nurses, medical students, a pharmacist, a dietitian, and other healthcare providers. At the very least, an intensivist and one other physician participated in each session. The number of patient visits during the study period averaged 6.4, and rounds duration averaged 117.9 minutes. Interruptions accounted for about 10 minutes per rounds session and social interruptions for another 11.5 minutes.

Overall, the time spent with each patient during rounds decreased by 54 seconds per patient. Using a nine-patient session as an example, Jones said the clinical staff spent about eight minutes less with the last patient seen compared with the first. The difference between the first four and last four patients seen was statistically significant (P<0.05).

Caffeinated coffee may protect against liver fibrosis

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Caffeine intake associated with coffee consumption has been linked to a reduced risk for clinical and pathologic progression of liver fibrosis in patients with hepatitis C virus, and coffee was also found to reduce the risk for liver enzyme elevations in patients with alcoholic liver disease. Drinking caffeinated coffee protects against liver fibrosis in patients with NAFLD, according to research published in the February issue of Hepatology by Jeffrey C. Molloy, MD, from the Division of Gastroenterology and Hepatology, Wilford Hall Medical Center, Lackland Air Force Base, Texas.

Moderate coffee consumption may be a benign adjunct to the comprehensive management of patients with [NASH]. Ne should however avoid risk factors, such as obesity, high alcoholic intake, and viral hepatitis. [Hepatology 2012;55:429-36]

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