Strengthening exercises to improve hand strength and functionality in rheumatoid arthritis with hand deformities: a randomized, controlled trial.

Rheumatoid arthritis (RA) is a systemic inflammatory and chronic disease of joints, which may result in irreversible deformities. To evaluate the effects of an exercise programme aimed at improving the hand strength in individuals with hand deformities resulting from RA and to analyse the impact these exercises have on functionality. Twenty women with RA hand deformities participated in the study. They were randomly divided into two groups as follows: Group 1 (n = 13) had women participating in the exercise programme aimed at improving handgrip (HS) and pinch strengths (PS) as well as the motor coordination of the hand; Group 2 (n = 7) had women with RA who received no treatment for their hands (control). The treatment programme for hands consisted of 20 sessions, twice a week and at-home exercises. Both groups were submitted to Health Assessment Questionnaire (HAQ) and evaluation of HS and PS by means of dynamometry. Re-evaluations were performed after 10 and 20 sessions in Group 1 and after 2 months in Group 2. After 20 sessions of physiotherapy, Group 1 had a significant gain in HS and PS (p < 0.05) in addition to the improvement of functionality as assessed by HAQ (p = 0.016). For Group 2, no difference was found between the variables analysed (p > 0.05). The strengthening exercises for individuals with RA hand deformity are beneficial to improve handgrip and pinch strengths as well as functionality.

O extrato de maracujá sobre a morfometria de hepatócitos da tilápia do Nilo / The passion fruit on hepatocytes morphometry of Nile tilapia

Avaliaram-se os efeitos do extrato de maracujá veiculado na dieta (0, 50, 100 e 200mg kg-1) sobre o consumo de alimento, o ganho em peso e os níveis de glicose e cortisol plasmático de juvenis de tilápias do Nilo (87,0±6,6g). Ao final do experimento (28 dias), os peixes foram eutanasiados para remoção do fígado, visando à avaliação da área citoplasmática, contagem de células e verificação dos estoques de glicogênio hepático. Os dados foram submetidos à ANOVA unidirecional, comparando-se as médias pelo Teste de Tukey (P<0,05), com posterior estudo de regressão, buscando estabelecer as curvas das áreas citoplasmáticas, em função das diferentes doses do extrato. A inclusão do extrato na dieta não afetou o consumo de alimento e o crescimento e todos os peixes apresentaram aumento da glicose e redução do cortisol plasmático, porém sem diferenças entre os tratamentos. As curvas de regressão indicaram aumento quadrático da área citoplasmática com a elevação da doses do extrato, principalmente para 100mg kg-1, resultando em uma curva dose-resposta em forma de "U" invertido. O aumento da área do citoplasma decorreu de um acúmulo de glicogênio hepático, conforme comprovado pela prova da amilase salivar. Concluiu-se que o extrato de maracujá pode ser fornecido na dieta de juvenis de tilápia, sem prejudicar o consumo alimentar e o crescimento dos animais e que o produto altera a morfometria dos hepatócitos, sugerindo a atividade de flavonóides sobre o metabolismo de carboidratos.

The effects of passion fruit extract (0, 50, 100 and 200mg kg-1) on food consumption, growth and glucose levels and plasma cortisol were investigated in juvenile Nile tilapia (87.0±6.6g). After 28 days, fish were killed and the liver was removed for study of cytoplasm area, cell count and verification of hepatic glycogen stores. The data were subjected to one-way ANOVA comparing the means by Tukey´s test (P<0.05), with further study to establish the regression curves of cytoplasm areas related to different doses of the extract. The inclusion of the extract in the diet did not affect food consumption and growth, and all fish showed increased glucose and reduced plasma cortisol, without differences between treatments. The cytoplasm area increased quadratically as the doses increased, mainly for 100mg kg-1, resulting in an inverted "U" dose-response curve. The increase of cytoplasm area resulted from hepatic glycogen storage, as confirmed by salivary amylase. It was concluded that passion fruit extract can be delivered in the diet of juvenile tilapia, without impairing of food consumption and growth, and that the product affects the hepatocytes morphometry, suggesting flavonoids activity on carbohydrate metabolism.

Fat and out in Salerno and its province: Adolescent obesity and early school leaving in Southern Italy.

We examine the determinants of obesity and its role in influencing early school leaving amongst adolescents in the city of Salerno and its province in Southern Italy. A human capital investment model is employed and this provides a framework within which to analyse the interrelated 'decisions' regarding schooling and overeating, taking into account the importance of time preference and the differential effects of adolescent obesity for males and females. We find that: (a) there is a strong and robust positive association between obesity and early school leaving; (b) there is evidence to support the notion that this association is the consequence of a causal relation running from obesity to school leaving; and, (c) there are significant gender differences in the nature of this relationship. These findings have important policy implications. In particular: (i) policies aimed at reducing obesity - such as the encouragement of sporting activity or the encouragement of healthier eating habits at school - may also have other beneficial effects through a reduction in early school leaving rates; and, (ii) the significant differences identified between male and female adolescents suggest that the adoption of some gender-specific policy measures would be useful.