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Background: Impaired glucose tolerance is common among obese adolescents, but the changes in insulin sensitivity and secretion that lead to this prediabetic state are unknown. We investigated whether altered partitioning of myocellular and abdominal fat relates to abnormalities in glucose homoeostasis in obese adolescents with prediabetes.Methods: We studied 14 obese children with impaired glucose tolerance and 14 with normal glucose tolerance, of similar ages, sex distribution, and degree of obesity. Insulin sensitivity and secretion were assessed by the euglycaemic-hyperinsulinaemic clamp and the hyperglycaemic clamp. Intramyocellular lipid was assessed by proton nuclear magnetic resonance spectroscopy and abdominal fat distribution by magnetic resonance imaging.Findings: Peripheral glucose disposal was significantly lower in individuals with impaired than in those with normal glucose tolerance (mean 35.4 [SE 4.0] vs 60.6 [7.2] micromoles per kg lean body mass per min; p=0.023) owing to a reduction in non-oxidative glucose disposal metabolism (storage). Individuals with impaired glucose tolerance had higher intramyocellular lipid content (3.04 [0.43] vs 1.99 [0.19]%, p=0.03), lower abdominal subcutaneous fat (460 [47] vs 626 [39] cm2, p=0.04), and slightly higher visceral fat than the controls (70 [11] vs 47 [6] cm2, p=0.065), resulting in a higher ratio of visceral to subcutaneous fat (0.15 [0.02] vs 0.07 [0.01], p=0.002). Intramyocellular and visceral lipid contents were inversely related to the glucose disposal and non-oxidative glucose metabolism and positively related to the 2 h plasma glucose concentration.Interpretation: In obese children and adolescents with prediabetes, intramyocellular and intra-abdominal lipid accumulation is closely linked to the development of severe peripheral insulin resistance. [ABSTRACT FROM AUTHOR]

Clinical trials have demonstrated traditional spa therapy effects in musculoskeletal disorders (MSDs). This is the first observational study in Italy aimed at evaluating in real-life the short-time effects of spa rehabilitation on pain, mood and quality of life (QoL) among degenerative or post-surgery MSDs patients. Through the involvement of six Italian spa facilities, 160 patients were enrolled; data from 123 patients were finally analysed. Seventy-nine patients (64.3%) accessed the spa for degenerative MSDs, while 44 (35.8%) had a post-surgical condition. All the patients included in the study underwent 12 sessions of water-based exercise (joint exercises, muscle strengthening, gait training, proprioceptive and balance techniques) conducted in thermal or in warm water pools, six sessions per week, for a period of 2 weeks from March 2019 up to October 2019. A group of 45 patients (36.6%) also received traditional thermal therapies, including 12 mud therapy sessions and 12 thermal baths, six times each week, for 2 weeks. Evaluation before and after the treatment included the Numerical Rating Scale (NRS), the Short Form Health Survey (SF-12) and the EuroQol-5D (EQ-5D). The analysis of the scores reported in the questionnaires after the treatment showed a significant improvement in all the scores evaluated. Comparison between patients that performed water-based exercise protocols alone (group A) and patients that in addition to water exercise performed traditional thermal interventions (group B) showed no statistically significant differences in NRSp, NRSa, NRSm, SF-12 PCS, SF-12 MCS and EQ-5D variations; only NRSa value reduction was lower in group B. Sulphate water was found to be associated with a lower reduction of all the scores considered, when compared to the other water types. Patients with degenerative or post-surgery MSDs showed favourable effects on pain, mood and QoL after water exercise training alone or in combination with traditional thermal therapy. Our research provides the first proof that spa rehabilitation can be in real-life conditions an appropriate alternative strategy for post-orthopaedic surgical outcomes recovery. In the future, these results will need to be further investigated., (© 2022. The Author(s).)

In the period 1987-2011, 387 cases of occupational asthma (OA) in local workers (LL) and 32 in migrants (LM) were diagnosed in the 36 level Center of Occupational Medicine at University of Padova. Total number of OA decreased from early nineties to 2011. However the proportion of OA in migrants increased from 0.7% to 36.4% along the study period. Severity and causing agents were similar in the two groups. The most frequent cause were isocyanates (68.7% LM vs 52.7% LL). Most of OA in migrants was observed in painters (46.9%), whereas the jobs in asthmatic LL were more widely distributed.

Objective: To determine short- and long-term effects of the Bright Bodies Weight Management Program on obese adolescents and to further observe if a diet or nondiet approach is more successful., Design: Twenty-five obese adolescents completed a 1-year, comprehensive weight-management program and returned for a 2-year follow-up. Adolescents were 11 to 16 years old (17 female, eight male) with mixed ethnic backgrounds. Although the program emphasizes a nondiet approach, eight children requested a structured meal plan (diet approach), while 17 were taught to make better food choices (nondiet approach). Body mass index (BMI) z score, body fat percent, and self-concept were measured at 0, 1, and 2 years. Outcomes were analyzed for the entire group and by diet method groups., Statistical Analysis: Changes in outcome variables were evaluated using covariance pattern models for repeated measures., Results: At 1 year, the entire group (N=25) demonstrated a decrease in BMI z score (P <.001) and body fat percent (P <.001), while self-concept scores increased (P <.001). At 2 years, the decrease in BMI z score was still significant (P =.004) and body fat percent and self-concept scores remained improved, although not significant compared to baseline (P =.15 and P =.10, respectively). When comparing dietary approaches, the dieting group (n=8) tended to show favorable results short-term for BMI z score at year 1 (P =.11), but by year 2, the nondieting group (n=17) further improved BMI z score (P =.006), while the dieting group reverted toward baseline., Conclusions: The Bright Bodies Weight Management Program was successful at decreasing BMI z scores both short and long term. In a separate analysis, dieting showed more superior short-term results, but a nondiet approach demonstrated improved long-term results.