Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up.

OBJECTIVE: To investigate the effects of 4-months intensive aquatic resistance training on body composition and walking speed in post-menopausal women with mild knee osteoarthritis (OA), immediately after intervention and after 12-months follow-up. Additionally, influence of leisure time physical activity (LTPA) will be investigated. DESIGN: This randomised clinical trial assigned eighty-seven volunteer postmenopausal women into two study arms. The intervention group (n = 43) participated in 48 supervised intensive aquatic resistance training sessions over 4-months while the control group (n = 44) maintained normal physical activity. Eighty four participants continued into the 12-months' follow-up period. Body composition was measured with dual-energy X-ray absorptiometry (DXA). Walking speed over 2 km and the knee injury and osteoarthritis outcome score (KOOS) were measured. LTPA was recorded with self-reported diaries. RESULTS: After the 4-month intervention there was a significant decrease (P = 0.002) in fat mass (mean change: -1.17 kg; 95% CI: -2.00 to -0.43) and increase (P = 0.002) in walking speed (0.052 m/s; 95% CI: 0.018 to 0.086) in favour of the intervention group. Body composition returned to baseline after 12-months. In contrast, increased walking speed was maintained (0.046 m/s; 95% CI 0.006 to 0.086, P = 0.032). No change was seen in lean mass or KOOS. Daily LTPA over the 16-months had a significant effect (P = 0.007) on fat mass loss (f2 = 0.05) but no effect on walking speed. CONCLUSIONS: Our findings show that high intensity aquatic resistance training decreases fat mass and improves walking speed in post-menopausal women with mild knee OA. Only improvements in walking speed were maintained at 12-months follow-up. Higher levels of LTPA were associated with fat mass loss. TRIAL REGISTRATION NUMBER: ISRCTN65346593.

Snorc is a novel cartilage specific small membrane proteoglycan expressed in differentiating and articular chondrocytes.

OBJECTIVE: Maintenance of chondrocyte phenotype is a major issue in prevention of degeneration and repair of articular cartilage. Although the critical pathways in chondrocyte maturation and homeostasis have been revealed, the in-depth understanding is deficient and novel modifying components and interaction partners are still likely to be discovered. Our focus in this study was to characterize a novel cartilage specific gene that was identified in mouse limb cartilage during embryonic development. METHODS: Open access bioinformatics tools and databases were used to characterize the gene, predicted protein and orthologs in vertebrate species. Immunohistochemistry and mRNA expression methodology were used to study tissue specific expression. Fracture callus and limb bud micromass culture were utilized to study the effects of BMP-2 during experimental chondrogenesis. Fusion protein with C-terminal HA-tag was expressed in Cos7 cells, and the cell lysate was studied for putative glycosaminoglycan attachment by digestion with chondroitinase ABC and Western blotting. RESULTS: The predicted molecule is a small, 121 amino acids long type I single-pass transmembrane chondroitin sulfate proteoglycan, that contains ER signal peptide, lumenal/extracellular domain with several threonines/serines prone to O-N-acetylgalactosamine modification, and a cytoplasmic tail with a Yin-Yang site prone to phosphorylation or O-N-acetylglucosamine modification. It is highly conserved in mammals with orthologs in all vertebrate subgroups. Cartilage specific expression was highest in proliferating and prehypertrophic zones during development, and in adult articular cartilage, expression was restricted to the uncalcified zone, including chondrocyte clusters in human osteoarthritic cartilage. Studies with experimental chondrogenesis models demonstrated similar expression profiles with Sox9, Acan and Col2a1 and up-regulation by BMP-2. Based on its cartilage specific expression, the molecule was named Snorc, (Small NOvel Rich in Cartilage). CONCLUSION: A novel cartilage specific molecule was identified which marks the differentiating chondrocytes and adult articular chondrocytes with possible functions associated with development and maintenance of chondrocyte phenotype.

Incidence of second hip fractures. A population-based study.

UNLABELLED: We studied the incidence of second hip fractures and medication use among the patients with sequential hip fractures. This study shows that the incidence rate of second hip fractures is higher than that of the first hip fractures. Improvement in osteoporosis care and a more critical policy for prescription of psychotropic drugs are needed. INTRODUCTION: This study had two goals: (1) to determine incidence of second hip fractures; (2) to describe changes in pharmacotherapy between first and second hip fractures, especially the use of those psychotropics which increase the risk of falling and also pharmacotherapy for osteoporosis. METHODS: The residents of Central Finland Health Care District who had sustained a hip fracture in 2002-2003 were followed up for subsequent hip fractures until 2006. Hip fracture patients were identified and clinical data were obtained by using hospital registers and medical records. RESULTS: Five hundred and one persons aged >or= 60 years suffered their first hip fracture in 2002-2003. During the follow-up of 936 person-years, 34 second hip fractures occurred. The cumulative incidence of second hip fractures was 5.08% (95% CI: 3.30 to 7.78) at one year, and 8.11% (95% CI: 5.73 to 11.43) at two years after the first fracture. The second part of this study investigated 75 patients with two non-contemporaneous hip fractures. Between the first and second fractures, the number of psychotropic drug users rose from 27 (36%) to 44 (59%). At the time of second hip fracture, osteoporosis had been diagnosed in 17 (23%) patients only. Twelve (16%) patients used bisphosphonates or calcitonin, 15 (20%) used calcium and 9 (12%) vitamin D supplements. CONCLUSIONS: There is a high incidence of second hip fractures. Secondary prevention of hip fractures needs to be improved. In addition to adequate treatment for osteoporosis, more attention should be directed toward appropriate use of psychotropic drugs.

Erosive effect of a sport drink mixture with and without addition of fluoride and magnesium on the molar teeth of rats.

A sport drink mixture (pH 3.2), either as such or supplemented with 15 ppm F or 38.5 ppm Mg or both, was given to Osborne-Mendel rats as the only liquid for 42 days. The erosion was scored on the lingual surfaces of the first mandibular molar teeth. Sport drink caused marked erosion, but in the groups where fluoride, alone or with magnesium, was added to the drink, the erosion damages were less severe. Magnesium alone had no clear effect on erosion. Dental plaque, induced by a powdered diet containing 15% sucrose, seemed to modify the erosion process by covering a part of the enamel and thus protecting these areas from the direct effect of acidic drink.