[Epidemiology and risk factors in osteoarthritis: literature review data from "OASIS" study]. / Epidemiologia e fattori di rischio dell'osteoartrosi: review della letteratura e dati dal progetto OASIS.

Ostheoarthritis (OA) is a social disease characterized by pain, inflammation and stiffness due to an involvement of articular cartilage, soft tissues and bone. OA is the most common rheumatic disease, every age can be affected but prevalence increases dramatically with age with a greater incidence in subjects between 40 and 50 years of age. Hip OA has an important correlation with weight, genetic factors, sex, previous traumas, occupational factors and age. People older than 35 have a prevalence of hip OA of 10.8% that becomes 35.4% in people older than 85. Knee OA has a great correlation with weight ,life style and physical activity. An Italian study demonstrated that the prevalence of this kind of OA is highest in subjects older than 65 that becomes 44% in people older than 80. In this report we explain the results of a study conducted in the South of Italy called the OstheoArtrithis Southern Italy Study (OASIS) that involved 456 doctors and 1782 patients of three different regions. The mean age of these patients was 66.3 years and we evaluated prevalence of hip, knee, hand and spine OA and correlated it to sex, age, weight and BMI. We also evaluated what kind of drugs were used for these patients. Knee OA is the most common subset of OA, the one that requires the highest number of examinations and the one that causes the greatest disability. The most common used drugs are Fans and Coxibs. Condroprotectors were not used much, probably because they are not considered to be very effective.

Factors influencing pain, physical function and social functioning in patients with osteoarthritis in southern Italy.

The aim of this study was to assess factors influencing bodily pain (BP), physical function (PF) and social functioning (SF) in patients with osteoarthritis (OA) from southern Italy A total of 1,782 patients (mean age 66.08 years, 570 men and 1,212 women) with knee, hip, spine or hand OA underwent a structured assessment comprising demographic data and the Short Form 36 (SF-36) BP, PF and SF scales. Separate multiple linear regression models were employed for statistical analysis. The mean disease duration was 9.18 years and the mean body mass index (BMI) was 27.06. The mean BP, PF and SF scores of 34.93 (SD 19.37), 63.58 (SD 26.53) and 47.89 (SD 21.83) for the study subjects were substantially lower than those expected for the general Italian population. Subjects who were younger with a shorter disease duration and lower BMI had better PF and SF Younger subjects with a lower BMI and a longer disease duration had less BP. Female sex was associated with more BP, worse SF and better PF. In conclusion, demographic and disease-related factors influence BP, PF and SF in southern Italian patients with OA.

[Sodium gold thiosulfate therapy: an open, viewed, multicenter trial in rheumatoid arthritis patients followed for two years]. / Terapia con tiosolfato di sodio e oro: studio osservazionale, aperto, multicentrico in pazienti con artrite reumatoide seguiti per due anni.

OBJECTIVE: To evaluate if parenteral gold-therapy with Sodium gold thiosulfate is effective and safe for the treatment of rheumatoid arthritis we began an open, multicenter trial. METHODS: 126 rheumatoid arthritis patients were treated with Sodium gold thiosulfate for two years. Efficacy, quality of life, progression of joint damage, inflammatory parameters and side effects were evaluated. RESULTS: Gold salts reduced joint inflammation and improved subjective and objective symptoms, quality of life and activity of illness within 6 months. Side effects appeared in 13,8% of all cases and regressed, promptly, when gold therapy stopped. The poor efficacy caused the interruption and the change from the gold therapy to others disease-modifying anti-rheumatic drugs (DMRDs) in 17,8 % of the patients. CONCLUSIONS: The follow-up showed Sodium gold thiosulfate was effective in Rheumatoid Arthritis and the survival in therapy was of 77,8% to one year and of 68,4% to two years.

Effect of acetyl-L-carnitine on lipid peroxidation and xanthine oxidase activity in rat skeletal muscle.

It has been reported that acetyl-L-carnitine (AcCn) can reduce the degenerative processes in the central nervous system of rats, modify the fluidity of membranes and decrease the accumulation of lipofuscins in neurones. In light of these considerations we have assayed the in vitro effect of acetyl-L-carnitine on spontaneous and induced lipoperoxidation in rat skeletal muscle; in addition, the effect of AcCn on XD/XO ratio was evaluated. The presence of AcCn (10-40 mM) in incubation medium significantly reduced MDA and conjugated diene formation in rat skeletal muscle; moreover, a significant decrease in induced MDA levels was observed when microsomal preparation where incubated in the presence of 10-40 mM AcCn. Since a significant reduction of XO activity was detected in the presence of 10-80 mM AcCn, the reduced lipid peroxidation by AcCn seems to be due to an inhibition of XO activity.

Effect of clonidine on glucose, insulin and glucagon responses to a protein meal in type 2 diabetics.

The authors investigated the effects of clonidine (alpha-2 stimulating agent) on blood glucose, insulin and glucagon levels in order to assess the alpha-adrenergic regulation of endocrine pancreatic secretion. Ten hypertensive female subjects affected with type 2 diabetes were studied; each subject was given a protein meal (boiled beef 200 g); blood samples were taken at -30, 0, 30, 60, 90 and 120 min; after this test each subject was treated for 4 days with clonidine (0.150 mg, 3 times/day per os); at the 5th day the protein meal was repeated under the same conditions except for the added administration of clonidine. Plasma glucose, insulin and glucagon were estimated. The administration of a protein meal caused a significant increase of blood glucose (peak at 60 min), insulin (peak at 90 min) and glucagon (peak at 90 min) levels; the association of clonidine caused an increase of blood glucose (single values and total areas) without changes of insulin and glucagon levels, when compared to those obtained before clonidine treatment. In conclusion, the association of clonidine to a protein meal caused impaired glucose tolerance presumably due to a direct glycogenolytic effect, occurring in the liver on account of an alpha-2 receptor stimulation, insulin and glucagon not being involved in this phenomenon.

Effect of metformin on blood glucose, insulin and C-peptide responses to glucagon in non-insulin dependent diabetics.

Since the C-peptide Radioimmuno active/Immuno Reactive Insulin (CPR/IRI) molar ratio is considered as an index of insulin hepatic extraction and tissue receptor binding, the AA. investigated the effects of metformin on this index after glucagon infusion in non-insulin dependent diabetics. Fourteen lean subjects (aged 48 to 67 years, mean 54 +/- 7) with non-insulin dependent diabetes were studied. At 9.00 a.m. each subject after overnight fasting, underwent glucagon infusion (1 mg i.v. diluted in 250 ml of saline, infused at a rate of 8.3 gamma/min for 2 hours); blood specimen were obtained at --15, 0, 30, 60, 90, 120 min. This test was repeated after a five-day treatment with metformin (1.5 g per os). For each sample plasma glucose by glucose oxidase method, plasma insulin and C-peptide by Radio Immuno Assay (RIA) method were determined. After treatment with metformin the hyperglycemia induced by glucagon was not influenced; nevertheless insulin and C-peptide plasma levels showed an evident reduction while CPR/IRI molar ratio was unchanged. The AA. suppose an indirect effect of metformin upon beta cells, namely a less pancreatic insulin requirement, mediated by an improvement of glucose utilization.

[Behavior of gastrinemia, insulinemia and glucagonemia in normal and diabetic subjects after a protein meal accompanied by cimetidine]. / Comportamento della gastrinemia, dell'insulinemia e della glucagonemia in soggetti normali e diabetici dopo pasto proteico associate a cimetidina.

Blood gastrin, sugar, insulin and glucagon were studied after a protein meal with or without 400 mg cymethidine per os in 7 normal subjects and 14 with anacidotic adult diabetes in a reasonable state of glycometabolic compensation. The association led to a significant enhancement of gastrin after 120' and 180', plus a rise in the total integrated gastrin response. Sugar and insulin were unaffected, while glucagon was distinclty, though not signifacantly, reduced. In a discussion of the results it is suggested that the rise in gastrin after cymethidine is not solely due to a pH-dependent negative feedback, since this should have led to an earlier (30', 60') rise, but also to the slight suppression of glucagon, which is physiologically endowed with the ability to inhibit secretion.