Differences in the prevalence and characteristics of metabolic syndrome in rheumatoid arthritis and osteoarthritis: a multicentric study.

The purpose of the study was to examine whether rheumatoid arthritis (RA) patients have higher prevalence of metabolic syndrome (MetS) than osteoarthritis (OA) patients in association with a higher level of chronic systemic inflammation in rheumatoid arthritis. A total of 583 RA and 344 OA outpatients were analyzed in this multicentric study. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. A 1.6-fold higher prevalence of MetS was found in patients with OA compared with the RA patients. Among the parameters of MetS, patients with OA had significantly higher levels of waist circumference, systolic blood pressure, fasting blood glucose and triglycerides, whereas HDL cholesterol and diastolic blood pressure values were similar in both groups of patients. Higher values of inflammatory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)] in MetS than in non-MetS patients and higher prevalence of MetS in patients with CRP level ≥5 mg/L in both RA and OA patients were found. In multivariate logistic regression analysis, significant predictors of MetS were type of arthritis (OA vs. RA; OR 2.5 [95 % CI 1.82-3.43]), age (OR 1.04 [95 % CI 1.03-1.06]) and ESR (OR 1.01; [95 % CI 1.00-1.01]). The significant association between OA and MetS was maintained in the regression model that controlled for body mass index (OR 1.87 [95 % CI 1.34-2.61]). The present analysis suggests that OA is associated with an increased risk of MetS, which may be due to a common underlying pathogenic mechanism.

Is the prevalence of arterial hypertension in rheumatoid arthritis and osteoarthritis associated with disease?

In this study, we compare the prevalence of arterial hypertension (HT) in rheumatoid arthritis (RA) and osteoarthritis (OA) patients, exposed to high- and low-grade chronic inflammation, respectively, to assess the possible association between chronic inflammation and HT. A total of consecutive 627 RA and 352 OA patients were enrolled in this multicentric study. HT was defined as a systolic blood pressure (BP) ≥ 140 and/or diastolic BP ≥ 90 mmHg or current use of any antihypertensive drug. Overweight/obesity was defined as body mass index (BMI) ≥ 25, and patients ≥65 years were considered elderly. The prevalence of HT was higher in the OA group than in the RA group [73.3 % (95 % CI, 68.4, 77.7) and 59.5 % (95 % CI, 55.6, 68.4) P < 0.001, respectively]. When the results were adjusted for age and BMI, the HT prevalence was similar in both groups [RA 59 % (95 % CI, 55.1, 63.8) OA 60 % (95 % CI, 58.4, 65.0)]. In both groups, the prevalence of HT was higher in the elderly and those who were overweight than in the younger patients and those with a BMI < 25. Overweight (BMI ≥ 25) and age ≥65 were independent predictors of HT in multivariate logistic regression model, which showed no association between HT and the disease (RA or OA). The results indicate a robust association of age and BMI with HT prevalence in both RA and OA. The difference in HT prevalence between RA and OA is due rather to age and BMI than to the features of the disease, putting into question specific association of HT with RA.

[Importance of kinesiologic recreation beginning in early rehabilitation in Zagreb]. / Vaznost kinezioloske rekreacije zapocete u ranoj rehabilitaciji u Zagrebu.

Rehabilitation of persons injured in the Croatian Homeland War is complex and prolonged because war wounds heal longer due to infections, additional complications and associated injuries of many organic structures. To make their prolonged hospitalization easier, the first sports competition of war-injured persons was organized in Zagreb on September 26th 1992. Out of 2457 wounded patients undergoing rehabilitation at the Dubrava University Hospital (UHD) in Zagreb till April 4th 1995, a total of 566 (23.03%) participated in sports activities. Competitions were organized in table tennis, darts, suspended bowling, sitting basketball, air gun shooting and mini golf. By participating in sports competitions, the wounded treated at the UHD and other hospitals were encouraged to continue such activities during their treatment in rehabilitation centers but also after finishing their medical rehabilitation. For the purpose of continuous follow-up of the war-wounded who wanted to continue sport activities the Guidance Center for Sport Activities of the Homeland War-Wounded was founded in Zagreb. The wounded that started sports activities on a recreational basis during treatment at the UHD are active today even in international competitions for handicapped and they achieve very good results. To reach this goal they have to exercise hard and regularly and this is possible only if their basic needs are fulfilled and they are well incorporated into their surroundings. This is an additional step in the social reintegration, i.e., the inclusion of these persons into their surroundings and all parts of the society they belong to and to which they gave the best part of themselves.

[The cervical spine involvement in patients with psoriatic arthritis]. / Afekcija vratne kraljeznice u bolesnika s psorijaticnim artritisom.

UNLABELLED: Psoriatic arthritis (PsA) is a systemic disease and cervical spine can be affected. The data regarding cervical spondylitis are very rare and diverse in literarture. The aim of study was to assess the prevalence of cervical spine involvement in patients with PsA. Between totally 41 patients with PsA we confirmed the incidence of 68% (29 patients) with symptomatic cervical spine disease and 29% (12 patients) with radiological evidence of inflammatory involvement. The most frequent radiological findings were apophyseal joint changes, rarely ligamentous calcification and syndesmophytes. Only one patient had subaxial subluxation. The most common type of PsA was axial disease with or without peripheral arthritis (46%) and the least common was oligoarthritis (22%). There was no statistically significant difference between any type of PsA and cervical involvement. CONCLUSION: inflammatory cervical spine changes are not common radiographic finding in patients with PsA and apophyseal joint affection is the most common radiologic sign.

[Weekly and daily intake of alendronate: comparison of tolerance in osteoporosis treatment]. / Usporedba podnosuivosti tjedne i dnevne primjene alendronata u lijecenju osteoporoze.

In this study we analyzed, considering complains of patients, tolerance of taking alendronate 70 mg once a week in comparison with daily intake of alendronate 10 mg. Subjects were patients that were treated for osteoporosis at Department for physical medicine and rehabilitation in Clinical hospital Dubrava. The diagnosis of osteoporosis was established by DXA densitometry. Pains in oesophagus were the main reason for ceasing of use of alondronate. According to our research patients tolerate taking alendronate 70 weekly 4,22 times better than alendronate 10 daily.

[The presence of CD30 on lymphocytes in the inflammatory infiltrate of acute atopic dermatitis]. / Pojavnost CD30 na limfocitima u upalnom infiltratu akutne faze atopijskog dermatitisa.

Atopic dermatitis (AD) has cellular immunohistochemical features similar to those of allergic contact dermatitis (ACD). There is plenty of evidence for T-cell activation in this disease such us the presence of T-lymphocytes which carry CD30, CD3, CD4, CD45RO markers. The aim of this study was to show the presence of lymphocyte-surface antigens including CD30, CD3, CD4, CD45RO in patients with acute AD and to compare the presence of the same molecules in patients with acute ACD (nickel-induced) because of the possible morphologic difference of these two entities. The presence of the stated molecules is immunohistochemically evaluated in biopsies of lesional skin in dermis and epidermis. Biopsies were obtained from twelve patients suffering from acute AD and from thirteen patients with ACD. The results show statistically significant higher average of presence and also much higher range of presence of CD30+, CD3+, CD4+, CD45RO+ lympohocytes in dermis and epidermis of patients with AD compared to the average and range in patients with ACD. Statistically much higher average of CD30, CD3, CD4, CD45RO is noticed in those occasions more in dermis than in epidermis in both groups of patients. High number of CD30+ lymphocytes in patients with acute AD does not however correlate with the severity of the disease evaluated according to clinical score for the evaluation of the severity of the disease, so called the SCORAD-index (Severity Scoring of Atopic Dermatitis). Our results showed an association betwen CD30 expression and acute AD but not with acute ACD which could evaluate CD3 as the useful marker in differentiating these two diseases.