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.

Do We Pay Enough Attention to Neuropathic Pain in Knee Osteoarthritis Patients?

The aim of the study was to determine the prevalence of neuropathic pain in knee osteoarthritis patients using painDETECT questionnaire, and to evaluate correlations between pain intensity, gender, age and types of treatment, and the presence of neuropathic pain. The study included 122 patients. All participants completed a questionnaire on sociodemographic data, duration of symp-toms, types of treatment and preventable risk factors (body mass index and waist circumference). The presence of neuropathic pain was assessed by painDETECT, according to which subjects were classified into three groups (neuropathic pain likely, possible, or unlikely). Neuropathic pain was likely in 18 (14.8%), possible in 30 (24.6%) and unlikely in 74 (60.7%) subjects. A significant positive correlation was found between visual analog scale for pain and painDETECT score. There was no statistically significant difference in gender, age, waist circumference and body mass index among three groups of participants according to painDETECT score. In conclusion, knee osteoarthritis patients with neuropathic pain component were experiencing higher levels of pain, implicating poorer pain control with common analgesics. Recognizing these patients as a distinct subgroup would allow clinicians to improve their treatment by using unconventional analgesics with central activity.

[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.

[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.