The disease modifying osteoarthritis drug diacerein is able to antagonize pro inflammatory state of chondrocytes under mild mechanical stimuli

SummaryObjectiveTo investigate the combination of mild mechanical stimuli and a disease modifying osteoarthritis drug (DMOAD) in inflammatory activated chondrocytes and to study the combination of drug and mechanical tension on the cellular level as a model for an integrated biophysical approach for osteoarthritis (OA) treatments.MethodsInterleukin-1beta (IL-1β) stimulated C28/I2 cells underwent mild mechanically treatment while cultured in the presence of the DMOAD diacerein. The pharmacological input of diacerein was evaluated by cell viability and cell proliferation measurements. Inflammation and treatment induced changes in key regulatory proteins and components of the extracellular matrix (ECM) were characterized by quantitative real-time PCR (qPCR). The effects on metalloproteinase-1 (MMP-1) activity and glycosaminoglycan (GAG) concentration in cell supernatants of treated cells were investigated.ResultsC28/I2 cells demonstrated significant changes in expression of inflammatory and cartilage destructive proteins in response to IL-1β stimulation. The chondroprotective action of diacerein in mechanically stimulated cells was mediated by a decrease in interleukin-8 (IL-8), fibronectin-1 (FN-1), collagen type I (Col 1) and MMP-1 expression levels, respectively. Augmented expression of interleukin-6 receptor (IL-6R) and the fibroblast growth factor receptors (FGFRs) by diacerein was not abolished by mechanical treatment. The observed effects were accompanied by a reduced cell proliferation rate, attenuated cell viability and extenuated MMP-1 activity.ConclusionDiacerein diversely regulates the expression of main regulatory proteins as well as components important to regenerate and set up ECM. Mechanical stimulation does not negatively influence the chondroprotective effect induced by diacerein treatment in immortalized human C28/I2 chondrocytes

Non-pharmacological treatment of osteoporosis with Nuclear Magnetic Resonance Therapy (NMR-Therapy)

Objectives: To demonstrate the long-term effects of the therapeutic use of nuclear magnetic resonance (NMR) on bone mineral density (BMD) parameters in patients with osteoporosis. Methods: We enrolled 103 patients aged between 45 and 89 years who had osteoporosis with a T-score of bone mineral density less than -2.5. All patients received an osteoporosis treatment with low field nuclear magnetic resonance using a special NMR device (MBST, MedTec, Germany) for one hour per day on 10 consecutive days. At baseline and 12 months after NMR treatment the BMD was measured by DEXA. Additionally, the levels of the bone turnover markers osteocalcin and bone crosslaps (B-CTX; crosslinked telopeptides of collagen 1) were measured by immunoassays. Results: BMD and serum levels of osteocalcin increased significantly from baseline to 12 months. B-CTX remained stable. Conclusions: Under therapeutically use of NMR-Therapy, BMD-parameters increased during 12 months after a treatment block (10 x 1h). Therefore, NMR-Therapy can be considered a useful alternative or supplement to medical therapy in patients with osteoporosis

Adipositas, Essverhalten und Persönlichkeitsstruktur – Erfolgreiche Veränderungen im Rahmen eines mehrwöchigen stationären Rehabilitationsaufenthaltes

Zusammenfassung: In der vorliegenden Studie wurde die Effizienz und Nachhaltigkeit eines psychologisches Behandlungsprogramms für adipöse RehabilitationspatientInnen (= PatientInnen mit Herz-Kreislauf- oder/und rheumatischen Erkrankungen) an 85 Patienten mittels Analyse zum Essverhalten (FEV) und zur Persönlichkeitsstruktur mittels des Freiburger Persönlichkeits-Inventars (FPI-R) evaluiert (Prä-, Post- und Katamneseuntersuchung mit Kontrollgruppendesign). Die Ergebnisse zeigen, dass das psychologische Programm bei den adipösen RehabilitationspatientInnen (N =53) zu einer erwünschten, vorteilhaften Veränderung des Essverhaltens führte. Einerseits nahm die kognitive Kontrolle des Essverhaltens, welche für eine erfolgreiche Gewichtsreduktion notwendig ist, erheblich zu; andererseits konnten negative Komponenten, nämlich die Störbarkeit des Essverhaltens sowie das Ausmaß an erlebten Hungergefühlen, deutlich reduziert werden. Auffallend gute Wirksamkeit bei weiblichen Patienten; wenngleich bei den Männern die erlebten Hungergefühle und der BMI sich ebenfalls nach 3 Monaten signifikant verminderten. Das Behandlungsprogramm zeigte unterschiedliche Effekte zwischen Rheuma- und Herz-Kreislaufpatienten.Abstract: Efficiency and sustainability of a psychological therapy programme for obese rehabilitation in-patients with cardiovascular and/or rheumatic diseases were studied by analyses of questionnaires concerning eating behaviour (FEV) and personality structure (Freiburger Persönlichkeitsinventar – FPI-R) of 85 obese patients. In this controlled study data were collected at admission, discharge, and follow-up after 1 year.The psychological programme resulted in an intended beneficial alteration of eating behaviour of the obese patients (N = 53). On the one hand, the cognitive control of eating behaviour that is needed for successful weight reduction increased significantly. On the other hand, negative components – in fact the disturb ability of eating behaviour and the extent of sensations of hunger – could be reduced significantly with differences in male and female. The therapy especially succeeded in female patients, although the sensations of hunger and the BMI of the male patients also reduced significantly after 3 months. The therapy programme also showed different effects regarding rheumatic or cardiovascular patients

Results of an Inpatient Preventive Health Care Program to Improve Quality of Life, Psychosocial Health, and Work Ability in Austria

Objective: The Austrian Federal Pension Insurance (PVA) developed a preventive inpatient health program, “Gesundheitsvorsorge-Aktiv (GVA),” for patients with musculoskeletal disorders. Individualized modular interventions and therapeutical measures (movement optimization, movement motivation, and mental health) are designed to improve occupational participation by influencing lifestyle factors and health-related quality of life. The study aimed to evaluate the new prevention-oriented and more personalized inpatient health program GVA.Methods: Patients underwent a standard inpatient health program, with emphasis on exercise management, exercise motivation, or psychological aspects. Submodule-dependent outcomes were assessed in patients (n = 330) at the start, end of treatment, and 6 months thereafter. Quality of Life (EQ-5D-5L), psychosocial aspects of the Patient Health Questionnaire (PHQ-D), and Work Ability Index (WAI) were queried.Results: The results consistently showed positive short and long-term effects. The subjective assessments of current work ability improved while the impairment of work performance was reduced. Positive changes in the psychosocial sphere were observed, alongside improvements in the health-related quality of life. Patients in the exercise optimization module performed better in all respects.Conclusion: In summary, GVA represents a valuable preventive health measure that leads to a holistic increase in well-being and can also ensure the maintenance of the ability to work

The Effects of Etodolac, Nimesulid and Naproxen Sodium on the Frequency of Sister Chromatid Exchange after Enclused Third Molars Surgery

are frequently used in oral surgical procedures in dentistry. The evaluation of the frequency of sister chromatid exchange (SCE) is accepted as a reliable cytogenetic method to assess the genotoxic effects of environmental factors. Materials and Methods: In this study, the genotoxic effects of various NSAIDs were assessed in 30 patients to who they were administered following encluosed third molar surgery using SCE analysis before and after the operation. The frequency of SCE was evaluated before the operation and after 3 days of etodolac, nimesulid and naproxen use. Results: There was no statistically significant difference in the frequency of SCE between the preoperative and postoperative states in patients given etodolac, nimesulid or naproxen sodium. Conclusion: Short term use of selective and non-selective NSAIDs was not associated with a significant genotoxic effect that could be detected using the SCE method in peripheric lymphocytes. Key Words: Genotoxicity, sister chromatid exchange, oral surgery, non-steroidal anti-inflammatory drug

Cardiac rehabilitation in Austria: long term health-related quality of life outcomes

<p>Abstract</p> <p>Background</p> <p>The goal of cardiac rehabilitation programs is not only to prolong life but also to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL). The aim of this study was to document the long-term effect of a 1-month inpatient cardiac rehabilitation intervention on HRQL in Austria.</p> <p>Methods</p> <p>Patients (N = 487, 64.7% male, age 60.9 ± 12.5 SD years) after myocardial infarction, with or without percutaneous interventions, coronary artery bypass grafting or valve surgery underwent inpatient cardiac rehabilitation and were included in this long-term observational study (two years follow-up). HRQL was measured with both the MacNew Heart Disease Quality of Life Instrument [MacNew] and EuroQoL-5D [EQ-5D].</p> <p>Results</p> <p>All MacNew scale scores improved significantly (p < 0.001) and exceeded the minimal important difference (0.5 MacNew points) by the end of rehabilitation. Although all MacNew scale scores deteriorated significantly over the two year follow-up period (p < .001), all MacNew scale scores still remained significantly higher than the pre-rehabilitation values. The mean improvement after two years in the MacNew social scale exceeded the minimal important difference while MacNew scale scores greater than the minimal important difference were reported by 40-49% of the patients.</p> <p>Two years after rehabilitation the mean improvement in the EQ-5D Visual Analogue Scale score was not significant with no significant change in the proportion of patients reporting problems at this time.</p> <p>Conclusion</p> <p>These findings provide a first indication that two years following inpatient cardiac rehabilitation in Austria, the long-term improvements in HRQL are statistically significant and clinically relevant for almost 50% of the patients. Future controlled randomized trials comparing different cardiac rehabilitation programs are needed.</p