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The Spanish version of the Educational Needs Assessment Tool (SpENAT), is a self-completed questionnaire that assesses the educational needs (ENs) in osteoarthritis (OA) patients, with the purpose of providing tailored and patient-centered information. This study established the sources of information that patients use and to evaluate the ENs of patients with knee osteoarthritis (KOA) using the SpENAT.

Resumo Objetivo Este estudo teve o objetivo de analisar a associação entre a osteoartrite (OA) de joelho e a síndrome metabólica (SM) em pacientes idosos não institucionalizados. Métodos Pesquisa transversal, aleatorizada, extraída de um estudo probabilístico por conglomerado realizado com 416 idosos de uma Unidade de Saúde da Família do nosso município. A SM foi definida de acordo com o National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), e a OA de acordo com a escala Kellgren-Lawrence (KL) (≥ 2). Resultados Para a análise estatística, foi realizada uma análise exploratória de dados, testes de Mann-Whitney ou Qui-quadrado e regressões logísticas uni e multivariadas, com nível de significância de p Conclusão Conclui-se que a OA de joelho associa-se à CC, independente do peso, e que o aumento em sua medida reflete em uma maior chance de SM em idosos não institucionalizados.

BACKGROUND: This study aimed to investigate the relationship between radiologic severity by the grades of the Kellgren-Lawrence scale (K&Ls) independently and in two groups (grades "0 and 1" and "2 to 4") and instruments that assess depression symptoms, cognitive loss, risk of fall and quality of life related to knee osteoarthritis. METHODS: The analyzed materials were derived from a database and collected between 2013-2014 in Amparo (São Paulo, Brazil). 181 elderly with knee osteoarthritis who had a radiologic exam were evaluated for depressive symptoms, cognitive loss, quality of life and risk of fall by: Geriatric Depression Scale (GDS), Mini Mental State Examination (MMSE), WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), Timed Up and Go test (TUG) and Berg Balance Scale (BBS). To statistical analyses was used Fisher's exact test, Mann-Whitney test, Kruskal-Wallis test and Spearman's coefficient. RESULTS: There was no significant relationship between the instruments investigated and the grades assessed individually. However, when assessed by groups, grades “2 to 4” had the worst WOMAC score, the highest frequency and the worst risk of fall in the BBS, but not in the TUG. For GDS and MMSE, no significant relationships were found. In addition, K&Ls was correlated with the WOMAC socre, with no differences between their domains. CONCLUSION: Only when evaluated in groups, the radiological scores of the Kellgren-Lawrence scale pointed to a worse status in the WOMAC and BBS and the WOMAC score accompanies the increase in the radiological grade.

BackgroundThis study aimed to investigate the relationship between radiological severity, as assessed by the individual grades and grouped grades (grades “0 and 1” and “2 to 4”) of the Kellgren-Lawrence scale (K&Ls), and depression symptoms, cognitive loss, risk of falls, and quality of life in relation to knee osteoarthritis, as assessed by other instruments.MethodsData recorded between 2013 and 2014 in Amparo (São Paulo, Brazil) were retrieved for analysis. A total of 181 elderly patients who had knee osteoarthritis and underwent a radiologic exam were evaluated for depressive symptoms, cognitive loss, quality of life, and risk of falls by the Geriatric Depression Scale (GDS), Mini-Mental State Examination (MMSE), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), timed up and go test (TUG), and Berg balance scale (BBS). For statistical analyses, Fisher’s exact test, Mann-Whitney test, Kruskal-Wallis test, and Spearman’s coefficient analysis were used.ResultsThere was no significant relationship between the scores of the instruments investigated and the individual K&Ls grades. However, when the K&Ls scores were assessed by groups, grades “2 to 4” were associated with the worst WOMAC score and the highest frequency and risk of falls according to the BBS but not according to TUG. For the GDS and MMSE, no significant relationships with the K&Ls grades were found. In addition, the K&Ls grade was correlated with the WOMAC score, regardless of the domain.ConclusionThe radiological scores of the Kellgren-Lawrence (K&L) scale were associated with poorer WOMAC and BBS scores only when the K&Ls scores were evaluated in groups, and the WOMAC score was associated with an increase in the radiological grade.

OBJECTIVES: This study aimed to provide evidence for understanding how to treat osteoarthritis (OA) in our country. Therefore, it was necessary to match information and investigations related to the treatment of the disease from the three main types of specialists involved: physiatrists, orthopedists and rheumatologists. METHODS: The authors acted as a scientific advisory committee. From the initial discussions, a structured questionnaire was developed for use with a group of specialists on OA using the Delphi technique. The questionnaire was sent to 21 experts appointed by the authors, and the results obtained were critically analyzed and validated. RESULTS: The prevalence of OA was 33% in Brazil, corresponding to one-third of the individuals in the reference population, which included individuals over 25 years of age. Another significant finding was that most patients did not receive any form of treatment in the early stages of OA. CONCLUSION: The committee pointed to the need for early intervention and that the available medicinal resources can fulfil this important role, as is the case with SYSADOA treatments. Glucosamine-based medicinal products with or without chondroitin could also fulfill this need for early treatment. The other generated evidence and included investigations were then grouped together and are the subject of this publication.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. BACKGROUND: Latin America is a heterogeneous region made up of different populations, cultures, latitudes, altitudes, and immigrants from different areas and ethnic groups. OBJECTIVE: The purpose of this study is to describe the clinical and demographic profile of patients with osteoarthritis (OA) evaluated by a selected group of rheumatologists in 13 Latin American countries. METHODS: A descriptive, observational, cross-sectional study was conducted in 13 Latin American countries of patients with symptomatic OA. Data were collected over a 3-month period using an ad hoc questionnaire to evaluate the clinical and demographic features of OA seen by rheumatologists. RESULTS: Among the 3040 patients, their average age was 62.5 years, and female-to-male ratio was 4.8:1. Patients with body mass index of greater than 30 kg/m or obesity was found in 38.2%. Approximately 88% had primary OA. Joints with OA were as follows: knee 31.2%, hand 9.5%, hand and knee 22.9%, proximal and distal interphalangeal joints (erosive OA) 6.5%, axial 6.6%, and hip 1.3%. Approximately 88.5% had radiographic severity of grade 2 or 3 on Kellgren-Lawrence scale (0-4). Nonsteroidal anti-inflammatory drugs were the predominant OA treatment included in combinations with glucosamine sulfate/chondroitin and viscosupplementation. Associated comorbidities included hypertension (39%), obesity (36.3%), diabetes mellitus (12%), and without comorbidity (12.7%). CONCLUSIONS: This is 1 of the largest population studies that evaluated the characteristics of OA in 3040 patients evaluated by rheumatologists in 13 Latin American countries. This study provides important data for each Latin American country to develop new health care planning in management of OA. Revisión por pares

Aim In the elderly population, rheumatic conditions are major causes of pain that restrict participation in activities and mobility, and cause difficulties in the execution of self-care tasks. The present study aimed to analyze the prevalence and factors associated with the self-reported rheumatic diseases and chronic joint symptoms of the elderly. Methods This transversal epidemiological survey involved 2209 older adults (aged ≥60 years). The investigation included sociodemographic factors, anthropometrics, activities of daily living, chronic conditions, medication and quality of life. Univariate and multivariate regression analysis were used for statistical procedures, P ≤ 0.05. Results The prevalence of rheumatism was 22.7%. Multivariate analysis showed that rheumatism was correlated with the following: female sex (OR = 1.91), high income (OR = 2.34), cardiovascular disease (OR = 1.42), cataracts (OR = 1.39), glucocorticoids (OR = 5.24), other anti-inflammatory medications (OR = 2.24) and pain (OR = 0.983). After adjusting for age and glucocorticoids, an association between cataracts and rheumatism was detected (OR = 1.32). The prevalence of symptoms was 45.6%. Multivariate regression results for symptoms included the following: female sex (OR = 1.40), body mass index ≥30.0 kg/m2 (OR = 3.31), functional capacity (OR = 0.990), general health (OR = 0.993) and pain (OR = 0.981). After adjustment for age and glucocorticoids, an association between cataracts and symptoms was detected (OR = 1.26). Conclusion There was a significant association of rheumatism and symptoms with women and high incomes. Obesity was associated with joint symptoms, which in turn were associated with an impaired quality of life. Cataracts and cardiovascular disease were associated with rheumatism. The identification of these characteristics in the elderly will contribute to a better understanding of this systemic disease and should be used to plan effective preventive measures. Geriatr Gerontol Int 2013; 13: 1043–1050.

The objective of this consensus is to update the recommendations for the treatment of hand, hip, and knee osteoarthritis (OA) by agreeing on key propositions relating to the management of hand, hip, and knee OA, by identifying and critically appraising research evidence for the effectiveness of the treatments and by generating recommendations based on a combination of the available evidence and expert opinion of 18 countries of America.Recommendations were developed by a group of 48 specialists of rheumatologists, members of other medical disciplines (orthopedics and physiatrists), and three patients, one for each location of OA. A systematic review of existing articles, meta-analyses, and guidelines for the management of hand, hip, and knee OA published between 2008 and January 2014 was undertaken. The scores for Level of Evidence and Grade of Recommendation were proposed and fully consented within the committee based on The American Heart Association Evidence-Based Scoring System. The level of agreement was established through a variation of Delphi technique.Both "strong" and "conditional" recommendations are given for management of hand, hip, and knee OA and nonpharmacological, pharmacological, and surgical modalities of treatment are presented according to the different levels of agreement.These recommendations are based on the consensus of clinical experts from a wide range of disciplines taking available evidence into account while balancing the benefits and risks of nonpharmacological, pharmacological, and surgical treatment modalities, and incorporating their preferences and values. Different backgrounds in terms of patient education or drug availability in different countries were not evaluated but will be important.

Musculoskeletal disorders are the major causes of the pain in the elderly population. Rheumatic conditions restrict participation in activities and mobility, as well as cause difficulties in the execution of self-care tasks. The assessment of health related quality of life (HRQOL) is an important indicator of the impact of rheumatic diseases on the physical, mental and social aspects. This study aims to analyze the influence of rheumatic diseases and chronic joint symptoms on the quality of life of the elderly (n=2209) aged 60 years or over. The effects of rheumatism and joint symptoms on quality of life were investigated by the Outcome Study Short-Form Health Survey (SF-36), and this analysis was adjusted for age and sex. The univariate analysis of variance and analysis of covariance (ANOVA and ANCOVAS) were used for statistical procedures, p≤0.05. Rheumatic diseases affected: functional capacity (F(1, 2012))=10.9 and pain (F(1, 2012))=34.77. Joint symptoms affected all components of the SF-36: physical functioning (F(1, 2012))=10.9; physical problems (F(1, 2012))=72.61; pain (F(1, 2012))=164.29; general health (F(1, 2012))=71.95; vitality (F(1, 2012))=55.78; social aspect (F(1, 2012))=73.14; emotional aspect (F(1, 2012))=49.09 and mental health (F(1, 2012))=44.72. There was a significant impact of rheumatic diseases on physical health, and that joint symptoms affected self-evaluations of physical and mental health. These results will contribute to a better understanding of this systemic disease and will be used for planning effective interventions.

A 43-year-old woman reported pain in the right hypochondrium, which had started 3 years before and had been worsening for the past few days. Claudication in the superior and inferior limbs, diffuse myalgia, dyspnea, precordialgia followed by dizziness and visual turbidity were added to the clinical picture. In the physical examination bilateral carotid bruit was observed, abdominal aorta murmur and the decrease of the right radial and left pedis pulses and arterial hypertension with difference in the diastolic pressure between limbs >10 mmHg was also observed. On cardiac catheterisation with aortography, right coronary with proximal parietal irregularities, slight pressure increase in right chambers and pulmonary artery, preserved left ventricle contractility, competent valves, carotid and subclavian partial obstruction, severe narrowing of the abdominal aorta below the diaphragm (80%) and right renal artery significant stenosis were observed. Takayasu’s arteritis (TA) diagnosis was established according to the ACR criteria based on the clinical symptomatology, on physical and image test findings. Two years later she presented malar rash, photosensitivity, nephropathy, leukopenia, lymphopenia and hemolytic anemia confirming the systemic lupus erythematosus (SLE) diagnosis. TA coexisting with SLE has rarely been reported.

Camurati-Engelmann disease is a rare bone disorder characterized by cortical thickening of the diaphysis of tubular bones, with sparing of the epiphysis. It has variable degrees of penetrance and expression, but may be very disabling for the affected individuals who manifest the painful symptoms. The authors report on two women with typical presentation of severe Camurati-Engelmann disease whose treatment with bisphosphonates failed to add any improvement beyond that elicited by corticosteroids alone.

The aim of this paper was to evaluate bone mineral density (BMD) in patients with systemic lupus erythematosus (SLE), to determine the role of corticosteroids and cytotoxic drugs and to assess estrogen effect on BMD in SLE.BMD (DEXA) at lumbar vertebrae (L2-L4) and at femoral neck was performed in 60 pre-menopausal SLE patients and in 64 controls. Estradiol level was measured in all the individuals. Age, age at disease onset, body mass index (BMI), time of disease, disease activity (SLEDAI), prednisone dose at the evaluation, total cumulative and cumulative prednisone dose in the last year and cytotoxic drugs were assessed.The mean plasmatic estradiol was 175.9 pg/ml in patients and 149.9 in controls. BMD was inferior in patients than that in controls (P0.0001). The mean current, cumulative and previous year prednisone doses were, respectively, 19.17 mg/d, 28.78 g and 5.33 g. There was no association between corticosteroids or cytotoxic drug used and low bone mass. The serum concentration of estradiol did not influence the bone mass. The BMI and age at disease onset exhibited an influence on BMD at L2.BMD was significantly lower in SLE patients but not related to CS (Corticosteroids)or other drugs; the estradiol in these patients had no effect on BMD. Low BMI interacting with early onset of disease might influence the probability of loss of bone mass.

Resume Objectif. – Evaluer la DMO (densite minerale osseuse) de patients atteints de lupus systemique (SLE), avec une attention particuliere sur la corticotherapie, les traitements immunosuppresseurs et les taux d'œstrogenes. Patients et methodes. – La DMO a ete mesuree par absorptiometrie bi-photonique au rachis lombaire (L2–L4) et au col femoral chez 60 femmes lupiques en pre-menopause et chez 64 volontaires saines. Les taux d'œstradiol ont ete mesures. L'âge au moment de l'etude, l'âge au debut de la maladie, l'index de masse corporelle (BMI), la duree d'evolution de la maladie, l'activite de la maladie (index d'activite de la maladie lupique), la dose de corticoides au moment de l'evaluation, la dose cumulative de corticoides et la corticotherapie de la derniere annee, les immunosuppresseurs ont ete notes. Resultats. – Le taux d'œstradiol plasmatique etait de 175,9 pg/ml chez les patients et 149,9 pg/ml dans le groupe controle. La DMO etait plus basse chez les patientes que dans le groupe controle ( p Conclusions. – La DMO etait significativement plus basse chez les patientes atteintes de LEAD mais n'etait pas reliee a l'utilisation de prednisone ou d'immunosuppresseurs. Les taux d'œstradiol n'influencaient pas la DMO de ces femmes en premenopause. Un indice de masse corporelle bas et une maladie ayant debute jeune augmentaient le risque de demineralisation osseuse.

Psychosis and swelling of the face and hands are rarely observed in adult polyarteritis nodosa (PAN). We describe a 21-year-old woman who presented with fever, livedo reticularis, tender subcutaneous nodules and arthritis. These manifestations did not respond to prednisone, but remitted when the drug was tapered. She had had psychosis since the age of 16 years. During the flares of the disease she presented with facial, periorbital and hand swelling. This finding is rarely observed in adult PAN. Arteriography showed multiple small aneurysms, of the mesenteric vessels consistent with a diagnosis of PAN. Our report discusses the diagnosis of PAN and emphasises the uncommon presentation of this case.

Background Although recent advances in knee osteoarthritis (OA) treatment and evaluation were achieved, to the best of our knowledge, few studies have evaluated the longitudinal effect of therapeutic modalities on the functional exercise capacity of patients with knee OA. The purpose was to investigate the effects of kinesiotherapy and electrotherapy on functional exercise capacity, evaluated using the six-minute walk test (6-MWT) in patients with bilateral knee OA. Secondary measurements included range of motion (ROM), severity of knee pain (VAS), and a measure of perceived health and physical function, evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Methods A total of 40 women with bilateral knee OA were assigned to three groups: kinesiotherapy (KIN, n = 16), transcutaneous electrical nerve stimulation (TENS, n = 12), or ultrasound (US, n = 10). The groups underwent 12 weeks of intervention twice per week. The participants were subjected to the 6-MWT, ROM, VAS and WOMAC index. These tests were performed before and after the intervention. The study was focused on outpatients and was carried out at Universidade Estadual de Campinas, Brazil. Results At follow-up, the KIN and US groups had significantly higher 6-MWT distances (19.8 ± 21.7 and 14.1 ± 22.5%, respectively) compared with their respective pre-intervention values. All treatments were effective for reducing pain and improving the WOMAC index. Conclusions We demonstrated that the 6-MWT is a tool that can be used to evaluate improvements in the functional exercise capacity of patients submitted to a clinical intervention.

To evaluate disease characteristics of childhood onset SLE in Latin America and to compare this information with an adult population in the same cohort of GLADEL. A protocol was designed as a multicenter, multinational, inception cohort of lupus patients to evaluate demographic, clinical, laboratory and serological variables, as well as classification criteria, disease activity, organ damage and mortality. Descriptive statistics, chi square, Fisher's exact test, Student's t test and multiple logistic regression were used to compare childhood and adult onset SLE. 230 patients were < 18 years and 884 were adult SLE patients. Malar rash, fever, oral ulcers, thrombocytopenia and hemolytic anemia and some neurologic manifestations were more prevalent in children (p < 0.05). On the other hand, myalgias, Sjögren’s syndrome and cranial nerve involvement were more frequently seen in adults (p < 0.05). Afro-Latin-American children had a higher prevalence of fever, thrombocytopenia and hemolytic anemia. White and mestizo children had a higher prevalence of malar rash. Mestizo children had a higher prevalence of cerebrovascular disease and cranial nerve involvement. Children met SLE ACR criteria earlier with higher mean values than adults (p: 0.001). They also had higher disease activity scores (p: 0.01), whereas adults had greater disease damage (p: 0.02). In Latin America, childhood onset SLE seems to be a more severe disease than adults. Some differences can be detected among ethnic groups.

Background Various neurological manifestations have been considered to be important features of Systemic Lupus Erythematosus (SLE) and indicative of Central Nervous System (CNS) involvement. Few studies of SNC include headache and the real prevalence of headache in SLE remain unknown, but some authors consider it one of the most frequent neurological symptoms, especially during acute disease. Objectives To determine the point prevalence and the different types of headache in patients with SLE. To investigate associations between headache and clinical and laboratory manifestation of SLE, corticosteroid therapy, disease activity and CNS involvement. Methods A cross-sectional study of 40 patients with SLE was compared to 40 patients with rheumatoid arthritis (RA) and 40 controls. To assess the different types of headache an especial questionnaire was elaborated, according with ACR case definition. Systemic disease activity was measured by SLEDAI. Statistics were performed by chi-square test and by Fisher’s exact test. Results Headache was observed in 62.5% in SLE compared to 47.5% (p = 0.26) in RA and to 35.1% in controls (p = 0.0247). The types of headaches observed in SLE was migraine in 46%, tension headache in 36% and 20% had headaches during their menses. In RA we observed that 15.7% (p = 0.05) had migraine, 21% had tension headache, 37.5% had headache related to visual problems and 26% had headaches during the menses. In the control people group the prevalence of migraine was 23% (p = 0.05), tension headache 38% and headache during the in 38%. There was no significant association between headache and clinical manifestations of SLE, with laboratory abnormalities or the use of corticotherapy. A significant association in SLE was observed between seizures and migraine (p When comparing the presence of migraine to clinical and laboratorial results we observe a significant association with Raynauds phenomenon (p Conclusion Migraine was more prevalent in SLE than in the control groups. The positive association between migraine and seizures and a higher score at SLEDAI could be related to a greater CNS involvement in these patients. In our study, migraine was associated to antiphospholipid antibodies. References Omdal R, Mellgren SI, Husby G. Clinical neuropsychiatric and neuromuscular manifestations in systemic lupus erythematosus. Scand J Rheumatol. 1988;17:113–17 Adelman DC, Saltiel E, Klinenberg JR. The neuropsychiatric manifestations of systemic lupus erythematosus: an overview. Semin Arthritis Rheum. 1986;15(3):185–99

Background The personnel engaged in physical fitness programmes can suffer from many injuries due to sustained training. 1,2 Musculoskeletal injuries related to exercise are the main cause of premature discharge from military service and temporary disabilities. 2,3 When the risk factors are well-known and identified, prevention strategies can be better targeted and become more effective.4,5 However, there is still a lack of complete knowledge regarding the aetiology of exercise related to musculoskeletal disorders, which makes the establishment of prevention methods empiric for such injuries. 6 Objectives To determine the injury rates related to physical training occurring at a Brazilian military school, to investigate the risk factors for musculoskeletal injuries in general and for the most prevalent musculoskeletal injury observed, and to assess the quality of life of injured participants and the improvement in quality of life after treatment. Methods 498 military students were investigated during an 11-month period and were subjected at the beginning of the military service to evaluations, including physical fitness tests and anthropometric measurements. The variables included in the model were: running test, push-up test, pull-up test, sit-up test, swimming test, height, weight, and body mass index. The injury data were obtained in the physiotherapy service, and a comparison between the injured and uninjured group was conducted. The quality of life of the injured participants was evaluated using the SF-36 questionnaire, which was applied again thirty days after treatment had begun. Results Musculoskeletal injuries were exhibited by 28.31% of the students. Of these injuries, 62.41% were overload injuries. Medial Tibial Stress Syndrome (MTSS) was the most prevalent injury. None of the studied variables represented risk factors for musculoskeletal injuries in general. Lower body mass index and lower weight were found to be risk factors for Medial Tibial Stress Syndrome. The quality of life of the injured participants improved substantially after treatment. Conclusions The studied variables are not risk factors for musculoskeletal injuries in general, while low BMI and low weight are risk factors for MTSS. Physiotherapy treatment does an important role in the quality of life of injured militaries. References Morken T, Mageroy N, Moen BE. Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study. BMC Musculoskeletal disorders 2007; 8:56. Mehri NS, Sadeghian M, Tayyebi A, et al. Epidemiology of physical injuries resulted from military training course. Iranian Journal of Military Medicine 2010;12(2):89-92. Taanila H, Hemminki AJM, Suni JH, et al. Low Physical Fitness is a strong predictor of health problems among young men: a follow-up study of 1411 male conscripts. BMC Public Health 2011; 11:590. Murphy DF, Connolly DAJ, Beynnon BD. Risk factors for lower extremity injury. A review of the literature. Br J Sports Med 2003; 37:13-29. Willems TM, Clercq DD, Delbaere K, et al. A prospective study of gait related risk factors for exercise-related lower leg pain. Gait & Posture 2005. Thacker SB, Gilchrist J, Stroup DF, et al. The prevention of shin splints in sports: a systematic review of literature. Med Sci Sports Exerc 2001; 34(1):32-40. Disclosure of Interest None Declared

Background : Articular cartilage is a unique tissue in that it is avascular with its nutrition and oxygen supply being dependent on the diffusion of solutes through the synovial fluid and to and from the subchondral bone. The oxygen levels in articular cartilage, therefore, are assumed to be low. Oxygen is an important modulator of gene expression and this regulation occurs largely through the activation of the transcriptional complex hypoxia-inducible factor-1 (HIF-1). However, little is known about how articular cartilage regulates genes in response to O 2 tension and whether this regulation occurs through HIF-1. Aim : The aim of this study was to investigate the expression profile of HIF-1α in normal and osteoarthritic (OA) chondrocytes under normoxic and hypoxic conditions, and in response to treatment with tumor necrosis factor alpha (TNFα). Methods : Articular chondrocytes from human normal and OA knee cartilage were isolated and cultured in suspension under normoxic (21% O 2 ) or hypoxic conditions (1% O 2 ). Chondrocytes were also treated with TNF-α under normoxic conditions. Nuclear extracts and total RNA were prepared and HIF-1α protein and mRNA levels were assayed by immunoblotting and Northern hybridization. Localization of HIF-1α by immunofluorescence was performed on frozen sections of cartilage tissue by confocal microscopy. Results : HIF-1α expression was detectable in human normal and OA chondrocytes and cartilage by Northern analysis, immunoblotting and immunofluorescence under normoxic conditions. Culture of OA or normal chondrocytes under hypoxic conditions for up to 16h resulted in a modest stabilization and/or increase of HIF-1α expression. Treatment of articular chondrocytes with TNFα resulted in an increase in HIF-1α protein steady state levels under normoxic conditions. The increase in HIF-1α expression induced by TNFα was partially blocked by pretreatment of the chondrocytes with inhibitors of NFκB or p38 MAP kinase. We also observed the expression of HIF-2α mRNA in human chondrocytes. Conclusion : HIF-1α is expressed in human normal and OA articular chondrocytes cultured under normoxic conditions. HIF-1α can be further induced or stabilized in articular chondrocytes by hypoxia or by treatment with TNFα. The relatively high constitutive expression of HIF-1α by chondrocytes may be an important adaptation to survival in the avascular-hypoxic environment of cartilage. Modulation of HIF-1α levels by TNF-α may have important implications for chondrocyte metabolism during degenerative joint disease. In addition, we detected for the first time the expression of HIF-2α mRNA in chondrocytes.

Background The purpose of this study was to investigate the influence of muscle mass and bone mineral density on markers of mobility in dwelling elderly women. Methods This cross-sectional study included 99 elderly women, who were 65 years old or above, in Campinas-SP, Brazil. To collect data, we used sociodemographic data, the body mass index (BMI), health status, comorbidities, use of medications, mobility tests (TUG and gait speed) and examinations of the body composition (densitometry with dual-emission X-ray absorptiometry “DXA”). In order to examine the relationship between muscle and bone mass with mobility (gait speed and TUG), we applied the Spearman correlation coefficient. Also was applied the analysis of covariance (ANCOVA) adjusted for age and comorbidities. To identify the factors associated with mobility, we used the univariate and multivariate logistic regression analysis. The level of significance for statistical tests was P