Marcos Tadeu Parron Fernandes

Association of interleukin-6 gene polymorphism (rs1800796) with severity and functional status of osteoarthritis in elderly individuals

Osteoarthritis (OA) is the most prevalent disease of the musculoskeletal system and it has an important genetic component. Despite several reports have shown the involvement of pro-inflammatory cytokine such as interleukin-1β and TNF-α, the role of interleukin-6 (IL-6) in osteoarthritis is still unclear. Thus, this study aimed to analyze the relationship between the single nucleotide polymorphism in the portion -572 of the promoter region of the IL6 gene (SNP -572G/C) with hip and knee OA in the elderly. In this case-control study, 257 physically independent elderly were recruited (case group: 92 individuals with osteoarthritis and control group: 165 individuals with no osteoarthritis). Blood samples were collected from patients for the DNA fragments extraction and amplification by real-time polymerase chain reaction (PCR) by TaqMan system for subsequent genotyping of IL6 gene. The degree of joint damage was assessed by radiographic classification based on the criteria of Kellgren and Lawrence. The functional status was evaluated by Lequesne and WOMAC questionnaires. It was observed that individuals carrying the C allele have lower susceptibility to osteoarthritis (OR=0.51, 95% CI: 0.32-0.80, p=0.004) and less radiological impairment for both hip (Fisher-Freeman-Halton test=4.2 and p=0.04) and knee joints (Fisher-Freeman-Halton test=4.7 and p=0.03). Regarding functional status, individuals carrying the C allele has a lower degree of functional impairment assessed by WOMAC (Mann-Whitney test, p=0.04), although no difference was observed in the Lequesne questionnaire (p>0.05). Additionally, it was observed a marked reduction in IL-6 serum levels in individuals with GC and CC genotypes when compared to individuals harboring GG genotype. In conclusion, the polymorphism -572G/C IL6 is a protective factor for the presence and severity of hip and knee osteoarthritis in the elderly. Further prospective studies with large sample size and methods (e.g. effect of this polymorphism on gene expression, haplotype analysis for IL-6 promoter polymorphism) are needed to validate this study findings.

Análise da influência da farmacoterapia sobre a qualidade de vida em idosos com osteoartrite

AIMS This study aimed to assess the influence of pharmacotherapy on health-related quality of life of elderly with ostheoartritis. METHODS Longitudinal study involving 91 older adults from both genders (Age: 70.36±5.57 years) from EELO project with self-reported knee or hip ostheoartritis, confirmed by radiographic analysis. Data regarding pharmacotherapy was assessed by a structured questionnaire and the quality of life was analyzed by SF-36 questionnaire at the initial moment and two years thereafter. All domains from quality of life were grouped in physical and mental components for further data analysis. RESULTS A statistically significant decline in health-related quality of life was observed (Wilcoxon test, p<0.05). However, it was observed a slighted decline in physical components in group treated with chondroitin/glucosamine when compared to other groups, according to Kruskal-Wallis test (p=0.007). On the other hand, it was not observed any influence of pharmacological treatment on mental components of health-related quality of life (p>0.05). CONCLUSIONS Treatment with condroitin/glucosamin contributes to a lower decline in physical component while it had no influence on mental component of health-related quality of life in older adults with ostheoartritis.

Postural Balance and Vitamin D Receptor Gene Polymorphism in Physically Independent Older Adults

This study aimed to assess the association between VDR polymorphisms and postural balance in physically independent elderly. 142 elderly persons were enrolled at this case-control study. In order to assess the balance, the individuals performed three 30-s trials of one-legged stance balance test on a BIOMEC400 force-platform (EMG System of Brazil, SP Ltda.), following a standardized protocol (with 30 s of rest between each trial). The main balance parameters used for analysis were: center of pressure area (COP), sway velocity (cm/s) and frequency (s) in both the antero-posterior (A/P) and the medio-lateral (M/L) axes. The VDR TaqI polymorphism analysis was by PCR-RFLP. The case group showed lower values of COP, sway velocity in A/P and M/L axes (p = 0.0007). Similar data were observed regarding frequency in A/P (p = 0.04) and M/L axes (p = 0.03). Therefore, carriers of the “C” allele have a better postural balance when compared to individuals with “T” allele.

Uso do questionário Lower Extremity Functional Scale (LEFS‐Brasil) em comparação com o Índice Algofuncional de Lequesne para definição de gravidade na osteoartrite de joelho e quadril

Osteoarthritis (OA) is a chronic joint disease with a high prevalence in the elderly.1 OA affects more often the hip and knee, compromising important aspects in activities of daily living such as walking, transposition of obstacles, home care and work activities.2 Several questionnaires have emerged to evaluate the functional capacity of patients with OA, which stand out by their simplicity and the ability to evaluate the perception of the

Patient-Controlled Analgesia (PCA) in Acute Pain: Pharmacological and Clinical Aspects

Moderate or severe pain are important sources of complications as well as morbidity and mortality in the postoperative period after surgical procedures. Patient‐controlled analge‐ sia (PCA) is an effective strategy for postoperative analgesia, since it may provide suitable analgesic dose just after system activation, with reduced periods of pain and an increase in patients’ satisfaction. Although intravenous and epidural routes are the typical approaches used for PCA, regional patient‐controlled analgesia has been shown to be an effective alter‐ native providing a higher standard of analgesia with lower incidence of adverse effects. New devices and routes of PCA administration (transdermal, sublingual, inhalation, and oral routes) have shown to be promising alternatives in clinical studies. Nowadays, there is still no consensus regarding which is the best route or drug used since clinical efficacy/safety depends on the complex comprehension of the drugs pharmacokinetic profile through dif‐ ferent routes of administration. Additionally, pharmacoeconomic studies are needed to evaluate the cost‐effectiveness of these approaches.

POLYMORPHISM OF THE COX-2 GENE AND SUSCEPTIBILITY TO COLON AND RECTAL CANCER

ABSTRACT Background: The colorectal neoplasm is the fourth most common malignancy among males and the third among females. In the Western world is estimated that 5% of the population will develop it, making this disease a major public health problem. Aim: To analyze the prevalence of the polymorphism -765G / C region of the COX-2 gene in colorectal cancer patients compared to a control group, analyzing the possible association between this polymorphism and susceptibility to colorectal cancer. Method: This is a case-control study with 85 participants. Were selected 25 with colorectal cancer (case group) and 60 participants without colorectal neoplasia (control group). The molecular genetic analysis was perform to identify the polymorphism -765G / C COX2 gene with standard literature technique. In addition, patient’s clinical and pathological data were analyzed. Results: There was a light increase in prevalence between men in the case group, although this difference was not statistically significant. The results showed a high prevalence of GC and CC genotype in individuals with colorectal cancer, demonstrating an association between the presence of the polymorphism in the COX2 gene and susceptibility to colorectal cancer in this pattern (p=0.02). Similarly, there was also difference in allele frequencies in the groups. When patients with cancer were separated by tumor location, there was a higher prevalence of polymorphism in the left colon (p=0.02). Conclusion: The polymorphism in the COX2 gene is associated with increased susceptibility to colorectal cancer, specially rectosigmoid tumors.