Tackling osteoarthritis during COVID-19 pandemic.

In this opinion article, we would like to draw attention to the fact that COVID-19 has a significant impact not only on immune-mediated arthritis but also on osteoarthritis (OA), the most common rheumatic disease. We suggest herein strategies for pain relief and symptom prevention in patients with OA during COVID-19 pandemic.

Nitric oxide and cyclooxygenase may participate in the analgesic and anti-inflammatory effect of the cucurbitacins fraction from Wilbrandia ebracteata.

Wilbrandia ebracteata is a medicinal plant from South America used in folk medicine for the treatment of chronic rheumatic diseases. We have shown that the high performance liquid chromatography-characterized (HPLC) dichloromethane fraction isolated from Wilbrandia ebracteata (WEDC) inhibits the parameters observed in experimental models of inflammation in vivo and in vitro. In the present study, we extend our previous observations on the analgesic effects of WEDC by investigating its actions using the hot plate test and zymosan-induced writhing test in mice, as well as zymosan-induced arthritis in rats evaluating articular inflammatory pain, cell migration and determination of NO release into the joint exudate. The effect of WEDC on the activity of COX-1 and COX-2 in vitro and its ulcerogenic capacity in vivo were also investigated. The oral treatment of the animals with WEDC (1-10 mg/kg) produced a significant, dose-dependent reduction of articular incapacitation and abdominal contortions in the writhing test. The same effect was not observed in the hot plate and rota-rod tests. WEDC also reduced nitrite release into the zymosan-inflamed joints. In the evaluation of COX activity, we observed that WEDC was able to selectively inhibit COX-2 but not COX-1 activity in COS-7 cells. Moreover, WEDC treatment did not show gastrointestinal toxicity. Our data confirm the anti-nociceptive activities of the WEDC and indicate that this effect could be associated with inhibition of cyclooxygenase-2 (COX-2) and nitric oxide release. The effects could be attributed to cucurbitacins since several of these were isolated from the WEDC.

Low incidence of hip fractures in an equatorial area.

Hip fractures in patients older than 60 years of age represent a serious morbidity linked to osteoporosis that contributes to its mortality rates. Both genetic and environmental influences have been reported as important factors related to the epidemiology of osteoporosis. Sobral, a city located in the northeast (equatorial zone) of Brazil (3 masculine S/40 masculine E) has 138,565 inhabitants, who are mostly white Portuguese and native Brazilian descendants. We evaluated the occurrence of hip fractures in Sobral between July 1996 and June 2000. This was a retrospective cohort-based study. Data were obtained from the medical records of the Santa Casa de Sobral, which is the reference hospital in this area. All chart records of patients aged >20 years with a diagnosis of femoral or hip fracture were revised. A total of 79 fractures were identified. Ten cases (12.6%) that occurred in patients <50 years of age were excluded from further analysis. Sixty-nine cases (87.3%) occurred in patients aged >50 years, comprising 19 (27.5%) men and 50 (72.4%) women. This gives an age-adjusted annual incidence rate of 5.59/10,000 per year in men and 12.4/10,000 per year in women, respectively, for people >50 years of age. Two patients, aged 79 and 82, died 9 and 6 days, respectively, after hospital admission. The average time of hospitalization was 7.5 days (range 4-19 days). As expected, there was a significant rise in hip fractures in people >50 years old. Interestingly, the hip fracture rate in this population is considerably lower (around 4 times less) than the reported rates in white Caucasians.