Hip and Knee Osteoarthritis in Patients with Chronic Myeloproliferative Neoplasms: A Cross-Sectional Study

BACKGROUND

Osteoarthritis (OA) is a progressive degenerative disease with an inflammatory background. Chronic myeloproliferative neoplasms (MPN) are clonal hematopoietic disorders characterized by chronic inflammation and a tendency for connective tissue remodeling.

AIM

This study aimed to investigate the prevalence and associated risk factors of symptomatic OA (sOA) in MPN patients.

PATIENTS AND METHODS

A total of 100 consecutive MPN (39 essential-thrombocythemia, 34 polycythemia-vera, 27 myelofibrosis) patients treated in two community hematologic centers were cross-sectionally evaluated. Patients were required to have both symptoms attributable to hip and/or knee OA and radiographic confirmation to be considered as having sOA.

RESULTS

The prevalence of hip and/or knee sOA was significantly higher among MPN patients than the previously reported prevalence in the general population of similar age (61% vs. 22%, p < 0.001). Hip sOA was present in 50%, knee sOA in 51% and sOA of both localizations in 41% of patients. A high proportion of MPN patients had radiographic signs of hip OA (94%) and knee OA (98%) in the presence of attributable symptoms. Among the other factors, sOA was univariately associated with the presence of JAK2 mutation, myelofibrosis phenotype, older age, higher body weight, and higher MPN-SAF score (p < 0.050 for all analyses). In the multivariate analysis, older age (odds ratio = 1.19, 95% confidence interval-CI 1.06-1.33) and higher body weight (OR = 1.15, 95% CI 1.06-1.25) were recognized as independent risk factors for sOA. On the other hand, cytoreductive treatment was a protective factor for sOA (OR = 0.07, 95% CI 0.006-0.86).

CONCLUSIONS

The prevalence of sOA in MPN patients was higher than that in the general population and seems to correlate with older age, increased myeloproliferation and a higher inflammatory state. Whether cytoreductive treatment may postpone OA development in MPN patients warrants additional confirmation.

Influence of Anticorrosive Pigment, Dry-Film Thickness and Conditioning Time on Protective Properties of Two-Component Epoxy Primer

The main protective properties of two-component epoxy coating are connected by the formation of a barrier of a certain thickness between the material and aggressive, environmentally induced reactants. Anticorrosive pigment is added to the coating in order to improve its protective effects. The conditioning time refers to the time interval required for the achievement of satisfactory cohesion bonds between the coating components, as well as a satisfactory adhesion force between the coating and the base material surface. This paper presents insights obtained after experimental research into the influence of input variables (the content of anticorrosive pigment in the coating, dry-film thickness, and conditioning time) on corrosion resistance. The specimens were kept in the aggressive atmosphere of a salt-spray test chamber within time intervals of 120, 240 and 480 h, where they were cyclically sprayed with a 5% sodium chloride (NaCl) solution, and then examined in laboratory conditions. Such a procedure imitated the aggressive conditions of a service environment. After exposure in the salt-spray test chamber, the specimens were tested to determine the protective properties of the coating and to evaluate damage occurring on the coating, with the purpose of assessing the coating quality in relation to the stated input variables. At all times, when the test samples were exposed to the salt chamber atmosphere, the anti-corrosion pigment content was found to have the greatest influence with the thickness of the dry coating film. The conditioning time was an influential factor to a lesser extent, and only in some observed cases. By analyzing the interactions of the input variables and the results obtained based on mathematical models and reaction surfaces, it was possible to define the most optimal values of the input parameters. For example, after 480 h of exposure in a salt chamber, notch corrosion of 0.6 mm was observed at a dry-film thickness of D1 and an anti-corrosion pigment content of 10%.

Potential clinically significant drug-drug interactions in prescribed pharmacotherapy in an outpatient setting

The aim of this study was to determine the most common potential clinically significant drug-drug unteractions (DDIs) in prescribed pharmacotherapy in an outpatient setting in Croatia. Twelve community pharmacies were randomly selected in this research. Retrospective pharmacotherapy record data analysis was conducted on consecutive eligible patients. Potential DDIs were detected using Lexicomp software that categorizes DDIs according to clinical significance. Categories C (monitor drug therapy), D (consider therapy modification) and X (avoid combination) are of clinical concern. In total, 1211 patients were enrolled in this study. The results showed that 84% of patients had at least one clinically significant interaction. The average number of interactions per patient was 4. Overall, 4798 potentially clinically significant DDIs were identified; 3945 (82.2%) required therapy monitoring, while other interactions (D and X category) required specific therapy modification. According to the level of clinical significance the most common clinical consequences of identified potential drug interactions were increased risk of hypotension, impaired renal function, central nervous system depression, gastrointestinal toxicity and QTc prolongation. Research indicates the high exposure to potential clinically significant DDIs in the prescribed pharmacotherapy in an outpatient setting and imposes the need for standardised models of pharmacist interventions.

Total hip arthroplasty in avascular necrosis of the femoral head in a patient with transplanted heart

With the improvement of transplantation techniques and immunosupresive treatment of transplanted patients, the number of heart transplantations increases worldwide including Croatia. The survival of such patients is significantly increased. Therefore, the prevalence of known complications is high, one of which is avascular necrosis of the femoral head. This paper presents a case of the first patient in Croatia who underwent bilateral hip arthroplasty due to bilateral avascular necrosis of the femoral head as a side effect of corticosteroid therapy after heart transplantation.