Evidence Based Approach to Perthes.

Perthes is a self-limiting disorder of paediatric hip. The outcome of this disorder is variable. Every aspect of it including, etiology, pathogenesis, pathology, classification, natural course, management and outcome is controversial. There is still no clear guideline for the management of Perthes disease. The aim of treatment is to prevent the head deformity and subsequent secondary osteoarthritis of hip. To maximize the results of containment procedures, measures to unstiffen the hip should be taken. Evidences are there that only a section of involved hips need intervention. Most untreated hips do not require intervention until the age of forty.

MicroRNAs and Their Role in Bone Remodeling and Pathogenesis.

MicroRNAs, a class of post-transcriptional gene expression regulators that bind to complementary sequences in the 3’ UTR or 5’ UTR of mRNAs have recently been detected in human body fluids including peripheral blood plasma as extracellular nuclease resistant entities. It is now clear that the biogenesis and functions of microRNAs are related to the molecular mechanisms of various clinical diseases and they can potentially regulate every aspect of cellular activity. This review will highlight our current understanding of microRNA biogenesis and their mechanisms of action. It will also summarize recent works on the role of microRNAs in bone remodeling including angiogenesis, osteoblast and osteoclast differentiation and in various bone related pathologies. An in-depth understanding of the roles of these regulatory mRNAs in the skeleton will be critical for the development of new therapeutics aimed on bone remodeling including fracture repair and bone-related diseases.

The association of anthropometric measures and osteoarthritis knee in non-obese subjects: a cross sectional study

OBJECTIVE: Body mass index (BMI) and knee osteoarthritis have a strong association, but other anthropometric measures lack such associations. To date, no study has evaluated non-obese knee osteoarthritis to negate the systemic and metabolic effects of obesity. This study examines the validity of the contention that BMI and other anthropometric measures have a significant relationship with knee osteoarthritis. METHODS: In total, 180 subjects with a diagnosis of knee osteoarthritis were recruited and classified according to Kellgren-Lawrence (KL) grades. Body mass index, mid-upper arm circumference, waist-hip ratio and triceps-skinfold thickness were recorded by standard procedures. Osteoarthritis outcome scores (WOMAC) were evaluated. RESULTS: (1) In both genders, the BMI was significantly higher for KL grade 4 than for grade 2; triceps-skinfold thickness was positively correlated with the joint space width of the tibial medial compartment. (2) In males, triceps-skinfold thickness significantly increased as the KL grades moved from 2 to 4; the significantly higher BMI found in varus aligned knees was positively correlated with WOMAC scores. (3) In females, the waist-hip ratio was significantly higher for KL grade 4 than for grade 2; a significant correlation was found between BMI and WOMAC scores. The waist-hip ratio was significantly associated with varus aligned knees and it positively correlated with WOMAC scores and with the joint space width of the tibial medial compartment. The mid-upper arm circumference demonstrated no correlation with knee osteoarthritis. CONCLUS'ON: This study validates the contention that BMI and other anthropometric measures have a significant association with knee osteoarthritis. Contrary to common belief, the triceps-skinfold thickness (peripheral fat) in males and the waist-hip ratio (central fat) in females were more strongly associated with knee osteoarthritis than BMI.

Medicina moderna: rumo à prevenção, à cura, ao bem-estar e à longevidade / Modern medicine: towards prevention, cure, well-being and longevity / La médecine moderne: vers la prévention, la guérison, le bien-être et la longévité / Medicina moderna: en direción a la prevención, a la cura, al bienestar y a la longevidad

A medicina moderna tem realizado muitas coisas nos campos de doenças infecciosas e de emergências para assistir a cura. Na maior parte dos outros campos, ela visa, sobretudo, ao controle, que é outro nome para o tratamento paliativo. A farmacologia, na qual se inclui a psicofarmacologia, é igualmente dirigida ao controle e ao alívio. Está na hora de profissionais da área e pesquisadores voltarem-se decisivamente para a prevenção e para a cura. Ademais, o outro grande desafio da medicina moderna é a longevidade aliada ao bem-estar. Avanços em vacinas contra hipertensão, diabetes, câncer etc. merecem atenção, bem como o papel da meditação, yoga, espiritualidade etc. na prevenção de doenças em vários níveis. Pesquisas sobre longevidade, mudanças no estilo de vida e centenários saudáveis merecem um exame especialmente minucioso na busca dos fatores que contribuem para a longevidade com bem-estar. Um olhar de perto para a medicina complementar e alternativa é necessário para encontrar modelos apropriados que esta possa vir a ter, à parte seus grandes discursos ou sua hostilidade para com o cuidado médico tradicional. A medicina é uma manifestação do Eros humano, e não deve tornar-se instrumento de seu Tanatos. Ela deve realizar seu verdadeiro potencial, de forma que Eros prevaleça, e Tanatos prevaleça apenas finalmente, não prematuramente.

Modern medicine has done much in the fields of infectious diseases and emergencies to aid cure. In most other fields, it is mostly control that it aims for, which is another name for palliation. Pharmacology, psychopharmacology included, is mostly directed towards such control and palliation too. The thrust, both of clinicians and research, must now turn decisively towards prevention and cure. Also, longevity with well-being is modern medicine's other big challenge. Advances in vaccines for hypertension, diabetes, cancers etc, deserve attention; as also, the role of meditation, yoga, spirituality etc in preventing disease at various levels. Studies on longevity, life style changes and healthy centenarians deserve special scrutiny to find what aids longevity with wellbeing. A close look at complementary and alternative medicine is needed to find any suitable models they may have, cutting aside their big talk and/or hostility towards mainstream medical care. Medicine is a manifestation of the human eros, and should not become a means of its thanatos. It must realise its true potential, so that eros prevails, and thanatos prevails only ultimately, not prematurely.

La médecine moderne a fait de grands progrès dans les domaines des maladies infectieuses et des secours médicaux. Par contre, dans la plupart des autres domaines, y compris la pharmacologie et la psychopharmacologie, elle vise surtout les soins palliatifs. Dorénavant, les cliniciens et chercheurs devront se concentrer sur la prévention et la guérison, ainsi que sur le vieillissement en bonne santé. Les progrès dans les domaines des vaccins contre l'hypertension, le diabète, le cancer, etc. méritent une attention particulière ainsi que le rôle de la méditation, due yoga et de la spiritualité dans la prévention des maladies à différents niveaux. Les études sur la longévité, les changements de style de vie et les centenaires en bonne santé sont essentielles pour découvrir les facteurs qui influencent le vieillissement en bonne santé. Les médecines complémentaires et alternatives doivent être examinées en détail pour trouver des modèles appropriés. La médecine est une manifestation de l'éros humain et ne doit pas passer au service du thanatos. Elle doit réaliser son véritable potentiel, de sorte que éros puisse prévaloir et que thanatos ne l'emporte qu'en dernière instance, et non pas de façon prématurée.

La medicina moderna ha dado mucho para ayudar a curar en el campo de las enfermedades infecciosas y de emergencias. En la mayor parte de los otros campos, ella visa, sobretodo, el control, que é otro nombre para el tratamiento paliativo. La farmacología, dentro de la cual se incluye la psicofarmacología, es igualmente dirigida al controle y al alivio. Es tiempo de profesionales del área e investigadores volcarse decisivamente para la prevención y la cura. Además, el otro grande desafío de la medicina moderna es la longevidad aliada al bienestar. Adelantos en vacunas contra la hipertensión, diabetes, cáncer etc. merecen atención, tanto como el papel de la meditación, yoga, espiritualidad etc., en la prevención de enfermedades en varios niveles. Investigaciones sobre longevidad, mudanzas en el estilo de vida y la existencia de centenarios saludables merecen un examen especialmente minucioso en la búsqueda de los factores que contribuyen para la longevidad con bienestar. Una mirada más próxima para la medicina complementaria y alternativa es necesaria para encontrar modelos apropiados que esta pueda llegar a tener, dejando de lado los grandes discursos y/o su hostilidad para con el cuidado médico tradicional. La medicina es una manifestación del Eros humano, y no debe tornar-se instrumento de su Tánatos. Ella debe realizar su verdadero potencial, de forma a que Eros prevalezca y Tánatos prevalezca apenas finalmente, no prematuramente.