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  • Treatment for Osteoarthritic Knees and Hips May Differ

    Duke University researchers who found that osteoarthritic knees, but not hips, are in a constant state of repair say that knee and hip osteoarthritis may need different treatment approaches.

    "This suggests the knee has capacity for repair we didn't know about and the main treatment strategy probably would need to focus on turning off the breakdown of knee tissue," says Virginia Kraus, MD, PhD, professor of Rheumatology and Immunology at Duke.

    The findings, published in Journal of Biological Chemistry, suggest that for hips, however, halting the degenerative process might not be enough. The hips would need a treatment to both stop degeneration and stimulate factors that could help to begin repair.

    The knee is very accessible for injections, so it would make sense to inject the knee with agents that could turn off the degradative processes, and these could be delivered periodically with close monitoring, Kraus said. A cocktail of drugs might be needed for the hip, however, both to halt the degradation and to stimulate the right type of reparative elements.

    Kraus and her team discovered a biomarker that is a measure of an altered (deaminated) protein, called D-COMP. In the circulation it signals hip degeneration and in cartilage it provides insight into the repair response of joint tissues. Kraus said this is the first biomarker specific to a particular joint site, and may be developed into a monitoring tool for hip-joint breakdown.

    The next step is to understand the reasons for the difference between knees and hips and also to use new tools to analyze the ankle for its level of repair response.

    Call for Abstracts: Bone and Skeletal Muscle Interactions

    Abstracts for a topical meeting of the American Society for Bone and Mineral Research (ASBMR), a founding member of the United States Bone and Joint Initiative, will be accepted until February 29. The meeting on bone and skeletal muscle interactions, July 17-18  in Kansas City, Missouri, will draw together leading muscle and bone researchers to exchange ideas, develop new collaborations, and accelerate the emerging scientific discoveries in the area of muscle and bone interactions. Information on abstract categories and submission criteria can be found on ASMBR's Web site. 

    Contact ASBMR for further information by e-mail or at 202/367-1161.

    IOM Outlines Strategies for 'Living Well' With Chronic Illness

    To improve the quality of life for people with chronic illnesses, models of chronic disease care should align the resources of community-based organizations, the health care delivery system, employers and businesses, the media, and the academic community, says a new report from the Institute of Medicine (IOM).

    Living Well with Chronic Illness: A Call for Public Action lays out a framework to guide the development and implementation of cross-cutting strategies that reduce the individual and societal burdens of chronic illness by helping people with chronic illnesses live well.

    Key findings of the report include:

    • All chronic illnesses hold the potential to worsen the overall health of the nation by limiting an individual's capacity to live well.
    • Evidence-based interventions aimed at preventing chronic disease (such as ending smoking, eating nutritious food, and limiting weight gain) need to be studied in people with 1 or more chronic illnesses to assess their effectiveness.
    • While a range of public policies have helped people with chronic illnesses, it is important to design and implement new public policies or explore promising approaches to further promote living well with chronic illnesses.
    • Enhanced collaboration among the public health, health care, and community nonhealth care sectors could produce better prevention and treatment outcomes for people living with chronic disease.

    IOM does not recommend a specific set of illnesses on which to focus public health action. Instead, it identifies 9 “exemplar” conditions that are diverse yet have various factors in common, including significant effects on the nation's health and economy. The conditions are arthritis, cancer survivorship, chronic pain, dementia, depression, type 2 diabetes, posttraumatic disabling conditions, schizophrenia, and vision and hearing loss.

    Two education sessions at PT 2012 will address the management of chronic illness. The Role of Physical Therapists in Public Health: Prevention and Management of Chronic Disease and Disability will be held June 8, 1 pm-3pm. The Management of Older Individuals With Chronic Illness: A Case-based Approach will be held June 8, 3 pm-5 pm.