The Mysterious “Shin Splint”

When I first started running about 7 years ago, I experienced pain in my right shin, which got worse with use and exercise. Specifically, this is pain in the medial tibia, exacerbated by stress and use (running). I asked around about it, and it was explained to me like this: these are “shin splints,” which are tears in the tendon which connects the muscle to the bone, specifically the calf muscle to the bone around that area. I was told that it was caused because the tendons are not strong enough to support the stress put on by the new exercise of the muscle pushing and pulling on it. The only thing to do is to rest and let it heal. So that’s what I was told. I let it heal by doing alternative cardio exercises like elliptical machine (which uses way fewer calories than running and doesn’t strengthen many muscles, but if you employ techniques to make it more difficult, you can strengthen the gluts & thighs) and rowing machine. After the pain went  away, I incorporated calf muscle-building exercise into my routine and never had a problem since. So that’s my anecdote.

What does the research say?

First of all the etiology (root biological cause) behind “medial tibial stress syndrome” is not known. So the story I was told, believed, and repeated, might not necessarily be true, but it is plausible. I found a pretty good review of risk factors (here). Continue reading

Towards an HIV Cure

In the past several months, there have been some highly publicized stories of individuals being “cured” of HIV. I put cured in quotes because these are case reports “functionally cured” … meaning after treatment has been withdrawn, the virus cannot be detected. There’s no way of knowing with 100% certainty that there isn’t at least one latent copy somewhere in the patients’ bodies. This is because of the nature of HIV and retroviruses in particular. The virus integrates its genome into the host’s genome. It can remain there dormant for years or the remainder of the host’s natural life without causing problems. While it is dormant, the host cells can themselves divide and replicate and expand what is known as the “viral reservoir.” At some point, many years down the line, the virus could be reactivated by some event (or from random chance) and what was just a single integration event …. could be thousands of cells producing new viral particles. So the only way to be 100% certain that someone is cured of a retrovirus is to check the genome of each and every susceptible cell and determine that it does not contain integrated latent virus. This isn’t really possible with a living person, so the best we can say is that someone continues to live “functionally cured.”

HIV Life Cycle. Current drugs prevent functioning of viral entry, reverse transcriptase, integrase, and protease. It does not prevent DNA replication via normal cell cycle of a latently-infected cell; which was what “eradication” therapy would target.

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Out of the Box Treatment for Multiple Sclerosis

I came across an article that is an interesting illustration of the scientific process in medicine that’s a good example of : 1. Good science reporting, 2. A well-reported Phase 1 clinical trial, 3. Good prior plausibility, and 4. Out of the box thinking.

There’s been some discussion of  bad science reporting when it comes to medicine. If something is lauded as a miracle-cure and it turns out not to be, then confidence in biomedical research is eroded. Sometimes real harm is done when people forgo evidence-based treatment in search of miracle “natural” cures. This is what is happening with stem-cell research, (too many miracles promised). I think stem cells are a good laboratory model for studying cell biology, possibly of certain diseases — but there’s little plausability that injecting stem cells into the body will cure everything from arthritis to Multiple Sclerosis. Continue reading