The ability of clinical tests to diagnose stress fractures: a systematic review and meta-analysis.

Study Design: Systematic literature review and meta-analysis.

Objectives: To evaluate the diagnostic accuracy of clinical tests to identify stress fractures in the lower limb.

Background: Stress fractures are a bone-related overuse injury primarily occurring in the lower limb and commonly affecting running athletes and military personnel.

Ultradian cortisol pulsatility encodes a distinct, biologically important signal.

Context: Cortisol is released in ultradian pulses. The biological relevance of the resulting fluctuating cortisol concentration has not been explored.

Objective: Determination of the biological consequences of ultradian cortisol pulsatility.

Ligand modulation of REV-ERBalpha function resets the peripheral circadian clock in a phasic manner.

The nuclear receptor REV-ERBalpha is a key negative-feedback regulator of the biological clock. REV-ERBalpha binds to ROR elements of the Bmal1 (Arntl) promoter and represses Bmal1 transcription. This stabilizing negative loop is important for precise control of the circadian pacemaker.

Drug insight: selective agonists and antagonists of the glucocorticoid receptor.

Glucocorticoid hormones exert a wide spectrum of metabolic and immunological effects. They function through the glucocorticoid receptor, a member of the nuclear receptor superfamily. Glucocorticoids are particularly effective as anti-inflammatory agents but often cause severe side effects.

Modelling the glucocorticoid receptor and producing therapeutic agents with anti-inflammatory effects but reduced side-effects.

Glucocorticoid hormones exert a wide spectrum of metabolic and immunological effects. They are synthesized from a cholesterol precursor and are structurally related to the other steroid hormones, progesterone, aldosterone and oestrogen. They act through the glucocorticoid receptor (GR), a member of the nuclear receptor superfamily.

Human macrophage migration inhibitory factor: a proven immunomodulatory cytokine?

Macrophage migration inhibitory factor (MIF) is a pro-inflammatory mediator with the ability to induce various immunomodulatory responses and override glucocorticoid-driven immunosuppression. Some of these functions have been linked to the unusual enzymatic properties of the protein, namely tautomerase and oxidoreductase activities. However, there are conflicting reports regarding the functional role of these enzymatic properties in normal physiological homeostasis and disease progression.