Antiresorptive drugs (bisphosphonates), atypical fractures and rebound effect: new evidence of similitude

Background: Homeopathy is based on treatment by similitude ('like cures like') administering to sick individuals substances that cause similar symptoms in healthy individuals, employing the secondary and paradoxical action of the organism as therapeutic response. This vital or homeostatic reaction of the organism can be scientifically explained by the rebound effect of drugs, resulting in worsening of symptoms after suspension of treatment. Bisphosphonates (BPs) reduce 'typical' fractures in patients with osteoporosis, but recent studies report 'atypical' fractures of the femur after stopping the BPs, a rebound effect may be the causal mechanism. Method: Review of the literature concerning the relationship between atypical femoral fractures and antiresorptive drugs (bisphosphonates), identifying the pathogenesis of this adverse event. Results: Several studies have described multiple cases of 'atypical' low-impact subtrochanteric stress fractures or complete fractures of the femur. These fractures are often bilateral, preceded by pain in the affected thigh, may have a typical X-ray appearance, and may delayed healing. Rebound of osteoclastic activity after suspension of antiresorptive drugs is a plausible mechanism to explain this phenomenon. Conclusion: As for other classes of drugs, the rebound effect of antiresorptive drugs supports Hahnemann's similitude principle (primary action of the drugs followed by secondary and opposite action of the organism), and clarifies this 'unresolved' issue. Unfortunately, the rebound effect is little discussed among health professionals, depriving them of important knowledge ensure safe management of drugs. Homeopathy (2012) 101, 231-242.

Effect of fungicides and alternative products in control of anthracnose and black spot of guava

This work aimed to evaluate the efficiency of fungicides in controlling in vitro and in vivo the causal agents of anthracnose (Colletotrichum gloeosporioides and C. acutatum) and black spot (Guignardia psidii) and evaluate the effect of alternative products to control these diseases. Inhibition of mycelial growth of the pathogens was evaluated for ten fungicides at concentrations of 1, 10 and 100 mg L-1 of active ingredient in potato-dextrose-agar medium. The effectiveness of the fungicides azoxystrobin + difenoconazole, cyproconazole, pyraclostrobin, tebuconazole and tebuconazole + trifloxystrobin in controlling disease incidence and severity of anthracnose, through applications in the field, was measured in fruits collected at three stages of maturation, according to the skin color ( dark green, light green and yellowish green). In postharvest dipping of fruits, the products evaluated were citric acid, peracetic acid, salicylic acid, sodium bicarbonate, chlorine dioxide, Ecolife (R) and chitosan. The fungicides azoxystrobin + difenoconazole, pyraclostrobin, tebuconazole and trifloxystrobin + tebuconazole were highly effective in inhibiting the in vitro mycelial growth of G. psidii and moderately to highly effective in inhibiting C. acutatum and C. gloeosporioides. In field conditions, the fungicide azoxystrobin + difenoconazole was effective in controlling anthracnose and black spot in fruit at three maturity stage ( skin color yellowish green). The alternative products tested were ineffective in the curative control of anthracnose and early blight at postharvest of guava.