The administration of steroid medications may not be useful when it comes to preventing hospitalization or improving respiratory symptoms for treating young children suffering with bronchiolitis, a common viral lower respiratory infection in infants.

The findings by Pediatric Emergency Care Applied Research Network (PECARN) are considered to offer invaluable insights on how to move ahead for treating one of the most common causes of infant hospitalization.

From News-Medical.Net:

The study compared hospitalization rates for 600 children between the ages of 2 months and 12 months who visited emergency rooms with moderate-to-severe bronchiolitis. Patients were treated with either a dose of dexamethasone (a glucocorticoid form of steroid medication) or a placebo and evaluated after one hour, and again at four hours. The hospital admission rate for both groups was identical at nearly 40 percent. Both groups improved during treatment, but the placebo group did as well as the group treated with active medication. The study was conducted in the emergency departments at 20 hospitals across the United States between November and April during a three-year period. Bronchiolitis is most common during the winter months.

“We learned that a commonly used treatment doesn’t work,” said Howard M. Corneli, M.D., professor of pediatrics at the University of Utah and the principal investigator on the study. “Now that we’ve demonstrated glucocorticoids aren’t effective in treating bronchiolitis, we can focus our efforts on finding better treatments and better preventive strategies.”

Nathan Kuppermann, M.D., a professor of emergency medicine and pediatrics at the University of California, Davis, chair of the PECARN network’s steering committee, and the senior investigator of the study, remarked that this study suggested the effectiveness of a research network such as PECARN for resolving difficult-to-answer questions.

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There is a possible link between irritability and perimenopausal and postmenopausal women but there are not any study results or evidence suggesting an association.

A study examining association between menopause with sex steroids, gonadotrophins, prolactin and thyroid hormones and with samples including of 163 women, with a mean age of 55.1 years (SD = 5.7) in relation to 124 postmenopausal and 26 perimenopausal women, suggested that a high score is visible on inward and outward irritability scales in women with chronic disease.

Though not linked directly with menopause, it could have been partially influenced by the growing age of menopausal women.

From News-Medical.Net:

The subjects completed the Irritability, Depression, Anxiety Scale, which is an 18-item self-report scale that assesses irritability as a temporary psychological state. Irritability is divided into ‘outwardly directed’ if it is expressed toward others and ‘inwardly directed’ if it is directed toward oneself. Climacteric symptoms were evaluated by Greene’s scale, which provides subscores for vasomotor symptoms. Insomnia was measured by the Athens Insomnia Scale. Chronic disease refers to the existence of hypertension, cardiac disease, diabetes mellitus or thyroid disease.

The study sample consisted of 163 women, with a mean age of 55.1 years (SD = 5.7). Of the total sample, 124 women were postmenopausal and 26 perimenopausal. Fifty-four women suffered from chronic disease. The mean score for inward irritability was 5.1 (SD = 2.4) and 5.9 (SD = 2.7) for outward irritability. The mean scores for inward and outward irritability, insomnia and vasomotor symptoms were not different between peri- and postmenopausal women (analysis of covariance, p > 0.05). A significant positive correlation was found between outward irritability and FSH (r = 0.25,p = 0.005) and LH levels (r = 0.26, p = 0.006). There was no significant association between inward irritability and hormonal levels. No significant relationships were detected between vasomotor symptoms, insomnia and menopausal status and the 2 subscales of irritability.

The results of this study are seen by many as evidence that suggests a possible link between menopause and outward irritability.

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High morning levels of testosterone can help city traders to make more than just average profits, as per a research conducted at the University of Cambridge.

The involved scientists hypothesized that the improvement in terms of performance can be attributed to the fact that testosterone is known for increasing the appetite for risk and confidence - two factors that are good enough for augmenting the performance of a trader.

From News-Medical.Net:

The researchers also speculated that if testosterone continued to rise or became chronically elevated, it could begin to have the opposite effect on a trader’s profitability by increasing risk-taking to unprofitable levels. Previous studies have shown that administered testosterone can lead to irrational decision-making. They believe that this is because testosterone has also been found to lead to impulsivity and sensation seeking, to harmful risk taking, and in extreme cases (among users of anabolic steroids) to euphoria and mania.

Testosterone may therefore underlie a secondary consequence of the ‘winner effect’ in which a previous win in the markets leads to increased, and eventually irrational, risk taking in the next round of trading.

The study noted that naturally produced steroids in the body, especially cortisol and testosterone, can have a positive influence when it comes to finding as to how and why people caught in crashes often find it tedious to make a rational decision.

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When it comes to treating patients with Duchenne Muscular Dystrophy (DMD), there could be nothing better and more effective than corticosteroids that are recommended as a first-line therapy for DMD.

This finding appeared in a new practice guideline published in the Neurology, the scientific journal of the American Academy of Neurology.

Richard T. Moxley III, MD, of the University of Rochester in Rochester, N.Y. and lead author, said that corticosteroids can be termed as the only effective drugs for providing relief to children with DMD.

From News.Bio-Medicine.Org:

The guideline authors reviewed all available research for the use of corticosteroids in the treatment of Duchenne muscular dystrophy. Corticosteroids are man-made drugs that are similar to the body’s hormone cortisone. Two corticosteroids, prednisone and deflazacort, were found to slow the rate of muscle deterioration, and are recommended as potential treatments to minimize the effect of Duchenne muscular dystrophy.

Prednisone was found to help muscle strength and function and should be offered as a treatment option. Deflazacort, a drug similar to prednisone, is also recommended as a treatment option but is not available in the United States at this time.

“Corticosteroids are the only effective drugs in providing improvements in children with Duchenne muscular dystrophy,” said lead author Richard T. Moxley III, MD, of the University of Rochester in Rochester, N.Y.

It was found out that two corticosteroids, prednisone and deflazacort, are exemplary to be recommended as potential treatment options as they have the unique ability of slowing down the rate of muscle deterioration leading to reduced effects of DMD.

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According to researchers from the Massachusetts General Hospital (MGH), the positive effects of anti-angiogenesis drugs for treating the deadly brain tumors called glioblastomas appear to result primarily from edema reduction and not from any direct effect of anti-tumor.

Rakesh K. Jain, PhD, director of the Steele Laboratory in the MGH Department of Radiation Oncology, the study’s co-senior author, said that the findings suggest that the antiangiogenesis therapy has the ability to improve patient survival rate even in cases of persistent tumor growth.

From Sciencedaily.com:

Mice treated with cediranib were found to have significant reductions in the size and permeability of tumor-associated blood vessels, compared with animals that did not receive the drug. Although treatment did not reduce the rate of tumor growth, mice receiving cediranib lived significantly longer than the control animals. Another group of tumor-bearing mice received the steroid drug most commonly used to treat edema, and though those animals also lived longer than controls, the survival benefit was greater for the mice receiving cediranib.

“This is the first paper to show that vascular normalization alone, without chemotherapy, can be effective against some tumors by controlling edema and that this anti-edema effect is better than that of currently used steroids,” Jain says. “Unfortunately, these anti-VEGF agents did not slow the tumor growth rate in these models; and since recurrent glioblastomas are highly resistant to currently used chemotherapy drugs, even if vascular normalization increases drug delivery, there may be little or no additional increase in patient survival. We urgently need to find better anti-tumor and anti-angiogenic agents.”

This study was supported by grants from the National Institutes of Health, the Susan G. Komen Foundation, the Damon Runyon Foundation, the U.S. Department of Defense, the Montesi Family Research Fund and AstraZeneca Pharmaceuticals, which manufactures cediranib under the brand name RECENTIN.

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As per a retrospective study of 22 patients conducted by a researcher at the Seattle Cancer Care Alliance, the usage of Avastin alone is safe as well as effective for delaying progression of brain tumor when it comes to treating a subgroup of recurrent Grade 3 brain tumors.

Avastin, known generically as bevacizumab, is the first-ever approved therapy for inhibiting angiogenesis.

Angiogenesis is the process by which new blood vessels are developed and transport vital nutrients to a tumor. It is important to note here that Avastin is approved for treating certain metastatic colon cancers and non-small cell lung cancer.

From Sciencedaily.com:

Chamberlain said he expects that patients treated with the drug will have a marked improvement in their quality of life because the use of steroids, a common treatment that has significant side effects, can be greatly reduced or even eliminated.

“While treatment with Avastin does dramatically improve survival time, the time that patients have left is of better quality and less about living with the disease itself,” Chamberlain said. In this study, the patients, ages 24-60, received an infusion of bevacizumab every two weeks for an average of 14.5 cycles (range was two to 39 cycles). Fourteen (64 percent) patients showed a partial response to the medicine as shown on radiographic scans. Two patients had stable disease and six had progressive disease. Progression-free survival ranged from three to 18 months and survival for the entire group of patients was three to 19 months.

Marc Chamberlain, M.D., author of the study and director of the Neuro-oncology Program at the SCCA and a professor of neurology and neurological surgery at the University Of Washington School Of Medicine, said that Bevacizumab is an important drug of all of the targeted therapies for gliomas.

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The journal Ophthalmology has reported on use of bevacizumab (Avastin) for providing relief to patients with macular edema and individuals with cystoid macular edema after cataract surgery.

Another study has described methods for enhancing the level of safety to make cataract surgery safer for diabetic retinopathy (DR) patients.

It is believed that diabetic retinopathy would be one of the greatest threats in the coming future with predictions for triple growth in such cases by the year 2050.

From Sciencedaily.com:

The Pan-American Collaborative Retina Study Group also reviewed the use of bevacizumab in patients with post-cataract surgery cystoid macular edema (CME) who had not responded to standard treatment. Twenty to 30 percent of all cataract surgery patients develop CME, in which the macula swells as fluid-filled cysts form. Usually the condition resolves without treatment and causes no permanent vision loss, but in a small percentage of patients vision remains worse than 20/40 and treatment is needed. Standard treatments include steroids, non-steroidal anti-inflammatories (NSAIDs), other medications, or surgery.

The researchers reviewed the records of 31 patients (36 eyes) who were treated with at least one IVB injection and followed for 12 months between 2005 and 2007. At the study’s outset the mean best-corrected visual acuity was 20/200, and at 12 months the mean was 20/80. Most eyes (72.2 percent) improved and the rest remained stable (27.8 percent). Macular thickness also decreased in most eyes. Patients who received two or more injections were significantly more likely to improve. No adverse systemic or vision side effects or outcomes were reported.

As per the Pan-American Collaborative Retina Study Group, led by J. Fernando Arevalo, MD, of the Caracas Central Ophthalmologic Clinic, Venezuela, treating DMME (diffused macular edema) with bevacizumab (Avastin), an anti-vascular endothelial growth factor (anti-VEGF) medication, is a better option though future studies in this regard to confirm efficacy and safety in treating these conditions.

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An existing drug for osteoporosis has been hailed as the first ever found for preventing loss of cartilage from osteoarthritis post joint injury besides being useful in regenerating some part of cartilage lost due to osteoarthritis.

This finding was presented on September 12, 2009 at the annual meeting of the American Society for Bone and Mineral Research in Denver.

From Sciencedaily.com:

Cartilage can become damaged by many kinds of injury and by mechanical stresses that come with age. Over time, damaged cartilage deteriorates to cause osteoarthritis (OA), with its attendant joint inflammation and pain. Currently available drugs like steroids or non-steroidal anti-inflammatory agents (e.g. Advil, Aleve) reduce pain but do not address the loss of cartilage behind the osteoarthritis, which is projected to afflict more than 50 million Americans by 2020.

Cartilage forms the sponge-like, shock-absorbing layers that keep the impact of running and jumping and lifting from grinding bones against each other in joints. The cell type at the heart of osteoarthritis is the chondrocyte, the cartilage-producing cell responsible for maintaining the integrity of joint cartilage.

Randy Rosier, M.D., Ph.D., professor within the Department of Orthopedics and Rehabilitation at the University of Rochester Medical Center, said physicians are presently left with no way to restore cartilage in patients who have lost it to osteoarthritis but the study results suggest that cartilage degeneration can be inhibited and the volume of cartilage in diseased joints be improved, at least in mice.

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The American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) is expected to issue the first national clinical practice guideline for helping healthcare practitioners in identifying and managing patients with hoarseness or dysphonia. These guidelines will emphasize on evidence-based management of hoarseness by clinicians and inform patients on the prevalence of this common vocal health issue.

From Sciencedaily.com:

Key features of the new guideline include:

* Most, but not all, hoarseness is the result of benign underlying or self-limiting factors; however, clinicians should consider the possibility of a serious underlying condition (growth or tumor of the larynx) or medication side effects as a cause.

* Laryngoscopy is an office procedure to visualize the larynx (voice box and vocal cords) that should be performed if hoarseness persists or if the cause is uncertain.

* Imaging studies, such as a CT or MRI scans, should not be obtained for a primary complaint of hoarseness prior to visualizing the larynx; laryngoscopy is the primary diagnostic modality and should be done first.

* Anti-reflux medicines should not be prescribed for hoarseness unless there are (a) signs or symptoms of gastroesophageal reflex disease (GERD), such as heartburn or regurgitation, or (b) signs of inflammation of the larynx seen during laryngoscopy.

* Steroids or antibiotics given by mouth are not recommended for hoarseness and should not be used routinely.

* Voice therapy is a well-established intervention for hoarseness that can be performed at any age. Laryngoscopy should be performed prior to voice therapy and results communicated to the speech-language pathologist. Therapy for hoarseness usually includes one to two sessions per week for four to eight weeks.

* Surgery is not the primary treatment for most hoarseness, but may be indicated for suspected cancer, other tumors or growths, abnormal movement of the vocal cords, or abnormal tone of the vocal cord muscles.

* The risk of hoarseness may be reduced by preventive measures such as staying well-hydrated, avoiding irritants (especially tobacco smoke), voice training, and amplification during heavy voice use.

This guideline was created by a multidisciplinary panel representing neurology, speech-language pathology, professional voice teaching, family medicine, pulmonology, geriatric medicine, nursing, internal medicine, otolaryngology – head and neck surgery, pediatric medicine, and consumers.

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A drug that is presently used for treating cancer may prove additional worth for treating lupus and complications of the central nervous system.

Rheumatologists at the Annual European Congress of Rheumatology in Vienna, Austria, discovered that Rituximab can be highly effective for treating patients with lupus.

Lupus is a disorder of the immune system in which the body attacks itself resulting in severe pain, diffused body organ damage, and inflammation besides reducing life quality of patients.

From News-Medical.Net:

Professor Neuwelt specialises in diagnosing and treating patients with CNS lupus. “It can be difficult to disentangle psychiatric disorders that arise from other causes,” he states. In a portion of patients, depression, seizures, verbal comprehension, perception and memory will be associated with lupus. People are understandably afraid to admit that their IQ has gone down or that they cannot read any more in fear of losing their job,” he continued. A careful history, ruling out other causes such as infection and drug side effects has improved diagnostic accuracy.

Professor Neuwelt, like others using this well-tested oncological drug in other forms of lupus, is concerned about the depletion of the B cells by rituximab for the long term. However, the risk/benefit ratio from this new treatment in its early stages is extremely promising. “It is the first drug in my 26 years of treating patients with severe central nervous system lupus, used alone or in combination with other therapies that has not only significantly boosted the quality of life for patients with this dreadful disease, but also reduced the burden of side effects of standard treatment with steroids and cyclophosphamide. However, we desperately need randomized-controlled trials.” he concluded.

Clinical professor Michael Neuwelt, at the University of California San Francisco and Stanford University, said that Rituximab is an effective drug that may be recommended as a gentle option for treatment lasting up to six months and with reduced side effect risk.

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