According to a new review of studies about the use of anti-inflammatory steroids for traumatic head injuries such as car crashes, the risk of death is increased due to such usage.

This analysis that was published by the British-based Cochrane Library draws heavily from a study of corticosteroid treatment for brain injury involving more than 10,000 patients.

Dr. Phil Alderson, lead author of the Cochrane study, said that the considerable increase in death with steroids found participating in the trial suggests that steroids are no longer to be routinely used in patients with traumatic head injury.

From News-Medical.Net:

Corticosteroids are “widely used in medicine to treat inflammation,” Alderson explains. “It is thought that some of the damage after a brain injury results from inflammation following the initial injury and that reducing inflammation might reduce this secondary injury.”

In the case of severe head injuries, the inflammation leads to swelling of the brain and its surrounding tissues, which in turns creates pressure in the skull that may lead to complications or death.

The 17 studies on steroid use and the risk of death examined by Alderson and colleagues included a total of 12,083 patients of all ages with clinically diagnosed traumatic brain injury, some of whom received steroid treatment within seven days of their injury.

The cause of death in patients who received steroid treatment in the new large trial was unclear, according the study’s authors. Some researchers have suggested that corticosteroids increase the likelihood of death by interfering with adrenal gland function.

This review appeared in the January issue of The Cochrane Library, a publication of the Cochrane Collaboration that evaluates medical research.

Tags: corticosteroids, steroid treatment, steroid use, steroids

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Steroids can have a long-lasting effect on brains of teenagers and may even flip the brain switch of adolescents for aggression that may last as much as two years, as per a U.S. study.

It was suggested by the study researchers that anabolic steroids may result in brain changes on a permanent basis, a fact that was based on results noticed in hamsters.

In the recent past, neuroscientists have shown a great concern about the rising adolescent abuse of anabolic-androgenic steroids (AASs).

From News-Medical.Net:

According to the researchers even after the drug was withdrawn, the newly vicious hamsters attacked, bit and chased the intruders, and the level of aggressiveness was 10 times greater than that of other hamsters which were only injected with oil.

Apparently the effects lasted for almost two weeks, which is the equivalent of half their adolescence.

After this period, the animals reverted to their normal playful defensiveness, but postmortems on the hamsters found there had been also been changes in their brain activity.

While they were being given steroids, a part of their brains called the anterior hypothalamus, which regulates aggression and social behaviour, pumped out more of a neurotransmitter called vasopressin.

Their full-blown aggression which was clearly drug-induced lasted for nearly two weeks of withdrawal.

Three weeks after withdrawal, vasopressin levels had subsided in line with the aggressive behaviour.

This study appeared in the current edition of Behavioral Neuroscience, Vol. 120, No. 1.

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A recent study has shown that Rituximab is an effective treatment option for Graves’ eye disease after steroids have failed to deliver expected results. It is worth noting here that rituximab is presently used for other autoimmune diseases.

Raymond S. Douglas, M.D., Ph.D., an oculoplastics specialist who recently joined the faculty of the U-M Kellogg Eye Center, noted on the drug potential in the online October issue of Ophthalmology.

From News-Medical.Net:

In the current study, Douglas observed improvement among the patients, four of whom were women, as early as four weeks following the first infusion of rituximab. Researchers also observed that the positive results were sustained 4 to 6 months after treatment.

“Treatment of the inflammatory component of Graves’ eye disease has not advanced appreciably over several decades,” says Douglas. High-dose steroids, sometimes in combination with orbital radiation, are still the first line treatment. But, says Douglas, “These are imperfect options because inflammation often recurs when the treatment ends.” He is hopeful that rituximab can offer sustained improvement. Douglas observes that the results from a small case series must be viewed with some caution. But given the substantial benefits for patients treated with rituximab, he sees good reason to proceed with a large-scale clinical trial to test this promising new drug.

It was suggested by the study that rituximab is an effective form of treatment when it comes to the most severe forms of Graves’ eye disease.

Tags: Graves' eye disease, rituximab, steroids

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According to a Saint Louis University study, sleep problems of 80-90 percent children suffering from obstructive sleep apnea (OSA) can be effectively treated with a tonsillectomy and adenoidectomy surgery.

This study was the largest to date and focused on potential factors such as age and ethnicity, which may have an effect on OSA diagnosis and surgery impact.

Ron Mitchell, M.D., professor of pediatric otolaryngology at Saint Louis University and the study’s author, said that OSA has a significant impact on life quality of children, much like chronic asthma or rheumatoid arthritis.

From News-Medical.Net:

“Even though OSA resolved in the overwhelming majority of children after the surgery, it is still crucial to identify and treat children with persistent OSA,” Mitchell says. “Otherwise these children will continue to experience the health, behavioral and learning problems associated with OSA.”

Several options for treating persistent OSA exist, including: nasal steroids, allergy treatment, additional surgery or continuous positive airway pressure (CPAP) mask. Over time, some children who did not experience immediate resolution will normalize, Mitchell says. Children who are overweight must lose weight in conjunction with the surgery for a successful outcome.

Obese children and children with Down’s syndrome or other genetic disorders that affect the craniofacial anatomy were excluded from the study because the rate of OSA is known to be higher.

It was emphasized by Dr. Mitchell that children scoring way outside normal parameters on behavioral measures were the greatest beneficiaries of the surgery.

Tags: chronic asthma, obstructive sleep apnea, Rheumatoid arthritis, steroids

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Women with naturally increased levels of DHEAs, the hormone precursor, were found to perform better in terms of cognitive function than their counterparts with reduced levels. This finding appeared in the March issue of the Journal of Clinical Endocrinology & Metabolism (JCEM).

This study revealed that cognitively intact women with increased circulating levels of DHEA (dehydroepiandrosterone) in the form of DHEA sulfate (DHEAS) fared better on executive function, concentration, and working memory tests.

From News-Medical.Net:

DHEA is a steroid precursor, which means that it is converted in the body to steroid hormones such as testosterone and estrogen. It is the most abundant circulating sex steroid in women.

Previous studies suggest that DHEA and DHEAS may have neuroprotective effects. These studies also suggest that the decline in the production of these steroids with healthy aging may contribute to neuronal dysfunction and degeneration, and thus cognitive decline.

Maintenance of cognitive function in elderly women is influenced by a number of health variables, including diabetes, hypertension, and smoking. Other studies have reported association between these factors and progression to dementia in elderly individuals. “In our study we were specifically interested in the associations between cognitive function and DHEAS, social circumstances, and leisure activities,” said Dr. Davis.

For this study, “Endogenous Androgen Levels in Women across the Adult Life Span,” 295 women, ages 21 to 77 (mean age 55), were recruited from an Australian community-based dataset. Each participant underwent a battery of tests known to measure a wide range of cognitive abilities, including verbal, visual, spatial and working memory, attention and concentration, speed, and accuracy. Women were excluded if they reported any health condition that might potentially adversely affect cognitive function.

Other researchers involved in the study were Sonal M. Shah, Dean P. McKenzie, Jayashri Kulkarni, Sonia L. Davison, and Robin J. Bell, all of the Monash University.

Tags: dehydroepiandrosterone, DHEA, sex steroid, steroids

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According to a new research, individuals with mild and persistent asthma and administered with twice-daily use of inhaled steroids may make lesser use of inhalers or switch to a new pill.

Stephen P. Peters, M.D., Ph.D., lead author and a professor of pediatrics, internal medicine-pulmonary and associate director of the Center for Human Genomics, remarked that this finding is good news for patients with mild, persistent asthma as it gives them extra choices for asthma management.

From News-Medical.Net:

The study, involving 500 children and adults with mild asthma, was conducted by the American Lung Association’s Asthma Clinical Research Centers. Its goal was to determine if patients whose symptoms are well controlled on twice daily inhaled corticosteroid can “step down” their medication use. The results are reported in the May 17 issue of the New England Journal of Medicine.

Asthma is considered mild, but persistent, when symptoms occur more than two times a week or cause the patient to awaken during the night more than twice a month. The standard treatment for mild-persistent asthma is twice-daily use of an inhaled steroid to prevent symptoms. Patients may also take additional drugs such as the inhaler albuterol, known as “rescue” therapy, to treat symptoms. A majority of people with asthma have mild disease, according to Peters.

The study involved patients whose asthma was treated with twice-daily inhaled fluticasone propionate (Flovent Discus), a commonly prescribed synthetic steroid. This drug is designed to suppress inflammation within the airways that can cause narrowing.

Peters said that it would be best for patients faring well with the twice a day inhaled corticosteroid treatment option and seeking other options to talk to their doctors before making a decision.

Tags: corticosteroid, fluticasone propionate, Inhaled steroids, steroids

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The use of fluoroquinolones, a class of antibiotics used for treating varying bacterial infections, can lead to double vision.

This finding was revealed in the September issue of Ophthalmology, the journal of the American Academy of Ophthalmology (Academy).

The researchers were led by Frederick W. Fraunfelder, M.D., and it was noted that doctors need to observe a high sense of care while prescribing fluoroquinolones and may consider stopping the therapy in incidents of diplopia occurrence.

From News-Medical.Net:

The researchers, led by Frederick W. Fraunfelder, M.D., found 171 cases between 1986 and 2009 of fluoroquinolone use associated with double vision through a review of reports from the Food and Drug Administration, World Health Organization, and the National Registry of Drug-Induced Ocular Side Effects. The median patient age was 51.6 years, medication doses were within recommended levels, and the interval from starting medication to onset of double vision was 9.6 days on average. Medication was discontinued in 53 patients, and diplopia resolved in all cases.

“Doctors need to be aware of this potential reaction when prescribing these antibiotics and consider stopping therapy if diplopia occurs,” Dr. Fraunfelder said. He also said that special care should be taken with patients who are older than 60, have had renal failure, or are taking steroids, and that thorough ophthalmic and neurological exams should be done to rule out other causes of double vision.

Descemet’s Stripping Endothelial Keratoplasty (DSEK) corneal transplant procedure was recommended as a safe and effective option for corneal endothelial diseases by a 2009 review as per the cornea panel of the Academy’s Ophthalmic Technology Assessment Committee, led by W. Barry Lee, M.D.

Tags: diplopia, double vision, DSEK, fluoroquinolones, steroids

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A new research has noted that women who ate large quantities of beef while in the stage of pregnancy had sons more likely to have poor sperm quality when adults.

It was suggested that growth promoters used in cattle could be the factor behind this reduced fertility situation.

Professor Shanna Swan, the lead author of the study that is published online in Human Reproduction journal, said that the findings suggest that maternal beef consumption is associated with lower sperm concentration and possible sub-fertility, which may have been influenced by the presence of anabolic steroids and other xenobiotics in beef.

From News-Medical.Net:

Growth promoters for cattle, such as the synthetic hormone diethylstilbestrol (DES), have been used in the USA since 1954. Although DES was banned for use in cattle in 1979, other hormones such as oestradiol, testosterone, progesterone, zeranol, trenbolone acetate and melengestrol continue to be used. Residues of these chemicals remain in the meat after slaughter and so, in the USA, the FDA has regulated their use to avoid unintended adverse effects in humans eating the meat and defined an “acceptable daily intake”. The International Joint Food and Agricultural Organization’s World Health Organization Expert Committee on Food Additives (JECFA) has also published ADIs. In Europe, the use of these hormones has been banned since 1988.

“These ADIs are based on traditional toxicological testing, and the possible effects on human populations exposed to residues of anabolic sex hormones through meat consumption have never, to our knowledge, been studied. Theoretically, the foetus and young children are particularly sensitive to exposure to sex steroids. Therefore, the consumption of residues of steroids in meat by pregnant women and young children is of particular concern,” said Prof Swan, who is director of the Center for Reproductive Epidemiology, associate chair for research and professor of obstetrics and gynecology at the University of Rochester School of Medicine and Dentistry.

It is expected that the reported intriguing relationship would stimulate further research for investigating the association between maternal beef consumption during pregnancy stage and sperm concentration in the male offspring.

Tags: anabolic steroids, fertility, oestradiol, progesterone, sex steroids, testosterone, Trenbolone acetate, xenobiotics, zeranol

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The incidences of steroid-enriched dietary supplements are now getting reported in large numbers, a fact that has been troubling anti-doping and government officials in the recent times.

According to researchers at Henry Ford Hospital, three cases of patients suffering from the adverse affects of steroid-enriched dietary supplements have been reported.

From News-Medical.Net:

The cases of three otherwise healthy adult males, ages 21 to 38, were reported with symptoms including nausea, anorexia, jaundice, severe itching and renal failure.

* A 21-year-old previously healthy white male presented with nausea, anorexia, jaundice, and severe itching. He denied alcohol consumption or illicit drug use and took no prescription medications on a regular basis but did acknowledge use of the over-the-counter supplement Superdrol, a bodybuilding agent containing methasteron, for several months before his presentation. He had purchased this compound over the internet, and he discontinued taking the supplement at the onset of his symptoms.

* A previously healthy 30-year-old white businessman initially presented to a hospital with a 5-week history of jaundice and severe itching. His medications included omeprazole and herbal supplements including chondroitin sulfate, glucosamine, glutamine, and creatine. He also acknowledged the use of a bodybuilding supplement that contained dehydroepiandrosterone. Concerned about his symptoms, he stopped consuming this supplement just before his hospitalization.

* A 38-year-old previously healthy white man initially presented for evaluation of jaundice. He first noticed the onset of scleral icterus 6 weeks previously. His symptoms included intense and worsening itching, generalized fatigue, nausea, decreased energy, and weight loss. His past history was unremarkable. He denied alcohol or illicit drug use and used no prescription medications. Owing to worsening of his symptoms and renal failure, he was admitted to the hospital.

Stuart C. Gordon, Division of Gastroenterology and Hepatology, Henry Ford Hospital, remarked that it was not previously known that over-the-counter health food supplements could have contained anabolic steroids that can result in damage to the liver.

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John Gay, executive director and CEO of the Natural Products Association (NPA), the oldest and largest trade association that represents retailers and manufacturers of dietary supplements and other natural products, has issued a statement in response to the U.S. Justice Department Drug Enforcement Agency’s (DEA) classification of boldione, desoxymethyltestosterone, and 19-nor-4,9(10)-androstadienedione as “anabolic steroids”‘ under the Controlled Substances Act (CSA).

From News-Medical.Net:

“The Natural Products Association and its members are very excited to see the DEA use the additional power the NPA and many others worked so hard to give to it through the Anabolic Steroid Control Act of 2004. The association has maintained all along that federal regulators have the authority they need. The DEA‘s listing of these three steroids demonstrates that federal regulators can indeed safeguard the shelves against these substances.

“While this was the DEA‘s first action under the 2004 law, we hope it will not be the last. As it stated at the Senate Judiciary Committee hearing in September on enforcement barriers affecting body building products and hidden steroids, the DEA anticipates that after these first steroids are scheduled it will be easier to follow up with more enforcement and in greater frequency. The Natural Products Association looks forward to working with the agencies as they use this ability to schedule any anabolic steroids that are masquerading as supplements.”

It is believed that tough times for steroid users are not far ahead as the steroid classification action by DEA is expected to keep a strict check on substance abuse in the coming days.

Tags: anabolic steroids, body building, boldione, Desoxymethyltestosterone, dietary supplements, steroids

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