Anabolic androgenic steroid induced necrotising myopathy

We describe the case of a 23-year-old gentleman who developed a severe generalised necrotising myopathy. Initially presenting with features of a virus-induced polymyositis, both symptomatic and biochemical improvements were initially achieved with glucocorticoid-based immunosuppression. Subsequently he represented with evidence of severe generalised rhabdomyolysis (creatinine kinase peaking at 210,000 U/L). Rendered anuric from the myogloburic assault, he required intensive care support from the development of multi-organ failure. Subsequent investigations failed to demonstrate an infective, inflammatory, metabolic or inherited aetiology. Muscle biopsy demonstrated severe generalised necrotising myopathy in the notable absence of inflammation. Confidential discussion with the patient and relatives confirmed a suspicion of anabolic androgenic steroid (AAS) abuse. There is limited literature as to the toxic effect of AAS compounds on muscle tissue, and these tend to focus on localised disease. Indeed, AAS have consistently been shown in animal models to produce a generalised myotrophic state. Apart from the social uses of such compounds, the scope for their supervised use in various medical conditions has been established since the 1960s.     

Gestational variations in the biochemical composition of the fetal fluids and maternal blood serum in goat

The purpose of this study was to determine the values of some metabolites, ions, and enzymes in maternal blood serum and fetal fluids in relation to pregnancy stage in singleton pregnant goats. Gravid uteri of goats were collected from local abattoirs. The allantoic and amniotic fluids as well as maternal blood samples were collected. Fetal age was determined according to crown–rump length by applying the age estimation formula that previously was presented for goat. The pregnancies were divided into five stages as: stage I (0–30?days), stage II (31–60?days), stage III (61–90?days), stage IV (91–120?days), and stage V (121?days to term). With the progress of pregnancy, the biochemical levels of fetal fluids and maternal serum changed as follows: there was a rise of total protein, urea, and creatinine concentrations in fetal fluids and serum; the level of glucose in serum, potassium, and ALK in fetal fluids and calcium and phosphorus in allantoic fluid increased; triglyceride and sodium contents of fetal fluids and serum decreased; glucose in fetal fluids, AST and LDH in serum and allantoic fluid, potassium and ALT in serum, and calcium and phosphorus in amniotic fluid and serum dropped; the values of AST, ALT, and ALK in amniotic fluid remained unchanged; and the levels of cholesterol and LDH in amniotic and allantoic fluids were constant in the whole gestation periods. The serum cholesterol value showed a significant decrease from stages 1 to 2 of pregnancy. But, it was not significant from stages 2 to 5 of gestation.     

Yohimbine Depresses Excitatory Transmission in BNST and Impairs Extinction of Cocaine Place Preference Through Orexin-Dependent,Norepinephrine-Independent Processes

The alpha2 adrenergic receptor (α₂-AR) antagonist yohimbine is a widely used tool for the study of anxiogenesis and stress-induced drug-seeking behavior. We previously demonstrated that yohimbine paradoxically depresses excitatory transmission in the bed nucleus of the stria terminalis (BNST), a region critical to the integration of stress and reward pathways, and produces an impairment of extinction of cocaine-conditioned place preference (cocaine-CPP) independent of α₂-AR signaling. Recent studies show yohimbine-induced drug-seeking behavior is attenuated by orexin receptor 1 (OX₁R) antagonists. Moreover, yohimbine-induced cocaine-seeking behavior is BNST-dependent. Here, we investigated yohimbine-orexin interactions. Our results demonstrate yohimbine-induced depression of excitatory transmission in the BNST is unaffected by alpha1-AR and corticotropin-releasing factor receptor-1 (CRFR₁) antagonists, but is (1) blocked by OxR antagonists and (2) absent in brain slices from orexin knockout mice. Although the actions of yohimbine were not mimicked by the norepinephrine transporter blocker reboxetine, they were by exogenously applied orexin A. We find that, as with yohimbine, orexin A depression of excitatory transmission in BNST is OX₁R–dependent. Finally, we find these ex vivo effects are paralleled in vivo, as yohimbine-induced impairment of cocaine-CPP extinction is blocked by a systemically administered OX₁R antagonist. These data highlight a new mechanism for orexin on excitatory anxiety circuits and demonstrate that some of the actions of yohimbine may be directly dependent upon orexin signaling and independent of norepinephrine and CRF in the BNST.     

Knowledge and Attitudes of Saudi Dental Undergraduates on Oral Cancer

Oral cancer awareness among future dental practitioners may have an impact on the early detection and prevention of oral cancer. A cross-sectional survey was undertaken to assess the current knowledge of future Saudi dentists on oral cancer and their opinions on oral cancer prevention. A pretested questionnaire was sent to 550 undergraduate dental students in the fourth, fifth, and sixth year of the Al-Farabi College for Dentistry and Nursing, Riyadh, Saudi Arabia. Questions relating to knowledge of oral cancer, risk factors, and opinions on oral cancer prevention and practices were posed. Four hundred seventy-nine students returned the questionnaire (87.1 %). Eighty-one percent of respondents correctly answered questions relating to oral cancer awareness. Eighty-seven percent of respondents felt confident in performing a systematic oral examination to detect changes consistent with oral malignancy. Interestingly, 57 % of respondents had seen the use of oral cancer diagnostics aids. Thirty-seven percent of respondents felt inadequately trained to provide tobacco and alcohol cessation advice. There is a need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Incorporating the use of oral cancer diagnostic aids should be made mandatory.     

Changes in the biochemical composition of fetal fluids and maternal blood serum during different days of gestation in cattle

The aim of this study was to determine the values of some metabolites, ions, and enzymes in maternal blood serum and fetal fluids in relation to gestation day in cattle. Gravid uteri of cattle were collected after slaughter. The allantoic and amniotic fluids as well as maternal blood samples were collected. Fetal ages were determined according to crown–rump length by applying the age estimation formula that previously was presented for cattle. The pregnancies were divided according to gestation days into four groups: 0–50, 51–100, 101–150, and 151–200?days. With the progress of pregnancy, the biochemical levels of fetal fluids and maternal serum changed as follows: there was a rise of total protein, urea, creatinine, and alkaline phosphatase values in fetal fluids and serum; the levels of glucose in maternal serum and potassium in fetal fluids increased; cholesterol, triglyceride, phosphorus, and sodium contents of fetal fluids and serum decreased; the concentrations of glucose and calcium in fetal fluids, lactate dehydrogenase (LDH) in serum and allantoic fluid, potassium in serum, and aspartate aminotransferase (ASAT) in amniotic fluid and serum dropped. The values of LDH in amniotic fluid, ASAT in allantoic fluid, alanine aminotransferase in amniotic and allantoic fluids, and calcium in maternal serum remained unchanged.     

Elevated serum neutrophil elastase is related to prehypertension and airflow limitation in obese women

Background  

Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.