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... including HIV/AIDS, hepatitis B and C, and infective end carditis, a potentially fatal inflammation f the inner lining f the heart. Bacterial infections can develop at the injection site, causing pain and abscess. Scientific research als shw's that aggression and ther psychiatric side effects may result frm abuse f anabolic sterid's.
Many users report feeling gd abut themselves while n anabolic sterid's, but researchers report that extreme md swings als can car, including manic-like symptm's leading t violence. Depression free is seen when the drugs are speed and may contribute t dependence n anabolic sterid's. Researchers report als that users may suffer frm paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming frm feelings f invincibility (1). Research als indicates that sme users might turn t ther drugs t alleviate sme f the negative effects f anabolic sterid's. Fr example, a study f 227 men admitted in 1999 t a private treatment center fr dependence n here r ther pics fund that 9. 3 percent had abused anabolic sterid's before trying any ther illicit drug. f these 9. 3 percent, 86 percent first used pics t contract insomnia and irritability resulting frm the anabolic sterid's. (2) Sterid's main side effect is t increase many parameters f aging.
This includes arthritis, degenerative changes f jones, etc. These are all well documented. Treating asthma with sterid's: When asthma cntrl deteriorates, a can strategy is t double r quadruple the maintenance dse f inhaled sterid's. In stable patients, this technique results in most improvements in spirometry and peak flw results, but the effect in patients wh are clinically deteriorating has nt been established. Harris and colleagues studied the ability f print during f the dse f inhaled sterid's t reduce the severity and duration f asthma exacerbations (1). f the 192 patients wh were allocated t the study inhaler, 175 completed the study, and 110 used the inhaler during the study.
In the place grup, 97 f 198 patients used the inhaler. In the treatment grup, 22 (11 percent) used ral crticsterid's compare with 24 (12 percent) in the place grup. The reasons fr beginning ral strip therapy were advice frm the primary care physician (24 patients), symptm's f deteriorating asthma cntrl (12 patients), and a fall in peak flw f at least 40 percent (10 patients). Although during the dse f inhaled crticsterid was associated with a small, nn significant reduction in the maximum fall in peak flw, the tw grup's did nt differ in the list peak flw recorded r changes in symptom sites. In addition, n effect was new in the time fr symptom sites r peak flw measurements t return t baseline values. These results were unchanged when patients with different severities f asthma were analyzed as independent grup's.
The authors conclude that during the dse f inhaled crticsterid's had little effect n uncles f asthma exacerbations in patients using maintenance inhaled sterid's. They speculate that a fourfold r greater increase in strip dse may be necessary fr clinical effect. Sterid's fr a sre that (6) In many ways, sterid's are water drugs. They help with pain, swelling, and inflammation.
They are the mainstay in treating many problems including asthma and allergies. But they have a downside. When used inappropriately r in excess, they can cause many problems. Dexamethasne is a strip comply used t treat children wh need this type f drug.
Many dates believe it helps lessen the pain f pharyngitis (sre that). T determine if dexamethasone really helps, dates at Texas A & M College f Medicine treated half f 184 children seen in their emergency department fr sre thrat's with dexamethasone and ther medications, such as antibiotics. The ther half received a place plus rating medicines. The success f treating with dexamethasone depended n whether r nt the child had a strep that. Fr children with a sre that caused by beta-hemolytic streptococcus (the technical name fr the bacterium that causes strep that) treated with dexamethasone, the average time fr the pain t begin t g away was six hur's. The child with a strep that nt treated with dexamethasone tk an average f 11. 5 hur's fr initial pain relief.
In all the children, it tk an average f ne and a half days fr the pain t completely g away. Fr the children wh have a viral sre that, dexamethasone actually increased the time t initial pain relief. It tk 13 hur's fr the wh received the dexamethasone compare t nine hur's fr the wh didn't. In all the children with viral sre thrat's, it tk abut tw days fr the pain t g away. The researchers concluded that although dexamethasone des for sme relieve t children with true strep that, in the lng term it makes n difference. Using this drug produced results that were "f marginal clinical importance. " Strip-Induced stenosis (3) While sterid's d decrease inflammation, they als decrease the formation f new bne, increase the breakdown f ld bne, and decrease the absorption f calcium frm fd by the by.
In the case f IBD, the development f stenosis may be compounded by the already lw amount f calcium absorbed by the by. T prevent early bne lss, sterid's should nly be used in the list effectual date fr the shortest amount f time. Strip treatment can be extremely useful fr many inflammatory conditions, but the benefits should be weighed against the potential fr series and permanent side effects such as stenosis. Crticsterid's The convoluted curse f enthusiasm and skepticism fr using crticsterid's in sepsis is striking and dates t uncontrolled reprt's in the 1950 s f improved uncles in a variety f severe infections. In 1974, Weitzman and Berger (8) systematically reviewed 32 regional clinical investigations, published frm 1950 t 1971, that addressed the use f crticsterid's in bacterial infections. They carefully examined each article fr adherence t standards fr paper experimental design and interpretation and fund that exceedingly few met acceptable standards.
f the 12 studies that addressed septic such, 9 advocated the use f crticsterid's and 3 concluded that sterid's were nt beneficial. nly tw f the favorable studies and 1 unfavorable study were perspective, and nly a single unfavorable study was randomized and double blinded. The authors concluded that property designed studies must be performed before the controversy can be reserved. Tw years later, Schumer (4) published a report in which very impressive reductions in.
mortality were demonstrated fr patients with septic such treated with crticsterid's. Mortality rates f 11. 6 % and 9. 3 % were seen fr patients treated with methylprednisolone (ne r tw dse's f 30 mg / kg IV) and dexamethasone (ne r tw dse's f 3 mg / kg IV), respectively, vs 38. 4 % fr patients receiving place. A concomitantly performed "respective" study (4) she similar results. Based n this report, it became standard practice in the late 1970 s and early 1980 s t administer high-dse crticsterid's at the not f septic such. Case examination f the report, however, revealed numerous concerns in study design and interpretation. In this study, a single investigate enrolled a that f 500 patients in either a "perspective" (n = 172) r a concomitant respective study (n = 328) n a surgical service at ne hospital ver a 9 -year period.
In the perspective study, patients wh had either "a septic history, " a "falling BP, " r positive bld culture results were randomized by a card system int the three treatment grup's. The primary utc was death attributable t septic such, described as .".. if the patient succumbed immediately t the such episode r had a continuing septic curse with episodes f such and then succumbed. " (4) The lack f blinding, subjective entry and end pint criteria, concomitant perspective and respective studies, and ther design flaws presented multiple pprtunities fr bias t affect the results and caused concern abut their validity. A life story At age 16, Table Htn was 6 feet 2 inches tall and weighed 180 pounds. By mst standards, he was a big guy.
Mst standards, that is, except his cach's. Htn, a promising pitcher n his high schl baseball team in Plan, Texas, was tld by his cach that he had t get bigger t become a star player. He decided the fastest way t accomplish that was t begin an intense weightlifting program, and t use sterid's. In the winter f 2003, Htn began lifting and "stacking" - taking multiple sterid's rally and by injection at the same time. He gained nearly 30 pounds f muscle.
He als developed a severe case f acne and exhibited sudden period f very aggressive behavior - s-called rid rages -cursing at case friends and angrily punching his fist through walls. Cnfrnted by his parents, Htn admitted his strip use and promised t stp. Shipping led 10 anther effect f strip use: severe depression. In July 2003, Htn committee suicide, a month after his 17 th birthday. Although Htn's suicide as a result f strip abuse was unusual, his decision t lake sterid's did nt surprise many health specialists. The National Institute n Drug Abuse estimates that thousands f teenagers in the United States use sterid's every year.
During the past decade, strip use and teens has risen by mre than 50 percent. Extent f Use Mnitring the Future annually assesses drug use and the Nations 8 th, 10 th, and 12 th grade students. Annual use f anabolic sterid's remained stable at under 1. 5 percent fr students in 8 th, 10 th, and 12 th grades in the early 1990 s, then started t rise. Peak rates f annual use curved in 2002 fr 12 th-graders (2. 5 percent), in 2000 and 2002 fr 10 th-graders (2. 2 percent), and in 1999 and 2000 fr 8 th-graders (1. 7 percent). Eight-graders reported significant decreases in lifetime and annual strip use in 2004, as well as a decrease in perceived availability f these drugs. A significant decrease in lifetime use was als measured and 10 th-graders fr 2004.
Mst anabolic sterid's users are male, and and male students, past year use f these substances was reported by 1. 3 percent f 8 th-graders, 2. 3 percent f 10 th-graders, and 3. 3 percent f 12 th-graders in 2004 (10). Anabolic Strip Use by Students Year 2004 Mnitring the Future Survey
8 th-Graders
10 th-Graders
12 th-Graders
Lifetime
1. 9 %
2. 4 %
3. 4 %
Annual
1. 1
1. 5
2. 5
30 -day
0. 5
0. 8
1. 6
These data are frm the 2004 Mnitring the Future Survey, funded by the National Institute n Drug Abuse, National Institutes f Health, DHHS, and conducted by the University f Michigan's Institute fr Social Research. The survey has tracked 12 th-graders illicit drug use and related attitudes since 1975; in 1991, 8 th- and 10 th-graders were added t the survey. What treatments are effective fr anabolic strip abuse Few studies f treatments fr anabolic strip abuse have been conducted.
Current knowledge is based largely n the experiences f a small number f physicians wh have worked with patients undergoing strip withdrawal. The physicians have fund that supportive therapy is sufficient in sme cases. Patients are educated abut what they may experience during withdrawal and are evaluated fr suicidal thoughts. If symptm's are severe r printed, medications r hospitalization may be needed. Sme medications that have been used fr treating strip withdrawal restore the hymnal system after its disruption by strip abuse. ther medications target specific withdrawal symptm's fr example, antidepressants t treat depression, and analgesics fr headaches and muscle and just pains.
Sme patients require assistance been simple treatment f withdrawal symptm's and are treated with behavioral therapies (2). Bibliography: Harris TW, et al. During the dse f inhaled crticsterid t prevent asthma exacerbations: randomized controlled trial. Lancet January 24, 2004; 363: 271 - 5. Ppe, H. G. , and Katz, D.
L. Affective and psychic symptm's associated with anabolic strip use. American Journal f Psychiatry. 145 (4): 487 - 490, 1988. Rth, B.
J; Gain-Bailey, S. stenosis in patients with bstructive lung disease n intermittent ral sterid's. CHEST, ct, 2005 by Schumer W. Sterid's in the treatment f clinical septic such. Ann Surg 1976; 184: 333 - 341 Steinberg, A. In defense f sterid's: Jse Case's surprisingly sensible case fr juice.
Read, June, 2005 Sterid's fr a sre that. Pediatrics fr Parents, Sept, 2003 Tresca, A. J. Lng-term use f prednisone could cst yu the health f yur bne's Weitzman S, Berger S. Clinical trial design in studies f crticsterid's fr bacterial infections.
Ann Intern Med 1974; 81: 36 - 42 Yesalis, C. E. Anabolic Steroids in Sports and Exercise, 2 nd edition. Champaign, IL: Human Kinetics. Yesalis, C. E. , Kennedy, N.
J. , Kopstein, A. N. , and Bare, M. S. Anabolic-androgenic steroid use in the United States. Journal of the American Medical Association 270 (10): 1217 - 1221, 1993...
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