X-ray powder diffraction data, unit-cell parameters, and space group for norethisterone enanthate, C27H38O3, are reported [a = 6.191(4) Å, b = 12.711(3) Å, c = 31.396(2) Å, α = 90°, β = 90°, γ = 90°, unit-cell volume V = 2471.16 Å3, Z = 4, ρcal = 1.104 g cm−3, and space group P212121]. All measured lines were indexed and are consistent with the P212121 space group. No detectable impurities were observed.

Several studies on the treatment of coronavirus disease 2019 (COVID-19) are being conducted, and various drugs are being tried; however, the results have not been uniform. Steroids have been widely used in the treatment of COVID-19, but their effects are controversial. As immunosuppressive and anti-inflammatory agents, steroids are considered to reduce lung damage by regulating various inflammatory responses. We report a case of severe acute respiratory syndrome coronavirus-2 pneumonia manifesting as a cryptogenic organizing pneumonia-like reaction and discuss its treatment, clinical course, and favorable outcomes after steroid administration.

X-ray powder diffraction data for estra-4,9-diene-3,17-dione, C18H22O2, are reported [a = 9.236(7) Å, b = 10.294(4) Å, c = 15.471(1) Å, unit cell volume V = 1471.11 Å3, Z = 4, and space group P212121]. All measured lines were indexed and are consistent with the P212121 space group. No detectable impurities were observed. The single-crystallographic data of the compound are also reported [a = 9.2392(7) Å, b = 10.2793(5) Å, c = 15.4822(7) Å, unit cell volume V = 1470.37(15) Å3, Z = 4, and space group P212121]. Both single-crystal and powder diffraction methods can get the similar structure data.

A patient with multiple psychosomatic disorder developed a steroid induced rare bipolar mood disorder (both mania and depression). The “unmasking effect” of steroids and a positive family history of psychiatric disorder as a possible risk factor, hitherto undocumented, is suggested in steroid induced psychosis.

Life-course experiences have been postulated to program hypothalamus–pituitary–adrenal (HPA) axis activity, suggesting that HPA axis activity is, at least partially, stable over time. Yet, there is paucity of data on the long-term stability of cortisol production and metabolism. We performed a prospective follow-up study in twins recruited from a nationwide register to estimate the stability of cortisol production and metabolism over time, and the contribution of genetic and environmental factors to this stability. In total, 218 healthy mono- and dizygotic twins were included. At the ages of 9, 12 and 17 years, morning urine samples were collected for assessment (by gas chromatography-tandem mass spectrometry) of cortisol metabolites, enabling the calculation of cortisol metabolite excretion rate and cortisol metabolism activity. Our results showed a low stability for both cortisol metabolite excretion rate (with correlations <.20) and cortisol metabolism activity indices (with correlations of .25 to .46 between 9 and 12 years, −.02 to .15 between 12 and 17 years and .09 to .28 between 9 and 17 years). Because of the low stability over time, genetic and environmental contributions to this stability were difficult to assess, although it seemed to be mostly determined by genetic factors. The low stability in both cortisol production and metabolism between ages 9 and 17 years reflects the dynamic nature of the HPA axis.

Introduction: Croup is a common viral upper airway infection in children aged 6 months to 6 years. Although a single dose of dexamethasone decreases return visits, the prescribed dose varies from 0.15mg/kg to 0.6mg/kg. Our objective was to examine the effect of varied dexamethasone dosing on unplanned return ED visits for croup. Methods: This was a retrospective chart review of IWK ED patient treatment records from September 1, 2014 – August 31, 2016 of children aged 6 months to 6 years with an ICD-10 discharge diagnosis code of croup. Data were abstracted by trained research assistants using a structured data collection form in REDCap. A sample of 5% of charts had double data abstraction to test for agreement. Our primary outcome was return visits to the ED within 7 days. Secondary outcomes were ED length of stay (LOS), admission to hospital and admission to the pediatric intensive care unit (PICU). Data were analyzed using descriptive statistics and chi-square for between group comparisons. Results: The dataset included 1595 patient visits for croup. Data analysis is in progress. Triage acuity as per CTAS included: resuscitation n = 5; emergent n = 351; urgent n = 558; less urgent n = 605; and, non-urgent n = 2. Most patients had no co-morbid conditions (n = 1548). Dexamethasone dosing varied: 0.15 mg/kg n = 64; 0.3 mg/kg n = 838; and, 0.6 mg/kg n = 493. ED LOS was under 1 hour in 483 patients, 1-3 hours in 805, 3-6 hours in 225 and 6-12 hours in 9 patients. Few patients were admitted to hospital (n = 22) and no patients were admitted to PICU. Within 7 days of the index visit, 78 patients had an unplanned return visit to the ED for croup. Conclusion: The data analysis is in progress. This study will inform our future research on a practice change in our ED to comply with the dose of dexamethasone recommended by the Canadian Pediatric Society for the treatment of croup in 2017.

The use of intranasal steroids by otolaryngologists in the treatment of patients with infective rhinosinusitis and after endonasal surgery, particularly endoscopic sinus surgery, is unlicensed, as stated in the British National Formulary and in the manufacturers' leaflets supplied with nasal steroid medications. However, despite this, nasal steroids continue to be prescribed in these circumstances. Debate continues as to the exact role of intranasal steroids in sinonasal infection and after sinonasal surgery and whether their use in these circumstances should still be unlicensed.

This article reviews the current medical literature regarding this topic and aims to clarify whether intranasal steroid usage in these circumstances should be recommended.

Wistar rats (ten per group) were fed either an oat-free control diet or a dietary fibre-rich test diet containing 500 g oat-based products/kg for 6 weeks. The oat-based products, containing 4–128 g/kg resistant starch, 30–92 g/kg β-glucan and 122–304 g/kg total dietary fibre, were oat flour extrudate, flour/Novelose (commercial resistant starch) extrudate (80:20 w/w), oat bran, bran/Novelose extrudate (80:20 w/w) and autoclaved oat flour. Serum total cholesterol decreased in the groups fed flour, flour/Novelose and bran/Novelose (P<0·05). In most of the test groups, count numbers of bifidobacteria were higher (P<0·001) and of coliforms were lower (P<0·05). The mass of the caecum walls and contents was greater in groups fed Novelose- and bran-containing diets (P<0·005). In all the test groups, pH values were lower in the intestinal contents (P<0·001), and caecal concentrations of acetate (P<0·001), propionate (P<0·05), butyrate (P<0·005) and total SCFA (P<0·001) were higher. The lowest concentrations of steroids were found in rats fed the autoclaved flour. In the other test groups, more bile acids appeared in the caecal (P<0·001) and colonic contents (P<0·005), as well as in the faeces, at week 6 (P<0·001). The highest bile acid excretion was found after feeding bran-containing diets. In the intestinal contents of all the test groups, more primary bile acids (P<0·001) appeared than in the control group. The excretion of steroids increased within the experimental period. Using extrusion technology, dietary fibre-rich oat-based products, which have beneficial physiological effects in rats, can be produced. Oat flour and bran are excellent sources for the preparation of directly edible oat products. Their nutritional properties can be further improved by the addition of resistant starch.

Within the near-Earth object population, one finds asteroids, comets, and meteorites thereby placing the NEO population at the center of the ACM conference. The longstanding gulf between the spectral properties of S-type asteroids and ordinary chondrite meteorites appears to be bridged, where the observational data are consistent with a space weathering type process. As much as 30% of the entire NEO population may reside in orbits having a Jovian Tisserand parameter <30, and among these roughly half are observed to have comet-like physical properties in terms of their albedos and spectra (taxonomy). Thus 15±5% of the entire NEO population may be comprised by extinct or dormant comets.