Postoperative acute kidney injury (AKI) worsens surgical outcomes. Previous studies have observed an age- and sex-dependent effect on postoperative AKI rates. The objective of our study was to determine whether preoperative exposure to male or female sex hormone therapies modified AKI risk after both noncardiac and cardiac surgery. We hypothesized that women older than 55 years on estrogen/progesterone replacement therapy and men on antiandrogen therapy would have lower odds of postoperative AKI compared to counterparts not receiving sex hormone therapies. We conducted a retrospective cohort study, using data from Duke University Medical Center from 2013 to 2023. The study included women older than 55 years and men older than 18 years undergoing surgery. Exclusions included patients with missing creatinine values, patients with chronic kidney disease stage 5 (CKD5), transplant cases, and minor cases. The primary exposure was preoperative utilization of exogenous sex hormones, and the primary outcome was the development of postoperative AKI, as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Multivariable logistic regression was used to examine the association of preoperative sex hormones with postoperative AKI. There were 82,557 patients in the cohort, with 68,471 undergoing noncardiac surgery and 14,086 undergoing cardiac surgery. Among men undergoing noncardiac surgery, exposure to antiandrogens was associated with lower odds of postoperative AKI (0.83, 95% confidence interval [CI], 0.72-0.96, P < .01). Among women undergoing noncardiac surgery, preoperative exposure to vaginal estrogen was associated with lower odds of postoperative AKI (adjusted odds ratio [OR], 0.61, 95% CI, 0.47-0.79, P < .001). Neither male nor female sex hormone exposures were associated with AKI risk after cardiac surgery. Preoperative antiandrogen therapy in men and vaginal estrogen therapy in women older than 55 years were associated with reduced odds of postoperative AKI after noncardiac surgery. Our findings provide correlative evidence that sex hormones might modify postoperative AKI outcomes, while revealing complexity in drug and patient selection.

Detecting testosterone (T) doping remains a significant challenge, driving the search for novel biomarkers and advancements in the steroidal Athlete's Biological Passport (ABP). Phase II metabolites of endogenous anabolic androgenic steroids (EAAS) have emerged as promising biomarkers, demonstrating prolonged detection times (DTs) and greater sensitivity compared to conventional biomarkers. Studies involving male participants investigated the effect of intramuscular, oral, and transdermal administration of T on these biomarkers and proposed their integration in future urinary steroid profiling. However, before the inclusion of phase II EAAS metabolites, it is crucial to address a range of possible doping scenarios and the influence of known confounding factors, like ethnicity or sex, on the steroid profile. This study addresses this gap by investigating the impact of oral and transdermal T administration on phase II EAAS metabolites in both men and women. This second part of the study presents the results for female participants, which have not been included in prior research on this topic. Results partially confirm the trends observed in men, with sulfate ratios exhibiting prolonged detection times and higher sensitivity compared to conventional steroid profile biomarkers following multiple oral and transdermal T administration. However, the evaluation in women showed greater variability due to lower steroid concentrations and greater fluctuations influenced by the menstrual cycle. This study provides additional evidence supporting the inclusion of phase II EAAS metabolites for enhanced detection of T doping. Further, it underscores the need for further research to address the unique challenges of female steroid profiling.

Erectile dysfunction and related variables due to anabolic steroid use. A review of reviews.

Profiling medicines containing anabolic steroids by electronic circular dichroism and infrared spectroscopies.

Proteinuria is a common laboratory finding in adolescents. It is often benign and due to transient causes or orthostatic proteinuria. However, it can also be an early sign of underlying conditions that may lead to long-term kidney damage. Early recognition and appropriate diagnostic evaluation are crucial to preventing or slowing disease progression. In this age group, proteinuria may result from newly diagnosed diseases, pre-existing conditions that become clinically evident during adolescence, or previously undiagnosed disorders. Additionally, several proteinuric conditions are specific to this age group, including those related to obesity, recreational drug use, and anabolic androgenic steroids, all of which have increased significantly in recent decades. Adolescence is a transitional phase between childhood and adulthood that presents unique diagnostic challenges due to reduced parental involvement, frequent underreporting of symptoms, and non-compliance with pharmacological treatment or diet. Furthermore, adolescents may receive care in either pediatric or adult settings, where clinical approaches and guidelines often differ. This educational review addresses the diagnostic approach to proteinuria in adolescents and aims to propose a unified algorithm for this age group.

Testosterone Replacement Therapy has evolved from speculative attempts in the 18th and 19th centuries to the isolation and synthesis of the hormone in the 1930s, followed by the development of different and safer methods of administration throughout the 20th century, leading to today's modern treatment protocols. Testosterone is the male sex hormone and is essential for maintaining male secondary sexual characteristics and fertility. Androgen deficiency seen in young men due to problems in brain regions such as the hypothalamus and pituitary gland, genetic problems, testicular disease, or damage caused by chemotherapy can be treated with testosterone replacement. Over the past decade, testosterone replacement therapy has been preferred for middle-aged or elderly men with age-related or obesity related declines in serum testosterone levels. However, these conditions are not approved indications for testosterone therapy. The benefits and safety of these drugs for treating age-related low testosterone levels have not yet been established. Some studies suggesting that testosterone replacement therapy increases the risk of cardiovascular disease led the FDA to issue a warning on January 31, 2014, which included explanations about the potential cardiovascular risks of testosterone replacement therapy. On February 28, 2025, the FDA issued a statement updating the risks of stroke, heart attack, and death after reviewing the results of a clinical study showing that approved testosterone products did not increase the risk of heart attack or stroke compared to a placebo, an inactive treatment. The FDA removed warnings about these risks from FDA-approved drugs. Only a warning regarding potential increases in blood pressure levels was added. The benefits of testosterone replacement therapy in treating the symptoms of hypogonadism have been proven by studies. This article contains a brief summary of studies conducted over the last 10 years regarding assessments of cardiovascular risks that may be associated with testosterone replacement therapy.

One of the most common endocrine disorders that impacts reproductive-aged women is Polycystic Ovary Syndrome (PCOS). There are various pharmacological agents used to manage the condition, such as antiandrogens, aromatase inhibitors, metformin, thiazolidinediones, and ovulation-inducing medications. Such medications focus on increasing insulin sensitivity and restoring ovulatory function. The clinical characterizations of polycystic ovary syndrome include hyperandrogenism, menstrual irregularities, and polycystic ovarian morphology. The objective of this research is to estimate the effectiveness of different medications on the signs and symptoms of polycystic ovary syndrome. Methods: From October to December 2024, a cross-sectional study was performed on 204 women in Iraq aged between 15 and 45 years to assess the therapeutic practices for PCOS. To acquire the relevant data, private gynecological consultations were held, including laboratory measurements and a questionnaire, which were analyzed using Microsoft Excel 2021. Results: The findings showed that the commonly-prescribed medications are Metformin (35.2%) and Diane 35 (34.8%). Furthermore, menstrual interruptions, hirsutism, and acne were the most commonly-reported symptoms. Hormonal evaluations show that there was heterogeneity between participants, especially regarding the levels of androgen and reproductive hormones. The findings are reflective of typical polycystic ovary syndrome clinical manifestations and the personalized pharmacological approaches used to manage symptoms and regulate hormones. Conclusion: Polycystic ovary syndrome is an intricate condition that can have different manifestations, including menstrual irregularities, obesity, acne, and hirsutism. Moreover, it can have significant metabolic and psychological implications. Despite being the most commonly administered drugs for the condition, Diane-35 and Metformin were found to impact quality of life. In turn, this highlights the need to develop treatment approaches that integrate pharmacological management with lifestyle changes in order to achieve the best possible outcomes.

Purpose: Prenatal androgen exposure, particularly testosterone, may play a pivotal role in shaping brain development and is hypothesised to affect intelligence and learning skills.The second-to-fourth digit ratio (2D:4D) is widely recognized as a biomarker for prenatal exposure to the androgenic hormone testosterone. The present study seeks to examine 2D:4D ratios in children diagnosed with specific learning disorder (SLD) and to assess comparatively these values with those of typically developing peers. Methods: Participants in the study were 94 children diagnosed with SLD and 57 healthy controls. Sociodemographic data were collected, and 2D:4D ratios for each hand were determined and differences between groups were examined. Results: Children diagnosed with SLD exhibited notably reduced 2D:4D digit ratios in both hands relative to typically developing peers. In the SLD group, lower 2D:4D ratios were observed in both sexes, with the difference reaching statistical significance for females’ left hand measurements. Conclusion: This evidence suggests that elevated testosterone exposure during the prenatal period may be implicated in the pathogenesis of SLD. By employing the non-invasive 2D:4D ratio, this study contributes to the growing body of evidence on biological markers associated with neurodevelopmental disorders.

The non-medical use of anabolic androgenic steroid (AAS) has significantly increased among athletes, bodybuilders, and individuals who focus on physical performance as well as body aesthetics. Although AAS has certain therapeutic benefits, use outside of medical supervision can lead to AAS withdrawal syndrome. This condition is characterized by physical and psychological symptoms, such as fatigue, decreased libido, anxiety, depression, and sleep disturbances. Its primary mechanism is the suppression of the hypothalamic–pituitary–gonadal (HPG) axis, which reduces endogenous testosterone production after discontinuation of AAS. Disruption of this axis not only decreases endogenous testosterone production but also alters gonadotropin hormone dynamics and androgen receptor responsiveness. Several risk factors, such as high doses, prolonged duration of use, specific usage patterns (cycling, stacking, pyramiding), and a history of psychological disorders, may exacerbate withdrawal symptoms. Management of AAS withdrawal syndrome includes short-term hormonal therapy, agents that stimulate endogenous testosterone production, psychological interventions, and physical rehabilitation. A multidisciplinary approach and close medical monitoring are required to restore endocrine function, prevent complications, and improve the patient’s psychological well-being. This paper provides a comprehensive overview to assist healthcare practitioners in recognizing, diagnosing, and appropriately managing AAS withdrawal syndrome.

Testosterone, an androgenic steroid hormone, regulates primary sexual characteristics and influences mood, cognition, social behavior, and sexual function. Deficiency, caused by factors such as aging and genetics, is linked to multiple disease conditions. However, current testosterone therapies are limited by extensive metabolism, poor solubility, and undesirable side effects. To address these limitations, we synthesized a four-armed star PEG-OH-linked testosterone (PEG-T). The in vitro release of testosterone from PEG-T was evaluated in buffer (pH 7.4) and mouse plasma. PEG-T was stable in the buffer, but released testosterone in plasma via esterase-mediated hydrolysis. Pharmacokinetics of testosterone and PEG-T were compared following intraperitoneal (IP) and subcutaneous (SC) administration. Following IP dosing, PEG-T exhibited a ~6-fold improvement in half-life compared to testosterone (1.18 h vs. 0.21 h), and a 54-fold increase in exposure (AUC0-t = 36.0 μM·h vs. 0.67 μM·h) at equimolar doses; furthermore, following SC dosing, PEG-T showed a 4-fold improvement in both half-life (3.57 h vs. 0.91 h) and plasma exposure (11.5 μM·h vs. 3.1 μM·h). Additionally, PEG-T showed lower liver and kidney to plasma ratios, which could potentially result in reduced hepatotoxicity and nephrotoxicity. Overall, PEG-T provides sustained release pharmacokinetics, representing a promising candidate for safer testosterone replacement therapy.

The endocrine regulation of testicular and ovarian development during early life in chelonians remains poorly understood, despite major morphophysiological changes occurring in this period. This study investigated the immunolocalization of estrogen (ER1 and ER2), androgen (AR), and aromatase (AROM) in the gonads and mesonephros of Podocnemis expansa during the first year after hatching (n = 5; males: 1, 3, 12 months; females: 2, 4 months). After euthanasia, gonads and mesonephros were collected, fixed in 10% buffered formaldehyde, and processed for immunohistochemistry. The intensity of immunoreactions varied according to age and sex, but not with tissue distribution. AROM, AR, ER1, and ER2 were detected in both gonads and mesonephros, confirming the persistence of steroidogenic and steroid-responsive activity after hatching. In males, AROM showed weak to moderate labeling in germ and interstitial cells of seminiferous tubules, whereas ER2 expression predominated in spermatogonia and interstitial endocrine cells. In females, AROM and AR were moderately expressed in the germinal epithelium and oogonia at two months, decreasing at four months, while ER2 persisted in follicles and oogonia. These findings suggest a dynamic endocrine environment influencing posthatch gonadal maturation, with the mesonephros acting as a transient extragonadal source of steroids. Despite the small, sex-unbalanced sample (due to lack of dimorphism), the results provide valuable baseline information and support future quantitative and functional studies on the reproductive endocrinology of P. expansa and other chelonians with temperature-dependent sex determination.

Category: Ankle, TraumaKeywords: Distal Tibia, Bone Stress Injuries, Bone Mineral DensityIntroduction/Purpose: Repetitive loading during basic combat training (BCT) results in tibial bone adaptation. Men show increases in cortical thickness, trabecular thickness, trabecular volumetric bone density, and cortical bone density during 8-10 weeks of U.S. Army BCT, yet ~5-7% of men sustain bone stress injuries (BSIs) during training. BSIs are a leading cause of BCT attrition.Sex steroid hormones regulate bone metabolism. While testosterone supports bone formation, work in older men suggests estradiol is a stronger determinant of skeletal health.8 Whether this is true in younger men remains to be studied. We tested whether cumulative estradiol, testosterone, and free testosterone exposure during BCT is associated with favorable changes in distal tibial microarchitecture.Methods: We collected high resolution peripheral quantitative computed tomography (HR-pQCT) scans at the distal tibia (4% of tibial length) in 67 men at the beginning and end of BCT. We measured serial serum hormones by LCM/MS/MS at weeks 0, 2, 4, 6, 8 and 10. Exposures were log2-means of estradiol, total testosterone, and free testosterone across all timepoints. Outcomes included total bone mineral density (Tt.BMD), cortical BMD (Ct. BMD), Ct area (Ct.Ar), trabecular BMD (Tb.BMD), Tb Thickness (Tb.Th), and Tb spacing (Tb.Sp). We fit ANCOVA models with robust standard errors, coefficients for hormones represent change per exposure doubling. False-discovery rate control (Benjamini–Hochberg) was applied across outcomes.Results: Participants were 17-28 (mean 20.9 ± 3.7) years old with normal BMI (mean 24.9 ± 3.9 kg/m2). Racial and ethnic diversity was represented: 38% identified as White, 23% as Black, and 39% as Other racial categories. Per-doubling estradiol was associated with higher distal tibial Tt.BMD (β=+2.6 mgHA/cm³, 95% CI 0.2–5.0, p=0.03), greater Ct.Ar (β=+1.13 mm2, 95% CI 0.17–2.10, p=0.02), and greater Tb.vBMD (β=+2.2 mgHA/cm³, 95% CI 0.1-4.3, p=0.04) at the end of BCT, adjusted for baseline bone parameter, age, and BMI. Other microarchitectural indices were null. Adding total or free testosterone did not attenuate estradiol effects, and testosterone measures were not independently associated with bone adaptation.Conclusion: In male trainees, greater estradiol exposure was associated with greater gains in measures of distal tibial size, density and microarchitecture independent of testosterone. These findings suggest estradiol is a key regulator of bone adaptation in young adult men. Given the modest sample and multiple outcomes, larger studies should confirm these associations and test links to tibial bone stress injury risk.

The illicit use of androgenic anabolic steroids, such as 17β-testosterone, in food-producing animals poses significant risks to animal welfare and consumer safety. Detecting exogenous administration of endogenous hormones like testosterone is particularly challenging, as the administered compound is chemically identical to naturally occurring hormones. In this study, we developed a metabolomics-based workflow using ultra-high-performance liquid chromatography coupled to quadrupole-Orbitrap high-resolution mass spectrometry to enhance detection of testosterone misuse in cattle. Serum samples from treated steers were analyzed using an untargeted metabolomics workflow combined with multivariate supervised modeling (OPLS-DA). Data processing with an optimized IPO-XCMS pipeline provided peak picking and alignment. OPLS-DA modeling provided robust class separation, correctly predicting the hold-out samples. Cross-validation and permutation testing further confirmed the model's stability and predictive reliability. Untargeted analysis identified three molecular features with high discriminatory power and positive correlation with the treatment, and a significant suppression of endogenous hormones (androstenedione, corticosterone, and progesterone) as part of a negative feedback response. Notably, these suppression effects persisted beyond the period of elevated testosterone responses. The proposed workflow offers a sensitive tool to strengthen regulatory surveillance by identifying both novel candidate markers and endocrine disruptions in suspected samples.

Influence of 60Co-γ-irradiation on the shelf life of yellow-feathered chicken meat and the degradation of anabolic androgenic steroids

The integrity of competitive athletics is increasingly compromised by sophisticated pharmacologies, rendering traditional sporadic testing of urine and blood insufficient for comprehensive oversight. This critical review examines the emergence of wearable electrochemical biosensors as a non-invasive alternative capable of bridging the gap between laboratory precision and real-time field monitoring. We propose a dual biofluid framework wherein sweat functions as a cumulative reservoir for lipophilic anabolic androgenic steroids due to ion trapping mechanisms, while saliva serves as a dynamic plasma ultrafiltrate suitable for tracking the pharmacokinetics of stimulants and psychotropic substances. The text provides a detailed analysis of biorecognition engineering, emphasizing the shift from labile enzymatic systems to robust synthetic receptors, including structure-switching aptamers and molecularly imprinted polymers, which offer superior stability under harsh environmental conditions. Furthermore, we evaluate the integration of functional nanomaterials such as metal-organic frameworks and MXenes that amplify signal transduction to meet the stringent Minimum Required Performance Levels established by the World Anti-Doping Agency. Technical challenges regarding biological interface fouling and sample handling are addressed through the discussion of zwitterionic antifouling coatings and active microfluidic routing. The review concludes by conceptualizing the Internet of Anti-Doping Bodies, a framework leveraging encrypted wireless data transmission and artificial intelligence pattern recognition to transform anti-doping into a continuous and preventive data-driven discipline.

Anabolic androgenic steroid (AAS) use is associated with various health risks, yet its impact on healthcare expenditures remains insufficiently explored. This nationwide register-based study examined direct healthcare costs among 1183 males sanctioned for AAS use in Denmark between 2006 and 2017, compared with 59 150 age- and sex-matched controls from the general population. Healthcare costs were calculated across primary care, hospital services, and prescription drugs, with up to 10 years of follow-up. AAS users had significantly higher total healthcare costs, with a mean excess of 3299 euros (EUR) per person (95% CI: 1857-4742; p < 0.0001) over the follow-up period, corresponding to approximately EUR 537 per AAS user per year. This represents a 45% increase over controls, whose average total costs were EUR 7393 per person. The cost difference was primarily driven by hospital care but was also evident in primary care and prescription medication use. Cumulative cost differences increased steadily over time and remained consistent across most diagnostic categories. AAS users were relatively young and otherwise expected to have low healthcare use, suggesting a notable health burden in this group. These findings add real-world evidence on the healthcare implications of AAS use and highlight a sustained cost difference between AAS users and controls over a prolonged period. Continued follow-up may be necessary to fully capture long-term costs, particularly as some complications may appear years after use.

The high prevalence of tic disorders in males may be related to androgenic steroids during the intrauterine period. During the critical period of fetal development, the release of high levels of gonadal androgens and stress hormones may contribute to the etiology of tic disorders. To investigate the possible association between these hormones and tic disorder, the ratio of two to four digits (2D:4D) was used as a measure of fetal hormone exposure. Eighty children aged 7–17 years, including 40 children diagnosed with tic disorder and 40 healthy controls, were included in a cross‐sectional study. All participants had a psychopathology assessment, and their 2D:4D ratio was measured digitally. The 2D:4D ratio in the left hand was significantly higher in the controls than in the cases ( p = 0.003). Multivariate logistic regression analysis also supported that a low left 2D:4D ratio was independently associated with tic disorder ( p = 0.011). Girls showed a positive correlation between right 2D:4D ratio and vocal tic scores ( r = 0.715, p = 0.013). However, the 2D:4D ratio did not appear to be significantly associated with comorbidities, age at diagnosis, or age at onset of motor tic, vocal tic, or sensory phenomena. The results suggest that fetal sex hormone exposure may play a role in the development of tic disorders. This study showed that children and young people with tic disorders had a different 2D:4D ratio compared to healthy controls. A correlation between the ratio and the severity of the symptoms was also found. These novel findings may provide a solid basis for future longitudinal and mechanistic studies examining prenatal androgen exposure as a contributing factor in the etiology and clinical heterogeneity of tic disorders.

The detection of the performance-enhancing drug testosterone (T) remains a significant challenge in doping control analysis. Longitudinal monitoring through the steroidal Athlete Biological Passport (ABP) is a valuable tool for T detection, but further research is needed to enhance its efficacy. Phase II metabolites of endogenous anabolic androgenic steroids (EAAS), including glucuronides and sulfates, have gained increasing interest as potential new biomarkers for the steroidal ABP. Notably, sulfate metabolites have demonstrated higher sensitivity to oral, transdermal, and intramuscular T administration, with extended detection windows compared to traditional biomarkers. However, before incorporating these promising biomarkers into urinary steroid profiling, it is essential to address the metabolic variations associated with different T administration methods, as well as differences related to ethnicity and sex. In this part of the study, we investigate the effects of oral and transdermal T administration on conventional biomarkers and phase II EAAS metabolites in male participants. Sulfate ratios indicated higher sensitivity to multiple administrations of testosterone undecanoate (TU) tablets and T gel, significantly prolonging detection times compared to conventional steroid profile biomarkers. Specifically, sulfate ratios such as androsterone sulfate (AS)/testosterone sulfate (TS) and epiandrosterone sulfate (EpiAS)/TS enabled detection for an average of 20 days following the last oral TU dose and at least 16 days after the last transdermal T application. These findings provide further evidence that incorporating sulfate EAAS metabolites into steroid profiling enhances detection capabilities. For advanced T doping detection, sulfate metabolites should be considered essential biomarkers in the steroid profile.

Androgenetic alopecia (AGA) is a common condition characterized by progressive hair loss, closely associated with androgen hormone activity and genetic predisposition. Although platelet-rich plasma (PRP) therapy has gained attention for its regenerative potential and ability to stimulate follicular activity, the synergistic effect of combining PRP with mesotherapy remains unexplored. This case report presents a successful protocol involving a male patient with advanced AGA whose condition was further aggravated by chemical damage from a bleaching procedure. The therapeutic protocol included intradermal injections of PRP in combination with customized blends of active ingredients by mesotherapy, administered in multiple sessions. Quantitative photographic analysis revealed a visual increase in hair density, along with notable improvements in hair thickness and scalp health. The patient expressed great satisfaction with both the aesthetic results and scalp comfort. These results demonstrate the potential of an integrative PRP-mesotherapy approach as safe and effective treatment for patients with complex androgenetic alopecia.

Gold nanostars-driven SERS biosensors for fingerprinting detection and quantitative profiling of anabolic steroids.