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Statins have recently been reported to cause a rare autoimmune inflammatory and/or necrotic myopathy that begins or persists after drug cessation.
We report on 26 patients seen at a neuromuscular centre between 2005 and 2011 who demonstrated muscle weakness/myalgias and creatine kinase elevations during or after statin treatment with continuation of signs and symptoms despite statin withdrawal.
All patients were treated with immunosuppressive therapy with good response; all improved biochemically and 86% improved clinically. Sixty-five percent of patients who attempted to taper off immunosuppressive therapy relapsed. We report on a novel finding whereby five of the seven patients who underwent multiple biopsies throughout their disease demonstrated a transformation of their histological diagnosis, with four progressing from having myofibre necrosis with minimal or no inflammation to a diagnosis of polymyositis.
This study offers preliminary evidence that statin-associated necrotizing myopathy and statin-associated polymyositis may not be separate entities but are part of the same pathophysiological spectrum. Both entities respond well to immunosuppression.
Male cats mate happily with any female in heat in the
neighborhood. Something similar occurs in colleges as
nearness and availability overwhelm all other considerations.
So we see young men and women marry people who happen to
be at hand when the time is ripe.
Philosophers have long debated the question of the existence of God. This is one of many philosophical issues in which the motivation for inquiry has come more perhaps from the side of human feeling than from disinterested scientific curiosity. Powerful emotions appear to prompt thinkers to devote effort to the attempt to prove or disprove the existence of God. The urgency of this task has made some of these philosophers pay less than adequate heed to the concepts they employ. It appears to have escaped the attention of many of them that the word “God” does not have a single meaning either in religious language generally or in philosophical theology. It is obvious that one of the important ways in which religious traditions differ is in their conceptions of the Deity. But a considerable number of different God-concepts may be distinguished in the Judeo-Christian religious tradition itself, and not even in Christian theology proper is the word “God” free of ambiguity.