Blood Cortisol Research Articles

Impact of a Holistic Health Intervention on the Well-Being of Elderly Thais

OBJECTIVE: Mental stress is a major risk factor of metabolic diseases and impairs quality of life in the elderly. The goal of this study was to investigate whether a mindfulness-based intervention can improve health parameters and reduce stress-related hormones in elderly Thais.
 
 METHODS: A total of 192 participants were recruited from urban (n = 96) and rural areas (n = 96) in central region of Thailand. Creative visual art relaxation and meditative movement exemplified by Dao De Xin Xi exercise were introduced as monthly workshops and individual participants were encouraged to practice regularly for three months. General health status, levels of blood pressure (BP), fasting blood sugar (FBS), cortisol and dehydroepiandrosteone (DHEA) were evaluated before and after completing the intervention.
 
 RESULTS: This mindfulness-based intervention was effective as assessed by several biological health parameters. However, the degree of effectiveness differed between participants in urban and rural groups. In urban group, BPs were significantly reduced in hypertension and pre-hypertension subgroups of participants, and levels of DHEA in low DHEA participants were significantly increased after the intervention. In contrast, FBS levels in diabetic and pre-diabetic participants in the rural group, but not in the urban group, were significantly decreased after the intervention. We found a trend toward improvement of cortisol levels in both groups. However, the levels of glycated hemoglobin in either group remained unchanged.
 
 CONCLUSION: This mindfulness-based intervention to elderly people improved health parameters related to metabolic diseases. Therefore, applying the intervention in primary healthcare may help promote the well-being in elderly.

The effects of aromatherapy with clove essential oil on memory function of patients during electroconvulsive therapy: A randomized controlled trial

Memory impairment is a common concern after receiving electroconvulsive therapy (ECT). The present study was conducted to investigate the effect of clove essential oil on memory improvement after electroconvulsive therapy (ECT). For this randomized controlled trial, 100 patients undergoing ECT were assigned to either the experimental group, which was to receive clove essential oil 2.5% for 5 min three times a week, or the control group, which was to receive routine care. The Wechsler Memory Scale-III (WMS-III) was used to evaluate memory in the patients before and after the first and second weeks of ECT. A blood cortisol test was also performed to measure their cortisol levels one and two weeks after the intervention. The patients’ baseline memory score did not differ between the two groups (P = 0.67). The memory score increased in the first week after ECT, it decreased in the second week in both groups but after adjusting for time, no significant differences were observed in the total memory score between the two groups (P = 0.67). The pairwise comparison of the memory score between the first and second weeks also suggested insignificant differences in the experimental group and significant differences in the controls (P = 0.01). Although cortisol levels decreased significantly in both groups after ECT (P = 0.005), the difference between the two groups was insignificant both before (P = 0.40) and after (P = 0.26) ECT. According to the present findings, clove essential oil neither improved memory in the patients nor affected their cortisol levels after ECT. Registered with the Iranian Registry of Clinical Trials (IRCT2014032317072N1).

Blood biochemical variables, antioxidative status, and histological features of intestinal, gill, and liver tissues of African catfish (Clarias gariepinus) exposed to high salinity and high-temperature stress

African catfish is a freshwater species with a high ability to resist brackish water conditions, but heat stress may impair the health status of fish. Thus, the impact of varying levels of water salinity (0, 4, 8, and 12 ppt) was investigated on the growth performance, survival rate, and blood biochemistry of African catfish (average weight: 180.58 ± 2.8 g and average length: 38 ± 1.2 cm) for 4 weeks; then, fish were stressed with high temperature (32 °C) for 72 h. The growth performance and survival rate were markedly higher in fish reared in 0, 4, and 8 ppt than fish in 12 ppt (p < 0.05). Before heat stress, the superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) activities, and malondialdehyde (MDA) levels were markedly increased in fish stressed with 12-ppt salinity (p < 0.05). After heat stress, all groups showed a marked increased SOD, CAT, GSH, and MDA levels than fish before heat stress in the same manner (p < 0.05). Furthermore, fish in the 12 ppt group showed severe intestinal, gill, and liver histological features. The levels of blood glucose and cortisol were markedly increased in fish exposed with 8 and 12 ppt than 0 ppt gradually either before or after heat stress (p < 0.05). The highest values of ALT, AST, urea, creatinine, and the lowest total protein, albumin, and globulin were observed in fish reared in 12 ppt. Significant salinity and heat stress interactions were seen on the ALT, AST, urea, creatinine, total protein, albumin, and globulin values (p < 0.05). The integrated multi-biomarker response (IBR) results showed marked differences among the groups and increased gradually before and after heat stress, with the highest IBR in 12 ppt. In conclusion, growing African catfish in high salinity (12 ppt) hampered the growth performance and health status while the heat stress improved the antioxidative status vis-a-vis increased lipid peroxidation along with higher stress-related markers in expressed both blood and tissue.

Natural Adrenocorticotropic Hormone (ACTH) Relieves Acute Inflammation in Gout Patients by Changing the Function of Macrophages.

Gout is a common arthritis caused by deposition of monosodium urate crystals. Macrophage is crucial in the process of monosodium urate (MSU)-induced inflammation. Although it has been reported that adrenocorticotropic hormone (ACTH) in nature can be used to cure urarthritis, the mechanism concerning macrophage is still not clear. However, gout patients manifest other complications, such as hypertension, diabetes, chronic kidney disease, and hormone intolerance, which limit efficacy of some of these first-line drugs. Therefore, this study aims to explore how natural ACTH can alleviate urarthritis through functional changes in macrophage. We analyzed the variations in VAS pain scores of five patients, knowing the time of action and detecting the level of cortisol and ACTH in patients 24 hours after the application of ACTH. The effect of natural ACTH on joint inflammation and the level of cortisol in blood in the mouse model was evaluated by studies in vivo. In vitro studies, we evaluated the effect of natural ACTH on macrophages and revealed different functions of ACTH and dexamethasone on macrophages in the transcriptional level. In patients with acute gout, natural ACTH can quickly alleviate pain and does not affect the level of cortisol and ACTH. Natural ACTH is able to ease the swelling and inflammatory cell infiltration caused by arthritis, without changing the level of cortisol. Besides, natural ACTH in vitro can alleviate acute gouty inflammation by regulating phagocytosis and polarization of macrophage, which also exerts different effects on the transcription of some related genes. Natural ACTH is able to alleviate acute gouty inflammation by regulating macrophage, and this effect differs from that of dexamethasone at the transcriptional level.

Relevance of cortisol and copeptin blood concentration changes in an experimental pain model

The effect of pain and analgesics on stress biomarkers is not well studied. We evaluated the effect of acute pain and analgesics on serum cortisol and copeptin in an experimental pain model in healthy volunteers. Healthy volunteers presented at 8 a.m. for an experimental pain stimulation. Cortisol and copeptin levels were measured before, during and after electrophysiological stimulation, first before and then during opioid delivery. Difference in biomarker levels compared to baseline levels was calculated, and potential influencing factors were evaluated by linear regression analysis. Cortisol decreased by 13% during the 10 min of rest at baseline, but copeptin did not change significantly. Cortisol had a median decrease of −24% or −83 nmol/l (−44 to −124 nmol/l, p = 0.0002) during the electrophysiological stimulation training session, while the median difference for copeptin was −22% or −1.01 pmol/l (−2.35 to 0.08 pmol/l, p = 0.0003). After administration of opioids, cortisol did not decrease but increased by 3% (p = 0.043), indicating an increasing opioids effect on cortisol. This effect was not visible for copeptin (median change −0.003 pmol/l (−0.50 to 0.24), p = 0.45). In this experimental pain model performed in the morning, moderate pain did not have a relevant effect on cortisol or copeptin levels, whereas opioids led to a discrete peak of cortisol.Clinicaltrials.gov identifier: NCT01975753 (registered on November 5, 2013, before start of recruitment).

Time of trauma prospectively affects PTSD symptom severity: The impact of circadian rhythms and cortisol

A key feature of posttraumatic stress disorder (PTSD) is a disruption of hypothalamic-pituitary-adrenal (HPA) axis feedback sensitivity and cortisol levels. Despite known diurnal rhythmicity of cortisol, there has been little exploration of the circadian timing of the index trauma and consequent cortisol release. Stress-related glucocorticoid pulses have been shown to shift clocks in peripheral organs but not the suprachiasmatic nucleus, uncoupling the central and peripheral clocks. A sample of 425 participants was recruited in the Emergency Department following a DSM-IV-TR Criterion A trauma. The Zeitgeber time of the trauma was indexed in minutes since sunrise, which was hypothesized to covary with circadian blood cortisol levels (high around sunrise and decreasing over the day). Blood samples were collected M(SD)= 4.0(4.0) hours post-trauma. PTSD symptoms six months post-trauma were found to be negatively correlated with trauma time since sunrise (r(233) = −0.15, p = 0.02). The effect remained when adjusting for sex, age, race, clinician-rated severity, education, pre-trauma PTSD symptoms, and time of the blood draw (β = -0.21, p = 0.00057). Cortisol levels did not correlate with blood draw time, consistent with a masking effect of the acute stress response obscuring the underlying circadian rhythm. Interactions between trauma time and expression of NPAS2 (punadjusted=0.042) and TIMELESS (punadjusted=0.029) predicted six-month PTSD symptoms. The interaction of trauma time and cortisol concentration was significantly correlated with the expression of PER1 (padjusted=0.029). The differential effect of time of day on future symptom severity suggests a role of circadian effects in PTSD development, potentially through peripheral clock disruption.

Maternal history of childhood maltreatment is associated with diurnal cortisol and DNA methylation of placental 11-beta-hydroxysteroid dehydrogenase type 2.

Accumulating evidence indicates that maternal hypothalamic-pituitary-adrenal (HPA) axis activity over pregnancy differs according to maternal history of childhood maltreatment. DNA methylation of the placental 11-beta-hydroxysteroid dehydrogenase (BHSD) type 2 enzyme regulates fetal exposure to maternal cortisol, yet the association between maternal history of childhood maltreatment and methylation of placental 11BHSD type 2 has not been previously studied. We examined if maternal cortisol production at 11 and 32 weeks' gestation (n = 89) and placental methylation of the 11BHSD type 2 gene (n = 19) differed among pregnant women with and without histories of childhood maltreatment. Twenty-nine percent of participants reported a history of childhood maltreatment (physical/sexual abuse). Women with histories of childhood maltreatment displayed lower cortisol in early gestation, hypo-methylation of placental 11BHSD type 2, and lower levels of cord blood cortisol. Preliminary results suggest alterations in cortisol regulation over pregnancy according to maternal history of childhood maltreatment.

Exploring Dried Blood Spot Cortisol Concentrations as an Alternative for Monitoring Pediatric Adrenal Insufficiency Patients: A Model-Based Analysis.

Congenital adrenal hyperplasia (CAH) is the most common form of adrenal insufficiency in childhood; it requires cortisol replacement therapy with hydrocortisone (HC, synthetic cortisol) from birth and therapy monitoring for successful treatment. In children, the less invasive dried blood spot (DBS) sampling with whole blood including red blood cells (RBCs) provides an advantageous alternative to plasma sampling. Potential differences in binding/association processes between plasma and DBS however need to be considered to correctly interpret DBS measurements for therapy monitoring. While capillary DBS samples would be used in clinical practice, venous cortisol DBS samples from children with adrenal insufficiency were analyzed due to data availability and to directly compare and thus understand potential differences between venous DBS and plasma. A previously published HC plasma pharmacokinetic (PK) model was extended by leveraging these DBS concentrations. In addition to previously characterized binding of cortisol to albumin (linear process) and corticosteroid-binding globulin (CBG; saturable process), DBS data enabled the characterization of a linear cortisol association with RBCs, and thereby providing a quantitative link between DBS and plasma cortisol concentrations. The ratio between the observed cortisol plasma and DBS concentrations varies highly from 2 to 8. Deterministic simulations of the different cortisol binding/association fractions demonstrated that with higher blood cortisol concentrations, saturation of cortisol binding to CBG was observed, leading to an increase in all other cortisol binding fractions. In conclusion, a mathematical PK model was developed which links DBS measurements to plasma exposure and thus allows for quantitative interpretation of measurements of DBS samples.

Physiological and psychological stress responses to labor and delivery during COVID-19 pandemic: a cohort study

Objective To evaluate objective (saliva cortisol) and subjective (questionnaire) stress levels during the Coronavirus disease (COVID-19) pandemic compared to before the pandemic and their effects on obstetric and neonatal outcomes. Methods This cohort study included 36 women with low-risk, singleton, term deliveries at a tertiary academic center during the COVID-19 pandemic and 49 who delivered before. Physiological stress was evaluated with salivary cortisol measurements, and emotional stress with stress scale questionnaires (0–10) during active and full dilation stages of labor, and 2-min postpartum. Cord blood cortisol and pH were obtained. Delivery mode, complications, and neonatal outcomes were evaluated. Results Psychological stress was higher for the COVID-19 group compared to controls during full dilation (6.2 ± 3.4 vs. 4.2 ± 3, p = .009). The COVID-19 group had significantly lower cord cortisol levels (7.3 vs. 13.6 mcg/dl, p = .001). No differences were found regarding salivary cortisol level assessments at active, full dilation and 2-min post-delivery (p = .584, p = .254, p = .829, respectively). No differences were found regarding pH < 7.1 (p = .487), 1- and 5-min Apgar scores < 7 (p = .179) and neonatal weight (p = .958). Conclusions Women who delivered during COVID-19 pandemic had higher stress levels at full dilation and lower cord cortisol levels, as may be expected after exposure to a chronic stressor.

Dietary L-Carnitine Affects Leukocyte Count and Function in Dairy Cows Around Parturition.

In early lactation, an energy deficit leading to a negative energy balance (NEB) is associated with increased susceptibility to disease and has been shown to be an important factor during transition in dairy cows. L-carnitine as a key factor in the mitochondrial transport of fatty acids and subsequently for β-oxidation and energy release is known to modulate mitochondrial biogenesis and thus influence metabolism and immune system. In the current study, we characterized hematological changes around parturition and investigated the potential effects of dietary L-carnitine supplementation on immune cell functions. For this approach, dairy cows were assigned either to a control (CON, n = 30) or an L-carnitine group [CAR, n = 29, 25 g rumen-protected L-carnitine per cow and day (d)]. Blood samples were taken from d 42 ante partum (ap) until d 110 post-partum (pp), with special focus and frequent sampling from 0.5 to72 h post-calving to clarify the impact of L-carnitine supplementation on leukocyte count, formation of reactive oxygen species (ROS) in polymorphonuclear cells (PMN) and peripheral mononuclear cells (PBMC) and their phagocytosis activity. Blood cortisol concentration and the capacity of PBMC proliferation was also investigated. All populations of leukocytes were changed during the peripartal period, especially granulocytes showed a characteristic increase up to 4 h pp. L-carnitine supplementation resulted in increased levels of eosinophils which was particularly pronounced one day before to 4 h pp, indicating a possible enhanced support for tissue repair and recovery. Non-supplemented cows showed a higher phagocytic activity in PBMC as well as a higher phagocytic capacity of PMN during the most demanding period around parturition, which may relate to a decrease in plasma levels of non-esterified fatty acids reported previously. L-carnitine, on the other hand, led to an increased efficiency to form ROS in stimulated PMN. Finally, a short period around calving proved to be a sensitive period in which L-carnitine administration was effective.

The growth performance, antioxidative capacity, and histological features of intestines, gills, and livers of Nile tilapia reared in different water salinities and fed menthol essential oil

Farming Nile tilapia in brackish water is one of the choices in the areas suffering from a lack of fresh water. Hence this study tested the effects of different salinity levels and dietary menthol essential oil (MNT) on the productivity of Nile tilapia. Two test diets were formulated with MNT (0.25%) or without MNT and fed to Nile tilapia stocked in 0, 5, 10, and 15 ppt salinity levels for 60 days. The growth performance, feed efficiency ratio, and survival rate indices were markedly (p < 0.05) affected by different salinity levels, dietary MNT, and their interaction. All groups showed significantly higher survival rate than fish in 15 ppt without MNT feeding (p < 0.05). The histopathological investigation of gills, intestines, and livers was prominently affected by increased salinity, while the addition of MNT clearly improved the morphological abnormalities. Fish in 15 ppt without MNT had the highest ALT and AST levels, while fish in 0 ppt with MNT had the lowest ALT and AST levels (p < 0.05). The blood glucose level was markedly increased in 10 and 15 ppt with MNT (p < 0.05), followed by fish in 5 ppt with MNT and 15 ppt without MNT. The blood cortisol level was markedly increased in 10 and 15 ppt with MNT (p < 0.05), followed by fish in 5 ppt with MNT, then 0, 5, and 10 ppt without MNT. Fish in 0 and 5 ppt salinity levels had higher SOD, CAT, GPx, and lower MDA levels (p < 0.05) than fish in 10 and 15 ppt without MNT feeding. In all groups, the SOD, CAT, and GPx were markedly enhanced by the addition of MNT while MDA levels were reduced (p < 0.05). The regression analysis illustrated that the best performances of Nile tilapia could be occurred by 1.84–8.04 ppt. At the same time, the inclusion of MNT resulted in increased tolerance of Nile tilapia up to 14.85 ppt based on the overall regression analysis results. In conclusion, dietary MNT relived the impacts of brackish water conditions on the productivity and the histological structure of gills, intestines, and livers of Nile tilapia.

Differential expression of placental 11β-HSD2 induced by high maternal glucocorticoid exposure mediates sex differences in placental and fetal development

A variety of adverse environmental factors during pregnancy cause maternal chronic stress. Caffeine is a common stressor, and its consumption during pregnancy is widespread. Our previous study showed that prenatal caffeine exposure (PCE) increased maternal blood glucocorticoid levels and caused abnormal development of offspring. However, the placental mechanism for fetal development inhibition caused by PCE-induced high maternal glucocorticoid has not been reported. This study investigated the effects of PCE-induced high maternal glucocorticoid level on placental and fetal development by regulating placental 11β-hydroxysteroid dehydrogenase 2 (11β-HSD2) expression and its underlying mechanism. First, human placenta and umbilical cord blood samples were collected from women without prenatal use of synthetic glucocorticoids. We found that placental 11β-HSD2 expression was significantly correlated with umbilical cord blood cortisol level and birth weight in male newborns but not in females. Furthermore, we established a rat model of high maternal glucocorticoids induced by PCE (caffeine, 60 mg/kg·d, ig), and found that the expression of 11β-HSD2 in male PCE placenta was decreased and negatively correlated with the maternal/fetal/placental corticosterone levels. Meanwhile, we found abnormal placental structure and nutrient transporter expression. In vitro, BeWo cells were used and confirm that 11β-HSD2 mediated inhibition of placental nutrient transporter expression induced by high levels of glucocorticoid. Finally, combined with the animal and cell experiments, we further confirmed that high maternal glucocorticoid could activate the GR-C/EBPα-Egr1 signaling pathway, leading to decreased expression of 11β-HSD2 in males. However, there was no significant inhibition of placental 11β-HSD2 expression, placental and fetal development in females. In summary, we confirmed that high maternal glucocorticoids could regulate placental 11β-HSD2 expression in a sex-specific manner, leading to differences in placental and fetal development. This study provides the theoretical and experimental basis for analyzing the inhibition of fetoplacental development and its sex difference caused by maternal stress.

Heat Stress-Induced Dysbiosis of Porcine Colon Microbiota Plays a Role in Intestinal Damage: A Fecal Microbiota Profile.

The pathological mechanisms of gastrointestinal disorders, including inflammatory bowel disease (IBD), in pigs are poorly understood. We report the induction of intestinal inflammation in heat-stressed (HS) pigs, fecal microbiota transplantation from pigs to mice, and explain the role of microorganisms in IBD. 24 adult pigs were subjected to HS (34 ± 1 °C; 75–85% relative humidity for 24h) while 24 control pigs (CP) were kept at 25 ± 3°C and the same humidity. Pigs were sacrificed on days 1, 7, 14, 21. Colonic content microbiome analyses were conducted. Pseudo-germ-free mice were fed by gavage with fecal microbiota from HS-pigs and CP to induce pig-like responses in mice. From 7 d, HS-pigs exhibited fever and diarrhea, and significantly lower colonic mucosal thickness, crypt depth/width, and goblet cell number. Compared with each control group, the concentration of cortisol in the peripheral blood of HS pigs gradually increased, significantly so on days 7, 14, and 21 (P < 0.01). While the concentration of LPS in HS pigs' peripheral blood was significantly higher on days 7, 14 (P < 0.01), and 21 (P < 0.05) compared with that of the control group. The colonic microbiome composition of HS-pigs was different to that of CP. By day 14, opportunistic pathogens (e.g., Campylobacterales) had increased in HS-pigs. The composition of the colonic microbiome in mice administered feces from HS-pigs was different from those receiving CP feces. Bacteroides were significantly diminished, Akkermansia were significantly increased, and intestinal damage and goblet cell numbers were higher in mice that received HS-pig feces. Moreover, we verified the relevance of differences in the microbiota of the colon among treatments. Heat stress promotes changes in gut microbiome composition, which can affect the colonic microbial structure of mice through fecal microbiota transplantation; the molecular mechanisms require further investigation. This study enhanced our understanding of stress-induced inflammation in the colon and the increase in diarrhea in mammals subjected to prolonged HS. Our results provide useful information for preventing or ameliorating deficits in pig production caused by prolonged exposure to high temperatures.

Abstract No.: ABS2258 : Evaluation of the efficacy of preoperative oral glucose loading for attenuating perioperative stress response to surgery under general anesthesia.

Background & Aims:Nutritional and metabolic preparation of the body facilitates mitigation of increased catabolism, insulin resistance and therby attenuates the stress responses to surgery. . Nutritional and metabolic preparation of the body facilitates in mitigation of increased catabolism, insulin resistance and thus stress response to surgery. The present study therefore aimed at evaluating the effects of preoperative oral glucose loading and its effects in decreasing the stress response to surgery.Methods:The present study included Forty adult patients scheduled for elective surgery under general anesthesia who were then randomly allocated into two groups of 20 patients each. Patients in group G received glucose orally on the evening before surgery (100g) and on the morning of surgery (50g). Patients in group N did not receive glucose. All patients of both groups followed standard American Society of Anaesthesiologists ( ASA) fasting guidelines. Assessment for blood glucose, cortisol and interleukin-6 along with patient well-being were made at different time intervals.Results:The magnitude of increase in the Serum Cortisol from the baseline was significantly more in group-N as compared to group-G. The increase in the blood glucose levels was significantly less in group-G at T24. The magnitude of increase in the interleukin-6 levels from the baseline was significant at T24 in both the groups. Also significant number of patients in group-N experienced thirst, hunger and anxiety. Patients in group-G experienced less intense pain when compared to group-N.Conclusion:I Preoperative oral glucose loading was associated with significant reduction in the stress-response to surgery because of the concomitant decrease in the magnitudeof increase in blood-glucose and serum-cortisol levels.Also enhanced a patient well-being postoperatively in the form of reduced pain and anxiety was the additional Benefit of preoperatively glucose loading.Group NGroup G P Mean±SDMedian (IQR)Mean±SDMedian (IQR)Cortisol (T0)202.22±289.8974.435 (23.46-267.95)279.63±258.67180.60 (92.65-355.81)0.028Cortisol (T1)596.46±536.15388.30 (202.94-1074.18)384.42±385.52231.50 (141.83-510.60)0.164Cortisol (T6)555.38±501.41280.43 (164.48-946.80)373.55±295.83234.30 (131.42-642.55)0.234Cortisol (T24)329.32±339.68137.7 (107.07-573.80)193.06±213.48113.70 (88.00-203.93)0.204

Changes in Physiological Levels of Cortisol and Adrenocorticotropic Hormone upon Hospitalization Can Predict SARS-CoV-2 Mortality: A Cohort Study.

There is some indication that coronavirus disease 2019 (COVID-19) causes hypothalamic-pituitary-adrenal axis insufficiency. However, being on glucocorticoids makes it difficult to fully investigate this axis, especially in patients with severe COVID-19. We aimed to discover if there was a connection between blood total cortisol and adrenocorticotropic hormone (ACTH) levels and mortality in patients with COVID-19. In Iran, 154 hospitalized patients with COVID-19 were studied in a prospective cohort study. ACTH and cortisol levels in the blood were measured on the first or second day of hospitalization. Most patients (52.6 vs. 47.4%) were men over 50 years old (55.8%), and 44.4% had an underlying illness. Serum cortisol and plasma ACTH medians were 15.6 (μg/dl) and 11.4 (pg/ml), respectively. 9.09% of the patients died. Cortisol levels were substantially lower in those who died (11.3 μg/dl) than in patients who were discharged (16.7 μg/dl, P < 0.01), while ACTH levels were unaffected. The most important factors determining mortality, according to the logistic model, were blood cortisol levels, the existence of an underlying disease, and the use of a mechanical ventilator. Cortisol levels that rose by one-unit correlated with a 26% lower risk of mortality. Comorbidities and mechanical ventilation increased the risk of death by 260 and 92 times, respectively. It can be concluded that in patients with COVID-19, a low cortisol level is linked to a high risk of mortality. Patients may sometimes have relative primary adrenal insufficiency. To judge and decide on therapeutic interventions, more reliable and long-term follow-up studies are required.

Cranial Electrotherapy Stimulation to Improve the Physiology and Psychology Response, Response-Ability, and Sleep Efficiency in Athletes with Poor Sleep Quality.

Athletes often have poor sleep quality before a competition. Sleep quality can stabilize mood and improve sports performance. The randomized controlled study explored the effects of cranial electrotherapy stimulation (CES) on the physiology, psychology, response-ability, and sleep quality of athletes who had poor sleep quality before a competition. Athletes who had poor sleep quality (Pittsburgh Sleep Quality Scale score > 5) and had a competition in less than 2 months were recruited. The athletes were grouped into the CES group, which received a 2-week CES treatment (n = 20, age = 21.55 ± 2.26 years), and a placebo group (n = 20, age = 21.05 ± 1.46 years), which received a 2-week sham CES treatment. We performed biochemical analysis, a simple reaction time test, choice reaction time tests, the Profile of Mood States, heart rate variability (HRV), and an Actigraphy activity recorder to measure outcomes before and after the interventions. Our results revealed no significant differences in blood urea nitrogen, creatine phosphate, testosterone, cortisol, and saliva pH between and within groups (p > 0.05). Significant decreases in negative mood states (i.e., anger, tension, and depression) and choice reaction time in the CES group were noted (p < 0.05), moreover, the anger, tension, and depression mood decreased from 0.36 ± 0.45 (95% CI = 0.16–0.55), 1.62 ± 0.97 (95% CI = 1.19–2.04), and 1.67 ± 1.06 (95% CI = 1.20–2.13) to 0.11 ± 0.20 (95% CI = 0.02–0.19, p = 0.03), 1.12 ± 0.74 (95% CI = 0.79–1.44, p = 0.04), and 0.81 ± 0.75 (95% CI = 0.48–1.13, p = 0.001), respectively. Additionally, choice reaction time was decreased from 420.85 ± 41.22 ms (95% CI = 402.78–438.91) to 399.90 ± 36.71 ms (95% CI = 383.81–415.98, p = 0.04) and was also noted in the CES group. For HRV, and Actigraphy activity for sleep measure, the low-frequency (LF)/high-frequency (HF) ratios changed from 1.80 ± 1.39 (95% CI = 1.19–2.40) to 1.21 ± 0.73 (95% CI = 0.89–1.53, p = 0.10), and sleep efficiency decreased from 87.94 ± 6.76% (95% CI = 84.97–90.90) to 81.75 ± 9.62% (95% CI = 77.53–85.96, p = 0.02) in the CES group. The change in LF/HF after the trial were found between CES and placebo groups (p < 0.05). Yet, the decrease in sleep efficiency in the placebo group were noted (p < 0.05). However, we found that the regression line for sleep efficiency was decreased less during the study while using CES. The CES intervention could reduce negative emotions, improve choice reaction times, enhance the parasympathetic and sympathetic nerve activity imbalances, and slow sleep efficiency deterioration. Regardless, small effect sizes of the application of CES on psychology response, response-ability, and sleep efficiency were concluded in athletes with poor sleep quality before a competition.

The effect of transdermal flunixin meglumine on blood cortisol levels in dairy calves after cautery disbudding with local anesthesia

The objective of this study was to evaluate the effect of the nonsteroidal anti-inflammatory drug transdermal flunixin meglumine (Finadyne Transdermal) on plasma cortisol, average daily weight gain, and standing and lying behavior of calves, when given at the time of disbudding combined with local anesthesia. A sedative was not used to minimize pharmacological interactions. Seventy-one female Holstein Friesian calves aged 13 ± 2 d, with an average weight of 48.9 ± 4.26 kg were enrolled in the study. All calves were randomly assigned to one of 3 treatment groups: (1) control group (CON, n = 27), (2) 1-flunixin group (1-FLU, n = 26) with a single administration of transdermal flunixin meglumine at disbudding, and (3) 2-flunixin group (2-FLU, n = 24) with 2 administrations of transdermal flunixin meglumine, the first treatment at disbudding and the second 6h after disbudding. Although the CON group received a placebo, 1-FLU and 2-FLU received flunixin meglumine transdermally. To account for plasma cortisol changes due to manipulation and handling of the calves, a sham disbudding procedure was performed one week before disbudding took place. Sham disbudding was conducted by using a cold cautery dehorner applied to each horn bud for 10 s. Disbudding was performed in a similar way by using a hot cautery dehorner. Plasma samples were collected to measure the stress biomarker cortisol at 7 different time points. Body weights were measured 4 times in 2 wk. Standing and lying behavior was assessed via 3-dimensional accelerometer. During sham disbudding and disbudding mean plasma cortisol concentrations were 6.09 ± 2.5 ng/mL and 5.16 ± 2.8 ng/mL, respectively. Treatment tended to have an effect on plasma cortisol concentrations during sham disbudding and had an effect on plasma cortisol concentrations during disbudding. Plasma cortisol concentrations were affected by treatment 2 h after disbudding in comparison to CON group. Furthermore, there was a significant effect on plasma cortisol concentrations 6 h after disbudding in contrast to CON. A return to baseline plasma cortisol levels (initial concentrations) was not achieved in CON during disbudding. There was no statistical difference between average daily weight gain and the treatment procedure. Total lying time was not affected by treatment after disbudding. In conclusion, transdermal flunixin meglumine given at the time of disbudding combined with local anesthesia decreased concentrations of the stress biomarker cortisol, but a second dose 6 h after disbudding had no further effect on plasma cortisol levels.

Impact of integrated neuromuscular inhibition technique versus electro-acupuncture stimulation of posterior tibial nerve in males with chronic pelvic pain of myofascial origin

The aim of the study was to examine the impact of the integrated neuromuscular inhibition technique and electro-acupuncture stimulation of posterior tibial nerve in males diagnosed with chronic pelvic pain of myofascial origin. Sixty male patients with chronic pelvic pain participated in this randomized, single-blind, active-controlled trial and they were randomly divided into 3 groups of equal size. The group A (20 patients) received integrated neuromuscular inhibition technique (INIT) and pelvic floor exercise, the group B (20 patients) received posterior tibial nerve electroacupuncture using TENS acupuncture as a noninvasive pelvic floor muscle neuromodulation technique and pelvic floor exercise, and the control group C (20 patients) received pelvic floor exercise only. Serum cortisol level (SCL) measurement was done, and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire score was used to assess the severity of symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The measurements were done at baseline and after the next two months. Comparing the three groups post treatment, our results show that there are statistically significant differences in serum cortisol level and in the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire score in both group A and B (p&lt;0.05). There are no statistically significant differences in the control group C (p&gt;0.05). The findings of this research showed a significant reduction of blood cortisol level and improvement of NIH CPSI questionnaire total value in men with chronic pelvic pain who used an integrated neuromuscular inhibition technique and percutaneous posterior tibial nerve stimulation, and a non-significant difference in the control group C. The INIT has superiority over electro-acupuncture stimulation of the posterior tibial nerve in reducing pain and improving quality of life.

Anxiolytic and antidepressant-like activities of aqueous extract of Azadirachta indica A. Juss. flower in the stressed rats

The aim of this study was to evaluate whether an aqueous extract of Azadirachta indica A. Juss. (A. indica) flower had anxiolytic and antidepressant-like effects in the stressed rats. Male Wistar rats were randomly allocated to one of two experimental groups: control or stress. The stress groups were received restraint stress for 3 h. The stressed rats were administered a vehicle, diazepam, fluoxetine, and A. indica at doses of 250, 500, and 1000 mg/kg BW for 30 days. The elevated plus-maze test (EPMT), the forced swimming test (FST), and the open field test (OFT) were used to assess anxiolytic and antidepressant-like behaviors. In the EPMT, the percentage of the number of open arm entries and the duration spent in open arms were measured. These measurements were considerably enhanced in the stressed rats treated with diazepam and A. indica flower extract at a dose of 500 mg/kg BW. Furthermore, the stressed rats given fluoxetine and A. indica flower extract at all doses employed in this study showed a significant reduction in the amount of time the rats were immobilized in the FST. However, there was no significant difference in spontaneous locomotor activity between any of the groups. Additionally, the stressed rats treated with either positive control medications or A. indica flower extract exhibited significantly higher brain dopamine (DA) and serotonin (5-HT) levels, but lower blood cortisol levels as compared to the stressed rats treated with vehicle. Moreover, A. indica flower extract had no harmful effect on the stressed rats’ liver tissue.

Sedation With Xylazine Hydrochloride Decreases the Stress Response in Merino Meat Sheep During Routine Hoof Trimming in a Tilt Table

We hypothesized that the hoof trimming in sheep in dorsal recumbency implicates a short but intensive stress situation and that the sedation with xylazine causes a decrease in the stress response in this situation. Ten healthy female merino meat sheep were randomly divided into two groups receiving either xylazine hydrochloride (0.1 mg/kg body mass (BM) applied intramuscularly) or a placebo treatment with 0.9% NaCl. Routine hoof trimming was performed in a tilt table and vital signs (rectal temperature (RT), heart rate (HR), and respiratory rate (RR)), 33 different behavioral traits and blood cortisol concentrations were recorded throughout the experiment at six different time points (total of 55 min). The procedure itself elicited a clear stress response (increase in the RR, RT, defensive movements, lip twitching, swallowing, and flight behavior). Parallelly, the blood cortisol concentrations were increased, reaching their maximum with 81.5 ng/ml in the control group when the sheep were tilted back into a standing position. In the sedated sheep, no increase in the RR and RT and a decrease in the HR were observed. In addition, the behavioral signs showed a decrease in flight, defensive, and general stress behavior (decrease in licking, movement of head and legs, and sitting on knees), complemented by the serum cortisol concentrations showing 2.28 times reduced concentration at the end of the procedure, compared to the control sheep. The results confirm our hypothesis and support the conduction of future trials investigating the feasibility and benefit of a sedation of sheep prior to routine hoof trimming under practical circumstances.