Blood Cortisol Research Articles

Orosomucoid: a promising biomarker for the assessment of exercise-induced fatigue triggered by basic combat training

BackgroundOrosomucoid (ORM) is a positive acute phase protein verified to be upregulated in various forms of exercise-induced fatigued (EIF) rodents. However, its association with EIF among human beings remained unknown. This study aimed to explore the association between serum ORM and EIF triggered by military basic combat training (BCT).MethodsThe degree of EIF were measured by Borg’s Rating of Perceived Exertion Scale (Borg-RPE-Scale®) as RPE score after BCT. Fifty-three male recruits were classified into three groups according to the RPE score: (1) group 1 (slight fatigue group): RPE score after BCT < 13; (2) group 2 (moderate fatigue group): RPE score after BCT = 13 or 14; (3) group 3 (severe fatigue group): RPE score after BCT > 14. The levels of blood ORM, lactate (LAC), cortisol and C-reactive protein (CRP) were determined before and after BCT. The diagnostic value of ORM was evaluated by receiver operating characteristic (ROC) curve analysis and logistic regression.ResultsAfter BCT, the level of LAC, CRP, and cortisol increased among all groups, but the changes had no significant between-group difference (all p > 0.05). The level of ORM had a specific significant increase in group 3 (p = 0.039), and the changes of ORM (ΔORM) had significant difference among groups (p = 0.033). ROC curve analysis showed that the estimated area under ROC curve for ΔORM was 0.724 (p = 0.009) with the recommended optimal cut-off value as 0.2565 mg/mL. Logistic analysis showed that recruits with ΔORM ≥ 0.2565 mg/mL had higher odds for suffering from severe EIF, 5.625 times (95% CI 1.542–20.523, p = 0.009) as large as those with ΔORM < 0.2565 mg/mL.ConclusionORM might be a promising biomarker of severe EIF triggered by BCT among male recruits. Its potential optimal cut-off value regarding ΔORM was recommended to be 0.2565 mg/mL.

Occupation and Psychophysiological Status of the Male Population of the Khanty-Mansi Autonomous Area

Introduction: The progressively growing road traffic intensity leads to a steady increase in the informational, emotional and psychological burden in drivers. Truck drivers are exposed to numerous occupational risk factors, including hard labor, constant psychological stress, vibration, noise, a fixed working position, poor visibility, and excess concentrations of noxious gases, all affecting their psychophysiological status. Objective: To study the relationship between professional work and characteristics of the psychophysiological status of the male population of the northern region and to establish the presence and strength of correlations between their elemental and psychoemotional status. Materials and methods: We assessed the psychoemotional status of 182 men aged 32.6 ± 6.2 years, including 94 truck drivers and 88 office workers, living in three northern cities of the Russian Federation. We also established their blood and urinary levels of catecholamines (adrenaline and noradrenaline) using enzyme immunoassay and measured hair magnesium and potassium levels using inductively coupled plasma atomic emission spectroscopy and inductively coupled plasma mass spectrometry. Results: We observed that the professional drivers of the northern region were more susceptible to psychological stress (p = 0.042…0.001), had higher levels of stress hormones (cortisol and adrenaline) in blood (p = 0.049…0.005) and urine (p = 0.004…0.003), but lower hair levels of magnesium and potassium, the trace elements essential for mental health (p = 0.004…0.003), than male office workers. The correlation analysis of the above parameters proved that psychological stress of the truck drivers was attributed to magnesium and potassium deficiency (r = -0.475…—0.601) and a high level of stress hormones (r = –0.514…–0.828). Conclusion: In order to stabilize emotional and psychological status and to improve the performance, physical health, and the quality of life of professional drivers, it is important to correct their micronutrient status using multivitamin/multimineral supplements and enriched foods.

Evaluation of carbohydrate loading on clinical results and metabolic responses in patients undergoing laparoscopic cholecystectomy

ObjectiveInsulin resistance is associated with a number of postoperative complication and delays recovery. Carbohydrate rich drinks given preoperatively may decrease these deleterious effects. This study evaluated the clinical effects of a preoperative carbohydrate loading in patients undergoing laparoscopic cholecystectomy. MethodsIn this a randomized clinical trial conducted at (XXX) Medical Center located, patients undergoing elective cholecystectomy were included. Patients were randomly divided into fasting and dextrose-receiving groups. The outcomes of this study are the pain, pre- and postoperative blood sugar, fasting blood sugar, insulin, cortisol, albumin, CRP (c-reactive protein), and wound conditions such as wound infection and the amount of fluid discharge from the drain. The data was statistically analyzed using SPSS v22. ResultsPatients who received carbohydrates before surgery experienced less pain on the day after surgery (P-value <0.05). Insulin resistance, CRP, CRP to albumin ratio and cortisol levels were significantly reduced in dextrose group (P-value <0.05) However, difference in glucose levels and albumin was not significant in the two groups. ConclusionThe present results show that although carbohydrate loading is associated with reduced postoperative pain and reduction in inflammatory factors along with insulin resistance.

Attenuation of metabolic stress response during spinal surgery under general anaesthesia - A comparison between preoperative carbohydrate drink or no carbohydrate load

Background: Surgery is a stress which stimulates the increase of counter regulatory hormones. Pre-operative prolonged fasting increases stress further. Although a pre-operative carbohydrate (CHO) drink has been variably reported to yield benefit in reducing the perioperative stress and is being used frequently for elective surgeries, some recent reports also reports that preoperative CHO loading did not result in increase or decrease in the post-operative complication rates when compared with placebo or fasting group. Aims and Objectives: The present study was designed to determine the stress response in the postoperative period at 24 h in terms of changes in the levels of cortisol and other biomarkers. Materials and Methods: This randomized, parallel group, and double-blind study was conducted in 75 patients aged 18–65 years, of American Society of Anesthesiologists Physical Status Classes I and II, scheduled for elective lumbar spine surgery under general anesthesia. The patients were randomly allocated to receive 300 ml plain water at 9 pm on the day before surgery and 2 h before operation (Group C, control, n=25), or 300 ml plain water at 9 pm on the day before surgery and solution containing 75 grams of glucose dissolved in 300 ml water in the morning 2 h before surgery (Group CHO-1, n=25), or to receive 75 grams of glucose dissolved in 300 ml water at 9 pm in the night before the surgery and again in the morning at 2 h before surgery (Group CHO-2, n=25). In all the three groups, the levels of insulin (C-peptide), lactate, glucose, and cortisol were determined preoperatively (before the induction of anesthesia) and 24 h postoperatively. Results: There was considerable difference between post-operative blood cortisol level among the three groups (583.9 vs. 462.3 vs. 389.6 nMol/L, Control vs., CHO load once or twice, respectively, P&lt;0.0001). A significant difference in post-operative values was also seen with other parameters such as serum lactate, glucose, and C-peptide. Considerable differences were seen in both preoperative and postoperative period in case of cortisol and lactate whereas it was limited to postoperative values in case of glucose and C-peptide. Conclusion: Pre-operative glucose loading showed better efficacy in suppressing perioperative stress response in terms of less rise of serum cortisol and lactate as compared to no CHO load.

High Maternal Cortisol Serum Levels as A Risk Factor for Preterm Labor

Preterm delivery is the leading cause of death for children under 5 years of age worldwide. Preterm delivery is one of the significant factors causing neonatal death due to complications associated with preterm birth. Complications of preterm delivery account for about 16% of all deaths in children under 5 years, and 35% of total deaths of newborns. There are several broad outlines of factors associated with preterm labor, including stress, inflammation or infection, overdistention of the uterus and the hypothalamic-pituitary-adrenal axis. Several studies show the role of cortisol caused by these factors. This study aimed to assess the relationship of maternal serum cortisol levels with the risk of preterm delivery. This study used a case-control design conducted at Sanglah Hospital, Denpasar from May to August 2021. A sample of 50 women was obtained which was divided into case groups and control groups. Serum cortisol examination used a 3 mL blood sample which was then examined using the ELISA method at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The results were analyzed using the chi square test. There was no significant difference in the characteristics of the two groups. There was a significant relationship between high serum cortisol levels and the incidence of preterm labor in pregnant women (p &lt; 0.001; 95% CI; 2.768-38.22; OR 10.29). High cortisol serum levels can increase the risk of preterm labor 10 times in pregnant women when compared to pregnant women with low cortisol blood serum levels.

The Relationship Between the Motor Lateralization and the Concentration of Cortisol and Tyrosine in Dogs Exposed to Stress During Veterinary Activities

ABSTRACT The aim of the study was to assess the relationship between the motor lateralization in dogs and the concentration of cortisol and tyrosine in their plasma during a visit to a veterinary clinic. The research group consisted of 56 dogs. Motor lateralization was tested by of an adhesive tape test. The stress intensity was assessed basing on the levels of cortisol and ft4 in the serum blood. The statistical analysis revealed that in the group of 56 dogs there were 14 left-pawed dogs, 36 right-pawed dogs, and 6 dogs did not show particular paw preference. The average cortisol levels in particular groups were as follows: 7.94 ug/dl, 3.92 ug/dl and 3.7 ug/dl, whereas the level of tyrosine in the subjects that demonstrated left-sided lateralization (mean ± SE) (1.95 ± 0.46 ng/dl) for those with right-side lateralization (1.56 ± 0.23 ng/dl) and ambilateral dogs (1.01 ± 0.22 ng/dl). The statistical calculation of Pearson’s χ2 showed a significant relationship between the sex and the lateralization (χ2 = 6.238, df = 2, p = 0.0442).

Response of blood glucose and GLP-1 to different food temperature in normal subject and patients with type 2 diabetes

BackgroundEating behavior is a major factor in type 2 diabetes. We investigated the different responses of glucose-regulating hormones to cold and hot glucose solutions in normal subjects and patients with type 2 diabetes.MethodsIn this crossover, self-controlled study, normal subjects (N = 19) and patients with type 2 diabetes (N = 22) were recruited and randomly assigned to a hot (50 °C) or a cold (8 °C) oral glucose-tolerance test (OGTT). The subsequent day, they were switched to the OGTT at the other temperature. Blood glucose, insulin, GIP, glucagon-like peptide-1 (GLP-1), and cortisol were measured at 0, 5, 10, 30, 60, and 120 min during each OGTT. After the hot OGTT, all subjects ingested hot (>42 °C) food and water for that day, and ingested food and water at room temperature (≤24 °C) for the day after cold OGTT. All participants had continuous glucose monitoring (CGM) throughout the study.ResultsCompared to cold OGTT, blood glucose was significantly higher with hot OGTT in both groups (both P < 0.05). However, insulin and GLP-1 levels were significantly higher in hot OGTT in normal subjects only (both P < 0.05). The GIP and cortisol responses did not differ with temperature in both groups. CGM showed that normal subjects had significantly higher 24-h mean glucose (MBG) (6.11 ± 0.13 vs. 5.84 ± 0.11 mmol/L, P = 0.021), and standard deviation of MBG with hot meals (0.59 ± 0.06 vs. 0.48 ± 0.05 mmol/L, P = 0.043), T2DM patients had higher MBG only (8.46 ± 0.38 vs. 8.88 ± 0.39 mmol/L, P = 0.022).ConclusionsFood temperature is an important factor in glucose absorption and GLP-1 response. These food temperatures elicited differences are lost in type 2 diabetes.

Clinical Observation of MRI Scanning Combined with Clinical Nursing for Surgical Breast Cancer Patients.

The aim of this study was to explore the application effect of perioperative nursing care for patients with breast cancer. In this paper, 100 breast cancer patients with lymphatic spread treated by breast surgery in September 2019 to December were selected as the evaluation objects. They were divided into two groups according to preoperative imaging examination, 50 cases in each group. Group A was examined by B-ultrasound before axillary lymphadenectomy, group B was examined by MRI before axillary lymphadenectomy, and group C was examined by B-ultrasound and MRI before axillary lymphadenectomy. The facts in the three groups of disease findings were compared. Compared with the control group, the proportion of negative emotions (such as stress and depression) in the control group decreased (P<0.05). The decrease in blood cortisol was higher than in the control group (P < 0.05). Improving the existing cancer surgery can improve the patient's heart rate and reduce blood cortisol so as to improve the patient's joint function and quality of life. The difficulty of nursing patients will also be reduced, which is medically necessary.

Effects of different protein levels on growth performance and stress parameters in beef calves under heat stress

This study investigated the effects of dietary protein levels under various heat stress (HS) conditions on the growth performance and stress parameters in Korean native beef calves. Male calves (n = 40; initial BW = 202.2 ± 3.31 kg) were randomly assigned to climatic-controlled chambers with 3 × 3 factorial arrangements. Calves were assigned into three dietary protein levels (low protein; LP = 12.5%, medium protein; MP = 15%, and high protein; HP = 17.5%) and three HS levels [mild: temperature-humidity index (THI) = 74 to 76, moderate: THI = 81 to 83, and severe: THI = 89 to 91] with control (threshold: THI = 70 to 73 and dietary protein level 12.5%). The calves were subjected to ambient temperature (22 °C) for 7 days and subsequently to the temperature and humidity corresponding to the target THI level for 21 days. The data were analyzed using the repeated-measures analysis by the GLM procedure of SAS. As a result, average daily gain (ADG) was decreased (P < 0.05) under severe HS level compared to the mild and moderate HS stress levels. However, HP increased ADG (P < 0.05) than moderate levels (LP) and severe levels (LP and MP). Under different HS levels (mild, moderate, and severe), HR, RT, and blood cortisol were increased (P < 0.05) compared to a threshold level, but no differences were observed in the parameters among various protein levels. Varied HS levels decreased the levels of blood glucose, NEFA, and amino acids (AAs) (lysine and glutamic acid) compared to a threshold (P < 0.05). But, the HP group resulted in increased (P < 0.05) levels of blood glucose, NEFA, and AAs (lysine and glutamic acid) compared to LP and MP groups under severe HS stress. The expression level of the HSP70 gene in peripheral blood mononuclear cell (PBMC) and hair follicles was increased (P < 0.05) following an increase in moderate and severe HS levels. Also, HSP70 gene expression in the HP group was decreased (P < 0.05) compared with LP and MP groups under intense HS level. Overall, HS in Korean native beef calves exhibited negative effects on ADG, blood glucose, NEFA, and AA profile. However, 17.5% of dietary protein (HP) could compensate for the growth of heat-exposed Korean native beef calves through the regulation of homeostasis by protein and energy metabolism. Also, it was evident that adequate protein (HP) is used as a major nutrient for HSP70 synthesis in PBMC and hair follicles causing, a boost in the immune system of heat-exposed Korean native beef calves.

The interplay between genetic variation and gene expression of the glucocorticoid receptor gene NR3C1 and blood cortisol levels on verbal memory and hippocampal volumes

The hypothalamus–pituitary–adrenal axis is the main physiological stress response system and regulating the release of cortisol. The two corticoid receptors encoded by the genes NR3C1 and NR3C2 are the main players in regulating the physiological response to cortisol. This biological system has been linked to neurocognitive processes and memory, yet the mechanisms remain largely unclear. In two independent general population studies (SHIP, total sample size > 5500), we aim to diseantangle the effects of genetic variation, gene expression and cortisol on verbal memory and memory associated brain volume. Especially for NR3C1 results exhibited a consistent pattern of direct an interactive effects. All three biological layers, genetic variation (rs56149945), gene expression for NR3C1 and cortisol levels, were directly associated with verbal memory. Interactions between these components showed significant effects on verbal memory as well as hippocampal volume. For NR3C2 such a complex association pattern could not be observed. Our analyses revealed that different components of the stress response system are acting together on different aspects of cognition. Complex phenotypes, such as cognition and memory function are regulated by a complex interplay between different genetic and epigenetic features. We promote the glucocorticoid receptor NR3C1 as a main target to focus in the context of verbal memory and provided a mechanistic concept of the interaction between various biological layers spanning NR3C1 function and its effects on memory. Especially the NR3C1 transcript seemed to be a key element in this complex system.

Взаимосвязи гормонального статуса и показателей красной крови с кардиореспираторной выносливостью у спортсменов и нетренированных юношей

The aim of this paper was to study red blood cell parameters and levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4) and cortisol, as well as their correlations in young male athletes and non-athletes, depending on their cardiorespiratory endurance. Materials and methods. The study involved 18 athletes (weightlifting, kickboxing) with the ranks ranging from First-Class Sportsman to Candidate for Master of Sport and 38 non-athletes. Hormone concentrations in the blood (cortisol, TSH, FT4) and blood parameters (haemoglobin, red blood cell count (RBC), their mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and haematocrit (НСТ)) were determined. The subjects’ physical endurance was assessed by calculating the cardiorespiratory index (heart rate divided by the respiratory rate). Results. In young men not involved in sports, no statistically significant differences between red blood cell parameters and hormonal status depending on the cardiorespiratory index were observed. At the same time, athletes with low exercise tolerance had statistically significantly lower MCV, MCHC, FT4, and TSH as well as elevated cortisol levels compared to endurance athletes. In young male non-athletes, we established an inverse correlation of TSH with RBC (r = –0.27) and HCT (r = –0.31) as well as of FT4 with RBC (r = –0.35), HCT (r = –0.28) and cardiorespiratory index at rest (r = 0.29). In athletes, cortisol correlated with exercise tolerance (r = 0.74), while FT4 correlated with cardiorespiratory index after exercise (r = 0.69). Thus, a decrease in thyroxine and an increase in cortisol blood levels in athletes correlate with lower cardiorespiratory endurance and exercise tolerance, while in non-athletes, with the activation of the erythropoietic function.

Cortisol Level Related to Depression in Women with Endometriosis

Background: Several main symptoms of endometriosis can lead to physical and psychological stress and also hormonal disturbances as the result of prolonged stress. Cortisol was associated with the onset of depression. This study aimed to determine the relationship between cortisol levels and depression in women with endometriosis at the Department of Obstetrics and Gynecology at Dr. Mohammad Hoesin General Hospital (RSMH) Palembang.&#x0D; Methods: A cross-sectional study was performed at the Reproductive Endocrinology and Infertility outpatient clinic and inpatient ward, Department of Obstetrics and Gynecology at Dr. Mohammad Hoesin General Hospital Palembang, from January to November 2020. There were 74 samples of endometriosis patients who met the inclusion criteria. The blood cortisol level was examined using the ELISA method. The determination of depression level was performed by filling out the Beck Depression Inventory questionnaire. Data were analyzed using SPSS version 22.0.&#x0D; Results: Seventy-four samples met the inclusion criteria. As many as 44 patients (59.5%) without depression, 20 patients (27%) with mild depression, 8 patients (10.8%) with moderate depression, and only 2 patients (2.7%) with severe depression. There were no differences in age, marital status, parity, menstrual cycle, and duration of treatment between endometriosis patients with and without depression (p &gt; 0.05). There was a significant difference in cortisol levels between endometriosis patients with and without depression (p = 0.017). Endometriosis patients with cortisol levels ≤ 7.4 mg/dl were three times more at risk of depression than endometriosis patients with cortisol levels &gt; 7.4 mg/dl. In addition, there was a significant relationship between cortisol level and depression status (OR = 3.023 (95% CI 1.153–7.942; p = 0.041). This study also found a significantly low negative correlation between cortisol levels and BDI scores (r = -0.249; p = 0.032).&#x0D; Conclusion: There was a significant relationship between serum cortisol levels and depression in women with endometriosis. Endometriosis patients with depression had significantly lower cortisol levels than endometriosis patients without depression.

Immune Functions Alterations Due to Racing Stress in Thoroughbred Horses.

Simple SummaryRacehorses are under constant stress when training and during competitions. It is known that high levels of cortisol, the hormone responsible for stress regulation, can impact the immune system. Hence, the importance of assessing the immune cells, blood components and cortisol during different times of athlete horses’ routines, including races. This research verified the impact of training and racing on the immune function of Thoroughbreds’ trough phagocytosis and oxidative neutrophil burst assays, serum cortisol determination, erythrocytes apoptosis, lymphoproliferation, and blood count analyses. Racehorses are constantly exposed to stress. Aiming to verify the state of blood components and cortisol alterations during their routine and after races, phagocytosis and oxidative neutrophil burst assays, serum cortisol determination, erythrocytes apoptosis evaluation, lymphoproliferation assays, and blood count tests were performed in thirty Thoroughbred racehorses, which were divided in two groups. The samples were taken right after races (moment 0 d), during rest periods (−11 d, +1 d, +3 d), and after training (−8, +2, +5). In both groups, the phagocytosis showed a decrease in percentage and intensity immediately after the race when comparing samples collected during rest or training periods. In the mean values of oxidative burst on samples collected immediately after the race, group I animals demonstrated a decrease (524.2 ± 248.9) when compared with those samples collected in other moments. No significant differences were found between the results of different moments regarding the apoptotic cells and lymphoproliferation assays. The mean values of serum cortisol levels were increased immediately after racing. There was an increase in the percentage of neutrophils found immediately after the race. It was possible to conclude that, although a transient reduction was found in the number of neutrophils, the horses’ adaptive function was not affected.

Glucocorticoid receptor blockers.

Mifepristone is the only glucocorticoid receptor antagonist currently approved for the treatment of Cushing's syndrome. Although originally developed as an abortifacient due to its blockade of the progesterone receptor, a number of case reports documented its efficacy as a glucocorticoid receptor blocker going back to 1985. The SEISMIC trial, published in 2012, provided sufficient data on efficacy and adverse effects for regulatory approval. Mifepristone provides clear benefits on glycemia, blood pressure, muscle weakness, body weight and the other myriad clinical manifestations of Cushing's syndrome. However, because it blocks the glucocorticoid receptor, blood cortisol and ACTH levels actually rise, rather than fall; this complicates patient management. Doses are adjusted based on clinical manifestations rather than hormone levels. Adverse effects include adrenal insufficiency due to overdosage, hypokalemia, and menorrhagia. Treatment of severe adrenal insufficiency requires high doses of dexamethasone. Other glucocorticoid receptor blockers without effects on the progesterone receptor are being developed. Because mifepristone inhibits CYP3A and CYP2C8/2C9, drug-drug interactions can occur. These potential adverse effects can largely be avoided with careful attention to detail. My opinion is that its current place in therapy is in patients with severe disease and in those not responding to other treatments.

The Effect of the Klim Feed Additive on Cortisol Levels in Cows During Stress

Currently, intensive animal breeding techniques are actively applied. It is absolutely impossible to avoid a technology stress under such conditions. Therefore, development of methods of correction of animal stress levels (especially during critical periods of animal life) is crucial.The objectiveof this research is to determine the effect of the Klim feed additive based on organic acids on cortisol levels during different technological periods.In the course of this research, 2 groups of cows (n=10 heads) were selected in one of livestock enterprises of the Leningrad region. Each cow had an average productivity, age of 3.5 to 4 years and second pregnancy; each cow was apparently healthy. By the moment of 21 days before the estimated calving date, each cow from the experimental group has been receiving the Klim feed additive mixed with a feed (dosage of 10 g per head: 5 g of active substance and 5 g of vanilla filling) daily for 50 days (the drug has been administered in an individual manner). Before administering the drug, each animal has undergone a clinical examination, blood sample of each animal has been collected for further research. No valid difference between parameters of the experimental and control groups has been identified at the moment of the research initial phase.Research results. One day after calving, in order to determine the stress level, the level of cortisol in blood has been identified for cows from the experimental and control groups. The research results prove that the level of cortisol in blood of the cows from the group that received the Klim feed additive was 62.72 ± 12.1 nmol/l, and the level of cortisol in blood of the cows from the control group was 96.62 ± 19.3 nmol/l. Such cortisol level shows that the animals from the control group have a high level of stress, which ultimately can result in negative effect on productivity and clinical status of these cows. Meanwhile, the cortisol level of the cows from the experimental group did not exceed standard limit values (20 – 80 nmol/l) – this verifies our assumption that the Klim feed additive relieves the manifestations of stress at early stage. One day after the rearrangement of cows (25 days after calving), the level of cortisol in blood of the animals from both groups has been identified. The level for the cows from the experimental group was 36.3 ± 8.4 nmol/l, the level for the cows from the control group was 50.18±11.7 nmol/l – this proves that these cows have a higher level of stress.In view of the above, it has been identified that the Klim feed additive had a positive effect on the adaptation capabilities of animals during stressful situations (pregnancy period and change of environment (rearrangement)).

Effect of high intensity laser in the treatment of myofascial trigger points in symptomatic knee osteoarthritis: A randomized single-blinded controlled trial

Background: Osteoarthritis (OA) is one of the most prevalent causes of musculoskeletal pain and disability among the middle age and elderly population. It significantly affects the overall quality of life of the affected individuals. Objectives: To find out the impact of high intensity laser therapy (HILT) on myofascial trigger points (MTrPs) in symptomatic knee OA. Methods: This is a single-blinded pre–post randomized experimental trial. A total of 40 patients, both male and female, falling within the age group of 35-55 years, BMI 25–29.9 Kg/Cm2, diagnosed with bilateral knee osteoarthritis (grade 2), were recruited as participants of the study. All the participants were clinically evaluated for the signs and symptoms of myofascial pain, tenderness over the vastus medialis muscle and the medial head of the gastrocnemius muscle. The participants were randomly allocated into two groups with n=20 in each group. The participants of the experimental group received high-power laser therapy and underwent exercises on the MTrPS of the vastus medialis and the medial head of the gastrocnemius muscle. The participants of the control group received placebo laser "sham laser" and underwent exercises for the vastus medialis and the medial head of the gastrocnemius muscle. A blood cortisol level test, pressure algometer, digital electronic goniometer, and the KOOS-PS questionnaire were used to measure the pain level, pain threshold, knee ROM, and knee function. Outcome assessment was done at Day 0 and post intervention at the end of 4 weeks. Results: The MANOVA test revealed that both groups improved significantly in all parameters at week 4, with the HILT group improving more than the sham group in blood cortisol levels, pressure algometer measures, knee passive ROM, and KOOS scores (P &lt; .05). Conclusion: HILT is an efficient approach in the treatment of MTrPs in knee OA.

Technostress Creators and Outcomes Among Egyptian Medical Staff and Students: A Multicenter Cross-Sectional Study of Remote Working Environment During COVID-19 Pandemic.

ObjectivesThis study aimed to investigate the technostress creators and outcomes among University medical and nursing faculties and students as direct effects of the remote working environment during the COVID-19 pandemic.BackgroundDue to the current COVID-19 pandemic, shifting to virtual learning that implies utilizing the information and communication technologies (ICTs) is urgent. Technostress is a problem commonly arising in the virtual working environments and it occurs due to misfitting and maladaptation between the individual and the changeable requirements of ICTs.MethodsA multicenter cross-sectional study was conducted in medicine and nursing colleges of 5 Egyptian universities and included both staff members and students. The data were collected through personal interviews, from January to May 2021. All the participants took a four-part questionnaire that asked about personal and demographic data, technostress creators, job or study, and technical characteristics and technostress outcomes (burnout, strain, and work engagement). Furthermore, participants' blood cortisol and co-enzyme Q10 (CoQ10) levels were tested in a random sample of the students and medical staff.ResultsA total of 3,582 respondents participated in the study, 1,056 staff members and 2,526 students where 33.3% of the staff members and 7.6% of students reported high technostress. Among staff members, total technostress score significantly predicted Cortisol level (β = 2.98, CI 95%: 0.13-5.83), CoQ10(β = −6.54, CI 95%: [(−8.52)–(−4.56), strain (β = 1.20, CI 95%: 0.93–1.47), burnout (β = 0.73, CI 95%: 0.48–0.97) and engagement (β = −0.44, CI 95%: [(−0.77)–(−0.11)]) whereas among students, total technostress score significantly predicted cortisol level (β = 6.64, CI 95%: 2.78–10.49), strain (β = 1.25, CI 95%: 0.72–1.77), and burnout (β = 0.70, CI 95%: 0.37–1.04). Among staff members and students, technology characteristics were significantly positive predictors to technostress while job characteristics were significantly negative predictors to technostress.ConclusionThe Egyptian medical staff members and students reported moderate-to-high technostress which was associated with high burnout, strain, and cortisol level; moreover, high technostress was associated with low-work engagement and low CoQ10 enzyme. This study highlighted the need to establish psychological support programs for staff members and students during the COVID-19 pandemic.

Comparison of the effects of different calorie amounts of enteral nutrition in hypercatabolism associated with ghrelin-POMC in endotoxemic rats

BackgroundHypercatabolism often occurs in critically ill patients, and it increases infection rates and mortality in these patients. Enteral nutrition (EN) is commonly used in case of hypercatabolism. However, the effect of amount of calories in EN on hypercatabolism remains unexplored.ObjectiveHere, we compared the effect of low-calorie, medium-calorie and high-calorie EN on hypercatabolism in the acute phase of endotoxemia, which is associated with gastrointestinal hormones and hypothalamic neuropeptide proopiomelanocortin (POMC).MethodsOverall 84 adult male Sprague–Dawley rats were used for research. A set of rats were divided into 5 groups, Control (NS) and lipopolysaccharide (LPS) groups were fed a standard chow diet; LPS + L (LPS + 40 kcal/kg/day EN), LPS + M (LPS + 80 kcal/kg/day EN) and LPS + H (LPS + 120 kcal/kg/day EN) groups received EN through a gastric tube for 3 days. Another set of rats were used for parallel control experiment and divided into 5 groups: NS + F (saline + fasting) and LPS + F (LPS + fasting) groups were given no food, NS + L (saline + 40 kcal/kg/day EN), NS + M (saline + 80 kcal/kg/day EN) and NS + H (saline + 120 kcal/kg/day EN) groups received EN through a gastric tube for 3 days. Hypercatabolism was evaluated by assessing skeletal muscle protein synthesis and atrophy, insulin resistance, and corticosterone levels. Moreover, serum inflammatory factors, gastrointestinal hormones, hypothalamic ghrelin, growth hormone secretagogue receptor-1α, hypothalamic neuropeptide, and intestinal injury indicators were detected.ResultsLow-calorie EN effectively increased serum and hypothalamic ghrelin possibly due to slight intestinal barrier damage, thereby decreasing hypothalamic POMC expression; consequently, it alleviated rat insulin resistance, reduced blood cortisol levels and muscle atrophy, and improved the survival rate of rats in the acute phase of endotoxemia. Interestingly, with an increase in calories in enteral nutrition, the aforementioned effects did not increase.ConclusionsLow-calorie EN could effectively increase gastrointestinal hormone ghrelin by reducing intestinal damage and suppressing POMC expression to ameliorate hypercatabolism when compared with medium-calorie and high-calorie EN. Therefore Low-calorie EN may be preferred for providing EN in the acute stage of endotoxemia.

Observation of hemodynamic variability and level of blood cortisol while induction with propofol and etomidate: A prospective, randomized, double blind study

: To observe the effects of propofol and etomidate induction on patients undergoing laproscopic cholecystectomies regarding serum cortisol level, hemodynamic parameters, pain on injection, myoclonus, and apnea on induction.: It is a prospective, randomized, double blind study. After approval from Institute Ethics Committee, sixty patients of age between 18 and 60 years with ASA grade I and II scheduled for laproscopic cholecystectomy under general anesthesia were randomly divided into two groups: Group A (n=30) would receive injection propofol 2 mg/kg i.v., Group B (n=30) would receive injection etomidate 0.3 mg/kg i.v. as induction agent. Vital parameters at induction, laryngoscopy and thereafter recorded. Pain on injection, myoclonus, apnea on induction were carefully watched. Serum Cortisol is measured at 1 hour before induction and at 2 hours and 24 hours after induction.: Demographic variables and baseline parameters were comparable in both groups.Propofol group show significant decrease in heart rate and mean blood pressure after induction in comparison to etomidate group. Pain on injection was more in group A while myoclonus activity was higher in Group B. Serum cortisol level is significantly lower in Group B post induction compared to Group A which comes to above baseline after 24 hrs but in normal range. Etomidate is a better induction agent than propofol in view of hemodynamic stability but also led to chemical evidence of adrenocortical insufficiency in patients with ASA grade I &amp; II undergoing elective laproscopic cholecystectomy under general anaesthesia which returns to normal in 24 hrs.

The role of cortisol in the association between prenatal air pollution and fetal growth: A prospective cohort study

Prenatal air pollutant exposure has been linked to impaired fetal growth. However, its special vulnerability windows and biological mechanisms remain unclear. A prospective birth cohort study including 7419 mother-newborn pairs was conducted from 2015 to 2020 to determine critical exposure windows and examine whether cortisol mediates the relationship between air pollutant exposure and fetal growth. Air pollutant data for PM2.5, PM10, SO2, and CO were obtained from the Hefei City Ecology and Environment Bureau. Data on fetal ultrasound measurements and birth size were collected. Maternal and cord blood samples were used for measuring cortisol. Prenatal air pollutant (PM2.5, PM10, SO2, and CO) exposure, particularly in the first trimester, was associated with reduced fetal size from later pregnancy to birth. An IQR increase in PM2.5 (β = 0.082, 95%CI: 0.029, 0.135), PM10 (β = 0.086, 95%CI: 0.036, 0.136), SO2 (β = 0.086, 95%CI: 0.028, 0.144), and CO (β = 0.063, 95%CI: 0.017, 0.109) exposure in the first trimester was associated with higher cord blood cortisol levels. Significant relationships were observed between air pollutant exposure in the first trimester and increased ratio of cord to maternal blood cortisol levels. Exposure to high levels of cord blood cortisol significantly reduced the Z scores of birth weight (β = −0.17, 95%CI: −0.23, −0.10), length (β = −0.09, 95%CI: −0.16, −0.03), and head circumference (β = −0.33, 95%CI: −0.42, −0.25). Mediation analysis showed that the association of air pollutant exposure in the first trimester with neonatal parameters mediated by cord blood cortisol was 20.62%. These results indicated that air pollutant exposure during pregnancy could reduce fetal growth by the increased fetal cortisol levels due to placental barrier impairment, with the critical window of exposure occurring in the first trimester.