Catecholamine Levels Research Articles

Histologic characterization of spontaneous catecholamine-induced cardiomyopathy in laboratory New Zealand White rabbits.

Catecholamine-induced cardiomyopathy (CCM) is an entity associated with increased levels of catecholamines causing subendocardial and papillary muscle cardiomyocyte degeneration and necrosis. In 2020, 49 autopsies from early rabbit deaths in a colony used for medical device biocompatibility studies were submitted for microscopic examination. Of the 49 rabbits, 26 had histologic changes consistent with CCM. No common stressor for CCM was determined in affected rabbits. Animals were generally male, were 12-16-wk-old, and were found dead or had bloating, lethargy, and/or diarrhea. Those observed with clinical signs were euthanized and autopsied per the organization's standard operating procedures. Heart lesions consisted of various degrees of apical subendocardial myocardial degeneration and necrosis. Common non-cardiac lesions included pulmonary congestion and edema, hepatic congestion and centrilobular hepatocellular degeneration, and/or variable intestinal submucosal edema.

Dexmedetomidine Effects on Surgical Stress Hormones

Background: Increased levels of cortisol and catecholamines are the reaction to tissue damage due to surgical trauma. Dexmedetomidine inhibits the synthesis of these two hormones.Objective: This study aimed to prove that dexmedetomidine reduces the endocrine response to surgical stress.Method: 40 patients who underwent Total Knee or Hip Replacement surgery with regional anesthesia were involved in the Double-Blind Randomized Controlled Trial Pre-Test – Post-Test Design, which was divided into two research groups: the therapy group and the control group. Changes in the body's response to stress during surgery were compared by assessing blood cortisol levels, heart rates (HRs), and mean arterial pressures (MAPs). The Beck Depression Inventory (BDI) was used to evaluate the level of depression. The numeric rating scale is used to evaluate perioperative pain, while the Ramsay scale is used to measure the level of sedation. Data analysis was carried out using the Statistical Program for Social Sciences (SPSS).Results: The cortisol levels of the therapy group compared to the control group (p = 0.016) decreased significantly immediately after surgery. Hemodynamic changes in the study, the heart rate (p=0.001), and mean arterial pressure (p=0.000) were significantly lower than the control group.Conclusion: Administration of dexmedetomidine during the surgical period reduces stress hormone responses. These results indicate that dexmedetomidine administration is good to apply, especially in TKR/THR.

Impact of 24 h shifts on urinary catecholamine in emergency physicians: a cross-over randomized trial

24-h shift (24 hS) exposed emergency physicians to a higher stress level than 14-h night shift (14 hS), with an impact spreading on several days. Catecholamines are supposed to be chronic stress biomarker. However, no study has used catecholamines to assess short-term residual stress or measured them over multiple shifts. A shift-randomized trial was conducted to study urinary catecholamines levels of 17 emergency physicians during a control day (clerical work on return from leave) and two working day (14 hS and 24 hS). The Wilcoxon matched-pairs test was utilized to compare the mean catecholamine levels. Additionally, a multivariable generalized estimating equations model was employed to further analyze the independent relationships between key factors such as shifts (compared to control day), perceived stress, and age with catecholamine levels. Dopamine levels were lower during 24 hS than 14 hS and the control day. Norepinephrine levels increased two-fold during both night shifts. Epinephrine levels were higher during the day period of both shifts than on the control day. Despite having a rest day, the dopamine levels did not return to their normal values by the end of the third day after the 24 hS. The generalized estimating equations model confirmed relationships of catecholamines with workload and fatigue. To conclude, urinary catecholamine biomarkers are a convenient and non-invasive strong measure of stress during night shifts, both acutely and over time. Dopamine levels are the strongest biomarker with a prolonged alteration of its circadian rhythm. Due to the relation between increased catecholamine levels and both adverse psychological effects and cardiovascular disease, we suggest that emergency physicians restrict their exposure to 24 hS to mitigate these risks.

The regulatory effects of serum catecholamines and endothelial cells in pig hemorrhagic shock and fluid resuscitation models

BackgroundAcute blood loss not only leads to systemic compensatory response, but also the induced changes in vascular endothelial function.These pathological changes may have potential compensatory significance for maintaining organ perfusion and fluid resuscitation. ObjectiveTo understand trauma-induced endotheliopathy and their compensatory roles in acute hemorrhage, a porcine model of hemorrhagic shock (HS) was used to evaluate changes in vascular endothelial factors and catecholamine levels at different time points from shock to fluid resuscitation. Methods: HS was induced in female pigs by rapid bleeding via the arterial sheath. Hemodynamic monitoring was performed using a pulse index continuous cardiac output (PiCCO) system in HS and fluid resuscitation. Femoral vein blood samples were collected at baseline and 40% mean arterial pressure (MAP, shock), MAP recovery, and 30 min, 1 h, and 2 h after recovery. Serum levels of catecholamine and Angiopoietin-1 (Ang-1), Angiopoietin-2 (Ang-2), Tie-2, Eselectin, intracellular adhesion molecule-1 (ICAM-1), soluble thrombomodulin (sTM), and Syndecan-1 (SDC-1) were evaluated using enzyme-linked immunosorbent assay (ELISA). ResultsSerum catecholamine levels were significantly higher in the shock than in the baseline state. Ang-1 and Ang-2 are endothelial growth factors secreted with distinct roles. Ang-1 stabilizes the endothelium and inhibits vascular leakage, and Ang-2 has the opposite effect. The ratio of Ang-2/Ang-1 was significantly higher in the shock state than in the baseline state; however, the Ang-1/Tie-2 ratio was comparable between the two states. This suggests that changes in vascular permeability may mainly depend on the upregulation of Ang-2 function. Serum levels of E-selectin, ICAM-1, sTM, and SDC-1 were significantly higher in the shock state than in the baseline state. After the MAP was restored to the baseline state, the levels of E-selectin, and SDC-1 remained higher compared with the baseline state until 1 h after MAP recovery. Conclusions: serum levels of catecholamines and vascular endothelial markers increased transiently under HS, promoting a compensatory response of the circulatory system to acute bleeding. This may be one of the potential theoretical basis for restrictive fluid resuscitation.

Abstract 6629: Cancer-associated nerves regulate anti-tumor immunity in pancreatic cancer

Abstract Nerves serve an emerging component of the tumor microenvironment (TME), contributing to tumorigenesis and cancer progression. Neural invasion (NI) is a common feature of pancreatic ductal adenocarcinoma (PDAC), accounting for distant metastasis and local recurrence. However, the mechanism by which tumor associated nerves (TANs) regulate anti-tumor immunity remains largely elusive. Here, we investigated the association between TANs and immunosuppressive TME to develop more effective therapeutic strategies for PDAC. Using tumor samples of PDAC patients, we identified that the nerves invaded by cancer cells showed increased adrenergic activation accompanied with no parasympathetic or sensory innervation changes. Patients with severe NI were associated with increased catecholamine levels. Additionally, single-cell RNA-sequencing and spatial transcriptome analysis of tumors from patients with PDAC revealed that peri-neural niches of severe NI patients were characterized by decreased CD8+ T cells and increased activity of M2 polarization of tumor-associated macrophages (TAMs), and regulatory T (Treg) cells, which was validated by multiplexed immunofluorescence staining. We further identified that CD8+ T cells expressing β-adrenaline receptors (β-ARs) reduced proliferation and cytokine production when exposure to catecholamines in a dose-dependent manner or co-cultured with dorsal root ganglia pretreated with cancer cells. KrasLSL-G12D; p53LoxP; Pdx1-CreER (KPC) mice treated with catecholamines accelerated tumor progression by inhibiting T cell-mediated antitumor responses, which was abrogated by surgical sympathectomy of KPC mice. Especially, in an orthotopic PDAC model, nonselective β-blocker propranolol in combination with immune checkpoint blockade (ICB) significantly enhanced active CD8+ T cells with concurrent reduced tumor growth. We suggest a novel regulatory mechanism of inhibiting anti-tumor immunity that can promote cancer progression mediated by TANs invasion. These data establish a close connection between the nerves, cancer cells, and immune cells and provide the potential novel targets of therapeutic approaches in PDAC. Citation Format: Ruiyuan Xu, Jianlu Song, Yuan Chen, Xinpeng Yin, Chengcheng Wang, Yupei Zhao. Cancer-associated nerves regulate anti-tumor immunity in pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6629.

Exploring a New Pathophysiological Association in Acne Vulgaris and Metabolic Syndrome: The Role of Biogenic Amines and Glutathione Peroxidase.

Background and Objectives: Metabolic disorders cause many skin issues, including acne vulgaris. This research investigated the function of glutathione peroxidase (GTPx) and biogenic amines as a potential novel pathophysiological link between metabolic syndrome (MetS) and acne vulgaris. Materials and Methods: The patients were distributed into two groups: metabolic precondition (MPG, n = 78) and control (CG, n = 81). To determine the extent of acne and metabolic preconditioning, patients were subjected to extensive clinical/paraclinical investigations. Additionally, catecholamine levels in urine and GTPx levels in blood were measured. Results: Mild acne was more common in the CG (32.1 vs. 6.4, p < 0.001), and severe acne was more common in the MPG (61.54 vs. 25.9, p < 0.001), with the average age being substantially higher in the MPG (23.81 vs. 21.05, p = 0.002). Significant variations were observed in the paraclinical levels for catecholamines (p < 0.05). In the MPG, most severe acne patients were overweight (52.1%), insulin-resistant (48.8%), or obese (47.9%). Moderate acne was most often linked to obesity (56%), overweight (44%), and insulin resistance (20%). Patients with severe acne (48.83%) had a considerably greater incidence of insulin resistance syndrome (p = 0.039) than those with moderate or severe acne (20%). The presence of two or three metabolic disorders considerably raised the risk of severe acne. Significant differences between groups were observed only in the subgroup of patients with severe acne, with lower values in the MPG (p = 0.015). Significant differences between groups were observed regarding the subgroup of patients with severe acne, with lower DTPx values in the MPG. At the group level, only CG patients with severe acne had reduced GTPx levels. Significant differences in catecholamine values were seen between groups (p < 0.05), independent of acne severity, except for adrenaline in mild acne patients (p = 0.059). Conclusions: The complex connection between GTPx and catecholamines in MetS suggests a significant role of these factors in the pathogenesis of acne associated with this condition, opening new perspectives in the research and treatment of acne in the context of MetS.

Relation of catecholamines with oxidative stress in patients undergoing cardiac surgery before and after endotracheal intubation

Inroduction&#x0D; Endotracheal intubation is used to maintain the airway open so that oxygen, medicine, or anesthesia can be administered. Anesthesia and surgery boost the release of cross-regulating hormones through physiological responses and psychological stress. There is a strong link between psychological stress and oxidative stress, according to research.&#x0D; Objective: - The goal of this study was to determine the levels of catecholamines (adrenaline and noradrenaline) and oxidative stress before and after endotracheal intubation in patients undergoing cardiac surgery and to study association between them.&#x0D; Material &amp; Methods: - Total 30 patients undergoing cardiac surgery were enrolled. Blood samples were collected before and after endotracheal intubation. Plasma adrenaline and noradrenaline levels were estimated by ELISA. MDA &amp; SOD were estimated by spectrophotometric method.&#x0D; Results: - Mean levels of plasma adrenaline (p&lt; 0.01), noradrenaline (p&lt; 0.0001) and Serum MDA (p&lt; 0.0001) were significantly decreased while Serum SOD were significantly increased (p&lt; 0.0001) after endotracheal intubation as compared to before endotracheal intubation by laryngoscopy in patients undergoing cardiac surgery. We found significant positive correlation of MDA with adrenaline and nor-adrenaline before and after intubation. SOD activity was negatively correlated with MDA, adrenaline and noradrenaline before and after intubation&#x0D; Conclusion: Elevated levels of adrenaline, noradrenaline, MDA, and lower levels of SOD show that patients are stressed prior to endotracheal intubation, resulting in a stronger stress response and increased oxidative stress. After intubation, the levels of adrenaline and noradrenaline reduced, indicating a reduction of stress. Our study also shows a link between psychological and oxidative stress. For a better outcome and to avoid subsequent complications, it is preferable to evaluate stress levels and oxidative stress in patients undergoing cardiac surgery before and after endotracheal intubation.

Adrenal pheochromocytoma impacts three main pathways: cysteine-methionine, pyrimidine, and tyrosine metabolism.

Pheochromocytomas and paragangliomas (PPGLs) cause symptoms by altering the circulation levels of catecholamines and peptide hormones. Currently, the diagnosis of PPGLs relies on diagnostic imaging and the detection of catecholamines. In this study, we used ultra-performance liquid chromatography (UPLC)/quadrupole time-of-flight mass spectrometry (Q-TOF MS) analysis to identify and measure the perioperative differential metabolites in the plasma of adrenal pheochromocytoma patients. We identified differentially expressed genes by comparing the transcriptomic data of pheochromocytoma with the normal adrenal medulla. Through conducting two steps of metabolomics analysis, we identified 111 differential metabolites between the healthy group and the patient group, among which 53 metabolites were validated. By integrating the information of differential metabolites and differentially expressed genes, we inferred that the cysteine-methionine, pyrimidine, and tyrosine metabolism pathways were the three main metabolic pathways altered by the neoplasm. The analysis of transcription levels revealed that the tyrosine and cysteine-methionine metabolism pathways were downregulated in pheochromocytoma, whereas the pyrimidine pathway showed no significant difference. Finally, we developed an optimized diagnostic model of two metabolites, L-dihydroorotic acid and vanylglycol. Our results for these metabolites suggest that they may serve as potential clinical biomarkers and can be used to supplement and improve the diagnosis of pheochromocytoma.

Clinical diagnosis of pheochromocytoma and paraganglioma-induced secondary hypertension through UPLC-MS/MS analysis of plasma catecholamines and their metabolites.

This study aimed to elucidate the clinical diagnostic value of plasma catecholamines and their metabolites for pheochromocytoma and paraganglioma (PPGL)-induced secondary hypertension using ultraperformance liquid chromatography-mass spectrometry (UPLC-MS/MS). The study population included 155 patients with PPGL that were divided into the PPGL with hypertension (n=79) and a PPGL without hypertension (n=76) groups, and 90 healthy volunteers and 90 patients with primary hypertension as the control groups. UPLC-MS/MS was performed to detect plasma levels of catecholamines and their metabolites, including dopamine, vanillylmandelic acid (VMA), norepinephrine, metanephrine, and normetanephrine. Receiver operating characteristic curves were generated to analyze the diagnostic value of the plasma levels of catecholamines and their metabolites in PPGL-induced secondary hypertension. Patients in the primary hypertension and PPGL without hypertension groups had higher levels of dopamine, VMA, norepinephrine, metanephrine, and normetanephrine than patients in the normal group (all p<.05). On the other hand, patients in the PPGL with hypertension group had higher levels of dopamine, VMA, norepinephrine, metanephrine, and normetanephrine than patients in the normal, primary hypertension, and PPGL without hypertension groups (all p<.05). Collectively, our findings showed that dopamine, VMA, norepinephrine, metanephrine, and normetanephrine are all effective biomarkers for the diagnosis of PPGL and PPGL-induced secondary hypertension.

Evaluation of Autonomic Nervous System Through Spectral Analysis in Patients with Ischemic Heart Failure: A Systematic Review

Abstract Heart failure is one of the most complex pathologies and most prevalent diseases, with around 64 million people affected globally (2% of the total adult population). In the initial phase of heart failure, studies have shown that the autonomic nervous system is in a state of imbalance, with an increase in the influence of the sympathetic nervous system on the heart. Persistence of long-term activation of the autonomic nervous system produces a decrease in the levels of myocardial catecholamines and also promotes down-regulation of beta-1 receptors. This article is a systematic review of papers from four well-known and important scientific databases on the subject of power spectral analysis of ECG Holter monitoring in patients with heart failure. The PRISMA technique was used to identify the most relevant articles on this subject, and their results were presented based on importance of their use for the diagnosis of heart failure, for risk stratification of sudden death or arrhythmias, for the evaluation of certain treatments used, or for other possible pathophysiological mechanisms involved in the evolution of the disease.

Narrative Review of the Effect of Endorphin Massage and Oxytocin Massage on Pain Intensity in Maternity Women

Background: Childbirth is the effort or process of expelling a full-term baby which is often accompanied by pain caused by contractions in the uterus. From the research results, it was found that 32% of 300 women who gave birth during the active phase experienced severe pain, 57% moderate pain, and 11% mild pain. Evidence shows that fear of vaginal childbirth and anxiety experienced by many women during their pregnancy. Therefore, it then led to their decision to choose other methods of birth such as Section Caesarea (SC). The effects of anxiety during labor could potentially result in excessive levels of catecholamines causing decreased blood flow to the uterus, decreased uterine contractions, decreased blood flow to the placenta, decreased oxygen available to the fetus, and can increase the length of labor. One of alternative methods of dealing with pain during the labor process is using non-pharmacological such as endorphin massage and oxytocin massage. Purpose: The aim of this literature study was to present information about the effect of endorphin massage and oxytocin massage on the intensity of pain among mothers giving birth. Methods: This research method was a literature review study. Journal searches were carried out by applying online database such as ScienceDirect, Google scholar, Pubmed, Scopus, Portal Garuda. Articles were selected based on inclusion and exclusion criteria. Result: The study investigated the influence of endorphin and oxytocin massages on pain intensity in maternity mothers during childbirth, revealing a significant reduction in pain levels following the administration of these massages. Both endorphin and oxytocin massages were found to alleviate pain, induce relaxation, and promote feelings of comfort and calmness, thereby facilitating a smoother birth process. Conclusion: The influence of endorphin massage and oxytocin massage is useful in reducing pain in maternity mothers

Can exposure to lisdexamfetamine dimesylate from juvenile period to peripubertal compromise male reproductive parameters in adult rats?

Lisdexamfetamine (LDX) is a d-amphetamine prodrug used to treat attention deficit and hyperactivity disorder, a common neurodevelopmental disorder in children and adolescents. Due to its action mediated by elevated levels of catecholamines, mainly dopamine and noradrenaline, which influence hormonal regulation and directly affect the gonads, this drug may potentially disrupt reproductive performance. This study evaluated the effects of exposure to LDX from the juvenile to peripubertal period (critical stages of development) on systemic and reproductive toxicity parameters in male rats. Male Wistar rats (23 days old) were treated with 0; 5.2; 8.6 or 12.1 mg/kg/day of LDX from post-natal day (PND) 23 to 53, by gavage. LDX treatment led to reduced daily food and water consumption, as well as a decrease in social behaviors. The day of preputial separation remained unaltered, although the treated animals exhibited reduced weight. At PND 54, the treated animals presented signs of systemic toxicity, evidenced by a reduction in body weight gain, increase in the relative weight of the liver, spleen, and seminal gland, reduction in erythrocyte and leukocyte counts, reduced total protein levels, and disruptions in oxidative parameters. In adulthood, there was an increase in immobile sperm, reduced sperm count, morphometric changes in the testis, and altered oxidative parameters, without compromising male sexual behavior and fertility. These findings showed that LDX-treatment during the juvenile and peripubertal periods induced immediate systemic toxicity and adversely influenced reproductive function in adult life, indicating that caution is necessary when prescribing this drug during the peripubertal phase.

An Insidious Comorbidity: Depression and Chronic Heart Failure

Depression and heart failure (HF) are in a close bilateral relationship: the appearance of one is potentiated by the other entity and the effects on the outcome are amplified within this ”dangerous liaison”. Depression is present in about one in five HF patients and is severe in almost half of them. The risk factors for depression in HF are female gender, elderly, the severity of HF symptoms, a history of isolated systolic hypertension or coronary heart disease (CHD), previous hospitalization and previous depressive episodes. Depression in HF patients increases medication non-adherence, is associated with poor outcomes after heart transplantation and is predictive of events and mortality in cardiac resynchronization therapy (CRT). The current assumptions related to the physiopathological mechanisms include a common genetic polymorphisms, inflammation, generalized immune system disturbance, disturbances of platelet function, increased catecholamine levels, deamination of monoamines linked with monoamine oxidase activity, a dysregulation of the autonomic nervous system, increased serotonin levels, ischemia, life-style and medication non-compliance, a poor familial support and social isolation. Assessment of cognitive functioning should be part of routine clinical examination in HF, the diagnosis of depression is based on questionnaires (e.g. Patient Health Questionnaire-2 - PHQ-2) and on clinical interview. There is still no consensus on the best therapy for HF patients with depression (non-pharmacological and pharmacological therapies) but, for sure, depression in HF is harder to treat.

Effect of lite touch on the anxiety of low-risk pregnant women in the latent phase of childbirth: a randomized controlled trial.

Women with perinatal anxiety have reduced coping capacity during labor, which affects labor progress and increases the likelihood of a cesarean section. Several non-pharmacological interventions for anxiety during childbirth are available. This study used the "lite touch" method, a non-pharmacological intervention based on physiological responses and obstetric clinical experience in women. We aimed to evaluate whether lite touch could relieve perinatal anxiety and investigate the effect of light skin stroking on the maternal hormones, catecholamine, and cortisol. This randomized clinical trial involved women with low-risk singleton pregnancies at full term or near term. Eligible pregnant women who were latent and did not undergo epidural anesthesia were randomized into two groups. Participants in the intervention group underwent routine prenatal care, including lite touch, whereas the control group underwent routine prenatal care alone. Demographic data were collected through a questionnaire. Labor anxiety was assessed using the State Anxiety Inventory, and saliva was collected before and after the intervention. Changes in saliva cortisol and catecholamine levels were analyzed using a double-antibody sandwich enzyme-linked immunosorbent assay. In total, 83 participants were included, with 43 and 40 in the intervention and control groups, respectively. In the intervention group, pre-intervention anxiety scores were significantly lower (p < 0.01) than post-intervention anxiety scores, whereas the control group showed no difference in anxiety scores before and after intervention (p > 0.05). Cortisol and catecholamine levels in saliva were significantly lower in the intervention group than in the control group after the intervention (p < 0.01). Lite touch can reduce the latent anxiety state of low-risk pregnant women, thereby maintaining in vivo stability and facilitating labor. https://www.chictr.org.cn/aboutEN.html, ChiCTR2300070905, Retrospectively Registered Date: April 26, 2023.

The use of dexmedetomidine in suppressing cardiovascular response due to intubation in general anesthesia

Endotracheal intubation is commonly used to maintain a safe airway during general anesthesia. This intubation action can trigger a dangerous response for the patient, one of which is the cardiovascular system. Increases in arterial blood pressure, plasma catecholamine levels, and heart rate are responses that can occur during intubation. Therefore, various methods and treatments have been used to control this cardiovascular response, including dexmedetomidine. Dexmedetomidine is a highly selective α2-adrenergic receptor agonist that has analgesic, sympatholytic, and sedative effects with minimal depression of ventilation. Much research has been done on how well dexmedetomidine works to stop the cardiovascular response to intubation. Dexmedetomidine was significantly associated with reductions in heart rate, systolic blood pressure, and MAP.

O-03 Adrenalectomy for Cushing's syndrome during pregnancy

Abstract Introduction Cushing's syndrome (CS) is rare in pregnancy because CS itself is a cause of anovulatory infertility due to excess cortisol secretion. Moreover it is also difficult to diagnose CS in pregnancy because placental production of corticotropin releasing and adrenocorticotropic hormone (ACTH), increased maternal production of estrogen induced corticosteroid binding globulin leads to physiological hypercortisolism during pregnancy. So physicians face a clinical overlap in many features of CS such as weight gain, fatigue, edema, hypertension, hyperglycemia, stretch marks, mood changes that can also be attributed to pregnancy. Thus their coexistence represents a diagnostic challenge. Herein we report a case of CS that was diagnosed and successfully treated during pregnancy. Clinical Case A 43-year-old gravida 3 female was consulted at the 21st week of gestation with persistent high blood pressure and hyperglycemia for a month. She had an obstetric history of 2 spontaneous first term abortion, 2 healthy labor 18 years ago and she was healthy after. She was in such a depressive mood that she was consulted with psychiatry many times. On physical examination edema, proximal weakness of lower extremities and hirsutism (modified Ferriman–Gallwey score of 9) was detected. Initial laboratory tests were all within normal range except potassium level (2.7 mmol/L), the results were not consistent with preeclampsia and there was a suspicious adrenal mass detected on ultrasound. She was currently receiving high dose antihypertensive treatment with methyldopa, calcium channel blockers, rapid acting and detemir insulin for diabetes and i.v. potassium replacement. We ruled out conns syndrome with normal plasma aldosterone renin ratio and found catecholamine levels normal. Hormonal analyses revealed with high plasma cortisol levels, increased nocturnal cortisolemia, a suppressed plasma ACTH and dehydroepiandrosterone sulfate level and distinctly elevated 24-hour urinary cortisol greater than 3-fold the upper normal reference range. Non contrast magnetic resonance imaging demonstrated a 47×32 mm left adrenal mass. Laparoscopic adrenalectomy was performed in the 26th week of gestation and the following histopathology revealed an adrenocortical adenoma. Antihypertensive medication was progressively reduced, glycemic control and hypokalemia reversal were achieved. She was followed up with appropriate glucocorticoid replacement. At 34 weeks of gestation, after sudden labor pain and regular uterine contractions a 2586 g male infant with Apgar scores of 8 was born by cesarean section. They were discharged in good health. Conclusion CS should be kept in mind especially in the case of hypertension and diabetes that started before the 20th gestational age. Analysis of the urinary free cortisol level and circadian rhythm of cortisol is necessary to diagnose. Despite the diagnostic challenge we can achieve better maternal and fetal outcomes with proper management.Figure 1.Non-contrast magnetic resonance imaging of the patient Table 1.Patient's laboratuary test results Table 2.Patient's laboratory test results

Cardiac monoamine oxidase-A inhibition protects against catecholamine-induced ventricular arrhythmias via enhanced diastolic calcium control.

A mechanistic link between depression and risk of arrhythmias could be attributed to altered catecholamine metabolism in the heart. Monoamine oxidase-A (MAO-A), a key enzyme involved in catecholamine metabolism and longstanding antidepressant target, is highly expressed in the myocardium. The present study aimed to elucidate the functional significance and underlying mechanisms of cardiac MAO-A in arrhythmogenesis. Analysis of the TriNetX database revealed that depressed patients treated with MAO inhibitors had a lower risk of arrhythmias compared with those treated with selective serotonin reuptake inhibitors. This effect was phenocopied in mice with cardiomyocyte-specific MAO-A deficiency (cMAO-Adef), which showed a significant reduction in both incidence and duration of catecholamine stress-induced ventricular tachycardia compared with wild-type mice. Additionally, cMAO-Adef cardiomyocytes exhibited altered Ca2+ handling under catecholamine stimulation, with increased diastolic Ca2+ reuptake, reduced diastolic Ca2+ leak, and diminished systolic Ca2+ release. Mechanistically, cMAO-Adef hearts had reduced catecholamine levels under sympathetic stress, along with reduced levels of reactive oxygen species and protein carbonylation, leading to decreased oxidation of Type II PKA and CaMKII. These changes potentiated phospholamban (PLB) phosphorylation, thereby enhancing diastolic Ca2+ reuptake, while reducing ryanodine receptor 2 (RyR2) phosphorylation to decrease diastolic Ca2+ leak. Consequently, cMAO-Adef hearts exhibited lower diastolic Ca2+ levels and fewer arrhythmogenic Ca2+ waves during sympathetic overstimulation. Cardiac MAO-A inhibition exerts an anti-arrhythmic effect by enhancing diastolic Ca2+ handling under catecholamine stress.

Biological Sex as a Moderator of Work Determinants of Health: Implications for Work and Stress.

This study examined whether biological sex moderates the relationship between experiences of workplace culture and urinary levels of catecholamines and their metabolites. We conducted a series of regression analyses (predictors: 3-methoxytyramine (3MT), 5-hydroxyindolacetic (5HIAA), and dopamine (DA); outcomes: employee engagement and workplace culture) in a sample of 218 participants. Compared to men, women rated workplace culture less positively (r = -0.210; p < 0.01) and had stronger positive associations with 3MT (r = 0.328; p < 0.001), DA (r = 0.376; p < 0.001), and 5HIAA (r = 0.168; p < 0.01). There was a significant moderation effect between 3MT and sex on employee engagement (b = -1.76 (SE = 0.84); p < 0.01), and 3MT had a positive significant association for men with engagement (p < 0.05); however, there was no significant association for women. Findings suggest that for women, less positive experiences with workplace culture could elevate 3MT, stimulating sympathetic nervous tone and potentially amplifying risks for negative health outcomes. Conversely, men who reported higher employee engagement had higher levels of 3MT, suggesting possible health risks associated with high levels of engagement, rather than lack of engagement. Overall, study findings suggested differential health risks based on biological sex, potentially impacting health risk policy development.

Interactive effects of cyanobacterial metabolites aeruginosin-98B, anabaenopeptin-B and cylindrospermopsin on physiological parameters and novel in vivo fluorescent indicators in Chironomus aprilinus larvae

We aimed to determine the effects of single cyanobacterial metabolites aeruginosin-B (AER-B), anabaenopeptin-B (ANA-B), cylindrospermopsin (CYL), their binary and ternary mixtures on biomarkers of Chironomus aprilinus larvae: oxygen consumption, fat body structure and two novel fluorescent indicators: imaging of nuclei in cells of body integument, and the catecholamine level. The obtained results showed that oxygen consumption was inhibited by single tested cyanobacterial metabolites except for ANA-B at the lowest concentration (250 μg/L). Although the mixtures of the metabolites inhibited oxygen consumption with antagonistic interactions between the components stimulation was noted in the group exposed to the lowest concentrations of AER-B + CYL (125 μg/L + 125 μg/L, respectively) and the ternary mixture of AER-B + ANA-B + CYL (83.3 μg/L + 83.3 μg/L + 83.3 μg/L, respectively). In vivo fluorescent staining with Hoechst 34580 showed that single AER-B had lower cytotoxic potential on body integument cells than ANA-B and CYL and most binary mixtures except for AER-B + CYL induced synergistic toxicity. Catecholamine level was decreased in animals exposed to single metabolites, their binary and ternary mixtures; however, the interactions between the components in the ternary mixture were antagonistic. Fat body was found to be disrupted in the larvae exposed to single metabolites and their combinations. Antagonistic toxic interactions between the oligopeptide components were found in most binary and the ternary mixtures; however, synergistic effect was noted in the binary mixture of AER-B + CYL. The results suggest that in natural conditions Chironomus larvae and possibly other benthic invertebrates may be affected by cyanobacterial metabolites, however various components and in mixtures and their concentrations may determine varied physiological effects and diverse interactions.

Vagal predominance correlates with mood state changes of winter-over expeditioners during prolonged Antarctic residence.

Winter-over expeditioners in Antarctica are challenged by various environmental and psycho-social stress factors, which may induce psychophysiological changes. The autonomic nervous system (ANS) plays a crucial role in the adaptation process under stress. However, the relationship between ANS activity and the mood states of expeditioners remains largely unexplored. This study aims to uncover the pattern of ANS adjustment under extreme Antarctic environments and provide new insights into the correlations between ANS activity and mood state changes, which may provide scientific data for medical interventions. Fourteen expeditioners at Zhongshan Station participated in this study. The study was conducted during four representative periods: pre-Antarctica, Antarctica-1 (pre-winter), Antarctica-2 (winter), and Antarctica-3 (summer). The heart rate variability (HRV) of the expeditioners was continuously measured for 24 hours to evaluate ANS activity. Plasma levels of catecholamines were tested by ELISA. Mood states were assessed by the Profile of Mood States (POMS) scale. HRV analysis showed a disturbance of ANS during winter and summer periods. For frequency domain parameters, very low frequency (VLF), low frequency (LF), high frequency (HF), and total power (TP) significantly increased during the second half of the mission. Especially, LF/HF ratio decreased during summer, indicating the predominance of vagal tone. Results of the time domain analysis showed increased heart rate variability during the austral winter and summer. Plasma epinephrine (E) significantly increased during residence in Antarctica. Compared with pre-Antarctica, the vigor, depression, and anger scores of the expeditioners decreased significantly during the austral summer. Notably, the depression score showed a moderate positive correlation with LF/HF, while weak negative correlations with other HRV indicators, including TP, VLF, and LF. Anger score showed a moderate positive correlation with LF/HF and weak negative correlations with the average normal-to-normal (NN) interval, and the root mean square of differences between adjacent RR intervals (RMSSD). Plasma E level weakly correlated with the average NN interval. Prolonged residence in Antarctica increased the ANS activities and shifted the cardiac autonomic modulation towards vagal predominance. The alteration of HRV correlated with mood states and plasma epinephrine levels.