Changes In Cortisol Levels Research Articles

Excessive Noise in Neonatal Units and the Occupational Stress Experienced by Healthcare Professionals: An Assessment of Burnout and Measurement of Cortisol Levels.

Excessive noise in the work environment has been associated with extra-auditory symptoms, which can have harmful long-term effects on individuals. The purpose of this study was to identify noise levels in neonatal intensive care units and investigate their impact on the occurrence of stress among healthcare professionals, using cortisol levels as a biomarker for Burnout Syndrome. This descriptive, observational, and cross-sectional study was conducted in four public teaching hospitals in Fortaleza, Ceará, Brazil. Sound pressure levels in the environment were measured, and questionnaires were administered to collect sociodemographic data and assess perceptions of the work environment and Burnout symptoms. Saliva samples were collected at the beginning and end of work shifts for cortisol quantification. The average sound pressure ranged from 59.9 to 66.4 dB(A), exceeding the recommended levels set by Brazilian and international legislation. Among the 256 participants, the average age was 39.4 years, with 95% being female. The majority (70.9%) were nurses, and 22.7% were physicians. There was no significant association found between noise and Burnout Syndrome, nor with changes in cortisol levels. However, a significant association was observed between the perception of excessive noise and the sensation of a stressful work shift (p = 0.012). All evaluated professionals displayed symptoms of Burnout. The high sound pressure levels indicated that the assessed environments did not meet the recommended standards for acoustic comfort, and this was associated with the participants' perception of stressful work shifts. While Burnout symptoms were evident in our participants, it was not possible to confirm a correlation with high noise levels.

Cortisol concentration as a marker of adaptation processes in children with infectious mononucleosis at different periods of the disease

BACKGROUND: Infectious mononucleosis is an acute infectious disease caused by EpsteinBarr virus. This virus replicates in B-lymphocytes but may be as well found in the epithelial cells of pharynx and parotid ducts. Its typical symptoms include fever, lymphadenopathy and herpetic angina, the endocrine system may also be involved in the pathologic process.
 AIM: The aim of the study is the change in cortisol levels in children of different sex and age during the peak and convalescence of infectious mononucleosis caused by the EpsteinBarr virus.
 MATERIALS AND METHODS: Under observation were 94 children aged 1 to 17 years, among them from 1 to 5 years 22%, from 5 to 10 years 39%, from 10 to 15 years 27%, from 15 to 17 years 12%, with a diagnosis of EpsteinBarr virus mononucleosis moderate severity. The diagnosis was made on the basis of clinical, anamnestic and laboratory data. Studies confirming the diagnosis were carried out in the laboratory of St. Petersburg State Pediatric Medical University. In addition to routine examinations (clinical minimum), determination of M- and G- antibody titers to the EpsteinBarr virus, detection of the EpsteinBarr virus genome in the blood by PCR, and determination of cortisol levels by enzyme-linked immunosorbent assay in blood serum.
 RESULTS: In all age groups, the cortisol concentration during the peak period was higher than during the convalescence period. At the same time, in girls in groups from 6 to 10 years old and from 11 to 16 years old, this difference was significant (1045.19 111.10 versus 740.97 120.68 nM/l and 977.31 81.40 versus 735.48 113.04 nM/l respectively). In boys of all age groups, the differences were significant and amounted to 1211.30 128.36 versus 864.63 126.90 nM/l in the group from 1 to 5 years old, and 1066.76 39.01 versus 817,90 101,52 nM/l in the age group from 6 to 10 years old, in the age group from 11 to 16 years 950.14 101.54 versus 779.61 125.68 nM/l.
 CONCLUSIONS: Changes in cortisol levels in children during the peak of infectious mononucleosis depend on the severity of the disease, the presence and nature of complications. The level of cortisol determines various options for adaptation to infectious mononucleosis.

Comparative efficacy of serratus anterior plane block (SAPB) and fentanyl for postoperative pain management and stress response in patients undergoing minimally invasive cardiac surgery (MICS).

Fast-tracking plays a significant role in reducing perioperative morbidity and postoperative hospital stay by facilitating early extubation and optimal pain control. Attenuating the stress response to surgery also has a crucial function in enhancing recovery. Serratus anterior plane block (SAPB) is a recently described technique for chest wall analgesia. More data is required to find out the effectiveness of analgesia by SAPB for minimally invasive cardiac surgery (MICS). The study aimed to assess the efficacy and safety of ultrasound-guided SAPB compared to fentanyl for controlling post-thoracotomy pain and stress response in patients undergoing MICS. Time framed comparative, prospective, and observational study. Patients undergoing MICS for coronary artery bypass grafting under general anesthesia were randomly assigned into two groups. SAPB group (Group A) patients were given 0.2% of 20 ml ropivacaine followed by catheter insertion for continuous infiltration at the end of the procedure. Fentanyl group (Group B) patients were given fentanyl infusion for postoperative analgesia. The primary outcome measured changes in visual analog scale (VAS) score (pain) and cortisol levels (for stress response) in both groups. VAS score was significantly low in Group A when compared to Group B (P < 0.0001). Cortisol levels were also lower in the SAPB group. Hemodynamic parameters (systolic blood pressure, diastolic blood pressure, pulse rate, and oxygen saturation) were more stable in Group A with a lesser requirement of top-up analgesics. SAPB was more effective than fentanyl in managing post-thoracotomy pain after MICS. Cortisol level was lower in the group that received SAPB.

Impact of Abortion on Hormonal Changes

Purpose: The aim of the study is to examine the impact of abortion on hormonal changes.&#x0D; Methodology: This study adopted a desktop methodology. This study used secondary data from which include review of existing literature from already published studies and reports that was easily accessed through online journals and libraries.&#x0D; Findings: The findings indicate that abortion can lead to hormonal alterations, including changes in estrogen, progesterone, cortisol, and thyroid hormone levels. These hormonal changes can have both short-term and long-term effects on women's physical and emotional well-being. The study reveals potential implications of hormonal changes following abortion. These implications include menstrual irregularities, altered reproductive hormone levels, increased stress responses, psychological distress, and potential impacts on sexual functioning and future fertility outcomes.&#x0D; Unique Contribution to Theory, Practice and Policy: The study was anchored on neuroendocrine theory of abortion-related hormonal changes which was proposed by Bagshawe, Campbell, Flett, and Maclean and psychoneuroimmunology (PNI) theory which was pioneered by Ader, Felten, and Cohen. Policymakers should prioritize the availability of comprehensive post-abortion care that includes monitoring and managing hormonal changes. This can be achieved by supporting healthcare systems, expanding access to reproductive healthcare facilities, and integrating hormonal health services into existing abortion care frameworks.

Stress across the Transition from Preschool to School: Association with the Development of Anxiety Symptoms in Children

Children experiencing maladjustment during the transition from preschool to school could further develop internalizing disorders, such as anxiety. Children’s sensitivity to stress is a good indicator of children’s adjustment, but atypical sensitivity, measured by cortisol concentrations, was often linked to later development of anxiety symptoms. Our previous study (PNEC, 2022) showed that most children’s morning cortisol concentrations increased during the first two weeks of kindergarten, and that the adaptation response rate varied between children two months after school entry. The current study aimed to test whether children’s atypical morning cortisol concentration across the transition to kindergarten was associated with an increase in anxiety symptoms 1.5 years later. To model morning cortisol concentrations during the transition, a latent growth model was used (n = 384; one sample for each of the four time-points). Anxiety symptoms were measured twice, before kindergarten entry and in first grade, by parent-report questionnaires. The items were combined using latent variables, one for each time-point. Controlling for pre-transition anxiety symptoms, cortisol level during the first week of school (β = -0.18) predicted anxiety symptoms 1.5 years later. Changes in cortisol levels across the transition did not add to the prediction. This study showed that low morning stress response to a normative environmental stressor was followed by increased levels of anxiety symptoms. Consistent with the stress sensitization hypothesis, this lower stress response is frequently linked to anxiety problems in children who previously experienced adversity; this remains to be examined in this sample.

It’s all in the hair: Changes in hair cortisol concentrations in reaction to the COVID-19 pandemic predicts post-traumatic stress symptoms in children

About 25 to 35% of victims of a traumatic event will develop post-traumatic stress disorder (PTSD). Low cortisol levels appear to be a risk factor for the development of PTSD. In adults, decreased diurnal and cumulative cortisol levels before or shortly after a traumatic event are associated with increased post-traumatic symptoms in the months thereafter. In contrast, results from the only two studies conducted in children showed that elevated diurnal cortisol levels shortly after exposure to a traumatic event are associated with more severe post-traumatic symptomatology. Given that a pandemic can induce post-traumatic stress symptoms, we investigated whether cumulative cortisol levels prior to and in the beginning stages of the COVID-19 pandemic in Quebec (Canada) predicted post-traumatic stress symptoms in children. We collected hair samples from 69 children (8-12 y/o) without history of psychopathology and exposure to a traumatic event. Cortisol levels were measured before (December 2019 - February 2020) and at the beginning of the pandemic (March 2020 - May 2020). Post-traumatic stress symptoms were assessed every 3 months between June 2020 (T1) and March 2021 (T4). The results showed that the percentage change in cumulative cortisol levels between the beginning of and prior to the pandemic predicted post-traumatic stress symptoms at T1. Specifically, a decrease in cortisol levels early in the pandemic was associated with increased post-traumatic stress symptoms. This study suggests that a decrease in cortisol in response to a stressful event may be a predisposing factor for PTSD in children.

Scoping Review of the Relationship between Salivary Cortisol and Depression

Anxiety and depression are some of the most common mental disorders associated with a dysregulation of the hypothalamic-pituitary-adrenal axis (HPA) and elevated cortisol levels in the saliva. The aim of this scoping review was to synthesize all of the current information about the relationship between salivary cortisol and depression as well as address some of the shortcomings in prior research to explore its potential applications in diagnosing depression. In late July 2022, records from 2012-2022 were identified using Web of Science, PubMed, and Scopus. Unique abstracts were screened using the following criteria: (1) depression and saliva; (2) anxiety and saliva; (3) age and salivary cortisol and depression; (4) sex and salivary cortisol and depression. 4,869 records were identified across all three databases; resulting in 90 unique abstracts. 11 articles met all inclusion criteria. On balance, most studies associated the dysregulation of the HPA with depression and anxiety disorders, with a cofactor being the cortisol awakening response. Several studies also presented sex and age-related differences in salivary cortisol measures. However, there were several inconsistencies with some studies showing no age and/or sex-related differences. Furthermore, several studies also emphasized the importance of testing morning salivary cortisol as an effective method to diagnose depression and anxiety disorders. The oral microbiome may play a role in mental health disorders through changes in inflammation and cortisol levels in saliva. Our review contributes to the existing literature on the topic, highlighting gaps and strategizing the next steps.

Do toddlers' levels of cortisol and the perceptions of parents and professional caregivers tell the same story about transition from home to childcare? A mixed method study.

Enrolling in childcare represents the first transition in toddlers' lives and lays the foundation for their well-being in childcare centers going forward. Child cortisol levels may be an indicator of how toddlers themselves experience their introduction to childcare. In the present study, we explored changes in toddler cortisol levels during their first month in childcare and at a 3-month follow-up, as well as the perceptions of parents and professional caregivers regarding the toddlers' settling-in process during the same period. This study used a mixed-method design. Saliva samples were collected from 113 toddlers and their cortisol levels analyzed. Qualitative notes were collected from parents (n = 87) and professional caregivers (n = 101). The data were analyzed using linear mixed model and thematic analyses, respectively. Changes in toddler cortisol levels and their parents' and professional caregivers' perceptions of the transition process fit well. Both data sources indicated an easy start in childcare when parents were present, while the first weeks separated from parents seemed quite demanding. After 3 months, the cortisol levels returned to a low level, while child well-being was perceived as high. Toddlers need time to adapt to childcare settings. Even if they are well taken care of by their keyworkers during the day, many toddlers are tired and exhausted in the evenings at home, particularly in the first weeks of separation from their parents. Both professional caregivers and parents should be aware of toddlers' need for emotional support during their transition to childcare.

Laughter as medicine: A systematic review and meta-analysis of interventional studies evaluating the impact of spontaneous laughter on cortisol levels.

Laughter as an expression of humor has been recognized as good medicine for centuries. The health benefits of humor-induced well-being remain unclear and thus we conducted a systematic review and meta-analysis of interventional studies to evaluate the impact of spontaneous laughter on stress response as measured by cortisol levels. Systematic review and meta-analysis. MEDLINE/PubMed, EMBASE, PsycINFO, Scopus, and Clinicaltrials.gov. Interventional studies, which could be either randomized placebo-controlled trials (RCTs) or quasi-experimental studies, conducted in adults that compared any spontaneous laughter intervention to a controlled setting and reported changes in cortisol levels were selected. We examined the impact of laughter on percentage change in cortisol levels by calculating pooled estimates of the absolute differences between arithmetic means before and after interventions as compared to control using random-effects model. Eight studies (315 participants; mean age 38.6) met our inclusion criteria; four were RCTs and four were quasi-experiment studies. Five studies evaluated the impact of watching a humor/comedy video, two studies evaluating laughter sessions administered by a trained laughter therapist, and one study evaluating a self-administered laughter program. Pooling these data showed a significant reduction in cortisol levels by 31.9% (95%CI -47.7% to -16.3%) induced by laughter intervention compared to control group with no evidence of publication bias (P = 0.66). Sensitivity analyses demonstrated that even a single laughter session induced a significant reduction of 36.7% in cortisol (95%CI -52.5% to -20.8%). In addition, analyses including the four RCTs reinforced these results by demonstrating a significant reduction in cortisol levels promoted by laughter as compared to the placebo arm [-37.2% (95%CI -56.3% to -18.1%)]. Current evidence demonstrates that spontaneous laughter is associated with greater reduction in cortisol levels as compared with usual activities, suggesting laughter as a potential adjunctive medical therapy to improve well-being. Registration number: CRD42021267972.

Exercise-related changes in the anabolic index (testosterone to cortisol ratio) and serum amyloid A concentration in endurance and racehorses at different fitness levels.

Increased training loads in both human and equine athletes are generally implemented to improve their physical performance. These loads are tolerated only within appropriate training periodization with regard to recovery time. Otherwise, training overload causes failure in the systemic adaptation, which at first leads to overreaching, and progressively to overtraining syndrome (OTS). Exercise endocrinology, and anabolic/catabolic balance as an indicator of athlete performance status and OTS has continued to attract attention. In human medicine, changes in testosterone and cortisol levels, as well as the testosterone to cortisol ratio (T/C; anabolic index), are suggested to be sensitive stress markers. However, there is a lack of research investigating these parameters for use in equine sports medicine. The aim of the study was to investigate the differences in testosterone, cortisol, and T/C in response to a single training session in two types of equine sports: endurance and race, together with serum amyloid A (SAA), the main acute phase response indicator of physical effort, and the overall health status in horses. Two groups of horses were enrolled in the study: endurance (n = 12) and racehorses (n = 32) of different fitness level. Blood samples were obtained before and after the exercise. On average, T increased 2.5 times after the race training in experienced racehorses and dropped in endurance horses regardless the fitness level (p < 0.05). In endurance horses, a decrease in T/C occurred after training in inexperienced horses (p < 0.05). In racehorses, a T/C decrease occurred in the inexperienced group (p < 0.05) and an increase in the experienced (p < 0.01). In conclusion, T/C ratio was found to be a potentially reliable indicator of fitness status especially in racing horses. These findings provide insight into the physiological response of the horses to different types of exercise and the potential use of hormone levels as markers of performance and adaptation.

Changes in serum cortisol levels after 10 days of overfeeding and fasting.

Chronic caloric deprivation and obesity are complicated by hypercortisolemia. The effects of acute overfeeding and fasting on circulating free cortisol levels and conversion of cortisone to free cortisol are unknown. We hypothesized that serum-free cortisol and free cortisol-to-cortisone ratio would increase after both overfeeding and fasting. This is a prospective study of 22 healthy volunteers who completed a 10-day high-calorie protocol followed by a 10-day fast, separated by a 2-wk washout. Morning free and total cortisol and free cortisone levels (LC/MS) were measured at baseline and after 10 days of each intervention. Both high-calorie feeding and fasting increased total and free cortisol and the free cortisol-to-free cortisone ratio (P = 0.001 to P = 0.046). There were sex interactions, with significant effects in men (P < 0.001), but not in women (P = 0.898 and 1.000, respectively) in subset analyses examining the effects of fasting on free cortisol and the free-to-total cortisol ratio. Overfeeding and fasting both increase circulating free cortisol levels and appear to alter the balance between cortisol and its inactive metabolite, cortisone. Further study is warranted to determine whether elevated cortisol levels contribute to complications of starvation and obesity, such as bone fragility.NEW & NOTEWORTHY Overfeeding and fasting both increase circulating free cortisol levels and appear to alter the balance between cortisol and its inactive metabolite, cortisone. The effect of fasting on free cortisol levels is modified by sex. Further study is needed to determine the mechanisms driving the increases in cortisol.

Time-dependent recurrence and resolution of pigment epithelial detachment in central serous chorioretinopathy

BackgroundCortisol plays a role in the pathogenesis of central serous chorioretinopathy (CSC). CSC patients have abnormal time-dependent changes in cortisol levels. Here we report a rare case of a patient with central serous chorioretinopathy whose pigment epithelial detachment (PED) exhibited time-dependent recurrence and resolution.Case presentationA 47-year-old man presented in 2016 for vision loss in the left eye related to recurrent CSC. During follow-up, his PED was observed to resolve spontaneously while he was still in our clinic and recurred the next morning. Such time-dependent changes of the PED were observed in several next follow-ups without any intervention. After excluding possible external factors, the abnormal diurnal variation of cortisol was considered as the internal factor affecting PED.ConclusionsThis is the first article that described the spontaneous time-dependent recurrence and resolution of PED without external interference, where endogenous cortisol may be responsible. Interventions against the abnormal cortisol level might be a potential treatment strategy for CSC. More research is urged to explore the impact of the diurnal change in cortisol levels on eyes with CSC.

Effects of routine procedures on salivary cortisol in mechanically ventilated neonates

Even though the stress secondary to invasive procedures has been investigated, less attention has been paid to the stimulation or pain caused by routine procedures on neonates. The changes in salivary cortisol concentration in mechanically ventilated NICU patients during routine procedures were monitored to provide reference and guidance for pain management. 80 mechanically ventilated neonates in the hospital from Sep 2021 to Mar 2022 were selected. The salivary cortisol levels of the neonates were monitored during nursing procedures and were categorized by their risk levels to the following groups: high-risk (endotracheal suctioning and arterial blood sampling), moderate-risk (gastric tube insertion, venipuncture), and low-risk (bedside bathing and diaper changes). The changes in heart rate were also recorded and compared. The concentration of cortisol in the saliva of the neonates was 1.5 ± 0.8 nmol/L during the sleeping state, 6.2 ± 1.3 nmol/L during endotracheal suctioning, 6.4 ± 1.4 nmol/L during arterial blood sampling, 6.1 ± 1.2 nmol/L during venipuncture, 4.4 ± 1.1 nmol/L during gastric tube insertion, 3.5 ± 0.8 nmol/L during bedside bathing, and 3.3 ± 0.9 nmol/L during a diaper change. The results revealed a statistically significant effect between routine procedures on salivary cortisol levels. Compared with the neonates in the control sleep state, there was a significant (P < 0.05) change in salivary cortisol concentration of infants undergoing high and moderate-risk nursing procedures. There was a small but significant (P < 0.05) change in salivary cortisol levels in infants who underwent low-risk procedures compared to infants in the control sleep state. Further, the fluctuation of salivary cortisol levels in routine procedures was more frequent compared with routine handling at night. The fluctuations of salivary cortisol concentration in high-risk procedures were larger than that of infants who underwent low-risk procedures, with the difference being statistically significant (P < 0.05). It was also determined that the top four influencing factors on the infants’ heart rate were arterial blood sampling venipuncture, intubation, endotracheal suctioning, and gastric tube insertion (P < 0.05). Monitoring the saliva cortisol concentration index and heart rates can reflect the impact of different routine procedures on newborns and can be used to manage neonatal pain in the future.

Does Modifying the Consent Process Based on the Dominant Intelligence Type Reduce Anxiety During 3rd Molar Operations?

Third molar surgery is one of the most commonly performed operations, usually associated with high anxiety. The purpose of this study was to determine if patients' anxiety would reduce if consent was modified to match their dominant intelligence type (DIT). A single center, prospective randomized clinical study was conducted in the Maxillofacial Surgery Clinic of Ordu University on patients admitted for lower third molar removal between October 2020 and June 2021. The participants were randomly assigned to a study group where consent was based on DIT or a control group where consent was obtained in the standard fashion. DIT was determined using the multiple intelligence test and was further categorized as visual/spatial, verbal/linguistic, and bodily/kinesthetic. The consent method was the primary and the type of DIT was the secondary predictor variable. The primary and secondary outcome variables were the salivary cortisol level and Modified Dental Anxiety Scale (MDAS) scores measured before and after the consent, and after the operation. Mann-Whitney U, Friedman, Kruskal Wallis, Pearson correlation, and χ2 tests were conducted for statistical analysis. Eighty patients (55 females and 25 males; mean age 23.5±6.2) were included. No significant difference was observed between the study and control groups for the change in cortisol levels and MDAS scores before-after consent (-11.15±62.64; -6.84±32.9) (P=.389), (-0.6±3.46; -0.7±2.49) (P=.832) and before consent-after operation (-39.80±108.2; -39.72±77.04) (P=.987), (-4.31±5.97; -3±4.34) (P=.867). The change in MDAS scores and cortisol levels was not correlated after consent (P=.587, r=0.62) and operation (P=.406, r=0.94). Providing consent based on DIT is not statistically different than providing consent in the standard fashion. The role of consent strategy in managing anxiety and lack of correlation between salivary cortisol and MDAS requires further investigation.

Change in plasma cortisol and glucose levels of Oncorhynchus keta according to water temperature

Chum salmon (Oncorhynchus keta) is a species of anadromous salmonid inhabiting coastal rivers in the North Pacific and the Arctic in the Bering and is the most widely distributed among Pacific salmon species. It is an important fish species in Korea as the salmon releasing project is being actively carried out. This study was conducted to investigate changes in the physiological activity of O. keta according to water temperature. Three experiments were conducted according to the water temperature and period, and the plasma concentrations of cortisol and glucose were analyzed from the blood samples of the experimental groups. Experiment I is a short-term water temperature experiment, in which water temperature stimulation was given for 4 hours at water temperatures of 12°C, 16°C (control), 20°C, and 24°C, and a recovery period was given for 4 hours. Experiment II is an experiment in which water temperature stimulation was given for 24 hours, 48 hours, and 72 hours at a high temperature of 24°C, and a recovery period was given for 12 hours, respectively. Experiment III is a long-term water temperature experiment, in which the water temperature was 12°C, 16°C (control), 20°C, and 24°C for 8 weeks. As a result of the experiment, in Experiment I, there was no significant difference in the survival rate between the experimental groups, but the concentration of cortisol and glucose in the plasma according to the set water temperature showed a significant difference. In Experiment II, there was no significant trend according to the maintenance time of the high-temperature state, but as the temperature increased, the plasma cortisol and glucose levels significantly increased compared to the control group. In Experiment III, all of the experimental group C (24°C) died in the 1st week, and there was no significant difference in the plasma glucose at the 1st and 8th weeks among the remaining experimental groups.

Changes in salivary cortisol and testosterone levels in male chimpanzees during the process of reunion with group members

Changes in salivary cortisol and testosterone levels in male chimpanzees during the process of reunion with group members

Serum cortisol and insulin-like growth factor 1 levels in major depressive disorder and schizophrenia

The pathophysiology underlying major depressive disorder (MDD) and schizophrenia is related to endocrine system functions and includes changes in the blood levels of cortisol and insulin-like growth factor 1 (IGF-1). However, these hormones have not been investigated simultaneously in patients with MDD and schizophrenia. We investigated the differences in serum cortisol and IGF-1 levels among patients with MDD and schizophrenia and controls. We included 129 patients with MDD, 71 patients with schizophrenia, and 71 healthy volunteers. Blood tests were performed between 6:00 am and 11:00 am after fasting. Serum cortisol levels were significantly higher in patients with schizophrenia than in patients with MDD and controls. Serum cortisol levels were significantly higher in patients with MDD than in controls. Serum IGF-1 levels were higher in both patient groups than in controls, whereas there was no significant difference between patients with MDD and schizophrenia. Both cortisol and IGF-1 levels were positively correlated with the Hamilton Rating Scale for Depression score in patients with MDD, whereas cortisol level was positively correlated and IGF-1 level was negatively correlated with the Brief Psychiatric Rating Scale score in patients with schizophrenia. The differences in the level of these hormones suggest pathophysiological differences between these disorders.

Dexamethasone Effect on Sudden Hearing Loss is Validated in Stress-induced Animal Models: Hypothetical Study.

Stress could be a contributing cause of sudden hearing loss. This study intended to develop an animal model of stress-induced sudden hearing loss and to evaluate the effects of dexamethasone. Two stress models (I and II) for rats were designed using various stressors and modified by adjusting the stress protocol to increase the threshold significantly. For the stress model with a significant increase in threshold after stress exposure, changes in cortisol levels according to stress exposure were measured. The threshold shift and the change in the cellular structure associated with stress exposure and dexamethasone administration were analyzed. While hearing thresholds increased only at 16 kHz in rats of stress model I (n=10), the thresholds increased at 16 and 32 kHz in rats of stress model II (n=16). Cortisol level increased after stress exposure (P = .015) in stress model II. Among stress model II rats (stress only and stress+dexamethasone groups), the threshold shift at 16 kHz significantly decreased 1 day after dexamethasone injection in the stress+dexamethasone group (n=8). Histologically, the cochlear cellularity of the stress+dexamethasone group was more compact than that of the stressonly group (n=8). Our preliminary study presented the development of an animal model of stress-induced sudden hearing loss and the positive results of steroids in terms of hearing recovery.

Behavioral and hormonal assessment of stress in foals (Equus caballus) throughout the weaning process.

This study had the aim to demonstrate the midterm effects (three weeks) of weaning on foals' welfare. For this purpose, foals' behavioral changes and fecal levels metabolites of cortisol were evaluated. The observations took place at the state stud farm of Baden-Wuerttemberg in Germany. Ten foals (six colts and four fillies) were observed from one day before weaning up until three weeks after weaning. Weaning was divided into three blocks, the first in September, the second in October, and the last in November. The behavioral observation was done during an eight-hour period between 7:00 a.m. and 5:00 p.m. The observer documented the exact behavior shown by the foal every five minutes during the eight hours. To scale the stress experienced by the foal, the glucocorticoid metabolite 11,17-dioxoandrostane was measured with the 11-oxoetiocholanolone enzyme immunoassay, which allows assessing the foal's plasma cortisol level changes throughout the trail through fecal samples. All foals displayed a distinct hormonal stress response to the weaning process through increased fecal cortisol metabolite levels. Their body posture distribution took a shift from mainly moving before weaning to mainly standing during the three weeks after weaning. Compared with the day before weaning, the foals showed less active behavior and significantly increased their resting behavior. Regarding the overall resting behavior, the weaned foals initially increased their time spent resting in a lying position during daytime and then started to decrease the time lying. After weaning, the foals showed a significant increase in resting while standing. In conclusion, the foals showed an expected behavioral development and an expected curve of cortisol metabolite values throughout the study. However, it seemed that the changes had not returned "back to normal" at three weeks after weaning. Therefore, we suggest that weaned foals need a minimum of three weeks to acclimate to the new situation.

A Study to Assess Changes in Cortisol Level and Heart Rate Variability between Fixed Duty and Shift Duty Health Care Providers in a Tertiary Care HospitalA Cross-Sectional Study

Introduction: Increased demand of service 24 hours around the clock has divided the workers into 2 domains as “Fixed duty” and “Shift duty”. Personals associated with shift duty are increasing in numbers day by day. Shift duty or more specifically night duty is associated with increased stress which results in high morbidity and decrease in work efficiency. Cortisol hormone and Heart Rate Variability (HRV) are useful parameters to determine the effects of stress. Aim: To find any change in cortisol levels, HRV, Athens score among the fixed duty and shift duty healthcare providers. Materials and Methods: A descriptive cross-sectional comparative study was conducted in a tertiary care hospital at Kolkata between July, 15th to Sept, 15th 2021. Predesigned and pretested questionnaire was made and ethical clearance was taken from institutional IEC. Then after taking consent total 120 (60 fixed duty and 60 shift duty) healthcare providers were recruited for the study. Subjects of the study filled up a questionnaire {including Athens Insomnia Scale (AIS)}. After applying exclusion criteria (any cardiovascular, neurological, psychological, sleep disorder) 120 health individuals were taken five minutes short-term HRV (time and frequency domain) recording in supine posture and 4 PM blood sample (for cortisol) were obtained from the participants which was further analysed in Chemiluminescence Immunoassay (CLI). Data was analysed in SPSS version 20.0. Statistical tests like student t-test, Cron bach’s alpha and chi-square tests were applied significant p&lt;0.05 (95% CI). Results: After analysis, shift duty workers showed a significant (p&lt;0.001, Odd’s 10.706) higher chance of having insomnia (Athens score &gt;6) than fixed duty workers. Blood test showed that shift duty workers had significantly high evening cortisol level than fixed duty workers (p= 0.036). The time domain of HRV showed that the parameters like Standard Deviation all NN interval (SDNN) (p=0.001), Mean HR (p=0.037), RMSSD (p &lt;0.001), NN50 (p=0.006), pNN50 (p=0.002) were significantly different in the two groups. Whereas the frequency domain of HRV showed that HF power was lower and LF power (p=0.002), LF/HF ratio (p &lt;0.001) were significantly higher in shift duty workers. Conclusion: The study showed that shift duty workers had comparatively higher stress levels resulting in significantly high sympathetic drive and increased risk of insomnia. This can be associated with morbidity and ill health in the shifting duty workers.