Decrease In Serum Cortisol Level Research Articles

Vitamin D and lactoferrin attenuate stress-induced colitis in Wistar rats via enhancing AMPK expression with inhibiting mTOR-STAT3 signaling and modulating autophagy.

Irritable bowel syndrome (IBS) is a global gastrointestinal disorder closely related to psychological stress exposure and local colonic inflammation. Herein, we investigated the effect of wrap-restraint stress (WRS) on rat behavior, on adenosine monophosphate-activated protein kinase-mammalian/mechanistic target of rapamycin-signal transducer and activator of transcription 3(AMPK-mTOR-STAT3) signaling, and autophagy in colonic mucosa. The impact of chronic administration of vitamin D3 and lactoferrin was compared.Twenty-four male Wistar rats were randomly divided into four groups. Chronic WRS protocol was applied as a rodent model of IBS. Group I: naïve animals, Group II: WRS animals, Group III: WRS-exposed and treated with vitamin D3 (500 IU/kg/day),and Group IV: WRS-exposed and treated with lactoferrin (300 mg/kg/day). In this study, we found that chronic administration of each of vitamin D3 and lactoferrin resulted in a significant increase in social interaction test, interleukin-10, AMPK, optical density of LC3B, goblet cell count and marked decrease in serum cortisol level, STAT3, inflammatory cell count, and optical density of mTOR in comparison to the WRS rats. Our findings suggest that both vitamin D3 and Lactoferrin could augment colonic autophagy through enhanced AMPK expression and inhibition of mTOR-STAT3 signaling, which offers practical insights into their clinical use in the prevention and therapy of IBS. However, lactoferrin intake as a nutritional supplement could be more helpful for stress-induced colitis treatment than vitamin D3.

Methanol extracts of Vernonia amygdalina Del increase the sex ratio of offspring in Rattus norvegicus rats

Several sex selection methods are available but with varying success rates, availability, and affordability. Vernonia amygdalina has been used by some Kenyan communities for the male child pre-selection at conception but these claims have not been scientifically ascertained. This study aims at evaluating the ability of this herbal plant to pre-select for the male child at conception. The roots of the plant were collected and processed before extraction using methanol. The obtained crude plant extracts were orally administered to Rattus norvegicus rats before and during mating for one week. Crude extracts at doses of 50, 87, and 150 mg/kg body weight were used to evaluate the effects of the plant on the sex ratio of pups and factors related to sex ratio. A P value of P<0.05 was set as the limit of significance. The extracts were also subjected to quantitative phytochemical and mineral analysis. The results indicated that treating female rats with the plant extract significantly increased the ratio of male to female pups in all the treatment groups. There was a significant decrease in serum cortisol levels in both male and female rats and an increase in vaginal pH in female rats. The 50 and 87 mg/kg doses caused a significant increase in estrogenic levels compared to the untreated group. These results validated the use of the plant by herbalists for the preselection of a male child at conception.

Effects of adding low-dose ketamine to etomidate on serum cortisol levels in critically ill cardiac patients: a randomized clinical trial

BackgroundEtomidate was associated with an inhibition of adrenal steroid synthesis. This study aimed to evaluate the effects of adding low-dose ketamine to etomidate to minimize the decrease in serum cortisol level in critically ill cardiac patients.MethodsSixty adult cardiac patients, ≥ 18 years, who underwent upper endoscopy and Colonoscopy to manage acute anemia in the cardiac intensive care units were enrolled. Patients were randomly divided into two groups: (group (E): n = 30) received etomidate 0.2 mg/kg IV followed by etomidate 0.05 mg/kg IV, and (group (KE): n = 30) received ketamine 0.5 mg/kg IV, then etomidate 0.1 mg/kg IV, followed by etomidate 0.05 mg/kg IV. The primary outcome was Serum cortisol level at 6 h after the procedure.ResultsThe mean postoperative cortisol level was significantly lower in group E (295.60 ± 49.218 nmol/L) versus group KE (461.00 ± 67.946 nmol/L), with 95% CI = 351.94 to 404.66; p = 0.000. In addition, the estimated serum cortisol reduction level was also significant between groups; In group E, the estimated cortisol level decreased nearly 53% from 632.40 ± 35.066 nmol/L to 295.60 ± 49.218 nmol/L 6 hours postoperative. While in group KE, the estimated cortisol level decreased only 27% from 639.13 ± 43.035 nmol/L to 461.00 ± 67.946 nmol/L.ConclusionsSingle-dose ketamine (0.5 mg/kg) was helpful to decrease the total dose of etomidate and hence decreased the percentage of serum cortisol level in such critically ill patients with preservation of patient satisfaction.Trial RegistrationThis study is registered on ClinicalTrials.gov (NCT04857450; principal investigator: Mostafa Mohammed Elsaid Elhamamsy; registration date: 23/04/ 2021).

Effects of tricaine methanesulfonate (MS-222) on sedation and responses of yellow catfish (Pelteobagrus fulvidraco) subjected to simulated transportation stress

This study evaluated the anesthetic and sedative effects of tricaine methanesulfonate (MS-222) on yellow catfish (Pelteobagrus fulvidraco), and determined its effectiveness for the simulated transportation. In the anesthesia induction and recovery experiment, the adult fish (87.5 ± 13.9 g) were treated with five concentrations of MS-222 (0, 40, 60, 90 and 110 mg L−1), respectively. The results showed that the effective concentration of MS-222 for short-term anesthesia induction was between 90 and 110 mg L−1, according to the principle of anesthesia within 3 min and recovery within 10 min. In the simulated transportation experiment, the fish (86.7 ± 11.4 g) were stored in tanks containing 40 mg L−1 MS-222 solution for 12 h. The results revealed that the content of water ammonia nitrogen in the MS-222 group was significantly lower than that of control group . The fish in the anesthetized transportation group showed a significant decrease in serum cortisol levels (43.11 ± 3.74 ng mL−1) compared with the control group (50.12 ± 0.65 ng mL−1), whereas the levels of serum glucose in fish exposed to MS-222 significantly increased . The hsp70 mRNA expression in the liver of anesthetized yellow catfish was found to significantly upregulate after transportation . Thus, it is concluded that the effective concentrations of MS-222 for sedation and anesthesia in adult yellow catfish were from 90 to 110 mg L−1, and while 40 mg L−1 MS-222 has the potential to be used for the transportation of yellow catfish within 12 h.

Ashwagandha for reduced stress and anxiety

Ashwagandha for reduced stress and anxiety

Serum Cortisol Levels with Etomidate Induction: A Speculation That Needs To Be Reviewed.

Context:Hemodynamic stability during induction of anesthesia is always a concern for an anesthesiologist. Propofol remains the most popular induction agent with its favorable characteristics and few drawbacks like decrease in heart rate and blood pressure (BP). Although etomidate provides better hemodynamic stability, its use declined due to reports of adrenocortical suppression.Aims:We designed a study to compare the effect of anesthetic induction with etomidate versus propofol on serum cortisol levels and hemodynamics.Settings and Design:This was a prospective randomized double-blind comparative study.Subjects and Methods:Sixty ASA PS classes I and II patients scheduled for laparoscopic inguinal hernia repair under general anesthesia were included in the study. Thirty patients received propofol 2 mg.kg−1 and thirty, etomidate 0.3 mg.kg−1. Blood samples for serum cortisol were withdrawn preoperatively, immediate postoperatively, and 24 h after surgery. Vitals were monitored throughout.Statistical Analysis Used:All data are presented as mean ± standard deviation and proportions. Demographic data were analyzed by Student's t-test, and Chi-square test was used to analyze changes over time. The statistical software SPSS version 25.0 was used for data analysis.Results:Systolic blood pressure (BP), diastolic BP, and mean BP were more stable in the etomidate group compared to the propofol group. Serum cortisol levels before surgery in both the groups were within normal limits and comparable, followed by a significant decline in the etomidate group and rise in the propofol group in the immediate postoperative period. The levels in the third sample were comparable in both the groups.Conclusion:Etomidate offers superior hemodynamic compared to propofol. A decrease in serum cortisol level in the etomidate group was transient returning back to normal within 24 h.

Acute Effect of Resistance Exercise on Serum Cortisol and its Correlation to Blood Glucose in Healthy Non Obese Adults: A Pilot Study

Introduction: Different types and intensity of resistance training/ exercises lead to variable cortisol responses, which is essential for growth and homeostasis on short term and long term basis. But the variable responses are not accurately defined to be of any help in tailoring one’s exercise program. Aim: To study the effect of resistance exercise on serum cortisol and its correlation to blood glucose in healthy non obese subjects. Materials and Methods: It was an experimental analytical pilot study extending from February 2017-July 2018 involving 48 healthy non obese subjects (24 males and 24 females) of age group 18-25 years, were enrolled in the study after the screening protocol. High volume exercise training regimen was used involving major muscle group of arms, legs and trunk. Regime involved five exercises with three sets. Between each set, subjects took 30 seconds rest and with each exercise, a rest period of one minute. Height, weight were measured to calculate Body Mass Index (BMI) and serum blood glucose was done along with serum cortisol. Results: The serum cortisol levels in males in pre-exercise group was 145.47±33.67 μg/dL while postexercise group had 116.57±34.40 μg/dL reflecting moderately significant decrease (p<0.01). The serum cortisol levels in females in pre-exercise group were 141.83±38.38 μg/dL while in postexercise group 118.46±35.53 μg/dL with a moderately significant decrease (p<0.01). The Random Blood Sugar (RBS) levels in both males and females postexercise was significantly increased (p<0.05). There was decrease in serum cortisol levels in comparison to rise in RBS in both genders, a highly significant decrease (p<0.001) in males in comparison to moderately significant decrease (p<0.05) in females. Conclusion: Resistance exercise induced decrease in cortisol hormone and its interplay with serum glucose can be better understood by multivariate/elaborate studies on a large sample size.

The status of serum cortisol before and after treatment of schizophrenia and its correlation to disease severity and improvement: A longitudinal study.

Background:Hypothalamic–pituitary–adrenal axis functioning, with cortisol as its major output hormone, has been presumed to play a key role in the development of psychopathology of schizophrenia.Objective:We examined the association of serum cortisol with disease severity and improvement in schizophrenia patients in Jimma, Ethiopia.Method:A total of 34 newly diagnosed schizophrenics were included in this study. Data on demographic, behavioral, clinical state, serum cholesterol level, and antipsychotic usage were obtained at baseline and after 8 weeks. The Positive and Negative Syndrome Scale was used to assess psychotic symptoms severity. A paired sample t-test was used to compare baseline and post-treatment values. Linear regression was used to assess associations.Result:Post-treatment serum cortisol level was significantly lower than its baseline value (p = 0.001). There was also a significant positive and negative psychotic symptoms decrease after treatment (baseline positive psychotic vs post-treatment positive psychotic symptoms: t(33) = 6.24 (95% confidence interval = 7.03,13.84, p = 0.000) and (baseline negative psychotic vs post-treatment negative psychotic symptoms: t(33) = 4.21 (95% confidence interval = 3.82, 10.99, p = 0.000).At baseline, neither positive nor negative subscore on the Positive and Negative Syndrome Scale showed an association with serum cortisol level (B = −0.016, p = 0.794 and B = −0.032, p = 0.594). However, serum cortisol level showed strong associations with post-treatment positive sub scores and negative sub scores (B = 0.167, p = 0.007) and (B = 0.144, p = 0.010) on the Positive and Negative Syndrome Scale.Conclusion:We found a significant decrease in serum cortisol level after antipsychotics treatment and that was associated with improvement in psychotic symptoms in schizophrenics in Jimma, Ethiopia.

Anxiolytic effect of minocycline in posttraumatic stress disorder model of Syrian hamsters.

Objective:The objective was to study the anxiolytic effect of minocycline in resident–intruder social conflict in submissive hamsters post resident intrusion model using open field test (OFT) and elevated plus maze (EPM) and serum cortisol levels.Materials and Methods:Fifty-two singly housed male Syrian hamsters were used, post standardization of an animal model. Resident intrusion was done (5 min), in which smaller hamsters were placed in the cage of larger hamster, and the behavior of smaller hamster was noted. Eight submissive hamsters per group (disease control, lorazepam group as a positive control, and the test drug was minocycline) were used, and the drug was administered immediately post resident intrusion, intraperitoneally. Behavioral tests, namely OFT and EPM, were done followed by retro-orbital blood collection for serum cortisol estimation. The level of significance was set at P < 0.05.Results:The minocycline group showed a statistically significant decrease in serum cortisol levels compared to the disease control group. Among all the variables pertaining to both the behavioral tests, namely EPM and OFT, the results indicated an anxiolytic effect, which was statistically significant compared to the disease control group.Conclusion:As per the biochemical test using serum cortisol levels and behavioral tests in the form of EPM and OFT, the study concluded that the anxiolytic effect of minocycline is at least comparable to the positive control, lorazepam.

Effectiveness of Mind Body Intervention on Subfertile Females: An Approach to Accesses Oocyte Quality

Introduction: In recent times, there is a much greater emphasis on the physical causes of infertility so thatpsychological effects can be ignored. There are, of course, a number of physical and emotional factors thatcan induce infertility. Mind and body interventions are efficient in lowering psychological distress therebyincreases the ART success rate, fetal outcome by improving the psychological and physiological stress. Thepurpose of the current study is to assess the relationship between effect of mind body intervention and serumcortisol level and oocyte quality.Aim and Objectives: To study the effectiveness of mind body intervention on oocyte quality and serumcortisol level in subfertile females.Materials and Method: This study is done in wardha test tube baby centre AVBRH (SAWANGI) WARDHARelevant data on the demographics and treatment history as well as the indications for IVF treatment willbe recorded. Serum cortisol level of all participant were analysed and then stimulated using a routine shortantagonist protocol.Observation and Result: From total recruited patient, one didn’t attended intervention program at all. Fourpatients attended intervention program from 4 to 6 week in discontinuation manner. Eight patients attendedup to 70% to 90% of intervention program and remaining 24 patients attended complete 10 week mind bodyintervention program. In group of 7 to 9 week intervention 6 patient out of 8 showed decrease in serumcortisol level. Patient who attended complete 10 weeks intervention they are showing significant decrease inserum cortisol level. From 40 patient, 24 attended complete 10 week mind body intervention, among them16(66%) gave positive response to mature oocyte retrieval.Discussion: In this research, a mind body intervention on subfertile females was created and to see theirresponse to mature oocyte in IVF study. Study revealed that, there were very few studies examined the roleof cortisol in relation to M II oocyte and finally clinical pregnancy outcomes. Two studies reported thatpregnancy rates were enhanced by adopting the MBI. This is in support to our study.Conclusion: This study concludes that, thereis direct correlation of serum cortisol level andoocyte quality and Mind-Body intervention iskey factor to improve oocyte quality

Acute response of serum cortisol to different intensities of resisted exercise in the elderly

BackgroundCortisol has a main role in stress response and high stress can affect the psychological and physical performance in the elderly.AimTo determine the acute response of serum cortisol to different intensities of resisted exercise in the elderly.Patients and methodsA total of 60 elderly patients from both sexes (60–70 years) were equally and randomly assigned to three resistive training bouts: low-intensity (group A, 30% of 1RM), moderate-intensity (group B, 50% of 1RM), and high-intensity (group C, 80% of 1RM) with a 90–120 s rest period between sets. Blood samples that were analyzed included serum cortisol hormone before and 15 min postintervention.ResultsThere was a statistically significant decrease in serum cortisol level in groups A and B at postintervention when compared with the preintervention value, while group C showed an insignificant difference.ConclusionIn a sample of elderly patients undergoing three bouts of different intensities of resisted exercise, a low to moderate resisted exercise was superior to high intensity in decreasing the serum cortisol and consequently less stress post-exercise.

Elevated lead levels from e-waste exposure are linked to sensory integration difficulties in preschool children

Exposure to lead is associated with adverse effects on neurodevelopment. However, studies of the effects of lead on sensory integration are few. The purpose of this research is to investigate the effect of lead exposure on child sensory integration by correlating the blood lead levels of children with sensory processing measures. A total of 574 children, from 3 to 6 years of age, 358 from an electronic waste (e-waste) recycling town named Guiyu, and 216 from Haojiang, a nearby town with no e-waste recycling activity, were recruited in this study. The median blood lead level in Guiyu children was 4.88 μg/dL, higher than the 3.47 μg/dL blood lead level in Haojiang children (P < 0.001). 47.2% of Guiyu children had blood lead levels exceeding 5 μg/dL. The median concentration of serum cortisol, an HPA-axis biomarker, in Guiyu children was significantly lower than in Haojiang, and was negatively correlated with blood lead levels. All subscale scores and the total score of the Sensory Processing Measure (Hong Kong Chinese version, SPM-HKC) in Guiyu children were higher than Haojiang children, indicating greater difficulties, especially for touch, body awareness, balance and motion, and total sensory systems. Sensory processing scores were positively correlated with blood lead, except for touch, which was negatively correlated with serum cortisol levels. Simultaneously, all subscale scores and the total SPM-HKC scores for children with high blood lead levels (blood lead > 5 μg/dL) were higher than those in the low blood lead level group (blood lead < 5 μg/dL), especially for hearing, touch, body awareness, balance and motion, and total sensory systems. Our findings suggest that lead exposure in e-waste recycling areas may result in a decrease in serum cortisol levels and an increase in child sensory integration difficulties. Cortisol may be involved in touch-related sensory integration difficulties.

Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation.

Context:Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia.Aim:The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA) during lengthy periodontal surgical procedures.Settings and Design:This was a randomized, split-mouth, cross-over study.Materials and Methods:A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS) was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures.Statistical Analysis Used:Paired t-test and repeated measure ANOVA.Results:The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation.Conclusion:Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.

Effect of intranasal dexamethasone on endogenous cortisol level and intraocular pressure.

Medical treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP) centers on the administration of steroids. High-dose topical nasal steroids (HDTNS) have shown promising results with less systemic effects than oral steroids. One promising HDTNS is 0.132% dexamethasone nasal spray. We investigated whether intranasal dexamethasone was associated with changes in serum cortisol and/or intraocular pressure (IOP). Patients with CRSwNP were treated with dexamethasone sodium phosphate 0.132% nasal spray twice daily. Morning serum cortisol and IOP were checked after at least 6 weeks of therapy. Twenty-eight patients met study criteria. The average serum cortisol level after at least 6 weeks of therapy (average duration of 38.3 weeks) was 9.8 μg/dL (normal range, 4 to 22 μg/dL). Ten patients had suppressed cortisol levels (average, 2.5 μg/dL). Ten patients underwent IOP measurements and none revealed ocular hypertension on tonometry. High-dose dexamethasone nasal spray given for a period of at least 6 weeks does appear to have the potential to cause a decrease in serum cortisol levels; however, future studies with greater power are necessary to support this claim. Additionally, similar administration of high-dose dexamethasone nasal spray did not reveal IOP diagnostic of ocular hypertension on single-measurement tonometry readings.

Bolus administration of steroid therapy is more favorable than the conventional use in preventing decrease of bone density and the increase of body fat percentage in patients with inflammatory bowel disease

IntroductionThe effects of short course of corticosteroids on the metabolic processes and bone formation has not been well studied. Our aim was to compare the efficacy, the side effects and the bone and lipid metabolisms in IBD patients using bolus or conventional tapering of methylprednisolone for 12weeks. Patients and methodsNineteen IBD patients received intravenous methylprednisolone of 1mg/kg for 5days tapered by 4mg per week. Patients were prospectively randomized in two groups. In “conventional” group (I) steroids were given daily. In “pulse” group (II) weekly doses of steroids were given on special days of the week. The body mass index (BMI) was measured before and after the corticosteroid therapy. Blood samples were collected to assess glucose level, electrolytes, cholesterol and triglyceride levels, inflammatory parameters, cortisol, osteocalcin and crosslaps values. Total body composition analysis was performed at the beginning and at the end of the steroid therapy. ResultsIn Group I, BMI increased, total body bone density decreased significantly at the end of the steroid therapy. Body fat percent showed a tendency to be higher at the end of steroid therapy in Group I. Cholesterol level increased significantly in Group I patients. The decrease in serum cortisol level was more remarkable in Group I vs. Group II after steroid therapy. Less side-effect occurred in Group II vs. Group I. DiscussionOur results suggest that bolus tapering of corticosteroids may have more favorable short term outcome than conventional tapering that may revolutionize steroid therapy in IBD.

The behavioral therapy for separation anxiety in dog

The puppies develop attachment to their mother between 3 and 12 weeks. In order to avoid the stress of separation from the mother, the separation should occur around the age of 3 weeks but not later than 6-7 weeks. If the separation is done after 12 weeks is already hard to avoid separation anxiety. At the time of separation from the mother, the puppies consider their master as their family, and when separation from them occur the puppy can experience different degrees of stress that can lead to separation anxiety syndrome. Biological material studied was represented by 112 dogs, of which 42 dogs were diagnosed with separation anxiety syndrome from that we formed a group of 12 dogs whose owners were actively involved in their treatment, and a major role lies in detachment therapy. As working methods were used: ethology consultation, evaluation grid for emotional and cognitive disorders in dogs, questionnaires for owners, observation sheet and statistical data processing. Using behavioral therapy as a method of treatment of separation anxiety in dogs caused a decrease in serum cortisol levels, total erythrocytes, total cholesterol, a slight increase in total leukocytes and magnesium levels, aspects which reveal therapeutic success. Treatment of separation anxiety in dog with behavioral modification techniques gave good results, having a working protocol reliable and easy to apply. In separation anxiety there is no partial recovery.

Nutritional Supplements and its Effect on Quality of Life and Sleep

Problem statement: Inadequate sleep has been recognized as a risk factor for poor health status. Mental stress, body pains, melatonin deficiency, late night awakening disturbing the body clock are triggers for poor quality of sleep and fatigue. Fatigue due to insomnia is a major cause for poor quality of life. Evidences suggest certain nutrients to exert profound influence on quality of sleep which in turn could affect quality of life. In the present study we examine to study the effects of food and nutrients on sleep and quality of life. Approach: 800 subjects were screened for sleep quality and presence of insomnia out of which, 34 subjects of both sexes aged 21-45 years included for the “Nutrition Intervention Study”. Nutrients and food components were assessed by three days Diet Diary Method and Sleep quality was assessed by Sleep Behavior and Insomnia Screening Questionnaire (ISQ) as well as the Pittsburgh sleep quality index. Blood and urine parameters were examined by standard methods. A prepost assessment method was adopted. Subjects were assessed for blood parameters like-serum cortisol, vitamin B12, ferritin, iron and magnesium; urine profile included was pH and Sp.Gr. Intervention period was 15 days and subjects were divided in to three groups depending upon criteria of diagnosis, i.e., Gr.1, subjects (n = 12) with low serum B12 levels, who were given B12 injections. Gr. 2(n = 12) and Gr. 3: (n = 10) subjects respectively were provided with beet root and poppy seeds drinks to be consumed every night (4 h before bed time). Results: Beet root consumption increased the ferritin level. B12 level increased significantly with beet root powder intervention. B12 supplementation effectively increased (from 152.87±23.9-1375.6±804.4 pg mL-1) serum levels of this vitamin and the difference was extremely significant statistically (p<0.01). It was highly encouraging to note a significant reduction in cortisol levels with B12 supplementation within a period of 15 days. Mean value of ferritin increased after poppy seed intervention; this improvement can be attributed to the iron content of poppy seed. A decrease in serum cortisol level was also noted, the mean levels before and after intervention being 16.6±3.4-11.7±2.5 mcg dL-1 affect a mean reduction of 4.9 mcg dL-1, although a striking difference was observed, it was statistically not significant. The maximum improvement in insomnia was found with poppy seed drink (63.6%) followed by beet root drink and B12 supplementation which varied from 54.6 and 33.4% respectively. Improvement of anxiety as a factor affecting insomnia was noted in 20% of subjects in B12 and 66.6% in beetroot drink supplementation groups. It was encouraging to witness a 100% improvement in the group with poppy seed intervention. Significant improvement was noted in the Circadian rhythm disorder in all intervention groups Parasomnia and Restless Leg Syndrome (RLS) recovery was seen in all the intervention groups while highest proportion RLS improvement was noted in B12 group. (Please give data) Significant improvement was seen in sleep quality among all the intervention groups administered either vitamin B12, or beet root or poppy seeds. Marked reduction in co-morbid symptoms like fatigue, memory function and improvement in scores for quality of life was observed. Conclusion: Nutritional supplements appear to be effective in improving sleep quality which might influence quality of life.

Slaughter value, meat quality, creatine kinase activity and cortisol levels in the blood serum of growing-finishing pigs slaughtered immediately after transport and after a rest period

The experimental materials comprised 44 hybrid [female (Polish Large White x Polish Landrace) x male Duroc] growing-finishing pigs. The animals were randomly divided into two groups: 24 pigs were slaughtered immediately after transport and 20 pigs were slaughtered after a 24-hour rest period in the lairage. The meat content of pork carcasses, carcass dressing percentage, the proximate chemical composition, physicochemical and sensory properties of meat and shear force values were determined. Serum creatine kinase activity and cortisol levels were determined in blood samples collected before transport and during carcass bleeding. Pigs slaughtered immediately after transport, compared with those slaughtered after a 24-hour rest period, were characterized by a higher meat content of the carcass and a higher carcass dressing percentage. Pre-slaughter handling had no effect on pork quality. The incidence of normal-quality meat, partially PSE (pale, soft, exudative) meat and PSE meat was similar in both groups. Chemical analysis showed that the content of dry matter, total protein, fat and minerals in meat was comparable in both groups. As regards the functional properties of the pork, samples from the carcasses of pigs that had rested before slaughter had a higher contribution of the red color component. Meat from pigs slaughtered immediately after transport had more desirable sensory properties. Pre-slaughter resting had a significant effect on those analyzed physiological parameters which were found to be good indicators of pre-slaughter stress. Serum creatine kinase activity and cortisol levels were higher in blood samples collected after transport (during carcass bleeding) than in samples collected before transport, pointing to a strong stress response of animals to pre-slaughter treatment. The decrease in serum cortisol levels in blood samples collected during bleeding from the carcasses of pigs slaughtered after a 24-hour rest period, compared with samples collected from animals slaughtered immediately after transport, suggests that rest before slaughter alleviated stress induced by pre-slaughter handling operations.

MEGESTROL ACETATE USE FOR ANOREXIA IN THE OLDER SUBJECT

To the Editor: I read with interest the recent article1 on the posthospitalization use of megestrol acetate suspension in older subjects with decreased appetite. Despite the use of megestrol in older subjects with weight loss, the data supporting its use in this population are limited. A previous study2 published in this Journal in 2000 showed no difference with the use of 800 mg/d megestrol suspension in a Department of Veterans Affairs nursing home at 12 weeks. At 3 months, there was an increase of 4 or more pounds in 61.9% of the patients treated with megestrol, compared with 21.7% for placebo. The increase was mostly in body fat and not in lean body mass. A small study,3 which lacked a placebo arm, showed a weight change of −3% to +11.3% 2 months after completion of a 28-day course of 480 mg megestrol acetate. A letter published in 1995 discussed four subjects and examined some inflammatory markers as well.4 A retrospective study examined deep vein thrombosis (DVT) incidence with megestrol use in a nursing home setting, but there was no control group.5 In a small retrospective study, there was an association with an increase in DVT risk with megestrol acetate as well.6 The exclusion of 99.3% of the subjects assessed at the start of the study limited the generalizability of the present study. Block randomization could have prevented the confounding effect of site of discharge. This trial had six primary (three for benefit and three for risk) and four secondary outcomes spread across four different groups. The only positive outcome was the higher prealbumin in the 400/mg/d group at Day 63 when compared with placebo. Was there a correction for the baseline difference in prealbumin (24.3 vs 18.3)? The development of two DVTs with one pulmonary embolism is troubling (Fischer exact test not significant), as is the decrease in serum cortisol level (statistically significant). Even though none of the subjects developed symptoms of adrenal insufficiency, addition of a stressor (e.g., infection) in this frail malnourished group may precipitate it. The consumer price of $4,750 per year (for the 800-mg suspension) is a barrier as well. An adequately powered study in older subjects, examining not only surrogate nutritional outcomes, but also the effect on mortality, health-related quality of life, and infections as primary outcomes would be helpful. Financial Disclosure: The author has no financial disclosure to report or any conflict of interest in regard to this manuscript. Author Contributions: Anupam Suneja was the sole author of this manuscript. Sponsor's Role: No sponsors.

Effects of cortisol administration on hepatic circulation during brain death in rabbits

Background. Hemodynamic instability and endocrinologic alterations during brain death contribute to dysfunction of donor organs. The present study was conducted to examine the effect of cortisol administration on hepatic circulation in brain-dead hypotensive donors. Methods. Brain death was created by inflating a balloon catheter inserted into the epidural space in rabbits. In another set of experiments, non-brain-dead rabbits were bilaterally adrenalectomized. At 1 hour of equilibration after brain death or adrenalectomy, cortisol at a dose of either 0.05 or 5 mg/kg/hr was given intravenously for 5 hours. Results. The induction of brain death resulted in a significant decrease in mean arterial pressure (MAP), whereas MAP after adrenalectomy was maintained. Both brain death and adrenalectomy caused an approximately 40% decrease in the portal vein blood flow (PVF) and hepatic tissue blood flow (HTF) and a significant increase in serum hyaluronic acid (HA) level as well as alanine aminotransferase (ALT) level. These changes were associated with a substantial decrease in serum cortisol level. Transmission electron microscopic examination showed swollen Kupffer cells with phagocytosis. Cortisol supplement after brain death or adrenalectomy significantly increased PVF and HTF to prevalues without affecting MAP. Both dosing rates of cortisol also significantly decreased serum HA and ALT levels and attenuated Kupffer cell activation. Conclusions. These results suggest that cortisol administration exhibits beneficial effects on hepatic circulation in hemodynamically unstable brain-dead animals. (Surgery 2002;131:450-62.)