Decrease In Cortisol Levels Research Articles

Safety and efficacy of a COVID-19 treatment with nebulized and/or intravenous neutral electrolyzed saline combined with usual medical care vs. usual medical care alone: A randomized, open-label, controlled trial.

Coronavirus disease 2019 (COVID-19) is currently the major public health problem worldwide. Neutral electrolyzed saline solution that contains reactive chlorine and oxygen species may be an effective therapeutic. In the present study, the treatment efficacy of intravenous and/or nebulized neutral electrolyzed saline combined with usual medical care vs. usual medical care alone was evaluated in ambulatory patients with COVID-19. A prospective, 2-arm, parallel-group, randomized, open-label, multi-center, phase I-II clinical trial including 214 patients was performed. The following two outcomes were evaluated during the 20-day follow-up: i) The number of patients with disease progression; and ii) the patient acceptable symptom state. Serial severe acute respiratory syndrome coronavirus 2 naso/oro-pharyngeal detection by reverse transcription-quantitative (RT-q) PCR was performed in certain patients of the experimental group. Biochemical and hematologic parameters, as well as adverse effects, were also evaluated in the experimental group. The experimental treatment decreased the risk of hospitalization by 89% [adjusted relative risk (RR)=0.11, 95% confidence interval (CI): 0.03-0.37, P<0.001] and the risk of death by 96% (adjusted RR=0.04, 95% CI: 0.01-0.42, P=0.007) and also resulted in an 18-fold higher probability of achieving an acceptable symptom state on day 5 (adjusted RR=18.14, 95% CI: 7.29-45.09, P<0.001), compared with usual medical care alone. Overall, neutral electrolyzed saline solution was better than usual medical care alone. Of the patients analyzed, >50% were negative for the virus as detected by RT-qPCR in naso/oro-pharyngeal samples on day 4, with only a small number of positive patients on day 6. Clinical improvement correlated with a decrease in C-reactive protein, aberrant monocytes and increased lymphocytes and platelets. Cortisol and testosterone levels were also evaluated and a decrease in cortisol levels and an increase in the testosterone-cortisol ratio were observed on days 2 and 4. The experimental treatment produced no serious adverse effects. In conclusion, neutral electrolyzed saline solution markedly reduced the symptomatology and risk of progression in ambulatory patients with COVID-19. The present clinical trial was registered in the Cuban public registry of clinical trials (RPCEC) database (May 5, 2020; no. TX-COVID19: RPCEC00000309).

Therapeutic Riding or Mindfulness: Comparative Effectiveness of Two Recreational Therapy Interventions for Adolescents with Autism.

Therapeutic riding (THR) and HeartMath (HM) mindfulness-based interventions have promise for reducing stress in adolescents with autism spectrum disorder. In three 10-week periods, this study compared THR, HM, and control on salivary cortisol, self-reported stress, parent-reported social responsiveness, and heart-rate variability. This crossover design included 27 participants (12–21 years) randomly assigned to order of intervention. Findings suggest that HM and THR manualized protocols are equally beneficial in decreasing cortisol levels immediately following a session, but HM sessions had more impact on heart-rate variability. There was no significant effect on follow-up cortisol levels within a week after either intervention, but THR had more impact on decreasing some self-reported stressors.

Dysregulated by stigma: Cortisol responses to repeated psychosocial stress in gay and heterosexual men

BackgroundResearch on pathways linking stigma with health inequalities affecting sexual minority populations, focused predominantly on exploring the hypothalamic-pituitary-adrenocortical (HPA) dysregulation profiles associated with chronic stress. One of such profiles reflecting a state of increased susceptibility to disease, and not yet studied among sexual minority individuals, is impaired habituation to repeated stress of the same type. In this study we explored whether sexual identity modulates endocrine stress responses and stress responses habituation in healthy heterosexual and gay men. We also explored the associations between perceived sexual minority stigma and cortisol response to stress in the latter group. MethodsGay (N = 49) and heterosexual (N = 40) men, aged 24.4 years, were confronted twice with the Trier Social Stress Test and provided 5 salivary cortisol samples for each of the two testing sessions. A multilevel mixed-effects approach was used to model the cortisol curve throughout the two-day procedure. Habituation to repeated stress was conceptualized as the decrease in the total cortisol levels as well as the change in the cortisol curvilinearity between the first and the second testing session. ResultsGay participants were characterized by significantly higher cortisol levels throughout both laboratory visits. Their cortisol levels were also predicted by perceived rejection from family due to minority sexual identity, and stigma-related vicarious trauma. Although neither group showed habituation defined as the decrease in cortisol level, the shape of the cortisol curve changed between both visits only in the heterosexual participants. ConclusionsIncreased cortisol levels observed in gay men are predicted by minority stressors. Combined with non-habituation, the upregulation of the HPA axis may constitute a physiological pathway linking stigma to adverse health outcomes.

Effect of two hypercaloric diets on the hormonal and metabolic profile of the adrenal gland.

Who disrupts who? It is not clear what the interaction is between a high calorie diet (HCD) and adrenal axis activation in obesity. The goal was to assess the effect of two hypercaloric diets commercialized in Algeria on the hormonal and metabolic profile of the adrenal gland in rabbits. Two classes of local male adult rabbits (n=16) and a finishing diet (FD) as a control for 15weeks. It has been shown that HCD-received animals have developed visceral obesity, dyslipidemia and insulin resistance IR by dramatically increasing body weight, visceral fat tissue and adrenal weight, combined with elevated plasma levels of ACTH, cortisol, leptin and insulin. The HCD diet increased the levels of cortisol in the visceral adipose tissue (VAT), in peri-adrenal adipose tissue (PAAT), and decreased cortisol levels in the liver. HCD also causes the process of inflammatory fibrosis associated with the migration and spread of chromaffin cells in the adrenal gland. This study gives new insights into how diet-induced obesity studied on local rabbits affects the biology of the adrenal gland. The correlation of these changes with paracrine connections between the chromaffin cell and glomerulosa indicates potential therapeutic methods for obese-related steroid hormone dysfunction.

Severe Cushing Syndrome Due to Ectopic ACTH Secretion by Pheochromocytoma

Introduction: Ectopic ACTH production is a very unusual cause of Cushing Syndrome (CS). When it occurs, lung cancer is the main cause. Very rarely, this ectopic source of ACTH can arise from a Pheochromocytoma (Pheo). A recent literature review identified less than 100 cases described. We present a case of 28 years old woman who was referred for adrenalectomy for CS with notorious adrenal mass. However, during the investigation, ectopic ACTH due a Pheo was identified. Case Report: A 28-year-old woman required emergency care for ecchymosis and asymptomatic hypertension (BP: 230x130mmHg). Hyperpigmentation of the skin was evident on physical examination. Severe hypokalemia (K: 2.5mEq/liter) was detected. She denied taking any medication and was unaware of any previous illness. She always had normal BP measurements as well as laboratory tests. No family history of adrenal disease or secondary hypertension causes. During hospitalization, the hypothesis of CS was made and confirmed after: cortisol after 1mg dexamethasone: 44.5mcg/dl (<1.8mcg/dl) and 24h urinary free cortisol: 6228 mcg/dl (28-213mcg/dl). Concomitantly, a CT scan of the abdomen exhibited a left adrenal mass (3.1x2.8x3.5cm) of uncertain etiology and ACTH: 352pg/ml (<46pg/ml). Additionally, the patient presented hyperglycemia during hospitalization. After confirmation of the ACTH dependent CS, pituitary MRI was performed with normal results and a chest CT scan ruled out lung masses. As there was still no etiological confirmation and due to clinical deterioration, it was decided to start Ketoconazole 200mg/day, rising until 600mg and spironolactone with doses up to 250mg/day with a significant improvement in hypokalemia, decreased cortisol levels and optimal BP control. Due to the extremely high levels of ACTH and indeterminate adrenal mass, the hypothesis of ACTH ectopic due Pheo was postulated. Patient underwent abdomen MRI with left adrenal mass with hypersignal at T2 and urinary metanephrines levels: 6132mcg/24h (<289mcg/24h), urinary normetanephrines: 1808mcg/24h (<732mcg/24h). Once the diagnosis was elucidated, she received preoperative preparation with alpha blocker (Doxazosin) and underwent adrenalectomy without complications. After discharge, she received prednisone 10mg/day. The patient presented normalization of BP levels, as well as glycemic control with a slight improvement in skin hyperpigmentation. The pathology department confirmed Pheo and an ACTH expression was observed in immunohistochemistry. A genetic panel for Pheo is running with no results so far. Conclusion: Despite an extremely rare cause of CS, the ectopic production of ACTH by a Pheo has extremely high mortality rates, especially when not diagnosed or managed correctly. The clinicians must always remain alert and suspect this syndrome when the patient has a confirmed ACTH dependent CS associated with adrenal masses.

369 Insomnia with objective short sleep duration is associated with increased cortisol in patients with Mild Cognitive Impairment

Abstract Introduction Mild cognitive impairment (MCI) is frequent in the elderly and is in a continuum with dementia in a significant amount of people. Both insomnia and increased cortisol levels have been suggested as risk factors for MCI. The goal of this study was to examine whether activation of the hypothalamic-pituitary-adrenal (HPA) axis, as measured by plasma cortisol levels, is associated with the insomnia with short sleep duration (ISS) phenotype, as measured by actigraphy, in elderly with MCI. Methods A sub-sample of 109 subjects with MCI and 92 cognitively non-impaired controls 60 years or older (75.37±6.54y) was recruited from a population-based cohort residing on Crete, Greece. Subjects underwent medical history, physical examination, neuropsychiatric evaluation, neuropsychological testing, 3-day 24-h actigraphy, assessment of subjective insomnia symptoms (i.e., difficulties initiating and/or maintaining sleep), and a morning blood draw to assay for plasma cortisol levels. The ISS phenotype was defined by the presence of at least one insomnia symptom and an actigraphy-measured sleep efficiency below the median of the entire sample (i.e., ≤81%). Group differences in plasma cortisol levels between MCI subjects with and without the ISS phenotype were tested using ANCOVA adjusting for age, gender, BMI and depression. Results Subjects with MCI had higher cortisol levels compared to controls (105.34±9.34 vs. 70.3±10.02 nmol/L, p&amp;lt;0.05). Subjects with MCI and the ISS phenotype (138.38±16.57 nmol/L) had significantly higher cortisol levels compared to those without insomnia (97.74±19.68 nmol/L) or those with insomnia and normal sleep duration (INS; 79.97±16.02 nmol/L, p=0.044). The association between the ISS phenotype and cortisol levels was modified by amnestic symptoms (p-interaction=0.079); commensurate, the ISS phenotype was associated with higher cortisol levels among the amnestic MCI subgroup (INS: 79.12±21.93 vs. ISS: 155.55±20.40 nmol/L, p=0.040), but not among the non-amnestic MCI subgroup (INS: 64.06±23.62 vs. ISS: 89.33±29.00 nmol/L, p=0.559). Conclusion The ISS phenotype is associated with increased cortisol levels in elderly with MCI, particularly those with amnestic type. Improving sleep quality, decreasing cortisol levels and lengthening sleep duration may slow down the progression of these individuals into dementia. Support (if any) National Strategic Reference Framework(NSRF), Program: THALES entitled “UOC-Multidisciplinary network for the study of Alzheimer’s Disease” Grant Cod:MIS 377299

Green space, air pollution, traffic noise and saliva cortisol in children: The PIAMA study.

At age 12 years, 1,027 participants of the Dutch PIAMA birth cohort collected three saliva samples during 1 day. We estimated residential exposure to green space (i.e., the average Normalized Difference Vegetation Index [NDVI] and percentages of green space in circular buffers of 300 m and 3,000 m), air pollution, and traffic noise. Associations of these exposures with the diurnal cortisol slope (in nmol/L per hour) were assessed by multiple linear regression, adjusting for potential confounders. Higher average NDVI and total percentage of green space in a 3,000 m buffer were associated with a larger diurnal decrease in cortisol levels (adjusted difference [95% confidence interval] = -0.11 nmol/L/hr [-0.21, 0.00 nmol/L/hr] per interquartile range increase in the average NDVI; -0.13 nmol/L/hr [-0.26, 0.00 nmol/L/hr] per interquartile range increase in the total percentage of green space). These associations were largely driven by associations with the percentage of agricultural green space and by associations in children living in nonurban areas. We observed no relationships between air pollution or traffic noise and the diurnal cortisol slope. Residential exposure to green space in a buffer of 3,000 m may be associated with lower stress levels in children 12 years of age.

Dehydroepiandrosterone sulfate (DEHA-S), cortisol and adrenocorticotropic hormone (ACTH) levels in drug-naive, first episode patients with psychosis

IntroductionImpaired response to stress and a pathological activation of the hypothalamic-pituitary-adrenal axis have been implicated in the pathophysiology of schizophreniaObjectivesTo measure serum ACTH, cortisol and DEHA-S levels in drug-naïve, first-episode patients with psychosis.MethodsResults are reported as mean (standard deviation, range). Paired t-test or Wilcoxon signed rank test were performed for group comparisons. The level of significance was set at p-value&lt;0.05. Statistical analysis was performed with Stata 15.1.ResultsData were included for 110 subjects (70 men, 40 women); 55 patients and 55 controls matched for age and sex. Mean age was 31.3 years (8.7, 18-48) in patients and 31.4 years (8.9, 17-49) in controls. Serum cortisol and Cortisol/DHEA-S ratio were statistically significantly lower in patients [12.6μg/dl (4.5, 3.5-24.5) and 5.3 (3.6, 1.3-19.5), respectively] compared to controls [15.5 μg/dl (4.9, 4.2-30.1) and 8 (4.7, 1.1-25.5), respectively] (p-value=0.0068 and 0.0005, respectively). Additionally, serum DHEA-S was statistically significantly higher in patients [306.5 μg/dl(165.4, 70-790)] compared to controls [240.1 μg/dl(113.5, 46-597)] (p-value=0.0114). ACTH was also higher in patients [28.5 pg/ml(15.7, 6.2-73.9)] than controls [26.5 pg/ml (15.3, 7-70.5)] but this difference wasn’t statistically significant (p-value=0.6359).ConclusionsWe report elevated DEHA-S, decreased cortisol levels and decreased cortisol/DEHA-S ratio in the patients’ compared to the controls’ group.DisclosureNo significant relationships.

Acute Impact of Mindfulness Meditation on Cognitive Performance

The beneficial effects of mindfulness meditation on higher-order cognitive performance as well as physiological parameters, such as decreased cortisol levels, blood pressure, pulse rate, and reaction time, have been studied extensively. However, most of these studies have been conducted over a relatively long term, comparing subjects who meditate on a regular basis with those who have never meditated. In this study, the acute effects of mindfulness meditation are investigated by examining the differences between tactile reaction time and temporal-order judgement (TOJ) obtained before and after a 10-minute meditation session in several case studies. Additionally, the participants reported their mood and stress levels in a survey before and after the meditation session. The results demonstrate that mindfulness meditation improves performance on the tactile reaction time and TOJ tasks, and it also promotes a peaceful state of mind.

Maternal experiences of childhood maltreatment moderate patterns of mother-infant cortisol regulation under stress.

The relation between maternal and infant cortisol responses has been a subject of intense research over the past decade. Relatedly, it has been hypothesized that maternal history of childhood maltreatment (MCM) impacts stress regulation across generations. The current study employed four statistical approaches to determine how MCM influences the cortisol responses of 150 mothers and their 4-month-old infants during the Still-Face Paradigm. Results indicated that MCM moderated cortisol patterns in several ways. First, lower MCM mothers and infants had strong positive associations between cortisol levels measured at the same time point, whereas higher MCM mothers and infants did not show an association. Second, infants of higher MCM mothers had cortisol levels that were moderately high and remained elevated over the procedure, whereas infants of lower MCM mothers had decreasing cortisol levels over time. Third, higher MCM mothers and infants showed increasingly divergent cortisol levels over time, compared to lower MCM dyads. Finally, patterns of cross-lagged influence of infant cortisol on subsequent maternal cortisol were moderated by MCM, such that lower MCM mothers were influenced by their infants' cortisol levels at earlier time points than higher MCM mothers. These findings highlight MCM as one contributor to processes of stress regulation in the mother-infant dyad.

Potential benefit of I-Tiao-Gung (Glycine tomentella) extract to enhance ornamental fish welfare during live transport

Multiple stressors associated with live fish transport, such as shaking, packing, hyper‑oxygenation, and cold stress, present a growing concern for fish welfare. The current study was designed to evaluate the fish welfare promoting effects of I-Tiao-Gung extract (Glycine tomentella, GTE), an extract derived from a Chinese herb, during live transport of blood parrot cichlid (Amphilophus citrinellus x Cichlasoma synspilum) and koi (Cyprinus carpio). The study analyzed plasma electrolytes, glucose, lactate, and cortisol levels from blood of both fishes during simulated transport. Results showed that adding GTE in water significantly decreased cortisol levels in blood parrot cichlid after 2–6 h and in koi after 4–6 h of simulated transport, respectively. Levels of glucose, lactate, and K+ in blood parrot cichlid began to elevate significantly between 2 and 6 h under stress. While levels of blood Na+, Ca2+ and lactate of koi significantly increased after simulated transport. Interestingly, Cl− levels were depressed significantly upon stress in both fishes. An indirect approach using ventilation frequency (VF) to gauge metabolism was taken to assess the physiological effects. VF was significantly slower in blood parrot cichlid after GTE addition comparing to that of the control group, but the effect was not significant in koi. Therefore, addition of GTE mitigated transport stress responses in both ornamental fishes through down-regulation of cortisol; thereby, promoting fish welfare during live transport.

Does Hypnofertility-Based Nursing Care Affect Cortisol Levels, Fertility Preparedness, and Pregnancy Outcomes in Women Undergoing In Vitro Fertilization? A Randomized Controlled Trial

This study used Hypnofertility-based interventions to determine whether these interventions would lead to increased fertility preparedness and pregnancy outcomes and decreased cortisol levels in women undergoing In Vitro Fertilization (IVF) treatment. This randomized, controlled, prospective study was conducted from November 2017 through March 2019 in 61 Turkish women with unexplained infertility (intervention group: 30, control group: 31). Hypnofertility-based nursing care included affirmations, visualization, imagination, and relaxation from the first day of treatment until the day of the pregnancy test. The Fertility Preparedness Scale, a saliva sample for cortisol level, and the pregnancy test results were used for data collection. Hypnofertility-based nursing care decreased the cortisol levels of women in the intervention group compared to that in the control group (p = 0.00). Though fertility preparedness was higher in the intervention group, the difference was not statistically significant (p = 0.13). Although interventions relieved the women during the treatment process, there was no anticipated effect on pregnancy outcomes (p = 0.75). Hypnofertility-based nursing care significantly reduce the cortisol levels, suggesting that the intervention helped women relax.

PSIII-23 Effect of feed antioxidants on behavior and stress resistance of fattening pigs

Abstract Antioxidants application (selenium, vitamin E and flavonoids) in pig diets provides solving the problem of oxidative stress effects. The research aims to study the efficiency of supplement Taxifolin feeding to reduce the stress effects. Experiments were performed using crossbred [(BWxL)xD] pigs (BW1=34.5–34.9 kg, N=36, n = 9) during the fattening period. Animals were allocated to 4 groups: 1 – control (standard forage – SF, without stress – STR-), 2 – control (SF, STR+), 3 – experimental (SF+0.2 mg kg Se, STR+), 4 – experimental group (SF+32 mg kg TAX, STR+). The animals were kept for 3 heads in a stall and to simulate technological stress, they were rotated within the 2nd, 3rd, and 4th groups every 14 days. The incidence of animal anxiety was directly dependent on the recorded acts of aggression (17%; 29%; 29%; 25% &amp; 8%; 27%; 35%; 30% of the total incidence, according to the experimental groups). In general, for the whole fattening period, the average daily gain increase by 1,6% was recorded in the fourth experimental group compared to the first control group (1012.1±43.5 vs. 996.4±32.8 g, P &amp;gt; 0.5). The Taxifolin effect was manifested as an “adaptive factor” to external stimuli under simulated stress, and contributed to a decrease in cortisol level in the animals’ blood at the end of the experiment (215±53 vs. 309±107, 294±111, 305±61 nmol/l, P &amp;gt; 0.5). At the end of the experiment pigs fed with Taxifolin had the higher lysis rate by 19.2% (42.0±4.8 vs. 22.8±2.5, P &amp;lt; 0.5), the lysozyme content in the blood serum – by 0.35 µg/ml (0.79±0.10 vs. 0.44±0.04 µg/ml, P &amp;lt; 0,5) compared to the control. Consequently, stressors prevention by using natural antioxidants (bioflavonoids) is justified. The work was supported by the grant No. 19-16-00068 of the Russian Science Foundation and GZ АААА-А18-118021590136-7.

Osilodrostat: A Novel Steroidogenesis Inhibitor to Treat Cushing's Disease.

To review data on efficacy and safety of osilodrostat (Isturisa), a novel oral steroidogenesis inhibitor for treatment of Cushing's disease (CD), a life-threatening endocrine disorder. A PubMed/CINAHL search from inception to September 25, 2020, was performed using the following keywords: osilodrostat, 11-beta hydroxylase, pituitary, ACTH hypersecretion, and Cushing's disease. Phase 2 and 3 clinical trials and supplementary documents investigating osilodrostat were obtained from a primary literature search, the manufacturer's website, and the Food and Drug Administration website. These articles evaluated the clinical pharmacology, efficacy, safety, adverse events, warnings, and precautions for osilodrostat. Osilodrostat was efficacious and safe in the treatment of CD in mostly middle-aged Caucasian women. A pivotal phase 3 study revealed a significant difference in 24-hour mean urinary free cortisol (primary end point) between osilodrostat and placebo (86% vs 29%; P < 0.001). Osilodrostat provides a potent and consistent effect in reducing life-threatening supraphysiological levels of cortisol in patients with CD. Hypocortisolism adverse effects can be mitigated by slowly increasing osilodrostat's dose at ≥2-week intervals. QT interval prolongation was noted; therefore, the QT interval must be monitored by the electrocardiogram. Increased levels of cortisol precursors during treatment with osilodrostat may increase the risk of hypokalemia, edema, and hypertension. Osilodrostat was efficacious in decreasing cortisol levels and safe in treating patients who have failed or are ineligible for pituitary surgery. Although risks exist, a pivotal clinical trial revealed efficacy in 86% of participants.

Effect Of Vetiver Essential Oil In 10% And 30% Concentration To The Cortisol Hormones Of Stressor-Induced Rats

Background: The number of people with mental health problems is still high in the world, especially depression. This incident is triggered by the stress of each individual on an ongoing basis and failure to adapt. Stress regulation is a preventive measure to prevent depression in individuals. Currently, there are many developing uses of essential oils as antistress relaxation therapy. Vetiver essential oil is believed to reduce stress levels. Purpose: This study aimed to determine the effect of using vetiver essential oil with different concentrations and administration periods on changes in cortisol levels. Methods: This study used Rattus norvegicus experimental animals with the Forced Swim Test (FST) as a stressor. Vetiver essential oil concentrations of 10% and 30% were administered with the essential oil preparation given after giving stressor. Stress level in experimental animals was measured from the hormone cortisol in the blood. The method of measuring cortisol in experimental animals was carried out using the Enzyme-Linked Immuno Sorbent Assay (ELISA) method. Results: This study obtained significant results from the Kruskal Wallis statistical test on decreasing cortisol levels in experimental animals by administering vetiver essential oil with 10% concentration. Changes in the cortisol hormone in experimental animals and cortisol levels were not affected by the length of time of administration.

Effect of combined pharmacological, behavioral, and physical interventions for procedural pain on salivary cortisol and neurobehavioral development in preterm infants: a randomized controlled trial.

Repeated procedural pain may lead to increased secretion of cortisol and future neurobehavioral development disorders in preterm infants. Changes in the cortisol level may mediate the effect of neonatal repetitive procedural pain on altered childhood neurobehavioral development in preterm infants. However, few studies have investigated the effect of combined pharmacological, behavioral, and physical interventions over repeated painful procedures on pain response, cortisol level, and neurobehavioral development. This study examined (1) the efficacy and safety of sucrose combined with massage, music, non-nutritive sucking, and gentle human touch to treat preterm infants with repeated procedural pain; (2) the cortisol level at discharge from the neonatal intensive care unit (NICU); (3) neurobehavioral development at 40 weeks' corrected gestational age; and (4) the potential mediating effect of the cortisol level in the combined interventions on neurobehavioral development. Stable preterm infants (n = 76) were randomized to receive routine care or combined interventions across repeated painful procedures throughout their NICU stay. The Premature Infant Pain Profile scores in the early, middle, and late periods of the NICU stay were measured, as were the basal salivary cortisol level at admission and discharge, the Neonatal Behavioral Neurological Assessment score at 40 weeks' corrected gestational age, and the incidence of adverse effects during the study period. Our findings indicated that the combined interventions remained efficacious and safe for reducing repeated procedural pain, decreased the cortisol level at discharge, and promoted early neurobehavioral development in preterm infants. This effect may have been mediated through decreased cortisol levels and reduced repeated procedural pain.

Effects of Relaxation Therapy Using Music on Breast Milk Production in Postpartum Mothers

Introduction: Low milk production is one of the main reasons mothers do not provide breast milk exclusively. Relaxation therapy interventions are expected to help increase milk production. Purpose: The purpose of this scoping review is to map available evidence related to the effect of relaxation therapy interventions on breast milk production in postpartum mothers. Methods: In this scoping review, the authors identify studies that explain the effect of relaxation therapy on breast milk production in postpartum mothers from three databases (PubMed, Wiley, and Science Direct). Searches are limited to studies published in English and present data for the period 2010-2019. The identified study was reviewed using the PRISMA Flowchart. Studies with quantitative designs related to the effect of relaxation therapy on the production of breast milk are then selected for review. Results: From a total of four articles that have been reviewed two sub-themes are found, relaxation therapy increases milk production (increased success of breastfeeding, increased milk secretion and fat content in breast milk) and relaxation therapy decreases maternal stress levels (decreases stress scores and cortisol levels). Conclusion: From this review, some evidences shows music therapy is effective in significantly increase milk production. All studies included in the review have limitations related to the research design or sample collection procedures. The method of relaxation therapy is simple, inexpensive, and easy to use without the involvement of hospital staff. Regarding the intervention, all the intervention groups in this study showed a significant effect compared to the control group.&#x0D; Keywords: Music Therapy, Relaxation Therapy, Breastfeeding, Lactating

Cooperation with closely bonded individuals reduces cortisol levels in long-tailed macaques.

Many animal species cooperate with conspecifics in various social contexts. While ultimate causes of cooperation are being studied extensively, its proximate causes, particularly endocrine mechanisms, have received comparatively little attention. Here, we present a study investigating the link between the hormone cortisol, cooperation and social bonds in long-tailed macaques (Macaca fascicularis). We tested 14 macaques in a dyadic cooperation task (loose-string paradigm), each with two partners of different social bond strength and measured their salivary cortisol before and after the task. We found no strong link between the macaques' cortisol level before the task and subsequent cooperative success. By contrast, we did find that the act of cooperating in itself led to a subsequent decrease in cortisol levels, but only when cooperating with closely bonded individuals. Two control conditions showed that this effect was not due to the mere presence of such an individual or the pulling task itself. Consequently, our study shows an intricate way in which the hypothalamic–pituitary–adrenal axis is involved in cooperation. Future studies should reveal whether and how our findings are driven by the anxiolytic effect of oxytocin, which has been associated with social bonding.

Influence of baby massage stimulation on the improvement of nutritional status, IGF-1, and cortisol level on undernourished infant

Aim: This study aims to prove the effect of infant massage stimulation on the improvement of vagal activity and neurological effects (HPA axis) in infants with 6-12 months of nutrition including increased nutritional status, insulin-like growth factor 1 (IGF-1) and decreased cortisol.Method: The design method used for this study was a quasi-experimental with randomized pre-test and post-test control group design. Samples in this study were infants aged 6-12 with undernutrition status as many as 24 person as an intervention group (infant massage interventions and complementary feeding) and 24 people in the control group (provision of supplementary feeding). Infant massage interventions carried out for 3 months. Data collected included body weight, IGF-1 level, and Cortisol.Results: Effective infant massage improves nutritional status (p = 0.035) / (p≤0.05), increases IGF-1 levels (p = 0.002) or (p &lt;0.05), and decreases cortisol levels (p = 0.022) / (p &lt;0.05).Conclusion: Infant massage stimulation increases body weight, IGF-1 level, and reduces cortisol in undernourished infants aged 6-24 months. It is recommended for every mother to apply baby massage stimulation for alternative treatments to improve the nutritional status of infants who are undernourished.

Cortisol, testosterone, and pain levels among patients undergoing McKenzie therapy and suboccipital relaxation

Sedentary lifestyle and the development of consumer electronics, often associated with a faulty posture, are widespread factors contributing to cervical spine dysfunction (CSD). The purpose of our study is to compare two methods of physical therapy of CSD: suboccipital relaxation and the McKenzie method. Their effect on perceived pain level and life quality was assessed using VAS and NDI scores. Serum levels of biochemical stress indicators like testosterone and cortisol were also evaluated. Eighty-six adult patients were divided into two groups: Group A and Group B. Group A included 42 patients treated using the McKenzie method. Group B consisted of 44 patients who underwent suboccipital relaxation. The therapy in both groups included three treatment sessions over a six-week period. Testosterone and cortisol levels were assessed using the ELISA technique. Pain evaluation was performed using the Visual Analogue Scale (VAS). The disability level was evaluated with the Neck Disability Index (NDI). In both groups, a similar improvement in VAS and NDI scores was observed. A distinct cortisol level decrease in patients subjected to the suboccipital relaxation was noticed, while the McKenzie method did not affect cortisolaemia significantly. We did not notice any difference in testosterone levels between the two groups. Both treatment methods contributed towards clinical improvement in our patients, represented by the drop in VAS and NDI scores. We also observed a biochemical improvement: decreased cortisol level in the group treated with suboccipital relaxation. Due to the important role of testosterone and cortisol in the pathogenesis of chronic pain, our study should be the pilot experience on their use as markers in CSD.