Urinary Catecholamine Levels Research Articles

Sympathetic activity markers in patients with resistant hypertension with renal dysfunction

Aim. To study the informativeness of sympathetic activity markers and perirenal adipose tissue (PRAT) in assessing renal function decline in patients with resistant hypertension (RH).Material and methods. The study included 63 patients with RH of both sexes aged 40-80 years. The main group included 19 patients with chronic kidney disease (CKD). The control group consisted of 44 patients with RH without CKD. All patients were assessed for uric acid, blood lipid profile, beta-adrenergic reactivity of erythrocyte mem­branes, free metanephrine and normetanephrine in plasma and 24-hour urine. The renal function was assessed by the glomerular filtra­tion rate calculated using the CKD-EPI equation. Twenty-four hour blood pressure monitoring was performed on the brachial artery of one arm at intervals of 15 minutes during the day and 30 minutes at night. Kidney size and PRAT were calculated based on the magnetic reso­nance imaging.Results. In both groups of patients, a significant increase in blood normetanephrine and beta-adrenergic reactivity of erythrocyte mem­branes relative to the reference values was shown. Blood and 24-hour urine metanephrine were within the reference intervals. No differences were found between the sympathetic activity indices in the main and control groups. In the main group patients, the PRAT thickness was greater (p=0,013), and the kidney diameter was smaller (p=0,046) than in the control group patients.Conclusion. CKD in RH patients is not accompanied by additional significant changes in sympathetic regulation, assessed by the blood and 24-hour urine catecholamine levels, the degree of beta-adrenergic receptor desensitization and variability of blood pressure. PRAT increase according to magnetic resonance imaging in patients with RH is associated with a decrease in renal filtration function.

Diffuse pulmonary hemorrhage as a rare presentation of pheochromocytoma: a case report with review of the literature

A 37-year-old male patient with a past history of fluctuating hypertension and insulin-treated diabetes mellitus presented to our clinic with a 1-year history of sudden-onset cough, dyspnea, and frank hemoptysis. Examination showed asthenia, moderate anemia, uncontrolled blood pressure, and a past history of one admission for management of hemoptysis and cardiac failure. The evaluation showed mild anemia, azotemia, low ejection fraction, contrast-enhanced computed tomography (CECT) of the chest, and sputum suggestive of pulmonary hemorrhage. Investigation during current admission revealed proteinuria, left suprarenal mass on USG, and clear lung parenchyma on chest X-ray and CECT. Autoimmune workup for vasculitis was negative and 24-h urinary catecholamine levels were elevated with CECT abdomen confirming pheochromocytoma. His blood pressure was controlled and he underwent laparoscopic left adrenalectomy with confirmation on histopathology. Postoperatively he is doing well with minimal requirement of antihypertensive, and diabetes is controlled with diet and exercise only. This case highlights diffuse alveolar hemorrhage as a rare presentation of pheochromocytoma. This case also highlights that secondary cause of hypertension should always be ruled out in case of uncontrolled hypertension in young patients to prevent devastating complications.

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

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

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

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

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

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

Levels of Serum and Urine Catecholaminergic and Apelinergic System Members in Acute Ischemic Stroke Patients

Objective: To compare levels of catecholaminergic system members, renalase, cerebellin, and their substrates, epinephrine, norepinephrine, and dopamine, and apelinergic system members, apelin, elabela, and nitric oxide in the blood and urine of patients with acute ischemic stroke and healthy controls. Materials and Methods: 42 patients with acute ischemic stroke and 42 age and sex-matched healthy controls were included in the study. Blood and urine samples were collected simultaneously and within the first 24 hours after the onset of acute stroke clinical manifestations and were measured using an ELISA method. Results: The levels of serum and urine cerebellin, renalase, epinephrine, norepinephrine, dopamine, apelin, elebela, and nitric oxide were similar in ischemic stroke and in control groups (P&amp;gt;0.05). Strong correlations were found between renalase, cerebellin, and catecholamine levels in serum and urine (p &amp;lt;0.001) both in stroke patients and controls. There were also strong correlations between apelin, elabela, and NO levels in serum and urine (p &amp;lt;0.001) in the two groups. Conclusion: Serum and urine cerebellin, renalase, epinephrine, norepinephrine, dopamine, apelin, elebela, and nitric oxide levels do not significantly change in the acute phase of ischemic stroke. Strong correlations among renalase, cerebellin, and catecholamines emphasize that these substances act together in healthy individuals and ischemic stroke patients. Similarly, strong correlations between apelin, elabela, and NO indicate that these agents act together in healthy subjects and patients with ischemic stroke.

Fulminant hypercorticism due to ACTG producing pheochromocytoma

Endogenous hypercorticism (EH) is a severe symptom complex caused by hypercortisolemia; according to the etiology, ACTH-dependent and ACTH-independent variants are distinguished, which, according to the literature, occur in 70-80% and 20-30% of cases, respectively. A rare cause of ACTH-dependent endogenous hypercorticism is ACTH-ectopic syndrome (ACTH-ES) (about 15-20% of cases). ACTH-ES is a syndrome of adrenocorticotropic hormone (ACTH) hyperproduction by neuroendocrine tumors of extrahypophyseal origin. Various tumors can secrete ACTH: bronchopulmonary carcinoid, small cell lung cancer, less frequently, thymus carcinoid, islet cell tumors and pancreatic carcinoid, medullary thyroid cancer, carcinoid tumors of the intestine, ovaries, as well as pheochromocytoma (PCC).This publication presents a clinical case of rarely detected paraneoplastic ACTH production by pheochromocytoma. Thepatient had clinical manifestations of hypercorticism, therefore, she applied to the Russian National Research Center of Endocrinology of the Ministry of Health of Russia. During the examination Cushing's syndrome (CS) was confirmed, multispiral computed tomography (MSCT) of the abdominal cavity revealed a voluminous formation of the left adrenal gland. Additional examination recorded a multiple increase in urinary catecholamine levels. Subsequently, the patient underwent left-sided adrenalectomy. The diagnosis of pheochromocytoma was confirmed morphologically, immunohistochemical study demonstrated intensive expression of chromogranin A and ACTH by tumor cells.

Acute repeated cage exchange stress modifies urinary stress and plasma metabolic profiles in male mice.

Exposure to a novel environment is psychologically and physically stressful for humans and animals. The response has been reported to involve enhanced sympathetic nervous system activity, but changes in nutrient levels under stress are not fully understood. As a form of exposure to a novel environment, repeated cage exchange (CE, four times at 2-h intervals for 8 h from 08:00 h) during the light phase with no restraint on movement was applied to A/J mice, a strain particularly prone to stress. Body temperature was measured with a temperature-sensing microchip implanted in the interscapular region. The stress conditions and anxiety level were evaluated by measuring urinary catecholamines and corticosterone and by performing an anxiety-like behavior test, respectively. Major nutrients such as glucose, fatty acids, and amino acids in the plasma were also examined. CE mice showed a significant increase in body temperature with each CE. They also showed a significantly greater reduction of body weight change, more water intake, and higher levels of urinary catecholamines and corticosterone and anxiety-like behavior score than control mice. The model revealed a significantly lower plasma glucose level and higher levels of several essential amino acids, such as branched-chain amino acids and phenylalanine, than those of control mice. Meanwhile, free fatty acids and several amino acids such as arginine, aspartic acid, proline, threonine, and tryptophan in both sets of mice were significantly decreased from the corresponding levels at 08:00 h, while similar plasma levels were exhibited between mice with and without CE. In conclusion, repeated CE stress was associated with changes in glucose and amino acids in plasma. Although further study is needed to clarify how these changes are specifically linked to anxiety-like behavior, this study suggests the potential for nutritional intervention to counter stress in humans exposed to novel environments.

Psychobiological stress response to a lung cancer diagnosis: a prospective study of patients in Iceland and Sweden

Background A diagnostic work-up leading to a lung cancer diagnosis is a severely stressful experience that may impact tumor progression. Yet, prospective data are scarce on psychological and biological components of stress at the time of lung cancer diagnosis. The aim of this study was to assess pre-to-post diagnosis change in psychological distress and urinary excretion of catecholamines in patients with suspected lung cancer. Methods Participants were 167 patients within the LUCASS study, recruited at referral for suspected lung cancer to University Hospitals in Iceland and Sweden. Patients completed questionnaires on perceived distress (Hospital Anxiety and Depression Scale, HADS) before and after diagnosis of lung cancer or a non-malignant origin. A subpopulation of 85 patients also provided overnight urine for catecholamine analysis before and at a median of 24 days after diagnosis but before treatment. Results A lung cancer diagnosis was confirmed in 123 (73.7%) patients, with a mean age of 70.1 years. Patients diagnosed with lung cancer experienced a post-diagnosis increase in psychological distress (p = 0.010), while patients with non-malignant lung pathology showed a reduction in distress (p = 0.070). Both urinary epinephrine (p = 0.001) and norepinephrine (p = 0.032) levels were higher before the diagnosis among patients eventually diagnosed with lung cancer compared to those with non-malignant lung pathology. We observed indications of associations between pre-to-post diagnosis changes in perceived distress and changes in urinary catecholamine levels. Conclusion Receiving a lung cancer diagnosis is associated with an increase in psychological distress, while elevated catecholamine levels are evident already before lung cancer diagnosis.

Predictive Factors of Early 18F-Fluorodeoxyglucose-Positron Emission Tomography Response to [131I] Metaiodobenzylguanidine Treatment for Unresectable or Metastatic Pheochromocytomas and Paragangliomas

Introduction: Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumours that produce catecholamines. [131I] metaiodobenzylguanidine (MIBG)-avid unresectable or metastatic PPGLs are treated with [131I] MIBG radionuclide therapy. A high metabolic tumour volume (MTV) and total lesion glycolysis (TLG) can be poor prognostic factors. Therefore, we evaluated the metabolic responses to [131I] MIBG therapy with respect to other clinical factors. Methods: A retrospective study was performed on a series of 20 patients who underwent FDG-PET before and after [131I] MIBG therapy. We administered a single dose comprising 5.5 GBq of [131I] MIBG (usually three times; for some cases, the number was increased or decreased considering treatment efficacy and side effects). Semi-quantitative parameters (SUVmax, MTV, and TLG) were calculated using the liver SUV (mean + 3 × standard deviation) as a threshold on Metavol software. The semi-quantitative FDG-PET parameters for determining response were complete response (CR), partial remission (PR), stable disease (SD), and progressive disease (PD). We divided our study participants into the PD and non-PD groups (i.e., SD + PR + CR) and compared the overall survival (OS) between the two groups. Subsequently, we evaluated the relationships between metabolic response and age, sex, tumour type, metastatic site, chemotherapy or external radiation history, and 24-h urine catecholamine levels by univariate logistic regression analyses. Results: Both MTV-based and TLG-based criteria for PD versus non-PD were significant prognostic factors (p = 0.014). However, treatment response as evaluated based on the SUVmax was not a significant predictor. Higher urinary dopamine levels were associated with poor metabolic response as assessed by MTV and TLG (OR 1.002, p = 0.029). The other clinical parameters were non-significant. Conclusion: Poor metabolic response (measured with MTV and TLG) to [131I] MIBG therapy in unresectable or metastatic PPGLs was related to shorter OS. The poor metabolic response can be predicted using the urinary dopamine level.

Coexistence of Pheochromocytoma and Primary Aldosteronism due to Multiple Aldosterone-producing Micronodules in the Ipsilateral Adrenal Gland.

A 46-year-old woman was referred for hypertension and a right adrenal tumor. Primary aldosteronism (PA) was suspected because of the high plasma aldosterone concentration-to-plasma renin activity ratio. However, a subsequent evaluation revealed coexistent PA and pheochromocytoma. We performed laparoscopic right adrenalectomy. Histology of the resected adrenal gland confirmed pheochromocytoma and multiple aldosterone-producing adrenocortical micronodules. Following adrenalectomy, the urinary catecholamine levels normalized, and hyperaldosteronism improved but persisted. Hypertension also improved but persisted and was normalized with spironolactone. The clinical course indicated that the PA lesions were likely bilateral. This was a histologically proven case of coexistent pheochromocytoma and PA due to multiple aldosterone-producing micronodules.

Urinary levels of cortisol but not catecholamines are associated with those of 8-hydroxy-2'-deoxyguanosine in uncomplicated primary hypertension.

The relationships between stress hormones and oxidative DNA damage have not yet been explored in human hypertension. We investigated the associations of urinary levels of cortisol or catecholamines with those of 8-hydroxy-2'-deoxyguanosine, a marker of oxidative DNA damage in primary hypertension. Untreated 156 primary hypertensives without apparent cardiovascular diseases were entered into the study. Following blood sampling after an overnight fast, 24-h blood pressure monitoring and 24-h urinary sampling were performed simultaneously to determine 24-h averaged values for blood pressure and urinary levels of cortisol, catecholamines and 8-hydroxy-2'-deoxyguanosine. Urinary cortisol significantly correlated positively with urinary 8-hydroxy-2'-deoxyguanosine in all studied participants (r = 0.334, P < 0.001). Contrary, either urinary adrenaline or urinary noradrenaline did not significantly correlate with urinary 8-hydroxy-2'-deoxyguanosine (r = 0.050, P = 0.553 or r = 0.063, P = 0.435). Additionally, the positive association of urinary cortisol with urinary 8-hydroxy-2'-deoxyguanosine remained highly significant after the adjustments for multiple confounders of oxidative stress such as age, gender, body mass index, smoking status, 24-h blood pressure, C-reactive protein and estimated glomerular filtration rate (partial r = 0.323, P < 0.001), although only approximately 10% of the variance in urinary cortisol was attributable to differences in urinary 8-OHdG (partial r2 = 0.104). Thus, our data indicate that cortisol but not catecholamines could at least partially contribute to the occurrence of oxidative DNA damage in primary hypertensives. The present study suggested the possibility that the overactivation of hypothalamic-pituitary-adrenal axis rather than sympathoadrenal system could enhance oxidative stress and attendant DNA oxidation in uncomplicated primary hypertension.

Study on Catecholamine Sensors Based on Noble Metal Nanoparticles Modified Ti3C2 Mxene

Catecholamines are neurotransmitters in the peripheral and central nervous systems, which maintain the normal physiological state of the human body. Studies have shown that the occurrence of many diseases are often accompanied by changes in catecholamine levels. Clinically, the detection of catecholamine levels in human plasma or urine can assist in the diagnosis of endocrine-related diseases and neurological diseases. However, catecholamines are easily oxidized, and the content in human body is very low. So the rapid detection of catecholamines is very important for the prevention and diagnosis of related diseases. In this paper, the electrochemical response characteristics of Ti3C2Tx MXene and noble metal nanoparticles modified Ti3C2Tx to dopamine (one type of catecholamine) were explored. The results shown that Ti3C2Tx would undergo irreversible oxidation at the anode potential and the single Ti3C2Tx modified electrode was not suitable for the detection of dopamine. So we further explored the modification of Pt and Au nanoparticles on the Ti3C2Tx/GCE electrode, and the experimental results shown that Au/Ti3C2Tx/GCE had higher sensitivity for measuring dopamine, while Pt/Ti3C2Tx/GCE had a larger linear range. Both electrodes had good stability and repeatability and could be used for the detection of catecholamines.

SHDB mutant functional metastatic paraganglioma: The efficacy of Lutetium-177 DOTATE

Abstract Introduction Therapeutic options for metastatic paraganglioma (PGL) are limited, especially in the presence of uncontrolled secondary hypertension (HTN). Early findings from Lutetium-177 (Lu-177) DOTATE show promise for efficacy, although data on HTN control and survival are uncertain. Herein, we presented the successful treatment of a patient with metastatic PGL and uncontrolled HTN with Lu-177 DOTATE. Clinical Case A 16-year-old woman was admitted to the emergency department with severe headache, nausea and vomiting. She also reported stomach and low back pain for three months. The patient's blood pressure was 220/140 mmHg and a sodium nitroprusside infusion was started to treat the hypertensive crisis. On physical examination she had abdominal tenderness. A computer tomography (CT) examination revealed 6 cm mass, multiple metastatic nodular lesions in the lung and liver, as well as lytic lesions in all bones, and metastatic lymph nodes in thorax and abdomen. She is referred to our department for further evaluation HTN. Laboratory examinations revealed that plasma norepinephrine 24926 ng/L (70–480), 24-hour urine norepinephrine 1335 µg/day (20–81), metanephrine 534 µg/day (52–341), 3-metoksitiramine 771 µg/day (0–451), normetanephrine 20456 µg/day (88–444). Other laboratory findings were normal range. MIBG I131 scan which showed pathological uptake of MIBG was demonstrated in the regions described on CT. Genetic panel by next-generation sequencing (NGS) identify germline mutation and she had heterozygous mutations in SHDB (c.725 G&amp;gt;A) and BUB1B (c.1378 C&amp;gt;T). Surgical treatment was performed, and pathological finding reported 6cm mass, Ki-67 labeling index: %2, chromogranin A diffuse positive and there was vascular invasion. It was confirmed to be malignant PGL. 131I-MIBG therapy couldn't be given because of drugs interaction that used by patient. She received 13 cycles chemotherapy (cyclophosphamide, vincristine, dacarbazine) and palliative radiotherapy to metastatic bone lesions. She continued, however, to suffer from low back pain and HTN. Rising plasma and urine catecholamine levels. Therefore, conventional chemotherapy had been discontinued and he was commenced on Lu-DOTATATE therapy. Up to now, she has received 2 cycles at intervals of three months. Her clinical response was excellent with gradual improvement of symptoms and quality of life. Blood pressure is now within normal values without medication. There was significant reduction in the size of overall metastatic disease on Ga-68 DOTATE scanning. Conclusion Lu-177 DOTATE has potential advantages (drug interaction, radiation-safety) compared with 131I-MIBG therapy and chemotherapy. Our case demonstrates significant clinical and biochemical success in patients with metastatic PGL in addition to excellent disease management with low toxicity from PRRT. Lu-177 DOTATATE therapy is an effective and safe modality of treatment for patients with metastatic PGL.

Factors Influencing Postmortem Catecholamine Level and Its Correlations With Agony Time and Cause of Death in Medicolegal Autopsy.

Catecholamines consisting of epinephrine (EP), norepinephrine (NE), and dopamine (DA) are known as a class of chemical neurotransmitters and hormones essential for regulation of physiological processes including stress responses. Many researchers have tried to establish a relationship between postmortem catecholamine level and agony time or underlying cause of death. However, relevant studies have yielded debatable results. This study was performed to determine characteristics of catecholamine distribution in postmortem specimens with various influencing factors and to assess relationships of postmortem catecholamine levels with agony time and cause of death. A total of 114 autopsy cases were analyzed for catecholamine levels and EP/NE ratios in femoral blood, heart blood, and urine specimens. Postmortem catecholamine levels according to sex, age, medical treatments (cardiopulmonary resuscitation [CPR] and EP injection), postmortem interval (PMI), agonal period, manner of death, and cause of death were evaluated. Close mutual relationships were noted among femoral and heart blood catecholamine levels. There was no correlation between blood and urine catecholamine levels. Catecholamine levels showed no significant differences according to sex, age, or manner of death. Heart EP and heart EP/NE ratio were significantly higher in the group with CPR. Femoral DA, heart EP, heart NE, heart DA, and urine DA were significantly increased in the group with EP injection. Urine NE and urine DA showed significant differences among PMI groups, with both increased over PMI. In correlation analysis, femoral DA and urine NE displayed weak correlations with PMI. Regarding agony time, femoral and heart DA were significantly increased in long agony group compared to those in the short agony group. With regard to the cause of death, multiple comparison analysis for major categories (natural death, injury, intoxication, asphyxia, drowning, and fire death) revealed a significant increase of femoral NE in asphyxia in comparison with injury. In subgroup analysis for the group without EP injection, femoral NE (P = 0.048), femoral DA (P = 0.039), and heart EP (P = 0.021) showed significant differences between PMI groups. Results of this study have important implications for understanding postmortem catecholamine distribution and their mutual associations, influences of clinical and demographic factors, and relationships with agony time and cause of death in Korean population. Although comprehensive demonstration of catecholamine level as stress index was not possible in the present study, the assessment of postmortem catecholamine levels could be used as a supportive tool in classification of agonal status and differential diagnosis of the cause of death in particular cases. Further investigation is needed on this issue.

Abstract 13157: Workplace Culture and Biomarkers of Sympathetic Activation

Workplace environment can impact health, but most research has focused on toxic chemicals. Recently, workplace culture—experiences, values, and behaviors unique to a workplace—is studied for its impact on overall health risk; however, connections with robust biologic markers of health remain to be established. Therefore, we examine associations between work environment and urinary levels of catecholamines and their metabolites as biomarkers of sympathetic activation. In 2018-19, we recruited participants (n=219) from an ongoing CV risk cohort to investigate workplace culture, overall well-being, and stress. Participants completed 7 questionnaires. Clean catch urine samples were used to measure catecholamines and their metabolites. To estimate associations between work and health scales and log or logit-transformed outcomes we used Pearson correlation and linear regression models adjusting for demographics and creatinine. Participants reporting higher well-being had lower levels of dopamine (DA) ( r = -0.28), serotonin (5HT) ( r = -0.17), and 3-methoxytyramine (3MT) ( r = -0.31), a product of dopamine breakdown. Participants reporting a more engaged workplace had lower levels of DA ( r = -0.20) and 3MT ( r = -0.22). Those reporting more positive workplace culture had lower levels of DA ( r = -0.17) and 3MT ( r = -0.26) and higher levels of norepinephrine ( r = 0.19) and 5-hydroxyindole-3-acetic acid (HIAA) ( r = 0.22). When participants identified more workplace isolation, they had higher levels of DA ( r = 0.19) and 3MT ( r = 0.19). Positive workplace culture was correlated with lower levels of DA ( r = -0.22) and 3MT ( r = -0.28) and higher levels of HIAA ( r = 0.22) and homovanillic acid ( r = 0.20). Given high correlations between catecholamines, we used 3MT for linear regression. In fully adjusted models we found in more positive work cultures, levels of 3MT remained significantly lower (β = -0.065 ±0.025, p = 0.01), accounting for 23% of the variance, and a significant positive association between workplace isolation and 3MT (β= 0.064 ±0.030, p = 0.04), accounting for 22% of the variance with 3MT, which may reflect greater dopamine degradation. These findings suggest an important relationship between how we work and sympathetic nervous system activity.

Boronate affinity paper spray mass spectrometry for determination of elevated levels of catecholamines in urine

The analysis of catecholamines, such as dopamine, epinephrine and norepinephrine in urine can be used in the diagnosis of certain pathologies, such as hormone-producing tumors. Here, a fast and simple quantitative boronate affinity paper spray tandem mass spectrometric (PS-MS/MS) method is established, which can improve selectivity and reduce ion suppression without needing any instrumental chromatography. We use here the property of boronic acids, which can selectively bind ortho-diol-containing compounds under alkaline conditions. Paper tip modification and catechol enrichment protocols were developed to selectively bind, clean up and subsequently desorb such catecholamines. Standard catecholamine solutions, as well as human urine samples were analyzed with the PS-MS(/MS) method, which is fast, cheap and easy-to-operate compared to HPLC-MS/MS. Despite its high simplicity, boronate affinity PS-MS/MS exhibits good performance compared to HPLC-MS/MS in human urine analysis in terms of precision (2.1%–7.2% vs. 1.1%–2.9%) and accuracy (−10.2%–9.3% vs. −4.8%–5.1%), and a physiologically relevant limit of detection (0.027–0.12 μg mL−1). The boronate affinity PS-MS/MS clearly achieved the detection limits that would allow the fast analysis of urine samples for clinical purposes, such as screening for pheochromocytoma (exceeding 0.5 μg mL−1).

Workplace Culture and Biomarkers of Health Risk.

Workplace culture has been studied for impact on health risk; however, connections with robust biologic markers of health remain to be established. We examined associations between the work environment and urinary levels of catecholamines and their metabolites as biomarkers of sympathetic nervous system activity, indicative of stress. We recruited participants (n = 219; 2018–2019) from a cardiovascular risk cohort to investigate workplace culture, well-being, and stress. Participants completed seven questionnaires. Urine samples were used to measure catecholamines and their metabolites by LC/MS/MS. Pearson correlation and linear regression models were used after adjusting for demographics and creatinine. Participants reporting higher well-being had lower urinary levels of dopamine, serotonin, and 3-methoxytyramine. Participants reporting a more engaged and more positive workplace had lower levels of dopamine and 3-methoxytyramine. Reported workplace isolation was correlated with higher levels of dopamine and 3-methoxytyramine. Given correlations between catecholamines, we used 3-methoxytyramine for linear regression. In fully adjusted models, in environments with a more positive culture, levels of 3-methoxytyramine remained lower (β = −0.065 ± 0.025, p = 0.01) and indicated a positive association between workplace isolation and 3-methoxytyramine (β = 0.064 ± 0.030, p = 0.04). These findings are consistent with an important relationship between workplace environment and sympathetic nervous system activity.

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

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

V13-10 LINEAR STAPLING DEVICE IN LAPAROSCOPIC PARTIAL ADRENALECTOMY FOR PHEOCHROMOCYTOMA IN MULTIPLE ENDOCRINE NEOPLASIA TYPE 2B

You have accessJournal of UrologyCME1 May 2022V13-10 LINEAR STAPLING DEVICE IN LAPAROSCOPIC PARTIAL ADRENALECTOMY FOR PHEOCHROMOCYTOMA IN MULTIPLE ENDOCRINE NEOPLASIA TYPE 2B Patricio Garcia Marchiñena, Andrés Germán Alfieri, Facundo Barbagallo, Ricardo Hosman Basto, and Alberto Jurado Patricio Garcia MarchiñenaPatricio Garcia Marchiñena More articles by this author , Andrés Germán AlfieriAndrés Germán Alfieri More articles by this author , Facundo BarbagalloFacundo Barbagallo More articles by this author , Ricardo Hosman BastoRicardo Hosman Basto More articles by this author , and Alberto JuradoAlberto Jurado More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002646.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Solitary adrenal glands, bilateral adrenal tumors or hereditary syndromes are indications of partial adrenalectomy to avoid the need for lifelong corticosteroid replacement. Laparoscopic partial adrenalectomy (LPA) is a safe and effective method in order to provide complete removal of small adrenal lesions, as well as preservation of normal glandular parenchyma. Our objective is to describe a LPA using a linear stapling device in a hereditary pheochromocytoma. METHODS: We present the case of a 29-year-old male with hypertension, anxiety and heart palpitations due to pheochromocytoma caused by multiple endocrine neoplasia type 2B. Urinary catecholamine levels were four times higher than normal. CT scan revealed a 33 mm hypermetabolic right adrenal mass. Transperitoneal LPA was performed with the patient in left lateral decubitus. Four trocars were placed as the described technique parallel to the costal line. Right adrenal tumor was resected using a vascular linear stapling device. To preserve the blood supply of the remnant adrenal gland, it was not extensively dissected and the main adrenal vein was totally preserved. RESULTS: The patient had uneventful postoperative recovery. Surgical time was 90 minutes. Patient was discharged on the 2nd day. Pathology confirmed a 3.5 cm benign composite pheochromocytoma-ganglioneuroma with negative surgical margins. After surgery the patient achieved a complete clinical and biochemical response. During a follow-up of 6 months, no biochemical or radiological recurrence was observed. CONCLUSIONS: LPA using a linear stapling device is a valid alternative to total adrenalectomy when normal adrenal tissue has to be preserved. Source of Funding: No source of fundings © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1034 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patricio Garcia Marchiñena More articles by this author Andrés Germán Alfieri More articles by this author Facundo Barbagallo More articles by this author Ricardo Hosman Basto More articles by this author Alberto Jurado More articles by this author Expand All Advertisement PDF DownloadLoading ...