Mean Cortisol Research Articles

Changes in the Serum Concentration Levels of Serotonin, Tryptophan and Cortisol among Stress-Resilient and Stress-Susceptible Individuals after Experiencing Traumatic Stress

Stress is a common response to many environmental adversities. However, once dysregulated, this reaction can lead to psychiatric illnesses, such as post-traumatic stress disorder (PTSD). Individuals can develop PTSD after exposure to traumatic events, severely affecting their quality of life. Nevertheless, not all individuals exposed to stress will develop psychiatric disorders, provided they show enhanced stress-resilience mechanisms that enable them to successfully adapt to stressful situations and thus avoid developing a persistent psychopathology. The study involved 93 participants. Of them, 62 comprised a study group and 31 comprised a control group. The aim of the study was to assess serotonin, cortisol and tryptophan concentration levels in subjects with PTSD (stress-susceptible; PTSD-SS) and in healthy individuals (stress-resilient; PTSD-SR), who had experienced a traumatic event but fully recovered after the trauma. The subjects were between 18 and 50 years of age (mean 35.56 ± 8.26 years). The serum concentration levels of serotonin, cortisol and tryptophan were measured with an ELISA kit. It was found that the serotonin, tryptophan and cortisol concentration levels were consistent with the features of both PTSD-SR and PTSD-SS patients. It was reported that the mean cortisol concentration levels increased more significantly in the PTSD-SS group than in the PTSD-SR group, versus those in the control group. Similarly, the PTSD-SS group was found to show a larger decrease in the mean serotonin concentration levels than the PTSD-SR group, versus those in the control group. No significant changes were found in the tryptophan concentration levels between the study groups, versus those in the control group. These findings can be useful when attempting to improve resilience in individuals using neuropharmacological methods. However, it is necessary to conduct more cross-sectional studies that would address different types of negative stress to find out whether they share common pathways.

Mindfulness based stress reduction among substance abuse patients at de-addiction center.

It is of interest to investigate the effectiveness of a mindfulness-based stress reduction program on stress and salivary cortisol among substance abuse patients. There were 60 drug addicts who were receiving treatment at the addiction centre. Samples are divided into 30 drug abuse patient experimental and 30 substance abuse patient control groups using the simple random sampling approach. Salivary cortisol, a pre-test stress biomarker, was measured and used to analyse the results. The MBSR programme was administered over thecourse of eight weeks, with two 1-hour sessions held each day, with a cap of 15 participants. The biomarker for stress (salivary cortisol) will be obtained once again at the end of the program to assess the post-test level of perceived stress and compare it to the results. Patients showed improvements in stress level (p < 0.05) following the 8-week MBSR program. The mean level of blood cortisol in the experimental group was 18.08 (3.62), which was dropped to 7.54 (1.29) before the intervention. The mean cortisol level in the experimental group differs by 10.54 (3.45) between pre and post intervention following the intervention (p value is < 0.005). Thus, there is a difference between the experimental conditions before and after the intervention. The mean serum cortisol level in the pre-test is 17.30 (2.34) and the mean serum cortisol level in the post test is 17.15 (2.31) in the control group (p value is > 0.005). Data shows that there is a significant difference between the groups. MBSR may be a beneficial intervention for reducing stress, in Patients taking treatment in de addiction centre.

A Nested Case-Control Study of Allopregnanolone and Preterm Birth in the Healthy Start Cohort.

Chronic stress is a risk factor for preterm birth; however, objective measures of stress in pregnancy are limited. Maternal stress biomarkers may fill this gap. Steroid hormones and neurosteroids such as allopregnanolone (ALLO) play important roles in stress physiology and pregnancy maintenance and therefore may be promising for preterm birth prediction. We evaluated maternal serum ALLO, progesterone, cortisol, cortisone, pregnanolone, and epipregnanolone twice in gestation to evaluate associations with preterm birth. We performed a nested case-control study using biobanked fasting serum samples from the Healthy Start prebirth cohort. We included healthy women with a singleton pregnancy and matched preterm cases with term controls (1:1; N = 27 per group). We used a new HPLC-tandem mass spectrometry assay to quantify ALLO and five related steroids. We used ANOVA, Fisher exact, χ2, t test, and linear and logistic regression as statistical tests. Maternal serum ALLO did not associate with preterm birth nor differ between groups. Mean cortisol levels were significantly higher in the preterm group early in pregnancy (13w0d-18w0d; P < 0.05) and higher early pregnancy cortisol associated with increased odds of preterm birth (at 13w0d; odds ratio, 1.007; 95% CI, 1.0002-1.014). Progesterone, cortisone, pregnanolone, and epipregnanolone did not associate with preterm birth. The findings from our pilot study suggest potential utility of cortisol as a maternal serum biomarker for preterm birth risk assessment in early pregnancy. Further evaluation using larger cohorts and additional gestational timepoints for ALLO and the other analytes may be informative.

Levels of Cortisol and Inflammatory Cytokines after The Induction of Various Sleep Deprivation Stress Models in Male Wistar Rats

&#x0D; &#x0D; &#x0D; Sleep deprivation (SD) can modulate the production of various cytokines, including pro-inflammatory cytokines such as IL-6, TNF-α, and IFN-γ, and anti-inflammatory cytokines such as IL-10. Paradoxical sleep deprivation (PSD) increases the risk of inflammation but can be relieved by sleep recovery (SR). This study aimed to determine the differences in levels of cortisol and inflammatory cytokines (IL-6, IL-10, TNF-α, dan IFN-γ) in male Wistar rats (Rattus norvegicus) after induction of various sleep deprivation stress models. Twenty-five of male Wistar rats were randomly divided into five groups: control, PSD (20 hours of SD/day for five days), Total Sleep Deprivation or TSD (24 hours of SD/day for five days), PSD+SR (PSD followed by SR), and TSD+SR (TSD followed by SR). The plasma cortisol levels were measured with ELISA, and inflammatory cytokine levels were measured with immunoassay and calculated with fold change. Mean cortisol levels were significantly increased in treatment groups compared to the control group (p=0.029). Multivariate analysis showed no statistically significant difference in inflammatory cytokine levels of IL-6 (p=0.658), IL-10 (p=0.065), TNF-α (p=0.399), and IFN-γ (p=0.283) in all groups. In conclusion, various sleep deprivation stress models affect cortisol levels but not inflammatory cytokine levels of IL-6, IL-10, TNF-α, and IFN-γ among male Wistar rats.&#x0D; &#x0D; &#x0D;

Аssessment of the antinociceptive efficacy of varieties of multimodal low-opioid general anesthesia during laparoscopic renal surgery

The main premise for the emergence of the concept of low-opioid general anesthesia was the phenomenon of the formation of drug/opioid dependence in patients undergoing surgery under multicomponent anesthesia with high doses of narcotic analgesics (opioids). Opioids were used as the main analgesics and in the postoperative period. The above factors contributed to the development of opiate addiction in operated patients in the late postoperative period. The mass nature of this phenomenon has become one of the most urgent problems in modern anesthesiology.&#x0D; Our study aimed to evaluate the antinociceptive/antistress efficacy of 3 types of low-opioid multimodal general anesthesia in laparoscopic renal surgery.&#x0D; Methods. Eighty patients who had undergone laparoscopic renal surgery under 3 types of general anesthesia were included in this prospective cohort study. All patients were operated under general anesthesia with tracheal intubation. Induction: intravenous (IV) propofol 2 mg/kg, fentanyl 1.5-2 μg/kg, atracurium 0.6 mg/kg. Maintenance of anesthesia: sevoflurane (MAC - 1.44±0.25% by volume). In group 1 (control group n = 26), analgesia was provided with fentanyl 3,89±2.03 μg/kg/h. In group 2 (n = 25), multimodal low-opioid general anesthesia was performed with fentanyl 1.76±1.2 μg/kg/h and IV lidocaine 1.5 mg/kg/h and subanesthetic doses of ketamine. In group 3 (n = 29), multimodal anesthesia with low opioids was performed with fentanyl 2.38±1.01 μg/kg/h in combination with dexmedetomidine 0.7 μg/kg/h. The efficacy of antinociceptive protection was assessed by the dynamics of changes in stress hormone levels, hemodynamic parameters, and blood glucose concentration.&#x0D; Results. The mean total dose of fentanyl used throughout the anesthetic period was: 369,23±83,75 μg in group 1, 216,0±47,26 μg in group 2, and 272,41±58,14 μg in group 3 (p &lt; 0.001). Mean cortisol levels were significantly different before and after surgery in groups 1 and 2: 371,0±161,61 nmol/l vs 562,72±226,87 nmol/l (p &lt; 0.01) and 531,08±218,02 nmol/l vs 831,33±235,32 nmol/l (p &lt; 0.01), respectively. In group 3, we did not detect any statistical difference: 393,51±134,69 nmol/l and 436,37±188,09 nmol/l, respectively (p &gt; 0.05). The mean level of adrenocorticotropic hormone increased significantly after surgery in all studied groups: 111.86% in group 1 (p &lt; 0.01), 122.02% (p &lt; 0.01) in group 2 and 78.59% (p &lt; 0.01) in group 3. Blood glucose levels in the postoperative (p/o) period did not exceed 6,16±1,67 mmol/l (p &gt; 0.05) in all groups. Hemodynamic parameters and BIS, which were maintained within 44±6.4%, indicated the adequacy of anesthesia and analgesia in the study groups.&#x0D; In group 1, 8 of 26 patients required additional analgesia with opioids during the p/o period (pain intensity on the VAS scale exceeded 4 points). In group 2 and group 3, 4 patients each required opioid analgesia, 16% and 15.38%, respectively. The next day after surgery, all patients were mobilized (sitting in bed, walking). Markers of renal function were also within normal range in all patients.&#x0D; Conclusion. The use of low-opioid multimodal anesthesia with IV lidocaine or dexmedetomidine during laparoscopic renal surgery provides an adequate anesthetic/antinociceptive effect. The use of dexmedetomidine in multimodal general anesthesia provides the greatest antinociceptive protection and reduces the stress response to surgery.

Comparison of dorsal penile nerve block alone and in combination with lidocaine–prilocaine cream in neonates undergoing circumcision: a randomized controlled study

BackgroundSuboptimal neonatal circumcision analgesia causes a significant stress response. There is continued search for more effective analgesia for neonatal circumcision. We aimed to determine whether lidocaine–prilocaine cream (LPC) prior to...

RF10 | PMON215 Greater changes in metabolic hormones are associated with a smaller decrease in pulsatile LH secretion in response to short term moderate energy restriction in healthy, young women

Abstract Background Energy restriction may result in hypothalamic amenorrhea by inhibiting GnRH secretion and downstream pulsatile LH secretion. Energy restriction also leads to adaptive changes in metabolic hormones. We sought to determine whether metabolic changes in response to energy restriction predict or mitigate inhibition of GnRH secretion. Methods Nineteen healthy women, (mean age ± SD; 23.36 ± 2.08 yrs) with regular ovulatory cycles and no evidence of energy restriction or excessive exercise, underwent two 5-day dietary interventions with identical exercise in the early follicular phase of two menstrual cycles. A neutral energy availability (NEA; 45 kCal/kg*LBM/d) was followed by a deficient energy availability (DEA; 20 kCal/kg*LBM/d) diet. On day five of each intervention, body composition was analyzed (BodPod®), and blood was sampled between 0800 —1600 hours for LH, TSH and GH, every 10 min, cortisol every 30 min, T3, reverse T3 (rT3) and T4 every 60 min, free T3 (FT3), free T4 (FT4) and TBG at 0800 h and 1600 h. We correlated means of pulsatile LH pulse frequency (LHPF) with integrated metabolic hormone changes across the day in the subset of women with reduced or unchanged LHPF after DEA (n=10) using linear regression. Results In ∼50% of healthy young women, LHPF decreased or was unchanged in response to short-term moderate energy deprivation. BMI and bodyweight declined after DEA in both groups while % fat mass was unchanged. TSH, T3, leptin, insulin declined, and T4 increased from NEA to DEA while glucose, cortisol and GH were unchanged. In subjects with reduced/unchanged LHPF, % delta T3 correlated inversely with delta LHPF (r=-0.727, p=0.017). Similarly, non-fasting delta TSH correlated inversely with % delta LHPF (r=-0.643, p=0.045), and % delta AUC TSH (r=-0.642, p=0.045) correlated inversely with DEA LHPF. Percent delta insulin (r= -0.722, p=0.018) and % delta insulin AUC (r= – 0.688, p=0.028) correlated inversely with delta LHPF. Percent delta insulin-glucose ratio (r=-0.772, p=0.009) and % change in AUC insulin-glucose ratio (r=-0.759, p=0.011) also correlated inversely with delta LHPF. This inverse relationship was preserved when insulin was normalized for caloric intake (n-insulin) was correlated with % delta LHPF (r=-0.722, p=0.018) and % delta AUC n-insulin correlated with delta LHPF (r= -0.631 and p= 0.050). Delta AUC leptin (r=-0.684, p=0.029) and % delta AUC leptin (r=-0.670, p=0.034) also correlated inversely with delta LHPF. Mean cortisol at NEA correlated inversely with LHPF during DEA (r=-0.816, p=0.007), implying that higher baseline cortisol levels may predict a greater relative fall in LHPF. Cortisol AUC in DEA also correlated inversely with LHPF in DEA (r=-0.722, p=0.028). Conclusion Our data suggest that greater changes in metabolic hormones may protect against the inhibitory effect of moderate energy deprivation on GnRH secretion in healthy young women with normal reproductive function. Presentation: Saturday, June 11, 2022 1:30 p.m. - 1:35 p.m., Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Effect of mother bonded rearing on growth, health and physiological state of Murrah buffalo calves

We investigated the effect of different types of mother-young contacts (fenceline, restricted and no contact) on the health, growth performance, behaviour and physiological state of Murrah buffalo calves. A total of 24 calves were allocated to three groups of 8: NCM (no calf-mother contact), RCM (restricted calf-mother contact) and FCM (fenceline calf-mother contact). At three months of age, the FCM calves had a higher average body weight (58.6 ± 1.5 kg) than the RCM (52.8 ± 1.3 kg) and NCM (53.6 ± 1.3 kg) calves (P < 0.05). The average daily gain (ADG) at three months of age was greater in FCM (0.6 ± 0.1 kg/d) than RCM (0.5 ± 0.1 kg/d) and NCM (0.5 ± 0.1 kg/d) calves (P < 0.05). The mean immunoglobulin G (IgG) concentrations were significantly greater on d 7, 28, 42 and d 56 of sampling (P < 0.05 for all comparisons) in FCM than RCM and NCM calves. The mean cortisol levels were highest in the NCM calves followed by RCM and the lowest values were observed in FCM calves on d 0, d 7, d 28, d 42 and d 56, respectively (P < 0.05, for all recorded days). The diarrhoea score and eggs per gram of faeces (EPG) were significantly greater in the NCM group compared to the RCM and FCM groups. The time spent in cross sucking, licking inanimate objects and self-licking was greatest (P < 0.05) in NCM calves, followed by RCM calves, and was almost non-existent in the FCM group on all the recorded weeks. Time spent in backward ear position was greater (P < 0.05) in FCM than RCM and NCM calves. The average time spent in forward ear position was greatest (P < 0.05) in the RCM calves followed by NCM with the lowest time observed in FCM calves. The mean duration of time spent by calves in the asymmetrical and axial ear position differed significantly (P < 0.05) among NCM, RCM and FCM calves, P < 0.05. The full and fenceline buffalo calf-mother contact system showed higher growth rates, lower levels of stress responses, oral stereotypies and eggs per gram of faeces. In addition, ear postures may be used as a dependable, and reliable measure of positive, low arousal emotional states.

ODP630 Antibiotics Transiently Reduce Circulating Cortisol and Inflammatory Biomarker Levels in Healthy Sprague Dawley Rats

Abstract Introduction Antibiotics are over-used in healthcare, but little is known regarding their effects on cortisol levels in healthy individuals. Furthermore, antibiotics influence the gut microbiome, but the interrelationships between these drugs, cortisol and the microbiome are unknown. Here, we exposed the gut microbiome of rats to a multi-drug antibiotic cocktail and examined effects on circulating cortisol and inflammatory biomarker levels. Methods Male and female (M,F) Sprague-Dawley rats (aged 8 weeks) were housed with phytoestrogen-free bedding, and received a phytoestrogen-free diet with water from glass bottles. Exposed rats received vancomycin (0.5g/L), ampicillin (1g/L), neomycin (1g/L), and metronidazole (1g/L) in their water for 8 days, then returned to normal water for another 13 days. Control rats received normal water throughout the study. Stool and serum samples were collected before starting antibiotics (Abx) (baseline), on day 8 of Abx (AbxD8), and at 13 days post-Abx (PAbxD13). Circulating levels of cortisol and a panel of 12 inflammatory biomarkers were analyzed using MILLIPLEX Hormone Panels and RECYTMAG-65K multiplex panels, respectively. Stool DNA was extracted and 16S V3/V4 libraries were sequenced on an Illumina MiSeq. Operational Taxonomic Unit (OTU) clustering and taxonomic analyses were performed using CLC Microbial Genomics Module v.2.5 (Qiagen). Results A total of 31 rats (M=16, F=15) received Abx and 17 (M=9, F=8) were controls. At baseline, mean cortisol levels were similar between groups (control=34. 08±10.21ng/mL, exposed=35. 05±9.72ng/mL, P=0.96). On AbxD8, cortisol levels decreased in the exposed group relative to controls (control=29.77±9.34ng/mL, exposed=17.35±8.21ng/mL, P&amp;lt;0. 0001), and returned to normal in the exposed group at PAbxD13 (control=33.88±16.65ng/mL, exposed=36.62±8.68ng/mL, P=0.85). Levels of all 12 inflammatory biomarkers were also decreased at AbxD8, and all except MCP1 returned to baseline levels by PAbxD13. Antibiotic exposure resulted in significant decreases in total stool DNA levels in exposed rats relative to controls on AbxD8 (P&amp;lt;0. 0001), but returned to baseline levels by PAbxD13. Stool microbial diversity was also decreased in exposed rats on AbxD8 relative to controls (P=1e-08 and P&amp;lt;0. 0001, respectively), and gut microbiome alterations were seen at multiple taxonomic levels. At PAbxD13, the stool microbiome of exposed rats remained perturbed, and only one phylum, Bacteroidetes, returned to baseline. Abx exposure changed associations between different phyla and levels of cortisol on AbxD8 relative to baseline, and although most of the associations reestablished at PAbxD13, the RA of phylum Proteobacteria was positively associated with levels of cortisol (R=0.243, P=0. 04), as opposed to baseline (R=-0.144, P=0.4). Conclusions Antibiotic exposure results in significant decreases in levels of cortisol as well as inflammatory biomarkers that are associated with perturbations of the gut microbiome, the majority of which returned to baseline following a 13-day antibiotic recovery period. These interrealtionships between cortisol, the gut microbiome and inflammatory biomarkers may have clinical significance. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Impact of Postural Corrective Training (TCP®) on overall glycemic control in diabetic middle-aged women

Introduction: Diabetes mellitus (DM) is a disease manifested by chronic hyperglycemia resulting from changes in the secretion and / or action of insulin, which can cause tissue damage. The practice of physical exercise is often recommended in the treatment of this disease because it improves glucose uptake due to increased insulin sensitivity. Objective: to evaluate the effect of Corrective Postural Training (TCP®) on the glycemic metabolism of patients with type 2 diabetes. Methods: Twenty-one women between 44 and 55 years old were divided into four groups: sedentary diabetics (SD); exercised diabetics (ED); non-diabetic exercised (NE); and non-diabetic sedentary (NS). TCP® was performed 3 times / week, for 1 hour / day, for a period of 20 weeks. Blood samples were collected pre- and post-intervention to determine cholesterol, triglycerides, HDL, fasting glycemia, glycated hemoglobin, estimated mean glycemia and cortisol. The Wilcoxon and Friedman tests were used to compare the results before and after intervention. Results: there was no significant difference in the anthropometric, biochemical and hormonal variables of all groups; however, glycated hemoglobin showed a significant difference (p &lt;0.05) in the ED group after 20 weeks. Important intragroup clinical changes were observed with return to the reference values of some of the analyzed parameters. Conclusion: The TCP® method may have contributed to the improvement of plasma levels of glycated hemoglobin in the ED group in addition to the clinical improvement of patients.

Preliminary Investigation into Developing the Use of Swabs for Skin Cortisol Analysis for the Ocean Sunfish (Mola mola).

Simple SummaryZoos and aquaria play an important role in preventing the mass extinction of wildlife through public awareness of conservation issues and providing a safe haven for wildlife populations. Because aquatic populations face many challenges due to pollution and global warming, it is important to develop an understanding of how species can cope with their environment whether it be in the wild or under human care. Here, we were interested in developing non-invasive methods to study fish stress physiology. We use the unique ocean sunfish (Mola mola) to develop the use of skin swabs to measure the stress hormone, cortisol. We used known times of stress including when a mola was injured or ill and during acclimation to the Monterey Bay Aquarium. We found that cortisol increased initially within the first month of being admitted to the aquarium, but returned to normal values afterward. Molas also had elevated cortisol when being treated for an injury or illness. This is the first step in the development of the use of skin swabs to collect samples for stress analysis in the mola. Additional biochemical analysis is needed to confirm these results and allow this method to be applied to other species of fish.The ocean sunfish (mola; Mola mola) is the heaviest bony fish in the world. This slow-moving fish often is injured by fishing boats that use drift gillnets attributing to its listing as Vulnerable by the IUCN. The Monterey Bay Aquarium (Monterey, CA, USA) has a program that brings in smaller molas from the ocean and acclimates them for an exhibit. When they grow too large for the million-gallon Open Seas exhibit, they are returned to Monterey Bay through a “reverse” acclimatization. Our overall goal was to use skin swabs to evaluate mola stress physiology to better understand the effects of this program. Our objectives were to validate this non-invasive method by taking opportunistic swabs throughout acclimatization and during stressful events. We swabbed each individual (n = 12) in three different body locations. Swabs were analyzed using a cortisol enzyme immunoassay. We averaged the three swabs and examined the absolute change of cortisol from the first taken upon handling to during treatments and the different acclimation stages. We considered elevated cortisol concentrations to be ≥1.5-fold higher than the first sample. Overall, mean (±SEM) cortisol varied among individuals (564.2 ± 191.5 pg/mL swab (range, 18.3–7012.0 pg/mL swab). The majority (four of six) of molas swabbed within the first week or month had elevated skin cortisol compared to their first sample. All seven molas that were being treated for an injury or illness had elevated skin cortisol (range, 1.7- to 127.6-fold higher) compared to their post-acclimation sample. This is the first step in validating the use of non-invasive skin swabs for glucocorticoid analysis in the mola. Further biochemical analysis is needed to determine the specific steroids that are being measured.

Effect of Etomidate vs Propofol for Total Intravenous Anesthesia on Major Postoperative Complications in Older Patients

Older patients may benefit from the hemodynamic stability of etomidate for general anesthesia. However, it remains uncertain whether the potential for adrenocortical suppression with etomidate may increase morbidity. To test the primary hypothesis that etomidate vs propofol for anesthesia does not increase in-hospital morbidity after abdominal surgery in older patients. This multicenter, parallel-group, noninferiority randomized clinical trial (Etomidate vs Propofol for In-hospital Complications [EPIC]) was conducted between August 15, 2017, and November 20, 2020, at 22 tertiary hospitals in China. Participants were aged 65 to 80 years and were scheduled for elective abdominal surgery. Patients and outcome assessors were blinded to group allocation. Data analysis followed a modified intention-to-treat principle. Patients were randomized 1:1 to receive either etomidate or propofol for general anesthesia by target-controlled infusion. Primary outcome was a composite of major in-hospital postoperative complications (with a noninferiority margin of 3%). Secondary outcomes included intraoperative hemodynamic measurements; postoperative adrenocortical hormone levels; self-reported postoperative pain, nausea, and vomiting; and mortality at postoperative months 6 and 12. A total of 1944 participants were randomized, of whom 1917 (98.6%) completed the trial. Patients were randomized to the etomidate group (n = 967; mean [SD] age, 70.3 [4.0] years; 578 men [59.8%]) or propofol group (n = 950; mean [SD] age, 70.6 [4.2] years; 533 men [56.1%]). The primary end point occurred in 90 of 967 patients (9.3%) in the etomidate group and 83 of 950 patients (8.7%) in the propofol group, which met the noninferiority criterion (risk difference [RD], 0.6%; 95% CI, -1.6% to 2.7%; P = .66). In the etomidate group, mean (SD) cortisol levels were lower at the end of surgery (4.8 [2.7] μg/dL vs 6.1 [3.4] μg/dL; P < .001), and mean (SD) aldosterone levels were lower at the end of surgery (0.13 [0.05] ng/dL vs 0.15 [0.07] ng/dL; P = .02) and on postoperative day 1 (0.14 [0.04] ng/dL vs 0.16 [0.06] ng/dL; P = .001) compared with the propofol group. No difference in mortality was observed between the etomidate and propofol groups at postoperative month 6 (2.2% vs 3.0%; RD, -0.8%; 95% CI, -2.2% to 0.7%) and 12 (3.3% vs 3.9%; RD, -0.6%; 95% CI, -2.3% to 1.0%). More patients had pneumonia in the etomidate group than in the propofol group (2.0% vs 0.3%; RD, 1.7%; 95% CI, 0.7% to 2.8%; P = .001). Results were consistent in the per-protocol population. Results of this trial showed that, compared with propofol, etomidate anesthesia did not increase overall major in-hospital morbidity after abdominal surgery in older patients, although it induced transient adrenocortical suppression. ClinicalTrials.gov Identifier: NCT02910206.

Changes in the adrenal gland and cortisol secretions in experimental acute Trypanosoma brucei brucei infection in Sahel bucks

The effects of experimental acute Trypanosoma brucei brucei infection on the function and structure of the adrenal gland of Sahel bucks were studied for forty days. Eight Sahel bucks aged between 8 and 15 months were used. They were divided into two groups of five (infected) and three (uninfected) bucks. Group I were inoculated with 1ml containing about 1×10⁶ trypanosomes (Trypanosoma brucei brucei, Federe strain) via the jugular vein. Group II was uninfected control. Parasitaemia in the infected bucks appeared 3-4 days post-infection. The mean serum cortisol concentrations of the uninfected control and the infected groups at day 0 were 3.33 ± 0.44 μg/dl and 2.4 ± 0.29μg/dl, respectively. By day 4 post-infection, the mean serum cortisol concentration of the infected group increased to its peak value of 21.8 ± 6.25μg/dl compared to 3.0 ± 0.86 μg/dl of the uninfected control on the day all infected bucks became parasitaemic. Grossly, the adrenal glands of the infected group were enlarged. Histopathologically, there was adrenal cortical hypertrophy in the infected group. The results indicate that acute trypanosomosis due to experimental T. brucei brucei infection in Sahel buck caused hypertrophy of the adrenal gland and a significant increase in the circulatory cortisol concentration of the infected bucks at the onset of parasitaemia followed by a decrease to pre-infection cortisol concentration till the end of the 40 days duration of the experiment. Further study on the long-term effect of experimental Trypanosoma brucei brucei infection on the adrenal gland of Sahel bucks is recommended.

Estimation of alpha amylase, cortisol, and pH level in saliva of patients wearing conventional and Biofunctional Prosthetic System complete dentures: A parallel randomized clinical trial

Statement of problemBiofunctional Prosthetic System (BPS) complete dentures have been reported to maintain a harmonious relationship with the surrounding oral structures and provide improved adaptation compared with conventional complete dentures. However, an evaluation of salivary changes and its constituents between BPS and conventional dentures is lacking. PurposeThe purpose of this parallel randomized clinical trial was to evaluate the alpha amylase, cortisol, and pH levels in saliva in participants provided with conventional and BPS complete dentures. Material and methodsSixteen completely edentulous participants were recruited for providing with conventional and BPS dentures (n=8). The levels of alpha amylase, cortisol, and pH in their saliva were evaluated by using an enzyme-linked immunosorbent assay (ELISA), colorimetric, and pH meter before insertion and 1 week and 1 month after denture insertion. The data were analyzed with repeated measure ANOVA and the Student t test (α=.05). ResultsThe mean ±standard deviation for pH was 6.94 ±0.22 in conventional complete dentures and 7.04 ±0.12 in BPS dentures; for alpha amylase, it was 206.75 ±14.64 and 210.88 ±15.72 IU/mL; and for cortisol, it was 0.29 ±0.05 and 31 ±0.04 nmol/L before insertion and 1 week and 1 month after denture insertion. From the repeated measures ANOVA, the mean pH and salivary cortisol were not statistically different (P>.05), but salivary amylase was statistically different (P<.05). The Student t test showed no significant difference in pH (P>.05), but a statistically significant difference in alpha amylase and salivary cortisol levels was found between the 2 groups (P<.05). ConclusionsNo significant difference in salivary pH was found in completely edentulous patients provided with conventional or BPS dentures, but significant differences were found in levels of alpha amylase and salivary cortisol.

Serum Concentrations of Immunoglobulins and Cortisol Around Parturition in Clinically Healthy Sows and Sows with Postpartum Dysgalactia Syndrome (PDS).

IntroductionThis study aimed to determine the profile of immunoglobulins and cortisol concentrations in serum around the periparturient period in sows suffering from postpartum dysgalactia syndrome (PDS) and in healthy sows.Material and MethodsA total of 45 sows with lactation impairment (Group PDS) and 58 clinically healthy sows with a physiological peripartum period (Group H) were subjected to a serological test (ELISA) for measurement of serum immunoglobulins (IgG, IgM, and IgA) and cortisol concentration.ResultsThe serum contents of IgG, IgM and IgA had highly similar profiles in PDS-affected sows and healthy ones. A significantly higher concentration of IgG at 28 and 14 days ante partum compared to days 3 and 7 post partum was only observed in Group H. The mean cortisol content remained at a highly similar level throughout the entire experiment in both groups.ConclusionThe results of the study indicate that lactation impairment such as PDS did not influence the immunoglobulin or cortisol concentration in sow serum.

Pediatric Groin Surgeries: A Comparison of Analgesic Effects of Caudal Block and Inguinal Field Block Using Plain Bupivacaine.

There is a paucity of studies in the West African sub-region which have compared both the intraoperative and postoperative analgesic effects of caudal block and inguinal field block using plain bupivacaine in groin surgeries in children. The study aimed to compare the duration of analgesia and complications of caudal block and inguinal field block in pediatric groin surgeries. This was a prospective, double-blind randomized study conducted at a tertiary health institution in North Central, Nigeria, over a period of 6 months. A total of 74 children scheduled for day case groin surgeries for inguinal hernia, hydrocoele and palpable undescended testis were recruited into the study. The effectiveness of the analgesic effect was assessed by measuring serum cortisol levels before surgery (i.e. baseline at 8am), 5minutes after caudal block or inguinal field block, and 1-hour after surgery. Post-operative pain was determined using FLACC score (Face, Legs, Activity, Crying and Consolability) every 15 minutes till 6 hours after surgery when the patients were discharged home and the caregivers measured the patients' pain scores using the FLACC score every 1 hour to a maximum duration of 10 hours after surgery. Data obtained from the study was entered into the study proforma and analysed using IBM SPSS version 21.0. The P value was considered statistically significant at <0.05. A total of 74 patients were recruited for this study, with 68 males (91.9%) and 6 females (8.1%). The children's age range was 6 months to 7 years, with a mean age of 3.35 ± 1.90 years. The mean basal serum cortisol levels of the caudal block group and inguinal block group were 11.15 ± 5.38 µg/dL and 10.79 ± 4.92µg/d respectively (p-value = 0.767). Five minutes after caudal block, the mean serum cortisol level was 10.50 ± 5.39µg/dL while inguinal field block was 10.63 ± 4.68µg/dL (p-value = 0.288). The mean serum cortisol level obtained one hour after each procedure was 9.34 ± 4.05 µg/dL for the caudal block group and 10.00 ± 3.56 µg/dL in the inguinal field block group with p-value = 0.275.Using the FLACC score, the mean duration of analgesia in caudal block group was 372.00 ± 71.55 minutes and was inguinal field block group was 387.43 ± 62.65 minutes with a p-value = 0.116. There was no anaesthetic technique related complications that was recorded in both caudal block group and inguinal group during the study period. This study demonstrated that caudal block and inguinal field block using plain bupivacaine provided comparable duration of analgesia in paediatric groin surgeries. Therefore, caudal block or inguinal field block using plain bupivacaine should be recommended for both intraoperative and postoperative analgesia in elective paediatric groin surgeries.

A Comparative Study on Influence of Stress on Diurnal Variations in Salivary Cortisol Levels among Selected Employed and Unemployed Women

Background: Secretion of stress hormone cortisol correlates with the intensity of stressors and their period of occurrence, and may have serious implications on health in the long run. Aim: This study explores the diurnal variations of the salivary cortisol levels among selected employed and unemployed women. Method and Material: From a population of 400 employed and 272 unemployed women, 40 women (20 employed and 20 unemployed) were selected. In order to compare the cortisol levels between women without stress and with stress, 5 each from employed and unemployed groups with normal stress scores and 15 from each group with mild to moderate stress scores based on the DAS (Depression, Anxiety and Stress Score) were included in the study. Results: Employed women exhibited two peaks in the hormonal profile, a sharp peak in the early morning (CAR-cortisol awakening response) with the mean cortisol level of 14.7 ± 5.9 nmol/l which slowly dropped to 10.1 ± 4.7 nmol/l in the noon and increased again by evening to 11.8 ± 4.6 nmol/l. Among the unemployed women, a single peak appeared for CAR that is 12.6 ± 3.5 nmol/l, which gradually declined to 8.1 ± 2.3 nmol/l by evening time. Conclusion: The extent of stress is exhibited by multiple peaking of cortisol levels among employed women. Unemployed women with stress had markedly high levels of cortisol compared with their counterparts with no stress. It is of greater concern that the employed women with stress have markedly high cortisol levels which could be an indication of health issues in the longer run.

Early oral feeding following duodenal resection and anastomosis: stressor or succour – a dog model

The effects of early oral feeding (EOF) on vital parameters and some stress markers after intestinal surgery was the focus of this study. Sixteen (16) Nigerian indigenous dogs were randomly assigned to 4 groups (n=4) which underwent duodenal resection and end-to-end anastomosis. Post operatively, group I animals were maintained on total parenteral nutrition (TPN) for 3 days while groups II-IV animals had parenteral nutrition with oral feeding instituted at 8, 12 and 24 hours respectively. The animals were monitored for side effects of TPN and EOF and post-operative complications. Vital parameters and some stress markers like the glucose and cortisol levels were monitored. The Mean heart and pulse rates of group I (TPN) animals were significantly (P &lt;0.05) higher than those of the EOF groups. The EOF groups had higher body weight post-operatively. On post-surgery day (PSD) 1, the mean glucose level of group I animals was significantly lower than those of group IV, while the mean cortisol values in all the groups showed a similar increase post-operatively which declined gradually after PSD 1. Therefore, EOF given 8, 12 or 24 hours after intestinal surgery is feasible, safe and more convenient, and improves nutritional status of dogs.

Cortisol levels in rural Latina breast cancer survivors participating in a peer-delivered cognitive-behavioral stress management intervention: The Nuevo Amanecer-II RCT

BackgroundCompared to their White counterparts, Latina breast cancer survivors have poorer survival rates and health-related quality of life, and higher rates of depression and anxiety which may be a result of chronic stress. Chronic stress impacts the hypothalamic-pituitary-adrenal (HPA) axis, resulting in cortisol dysregulation which may be associated with breast cancer survival. However, cortisol levels and cortisol profiles of Latina breast cancer survivors are poorly characterized due to their underrepresentation in biomedical research. ObjectiveThe objective of this study was to describe cortisol levels and patterns of cortisol secretions in rural Latina breast cancer survivors participating in an RCT study of Nuevo Amanecer-II, an evidence-based peer-delivered cognitive behavioral stress management intervention. MethodsParticipant-centered recruitment and collection strategies were used to obtain biospecimens for cortisol analysis. Nine saliva samples (3/day for 3 days) and a hair sample were obtained at baseline and 6-months (3-months post-intervention). We describe cortisol levels and profiles, explore correlations of biomarkers with self-report measures of stress and psychological distress, and compare women who received the intervention with a delayed intervention group on biomarkers of stress. Mean hair cortisol concentration (HCC) was used to assess chronic stress. Based on daily measures of cortisol (awakening, 30 min post-awakening, and bedtime), we calculated three summary measures of the dynamic nature of the cortisol awakening response (CAR): 1) the CAR slope, 2) whether CAR demonstrates a percent change ≥40, and 3) total daily cortisol output (AUCg). Linear and log-binomial regression, accounting for multiple samples per participant, were used to compare cortisol measures at 6-month follow-up by treatment arm. ResultsParticipants (n = 103) were from two rural California communities; 76 provided at least one saliva sample at baseline and follow-up and were included in the analysis. At baseline, mean age was 57 years, mean years since diagnosis was 2 years, 76% had a high school education or less, and 34% reported financial hardship. The overall median CAR slope was 0.10, and median cortisol AUCg (in thousands) was 11.34 (range = 0.93, 36.66). Mean hair cortisol concentration was 1751.6 pg/mg (SD = 1148.6). Forty-two percent of samples had a ≥40% change in CAR. We found no statistically significant correlations between the cortisol measures and self-reported measures of stress and psychological distress. At follow-up, no differences were seen in HCC (mean difference between intervention and control: −0.11, 95% CI -0.48, 0.25), CAR slope (0.001, 95% CI -0.005, 0.008), cortisol AUCg (−0.15, 95% CI -0.42, 0.13), or ≥40% change in CAR (prevalence ratio 0.87, 95% CI 0.42, 1.77) between treatment arms. ConclusionOur findings of flattened cortisol profiles among more than half of the sample suggest potential HPA-axis dysregulation among rural Spanish-speaking Latina breast cancer survivors that merits further study due to its implications for long-term survival. Trial registrationhttp://www.ClinicalTrials.gov identifier NCT02931552.

Cortisol Levels During Acute Illnesses in Children and Adolescents

Endogenous cortisol levels in children and adolescents during acute illnesses can contribute to the evidence base required to optimize glucocorticoid (GC) stress doses for children and adolescents known to have GC deficiency. To identify endogenous cortisol levels during a range of acute illnesses in children and adolescents without GC deficiency from published evidence. CINAHL, Cochrane Library, Cochrane Database of Systematic Reviews, Embase, and MEDLINE were searched for studies published between January 1, 2000, and June 30, 2020. Two reviewers independently identified relevant studies. Differences were resolved by joint discussion. Inclusion criteria were common acute illnesses, age from 1 month to 18 years, and basal blood cortisol levels obtained within 48 hours of presentation. Studies with fewer than 5 participants and those that included participants known to have GC deficiency or a history of treatment that could affect cortisol levels were excluded from the review. Data for predefined fields were extracted and independently checked by separate pairs of reviewers. Overall weighted means and pooled SDs for cortisol levels were calculated. All 15 studies included were hospital based and included 864 unique participants: 14 studies were prospective observational studies, 1 was part of a trial, and 5 included control individuals. Mean cortisol levels were higher in all participants with an acute illness (n = 689) than in controls (n = 175) (difference in weighted means, 18.95 μg/dL; 95% CI, 16.68-21.22 μg/dL). Cortisol levels were highest in patients with bacterial meningitis (weighted mean [pooled SD], 46.42 [22.24] μg/dL) and were more than 3-fold higher in the group with severe gastroenteritis (weighted mean [pooled SD], 39.64 [21.34] μg/dL) than in the control group. Among the subgroups with sepsis, those with shock had lower cortisol levels than those without shock (weighted mean [pooled SD], 27.83 [36.39] μg/dL vs 37.00 [23.30] μg/dL), but levels in nonsurvivors did not differ from levels in survivors (weighted mean [pooled SD], 24.89 [51.65] μg/dL vs 30.53 [30.60] μg/dL). This systematic review found that, in children and adolescents without GC deficiency, circulating cortisol levels were higher during acute illnesses than those in controls and also varied across a range of acute illnesses. Whether these levels need to be achieved with exogenous GC stress doses tailored according to the nature and severity of the illness in children and adolescents with GC deficiency warrants investigation.