Distinct activation of the sympathetic adreno-medullar system and hypothalamus pituitary adrenal axis following the caloric vestibular test in healthy subjects.

INTRODUCTION: The vestibular acute stress induces reversible alert-like reactions that involve the sympathetic adrenal-medullar system and hypothalamic-pituitary-adrenal axis responses. The present study aimed to evaluate salivary α-amylase and salivary cortisol production in relation with cardiovascular reactivity induced by acute stress in healthy subjects. MATERIAL AND METHODS: Forty-eight young healthy male volunteers were examined under basal conditions and at various times after reaching the maximal nystagmic reaction following air caloric vestibular test. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded at the same time as measurement of the salivary α-amylase and salivary cortisol. At the end of the caloric vestibular test session, perceived stress scale questionnaires were administered to measure the self-perceived stress impact induced by the task, and individual scores were compared with those measured on the enrollment day. RESULTS: Following caloric vestibular test-evoked vertigo, salivary α-amylase and cortisol showed distinct trends in their production after acute stress: Student's t-test was used to compare the α-amylase vs cortisol slopes of the respective interpolated regression lines, and the difference was significant (t = -3.283; p<0.001); an increase in salivary cortisol production corresponded with a decrease in the salivary α-amylase concentration. In addition, salivary biomarker modifications were associated with consistent changes in the heart rate, systolic blood pressure and mean arterial pressure. CONCLUSIONS: Using the air caloric vestibular test task as a stressor, the present study demonstrated a connection between the acute hormonal stress response to vestibular stimulation and cardiovascular output. However, further research is needed before we can define the potential importance of the consistent cardiovascular activity changes evoked by vestibular stimulation and the possible functional consequences for cardiovascular regulation and orthostatic tolerance in humans.

No definitive evidence for a connection between autoimmune thyroid diseases and stress in women.

The purpose of this literature review was to examine the available clinical studies performed during the last 15 years to identify if there is a causal relationship between the onset and course of autoimmune thyroid diseases (AITDs) and the hypothalamic-pituitary-adrenal (HPA) axis/sympathetic-adrenomedullary system (SAM) (dys)function in women. Using the PubMed, Web of Science and Scopus databases, a comprehensive search was performed, and 14 articles were finally identified. The majority of selected studies suggested a causal connection between Graves' Disease (GD) and stress, as well as between Hashimoto Thyroiditis (HT), with its variant postpartum thyroiditis, and stress. However, due to heterogeneity in the protocols, mainly based on the theoretical side effects of stress on the immune-neuroendocrine system, and the different modalities used to establish the impact of stress on individuals, no definitive conclusions could be reached to explain the mechanisms by which stress contributes to the onset of AITDs in women and to determine whether stress management could help in modifying the course of AITDs.

Self-medication with antimicrobial drugs among university students in a Northeast region of Romania.

UNLABELLED: Self-medication with antimicrobial drugs is an important problem in the world and may lead to serious consequences for healthcare systems. OBJECTIVE: To evaluate the prevalence and patterns of self-medication with antimicrobial drugs among university students in a Northeast region of Romania. MATERIAL AND METHODS: A cross-sectional questionnaire-based study was conducted to collect data from medical and non-medical students who lived in residence halls. Data were analyzed using descriptive statistics and the chi-square test, when applicable. RESULTS: Out of the 320 questionnaires distributed, a total of 281 students completed and returned the questionnaires. Among these, 115 (41%) respondents admitted to have used at least one antibiotic in the six months prior to the survey, 44% of whom did not seek medical advice (irrational self-medication). The most common antimicrobial drugs used for self-medication were amoxicillin (37%), amoxicillin-clavulanate (33%), ciprofloxacin and penicillin (14%) and the most frequently reported reasons for self-medication were respiratory and oral infections (31%), common cold (25%), and genitourinary infections (20%). Some students mentioned the use of more than one antimicrobial drug, for more than one disease. CONCLUSIONS: self-medication with antimicrobial drugs is a relatively common practice among students in Romania. This suggests the need for interventions to prevent the irrational use of antimicrobial drugs, such as the implementation of national programs for public education regarding the risks and consequences for the health of irrational use of antimicrobials.