Occupational exposure to pesticides deregulates systemic cortisol levels in women with breast cancer and correlates with poor prognosis features

Pesticides have been pointed out as hormone disruptors and may significantly affect the prognosis of hormone-dependent diseases such as breast cancer (BC). Here, we investigated the impact of occupational pesticide exposure on systemic cortisol levels in female rural workers diagnosed with BC. Occupational exposure was assessed by interviews with a standardized questionnaire. Plasma samples (112 from pesticide-exposed women and 77 from unexposed women) were collected in the afternoon, outside the physiological cortisol peak, and analyzed by a chemiluminescent paramagnetic immunoassay for the quantitative determination of cortisol levels in serum and plasma. The results from both groups were categorized according to patients' clinicopathological and exposure data. BC pesticide-exposed women presented higher levels of cortisol than the unexposed. Higher cortisol levels were also detected in the exposed group with more aggressive disease (triple-negative BC), with tumors over 2 cm, with lymph node metastases, and with high risk of disease recurrence and death. These findings demonstrated that there is an association between pesticide exposure and BC that affected cortisol levels and correlated to poor disease prognosis.

Maternal obesity and its repercussions on melatonin and cortisol in breast milk and human colostrum

Introduction: scientific evidence has highlighted the role of chronobiological disruptions in promoting obesity through mechanisms involving important circadian rhythm hormones: melatonin and cortisol. These hormones are present in human colostrum and serve as crucial maternal and child protection mechanisms against obesity and childhood infections, owing to the intense interaction between mother and child during pregnancy and breastfeeding. Consequently, the melatonin and cortisol hormones present in human colostrum hold promise as potential candidates for yielding clinically applicable results and supporting future intervention strategies aimed at reducing obesity and neonatal infections. However, there is a scarcity of literature on this subject. Objective: the objective of this study is to to analyze the impact of maternal obesity on the levels and functions of melatonin and cortisol in colostrum and breast milk. Methods: a systematic review of the scientific literature was conducted following the recommendations outlined in the PRISMA protocol. Original articles published in English were searched in the PubMed, Medline, Lilacs, and Scopus databases. There were no restrictions on the publication year. Results: a total of 37 articles were identified from the searched databases. After removing duplicates and applying the inclusion and exclusion criteria, only five studies were relevant to the topic: two studies addressing melatonin and three studies analyzing cortisol. This review revealed that melatonin levels are elevated in the colostrum of obese women, and for this particular group, it has the potential to restore phagocyte activity and increase lymphocyte proliferation. Studies on cortisol have demonstrated that maternal obesity does not alter the levels of this hormone in breast milk. Conclusion: breastfeeding should be encouraged for all populations, and further original research should be conducted to elucidate the protective mechanisms of colostrum and breast milk.

Introdução: evidências científicas enfatizam que disrupções cronobiológicas podem promover a obesidade por mecanismos envolvendo ação de importantes hormônios marcadores do ritmo circadiano: a melatonina e cortisol. Estes hormônios estão presentes no colostro humano e representam importante mecanismo de proteção materno infantil frente à obesidade e infecções infantis, devido à intensa interação entre mãe e filho durante a gravidez e amamentação. Assim, os hormônios melatonina e cortisol presentes no colostro humano representam promissores candidatos para fornecer resultados com capacidade de aplicação clínica e de embasamento de futuras estratégias de intervenção com enfoque na redução da obesidade e de infecções neonatais. Entretanto, são escassos os estudos na literatura sobre o tema. Objetivo: analisar as repercussões da obesidade materna sobre os níveis e as ações da melatonina e do cortisol no colostro e leite materno. Método: foi realizada uma revisão sistematizada da literatura científica seguindo as recomendações do protocolo Prisma. Foram pesquisados artigos originais, publicados em inglês, nas bases de dados PubMed, Medline, Lilacs e Scopus. Não houve restrição quanto ao ano de publicação. Resultados: foram identificados 37 artigos nas bases de dados pesquisados, 15 artigos foram excluídos por estarem duplicados, após aplicação do critério de inclusão e exclusão apenas 5 estudos tiveram relação ao tema, sendo 2 estudos abordando sobre melatonina e 3 pesquisas que analisaram o cortisol. Esta revisão mostrou que a melatonina está elevada em colostro de obesas e para este grupo ela possui potencial de restaurar atividade de fagócitos e de elevar a proliferação de linfócitos. Os estudos sobre o cortisol ilustraram que os níveis deste hormônio no leite materno não foram alterados pela obesidade materna. Conclusão: o aleitamento materno deve ser encorajado para todos os públicos, assim como mais pesquisas originais devem ser desenvolvidas para descrever os mecanismos protetores do colostro e leite materno

Comparison of two psychotherapies in cortisol response and their efficacy in reducing symptoms of anxiety and depression in women victims of intimate partner violence / Comparación de dos psicoterapias en la respuesta del cortisol y en su eficacia para reducir los síntomas de ansiedad y depresión en mujeres víctimas de violencia de pareja

Abstract Introduction There is a growing need to implement evidence-based psychological treatments for women victims of intimate partner violence (IPV) who commonly experience stress-related disorders such as anxiety, depression, or suicide risk, as well as altered cortisol reactivity. Objective 1. To compare the changes in depressive and anxious symptomatology, quality of life, and cortisol reactivity after two different interventions, Acceptance and Commitment Therapy (ACT, based on psychological flexibility) or Interpersonal Therapy (IPT, based on empowerment) in women exposed to IPV. 2. To compare the changes in relation to the presence of suicide thoughts. Method A clinical sample of 50 women (ages 21-74) randomly assigned to attend ACT or IPT, completed pre- and post-intervention questionnaires about intimate partner violence, quality of life, depression, anxiety, and measurements of salivary cortisol reactivity (basal, 15, 30, and 45 minutes after a cognitive challenge). We used Generalized Estimating Equation Models for data analysis. Results There was a significant improvement post-intervention in all variables, regardless of the type of psychotherapy or the presence of suicide thoughts. Before interventions, women that reported suicide thoughts had severe symptoms of depression, anxiety, worse quality of life, and a cortisol hyper-response profile, in contrast to women without suicide thoughts who had moderate symptoms and no cortisol response. Cortisol response to the cognitive test decreased in all women after both therapies. Discussion and conclusion Although different psychological approach, ACT, and IPT effectively improved mental health, quality of life, and changed cortisol reactivity of women exposed to IPV, including women at suicide risk.

Resumen Introducción Son necesarios tratamientos basados en evidencia para mujeres víctimas de violencia de pareja (IPV), con trastornos relacionados con estrés como ansiedad, depresión y riesgo suicida y alteraciones en la reactividad del cortisol. Objetivo Comparar los cambios en la sintomatología depresiva, ansiosa, calidad de vida y reactividad del cortisol después de aplicar Terapia de Aceptación y Compromiso (ACT, basada en la flexibilidad psicológica) o Terapia Interpersonal (IPT, basada en el empoderamiento) en mujeres expuestas a IPV y compararlos en función al pensamiento suicida. Método Una muestra clínica de 50 mujeres (entre 21 y 74 años) fueron asignadas aleatoriamente a recibir ACT o IPT, completaron antes y después, cuestionarios sobre IPV, calidad de vida, depresión y ansiedad, y mediciones de cortisol (basal, 15, 30 y 45 minutos después de un reto cognitivo) en saliva en respuesta a un reto cognitivo. Utilizamos modelos de Ecuaciones de Estimación generalizada para analizar los datos. Resultados Mejoraron significativamente todas las variables, independientemente del tipo de psicoterapia y del pensamiento suicida. Antes de la intervención, las mujeres con ideación suicida presentaron depresión y ansiedad severas, peor calidad de vida e hiper-respuesta de cortisol, en contraste con las mujeres sin ideación, quienes presentaron síntomas moderados y una respuesta de cortisol plana. El cortisol disminuyó en todas las mujeres después de ambas terapias. Discusión y conclusión Ambas terapias IPT y ACT mejoraron la salud mental y calidad de vida de las mujeres con IPV y modificaron la reactividad del cortisol, incluyendo a las pacientes que reportaron ideación suicida.

Coherence and vitals of medicinal herbs, nutrients, and yoga in stress management and psychological stasis

When the time lows of the psychological body, about the human mind, there is a vital relationship between the psychological and somatic body leading to stress and mishaps. This could be a lack of coherence among significant components in the body, which are characterized by hormones such as cortisol and adrenaline that come into play. Cortisol and adrenaline are released when there is usually a response of fight or flight, where these hormones get ready to handle the body’s reaction, and when this happens properly, it yields stress. Stress occurs through all age groups across every ethnicity and population, as the functioning of the mind is very similar. Managing this emerging stress and anxiety condition could be done through the easy way of the modern system of medicine, allopathy. Alternatively, the traditional method comes in handy to maintain such a condition with hardly any long-term side effects. A few conventional techniques like the practice of yoga, support of the proper nutrients, and certain medicinal herbs are bent to see a change in the perspective of coping mechanisms that results in a stress-free environment within the human mind. Many patterns of practices are noticed that there are specific nutrients and supplements formulated with medicinal herbs with significant pharmacological properties and the ancient activity of yoga aid in stress management. Using and practicing regularly can help in an integrated caliber of living. This review article sheds information and collation on such significant medicinal herbs, nutrients, and renounced practices of yoga that play together in the balance of the human body to overcome the distress of the mind. Many studies have noticed that medicinal herbs, nutrients, and specific yogic asanas help handle stress and anxiety, giving a holistic living pattern.

Role of HPA Axis Dysregulation in Cancer-related Fatigue Based on Principle of "Treating Overstrain with Warming" / 中国实验方剂学杂志

This paper discusses the theoretical basis of traditional Chinese medicine （TCM） for the treatment of cancer-related fatigue （CRF） based on the principle of treating overstrain with warming in the Huangdi's Internal Classic 《黄帝内经》 and the role of hypothalamic-pituitary-adrenal （HPA） axis dysregulation in CRF， aiming to provide new ideas for the clinical treatment of CRF. In the pulsatile regulation of the HPA axis， cortisol， which is synthesized and released by the adrenal cortex， plays an essential role in the life activities. The abnormal circadian rhythm and reduced serum level of cortisol are major factors leading to CRF. Therefore， increasing the serum level and stimulating the biological activity of cortisol and restoring the normal function of HPA axis are important targets for the treatment of CRF and also the key to the TCM treatment of this disease. According to the TCM principle of treating overstrain with warming， we interpreted the etiology and clinical manifestations of overstrain and further explored the causes of CRF. It is believed that the depletion of Qi and blood， Yin and Yang， and fluid in the kidney， spleen， and liver is the key of the disease， which results in symptoms such as fatigue. Further， we elaborated on the theoretical connotation of warming and summarized the two main treatment principles of tonifying with warm-natured herbs and relieving fever with sweet- and warm-natured herbs. According to the different characteristics of the organs affected by pathogen， we proposed the treatment method of warming kidney to cultivate essence， warming stomach and nourishing spleen to replenish Qi， nourishing liver and tonifying blood to promote Qi movement， and relieving fever with sweet- and warm-natured herbs to alleviate fatigue. The warming method can elevate the serum level and invigorate the biological functions of cortisol in CRF patients， which provides a new theoretical basis for alleviating the symptoms and improving the quality of life of cancer patients in clinical practice.

Avaliação da qualidade do sono e níveis séricos de serotonina e cortisol em pacientes com dor crônica / Evaluation of sleep quality and serum levels of serotonin and cortisol in patients with chronic pain / Evaluación de la calidad del sueño y de los niveles séricos de serotonina y cortisol en pacientes con dolor crónico

A dor crônica pode acometer indivíduos de qualquer idade e está atribuída a maior morbidade, declínio cognitivo e imobilidade. Nos pacientes com dor crônica, ocorrem alterações importantes na neurotransmissão, além de alterações endócrinas relacionadas ao estresse. Além do mais, a má qualidade do sono leva a alterações cognitivas, irritabilidade e fadiga durante o dia e está, comumente, presente em pacientes com dor crônica. Assim, o presente estudo avaliou, por meio da aplicação de questionários a indivíduos adultos com diagnóstico de dor crônica, atendidos em ambulatório de reumatologia da microrregião de Alfenas-MG, a qualidade de vida, o padrão da dor e a qualidade do sono, além da análise da dosagem sérica de serotonina e cortisol. Dos 57 pacientes que fizeram parte da amostra, a maioria era composta por mulheres (91,2%), com idade maior de 40 anos (87,7%). Os principais diagnósticos envolvidos foram fibromialgia (35%), osteoartrite (21%) e artrite reumatoide (14%). Os resultados obtidos apontaram moderada intensidade da dor e interferência das atividades diárias, regular estado de saúde geral e má qualidade do sono nestes indivíduos. De acordo com os dados, não houve correlação estatisticamente relevante entre a severidade da dor e a qualidade de sono, tampouco entre a severidade da dor e o estado de saúde geral. Por outro lado, houve correlação positiva moderada entre a severidade da dor e a interferência nas atividades diárias, e correlação negativa moderada entre a severidade da dor e a saúde mental do indivíduo. Também ficou claro que a interferência da dor nas atividades diárias impacta negativamente na saúde mental. Não foi possível constatar uma relação entre a má qualidade do sono e maior intensidade da dor, mas sim entre qualidade de sono e saúde mental, impactando significativamente também no estado geral de saúde. A qualidade do sono impacta ainda na relação das atividades do cotidiano e influencia negativamente a saúde mental. Por fim, no presente estudo não foi evidenciada correlação significativa entre o diagnóstico de dor crônica e alterações de níveis séricos de serotonina e cortisol. Em conclusão, os achados demonstram a complexidade do tratamento de pacientes com dor crônica. Considerando que a dor crônica desencadeia um amplo espectro de alterações orgânicas e cognitivas, torna-se essencial compreender como essas alterações se associam, para que sejam desenvolvidas abordagens preventivas e terapêuticas mais efetivas.

Chronic pain can affect individuals of any age and is associated with increased morbidity, cognitive decline, and immobility. In patients with chronic pain, there are important changes in neurotransmission, in addition to stress-related endocrine changes. Moreover, poor sleep quality leads to cognitive changes, irritability, and fatigue during the day and is commonly present in patients with chronic pain. Thus, the present study evaluated, by means of applying questionnaires to adult individuals diagnosed with chronic pain, seen at a rheumatology outpatient clinic in the Alfenas-MG microregion, the quality of life, the pattern of pain and the quality of sleep, in addition to the analysis of serum serotonin and cortisol levels. Of the 57 patients who were part of the sample, most were women (91.2%), aged over 40 years (87.7%). The main diagnoses involved were fibromyalgia (35%), osteoarthritis (21%), and rheumatoid arthritis (14%). The results obtained indicated moderate pain intensity and interference with daily activities, regular general health status, and poor sleep quality in these individuals. According to the data, there was no statistically relevant correlation between pain severity and sleep quality, nor between pain severity and general health status. On the other hand, there was a moderate positive correlation between pain severity and interference with daily activities, and a moderate negative correlation between pain severity and the individual's mental health. It was also clear that pain interference with daily activities negatively impacts mental health. A relationship between poor sleep quality and greater pain intensity could not be found, but rather between sleep quality and mental health, impacting significantly on overall health status as well. Sleep quality also impacts the relationship of activities of daily living and negatively influences mental health. Finally, in the present study no significant correlation was evidenced between the diagnosis of chronic pain and changes in serum levels of serotonin and cortisol. In conclusion, the findings demonstrate the complexity of treating patients with chronic pain. Considering that chronic pain triggers a broad spectrum of organic and cognitive changes, it becomes essential to understand how these changes associate so that more effective preventive and therapeutic approaches can be developed.

dolor crónico puede afectar a individuos de cualquier edad y se asocia a una mayor morbilidad, deterioro cognitivo e inmovilidad. En los pacientes con dolor crónico se producen importantes alteraciones en la neurotransmisión, además de cambios endocrinos relacionados con el estrés. Además, un sueño de mala calidad conduce a alteraciones cognitivas, irritabilidad y fatiga durante el día, y está comúnmente presente en pacientes con dolor crónico. Así, el presente estudio evaluó, mediante la aplicación de cuestionarios a individuos adultos diagnosticados de dolor crónico, atendidos en una consulta externa de reumatología de la microrregión de Alfenas-MG, la calidad de vida, el patrón de dolor y la calidad del sueño, además del análisis del dosaje sérico de serotonina y cortisol. De los 57 pacientes que formaron parte de la muestra, la mayoría eran mujeres (91,2%), mayores de 40 años (87,7%). Los principales diagnósticos fueron fibromialgia (35%), artrosis (21%) y artritis reumatoide (14%). Los resultados obtenidos señalaron una intensidad moderada del dolor y una interferencia de las actividades cotidianas, un estado de salud general regular y una mala calidad del sueño en estas personas. Según los datos, no existía una correlación estadísticamente relevante entre la intensidad del dolor y la calidad del sueño, ni entre la intensidad del dolor y el estado general de salud. Por otro lado, existía una correlación positiva moderada entre la intensidad del dolor y la interferencia en las actividades cotidianas, y una correlación negativa moderada entre la intensidad del dolor y la salud mental del individuo. También quedó claro que la interferencia del dolor en las actividades cotidianas repercute negativamente en la salud mental. No fue posible encontrar una relación entre una mala calidad del sueño y una mayor intensidad del dolor, sino más bien entre la calidad del sueño y la salud mental, lo que también repercute significativamente en el estado general de salud. La calidad del sueño también repercute en la relación de las actividades diarias e influye negativamente en la salud mental. Por último, en el presente estudio no se evidenció una correlación significativa entre el diagnóstico de dolor crónico y las alteraciones en los niveles séricos de serotonina y cortisol. En conclusión, los hallazgos demuestran la complejidad del tratamiento de los pacientes con dolor crónico. Teniendo en cuenta que el dolor crónico desencadena un amplio espectro de alteraciones orgánicas y cognitivas, se hace imprescindible comprender cómo se asocian estas alteraciones, para poder desarrollar abordajes preventivos y terapéuticos más eficaces.

Single-center experience with vascularized adrenal displacement for the treatment of primary bilateral macronodular adrenal hyperplasia / 现代泌尿外科杂志

【Objective】 To explore a new treatment of primary bilateral macronodular adrenal hyperplasia (PBMAH) and its efficacy. 【Methods】 Clinical data of 20 PBMAH patients treated in our hospital during Mar.2010 and Apr.2021 were retrospectively analyzed. All patients underwent laparoscopic subcutaneous displacement of vascularized adrenal. The clinical symptoms, plasma free cortisol, adrenocorticotrophic hormone (ACTH), and 24 h urinary free cortisol were regularly monitored after surgery. 【Results】 Of all 20 patients, 19 were followed up for 18 to 120 months (median 60 months). Three months after surgery, reexamination showed 1 patient had decreased plasma free cortisol and increased ACTH, but had no symptoms of low corticosteroids. After another 3 months, the plasma free cortisol and ACTH returned to normal. After 4 to 48 months, the parameters recovered in all patients and the clinical symptoms disappeared. 【Conclusion】 Laparoscopic vascularized adrenal displacement is a new and effective method for the treatment of PBMAH. It can alleviate the Cushing syndrome with no obvious adverse reactions.

Oral Health Status and Salivary Parameters in Stroke Patients at a Tertiary Hospital

@#Introduction: Dental caries and impaired salivary function are very common but undertreated. The aim of this study was to investigate the oral health status and salivary parameters of stroke patients. Methods: A cross-sectional study was carried out on 54 stroke and 54 non-stroke patients attending rehabilitation treatment at Hospital Universiti Sains Malaysia. Decay, Missing and Filled Teeth (DMFT) index and plaque scores were used to evaluate patients’ oral health. Salivary parameters such as salivary cortisol, salivary flow rate, pH and buffering capacity were measured. Salivary cortisol was analysed using Cobas E6000 automated immunoassay. Results: Among the 54 stroke patients, the majority were Malays 72.2% and 63.0% were male, with a mean age of 48.1 (14) years. There was a significant difference of dental caries between stroke patients, at 17.6 (4.26), compared to 15.7 (5.38) for non-stroke patients (p=0.042). Only 53.7% of stroke patients had good oral hygiene, compared to, 85.2% among non-stroke patients’ (p-value= 0.001). Salivary parameters showed no significant differences (p>0.05). However salivary cortisol levels were higher in stroke patients 5.2(5.1) nmol/L) than in non-stroke patients 4.0 (3.6) nmol/L). There was no significant correlation between salivary parameters and DMFT index (P>0.05). Conclusion: Stroke patients had more dental caries and poor oral hygiene compared to non-stroke patients. Salivary parameters showed no significant difference between stroke and non-stroke patients.

Aldosterone and cortisol-secreting adrenocortical carcinoma: a 10-year follow-up case report and literature review / 中华内分泌代谢杂志

A 10-year follow-up case of aldosterone and cortisol-secreting adrenocortical carcinoma, a rare disease presenting as an adrenal space-occupying lesion accompanied with hypertension and hypokalemia was reported, and the medical record was investigated in detail. Through case presentation and literature review, it was noted that patients with adrenocortical carcinoma presented a difference in clinical manifestations, pathology, and biological behaviors. This paper may help clinicians enhance their understanding of adrenocortical carcinoma. Especially significant adrenal space-occupying lesions highly suspicious of recurrence and producing different types of endocrine hormones should be paid more attention.

Evaluation of Stress among Dental Undergraduates and Postgraduates Using Salivary Cortisol as a

Background: Stress is a non?specific response of the body to any demand. Professional education has a certain level of stress inherent in it. Dental students have been reported in the literature to experience more stress than medical students. Objective: To evaluate the stress levels of dental students: first?year undergraduates, house surgeons, and final?year postgraduates, using salivary cortisol as a stress biomarker. Materials and Methods: Dental students above 18 years of age and without any systemic illness were included in the study. Those students with a drug history of corticosteroids, anti?depressants, and oral contraceptives were excluded from the study. Female participants experiencing pre?menstrual symptoms, pregnancy, and familial stressor issues were excluded from the study. First?year undergraduates, house surgeons, and final?year postgraduates were enrolled in the study. Unstimulated whole saliva was collected in the morning and evening between 9:00 and 10:00 am and between 3:00 and 4:00 pm. Salivary cortisol levels were assessed by chemiluminescence immuno?assay (CLIA). Results: Paired sample t?test was used to compare the diurnal variation among morning and afternoon samples within the groups. The salivary cortisol levels were found to be significant within the groups. One?way ANOVA was used to compare the salivary cortisol levels between the groups. The salivary cortisol levels within the groups were not statistically significant. Conclusion: Salivary cortisol is a non?invasive biomarker of stress. Postgraduates had higher salivary cortisol levels than other study groups.

Central adrenal insufficiency: who, when, and how? From the evidence to the controversies - an exploratory review

ABSTRACT Central adrenal insufficiency (CAI) is a life-threatening disorder. This occurs when ACTH production is insufficient, leading to low cortisol levels. Since corticosteroids are crucial to many metabolic responses under organic stress and inflammatory conditions, CAI recognition and prompt treatment are vital. However, the diagnosis of CAI is challenging. This is not only because its clinical presentation is usually oligosymptomatic, but also because the CAI laboratory investigation presents many pitfalls. Thus, the clarification of when to use each test could be helpful in many contexts. The CAI challenge is also involved in treatment: Several formulations of synthetic steroids exist, followed by the lack of a biomarker for glucocorticoid replacement. This review aims to access all available literature to synthesize important topics about who should investigate CAI, when it should be suspected, and how CAI must be treated.

Variaciones Diurnas de las Concentraciones de Cortisol Salival en Adultos Jóvenes Sanos

RESUMEN: Determinar las variaciones diurnas de las concentraciones de cortisol salival (CORTs) en adultos jóvenes sanos. Estudio descriptivo de corte transversal. Un total de 50 estudiantes universitarios, sin antecedentes de trastornos físicos o psiquiátricos, recogieron muestras de saliva completa no estimulada en sus hogares, por la mañana (6:30- 7:30 AM) y la tarde (4:00-6:00 PM). El CORTs se analizó utilizando inmunoensayo por quimioluminiscencia. El análisis estadístico de los resultados se realizó mediante la prueba t de Student y coeficiente de correlación de Pearson. El valor medio de CORTs de la mañana (0,29 ± 0,11 mg/dl) es significativamente más alto (t = 15,43, p < 0,0001) en comparación con la tarde (0,06 ± 0,03 mg/dl), con un coeficiente de variabilidad muy alto. La asimetría (As) y kurtosis (K) vespertinas (As=3,10; K=8,69) fueron mayores que las matutinas (As= 0,45; K= -1,07). Resultaron significativos los coeficientes entre CORTs-AM y CORTs-PM (r = 0,36, p = 0,0106), pero no entre CORTs edad, IMC y género. La variabilidad diaria, intra e interindividual, fue alta para todos los resultados de CORTs. Estos resultados facilitarán la interpretación de la variabilidad biológica del CORTS en salud y enfermedad.

ABSTRACT: To determine the diurnal variations of salivary cortisol (sCORT) concentrations in healthy young adults. Descriptive cross-sectional research design. A total of 50 university students, with no history of physical or psychiatric disorders, collected samples of unstimulated whole saliva at home, in the morning (6:30-7:30 AM) and in the afternoon (4:00-6:00 PM). The CORTs were analyzed using chemiluminescence immunoassay. Statistical analysis was performed using Student's t test and Pearson's correlation coefficient. The mean CORTs value in the morning (0,29 ± 0,11 mg/dl) is significantly higher (t = 15,43, p <0,0001) compared to the afternoon (0,06 ± 0,03 mg/dl), with a very high coefficient of variability. The asymmetry (As) and kurtosis (K) in the evening (As = 3,10; K = 8,69) were greater than in the morning (As = 0,45; K = -1,07). The coefficients between CORTs-AM and CORTs-PM were significant (r = 0,36, p = 0,0106), but not between CORTs with age, BMI and gender. Intra- and inter-individual daily variability was high for all CORTs results. These results will facilitate the interpretation of the biological variability of CORTS in health and disease.

Association of hemolysismarkers and cortisol level with different severity of sickle cell disease among Sudanese patients

Background:Sickle cell anemia (SCA) is an inherited disorder of hemoglobin. Several biomarkers have been identified, which is essential in the different clinical presentations of the disease. This study aimed to determine the association between hemolysis markers andcortisol level with varying severity groups of Sudanese patients with SCA.Methods:This descriptive cross-sectional study included 100 patients with sickle cell disease between February 2016 and April 2017. According to Hedo et al scoring, medical history was obtained to conduct disease severity. A total of 3ml of venous blood was collected from each patient. A complete hemogram was performed using an automated hematology analyzer (Sysmix®-KX-21N). Bilirubin and lactate dehydrogenase (LDH) were estimated using a spectrophotometer, while cortisol was measured using the Elecsys® system 2010 E170. The reticulocyte count was performed manually. Data were analyzed using statistical package for the social sciences (SPSS)version 21 computer software program.Results:Disease severity was variable and was categorized into; eighteen (18%) patients had mild symptoms, while 70 (70%) patients had moderate disease, and 12 (12%) patients had severe disease. The analysis of variance (ANOVA)test showed that hemoglobin, reticulocyte count, LDH, and direct bilirubin were positively correlated with disease severity,p value: 0.001, 0.04, 0.00, and 0.02, respectively. While indirect bilirubin, total bilirubin, and cortisol did not correlate withdisease severity, the pvalue was (0.248, 0.083, and 0.868, respectively).Conclusions:This study confirmed that the hemolysis markers (Hb, reticulocyte count, direct bilirubin and LDH) were positively associated with disease severity. In contrast, indirect bilirubin, total bilirubin, and cortisol levels were not associated with the disease severity.

Hyperadrenocorticism treatment of a dog with high dilution: case report

Hyperadrenocorticism is a common endocrinopathy in dogs, associated to an excessive production or administration of cortisol.Aims:Report the evolution of homeopathic treatment in spontaneous hyperadrenocorticism analyzing with basal and post-acth stimulation cortisol values of a yorkshire male dog with 10 years old, diagnosed from the suppression test with low dose of dexamethasone and stimulation with ACTH, as well as complementary tests.Methodology: Homeopathic treatment was chosen, based on the principle of similitude usingIgnatia amarabecause the patient presents repertorized mental symptoms such as separation anxiety syndrome, docility, annoyances and jealousy and also because it is efficient and less harmful. It was associated to cortisol biotherapy to inhibit cortisol production and adrenal biotherapy to control the response of excess of the cortisol producted by the gland. The exposed information is consented by the tutor.Results:The dog was in convencional treatment with trilostane but didn't response to the therapy, showing 5,41 µg/dL of basal result and 11,8 µg/dL of post-acth result and the symptoms were worst on 12/12/2021, presenting lethargic, panting, more evident alopecia and severe muscle weakness which the patient unable to stand. Therefore, the protocol was recommended for 3 months, included 3 globules ofIgnatia amara30cH orally, every 12 hours, 3 globules of cortisol biotherapy 30 cH and also of adrenal biotherapy 6 cH every 24 hours. On 03/28/2022 the basal and post-acth stimulation results was 3,71 µg/dL e 5,79 µg/dL respectively and the patient was more active, the skin was better and even with difficulty it was movingand having more independence.Conclusion: Homeopathic treatment with high dilution was effective, keeping the indices with the recommended range of post acth between 2.0 and 5.0, confirming an adequate therapeutic monitoring and symptomatic improvement.

The effects of stress reduction strategies of breathing technique relaxation programme and positive psychology on biochemical variable response among schoolteachers

We aimed to investigate the effects of job stress on the biochemical variables of schoolteachers before and after stress reduction strategies. In 2019, 200 schoolteachers (98 males, 102 females) in the private and fully aided higher secondary schools of urban and rural areas in Vellore, India were enrolled in the study based on the principle of consecutive sampling. Questionnaires were used to investigate demographic characteristics and occupational stress-related factors. Fasting blood glucose was detected by venous plasma and a biochemical analyser with the cut-off thresholds method. Salivary cortisol was determined by the specific enzyme-linked immunosorbent assay kit method. Total cholesterol in serum was determined by the CHOD-PAP method. Serumalbumin was detected by the bromocresol green dye-binding method on a Roche Modular DP analyser (Roche Diagnostics). Blood pressure was measured by aneroid sphygmomanometers. Levels of fasting blood glucose, salivary cortisol, albumin and cholesterol were lower in the high-tension group than those in the low-tension group. Those of the high-coping strategy group were higher than those of the low-coping strategy group. Systolic blood pressure and diastolic blood pressure significantly reduced among the intervention groups after administering the relaxation response programme for three and six weeks, respectively, to urban and rural school teachers. Occupational stress can lead to increased salivary cortisol, cholesterol, albumin, blood glucose and blood pressure levels. The relaxation response programme resulted in quantifiable improvements in physiological markers of stress in rural and urban schoolteachers.

Restorative effects of forest therapy on mental health of fatigued female office workers / 环境与职业医学

Background Female office workers are prone to fatigue due to work and life stress. The natural environment has a positive effect on health, but little research has focused on the effects of forest therapy on physical and mental health of female office workers. Objective To explore the effect of forest therapy on the mental health of fatigued female office workers. Methods In this study, two environments, urban and forest, were selected. A total of 12 subjects with fatigue were recruited and randomly divided into two groups, urban and forest, six subjects in each group, with mean ages of 24.7 and 28.4 years, respectively, all of whom were company employees. The Brief Mood Scale, the Chinese version of Stress Self-Rating Scale, and the Fatigue Self-Rating Scale were distributed to assess baseline psychological indexes of mood, fatigue, and stress status. Higher scores indicate higher levels of negative mood, fatigue, and stress, respectively. The forest group participated in an on-site experiment using forest therapy (forest walks and sits in a forest environment), and the urban group followed the same schedule as the forest group conducting walks and sits in an urban environment. Salivary cortisol was used as the physiological index. Baseline physiological indices were collected on the first day of the experiment, and the on-site forest therapy experiment and collecting physiological and psychological indices were conducted on the second day; physiological indices were collected in the morning before the walk and physiological and psychological indices were collected after the walk, physiological indices were collected in the afternoon before and during the sitting, and psychological indices were collected after the sitting. Subjects' mood and fatigue status were followed up one week after the activity. Mann-Whitney U test and Wilcoxon signed rank test were used to assess the changes of the indicators. Results As to the physiological indicator, the salivary cortisol concentrations before and after the morning walk in the forest group were lower than the corresponding baseline values (both P=0.043); and the decreases were 2.21 and 1.86 nmol·L−1 respectively. Differences between groups showed a trend towards a greater decrease in salivary cortisol concentrations in the forest group than in the urban group after walking and at the 15 th min of sitting (both P=0.068). Among the mood indicators, the forest group showed a greater decrease than the urban group in fatigue dimension after walking (P=0.065) and after sitting (P=0.024); the forest group showed a greater decrease than the urban group in vitality dimension after walking (P=0.054) and after sitting (P=0.045); and the forest group showed a greater decrease than the urban group in "total mood disorder" after sitting (P=0.054). Among the fatigue indicators, the forest group showed a greater decrease in "physical fatigue", "mental fatigue", "consequences of fatigue", and "general fatigue" after walking and sitting than the urban group (all P<0.05). Among the stress indicators, there were not statistically significance of "tension", "loss of control", and "total stress score" between the two groups after sitting (both P>0.05). After one week after the activity, there were not statistically significant differences of mood and fatigue between the two groups (both P>0.05). Conclusion Forest therapy has a regulating effect on symptoms of negative mood, and fatigue in fatigued female office workers, but the effects of a short-term forest therapy last for a limited duration.

Correlation of plasma prolactin and cortisol with vasovagal syncope in children / 中华实用儿科临床杂志

Objective:To investigate the changes of plasma prolactin (PRL) and cortisol (Cor) in the head up tilt test (HUT) in children with vasovagal syncope (VVS), and their correlation with VVS.Methods:From May 2019 to May 2020, 75 children diagnosed as VVS through positive HUT in the Children′s Hospital, Capital Institute of Pediatrics were retrospectively recruited as VVS group, while 29 healthy children with negative HUT during the same period were collected in healthy control group.Heart rate (HR) and blood pressure [systolic and diastolic blood pressure (SBP, DBP)] were monitored using a noninvasive continuous blood pressure monitor.The changes of HR, SBP and DBP were analyzed and their differences between the supine position and positive reaction of HUT were compared.The contents of PRL and Cor in the supine position and positive reaction of HUT were measured using the electrochemiluminescence, and their changes (ΔPRL and ΔCor) were calculated.Differences between groups were analyzed by the two-tailed Student′s t-test or the Mann- Whitney test.Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of ΔPRL on VVS. Results:There were no significant differences in the age, gender, body mass index, blood electrolyte, syncope frequency and syncope course between VVS group and healthy control group (all P>0.05). There was no significant difference in syncope frequency and course of syncope among subtypes of VVS group (vasodepressor syncope, mixed syncope, cardioinhibitory syncope)(all P>0.05). Compared with healthy control group, PRL after HUT was significantly higher in VVS group[36.23 (22.08, 61.97) μg/L vs.11.47 (8.00, 23.25 ) μg/L, Z=-5.40, P<0.01]. Both ΔPRL [25.36( 9.92, 48.93) μg/L vs.-0.10(- 2.67, 9.32) μg/L, Z=-5.39, P<0.01] and ΔCor [(84.4±43.6) μg/L vs.(57.6±64.6) μg/L, t=-2.44, P<0.05 ] were significantly higher in VVS group than those of healthy control group.PRL at HUT positive reaction was negatively correlated with SBP and DBP ( r=- 0.46, -0.45, all P<0.01). In VVS group, PRL at HUT positive reaction was negatively correlated with SBP ( r=-0.38, -0.24, all P<0.05). In VVS group, ΔCor after HUT was negatively correlated with SBP ( r=-0.25, P<0.05). ROC curves revealed that the cut-off value of ΔPRL in predicting HUT was 4.03 μg/L, with the sensitivity of 89.3% and specificity of 72.4%. Conclusions:Plasma PRL and Cor increase during syncope in VVS children, and plasma PRL is correlated with blood pressure drop.The increased plasma level of PRL in VVS children with positive HUT is correlated with blood pressure, and ΔCor is correlated with SBP.Plasma PRL and Cor may be involved in the pathogenesis of VVS and ΔPRL presents the diagnostic potential of VVS in children.

Stress induced by pre-slaughter farm conditions in pigs / [Estresse induzido pelas condições da fazenda pré-abate em suínos]

Cortisol is a steroid hormone, one of the glucocorticoids, made in the cortex of the adrenal glands and then released into the blood, which transports it in the entire body. Almost every cell contains receptors for cortisol and so cortisol can have lots of different actions depending on which sort of cells it is acting upon. These effects include controlling the body's blood sugar levels and thus regulating metabolism, acting as an anti-inflammatory product, controlling salt and water balance and influencing blood pressure. The study was conducted over a period of 3 months, between March-August 2020, in 2 swine farms in Iasi county, Romania, on a total of 46 pigs, 3 to 4 months old, both males and females, in order to investigate stress levels in finishing facilities. The study revealed higher levels of cortisol while eosinophil counts severely decreased, changes which are associated with a strong reaction to stress for individuals that were housed in finishing facilities.(AU)

O cortisol é um hormônio esteroide, um dos glicocorticoides, produzido no córtex das glândulas suprarrenais e, em seguida, liberado no sangue, que o transporta por todo o corpo. Quase todas as células contêm receptores para o cortisol e, portanto, ele pode ter muitas ações diferentes, dependendo do tipo de célula sobre a qual atua. Esses efeitos incluem controlar os níveis de açúcar no sangue do corpo e, assim, regular o metabolismo, atuando como um produto anti-inflamatório, controlando o equilíbrio de sal e água e influenciando a pressão arterial. O presente estudo foi realizado durante um período de três meses, entre março-agosto de 2020, em duas granjas de suínos no condado de Iasi, Romênia, em um número total de 46 porcos, de três a quatro meses de idade, machos e fêmeas, a fim de investigar níveis de estresse nas instalações de acabamento. O estudo revelou níveis mais elevados de cortisol, enquanto a contagem de eosinófilos diminuiu severamente, mudanças que são consideradas associadas a uma forte reação ao estresse para indivíduos que foram alojados em instalações de acabamento.(AU)

MINI REVIEW: ASSOCIATION BETWEEN SERUM CORTISOL LEVELS AND COVID-19 DISEASE

Serum cortisol concentration indicates the severity of the underlying condition. More severe disease results in increased cortisol concentrations in the blood, increasing the probability of a catastrophic outcome. A high level of serum cortisol is found in patients with community-acquired pneumonia, and these patients are more likely to develop major complications and death. Corticosteroids are endogenous hormones that are produced by the hypothalamus pituitary adrenal pathway, which is involved for stress response. Considering, known risk factors of endocrine disturbance, there has been minimal discussion on measuring the serum cortisol concentration in COVID-19 patients. SARS-CoV-2 mediated pathogenetic pathways, may also affect endogenous steroid synthesis, particularly cortisol. For the purpose of improving survival rate in severe COVID-19 individuals, we discuss briefly about the current and new findings in the support of measuring the serum cortisol levels in severe COVID-19 individuals and facilitate better treatment management in this article.