Modulation of neuropeptide Y levels is impaired in crack withdrawal patients

Abstract Introduction The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has a key role in drug addiction susceptibility. In addition to the well-known relationship between cortisol and the HPA axis, other molecules are involved with stress response and could modify the HPA activation, such as the neuropeptide Y (NPY), which has anxiolytic proprieties. There are few studies evaluating the effect of NPY levels on addiction, especially in crack cocaine dependence. Objective To evaluate NPY in crack users during early withdrawal to determine its relationship with drug use and cortisol levels. Methods We analyzed 25 male inpatient crack users. Serum NPY levels were measured at admission and discharge (mean of 24 days). Morning salivary cortisol was measured at admission. Results Serum NPY levels at admission and discharge were very similar. Lower NPY levels at discharge were associated with higher lifetime crack use. Also, a negative correlation was found between morning cortisol and delta NPY (NPY discharge - NPY admission). Conclusion These preliminary findings indicate that crack use influences the modulation of NPY levels and modifies stress response. The NPY pathway may play an important role in the pathophysiology of crack addiction, and the anxiolytic effect of NPY may be impaired in crack users. Future studies should consider NPY as a measurable indicator of the biological state in addiction.

Insulin resistance and associated factors: a cross-sectional study of bank employees

OBJECTIVE: Insulin resistance is characterized by the failure of target cells to respond to normal levels of circulating insulin, and this condition is related to cardiovascular disease. This study sought to evaluate the prevalence of insulin resistance and its association with markers of metabolic abnormalities and metabolic syndrome in bank employees. METHODS: A cross-sectional study was performed on 498 working men and women aged ≥20 years old. The Homeostasis Model Assessment (HOMA-IR) was used to determine the presence of insulin resistance based on cut-off values of ≤2.71 for normal insulin levels and >2.71 for insulin resistance, as established for the adult Brazilian population. RESULTS: It was observed that the 52 (10.4%) overweight individuals with insulin resistance were 4.97 times (95%CI 1.31-18.83) more likely to have high HOMA-IR values than the normal-weight participants; among those who were obese, the likelihood increased to 17.87 (95%CI 4.36-73.21). Individuals with large waist circumferences were 3.27 times (95%CI 1.03-10.38) more likely to develop insulin resistance than those who were within normal parameters. The HOMA-IR values differed between subjects with and without metabolic syndrome, with values of 2.83±2.5 and 1.10±0.81 (p=0.001), respectively. The levels of insulin, ultrasensitive C-reactive protein and uric acid were also associated with insulin resistance. CONCLUSION: The prevalence of insulin resistance among bank employees is high, and insulin resistance is associated with and serves as a marker of metabolic syndrome. Cardiovascular disease and metabolic syndrome-associated metabolic abnormalities were observed, and insulin resistance may be a risk factor in this group of professionals.

Serum concentrations of brain-derived neurotrophic factor in patients diagnosed with gender dysphoria undergoing sex reassignment surgery / Concentração sérica de fator neurotrófico derivado do cérebro em pacientes diagnosticados com disforia de gênero que realizaram cirurgia de redesignação sexual

Abstract Introduction: Transsexualism (ICD-10) is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS) and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF) appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology. We hypothesize that BDNF may be a biomarker of alleviation of gender incongruence suffering. Objectives: To measure preoperative and postoperative serum BDNF levels in transsexual individuals as a biomarker of alleviation of stress related to gender incongruence after SRS. Methods: Thirty-two male-to-female transsexual people who underwent both surgery and hormonal treatment were selected from our initial sample. BDNF serum levels were assessed before and after SRS with sandwich enzyme linked immunosorbent assay (ELISA). The time elapsed between the pre-SRS and post-SRS blood collections was also measured. Results: No significant difference was found in pre-SRS or post-SRS BDNF levels or with relation to the time elapsed after SRS when BDNF levels were measured. Conclusion: Alleviation of the suffering related to gender incongruence after SRS cannot be assessed by BDNF alone. Surgical solutions may not provide a quick fix for psychological distress associated with transsexualism and SRS may serve as one step toward, rather than as the conclusion of, construction of a person's gender identity.

Resumo Introdução: O transexualismo (CID-10) é uma condição caracterizada por forte e persistente dissociação com o gênero atribuído. A cirurgia de redesignação sexual (CRS) e a terapia hormonal (TH) permitem que indivíduos transexuais se sintam mais congruentes com seu gênero e, por isso, têm desempenhado papel importante nos últimos 70 anos. O fator neurotrófico derivado do cérebro (BDNF) parece desempenhar um papel fundamental na recuperação do trauma cirúrgico agudo e vulnerabilidade ambiental à psicopatologia. Nós hipotetizamos que o BDNF pode ser um biomarcador de alívio do sofrimento de incongruência de gênero pós-CRS. Objetivos: Mensurar os níveis séricos de BDNF no pré e pós-operatório em indivíduos transexuais como biomarcador de alívio de estresse relacionado à incongruência de gênero após a CRS. Métodos: Trinta e duas pessoas transexuais masculino para feminino submetidas a cirurgia e tratamento hormonal foram selecionadas de nossa amostra inicial. O nível sérico de BDNF foi avaliado antes e depois da CRS pela técnica ELISA. O tempo decorrido entre as coletas de sangue pré e pós-CRS foi medido. Resultados: Não houve diferença significativa nos níveis de BDNF pré e pós-CRS ou em relação ao tempo decorrido entre a CRS e a coleta. Conclusão: O alívio do sofrimento relacionado à incongruência de gênero pós-CRS não pode ser avaliado apenas pelo BDNF. Soluções cirúrgicas podem não fornecer uma solução rápida para o sofrimento associado ao transexualismo, e a CRS pode servir como um passo em direção à, em vez de conclusão da, construção da identidade de gênero de uma pessoa.

Problemas bioéticos en la investigación de nuevas vacunas: ¿obedecen a razones de salud pública? / Bioethical problems in researching new vaccines: Do they respond to public health reasons?

Los problemas éticos de las investigaciones sobre vacunas han crecido en las últimas décadas en frecuencia y magnitud debido a la posición dominante de la industria farmacéutica en el desarrollo de esos estudios. Las tradicionales cuestiones de seguridad y eficacia se han visto agravadas por el conflicto de intereses introducido por la competencia comercial en un mercado a escala global de miles de millones de dólares. La integridad profesional de los investigadores, la responsabilidad moral de los patrocinadores, y la regulación y control por parte de los Estados nacionales, se muestra cuestionada en varios ejemplos. Los resultados de estos cambios son las amenazas a la protección de los derechos de las personas incluidas en estas investigaciones y el discutible progreso que resulta para la salud pública.

The ethical problems in vaccine research have grown in frequency and magnitude in last decades, due to the dominant place of the pharmaceutical industry in the development of such studies. Traditional issues of security and efficacy have been aggravated by the conflicts of interests introduced by commercial competition in a global market worth billions of dollars. We present here a few examples in which the professional integrity of researchers, the moral responsibility of sponsors, and the public regulation and control by national States are put into question. The consequences of these changes represent serious threats to the rights of people included in these studies as well as disputable progress for public health.

Control metabólico en pacientes diabéticos tipo 1 chilenos: rol del estrés psicológico / Association between psychological stress and metabolic control in patients with type 1 diabetes mellitus

Background: An association between psychological stress and metabolic control can occur in patients with diabetes. Aim: To determine the longitudinal association between different psychological stress domains (emotional burden, physician-related distress, regimen-related distress, diabetes-related interpersonal distress) and metabolic control of adolescents with Type 1 diabetes. Material and Methods: An intentional sample of 20 Type 1 diabetic adolescents aged 15 ± 4 years was followed-up for one year. Three HbA1c determinations were performed and a stress self-report was obtained with the Polonsky' Diabetes Distress Scale. Results: Several analyses were conducted using growth curve modeling. The first model included the HbA1c measures, the time term (coded as 0, 1, 2) and several covariates (age, years living with type 1 diabetes mellitus, sex, and physical activity). An overall negative linear trend was found for HbA1c. Subsequent models added the stress domains finding that high levels of emotional burden and regimen related-distress were associated with higher HbA1c levels across all exams. A marginal association was found between diabetes-related interpersonal distress and HbA1c. Conclusions: Stress levels in type 1 diabetic adolescents deserve attention. Different psychological stress factors predicting metabolic control trajectories in type 1 diabetic adolescents were found.

Brief daily postpartum separations from the litter alter dam response to psychostimulants and to stress

Neonatal handling induces several behavioral and neurochemical alterations in pups, including decreased responses to stress and reduced fear in new environments. However, there are few reports in the literature concerning the behavioral effects of this neonatal intervention on the dams during the postpartum period. Therefore, the aim of the current study was to determine if brief postpartum separation from pups has a persistent impact on the dam's stress response and behavior. Litters were divided into two neonatal groups: 1) non-handled and 2) handled [10 min/day, from postnatal day (PND) 1 to 10]. Weaning occurred at PND 21 when behavioral tasks started to be applied to the dams, including sweet food ingestion (PND 21), forced swimming test (PND 28), and locomotor response to a psychostimulant (PND 28). On postpartum day 40, plasma was collected at baseline for leptin assays and after 1 h of restraint for corticosterone assay. Regarding sweet food consumption, behavior during the forced swimming test or plasma leptin levels did not differ between dams briefly separated and non-separated from their pups during the postpartum period. On the other hand, both increased locomotion in response to diethylpropion and increased corticosterone secretion in response to acute stress were detected in dams briefly separated from their pups during the first 10 postnatal days. Taken together, these findings suggest that brief, repeated separations from the pups during the neonatal period persistently impact the behavior and induce signs of dopaminergic sensitization in the dam.

Estimation of relationship between psychosocial stress and periodontal status using serum cortisol level: A clinico-biochemical study.

Aims and Objectives: Psychological conditions, particularly psychosocial stress, have been implicated as risk indicators for periodontal disease. The aim of the present study was to explore the role of psychosocial stress that influences the periodontium with the use of a questionnaire data and serum cortisol level. Materials and Methods: In this study 47 subjects, both male and female, were taken and divided into two groups. Group I comprised of 16 chronic periodontitis subjects. Their stress level was evaluated using a standard questionnaire method (social readjustment rating scale). Plaque index (PI), gingival index (GI), periodontal disease index (PDI) and serum cortisol level were also measured. Group II comprised of 31 stressed subjects and their clinical parameters PI, GI, PDI and cortisol level were recorded. Statistical Analysis Used: Spearman's rank correlation coefficient and unpaired 't' test. Results: In group I statistically significant correlation (P<0.05) was found between cortisol and PDI; and cortisol and PI. In group II positive correlation was found between stress, cortisol, PI, GI and PDI. A statistically significant correlation was found between cortisol and smoking. Conclusion: Stress may be a contributing factor in periodontal disease.

Role of Corticotrophin-releasing Factor in the Stress-induced Dilation of Esophageal Intercellular Spaces

Corticotrophin-releasing factor (CRF) plays a major role in coordinating stress responses. We aimed to test whether blocking endogenous CRF activity can prevent the stress-induced dilation of intercellular spaces in esophageal mucosa. Eighteen adult male rats were divided into 3 groups: 1) a non-stressed group (the non-stressed group), 2) a saline-pretreated stressed group (the stressed group), 3) and an astressin-pretreated stressed group (the astressin group). Immediately after completing the experiments according to the protocol, distal esophageal segments were obtained. Intercellular space diameters of esophageal mucosa were measured by transmission electron microscopy. Blood was sampled for the measurement of plasma cortisol levels. Mucosal intercellular spaces were significantly greater in the stressed group than in the non-stressed group. Mucosal intercellular spaces of the astressin group were significantly smaller than those of the stressed group. Plasma cortisol levels in the stressed group were significantly higher than in the non-stressed group. Pretreatment with astressin tended to decrease plasma cortisol levels. Acute stress in rats enlarges esophageal intercellular spaces, and this stress-induced alteration appears to be mediated by CRF. Our results suggest that CRF may play a role in the pathophysiology of reflux-induced symptoms or mucosal damage.

Anti-stress and anti-oxidant effects of roots of Chlorophytum borivilianum (Santa Pau & Fernandes).

The aqueous extract of C. borivilianum (250 mg/kg for 7 days) significantly reverted the elevated levels of plasma glucose, triglycerides, cholesterol and serum corticosterone and also reduced the ulcer index, adrenal gland weight more as effectively as the standard drug (diazepam) in rats. At 125 mg/kg po, it showed a mild anti-stress activity. Under in vitro 1,1-diphenyl-2-picrylhydrazyl (DPPH*) free radical scavenging assay and lipid peroxidation assay the extract considerably inhibited, in a dose-dependent manner, the levels of DPPH* free radicals and thiobarbituric acid reactive substances, respectively thus showing significant antioxidant property. The results suggested that it could be used for the treatment of oxidative stress-induced disorders.

Effects of stresses on serum cortisol level in Bangladeshi people.

The present study was undertaken to estimate serum cortisol level in control experimental groups in Bangladeshi people. For this purpose a total number of 55 subjects of age range (18-55) years were selected from Mymensingh Medical College Hospital during July 2003 to June 2004. Subjects included in this study were divided in to two main groups: control (n=13) and experimental (n=42). According to different types of stress the experimental group was further divided in to four subgroups: infection, psychiatric, pre and post surgery. Blood samples were collected from all subjects with aseptic precautions at 8 AM and serum cortisol concentration was measured by Radioimmunoassay method. Statistical analyses were done by using Student's 't' test. A distinct and statistically significant increased serum cortisol level was observed in infection, psychiatric disorders and post surgical group in comparison to control group (P< 0.001). While no significant difference was observed in pre surgery when compared to that of control group.

Subjective versus objective stress in noncritically ill hospitalized and outpatient adult men

Um estudo transversal de 120 indivíduos foi executado visando avaliar hormônios do estresse e estresse subjetivo (ansiedade) em casos ambulatoriais e hospitalizados. O objetivo era determinar o grau de estresse objetivo, bem como correlacionar este achado com queixas subjetivas, estimadas pelo Inventário de Ansiedade de Beck. MÉTODO: Três populações foram investigadas, nominalmente doentes clínicos ambulatoriais (Grupo I, n= 30), enfermos clínicos hospitalizados (Grupo II, n=30), e pacientes cirúrgicos hospitalizados (Grupo III, n= 30). Os controles (Grupo IV, n= 30) eram voluntários sadios recrutados entre profissionais da saúde e estudantes. Todos casos hospitalizados foram documentados na admissão, antes de quaisquer procedimentos terapêuticos, e somente homens foram selecionados em todos os grupos, a fim de contornar interações hormonais. A adrenalina, noradrenalina e cortisol foram mensurados pela manhã, e o Inventário de Ansiedade de Beck foi aplicado por uma psicóloga especializada. RESULTADOS: Os três grupos de doentes exibiram níveis de ansiedade superiores aos dos controles. As taxas hormonais não estavam apreciavelmente alteradas, e não se corelacionaram com os achados de estresse subjetivo (ansiedade). CONCLUSÕES: 1) Anormalidades subjetivas (Inventário de Ansiedade de Beck ) foram comuns tanto em populações internadas quanto ambulatoriais, sem diferenças entre os grupos; 2) Estresse objetivo (hormonal) foi mais difícil de confirmar e os valores raramente ultrapassaram a faixa de referência; 3) Não se conseguiu demonstrar correlação entre as duas órdens de variáveis; 4) Estudos adicionais são necessários para definir a quantificação e a interpretação de estresse em populações enfermas, especialmente para fins de diagnóstico nutricional e prescrição dietética;

The influence of surgical stress on the psychoneuro-endocrine-immune axis.

Stress is known to depress the immune system severely. This study was done to evaluate whether surgical stress influenced polymorphonuclear (PMN) and monocyte functions in association with serum cortisol and the anxiety score as measured on the HARS Rating Scale. We found that surgery (irrespective of whether it was major or minor) significantly depressed PMN and monocyte functions and increased serum cortisol levels. PMN phagocytosis correlated significantly (p < 0.05) with the rise in serum cortisol. In spite of these changes, postoperative clinical recovery was uneventful. No major alterations in the HARS scores were noted pre and post operatively. This study demonstrates that surgical stress depresses the immune system with a concomitant rise in cortisol.

Effects of stress upon plasma estradiol and progesterone levels and the rate of oviductal embryo transport in the rat

The possibility that changes in sex steroid levels associated with stress could alter the rate of oviductal embryo transport was investigated in the rat. To this end, the effect of cold-swimming and cold-restraint upon estradiol (E2) and progesterone (P) serum levels and embryo transport were assessed. Swimming in water at 16 degrees C for 10 min two or four times between 16:00 and 22:00 h on day 3 of pregnancy caused a modest acceleration of embryo transport that was not associated with decreased fertility. Restraint at 10 degrees C for 2 h between 13:00 and 15:00 h on the first 4 days of pregnancy did not affect embryo transport. Both stimuli increased corticosterone serum levels. Cold-swimming produced a severe hypothermia as compared to cold-restraint and increased serum E2, decreasing significantly the ratio P/E2. Cold-restraint increased the P/E2 ratio. When rats swam in cold water for 10 min twice and were rewarmed by immersion in water at 38 degrees C during 20 min, embryo transport was accelerated despite that no changes occurred in the blood levels of sex steroids. It is concluded that oviductal embryo transport is minimally affected by stress in the rat and that the effect of acute immersion may be independent of alterations in circulating sex steroid levels

Extensive chronic cutaneous leishmaniasis as a stress factor affecting plasma testosterone, cortisol, prolactin and lutenizing hormone levels

Cutaneous leishmaniasis leads to widespread disfiguring scars which cause profound psychological trauma in patients affected with the disease. Stress situations in man are known to alter the serum levels of a number of hormones. Fifty male patients who were subjected to severe chronic stress due to cutaneous leishmaniasis were investigated for their plasma testosterone, cortisol, prolactin, and luteinizing hormone [LH] levels. In comparison to 20 normal subjects, these patients showed significant decrease in plasma testosterone levels and significant increase in plasma cortisol and prolactin levels

Respuesta del estrés y valores de hemoglobina y hematocrito en la policitemia relativa / Stress response and hemoglobin and hematocrit values in relative polycythemia

Se informa que para determinar los efectos del estrés inducido por la estimulación psicosocial sobre los niveles de hemoblobina (Hb.) y de hematocrito (Hto.) en un grupo de 10 enfermos con policitemia relativa (PR), se efectuaron 2 series de observaciones experimentales. Se señala que el modelo de estimulación emocional empleado consistió en una situación experimental de 20 min. de duración, inducida a partir de la realización simultánea de tareas cognitivas, de elevada significación personal para los sujetos, fuera de su control, bajo presión temporal y con retroalimentación social negativa. Se destaca que la situación experimental produjo en estos sujetos incrementos significativos en la Hb. y el Hto. Se determina que estas variaciones hematológicas no eran producto de posibles errores constantes entre las primeras y segundas mediciones de laboratorio

Relationship of examination stress to serum lipid profile.

Although mental stress as well as hypercholesterolaemia have been individually linked with atherosclerosis, the relationship between mental stress and hypercholesterolaemia is poorly understood. Serum lipid profile was studied in eight male medical student volunteers before, near and after examinations. Identical observations were also made on seven well-matched control volunteers. As compared to pre-exam levels, total serum cholesterol (T-C) increased significantly (P less than 0.05) near exams, and so did low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C). The HDL-C/T-C and HDL-C/LDL-C ratios remained essentially constant throughout the study. Control subjects did not show any significant change in serum lipid profile. Further serial measurement in five of the subjects revealed that examination-related changes were transient. Moreover, a second examination after about 40 days did not evoke any change in the lipid profile. The response to examination stress may be related to the enhanced utilisation of cholesterol in the adrenal cortex for steroidogenesis.