Black Phosphorus-Based Reusable Biosensor Platforms for the Ultrasensitive Detection of Cortisol in Saliva.

A black phosphorus (BP)-based reusable biosensor platform is developed for the repeated and real-time detection of cortisol using antibody-conjugated magnetic particle (MP) structures as a refreshable receptor. Here, we took advantage of the low-noise characteristics of a mechanically exfoliated BP-based field-effect transistor (FET) and hybridized it with anti-cortisol antibody-functionalized MPs to build a highly sensitive cortisol sensor. This strategy allowed us to detect cortisol down to 1 aM in real time and discriminate cortisol from other hormones. In this case, we could easily remove MPs with used antibodies from the surface of a BP-FET and reuse the chip for up to eight repeated sensing operations. Moreover, since our platform could be fabricated using conventional photolithography techniques and the sensor can be reused multiple times, one should be able to significantly reduce operation costs for practical applications. Furthermore, this method could be utilized to detect different hormones with high sensitivity and selectivity in complex environments such as artificial saliva solutions. In this respect, our reusable BP-FET biosensing platform can be a powerful tool for versatile applications such as clinical diagnosis and basic biological analysis by conjugating various antibodies.

Investigation of Hypothalamic Pituitary Adrenal Axis and Oxytocinergic System Changes in a Pragmatic Randomized Controlled Feasibility Trial of Acupuncture for Antenatal Depression.

Background: Antenatal depression is common and associated with detrimental impacts on women and their families. Disrupted neuroendocrine functioning is reported in women experiencing perinatal mental health disturbances. Preliminary randomized controlled trial (RCT) evidence suggests acupuncture may provide a safe and effective adjunct treatment; however, underlying mechanisms of effect are unclear. We conducted an RCT examination of acupuncture for the management of antenatal depressive symptomologies, which included oxytocinergic and hypothalamic pituitary adrenal (HPA) axis system evaluations. This article reports postintervention changes to cortisol: dehydroepiandrosterone (DHEA) ratios, and oxytocin (OT) hormone concentrations. Methods: Fifty-seven women with Edinburgh Postnatal Depression Scale (EPDS) scores ≥13 were randomized to receive individually tailored depressed specific acupuncture, progressive muscle relaxation (PMR) attention comparator, or treatment as usual (TAU). Weekly 1-h sessions were conducted for 8 weeks (24-31 of pregnancy). Preintervention and postintervention saliva samples were collected. Results: Postintervention mean cortisol: DHEA ratio differences were not significantly predicted by group allocation (n = 46, p = 0.065). Two-group comparisons demonstrated cortisol: DHEA ratios were significantly increased and predicted by group allocation when acupuncture was compared to TAU (p = 0.039); however, not between acupuncture and PMR (p = 0.179), or PMR and TAU (p = 0.421). Postintervention OT concentrations were not significantly predicted by group allocation. Limitations: Small sample size and posthoc analysis Conclusion: Findings suggest positive regulation of the HPA axis may be an underlying mechanism by which acupuncture provided the significant improvements to antenatal depression, stress, and distress observed in this cohort. Trial Registration: Registered on March 19, 2015, with the Australian New Zealand Clinical Trials Registry (ACTRN12615000250538).

Salivary Cortisol Levels and Clinical Signs of Stress in Premature Neonates Treated with Vimala Massage: A Randomized Controlled Trial.

Background: In neonatal intensive care units across the world, premature neonates are exposed to a very stressful environment with high levels of noise, bright lights, pain, infections, invasive procedures, and a lack of maternal contact. Stress is manifested by increased cortisol levels and clinical signs of stress. Objective: To assess the impact of Vimala massage on (1) salivary cortisol levels (primary outcome) and (2) clinical signs of stress (secondary outcomes) in premature neonates. Methods: Neonates (28-36 weeks gestational age) admitted to a nursery unit were randomized one-to-one to receive 15-20 min of Vimala massage administered by their parents twice daily and usual care, or to usual care alone. Salivary cortisol levels were measured by enzyme-linked immunosorbent assay (ELISA) on days 1 and 5. Heart rate, respiratory rate, caloric intake, weight gain, and growth were recorded daily. Groups were compared with t tests, U-tests, and repeated measures analysis of variance. Results: Seventy neonates, 35 in each group, were included. Groups were comparable at baseline. The median decrease in salivary cortisol levels was 0.12 µg/dL in the massage group and 0.07 µg/dL in the control group (p = 0.22). Over 5 days, the massage group had significant decreases in resting heart rate (p = 0.003) and respiratory rate (p = 0.028), and greater weight gains (p = 0.0002), relative to controls. Conclusions: In this randomized trial, adding Vimala massage to usual nursery care was not associated with a significant decrease in salivary cortisol levels in premature neonates, when compared with usual nursery care alone. There were improvements in clinical signs of stress.

Development and validation of a deep eutectic solvent-assisted liquid-liquid extraction method for simultaneous quantification of six steroid hormones in serum by liquid chromatography-tandem mass spectrometry.

Steroid hormones have been reported to be associated with endocrine system diseases. This paper proposes a novel procedure of deep eutectic solvent (DES)-assisted liquid-liquid extraction (LLE) to extract six steroid hormones (including cortisone, cortisol, androstenedione, testosterone, 17-hydroxyprogesterone, and progesterone) from serum coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS). A total of five types of L-proline, choline chloride, and citric acid-based DESs were tailored; the DES from L-proline and ethylene glycol at a molar ratio of 1:4 with 20 % acetonitrile was selected as the best-fit assisted solvent for the six steroid hormones compared with other DESs. The parameters for extraction by selected DES were optimized using Box-Behnken design (BBD), and the optimal extraction conditions are 200 µL of acetonitrile, 100 µL of the sample, and 80 µL of DES. Under optimum conditions, the method has good linear calibration ranges (between 0.07 ng mL-1 and 600 ng mL-1), correlation coefficients of determination (r2>0.99), and low limits of quantification (between 0.02 and 0.60 ng mL-1). The extraction recoveries were in the range of 81.84-114.43 %, and the intra-day and inter-day relative standard deviations (RSDs) were less than 10 %.In general, the DES-LC-MS/MS method is a simple and environmentally-friendly method, which can be complementary to the presently available methods for determining steroid hormones in serum.

Comparison of distraction techniques using salivary biomarkers during local anaesthesia administration in children aged 3-5 years: A clinical study.

Aim: In paediatric dentistry, pain is adversely influenced by a child's level of anxiety. Ironically, the most common form of pain control used in dentistry, local anaesthesia, can itself produce anxiety. One of the techniques to overcome a child's anxiety is using distraction. The aim of the present study was to evaluate the effectiveness of distraction techniques, i.e. audio distraction (AD) and audio-visual distraction (AVD) by measuring salivary stress biomarker (salivary cortisol and salivary alpha-amylase) levels in 3-5 year-old children. Materials and Methods: Forty children aged 3-5 years were divided randomly into two groups; (Group I = AD, Group II = AVD). Cotton pellets were placed in the lingual vestibule to collect a sample of saliva. Children were then asked to wear overhead phones in the AD group, connected to a phone, and rhymes were played. In AVD, a cartoon movie was shown to the children using AV glasses. Simultaneously, local anaesthesia was administrated to children, after which another saliva sample was collected. Biomarker estimation was done using ELISA. Fisher's exact test was used for statistical analysis. Results: Statistically significant results were seen with Group II compared to Group I (cortisol-P = 0.009; salivary alpha-amylase-P = 0.03). Conclusion: Both distraction techniques are effective in reducing stress but compared to AD, AVD is more efficacious.

The effect of emotional freedom technique and music applied to pregnant women who experienced prenatal loss on psychological growth, well-being, and cortisol level: A randomized controlled trial.

INTRODUCTION: Research has shown that application of emotional freedom technique and music ensures psychological growth, increases well-being, and decreases cortisol level. PURPOSE: In the study, it was aimed to determine the effect of EFT and music applied to pregnant women who had experienced prenatal loss on their psychological growth, well-being, and cortisol level. METHODS: The study was conducted as a randomized controlled trial in a city hospital in eastern Türkiye with 159 pregnant women, 53 of whom were in the EFT, 53 in the music group, and 53 in the control group. The study data were collected through Subjective Units of Disturbance Scale (SUDS), Subjective Units of Experience (SUE) Scale, Post Traumatic Growth Inventory (PTGI), and WHO-5 Well-Being Index, and saliva samples were taken for cortisol evaluation. EFT was applied to the women two times every other week; the women in the music group listened to music two times every other week. Throughout the week following the first intervention, the women continued the interventions at home. RESULTS: It was determined that EFT and music significantly decreased the participants' subjective anxiety and salivary cortisol median scores, the lowest anxiety was in the EFT group, and PTGI and WHO-5 Well-Being Index mean scores increased (p < 0.005). Further analyses showed that EFT was more effective in terms of increasing well-being than music (p < 0.001; a > b > c). It was determined that the anxiety levels and salivary cortisol median values of the control group were statistically significantly higher compared to the EFT and music groups (p < 0.001). CONCLUSION: It was found that EFT and music applied to the women who had experienced prenatal loss decreased anxiety, ensured psychological growth, improved well-being, and decreased salivary cortisol level.

Association of serum cortisol and cortisone levels and risk of recurrence after endocrine treatment in breast cancer.

Metabolic reprogramming in breast cancer involves changes in steroid hormone synthesis and metabolism. Alterations in estrogen levels in both breast tissue and blood may influence carcinogenesis, breast cancer growth, and response to therapy. Our aim was to examine whether serum steroid hormone concentrations could predict the risk of recurrence and treatment-related fatigue in patients with breast cancer. This study included 66 postmenopausal patients with estrogen receptor-positive breast cancer who underwent surgery, radiotherapy, and adjuvant endocrine treatment. Serum samples were collected at six different time points [before the start of radiotherapy (as baseline), immediately after radiotherapy, and then 3, 6, 12 months, and 7-12 years after radiotherapy]. Serum concentrations of eight steroid hormones (cortisol, cortisone, 17α-hydroxyprogesterone, 17ß-estradiol, estrone, androstenedione, testosterone, and progesterone) were measured using a liquid chromatography-tandem mass spectrometry-based method. Breast cancer recurrence was defined as clinically proven relapse/metastatic breast cancer or breast cancer-related death. Fatigue was assessed with the QLQ-C30 questionnaire. Serum steroid hormone concentrations measured before and immediately after radiotherapy differed between relapse and relapse-free patients [(accuracy 68.1%, p = 0.02, and 63.2%, p = 0.03, respectively, partial least squares discriminant analysis (PLS-DA)]. Baseline cortisol levels were lower in patients who relapsed than in those who did not (p < 0.05). The Kaplan-Meier analysis showed that patients with high baseline concentrations of cortisol (≥ median) had a significantly lower risk of breast cancer recurrence than patients with low cortisol levels (

Assessing stress using repeated saliva concentration of steroid hormones in dementia care dyads: results from a controlled pilot care music intervention.

Background: Stress-related biomarkers have the potential to provide objective measures of whether interventions directed at people with dementia (PWD) and their family caregivers (FCG) are successful. The use of such biomarkers has been limited by logistical barriers to sample collection. Objective: Explore saliva concentration of steroid hormones in dementia care dyads during a music intervention. Methods: Consecutive PWD attending a memory evaluation center and their FCG were allocated to either an intervention-with-music or a non-intervention control group. All were living at home. Stress biomarkers, salivary cortisol and dehydroepiandrosterone sulfate (DHEA-S) samples were collected by the PWD and their FCG, in the morning and evening, 5 days a week, for 8 consecutive weeks. Biomarker concentrations of the intervention and the control groups were compared at week 8, in an intention-to-treat approach with adjustment for baseline value. Results: Twenty-four PWD in the intervention group and 10 in the control group, and their FCG were included in the analyses. The mean number of morning saliva collections was similar in the intervention and the control groups, ranging from 4.3 to 4.9 per participant weekly during the first 7 weeks, declining to 3.3 during week 8. Median log morning cortisol (pg/mL) among caregivers was lower in the intervention group than in the control group (8.09 vs. 8.57, P = 0.0133). Conclusion: This study demonstrates that music intervention was associated with lower morning saliva cortisol concentrations for FCGs.

Differences in the diurnal variation of salivary stress biomarkers during the coronavirus (COVID-19) pandemic between telecommuters and office workers.

OBJECTIVES: It is necessary to objectively assess the stress state of workers, from the standpoint of holistic palliative care, in order to determine how the rapid change in work styles in the "live with coronavirus era"-in which people will coexist and live with the coronavirus (COVID-19)-will affect their physical and mental health. The aim of this study is to assess the impact of rapid changes in work patterns during the COVID-19 pandemic on the neuroendocrine stress response of workers. DESIGN AND METHODS: A total of sixteen subjects, 9 telecommuters (2 males, 7 females; age, 37.1±2.6 years) and 7 office workers (3 males, 4 females; age, 37.3±3.0 years) who provided their informed consent were enrolled in this prospective observational study. Saliva was collected four times a day (after waking, noon, evening, and before bedtime) and three times a week (Monday, Wednesday, and Friday) during May and June 2020. The saliva samples were stored at -20°C until measurement. Saliva components were analyzed by ELISA for cortisol, melatonin, s-IgA, and oxytocin. RESULTS: The diurnal variation of salivary components between telecommuting and office work groups was investigated. Cortisol showed diurnal variation with higher secretion during waking hours and lower secretion toward nighttime in both groups, and no modulation was observed. In the office work group Melatonin showed diurnal variation, with increased secretion at night. In contrast, the telecommuting group showed modulation, with higher secretion at waking and lower secretion at night. s-IgA showed diurnal variation with a high level at waking and a low level thereafter in both groups, and no modulation was observed. The telecommuting group showed higher oxytocin levels in comparison to the office work group. CONCLUSIONS: These results suggest that the absence of commuting in the telecommuting group reduces anxiety due to infection, and that the diurnal variation of melatonin may be due to the alteration of circadian rhythm caused by being at home all day.

Imagine HEALTH: Changes in diurnal salivary cortisol patterns following a 12-week guided imagery RCT lifestyle intervention in predominantly Latino adolescents.

OBJECTIVE: Alterations in diurnal salivary cortisol patterns have been linked to adverse metabolic health outcomes. We have previously shown that stress-reduction guided imagery (GI) can reduce salivary cortisol levels acutely. We now ask whether addition of GI into a 12-week lifestyle intervention designed to improve eating and physical activity behaviors can alter diurnal salivary cortisol patterns and perceived stress. METHODS: 232 adolescent participants (ages 14-17 years) were cluster randomized by school into one of four intervention arms: non-intervention Control (C; n = 51), Lifestyle (LS; n=61), Stress-Reduction GI (SRGI; n = 55), and Lifestyle Behavior GI (LBGI; n = 65). LS group received one nutrition and one physical activity class per week after-school for 12 weeks. SRGI and LBGI groups received same LS classes plus an additional weekly GI session. Salivary cortisol was assessed pre- and post-intervention on 3 days, 3 times daily, at awakening, 30-minutes post-awakening, and in the evening to determine Cortisol Awakening Response (CAR) and Diurnal Cortisol Slope (DCS). Perceived Stress Scale (PSS) was administered pre- and post-intervention. Mixed effects modeling was used for intent-to-treat analysis and sensitivity analysis was used for those participants adherent to intervention protocol. RESULTS: Analysis of 208 subjects with complete data showed a small between-group increase in CAR in LBGI vs C (p = 0.045, d=0.24), with no significant group differences among other intervention arms. There were no between group differences in change in DCS or change in PSS after 12-weeks. Amongst adherent participants, LBGI showed a small-moderate increase in CAR (p = 0.03, d=0.37), and moderate-large reduction in PSS (p = 0.02, d=-0.66) compared to C. There were no other between group differences in CAR, DCS, or PSS. CONCLUSION: LBGI led to an increase in CAR, and in adherent subjects, a decrease in PSS, suggesting GI may be a mind-body intervention that can affect both objective and subjective measures of the stress response. Whether changes in cortisol patterns in this population affect measures of mental or physical health remains to be determined.

Two new triterpenoids preventing the hydrocortisone-induced injury in HMEC-1 cells from Momordica charantia L.

Momordica charantia L. (M. charantia) is an annual climbing herb in Cucurbitaceae. As a medicinal and edible homologous plant, it has a long history of application. This study aims to isolate and identify the chemical constituents from M. charantia and evaluate their prevention effect on hydrocortisone-induced injury in HMEC-1 cells. 10 kg of M. charantia was extracted with 95% ethanol for three times and partitioned with petroleum ether, dichloromethane and n-butanol. The dichloromethane part was performed by silica, ODS silica, Sephadex LH-20 column chromatography and semi-preparative HPLC to obtain two new compounds. The prevention effect on hydrocortisone-induced injury in HMEC-1 cells of these two compounds was determined by the method of CCK-8. The cell viability of HMEC-1 cells treated with 2 (25 µM) was 85.85% ± 4.39%. The results indicated that 2 exhibited significantly prevention effect on hydrocortisone-induced injury in HMEC-1 cells but 1 exhibited no this activity in vitro.

Relación entre el estímulo musical y la producción de leche en madres con recién nacidos menores de 34 semanas en un centro de terapia intensiva: una experiencia de musicoterapia en Uruguay / Relationship between musical stimulation and milk production in mothers with newborns younger than 34 weeks old in an intensive care center: a music therapy experience in Uruguay / Relação entre o estímulo musical e a produção de leite materno em mães com recém nascidos menores de 34 semanas de vida assistidos no centro de terapia intensiva: experiencia de musicoterapia no Uruguai

Introducción: La relación entre producción de leche materna y la música ha sido reportada en diversas publicaciones científicas. No hay publicaciones en Uruguay que analicen esta relación. Este estudio fue realizado por el Instituto Universitario CEDIIAP junto a la Universidad ORT, el Banco de Leche Humana del Hospital Pereira Rossell (CHPR), de la Administración de los Servicios de Salud del Estado. Fue aprobado por el Comité de Ética del CHPR. Objetivo: evidenciar la relación entre el estímulo musical y la producción de leche de madres de recién nacidos pretérmino internados en Cuidados Intensivos del CHPR. Material y métodos: estudio cuasiexperimental, de corte longitudinal, prospectivo, diseño doble: intervención antes después y en paralelo (un grupo contra el otro) utilizando audición de canciones elegidas por las madres con andamiento modificado. Criterios de inclusión: cohorte de madres de recién nacidos ≤ 34 semanas de gestación, sin alimentación a pecho directo, medicación psiquiátrica o que afectara la producción de leche. Se analizó cortisol en saliva y volumen de leche. Como análisis multivariado final, se aplicó el modelo lineal general de medidas repetitivas. Resultados: el estudio se realizó entre marzo de 2017 y agosto de 2018 con 31 madres (15 intervención, 16 control). El grupo intervención presentó mayor producción láctea en los 2 primeros días y disminución del 57 % en niveles de cortisol frente al grupo control. Conclusiones: más allá de las limitaciones del trabajo, los resultados apuntan a que la musicoterapia podría colaborar en la disminución del estrés, el disfrute de la lactancia materna y, consecuentemente, en una mayor producción de leche.

Introduction: the relationship between breast milk production and music has been previously reported in several peer reviewed journals. There are no studies in Uruguay analyzing this relationship. The present study was performed by the CEDIIAP University Institute jointly with the ORT University, at the Pereira Rossell Hospital Human Milk Bank (CHPR) of the Administration of State Health Services (ASSE) in Montevideo. It has been approved by the CHPR's Ethics Committee. Objective: demonstrate the influence of musical stimulation on milk production of mothers with preterm newborns admitted in the CHPR Neonatology Intensive Care Unit. Material and Methods: longitudinal, prospective experimental study with double design: intervention before, simultaneous (one group against the other) and after the study. We used the music therapy technique of listening to songs chosen by the mothers and modified gait. Milk volume was quan- tified, and cortisol presence was analyzed in saliva. The General Linear Model of repetitive measures was applied. Inclusion criteria: cohort of mothers of newborns ≤ 34 weeks of gestation, without direct breastfeeding, psychiatric medication or affecting milk production. Saliva cortisol levels and milk volume were analyzed. As a final multivariate analysis, the General Linear Model of repetitive measures was applied. Results: the study was carried out from March 2017 till August 2018 with a total of 31 mothers (15 intervention, 16 control). Higher milk production in the first two days and a decrease of 57% in cortisol levels were observed in the intervention group compared to the control group. Conclusions: in spite of the limitations of this paper, our results suggest that music therapy can help to reduce the stress and increase the enjoyment of breastfeeding and consequently generate a higher milk production.

Introducion: a relação entre produção do leite materno e a música foi apontada com evidências científicas em vários jornais. Não existem publicações no Uruguai que analisem esta relação. Este estudo foi realizado pelo Instituto universitário CEDIIAP junto com a Universidade ORT, o Banco de Leite Humano do Hospital Pereira Rossell (CHPR) da Administração dos Serviços de Saúde do Estado. Foi aprovado pelo Comité de Ética do CHPR. Objetivo: evidenciar a relação entre o estímulo musical e a produção do leite de mães com recém nascidos prematuros internados na unidade de cuidados intensivos do CHPR. Material e metodo: estudo quase experimental de corte longitudinal, prospectivo com desenho duplo: intervenção antes, depois e em paralelo (um grupo contra o outro) utilizando a audição de canções escolhidas pelas mães e andamento modificado. Critérios de inclusão: coorte de mães de recém nascidos ≤ 34 semanas de gestação sem alimentação a peito direto, nem medicação psiquiátrica ou que afetara a produção de leite. Foi analisado o cortisol em saliva e o volumem de leite. Aplicouse o Modelo Linear General de medidas repetitivas como análise multivariado final. Resultados: o estudo foi realizado entre março 2017 e agosto 2018 com 31 mães (15 do grupo intervenção, 16 do grupo controle). Foi observada maior produção láctea no grupo de intervenção nos dois primeiros dias e diminuição de 57% nos níveis de cortisol em relação ao grupo controle. Conclusões: além das limitações do paper, os resultados apontam para que a musicoterapia poderia colaborar na diminuição do estresse, o desfrute da lactância materna e consequentemente poderiam resultar em uma maior produção de leite.

The effect of mindfulness on the inflammatory, psychological and biomechanical domains of adult patients with low back pain: A randomized controlled clinical trial.

OBJECTIVE: This study aims to study the effect of mindfulness-based program on the psychological, biomechanical and inflammatory domains of patients with chronic low back pain. METHODS: A multicentre randomized and controlled clinical trial of parallel groups in patients with chronic low back pain between March 2019 to March 2020. Participants with no experience in mindfulness based intervention, were randomized to receive (36 patients) or not (34 patients) mindfulness-based stress reduction program for chronic back pain (MBSR-CBP). The program was performed in 9 sessions. Patients with chronic low back pain due to symptomatic discopathy (degenerative disc disease or herniated disc) were included. The principal outcome was changes in the blood level of cortisol and cytokines (tumor necrosis factor- α (TNF- α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6) and interleukin-17 (IL-17)). Secondary outcomes (psychological factors, pain, and quality of life) were measured by validated questionnaires. RESULTS: Of the 96 randomized patients, 70 who completed the study were included in the analysis (mean [range] age: 53 [33-73] years; 66% females). MBSR-CBP stopped the increase in cortisol, and reduced pro-inflammatory cytokine IL-1ß (p = 0.05). It reduced depression (p = 0.046) and stress (p = 0.0438), perceived pain (p < 0.0001), and limitations related to health (p < 0.0001). It also increased the physical function (p = 0.002) and sleep quality (p = 0.05). Furthermore, it significantly increased life satisfaction (0.006), well-being (p = 0.001) and vitality (p < 0.0001). It also increased self-compassion (p < 0.0001) and significantly reduced the overidentification (p<0.0001) and catastrophization (p = 0.002). CONCLUSIONS: MBSR-CBP could be part of a multidisciplinary approach in the management of patients suffering from chronic low back pain.

Salivary Biomarkers Associated with Psychological Alterations in Patients with Diabetes: A Systematic Review.

The care of individuals with diabetes needs a holistic perspective, taking into account both the physical disease and the mental health problems that may be associated. Different studies show a higher prevalence of depression or anxiety issues in diabetes patients than in the general population, which is why diabetes can be considered one of the chronic diseases in which psychological care is crucial to maintain quality of life. The objective of this review is to examine the published articles that relate the bidirectional associations between objective and subjective measures of anxiety, depressive symptomatology, stress, sleep quality, and salivary biomarkers in patients with diabetes. For this, a search was carried out in the electronic databases PubMed, Cochrane, and SCOPUS using the keywords "diabetes", "saliva", "sleep", "anxiety", "depression", and "stress" for works published up until May 2022 and limited to the English and Spanish languages. The sample comprised 14 articles, 5 of which analysed the associations between depressive symptomatology and salivary biomarkers in people with diabetes. Among the salivary biomarkers most frequently used to evaluate psychological alterations in persons with diabetes are cortisol and melatonin. Thus, significant changes in the levels of these biomarkers were observed in most studies. Four out of five studies reported a statistically significant relationship between increased salivary cortisol in the evening/midnight or the cortisol awakening response and depressive symptoms. In contrast, lower cortisol levels upon waking in the morning were observed when there was no depression or anxiety. Regarding the association between salivary cortisol values and sleep quality in patients with diabetes, lower morning cortisol values related to prolonged nighttime sleep were common in the analysed studies. Low melatonin concentrations showed a negative correlation with sleep quality. As it is an easy-to-apply and non-invasive method, the measurement of salivary biomarkers can be very useful for predicting psychological alterations in patients with diabetes. Further scientific studies are required to determine the sensitivity of these biological substances acting as biomarkers for detecting sleep disorders and psychological alterations.

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.

Profiling steroid and thyroid hormones with hair analysis in a cohort of women aged 25 to 45 years old.

Objective: Endogenous hormones regulate numerous physiological processes in humans. Some of them are routinely measured in blood, saliva and/or urine for the diagnosis of disorders. The analysis of fluids may, however, require multiple samples collected at different time points to avoid the high variability in the concentration of some hormones. In contrast, hair analysis has been proposed as an interesting alternative to reveal average hormone levels over a longer period. In this work, we developed and validated an analytical method for analyzing 36 endogenous steroid and thyroid hormones and one pineal hormone in human hair using ultra-performance liquid chromatography (UPLC)-tandem mass spectrometry (MS/MS). Methods: Sample preparation involved hair decontamination, pulverization, methanol extraction, and purification with C18-solid phase extraction. Extracts were then divided into two portions, respectively injected into an UPLC-MS/MS system, and analyzed using two different instrumental methods. The method was applied to a healthy female population aged 25-45 years. Results: The method was validated on supplemented hair samples for the 37 targeted hormones, and its application to the population under study allowed to detect 32 compounds in 2-100% of the samples. Complete reference intervals (2.5-97.5th percentiles) were established for estrone, 17ß-estradiol, androstenedione, dehydroepiandrosterone, progesterone, 17α-hydroxyprogesterone, cortisone, cortisol and 3,3',5-triiodo-L-thyronine. Hair cortisone, cortisol, tetrahydrocortisone and tetrahydrocortisol concentrations were highly correlated with each other, with Kendall's τ correlation coefficients ranging from 0.52 to 0.68. Conclusion: Allowing the detection of 32 hormones from different chemical classes, the present method will allow to broaden hormonal profiling for better identifying endocrine disorders.

A short Mindfulness retreat can improve biological markers of stress and inflammation.

OBJECTIVE: Mindfulness practice, a form of meditation, has shown benefit for psychological and physical health. In this study, we investigated the effect of an intensive period of Mindfulness practice on some biological mediators of stress and inflammation during a 3-day residential retreat. METHODS: A total of 95 healthy individuals (aged 18-67) were recruited and randomized to a Mindfulness retreat arm or an active control arm. Before (t0) and after (t1) the intervention, all the participants were assessed for salivary cortisol levels and for a panel of pro- and anti-inflammatory cytokines measured in saliva. Psychometric measures on stress, anxiety and awareness were carried out using PSS, STAI-Y and MAAS questionnaires, respectively. RESULTS: As to the within-group differences, we observed a statistically significant decrease in perceived stress (ß = -8.85, p < 0.0001), and anxiety scores (ß = -12.39, p < 0.0001), while awareness increased (ß = 15.26, p < 0.0001) between t0 to t1 in retreat participants. In the mindfulness intervention group, we also observed a statistically significant reduction in the levels of pro-inflammatory cytokines IL-6 (ß = -0.94 p = 0.001) and IL-8 (ß = -176.40, p < 0.0001), and an increase in anti-inflammatory IL-10 (ß = 0.89 p < 0.0001) levels at the end of the retreat. At t1 we observed a highly significant correlation between cortisol levels and both anxiety (r = 0.56, p < 0.0001) and perceived stress (r = 0.92, p < 0.0001) scores. CONCLUSIONS: Mindfulness retreat participants showed a significant reduction in perceived stress and anxiety levels, as well as an improved balance of some key mediators of inflammatory states. Our data provide evidence that a mindfulness retreat may be effective in improving physical and mental health. Future studies with larger numbers of subjects and follow-up periods may examine mindfulness practice as a non-pharmacological alternative to promote stress reduction and overall health and wellbeing.

Inter-individual differences in pain anticipation and pain perception in migraine: Neural correlates of migraine frequency and cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio.

Previous studies targeting inter-individual differences in pain processing in migraine mainly focused on the perception of pain. Our main aim was to disentangle pain anticipation and perception using a classical fear conditioning task, and investigate how migraine frequency and pre-scan cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio as an index of neurobiological stress response would relate to neural activation in these two phases. Functional Magnetic Resonance Imaging (fMRI) data of 23 participants (18 females; mean age: 27.61± 5.36) with episodic migraine without aura were analysed. We found that migraine frequency was significantly associated with pain anticipation in brain regions comprising the midcingulate and caudate, whereas pre-scan cortisol-to DHEA-S ratio was related to pain perception in the pre-supplementary motor area (pre-SMA). Both results suggest exaggerated preparatory responses to pain or more general to stressors, which may contribute to the allostatic load caused by stressors and migraine attacks on the brain.

Mind training, stress and behaviour-A randomised experiment.

In this paper, we evaluate the effects of a psychological training, called Mindfulness-Based Stress Reduction (MBSR) on stress and risk and time preferences. MBSR is a well-known psychological technique, which is believed to improve self-control and reduce stress. We conduct the experiment with 139 participants, half of whom receive the MBSR training, while the other half are asked to watch a documentary series, both over 4 consecutive weeks. Using a range of self-reported and physiological measures (such as cortisol measures), we find evidence that mindfulness training reduces perceived stress, but we only find weak evidence of effects on risk and inter-temporal attitudes.

The embodiment of water insecurity: Injuries and chronic stress in lowland Bolivia.

Water is critical to health and wellbeing. Studies have theorized that problems with water can become embodied, yet few studies have quantified this. Therefore, we first sought to understand the lowland Bolivian water environment of Tsimane' forager-horticulturalists. We assessed the water environment holistically, using objective measures of water quality and water services (Joint Monitoring Programme's drinking water services ladder) and subjective measures, including perceived water safety and water insecurity experiences [Household Water Insecurity Experiences Scale (HWISE)]. We tested how water service levels, perceived water safety, and water fetching frequency were associated with HWISE scores using Tobit regression models among 270 households. We then tested if and how water becomes embodied via self-reported water-related injury and a chronic stress biomarker, hair cortisol concentration (HCC). Results demonstrated that, compared with households using surface water, households with basic water services had HWISE scores 1.59-pts lower (SE = 0.29; P < 0.001). Ingestion of water perceived to be "bad" and more daily water-fetching trips were associated with higher HWISE scores. Twenty percent of households reported prior water-related injuries, with women most commonly injured. In logistic regressions, each point higher HWISE score was associated with 28% (95%CI:1.16-1.41; P < 0.001) higher odds of injury. Basic water services compared to surface water was associated with 48% lower odds (OR = 0.52; 95%CI:0.33-0.82; P = 0.005) of injury. Finally, using linear regressions among 332 adults, HWISE scores were not associated with HCC. Past water-related injury was associated with higher HCC (Beta = 0.31; SE = 0.09; P = 0.029) among women, but not men. Relying on unimproved water services compared to surface was associated with 46.2% higher HCC for women (Beta=0.38; SE=0.14; P=0.048) and 55.3% higher HCC for men (Beta=0.44; SE=0.15; P=0.044), respectively. Overall, our findings demonstrate that water insecurity can become embodied through water-related injuries and elevated HCC. Improving water service levels through an equity lens may help ameliorate water insecurity and its accompanying negative health effects.