Salivary alpha-amylase, cortisol and chromogranin A responses to a lecture: impact of sex.

The aim of this study was to (1) examine the presence of stress on professors when they teach in front of 200 students and analyse objectively such stress using biomarkers such as salivary cortisol, chromogranin A (CgA) and alpha-amylase (AA) (2) investigate whether sex affects the reactivity of salivary alpha-amylase (sAA) and cortisol concentrations and the interaction of both hormonal systems. Fifty-two participants (26 women and 26 men) collected nine unstimulated saliva samples on 2 days, (one working day, and one resting day). Cortisol concentrations and AA activity measured on the teaching day were significantly higher than those noted on the resting values. No differences between the resting day and the teaching day were reported for CgA. Our results showed a cortisol response to teaching, which was characterized by an anticipatory rise. The AA level was significantly increased after the end of the lecture, and returned to the pre-lecture level 30 min after the end of the lecture. The awakening cortisol response noted on the teaching day was significantly higher in females than in males. No baseline sex differences in sAA and CgA were observed and men and women seem to have a comparable reactivity in sAA, CgA and cortisol levels on lecture stress. The mechanisms that leads to modify activity of salivary AA and CgA due to stress is not entirely understood and further research is needed to elucidate them.

[Sickle cell anemia and pregnancy. Complications and management]. / Drépanocytose et grossesse. Complications et prise en charge.

An increasing number of sickle cell disease patients are deciding to bear children. The high risk of fetal and maternal complications in pregnant sickle cell disease patients mandates multidisciplinary management. Risks include spontaneous abortion, vasculorenal syndrome, fetal growth retardation, and fetal death in utero. The rates of cesarean section, maternofetal infection, and maternal death are higher than in the population at large. The diagnosis should be made prior to conception or during early pregnancy. Frequent visits with the obstetrician, hematologist, and anesthesiologist/intensivist are mandatory. Exchange transfusion or blood transfusion may be indicated in patients with a history of serious obstetrical or hematologic complications. Risks are highest in late pregnancy, during delivery, and in the postpartal period. However, the entire pregnancy is a high-risk period that warrants close monitoring.

[Acute pancreatitis and biochemical markers. Isoamylase]. / Pancréatites aiguës et marqueurs biochimiques. Isoamylase.

Amylase activity in blood and urine, lipase activity in blood, and amylase/creatinine clearance ratio have been prospectively compared in order to test these parameters against estimation of pancreatic isoamylase. Pancreatic isoamylase had been evaluated by inhibition methodology and not by electrophoresis. One hundred patients admitted for strictly sus-umbilical abdominal pain in emergency unit have been studied. Results show that we do not have in blood specific biochemical marker for acute pancreatitis. Lipase and P isoamylase activity evaluation have about the same specificity. In emergency situation the choice of routine investigation will be rather based on methodological simplicity and lower cost.