Plasma dehydroepiandrosterone-sulphate is related to personality and stress response.

OBJECTIVES: Dehydroepiandrosterone-sulphate (DHEAS) physiologic relevance remains controversial. However, several central nervous system and behavioural effects of DHEAS have been described. We explored the relation between DHEAS and both pituitary-adrenal axis reactivity and personality in human subjects. DESIGN: We studied 120 consecutive patients assisted at the out patient endocrine department of a public central hospital before medical treatment. Personality was evaluated with the Minnesota Multiphasic Personality Inventory (MMPI) and the pituitary-adrenal axis reactivity was assessed with the CRH test. RESULTS: Baseline DHEAS was inversely related to peak/basal cortisol (parcial r=-0.454, p<0.05) response to CRH infusion. DHEAS reactivity in the CRH test was directly related to the Deviant Behaviour triad (BD) (r=0.257, p<0.05) and type A personality (AP) (r=0.295, p<0.05). Basal ACTH was directly related to baseline DHEAS (r=0.366, p<0.001) and together with age and gender explained 34% of DHEAS variability. CONCLUSIONS: DHEAS may be a protective factor against an excessive cortisol response when people are under stress situations. Personality may be related to DHEAS reactivity.

Plasma corticotropin releasing hormone during the feeling of induced emotions.

OBJECTIVES: Central neuropeptides modulate behaviour. Plasma levels of neuropeptides may reflect central levels due to specific brain-to-blood transport systems. We purposed to show the modulation of plasma corticotropin releasing hormone (CRH) levels in relation to induced emotions. DESIGN: Three groups were defined. For experimental groups A and B, an emotionally significant movie fragment was projected for 20 min, while no film projection occurred in group C. Peripheral venous blood samples were collected before, 10 and 60 min after the film or at 0 and 30 min for group C. Total CRH was measured in plasma. Personality was evaluated by the Minnesota Multiphasic Personality Inventory (MMPI). RESULTS: Plasma CRH levels did not change in the condition with no movie projection - group C - 346 + or - 198 vs. 327 + or - 143 pg/mL. Plasma CRH levels dramatically increased with the projection of a dramatic movie - group A - 394 + or - 147 vs. 791 + or - 636 vs. 803 + or - 771 pg/mL, p<0.05. Plasma CRH increased less markedly in the condition with the projection of a comic movie - group B - 364 + or - 138 vs. 486 + or - 260 vs. 483 + or - 228 pg/mL, p<0.05 for differences between samples 1 and 3. Baseline plasma CRH was significantly and independently related to the neurotic triad and psychotic dyad - partial r=0.328 and 0.267, respectively, p<0.05. CONCLUSIONS: We conclude that plasma CRH levels increase with experimental emotion induction and that baseline levels are significantly related to behavioural traits. Plasma levels of neuropeptides may reflect central levels and may be useful in clinical medicine and in the study of behavioural disorders.

[Malnutrition in morbid obesity]. / Desnutrição na obesidade mórbida.

Nutritional deficiences are common in patients who have undergone bariatric surgery for morbid obesity. There are limited data on nutritional status before surgery. We now begin to realize the importance and the high frequency of that situation in the morbidly obese who have never undergone any invasive procedure. It is very important to acknowlegde this fact, so that specific therapy is begun before surgery. It is our conviction that in doing so we minimize the risk of having serious deficiencies after surgery. We report a case of a morbidly obese woman with nutritional deficiencies before bariatric surgery.