The effect of lavender and rosemary aromatherapy application on cognitive functions, anxiety, and sleep quality in the elderly with diabetes.

OBJECTIVE: This study aimed to determine the effects of aromatherapy use on cognitive function, anxiety, and sleep quality in the elderly with diabetes. METHODS: The study was conducted with 63 participants aged 65 and over. Participants were randomly divided into three groups: lavender, rosemary and control groups. The intervention continued for four weeks. Data was collected using the Blessed Orientation Concentration Test, State-Trait Anxiety Scale, and Pittsburgh Sleep Quality Scale. Data were analyzed using One-Way ANOVA, Mann-Whitney U/Kruskal-Wallis, Wilcoxon and Friedman tests. RESULTS: In both intervention groups, the 4th week scores of cognitive functions, anxiety, and sleep quality after aromatherapy were significant compared to the baseline scores. In the control group, state anxiety scores were significantly higher in the 2nd and 4th weeks compared to the initial scores. CONCLUSIONS: Inhaling lavender and rosemary has been observed to improve cognitive function and sleep quality and reduce anxiety levels. The effects of the essential oils used in the research were evaluated over four weeks. It is thought that studying for a longer period and with more samples would be beneficial. There is a need for studies examining its effects, especially in the elderly with diabetes.

Evaluation of the role of mitofusin-1 and mitofusin-2 in periodontal disease.

BACKGROUND: Mitochondria and endoplasmic reticulum are key cellular organelles and create contact sites (mitochondria-endoplasmic reticulum contact [MERC]), which plays a major role in calcium metabolism, apoptotic processes, and inflammation. Previously, proteins that have been associated with these MERC contact sites mitofusin-1 (MFN1) and mitofusin-2 (MFN2) have been found to be downregulated in periodontal disease in vitro. Therefore, the aim of the current study was to evaluate MFN1 and MFN2 in gingival crevicular fluid (GCF) of patients with periodontal disease compared with healthy controls clinically. METHODS: A total of 48 participants were divided into three groups including periodontally healthy (n = 16), patients with gingivitis (n = 16), and patients with stage 3 grade B periodontitis (n = 16). GCF levels of MFN1, MFN2, calcium (Ca), caspase-1, and tumor necrosis factor-alpha (TNF-α) were determined via enzyme-linked immunosorbent assay (ELISA). Results were calculated as total amount and concentration. RESULTS: MFN1 levels (total amount) were significantly higher in patients with periodontitis and gingivitis when compared with healthy controls (p < 0.05). However, concentration levels of MFN1, MFN2, Ca, caspase-1, TNF-α significantly decreased in periodontal disease groups compared with healthy controls (p < 0.05). A positive correlation was detected among all evaluated markers (p < 0.05). CONCLUSION: The MERC protein MFN1 may have a role in the pathogenesis of periodontal disease due to its increase in GCF of patients with periodontitis and gingivitis.

Activities of the hypothalamo-pituitary-adrenal axis and autonomic nervous system following a strong earthquake.

This study aimed to investigate the effects of post-traumatic stress, caused by a strong earthquake, on the hypothalamo-pituitary-adrenal axis (HPA) and autonomous nervous system activity (ANS). Activities of the HPA (as salivary cortisol) and ANS (as heart-rate variability [HRV]) were measured following the 2020 Elazig (Türkiye) earthquake (6.8 Richter Scale, classified as strong). A total of 227 participants (103 men (45%) and 124 women (%55)) provided saliva samples twice, namely, 1 week and 6 weeks after the earthquake. Of these participants, HRV was measured in 51 participants by 5 min continuous electrocardiogram (ECG) recording. Frequency- and time-domain parameters of the HRV were calculated to assess the activity of ANS and low/high frequency (LF/HF) ratio was used as surrogate for sympathovagal balance. Salivary cortisol levels decreased from week 1 towards week 6 (17.40 ± 1.48 and 15.32 ± 1.37 ng/mL, respectively, p < 0.05). There were no gender differences (17.99 ± 2.63 and 16.90 ± 1.60 ng/mL, respectively for females and males, p > 0.05) for salivary cortisol levels. There were no differences in time- and frequency domain parameters of the HRV including LF/HF ratio (2.95 ± 0.38 ms2 and 3.60 ± 0.70 ms2 , respectively for week 1 and 6, p > 0.05). The data show that HPA axis activity, but not that of the ANS, remains higher 1 week after the earthquake but decreases afterwards towards the sixth week, suggesting that the HPA axis might be responsible for the long-term effects of a traumatic event like a strong earthquake.

Heart Rate Variability and Cortisol Levels Before and After a Brief Anaerobic Exercise in Handball Players.

ABSTRACT: Kayacan, Y, Makaraci, Y, Ucar, C, Amonette, WE, and Yildiz, S. Heart rate variability and cortisol levels before and after a brief anaerobic exercise in handball players. J Strength Cond Res 37(7): 1479-1485, 2023-Evaluating stress in athletes is important for monitoring overall physiologic load and is a core practice for sport performance teams. This study examined relationships between 2 metrics of training stress, heart rate variability (HRV) and cortisol, before and after intense anaerobic power testing. Electrocardiogram recordings and saliva samples were collected before and immediately after a Wingate anaerobic power test (WAnT-30) from professional handball players ( n = 20) and sedentary controls ( n = 18). Between-group differences and correlations were computed to assess study hypotheses. No differences were observed in HRV frequency-dependent parameters between groups, but in athletes, Min. R-R ( p < 0.01) and Avg.R-R ( p = 0.03) before WAnT-30 and the percentage of successive normal cardiac beat intervals greater than 50 milliseconds (i.e., pNN50; p = 0.03) after WAnT-30 were elevated. A high positive correlation was detected between the pretest and post-test cortisol levels in athletes ( p = 0.0001; r = 0.87) but not in sedentary individuals. No correlations were observed between the cortisol levels and WAnT-30 power parameters in either group. Relationships were evident in the standard deviation of RR intervals ( p = 0.02, r = -0.53), square root of the mean squared difference of successive RR intervals ( p = 0.043, r = -0.46), very low frequency ( p = 0.032; r = -0.480), high-frequency ( p = 0.02; r = -0.52) variables, and pretesting cortisol in athletes. These findings suggest that HRV analysis is a valuable tool for examining cardiovascular regulation, independent of cortisol; the data may provide valuable information for performance teams in evaluating acute stress.

The Effect of Aromatherapy on Blood Pressure and Stress Responses by Inhalation and Foot Massage in Patients With Essential Hypertension: Randomized Clinical Trial.

A 3-arm, parallel group, randomized clinical trial examines the effect of aromatherapy through inhalation and foot massage on blood pressure and stress response in patients with essential hypertension. Lavender oil reduced blood pressure, heart rate, serum cortisol, and subjective anxiety in hypertensive patients.

Intensive chemotherapy perturbs heart rate variability in children with cancer.

OBJECTIVES: In children, cancer chemotherapy may impair the functioning of the cardiac autonomic nervous system. Moreover, it is not known whether there are any differences between intensive and maintenance phases of chemotherapy. Therefore, the aim of the current study was to assess autonomic nervous system activity using heart rate variability, in children receiving intensive or maintenance cancer chemotherapy. METHODS: For that purpose, children who were healthy (healthy control, n = 30), receiving intensive chemotherapy (chemotherapy, n = 30), and receiving maintenance chemotherapy (maintenance, n = 25) were included in the study. Autonomic nervous system activity was measured by means of heart rate variability. Electrocardiogram recordings were used to calculate time- and frequency-domain heart rate variability parameters. RESULTS: Time-domain parameters such as standard deviation of NN intervals and frequency-domain parameters such as total power were lower during the intensive chemotherapy but not during maintenance phase (standard deviation of NN intervals: 50±5, 33±3, and 48±3 ms, and total power: 2613±504, 1379±296 and 2295±264 ms2, respectively for healthy control, chemotherapy and maintenance groups, P<0.001 for both standard deviation of NN intervals and total power). DISCUSSION: The present results indicate that intensive chemotherapy perturbs the function of heart rate variability in children, with recovery during the maintenance phase. This suggests that intensive chemotherapy is likely to affect the autonomic nervous system but this effect does not appear to be permanent.

Daily cortisol awakening response and menstrual symptoms in young females.

Menstrual symptoms include some rhythmical changes and stress perception but women differ in duration and severity of these symptoms. It is not known whether these differences are associated with cortisol awakening response (CAR). The aim of the current study was to follow young women daily for the CAR and menstrual parameters throughout the whole menstrual cycle. Healthy and regularly cycling young women (n = 16, 17 to 31-year-old) participated in the current study. The daily records of severity of problems (DRSP) was filled in daily by the participants. CAR was also assessed daily form the salivary samples collected at a 0-, 15-, 30- and 60-min post-awakening. In terms of daily awakening cortisol profiles, women had either 2-20 (n = 3), or 20-200 (n = 8) or 200-2000 (n = 5) ng/ml cortisol according to the median levels throughout their cycle. CAR was weakly and negatively correlated with DRSP scores but strongly and positively with oestradiol (R2  = 0.300; p = 0.000) and progesterone (R2  = 0.490; p = 0.000) concentrations. Individuals with higher oestradiol and progesterone concentrations did not have high DRSP scores. In conclusion, CAR had a very high between-subject difference but had a low within-subject difference throughout the days of menstrual cycle, suggesting that CAR is a relatively stable personal trait. Moreover, the interplay between cortisol, progesterone and oestradiol appears to be important for the severity of menstrual symptoms.

Autonomic nervous system activity under rotational shift programs: effects of shift period and gender.

Rotational shifts perturb homeostatic mechanisms in a sexually dimorphic way and may compromise the activity of the autonomic nervous system during day- and night-shifts. Heart rate variability (HRV) is a non-invasive measure to assess autonomic control of the heart. Our aim in this study was to assess HRV by short-term continuous electrocardiogram in female (n=40, average age: 31, average working year: 7) and male (n=40, average age: 29, average working year: 6) nurses under rotational shift programs, HRV is derived from short-term electrocardiogram recordings, carried out both at day- and night -shifts, and included time-domain [e.g., standard deviation of NN intervals, SDNN (ms); percentage of successive RR intervals that differ by more than 50 ms, pNN50 (%); root mean square of successive RR interval differences, RMSSD (ms)] and frequency-domain [very low frequency, VLF; low frequency, LF; high frequency, HF; LF/HF] parameters. Heart rates were similar across the groups but males had lower SDNN (p=0.020), RMSSD (p=0.001). pNN50 (p=0.001), VLF (p=0.048) and HF (p=0.001) but had higher LF/HF ratio (p=0.000) than females. In general, these parameters did not differ between day- and night-shifts (p<0.05). Lower HRV parameters and higher LF/HF in males suggest that they may be under greater threat for disease progression.

Effects of acupuncture on pain and levels of IL-17 and IL-23 in the treatment of non-thermal endovenous ablation: A randomized clinical trial.

OBJECTIVES: Acupuncture is one of the oldest therapeutic interventions in the world for the treatment of pain, musculoskeletal diseases, and inflammation. This study aimed to investigate the effect of acupuncture on pain and IL-17 and IL-23 levels in the treatment of endovenous ablation. METHODS: The study was a randomized controlled trial. Patients were divided into group C (Control, n = 35) and group A (Acupuncture, n = 35). Group A patients were treated with acupuncture 24 h preoperatively. Follow-up checkups were conducted intraoperatively, postoperatively, and on the third day. RESULTS: There was no difference between men; there was a difference between women. Visual analog scale score was lower in group A at the intraoperative third and fifth minutes (0.00 vs. 1 and 0.00 vs. 0.5). Analgesic consumption was lower in group A at the end of third day (p = 0.024). Postoperative IL-17 levels were higher than preoperative levels in group A (23.58 vs. 19.33). Postoperative IL-23 levels were lower than preoperative levels in group A (13.66 vs. 29.51). Group C showed increased postoperative IL-23 levels (28.81 vs. 33.51). Preoperative IL-17 and postoperative IL-23 levels were lower in group A than in group C (19.33 vs. 27.69 and 13.66 vs. 33.51). Although no difference was observed between group A and group C in preoperative saphenous vein diameter, postoperative saphenous vein diameter was smaller in group A (p = 0.008). Saphenous vein diameter was smaller on day 3 in group A than in group C (p = 0.043). CONCLUSION: Acupuncture is effective on acute pain and level of IL-23 in the treatment of endovenous ablation using cyanoacrylate.

The hypothalamic-pituitary-adrenal axis activity in archers: cortisol release, stress, anxiety and success.

BACKGROUND: Archery is a unique sport requiring simultaneous physical and psychological focusing for precisely hitting the small, distant target. Thus, in this sport, the effects of stress and anxiety on success might be more pronounced as a slight deviation in aiming may translate into a large error in meeting the target. Therefore, the current study aimed to assess the interrelationship between anxiety, cortisol awakening response (CAR), cortisol levels during the shooting period, and success in professional male archers during a national tournament. METHODS: Archers (16-20 years old, male, N.=20) shooting with recurve bow participated in the current study during the indoor archery championship. For the assessment of CAR, salivary samples were collected at 0- (wake up), 30-, 45- and 60-min postawakening on three consecutive days, namely qualification, individual elimination, and team shooting days. On the first two days of the shootings (i.e., qualification and elimination), shooting salivary samples were collected at 30 and 15 minutes before the shootings, at half-time and just after the shootings. State and trait anxiety inventory were filled in on the day of registration (the day before qualification shootings). RESULTS: CAR, measured as the area under the curve (AUC), was higher on the elimination day (P=0.038) compared to the qualification day. Shooting cortisol levels were also higher on the elimination day compared to the qualification day (P=0.004). Archers having high rankings on qualification day also had higher success rates on elimination day (r=0.963, P<0.001). CONCLUSIONS: Moderately increased state anxiety, higher CAR, and elevated shooting cortisol levels appear to be the integral components of the elimination stage during a real competition in archery. Thus, assessment of secretion dynamics of cortisol appears to be a valuable objective tool for understanding the neuroendocrine control during the competition days.

Analysis of long-term antibody response in COVID-19 patients by symptoms grade, gender, age, BMI, and medication.

The first aim of the study was to analyze the change in antibody titer at 15-day intervals until 60 days postsymptom onset (PSO). The second aim was to analyze the relationship between antibody titer and symptom grade, gender, age, body mass index (BMI), medications, vitamin supplements, and herbal therapies. Blood samples were collected from 43 patients (5 mild, 21 moderate, 17 severe diseases), 18 women (41.9%), and 25 men (58.1%), on 15, 30, 45, and 60 days PSO after COVID-19 infection. The serum antibody titers were determined by measuring the COVID-19 immunoglobulin G (IgG) antibodies by enzyme-linked immunoassay (ELISA). Associations between the duration of symptoms, demographic and clinical parameters, medications and vitamins used, and herbal therapies were evaluated by interviewing the participants. Within the first 15 days of illness, 81.4% of the patients were positive. From Day 45 PSO, seropositivity was 89.5%. The anti-SARS-CoV-2 antibody titers were statistically higher in men than women at all times (p < 0.01). Antibody titer was higher in older participants compared to younger participants (p < 0.02). Plaquenil or favipiravir use did not affect antibody response (p > 0.05). Men had a higher fever (p = 0.006), shortness of breath (p = 0.004), and chest pain (p = 0.03) than women. We found powerful antibody response by 60 days PSO, as well as higher antibody response and severity of symptoms in the men gender. Data also showed that SARS-CoV-2 antibodies are higher in individuals with older age, whereas BMI, concomitant chronic disease, and medications had no effect on antibody titers.

Cesarean delivery is associated with suppressed activities of the stress axes.

Maternal pre- and post-delivery stress levels might be different for vaginal or cesarean deliveries. This study aimed to investigate the effects of type of delivery (vaginal or cesarean) and time of delivery (pre- and post-delivery) on the stress axes of the body, namely the hypothalamic-pituitary adrenal axis (HPA) and autonomic nervous system (ANS).Ninety-one pregnant women were volunteered to participate this prospective study. In these women, pre- and post-delivery HPA and ANS activities were measured noninvasively by salivary cortisol and heart rate variability (HRV), respectively. HRV was measured by 5-min electrocardiogram recording and time- and frequency-domain parameters were computed.Salivary cortisol concentration and HRV parameters were higher in women having vaginal delivery than those having cesarean delivery (p < 0.05). Cortisol levels did not differ between pre- and post-delivery (p > 0.05) but the time-domain parameters of HRV decreased post-delivery (p < 0.05). No interactions were observed between the types and times of delivery (p > 0.05).HPA and ANS axes had different activity patterns throughout the delivery process and they were higher during vaginal delivery, suggesting that they are integral parts of normal birth process and that cesarean delivery perturbs the activity of both axes.

Effect of reflexology on ankle brachial index, diabetic peripheral neuropathy, and glycemic control in older adults with diabetes: A randomized controlled trial.

OBJECTIVE: The purpose of this study was to determine the effect of foot reflexology on ankle brachial index, diabetic peripheral neuropathy and glycemic control in older adults with diabetes. METHODS: A randomized controlled, parallel-group trial study was conducted at the outpatient elderly health center in Bolu, Turkey. 48 adults aged 65 and over enrolled in the elderly health center were randomized into two groups in a ratio of 1:1 (experimental, n = 24; control, n = 24). Foot reflexology was performed for 12-week in the experimental group, whereas the control group continued their routine treatment and follow-up. The outcome measures included: (1) ankle brachial index, (2) diabetic peripheral neuropathy measured by a comprehensive foot exam, and (3) glycemic control by a glycated hemoglobin A blood test at baseline and after 12 weeks. RESULTS: Post-test diabetic peripheral neuropathy scores (p < 0.001) and glycated hemoglobin A levels (p = 0.002) decreased in the experimental group and increased in the control group. There was no significant between-group difference regarding post-test ankle brachial index scores (p = 0.726). Foot reflexology had a medium effect size on diabetic peripheral neuropathy (95% confidence interval 0.003-2.24; d = 0.51; p < 0.001) and glycated hemoglobin A (95% confidence interval 0.72-1.22; d = 0.52; p = 0.002). CONCLUSIONS: A foot reflexology practice can be a useful for improving the glycemic control and diabetic peripheral neuropathy in the older adults with diabetes. TRIAL REGISTRATION NUMBER: NCT04416503.

Erythrocyte transfusion restored heart rate variability in children with thalassemia major.

Thalassemia major (TM) is a severe transfusion-dependent anemia. Regular erytrocyte transfusion is required for the treatment of thalassemia patients. However, repeated transfusion may result in impairements in heart function. In this study, we aimed to investigate short-term effects of erythrocyte transfusion on autonomic control of heart in children with thalassemia major. For that purpose heart rate variability (HRV), which is a non-invasive method used to evaluate the effects of the autonomic nervous system on the heart rhythym, was measured before and after erythrocyte transfusion and compared to the healthy controls. Children diagnosed with TM (n = 17) and sex and age matched healthy children (HC, n = 30) were included in the study. HRV values of TM patients were measured 5 min before erythrocyte transfusion (BET, n = 17) and 5 min after erythrocyte transfusion (AET, n = 17). Parameters of time-domain and frequency-domain of HRV were evaluated in all participants. Heart rate (HR) was higher in the BET than AET (P = 0.002) but there was no difference between AET and HC groups (P > 0.05). HRV parameters were lower in BET than AET (P < 0.05) but there were no statistical difference between AET and HC (P> 0.05). The data suggest that, in thalassemia major patients, erythrocyte transfusion restores HR and HRV parameters to the levels observed in healthy controls and, thus, in short-terms, appears to be beneficial for the autonomic control of the heart.

Analysis of the effects of hypothalamic-pituitary-adrenal axis activity in menstrual cycle on ankle proprioception, dynamic balance scores and visual-auditory reaction times in healthy young women.

OBJECTIVES: Menstrual cycle (MC) can affect not only the female reproductive system, but also functions such as neuromuscular performance. For this reason, the aim of this study is to investigate the effect of hypothalamic-pituitary-adrenal axis (HPA) activity in MC on proprioception, balance and reaction times. METHODS: For cortisol analysis, saliva samples were taken from the same women (n=43) in the four phases of MC. While State Trait Anxiety Inventory-I (STAI-I) was applied in each phase to support cortisol analysis, pain was measured with visual analogue scale (VAS). Proprioception, dynamic balance, visual and auditory reaction times (VRT-ART) measurements were made in the four phases of MC. RESULTS: Cortisol, STAI-I and VAS scores, angular deviations in proprioception measurements, dynamic balance scores, VRT and ART measurements were found to show statistically significant difference between MC phases (p<0.05). As a result of the post hoc test conducted to find out which MC phase the statistical difference resulted from, it was found that statistically significant difference was caused by the mensturation (M) phase (p<0.05). CONCLUSIONS: It was found that neuromuscular performance and postural control was negatively affected by HPA axis activity in M phase of MC and by pain, which is a significant menstrual symptom.

Effects of late-night eating of easily-or slowly-digestible meals on sleep, hypothalamo-pituitary-adrenal axis, and autonomic nervous system in healthy young males.

Aim of the current study was to assess the effects of the digestibility of late-night high calorie meal on sleep and the activities of the hypothalamo-pituitary-adrenal (HPA) and autonomous nervous system (ANS) in healthy young males. For that purpose, effects of an easily digestible meal (starch + sugar-rich meal, SSR, i.e., dessert) or a slowly digestible meal (protein + fat-rich, PFR, i.e. kebab) were investigated in a crossover design in 16 participants (20-26 year old). They did not eat anything after 07:00 PM on Day 0; had an SSR meal on Day 1 and a PFR meal on Day 2 at 10:00 PM. HPA and ANS activities were measured by cortisol awakening response (CAR) and heart rate variability (HRV), respectively. The participants provided salivary samples for CAR; had a 5-min continuous electrocardiogram recording for HRV; and filled in sleep questionnaires. Late-night eating of SSR and PFR diets increased the area under the curve of CAR (p < 0.05) but did not affect HRV parameters (p > 0.05). PFR meal significantly disturbed sleep (p < 0.05). The data suggests that increased activity of HPA, but not ANS, might be involved in pathophysiology of late-night eating and that this might be due to disturbed sleep if slowly-digestible meal is consumed.

Cortisol Awakening Response and Heart Rate Variability in the Menstrual Cycle of Sportswomen.

Purpose: This study aimed to examine the activities of heart rate variability (HRV) and cortisol secretion as markers of the autonomous nervous system (ANS) and the hypothalamic-pituitary-adrenal axis (HPA) during the menstrual cycle in female athletes. Method: Saliva samples of the participants (n = 28) were collected successively at 0, 15, 30, and 60 min after awakening to assess cortisol awakening response (CAR) during each of four phases of the menstrual cycle (the menstruation, ovulation, luteal, and premenstrual phases). Diurnal saliva samples were collected at noon, in the evening (17:00) and 22:00 for cortisol analysis. HRV was measured in the menstrual and premenstrual phases at rest (12:00-14:00). Results: There was no difference between CAR parameters in the menstrual phases. CAR parameters and diurnal cortisol levels were significantly correlated with each other throughout the menstrual cycle. Mean cortisol was a strong predictor of the area under the curve (AUC: S = 0.042; R-Sq = 98.4%). Time-dependent parameters of HRV (standard deviation of the N-N interval [SDNN; P = .049] and the root mean square of the successive R-R differences [rMSSD; P = .038]) were significantly higher in the menstrual phase. There were no correlations between CAR and HRV parameters. Conclusions: We suggest that the hypothalamic-pituitary-adrenal axis activity and the autonomic nervous system work in a separate manner that is not affected by the menstrual phases in sportswomen. The present study contributed to a better understanding of the relationship between the dynamics of cortisol release and the autonomic nervous system in different phases of the menstrual cycle in female athletes.

Stress in couples undergoing assisted reproductive technology.

PURPOSE: To determine the associations between pre-treatment self-reported stress level, salivary cortisol levels, and clinical pregnancy outcome in couples undergoing assisted reproductive technology treatment (ART). STUDY DESIGN: Seventy-five couples (150 patients) undergoing ART treatment were enrolled in this study. Psychological variables were assessed using the Perceived Stress Scale, Beck Anxiety Inventory, State-Trait Anxiety Inventory, and Beck Depression Inventory. Salivary cortisol levels were obtained from each couple prior to commencing gonadotropin treatment at several times (upon waking and at 15, 30, and 60 min after waking). RESULTS: There was no statistically significant association between the self-reported stress levels and the ART treatment outcome in couples. Women with a successful outcome after ART treatment had higher median salivary cortisol levels than women who had an unsuccessful result [24.7 (19.9-63.1) vs. 20.7 (10.4-30.4), respectively]. There was no statistically significant difference in the median salivary cortisol levels of men in relation to ART treatment outcome. Salivary cortisol levels of the couples were not correlated. CONCLUSIONS: Women who had higher median salivary cortisol levels in the pre-treatment period had a higher clinical pregnancy rate. This result suggests that moderately increased activity of the hypothalamic-pituitary-adrenal axis during ART treatment might be associated with successful conception.

Effects of Half- or Whole-Night Shifts on Physiological and Cognitive Parameters in Women.

BACKGROUND: The study assessed the effects of whole- or half-night shifts on leptin, melatonin, sex hormones, interleukin (IL)-1ß, tumor necrosis factor-α (TNF-α), IL-6, hematological parameters, sleep quality and attentional performance in women working in the health sector. MATERIALS AND METHODS: Women working whole-night shifts (16:00-08:00 hours, n = 20), half-night shifts (16:00-24:00 hours, n = 20) or day shifts (08:00-16:00 hours, n = 20) participated in the study. Blood pressure, respiratory rate, proximal skin temperature (forehead), blood glucose, leptin, melatonin, estradiol, progesterone, IL-1ß, TNF-α, and IL-6 concentrations, complete blood count and erythrocyte sedimentation rate (ESR) were measured in the beginning and at the end of the shifts. The participants filled in sleep quality questionnaires and performed visual attention tests. RESULTS: Half- and whole-night shifts caused problems in sleep duration and quality and disturbed the melatonin rhythm. Women working both half- and whole-night shifts had significantly higher nucleated erythrocytes (P = 0.006), eosinophils (P = 0.031), lymphocytes (P = 0.001) and leptin concentrations (P = 0.001) but had lower ESR (P = 0.046) and neutrophil percentage (P = 0.001) than that of day-time workers. Whole-night shifts caused additional changes including lower attentional performance (P = 0.035), lower platelet counts (P = 0.000) and lower estradiol levels (P = 0.029), but higher TNF-α levels (P = 0.000), than the control group. Moreover, whole-night shifts increased IL-1ß levels before the shift (P < 0.001) and increased IL-6 levels over the half-night shifts (P < 0.05). CONCLUSIONS: Half-night shifts disturbed sleep parameters and the melatonin rhythm, perturbed blood cell turnover and increased leptin levels. Whole-night shifts caused additional problems including suppressed estradiol, activated inflammatory responses and decreased visual attention. All together, the data suggest that night shifts, especially whole-night shifts, should be refrained from or countermeasures should be taken.

The effect of stress-induced cortisol increase on the sense of ankle proprioception.

OBJECTIVES: The aim of this study is to analyze the effect of stress-induced cortisol increase on the sense of ankle proprioception. PATIENTS AND METHODS: Between April 2016 and May 2016, a total of 60 students (30 males, 30 females; mean age: 19.2±1.5 years; range, 19 to 20 years) from Inönü University, Faculty of Medicine, Department of Freshmen were included in the study. Separate measurements were made for the right and left ankle to make ankle proprioception measurements a month before the committee exam during their relaxed period using a device designed with digital inclinometer. The sense of ankle proprioception was measured at 10° dorsiflexion (DF), 11° plantar flexion (PF), and 25° PF angles with open eyes and closed eyes using active reproduction test. Salivary samples were taken for stress assessment and State Trait Anxiety Inventory-I (STAI-I) was conducted. The same tests were repeated on the day of committee exam. RESULTS: Test results showed no statistically significant difference between the right and left ankle proprioception measurements of 10° DF, 11° PF, and 25° PF angles with open eyes (p>0.05). However, a statistically significant difference was found between the right and left ankle proprioception scores at the same angles with closed eyes (p<0.05). According to the Wilcoxon analysis conducted for the comparison of the relaxed and stressed periods of cortisol and STAI-I inventory, a statistically significant difference was found (p<0.05). The Spearman's Rho analysis showed no significant correlation between the right and left ankle proprioception scores and cortisol and STAI-I with open eyes, while there was a statistically significantly positive direction and low correlation between the same angles with closed eyes. CONCLUSION: Our study results show that the increase in the stress-related cortisol is negative for the ankle proprioception sense.