Role of testosterone: cortisol ratio in age- and sex-specific cortico-hippocampal development and cognitive performance.

Testosterone (T) and cortisol (C) are steroid hormones that have been argued to play opposing roles in shaping physical and behavioral development in humans. While there is evidence linking T and C to different memory processes during adulthood, it remains unclear how the relative levels of T and C (TC ratio) may influence brain and behavioral development, whether they are influenced by sex of the child, and whether or not they occur as a result of stable changes in brain structure (organizational changes), as opposed to transient changes in brain function (activational changes). As such, we tested for associations among TC ratio, cortico-hippocampal structure, and standardized tests of executive, verbal, and visuo-spatial function in a longitudinal sample of typically developing 4-22-year-old children and adolescents. We found greater TC ratios to be associated with greater coordinated growth (i.e. covariance) between the hippocampus and cortical thickness in several areas primarily devoted to visual function. In addition, there was an age-related association between TC ratio and parieto-hippocampal covariance, as well as a sex-specific association between TC ratio and prefrontal-hippocampal covariance. Differences in brain structure related to TC ratio were in turn associated with lower verbal/executive function, as well as greater attention in tests of visuo-spatial abilities. These results support the notion that TC ratio may shift the balance between top-down (cortex to hippocampus) and bottom-up (hippocampus to cortex) processes, impairing more complex, cortical-based tasks and optimizing visuospatial tasks relying primarily on the hippocampus.

Análisis psicométrico de la Escala de Soledad de UCLA (Versión 3) en una muestra de guardias civiles / No disponible

La soledad es un constructo psicológico complejo que influye en nuestra salud a través del estrés y el cortisol. En este estudio se analizó psicométricamente la traducción española de la UCLA Loneliness Scale (Versión 3) en una muestra de miembros de la Guardia Civil. Los resultados señalaron una fiabilidad adecuada (alfa de Cronbach 0,954) para fines de investigación y de evaluación de individuos concretos. Se calculó el índice KMO (0,969), la prueba de la esfericidad de Bartlett (χ2 (190)=14.406,221, ρ<0,000) y el determinante de la matriz de correlaciones (0,0000018), para estudiar la conveniencia de realizar un análisis factorial. Para dicho análisis se utilizó la matriz de correlaciones policóricas (explica el 81,49% de la varianza total), extrayendo dos componentes a través el método de Componentes Principales y la rotación Varimax (10.184 y 1.080). No parece necesario eliminar ni revisar ninguno de los ítems (correlación ítem-total 0,486-0,804). En consecuencia, se concluye que esta escala podría ser válida para estudiar cómo influye esta variable en el estado de salud de los miembros de este cuerpo de policía militarizado

Loneliness is a complex psychological construct that influences our health through stress and cortisol. In this study we examined psychometrically the Spanish translation of the UCLA Loneliness Scale (Version 3) in a sample of members of the Guardia Civil. The results showed adequate reliability (Cronbach’s alpha .954) for research and evaluation of specific individuals. KMO index was calculated (.969), the Bartlett’s test of sphericity (χ2 (190)=14406.221, ρ<.000) and the determinant of the correlation matrix (.0000018), to examine the appropriateness of analysis factorial. For this analysis we used the polychoric correlation matrix (explains 81.49 % of the total variance), extracting two components through the principal components analysis (PCA) and varimax rotation (10,184 and 1,080). On the other hand, does not seem necessary to delete or revise any items (item-total correlation .486-.804). Consequently, it is concluded that this scale might be valid to study how this variable influences the health of the members of this militarized police force

Effect of epidural levobupivacaine and levobupivacaine with fentanyl on stress response and postoperative analgesia after total knee replacement.

BACKGROUND: Providing sufficient and convenient analgesia is crucial during the postoperative period after totalknee replacement (TKR) to enhance patient mobility and reduce stress response to surgery. The scope of this study is to compare the effects of levobupivacaine and levobupivacaine plus fentanyl on stress response and analgesic efficiency after TKR. METHOD: In this study, 40 ASA I - II patients scheduled to undergo TKR were subjected to combined spinal epidural anesthesia (CSEA) injecting of 15 mg levobupivacaine and randomly assigned to receive either levobupivacaine 0.125% (Group L) or levobupivacaine 0.125% plus fentanyl 4 µg ml-1 (Group F) during postoperative period via the epidural route. Patient controlled epidural analgesia (PCEA) was offered for 24 hours. Venous blood samples were assayed for adrenocorticotropic hormone (ACTH), cortisol and prolactin levels before surgery and after analgesia administration. Analgesia was assessed using a visual analogue scale (VAS) at rest (VASR) and during movement (VASM). RESULTS: There was no statistically significant difference between the groups in terms of total doses, bolus requests, bolus delivered and side effects (p > 0.05). The ACTH, cortisol and prolactin levels increased following the surgery and decreased during PCA infusion in both groups where the decline in Group F was significant (p < 0.05) at 24 hours after the analgesic treatment and 48 hours after the surgery. CONCLUSION: We have demonstrated that infusion of levobupivacaine (0.125%) in combination with fentanyl (4 µg ml-1) using PCEA suppressed stress response to surgery significantly and provided better pain relief than levobupivacaine (0.125%) alone after TKR.

Pattern of corticosteroid allergy in Thailand.

BACKGROUND: Corticosteroid allergy is a complication of topical therapy detected by patch-testing with corticosteroid allergens. OBJECTIVE AND METHODS: Ten-year retrospective review to study the prevalence and patterns of corticosteroid allergy in Thai patients. RESULTS: Of 882 patients who were patch-tested, 29 (3.29%) had allergic reactions to corticosteroids. Of these 29 patients, 17 (58.62%) had positive reactions to one corticosteroid, and 12 (41.38%) reacted to multiple corticosteroids. Rates of reaction to corticosteroid groups ranged from 31.03 to 80.95%. Concomitant reactions between groups were noted. The prevalence of topical corticosteroid allergy (using two screening allergens, tixocortol pivalate and budesonide) was 2.27% (20 of 882). Testing with additional steroid allergens in suspected cases increased the prevalence to 3.29%. Tixocortol pivalate detected 51.72% of corticosteroid-allergic cases, and budesonide detected 24.14%. Combining both tixocortol and budesonide detected 68.97% of cases. CONCLUSION: Corticosteroid allergy is found to multiple corticosteroids, and concomitant reactions occur across groups. Group D1 corticosteroid esters produced a higher positive reaction rate (61.9%) than groups D2 (52.38%) and A (51.72%). This may be due to different prescribing habits or the easy access to D1 corticosteroids sold over the counter by pharmacies in Thailand.

Anorectal drug products for over-the-counter human use. Final rule.

The Food and Drug Administration (FDA) is issuing a final rule establishing that any over-the-counter (OTC) drug product containing a combination of hydrocortisone and pramoxine hydrochloride (HCl) for anorectal use is not generally recognized as safe and effective and is misbranded. This combination product is not currently marketed OTC. This final rule discusses data on the combination of hydrocortisone and pramoxine HCl that were still under review when an earlier final rule on OTC anorectal drug products was issued. This rule is part of FDA's ongoing review of OTC drug products.

Age differences in muscarinic cholinergic receptors assayed with (+)N-[(11)C]methyl-3-piperidyl benzilate in the brains of conscious monkeys.

Age-related changes in muscarinic cholinergic receptors were evaluated with the novel ligand (+)N-[(11)C]methyl-3-piperidyl benzilate ((+)3-MPB) in the living brains of young (5.9 +/- 1.8 years old) and aged (19.0 +/- 3.3 years old) monkeys (Macaca mulatta) in the conscious state using high-resolution positron emission tomography (PET). For quantitative analysis of receptor binding in vivo, metabolite-corrected arterial plasma radioactivity curves were obtained as an input function into the brain, and kinetic analyses using the three-compartment model and graphical Logan plot analysis were applied. Kinetic analyses of [(11)C](+)3-MPB indicated a regionally specific decrease in the receptor binding in vivo determined as binding potential (BP) = k(3)/k(4) in aged animals compared with young animals. Thus, the frontal and temporal cortices as well as the striatum showed age-related reduction of muscarinic cholinergic receptors in vivo, reflecting the reduced receptor density (B(max)) determined by Scatchard plot analysis in vivo. In the hippocampus, although BP of [(11)C](+)3-MPB indicated no significant age-related changes, it showed an inverse correlation with individual cortisol levels in plasma. When the graphical Logan plot analysis was applied, all regions assayed showed significant age-related decrease of [(11)C](+)3-MPB binding. These results demonstrate the usefulness of kinetic three-compartment model analysis of [(11)C](+)3-MPB with metabolite-corrected arterial plasma input as an indicator for the aging process of the cortical muscarinic cholinergic receptors in vivo as measured by PET.

Distribution between protein-bound and free forms of plasma cortisol in the gilt and fetal pig near term.

Thirty-five time-dated pregnant gilts were used to document plasma levels of total and free cortisol, corticosteroid-binding globulin (CBG) binding capacity, and percent distribution of cortisol among protein-bound (CBG and albumin) and free forms in the fetal pig during the last 24 days of gestation. Plasma from fetal pigs on days 110-114 of gestation (gestation length 114 days) had significantly higher levels of total cortisol (p < 0.01), percent albumin-bound and free cortisol (p < 0.10), and free cortisol concentration (p < 0.05) compared to samples on days 90, 100 and 105. Fetal plasma CBG binding capacity increased (p < 0.05) linearly from day 100 to 114. Fetal pigs located in the cervical region of the uterus had lower (p < 0.05) total and free cortisol and higher (p < 0.05) albumin and total protein concentrations compared to fetuses in the middle and oviductal regions. Total, percent free and free cortisol concentrations in maternal plasma on days 105-114 were greater (p < 0.10) than that measured on days 12-100 of gestation. These results suggest that the developmental patterns of plasma cortisol and CBG in the prenatal pig are directly related and highly similar to those of another precocious species, the sheep.

Longitudinal study of adrenal steroids in a cohort of HIV-infected patients with hemophilia.

The objective of the study was to relate plasma dehydroepiandrosterone sulfate (DHEA-S) concentrations to the progression of HIV infection in individual HIV-infected men with hemophilia and to obtain information on the cause of DH EA-S alterations. Blood samples were obtained from 16 men with hemophilia; in 9 men serial samples were available for up to 11 years after HIV-1 infection. Control samples were obtained from men of comparable ages without hemophilia or HIV infection. Measurements were made of CD4+ cell counts, plasma adrenocorticotropic hormone (ACTH), cortisol, DHEA, DHEA-S, and prolactin. Before HIV infection, men with hemophilia had significantly lower plasma levels of DHEA-S than control men. After infection, 3 of 9 subjects studied serially had little or no change in plasma DHEA-S levels or in CD4+ cell counts over 11 years. Four of the 9 i n whom AIDS developed had progressive decreases in plasma DHEA-S concentrations that, in some cases, preceded a precipitous fall in CD4+ cell counts. Major decreases in plasma DHEA-S levels before falls in CD4+ counts were observed in 2 ot her subjects who had other severe illnesses. None of the decreases in DHEA-S levels were associated with decreased concentrations of plasma cortisol, ACTH, or prolactin. We conclude that plasma DHEA-S is an indicator of general health rather than a specific indicator for progression of HIV. The decrease in plasma DHEA-S is not related to ACTH stimulation of the adrenal gland or to cortisol secretion, but it may be related to cytokines that can inhibit 17-hydroxylation of DH EA-S precursors.