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1.
Eur J Endocrinol ; 182(2): 207-217, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31804965

RESUMO

Objective: Monitoring of patients with Cushing's disease on cortisol-lowering drugs is usually performed with urinary free cortisol (UFC). Late-night salivary cortisol (LNSC) has an established role in screening for hypercortisolism and can help to detect the loss of cortisol circadian rhythm. Less evidence exists regarding the usefulness of LNSC in monitoring pharmacological response in Cushing's disease. Design: Exploratory analysis evaluating LNSC during a Phase III study of long-acting pasireotide in Cushing's disease (clinicaltrials.gov: NCT01374906). Methods: Mean LNSC (mLNSC) was calculated from two samples, collected on the same days as the first two of three 24-h urine samples (used to calculate mean UFC [mUFC]). Clinical signs of hypercortisolism were evaluated over time. Results: At baseline, 137 patients had evaluable mLNSC measurements; 91.2% had mLNSC exceeding the upper limit of normal (ULN; 3.2 nmol/L). Of patients with evaluable assessments at month 12 (n = 92), 17.4% had both mLNSC ≤ULN and mUFC ≤ULN; 22.8% had mLNSC ≤ULN, and 45.7% had mUFC ≤ULN. There was high variability in LNSC (intra-patient coefficient of variation (CV): 49.4%) and UFC (intra-patient CV: 39.2%). mLNSC levels decreased over 12 months of treatment and paralleled changes in mUFC. Moderate correlation was seen between mLNSC and mUFC (Spearman's correlation: ρ = 0.50 [all time points pooled]). Greater improvements in systolic/diastolic blood pressure and weight were seen in patients with both mLNSC ≤ULN and mUFC ≤ULN. Conclusion: mUFC and mLNSC are complementary measurements for monitoring treatment response in Cushing's disease, with better clinical outcomes seen for patients in whom both mUFC and mLNSC are controlled.


Assuntos
Ritmo Circadiano , Hidrocortisona/metabolismo , Hipersecreção Hipofisária de ACTH/metabolismo , Adenoma Hipofisário Secretor de ACT/complicações , Adenoma Hipofisário Secretor de ACT/cirurgia , Adulto , Feminino , Hormônios/uso terapêutico , Humanos , Hidrocortisona/urina , Masculino , Pessoa de Meia-Idade , Hipersecreção Hipofisária de ACTH/tratamento farmacológico , Hipersecreção Hipofisária de ACTH/etiologia , Hipersecreção Hipofisária de ACTH/urina , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/cirurgia , Saliva/química , Somatostatina/análogos & derivados , Somatostatina/uso terapêutico , Resultado do Tratamento
2.
Zoo Biol ; 39(1): 51-55, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31746026

RESUMO

Positive reinforcement training (PRT) is associated with increases in species-typical behavior and decreases in stereotypic and abnormal behavior in participating animals. Physiological changes following PRT, for example, increases in oxytocin (OXT) and/or decreases in cortisol (CORT), may facilitate these behavioral changes. This study evaluated salivary OXT and salivary CORT concentrations in two adult male western lowland gorillas (Gorilla gorilla gorilla) following PRT with their primary animal care staff. Following PRT, no change in OXT was observed. CORT decreased in one subject following PRT. Changes in endogenous OXT are related to affiliative interactions and interact with strongly bonded conspecifics. PRT may not activate the oxytocinergic system because PRT is not a species-specific affiliative interaction and/or animal care staff are not viewed as conspecifics. Regardless, PRT may still be viewed as a positive interaction resulting in stress reduction via a decrease in CORT. Relationships are unique, thus these results only apply to these two gorillas and one animal caregiver. Larger population-level studies are needed to understand overall trends in human-animal interactions, and ultimately human-animal relationships. Further evaluation of physiological changes following human-animal interactions should be informative for understanding the human-animal relationship in zoos.


Assuntos
Gorilla gorilla/fisiologia , Hidrocortisona/química , Ocitocina/química , Saliva/química , Criação de Animais Domésticos , Animais , Animais de Zoológico , Comportamento Animal/fisiologia , Hidrocortisona/metabolismo , Masculino , Ocitocina/metabolismo
3.
Gen Comp Endocrinol ; 285: 113267, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31491375

RESUMO

Corticosterone is widely regarded to be the predominant glucocorticoid produced in amphibians. However, we recently described unusually low baseline and stress-induced corticosterone profiles in eastern hellbenders (Cryptobranchus alleganiensis alleganiensis), a giant, fully aquatic salamander. Here, we hypothesized that hellbenders might also produce cortisol, the predominant glucocorticoid used by fishes and non-rodent mammals. To test our hypothesis, we collected plasma samples in two field experiments and analyzed them using multiple analytical techniques to determine how plasma concentrations of cortisol and corticosterone co-varied after 1) physical restraint and 2) injection with adrenocorticotropic hormone (ACTH), the pituitary hormone responsible for triggering the release of glucocorticoids from amphibian interrenal glands. Using liquid chromatography-mass spectrometry, we found that baseline and restraint-induced plasma concentrations of cortisol were more than five times those of corticosterone. We then demonstrated that plasma concentrations of both glucocorticoids increased in response to ACTH in a dose-dependent manner, but cortisol concentrations were consistently higher (up to 10-fold) than corticosterone. Cortisol and corticosterone concentrations were not correlated with one another at basal or induced conditions. The extremely low plasma concentrations of corticosterone in hellbenders suggests that corticosterone could simply be a byproduct of cortisol production, and raises questions as to whether corticosterone has any distinct physiological function in hellbenders. Our results indicate that hellbenders produce cortisol as their predominant glucocorticoid, supporting a small and inconclusive body of literature indicating that some other amphibians may produce appreciable quantities of cortisol. We hypothesize that the use of cortisol by hellbenders could be an adaptation to their fully aquatic life history due to cortisol's ability to fulfill both mineralocorticoid and glucocorticoid functions, similar to its functions in fishes. Given the large number of amphibian species that are fully aquatic or have aquatic life stages, we suggest that the broadly held assumption that corticosterone is the predominant glucocorticoid in all amphibians requires further scrutiny. Ultimately, multi-species tests of this assumption will reveal the ecological factors that influenced the evolution of endocrine adaptations among amphibian lineages, and may provide insight into convergent evolution of endocrine traits in paedomorphic species.


Assuntos
Glucocorticoides/metabolismo , Hidrocortisona/metabolismo , Urodelos/metabolismo , Hormônio Adrenocorticotrópico/metabolismo , Animais , Corticosterona/sangue , Hidrocortisona/sangue , Masculino , Urodelos/sangue
5.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(9): 1023-1029, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31645492

RESUMO

OBJECTIVE: To study the salivary cortisol level, and to analyze the correlation between salivary cortisol and peri-abortion depression in the women suffering termination of pregnancy for fetal anomaly.
 Methods: Comparing the difference in salivary cortisol level between the women with and without depression when they underwent termination of pregnancy for fetal anomaly in a prospective cohort study. Analyzing the correlation between salivary cortisol and peri-abortion depression through logistics regression analysis.
 Results: The salivary cortisol awakening response was lower in women with depression than women without depression. Based on the logistics regression analysis, the salivary cortisol awakening response showed a negative correlation with pre-abortion (OR=0.063, 95% CI 0.005 to 0.754) and post-abortion (OR=0.002, 95% CI 0.000 to 0.061) depression.
 Conclusion: Cortisol awakening response possesses a negative correlation with peri-abortion depression, and it is a predictive factor for post-abortion depression.


Assuntos
Transtorno Depressivo/metabolismo , Hidrocortisona/metabolismo , Depressão , Feminino , Humanos , Gravidez , Estudos Prospectivos , Saliva/metabolismo
6.
Medicine (Baltimore) ; 98(37): e17186, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517876

RESUMO

BACKGROUND: Ashwagandha (Withania somnifera (L.) Dunal) is a herb traditionally used to reduce stress and enhance wellbeing. The aim of this study was to investigate its anxiolytic effects on adults with self-reported high stress and to examine potential mechanisms associated with its therapeutic effects. METHODS: In this 60-day, randomized, double-blind, placebo-controlled study the stress-relieving and pharmacological activity of an ashwagandha extract was investigated in stressed, healthy adults. Sixty adults were randomly allocated to take either a placebo or 240 mg of a standardized ashwagandha extract (Shoden) once daily. Outcomes were measured using the Hamilton Anxiety Rating Scale (HAM-A), Depression, Anxiety, and Stress Scale -21 (DASS-21), and hormonal changes in cortisol, dehydroepiandrosterone-sulphate (DHEA-S), and testosterone. RESULTS: All participants completed the trial with no adverse events reported. In comparison with the placebo, ashwagandha supplementation was associated with a statistically significant reduction in the HAM-A (P = .040) and a near-significant reduction in the DASS-21 (P = .096). Ashwagandha intake was also associated with greater reductions in morning cortisol (P < .001), and DHEA-S (P = .004) compared with the placebo. Testosterone levels increased in males (P = .038) but not females (P = .989) over time, although this change was not statistically significant compared with the placebo (P = .158). CONCLUSIONS: These findings suggest that ashwagandha's stress-relieving effects may occur via its moderating effect on the hypothalamus-pituitary-adrenal axis. However, further investigation utilizing larger sample sizes, diverse clinical and cultural populations, and varying treatment dosages are needed to substantiate these findings. TRIAL REGISTRATION: Clinical Trials Registry-India (CTRI registration number: CTRI/2017/08/009449; date of registration 22/08/2017).


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Estresse Psicológico/tratamento farmacológico , Adulto , Ansiolíticos/efeitos adversos , Ansiedade/metabolismo , Sulfato de Desidroepiandrosterona/metabolismo , Método Duplo-Cego , Feminino , Humanos , Hidrocortisona/metabolismo , Masculino , Fitoterapia , Extratos Vegetais/efeitos adversos , Estresse Psicológico/metabolismo , Testosterona/metabolismo , Resultado do Tratamento
7.
Complement Ther Med ; 46: 62-68, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519289

RESUMO

BACKGROUND: Tinnitus is the perception of sound when no external sound source is present. In some cases, this perception coincides with, or results in, stress. Tinnitus-related distress has been associated with increased levels of cortisol and elevated levels of sympathetic tone. Our primary hypothesis was that short-term sound exposure would reduce tinnitus perception and various physiological measures of stress. A secondary hypothesis was that a self-selected nature sound would reduce physiological markers of stress more than broadband noise. METHODS: Twenty-one participants with constant bothersome tinnitus underwent an audiological assessment. Measurements of blood pressure, heart rate, salivary cortisol and cortisone concentrations, and tinnitus ratings were carried out three times: prior to and, in a counterbalance order, after 30 min of broadband noise and after 30 min of a self-selected nature sound (from: ocean waves, stream, rain or shower sounds). RESULTS: Findings revealed significant reductions in blood pressure measurements following broadband noise. None of the other stress measures demonstrated a statistically significant change. Both broadband noise and nature sounds elicited significant improvements in ratings of tinnitus. CONCLUSIONS: While both sound types had a positive impact on many dimensions of tinnitus, only the broadband noise was associated with a reduction in blood pressure. These results are consistent with a complex interaction between sound and tinnitus and suggest a multifactorial basis to sound therapy that includes a reduction in arousal.


Assuntos
Biomarcadores/metabolismo , Som/efeitos adversos , Zumbido/metabolismo , Zumbido/fisiopatologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Feminino , Humanos , Hidrocortisona/metabolismo , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Vet J ; 252: 105357, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31554592

RESUMO

Hair cortisol might better represent chronic stress than salivary cortisol in piglets. To test this hypothesis, 24 female, 7-day old piglets were allocated to two groups and artificially reared. The piglets in the stressed group were exposed to overcrowding (0.10m2/piglet) and frequent mixing with unfamiliar piglets until the age of 28 days. The control group remained in an unchanging group at a density of 0.29m2/piglet. After 3 weeks, stressed animals had gained significantly less weight (median, here and throughout, 7.58kg) than the control animals (6.43kg; P=0.021). Additionally, hair from the stressed group contained significantly higher cortisol concentrations (87.29 vs. 75.60pg/mg hair; P=0.005), whereas salivary cortisol concentrations did not significantly differ between groups (0.30 vs. 0.25 µg/dL saliva; P=0.447). Weight gain and hair cortisol concentrations were significantly correlated (P=0.036, r=-0.430), but neither of these parameters were correlated with salivary cortisol concentrations (P=0.929, r=0.019 and P=0.904, r=0.026, respectively).


Assuntos
Criação de Animais Domésticos , Cabelo/metabolismo , Hidrocortisona/metabolismo , Saliva/metabolismo , Estresse Fisiológico , Doenças dos Suínos/diagnóstico , Animais , Animais Recém-Nascidos , Feminino , Masculino , Suínos
9.
Artigo em Inglês | MEDLINE | ID: mdl-31546873

RESUMO

The paper presents the application of natural materials, especially wood, which are relevant for human well-being in built environments of health, social, and day care facilities. These properties were tested by a complex methodology in a case study in the wooden waiting room at National Oncology Institute in Bratislava. In this space, experimental tests of physiological responses were further executed on 50 volunteers moving in the waiting room for 20 min. In this article, the EEG (electroencephalograph) (four persons) and emotions from the faces of all our volunteers before entering and after a stay in a wooden waiting room were recorded. Specifically, the ECG (electrocardiograph), heart rate (HR), and respiration activity were measured by using our own designed ECG holter (40 persons), and also blood pressure and cortisol levels were observed. The usage of wooden materials verifies their regenerative and positive impact on the human nervous system, through the appealing aesthetics (color, texture, and structures), high contact comfort, pleasant smell, possibility to regulate air humidity, volatile organic compound emissions (VOC-emissions), and acoustic well-being in the space.


Assuntos
Ambiente Construído , Saúde , Madeira , Adolescente , Adulto , Afeto , Pressão Sanguínea , Institutos de Câncer , Eletrocardiografia , Eletroencefalografia , Feminino , Frequência Cardíaca , Humanos , Hidrocortisona/metabolismo , Masculino , Compostos Orgânicos/análise , Madeira/química , Madeira/microbiologia , Adulto Jovem
10.
J Toxicol Sci ; 44(9): 575-584, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474739

RESUMO

The adrenal gland is the most common toxicological target of drugs within the endocrine system, and inhibition of adrenal steroidogenesis can be fatal in humans. However, methods to evaluate the adrenal toxicity are limited. The aim of the present study was to verify the usefulness of simultaneous measurement of blood levels of multiple adrenal steroids, including precursors, as a method to evaluate drug effects on adrenal steroidogenesis in cynomolgus monkeys. With this aim, physiological and drug-induced changes in blood levels of adrenal steroids, including cortisol, aldosterone, androgen, and their precursors were examined. First, for physiological changes, intraday and interday changes in blood steroid levels were examined in male and female cynomolgus monkeys. The animals showed circadian changes in steroid levels that are similar to those in humans, while interday changes were relatively small in males. Next, using males, changes in blood steroid levels induced by ketoconazole and metyrapone were examined, which suppress adrenal steroidogenesis via inhibition of CYP enzymes. Consistent with rats and humans, both ketoconazole and metyrapone increased the deoxycorticosterone and deoxycortisol levels, probably via CYP11B1 inhibition, and the increase was observed earlier and with greater dynamic range than the changes in cortisol level. Changes in other steroid levels reflecting the drug mechanisms were also observed. In conclusion, this study showed that in cynomolgus monkeys, simultaneous measurement of blood levels of adrenal steroids, including precursors, can be a valuable method to sensitively evaluate drug effects on adrenal steroidogenesis and to investigate the underlying mechanisms.


Assuntos
Glândulas Suprarrenais/efeitos dos fármacos , Glândulas Suprarrenais/metabolismo , Aldosterona/sangue , Aldosterona/metabolismo , Androgênios/sangue , Androgênios/metabolismo , Cromatografia Líquida/métodos , Hidrocortisona/sangue , Hidrocortisona/metabolismo , Cetoconazol/toxicidade , Metirapona/toxicidade , Espectrometria de Massas em Tandem/métodos , Animais , Ritmo Circadiano , Desoxicorticosterona/metabolismo , Feminino , Humanos , Macaca fascicularis , Masculino , Esteroide 11-beta-Hidroxilase/antagonistas & inibidores
11.
World Neurosurg ; 132: 161-164, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31505284

RESUMO

BACKGROUND: Double pituitary adenomas are a rare occurrence. Synchronous clinical manifestation is extremely rare. CASE DESCRIPTION: We report a case of a 51-year-old female with symptoms of both hypercortisolism and acromegaly during the past 2 years. Endocrine evaluation confirmed active acromegaly and revealed adrenocorticotropin hormone-dependent hypercortisolemia. Preoperative magnetic resonance imaging of the pituitary demonstrated separated double microadenomas with different intensity. Immunohistochemical analysis of each separate adenoma confirmed an exact diagnosis. The diagnosis of acromegaly and adrenocorticotropin hormone-dependent Cushing's disease was confirmed. CONCLUSIONS: This is the third reported case in the literature of synchronous clinical manifestation of acromegaly and Cushing's disease. Extensive surgical exploration of the sella must be performed to avoid surgical failures from residual tumor. Immunohistochemical analysis is required to confirm an exact diagnosis for each of the double pituitary adenomas.


Assuntos
Adenoma Hipofisário Secretor de ACT/diagnóstico por imagem , Adenoma Hipofisário Secretor de ACT/cirurgia , Acromegalia/diagnóstico por imagem , Acromegalia/etiologia , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Hipersecreção Hipofisária de ACTH/diagnóstico por imagem , Hipersecreção Hipofisária de ACTH/etiologia , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Corticotrofos/metabolismo , Feminino , Humanos , Hidrocortisona/metabolismo , Imuno-Histoquímica , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Somatotrofos/metabolismo , Resultado do Tratamento
12.
PLoS One ; 14(8): e0220112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31390349

RESUMO

Short stress management interventions such as relaxation therapy have demonstrated preliminary effectiveness in reducing stress-related problems. A promising tool to strengthen the effectiveness of relaxation-based interventions is the use of verbal suggestions, as previous research provided evidence that verbal suggestions can induce positive outcome expectancies, facilitate adaptive responses to stress and improve health outcomes. The present experimental proof-of-concept study aimed to investigate the effects of a brief relaxation intervention and specifically the role of verbal suggestions on stress-related outcomes assessed by self-report questionnaires and psychophysiological data. 120 participants (mean age = 22.1 years) were randomized to one of four intervention conditions: a brief relaxation intervention plus verbal suggestions condition, a brief relaxation intervention only condition, a verbal suggestions only condition, and a control condition. Afterwards, participants were subjected to a psychosocial stress challenge to assess reactivity to a stressful event. Immediately after both relaxation interventions (with and without verbal suggestions), lower self-reported state anxiety was found compared to the control condition, but no differences were observed in response to the stressor. The verbal suggestions only condition did not impact state anxiety. No significant effects were found for verbal suggestion interventions on cortisol, alpha amylase, heart rate and skin conductance. This is the first study investigating the role of verbal suggestions in the effectiveness of a brief relaxation intervention. Although this experimental proof-of-concept study provides support for the effectiveness of a brief relaxation intervention in lowering state anxiety directly after the intervention, the effects did not impact the response to a subsequent stressor and we did not observe any evidence for the add-on effectiveness of verbal suggestions. The effectiveness of brief relaxation interventions on stress responses should be investigated further in future research by incorporating interventions that are tailored to the specific stress challenge and various types of verbal suggestions.


Assuntos
Terapia de Relaxamento/métodos , Sugestão , Adolescente , Adulto , Ansiedade/metabolismo , Ansiedade/fisiopatologia , Ansiedade/psicologia , Ansiedade/terapia , Feminino , Resposta Galvânica da Pele , Frequência Cardíaca , Humanos , Hidrocortisona/metabolismo , Masculino , Saliva/metabolismo , Autorrelato , Resultado do Tratamento , Adulto Jovem , alfa-Amilases/metabolismo
13.
Eur J Endocrinol ; 181(4): K29-K35, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31382242

RESUMO

Objective: The diagnosis of Cushing's disease (CD) is particularly challenging in patients with chronic kidney disease (CKD) due to abnormalities of the hypothalamo-pituitary-adrenal axis associated with the latter. This case report presents discrepant biochemical findings in a patient with CKD who was subsequently diagnosed with CD, and outlines principles which may guide the definitive diagnosis of CD in this context. Methods: The case of a patient with Stage 4 CKD who underwent transsphenoidal surgery for pituitary-dependent CD is presented. A literature review was conducted to identify similar cases and characterise features of hypothalamo-pituitary-adrenal axis dysfunction in CKD. Results: The patient discussed herein presented with markedly elevated plasma adrenocorticotrophic hormone (ACTH) due to a pituitary macroadenoma, with normal 24-h urine free cortisol (24-UFC) but abnormal overnight dexamethasone suppression testing and elevated midnight salivary cortisol. He experienced biochemical remission after undergoing transsphenoidal adenomectomy. A literature review revealed that CKD can be associated with elevated serum cortisol, reduced UFC and elevated plasma ACTH. Only four other cases of CD being diagnosed in a patient with CKD have been published. The loss of a circadian rhythm of cortisol secretion was the most common feature among all cases. Conclusions: To establish a definitive diagnosis of CD in the context of pre-existing CKD, the absence of circadian rhythms of cortisol and ACTH is a more sensitive indicator than 24-UFC and low-dose dexamethasone suppression testing.


Assuntos
Hipersecreção Hipofisária de ACTH/complicações , Hipersecreção Hipofisária de ACTH/diagnóstico por imagem , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico por imagem , Hormônio Adrenocorticotrópico/metabolismo , Idoso , Ritmo Circadiano/fisiologia , Diagnóstico Diferencial , Humanos , Hidrocortisona/metabolismo , Masculino , Hipersecreção Hipofisária de ACTH/metabolismo , Insuficiência Renal Crônica/metabolismo
14.
Am J Audiol ; 28(3): 686-696, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31430174

RESUMO

Purpose There is a growing body of literature that suggests a linkage between impaired auditory function, increased listening effort, and fatigue in children and adults with hearing loss. Research suggests this linkage may be associated with hearing loss-related variations in diurnal cortisol levels. Here, we examine variations in cortisol profiles between young adults with and without severe sensorineural hearing loss and examine associations between cortisol and subjective measures of listening effort and fatigue. Method This study used a repeated-measures, matched-pair design. Two groups (n = 8 per group) of adults enrolled in audiology programs participated, 1 group of adults with hearing loss (AHL) and 1 matched control group without hearing loss. Salivary cortisol samples were collected at 7 time points over a 2-week period and used to quantify physiological stress. Subjective measures of listening effort, stress, and fatigue were also collected to investigate relationships between cortisol levels, perceived stress, and fatigue. Results Subjective ratings revealed that AHL required significantly more effort and concentration on typical auditory tasks than the control group. Likewise, complaints of listening-related fatigue were more frequent and more of a problem in everyday life for AHL compared to the control group. There was a significant association between subjective ratings of listening effort and listening-related fatigue for our AHL, but not for the control group. In contrast, there was no significant difference in cortisol measures between groups, nor were there significant associations between cortisol and any subjective measure. Conclusions Young AHL experience more effortful listening than their normal hearing peers. This increased effort is associated with increased reports of listening-related fatigue. However, diurnal cortisol profiles were not significantly different between groups nor were they associated with these perceived differences.


Assuntos
Ritmo Circadiano , Surdez/reabilitação , Fadiga/metabolismo , Hidrocortisona/metabolismo , Estresse Psicológico/metabolismo , Adulto , Estudos de Casos e Controles , Implantes Cocleares , Fadiga/psicologia , Feminino , Humanos , Masculino , Projetos Piloto , Estresse Psicológico/psicologia , Adulto Jovem
15.
Int J Sports Med ; 40(12): 762-767, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31466082

RESUMO

This study compared internal load variable dynamics across three consecutive football matches and investigated its relationship with the number of sprints performed by players. Twenty-three male players had blood and salivary samples collected for hormonal concentration (testosterone, cortisol, and testosterone-cortisol ratio), and serum analysis (interleukin-6, interleukin-1-beta, and c-reactive-protein), respectively. Sprints were measured through Global Position System devices. Testosterone and testosterone-cortisol-ratio presented a decreasing behavior up to the second match, and all other indicators presented an increasing behavior during the same period, c-reactive-protein was the only indicator observed to significantly rise up to the third match as well (0.38±0.02 mg/L; 0.49±0.05 mg/L; 0.69±0.05 mg/L; 0.89±0.08 mg/L). C-reactive-protein showed strong correlations with sprints in the second and third matches (p<0.01, r=0.71 and 0.79), and weak-to-moderate in the first one (p<0.05, r=0.59). Interleukin-6 and interleukin-1-beta presented weak-to-moderate correlation in every match (p<0.05, r=0.48 to 0.51; r=0.51 to 0.55) while testosterone-cortisol ratio presented weak-to-moderate correlation only in the third one (p<0.05, r=0.42). Multilevel linear regression showed that c-reactive-protein had a higher R2 than other biomarker in any regression model (R2=0.624; p<0.001). Therefore, c-reactive-protein can be a valid and reliable indicator of sprinting in competitive football. Future research should explore longer periods of monitoring and/or others external load variables so that other behaviors may arise to knowledge.


Assuntos
Proteína C-Reativa/metabolismo , Comportamento Competitivo/fisiologia , Corrida/fisiologia , Futebol/fisiologia , Adolescente , Biomarcadores/sangue , Biomarcadores/metabolismo , Humanos , Hidrocortisona/sangue , Hidrocortisona/metabolismo , Interleucina-1beta/sangue , Masculino , Músculo Esquelético/lesões , Músculo Esquelético/fisiopatologia , Receptores de Interleucina-6/sangue , Saliva/metabolismo , Testosterona/sangue , Testosterona/metabolismo , Adulto Jovem
16.
Biol Res Nurs ; 21(5): 510-518, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31296023

RESUMO

OBJECTIVE: Low sleep quality (LSQ) activates the hypothalamic-pituitary-adrenal (HPA) axis and is related to arousal. Nursing staff, who work in shifts, tend to exhibit LSQ, which affects the level of vigor after awakening. This study investigated the effects of nocturnal sleep quality on diurnal cortisol profiles and sustained attention in day-shift nurses. METHOD: This study adopted a prospective cross-sectional design. Participants were recruited from a university-affiliated hospital in northern Taiwan. In the initial stage of this study, the Chinese Pittsburgh Sleep Quality Index (PSQI) Questionnaire was administered to 199 participants to categorize them as either LSQ (PSQI > 5) or high sleep quality (HSQ; PSQI ≤ 5). Participants were then randomly sampled from the two groups. Nocturnal sleep data and four diurnal saliva samples were collected for each participant. Sustained attention was measured before they started work. A total of 32 and 29 participants in the HSQ and LSQ groups, respectively, completed the data collection process. RESULTS: Compared with the HSQ group, the LSQ group exhibited earlier wake-up times (p = .02), a flatter cortisol awakening response (CAR) slope (p < .01), a flatter morning-to-evening slope (p < .01), and prolonged reaction speed and mean reaction time before starting work (p < .01). CONCLUSION: Compared with the HSQ group, the LSQ group exhibited impaired HPA-axis regulation, with a flatter CAR and diurnal cortisol slope and poor sustained attention in the morning. Nursing staff are advised to achieve HSQ to improve attention and performance levels and maintain optimum work safety.


Assuntos
Atenção/fisiologia , Hidrocortisona/metabolismo , Enfermeiras e Enfermeiros/estatística & dados numéricos , Vigília/fisiologia , Adulto , Ritmo Circadiano/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Sistema Hipófise-Suprarrenal , Estudos Prospectivos , Sono/fisiologia , Taiwan
17.
Am J Audiol ; 28(3): 583-596, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31318575

RESUMO

Purpose Tinnitus is a chronic medical condition that can result in distress, concentration difficulties, and clinical depression. An effective, objective measure of tinnitus distress does not currently exist. Endocrinal studies into the condition have been few, with those investigating the cortisol awakening response limited in scope. It was hypothesized that distressed individuals with tinnitus would awaken and be unable to effectively prepare for the day ahead due to a blunted cortisol response. Method Twenty individuals with varying tinnitus distress were compared with a control group (n = 10) in a pilot study, which measured salivary cortisol concentrations on awakening. Multiple exclusion variables were applied. Results In line with previous studies, total cortisol volume (as measured by area under the curve) was not found to be significantly different in the most distressed individuals with tinnitus, F(2, 26) = 0.254, p = .777ns. However, a separate measure of changing cortisol levels-the area under the curve with respect to increase (or AUCi)-was found to be significantly less robust in those individuals reporting the most severe tinnitus distress, F(2, 26) = 7.671, p = .002. This indicates that fewer resources would be available to cope with the demands of the day ahead. Additionally, the AUCi correlated negatively with tinnitus distress later the same day. Conclusions Relationships between proposed objective and self-reported components of self-reported tinnitus distress are considered, with some aspects of tinnitus distress more closely related to physiological mechanisms than others. It is suggested that, with further research, the cortisol awakening response (AUCi) may be put forward as a credible objective biomarker of tinnitus distress.


Assuntos
Ritmo Circadiano , Hidrocortisona/metabolismo , Estresse Psicológico/metabolismo , Zumbido/psicologia , Adulto , Área Sob a Curva , Estudos de Casos e Controles , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/psicologia
18.
Surg Clin North Am ; 99(4): 747-758, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255204

RESUMO

Without the overt clinical signs and symptoms associated with Cushing's syndrome, the diagnosis of subclinical Cushing's syndrome (SCS) is primarily based on biochemical evaluation. Despite being labeled as "subclinical," SCS is associated with significant morbidity that can be improved with adrenalectomy. Minimally invasive adrenalectomy is associated with low morbidity in the hands of experienced adrenal surgeons and is recommended as the treatment of choice for SCS patients with SCS-associated comorbidities.


Assuntos
Adrenalectomia/métodos , Síndrome de Cushing/cirurgia , Tomada de Decisões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Síndrome de Cushing/diagnóstico , Síndrome de Cushing/metabolismo , Humanos , Hidrocortisona/metabolismo
19.
Medicine (Baltimore) ; 98(26): e16114, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261527

RESUMO

OBJECTIVE: Cognitive impairment subjects exhibit high cortisol levels that are associated with low brain activity, but negative emotions with high cortisol are associated with high brain activity and reduced cognition. Emotion regulation, glucocorticoid hormones, and brain activity all interact with cognitive impairment. Therefore, we aimed to investigate cognitive impairment differences related to sex, morning salivary cortisol, emotion regulation, and brain activity in elderly people. METHODS: A total of 64 participants (19 males and 45 females) were tested by the Montreal cognitive assessment. Next, morning saliva was collected from each participant and analyzed by enzyme-linked immunosorbent assay, and the brain activity of the participants was subsequently recorded. Finally, emotion regulation was assessed via the Brunel mood scale questionnaire. RESULTS: The results revealed that attention was significantly lower in elderly females than in elderly males. Depression and vigor were significantly higher in elderly females than in elderly males. Brain activity of the slow (delta and theta) and fast (beta and high beta) waves was significantly higher in elderly females than in elderly males. Moreover, attention was negatively correlated with the theta wave, whereas delayed recall was positively correlated with the theta wave and salivary cortisol. Depression was positively correlated with the high beta wave and language skill, whereas the high beta wave was negatively correlated with visuoconstructional skill. CONCLUSION: The brain activity, emotion, and cortisol were influenced by cognitive impairments, although the relation of brain activity with glucocorticoid hormones remains inconclusive. This finding may be useful to the brain aging process, promote healthy brain aging, and prevent neurodegenerative conditions.


Assuntos
Encéfalo/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Emoções , Hidrocortisona/metabolismo , Idoso , Atenção , Depressão/fisiopatologia , Eletroencefalografia , Ensaio de Imunoadsorção Enzimática , Função Executiva , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Saliva/metabolismo , Autocontrole , Fatores Sexuais
20.
Midwifery ; 77: 101-109, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31306998

RESUMO

OBJECTIVE: An increase in the number of women who have fear of birth [FOB] has been reported globally; yet, how these women are identified varies. This study aimed to identify the most effective way of measuring FOB in clinical practice. DESIGN: This paper reports on a prospective cohort study; a core element of an explanatory mixed-methods study. This element explored the appropriateness of measures of anxiety (biomarkers and validated questionnaires) and observed any relationship between anxiety levels and clinical outcomes. PARTICIPANTS: A purposive sampling strategy was used. One hundred and forty-eight primigravida, during the 1st trimester, in two tertiary maternity units in England were included. METHODS: Demographic and baseline data were collected from participants in the first trimester of pregnancy along with FOB scores, and a saliva sample to measure cortisol level. In the third trimester, a second FOBS score, and saliva sample were collected, and the Personal Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were administered to measure depression and anxiety respectively. FINDINGS: The FOBS was completed by 148 women in the first trimester and 80 in the third. Using a cut-off of 54, 30/148 (20%) women had a FOB in the first trimester; 21/80 (26%) had a FOB in the third trimester, 15 (19%) of whom also had a FOB in the first. Compared with the first trimester, 51/80 women showed an increase in FOBS score, with 14 scores increasing above and 8 scores decreasing below the cut-off of 54. FOBS scores were not correlated with salivary cortisol in either trimester (first trimester Spearman's ρ=0.08, p = 0.354, n = 144; third trimester ρ=0.12, p = 0.309, n = 71) but they were correlated with PHQ-9 and GAD-7 scores in the third trimester (PHQ-9 ρ=0.53, p = 0.010, n = 23; GAD-7 ρ=0.45, p = 0.033, n = 23) although not sufficiently high enough to demonstrate convergent validity against those measures of depression and anxiety. They were also associated with a previous history of depression but only in the first trimester (p = 0.011). FOBS scores showed considerable variability and a high measurement error, indicating a need for further refinement and psychometric testing. CONCLUSION: The FOBS is a potentially effective way of measuring FOB in clinical practice and research, but it requires refining. Scores are not related to salivary cortisol levels but are correlated with validated scores for anxiety and depression. An enhanced version of the FOBS could be used in clinical practice to measure FOB.


Assuntos
Medo/psicologia , Número de Gestações , Parto/psicologia , Gestantes/psicologia , Adulto , Estudos de Coortes , Inglaterra , Feminino , Humanos , Hidrocortisona/análise , Hidrocortisona/metabolismo , Estudos Longitudinais , Programas de Rastreamento/métodos , Gravidez , Primeiro Trimestre da Gravidez/psicologia , Estudos Prospectivos , Psicometria/instrumentação , Psicometria/métodos , Saliva/metabolismo , Inquéritos e Questionários
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