scholarly journals Regulation of Cortisol in Patients Undergoing Total Joint Arthoplasty

2021 ◽  
Vol 27 ◽  
pp. 107602962198761
Author(s):  
Rajan Khanna ◽  
Hannah Slovacek ◽  
Jeffrey Liles ◽  
Sandra Haddad ◽  
Pavel Poredos ◽  
...  
Keyword(s):  
Emotional Stress ◽  
Total Joint Arthroplasty ◽  
Plasma Cortisol ◽  
Serum Cortisol ◽  
Joint Arthroplasty ◽  
Plasma Cortisol Level ◽  
Definitive Treatment ◽  
Elisa Kit ◽  
Post Operation ◽  
Cortisol Levels

Osteoarthritis is a condition in which joint cartilage and bone degenerate progressively over time. Total joint arthroplasty is a definitive treatment. Cortisol is a hormone that is associated with pain and inflammation. This study aims to investigate the cortisol levels in patients undergoing total joint arthroplasty. Plasma samples were collected from 71 total joint arthroplasty (TJA) patients at baseline (pre-surgery), 24 hours post-operation, and 5 days post-operation. Cortisol levels were measured in each sample using a commercially available ELISA kit. All results were compiled as group means ± SD. The plasma cortisol level at baseline were 218.5 ± 12 ng/mL. The 24-hour post-surgical samples showed a marked increase in cortisol levels 240.7 ± 15 ng/mL. The blood samples drawn at the 5th day after surgery showed a downward trend (74 ± 12 ng/mL). At 5 days post-operation, cortisol levels were significantly lower than at baseline or 24 hours post-operation. These results point to the fact that prior to surgery, the patient’s emotional stress contributes to increased serum cortisol levels. The higher level of cortisol persists at 24 hours post-operation due to inflammation from the procedure. This data also suggests that at 5 days post-operation, the inflammatory response from the surgery and emotional stress subside, resulting in a near normalization of the cortisol levels. Cortisol is a hormone that plays a major role in the body’s response to surgery. The relevance between cortisol and different points in the surgical timeline has the potential to prognosticate and improve recovery measures.

Plasma Cortisol Levels in Depression

1966 ◽  
Vol 112 (493) ◽  
pp. 1263-1267 ◽  
Author(s):  
R. J. Doig ◽  
R. V. Mummery ◽  
M. R. Wills ◽  
A. Elkes
Keyword(s):  
Diurnal Variation ◽  
Sleep Disturbance ◽  
Cortisol Level ◽  
Plasma Cortisol ◽  
Normal Subjects ◽  
Plasma Cortisol Level ◽  
Fundamental Characteristic ◽  
Sleep Period ◽  
Cortisol Levels ◽  
Abrupt Rise

Sleep disturbance is commonly found in depression. Plasma cortisol levels in non-hospitalized normal subjects show a rise prior to waking, with peak values at between 5 and 8 a.m. (9, 10). In a group of eight normal subjects, Perkoff (10) changed the sleep rhythm to sleeping during the day, using darkened rooms, and found that the plasma cortisol level followed suit, rising sharply in the two-hour period before waking. He stated: “A fundamental characteristic of the diurnal variation of plasma 17 OHCS concentration is the abrupt rise which occurs during the sleep period.”

MEASUREMENT OF PLASMA CORTISOL LEVELS IN THE EEL ANGUILLA ANGUILLA IN RELATION TO OSMOTIC ADJUSTMENTS

1971 ◽  
Vol 50 (1) ◽  
pp. 75-96 ◽  
Author(s):  
J. N. BALL ◽  
I. CHESTER JONES ◽  
M. E. FORSTER ◽  
G. HARGREAVES ◽  
E. F. HAWKINS ◽  
...  
Keyword(s):  
Plasma Cortisol ◽  
Sea Water ◽  
Anguilla Anguilla ◽  
Plasma Cortisol Level ◽  
Hormonal Control ◽  
Total Cortisol ◽  
Competitive Protein Binding ◽  
Low Levels ◽  
Cortisol Levels

SUMMARY The competitive protein-binding radioassay (CPB method) of Murphy (1967) has been adapted to determine total cortisol levels in the plasma of the eel, Anguilla anguilla L. Validation of the method for this species depended in part on the development of a chromatographic—fluorimetric technique for eel cortisol, following classical procedures and using radioactive tracers; by this means, the specificity of the CPB method for cortisol in eel plasma was established. Accuracy, precision and sensitivity of the CPB method were also investigated and were shown to be satisfactory. Plasma total cortisol levels were determined in eels during osmotic adjustments after transfers from fresh water (FW) to sea-water (SW) and vice versa, and from FW to distilled water. Plasma osmotic pressure and/or sodium levels were monitored simultaneously, to follow the progress of osmotic regulation. In only one of the transfer situations did the plasma cortisol level change significantly, showing a marked transitory increase during the first few days after transfer from FW to SW, corresponding to the development and correction of an 'osmotic crisis'. Plasma cortisol levels were the same in eels adapted for long periods to FW and to SW. Plasma cortisol fell to extremely low levels after hypophysectomy. These results are discussed in the light of the literature on hormonal control of osmoregulatory mechanisms in the eel, with particular emphasis on the role of adrenocorticosteroids in ionic regulation of animals in SW.

scholarly journals Cyclic Cushing's syndrome

2010 ◽  
Vol 56 (4) ◽  
pp. 44-51
Author(s):  
E I Marova ◽  
I A Voronkova
Keyword(s):  
Cushing’S Syndrome ◽  
Clinical Signs ◽  
Serum Cortisol ◽  
Cushing's Syndrome ◽  
Plasma Cortisol Level ◽  
Average Life Expectancy ◽  
Ectopic Acth ◽  
Number Of Patients ◽  
Free Cortisol ◽  
Cortisol Levels

The cyclic Cushing's syndrome is a rare disease characterized by multiple episodes of elevated cortisol levels alternating with periods of its normal secretion. The so-called hypercorticism cycles may be either regular or episodic with intercycle intervals as long as a few days to several years. Most researchers agree that the reliable diagnosis of cyclic Cushing's syndrome should be based on laboratory detection of 3 peaks and 2 falls of plasma cortisol level. Cyclic Cushing's syndrome may be either ACTH dependent or independent. A review of 65 verified cases indicates that this condition may be caused by pituitary corticotropinoma (54%), ectopic ACTH-producing tumour (26%), and adrenal tumour (roughly 11%). The cause of the disease remains uncertain in 9% of the patients. Pathophysiological mechanisms of cyclic Cushing's syndrome are poorly known. In certain cases of bilateral macronodular adrenal hyperplasia or adrenal corticosteroma, it may be associated with the presence of ectopic receptors or anomalous expression of normally located receptors. The majority of the patients presenting with cyclic Cushing's syndrome exhibit symptoms of classical hypercorticism that manifest themselves either on a permanent or cyclic basis. In a small number of patients, clinical signs of cyclic Cushing's syndrome are virtually absent. Variations of the clinical picture and conflicting results of hormonal assays taken together make cyclic Cushing's syndrome difficult to diagnose. Therefore, physicians must be aware of this condition and actively search for it in all patients believed to have an enhanced cortisol production despite normal results of laboratory analysis. Frequent changes of urinary or salivary free cortisol levels are reliable and convenient criteria for cyclic Cushing's syndrome in patients suspected to have this condition. Results of cortisol stimulation or suppression tests are likely to lead to a false conclusion due to spontaneous falls and rises in serum cortisol levels at the time of analysis. Given laboratory confirmation of cyclic Cushing's syndrome, subsequent studies should be focused on the elucidation of its cause. The average life expectancy of patients with cyclic Cushing's syndrome remains to be determined.

DIURNAL FLUCTATION OF PLASMA CORTISOL LEVELS IN THE GUINEA PIG

1979 ◽  
Vol 90 (4) ◽  
pp. 692-695 ◽  
Author(s):  
David R. Garris
Keyword(s):  
Guinea Pig ◽  
Cortisol Level ◽  
Plasma Cortisol ◽  
Plasma Cortisol Level ◽  
Dark Phase ◽  
Diurnal Changes ◽  
Light Phase ◽  
Dramatic Rise ◽  
Cortisol Levels

ABSTRACT Diurnal changes in the basal levels of plasma cortisol were studied in the female guinea pig. Plasma cortisol levels were determined at 8 bleeding times during the entrained 24 h photoperiod (14 h light/10 h dark: lights on 06.00 h). Plasma cortisol levels remained low during the dark phase of the cycle ranging between 6.4 and 9.0 μg/100 ml. However, at 4 h prior to the onset of the light phase of the photoperiod, a dramatic rise in the plasma cortisol level was measured, which peaked between 04.00 and 08.00 h at 12.3 μg/100 ml. A subsequent decline in plasma cortisol levels was measured throughout the light phase of the cycle, reaching basal levels before the onset of the dark phase. These data indicate that a diurnal fluctation in plasma cortisol occurs in the guinea pig which is very reminiscent of that seen in the human and in contrast with that observed in the rat.

scholarly journals Simultaneous Determination of Plasma Cortisol by High Pressure Liquid Chromatography and Radioimmunoassay Methods in Fish

2007 ◽  
Vol 76 (1) ◽  
pp. 59-64 ◽  
Author(s):  
J. Blahová ◽  
R. Dobšíková ◽  
Z. Svobodová ◽  
P. Kaláb
Keyword(s):  
Liquid Chromatography ◽  
Common Carp ◽  
Cortisol Level ◽  
Plasma Cortisol ◽  
High Performance ◽  
Serum Cortisol ◽  
Plasma Cortisol Level ◽  
Serum Cortisol Level ◽  
Long Distance

The aim of the study was to compare the sensitivity of High Performance Liquid Chromatography (HPLC) and Radioimmunoassay (RIA) analytical methods in the determination of blood plasma cortisol level of common carp (Cyprinus carpio L.). Cortisol, the most potent glucocorticoid, is widely used as an indicator of stress. The monitoring of plasma cortisol concentration was performed during the test focused on stress response caused by handling and long-distance transport of common carp. The samples were collected before, during and after transport. The correlation between blood cortisol level in fish measured by HPLC and RIA was determined using 66 samples. The correlation was HPLC = 0.9454 RIA + 0.40676 and correlation coefficient was 0.815. From the presented results it can be concluded that both methods (RIA and HPLC) can be used for the determination of plasma (serum) cortisol level.

scholarly journals The Adrenal Cortex, an Underestimated Site of SARS-CoV-2 Infection

2021 ◽  
Vol 11 ◽  
Author(s):  
Yanfei Mao ◽  
Bo Xu ◽  
Wenbin Guan ◽  
Dunfeng Xu ◽  
Feng Li ◽  
...  
Keyword(s):  
Adrenal Cortex ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Plasma Cortisol ◽  
Plasma Cortisol Level ◽  
Relative Adrenal Insufficiency ◽  
Zona Fasciculata ◽  
Cortical Function ◽  
Adrenocortical Cells ◽  
Cortisol Levels

BackgroundThe majority of the critically ill patients may have critical illness-related corticosteroid insufficiency (CIRCI). The therapeutic effect of dexamethasone may be related to its ability to improve cortical function. Recent study showed that dexamethasone can reduce COVID-19 deaths by up to one third in critically ill patients. The aim of this article is to investigate whether SARS-CoV-2 can attack the adrenal cortex to aggravate the relative adrenal insufficiency.MethodsWe summarized the clinical features of COVID-19 reported in currently available observational studies. ACE2 and TMPRSS2 expression was examined in human adrenal glands by immunohistochemical staining. We retrospectively analyzed serum cortisol levels in critically ill patients with or without COVID-19.ResultsHigh percentage of critically ill patients with SARS-COV-2 infection in the study were treated with vasopressors. ACE2 receptor and TMPRSS2 serine protease were colocalized in adrenocortical cells in zona fasciculata and zona reticularis. We collected plasma cortisol concentrations in nine critically ill patients with COVID-19. The cortisol levels of critically ill patients with COVID-19 were lower than those in non-COVID-19 critically ill group. Six of the nine COVID-19 critically ill patients had random plasma cortisol concentrations below 10 µg/dl, which met the criteria for the diagnosis of CIRCI.ConclusionWe demonstrate that ACE2 and TMPRSS2 are colocalized in adrenocortical cells, and that the cortisol levels are lower in critically ill patients with COVID-19 as compared to those of non-COVID-19 critically ill patients. Based on our findings, we recommend measuring plasma cortisol level to guide hormonal therapy.

scholarly journals Characteristics of adrenal insufficiency in hemodialysis patients

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naro Ohashi ◽  
Yukitoshi Sakao ◽  
Taichi Sato ◽  
Sayaka Ishigaki ◽  
Shinsuke Isobe ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Glands ◽  
Characteristic Curve ◽  
Serum Cortisol ◽  
Plasma Cortisol Level ◽  
Serum Cholinesterase ◽  
Test Results ◽  
Subjective Symptoms ◽  
Inflammatory Status ◽  
Cortisol Levels

Abstract Background Adrenal insufficiency causes abnormal subjective symptoms such as general fatigue, signs such as hypotension, and abnormalities such as hypoglycemia and leads to poor prognosis. However, all these are also observed in hemodialysis (HD) patients without adrenal insufficiency. The morphology of the adrenal glands in HD patients with adrenal insufficiency is unclear. Therefore, this study was performed to clarify the characteristics of adrenal insufficiency in HD patients. Methods Seventeen HD patients who had abnormal subjective symptoms and test results indicating adrenal insufficiency and whose serum cortisol levels were less than 18 μg/dL were recruited. Results Seven HD patients were diagnosed with adrenal insufficiency. No significant differences were found about abnormal subjective symptoms and images between patients with and without adrenal insufficiency. The levels of serum cortisol and serum cholinesterase were significantly lower in patients with adrenal insufficiency than in those without adrenal insufficiency. A plasma cortisol level of 8.45 μg/dL showed the highest sensitivity and specificity in the receiver operating characteristic curve. The serum cortisol levels were significantly and negatively associated with the plasma ferritin levels in patients with adrenal insufficiency. Multiple linear regression analyses revealed that the serum cortisol levels showed a significant negative association with the plasma ferritin levels after adjustments. Conclusions It is difficult to infer adrenal insufficiency in HD patients by subjective symptoms and images of the adrenal glands. Adrenal insufficiency correlates with nutritional and inflammatory status, and the levels of serum cholinesterase and plasma ferritin might reflect their corresponding status.

scholarly journals Adaptogens as anti-stress agents in reducing increased plasma cortisol level during stress

2021 ◽  
Vol 8 (3) ◽  
pp. 198-203
Author(s):  
Anju ◽  
Ashis Kumar Ghosh
Keyword(s):  
Stress Response ◽  
Cortisol Level ◽  
Plasma Cortisol ◽  
Withania Somnifera ◽  
Plasma Cortisol Level ◽  
Ocimum Sanctum ◽  
Standard Group ◽  
Adrenal Hormone ◽  
Cortisol Levels ◽  
Pituitary Adrenal Axis

The stress response involves the activation of both the sympathetic-adrenal response and the hypothalamic-pituitary-adrenal axis. During times of increased stress, the adrenal gland is stimulated to produce increased levels of hormones. Cortisol, the main hormone involved in the stress response, is secreted in increased amounts within minutes of a perceived stressor. Cortisol secretion can increase as much as 20-fold and has several important physiological effects. Short-term surges in cortisol levels can suppress inflammation and at the same time suppress immune function. Though inflammation control is important, surges of sustained levels of cortisol are not healthy and ultimately lead to premature aging, degenerative disease, and increased susceptibility to cancer. Studies show that psycho-social stress activates the hypothalamus-pituitary-adrenal axis causing an increase in morning cortisol levels, which correlated to the subjects reports of increased fatigue and anxiety. Although this stress response is important for survival during an acute stressor, prolonged activation of the stress response may lead to adrenal exhaustion in which cortisol levels drop to insufficient levels resulting in fatigue or illness. Many herbs have been shown to impact adrenal function. Adaptogens are plants that produce a non-specific response improving the physiological resistance to stressors. These herbs are often used in the context of adrenal support formulas to balance adrenal hormone levels. It is believed that adaptogenic herbs can increase low levels of adrenal hormone or decrease levels that are elevated. Additionally, these herbs provide balancing activity on many body systems that are impacted by stress, such as the immune response and blood sugar control.In the present study, we have evaluated the efficacy of ethanolic extract of Ocimum sanctum 47mg/kg p.o, Withania somnifera 23 mg/kg p.o and Bacopa monnieri 23 mg/kg p.o on plasma cortisol level in mice subjected to swim endurance test and cold restraint stress. The standard group was administered water-soluble root powder of Panax ginseng 100 mg/kg p.o and the stress control group was administered distilled water orally for 7 days. It was found that mice pretreated with ethanolic extracts of Ocimum sanctum, Withania somnifera and Bacopa monnieri showed a fall in the plasma cortisol level. The standard group also showed a significant decrease in the plasma cortisol level compared to the stress and normal control groups.

scholarly journals Regulation of 11 beta-hydroxysteroid dehydrogenase type 2 activity in ovine placenta by fetal cortisol

2002 ◽  
Vol 172 (3) ◽  
pp. 527-534 ◽  
Author(s):  
KA Clarke ◽  
JW Ward ◽  
AJ Forhead ◽  
DA Giussani ◽  
AL Fowden
Keyword(s):  
Plasma Cortisol ◽  
Inverse Correlation ◽  
Hydroxysteroid Dehydrogenase ◽  
Plasma Cortisol Level ◽  
Late Gestation ◽  
Fetal Sheep ◽  
Fetal Plasma ◽  
Ovine Placenta ◽  
Cortisol Levels

The effect of fetal cortisol on the activity of the type 2 isoform of the enzyme, 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD2), was examined in ovine placenta and fetal kidney by measuring tissue 11 beta-HSD2 activity during late gestation when endogenous fetal cortisol levels rise and after exogenous cortisol administration to immature fetuses before the prepartum cortisol surge. Placental 11 beta-HSD2 activity decreased between 128-132 days and term (approximately 145 days of gestation) in association with the normal prepartum increase in fetal plasma cortisol. Raising fetal cortisol levels to prepartum values in the immature fetus at 128--132 days of gestation reduced placental 11 beta-HSD2 activity to term values. In contrast, 11 beta-HSD2 activity in the fetal renal cortex was unaffected by gestational age or cortisol infusion. When all the data were combined, there was an inverse correlation between the log fetal plasma cortisol level at delivery and placental 11 beta-HSD2 activity, expressed both on a weight-specific basis and per mg placental protein. Fetal cortisol therefore appears to be a physiological regulator of placental, but not renal, 11 beta-HSD2 activity in fetal sheep during late gestation. These findings have important implications, not only for glucocorticoid exposure in utero, but also for the local actions of cortisol within the placental tissues that are involved in initiating parturition in the sheep.

scholarly journals Assessment of salivary alpha-amylase and cortisol as a pain related stress biomarker in dogs pre-and post-operation

2022 ◽  
Vol 18 (1) ◽  
Author(s):  
Eun-Ha Kang ◽  
Seol-Hee Park ◽  
Ye-In Oh ◽  
Kyoung-Won Seo
Keyword(s):  
Pain Score ◽  
Serum Cortisol ◽  
Alpha Amylase ◽  
Enzyme Linked Immunosorbent Assay ◽  
Salivary Alpha Amylase ◽  
Pain Scores ◽  
High Pain Score ◽  
Post Operation ◽  
Cortisol Levels ◽  
Related Stress

Abstract Background The use of salivary biomarkers has garnered attention because the composition of saliva reflects the body’s physiological state. Saliva contains a wide range of components, including peptides, nucleic acids, electrolytes, enzymes, and hormones. It has been reported that salivary alpha-amylase and cortisol are biomarkers of stress related biomarker in diseased dogs; however, evaluation of salivary alpha-amylase and cortisol pre- and post- operation has not been studied yet. The aim of this study was to evaluate salivary alpha-amylase and cortisol levels in dogs before and after they underwent surgery and investigate the association between the salivary alpha-amylase and cortisol activity and pain intensity. For this purpose, a total of 35 dogs with disease-related pain undergoing orthopedic and soft tissue surgeries were recruited. Alpha-amylase and cortisol levels in the dogs’ saliva and serum were measured for each using a commercially available canine-specific enzyme-linked immunosorbent assay kit, and physical examinations (measurement of heart rate and blood pressure) were performed. In addition, the dogs’ pre- and post-operative pain scores determined using the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF) were evaluated. Results After surgery, there was a significant decrease in the dogs’ pain scores (0.4-fold for the CMPS-SF, p < 0.001) and serum cortisol levels (0.73-fold, p < 0.01). Based on their pre-operative CMPS-SF scores, the dogs were included in either a high-pain-score group or a low-pain-score group. After the dogs in the high-pain-score group underwent surgical intervention, there was a significant decrease in their CMPS-SF scores and levels of salivary alpha-amylase, serum alpha-amylase, and serum cortisol. Additionally, there was a positive correlation between salivary alpha-amylase levels and CMPS-SF scores in both the high- and low-pain-score groups. Conclusions The measurement of salivary alpha amylase can be considered an important non-invasive tool for the evaluation of pain-related stress in dogs.

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