Swallowed glucocorticoid therapy for eosinophilic esophagitis in children does not suppress adrenal function

2015 ◽  
Vol 28 (9-10) ◽  
Author(s):  
Katherine Q. Philla ◽  
Steve B. Min ◽  
Jody N. Hefner ◽  
Robin S. Howard ◽  
Brian J. Reinhardt ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Serum Cortisol ◽  
Post Treatment ◽  
Adrenal Function ◽  
Glucocorticoid Therapy ◽  
Current Standard ◽  
Glucocorticoid Treatment ◽  
Daily Range ◽  
Significant Difference ◽  
Cortisol Levels

AbstractThe purpose of this study was to examine the effect of chronic swallowed glucocorticoids on adrenal function during the treatment of eosinophilic esophagitis (EoE) in children.Serum cortisol levels were obtained in children with EoE pre- and post-treatment with swallowed glucocorticoids. Exclusion criteria included those on any additional steroid therapy. Once diagnosed with EoE by esophageal biopsy, subjects were treated based on current standard of care with either swallowed fluticasone or budesonide. At the time of follow-up, esophagogastroduodenoscopy and blood sampling was repeated. Both pre- and post-treatment serum cortisol samples were collected fasting, between 07:00 and 10:00, and determined using a competitive binding method assay. The distribution of differences in cortisol levels between the pre- and post-treatment samples satisfied the assumption for normality and were subsequently analyzed using the paired t-test.Pre- and post-treatment serum cortisol levels were examined in 14 children who met clinical and histological diagnostic criteria for EoE. Mean age was 10.1 years (range 2–17 years) with 71% male and 29% female subjects. Swallowed glucocorticoid treatment included fluticasone in 79% and budesonide in 21% of subjects. Mean dosage of fluticasone was 704 μg daily (range 220–880 μg daily) and budesonide 0.8 mg daily (range 0.5–1 mg daily), along with a mean treatment length of 17 weeks (range 8–43 weeks). No significant difference in serum cortisol was found following treatment with swallowed fluticasone or budesonide (mean change 1.9 μg/dL, p=0.75, SD of the change=21.2).Swallowed glucocorticoid therapy does not appear to significantly affect the adrenal axis in children, and therefore, may represent a safe therapy for EoE.

scholarly journals Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Humaira Fayyaz ◽  
Shazadi Ambreen ◽  
Hammad Raziq ◽  
Azmat Hayyat
Keyword(s):  
Vasovagal Syncope ◽  
Serum Cortisol ◽  
Tilt Test ◽  
Control Group ◽  
Postural Tachycardia Syndrome ◽  
P Value ◽  
Cross Sectional ◽  
Postural Tachycardia ◽  
Significant Difference ◽  
Cortisol Levels

Objectives: To compare the levels of cortisol in patients of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS). Methods: A cross-sectional analytical study was conducted at Islamic International Medical College, Rawalpindi and Electrophysiology Department at (AFIC). This study included 80 subjects, comprising of 35 patients in each group of vasovagal syncope and postural tachycardia syndrome and 10 healthy subjects. Patients with complaint of syncope was evaluated for vasovagal syncope and postural tachycardia syndrome using Head Up Tilt Test (HUTT). Blood samples of all the participants were taken and serum cortisol was analyzed using ELISA method. Results were analyzed on SPSS Statistics 21 using ANOVA with a p-value of ≤0.05 regarded as significant. Results: Hormonal analysis shows that cortisol levels in the vasovagal, postural tachycardia syndrome and in control group was 153±16.7pg/ml, 160.17±pg/ml, and 69.65±5.8pg/ml respectively. Cortisol levels were significantly higher in both vasovagal and POTS groups as compared to controls with a p-value of 0.04 and 0.023 respectively. However, there was no significant difference between vasovagal and POTS patients with p value 0.570. Conclusion: It is concluded from the study that cortisol responses of VVS and POTS were positive. doi: https://doi.org/10.12669/pjms.38.1.4122 How to cite this:Khan HF, Ambreen S, Raziq H, Hayat A. Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4122 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effect of Interferential Current on Perceived Pain and Serum Cortisol Associated with Delayed Onset Muscle Soreness

1997 ◽  
Vol 6 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Randy J. Schmitz ◽  
David E. Martin ◽  
David H. Perrin ◽  
Ali Iranmanesh ◽  
Alan D. Rogol
Keyword(s):  
Muscle Soreness ◽  
Mixed Model ◽  
Beat Frequency ◽  
Serum Cortisol ◽  
Delayed Onset Muscle Soreness ◽  
Delayed Onset ◽  
Significant Difference ◽  
Perceived Pain ◽  
Interferential Current ◽  
Cortisol Levels

The purpose of this study was to assess the effect of interferential current (IFC) on perceived pain and serum Cortisol levels in subjects with delayed onset muscle soreness (DOMS). DOMS was induced in 10 subjects through repeated eccentric contractions of the elbow flexors. Forty-eight hours later subjects were evaluated. Starting at t = 0:00, blood samples were withdrawn from a superficial vein every 5 min for 65 min. At t = 0:05, subjects received IFC of 10 bps or IFC of 100 bps. Perceived pain levels were evaluated prior to catheter insertion and at t = 0:35, 0:50, and 0:65. Two mixed-model analyses of variance revealed a significant decrease in perceived pain scores across time for both treatment groups but no significant difference in serum Cortisol for the two groups. It was concluded that IFC of high and low beat frequency is effective in controlling the pain of DOMS but does not elicit a generalized stress response as indexed by increasing serum Cortisol levels.

Effects of intranasal glucocorticoids on endogenous glucocorticoid peripheral and central function

1995 ◽  
Vol 144 (2) ◽  
pp. 301-310 ◽  
Author(s):  
U Knutsson ◽  
P Stierna ◽  
C Marcus ◽  
J Carlstedt-Duke ◽  
K Carlström ◽  
...  
Keyword(s):  
Serum Cortisol ◽  
Adrenal Function ◽  
Systemic Effects ◽  
Mrna Levels ◽  
Urinary Cortisol ◽  
Short Term ◽  
Central Function ◽  
Peripheral Lymphocytes ◽  
Long Term Treatment ◽  
Cortisol Levels

Abstract Glucocorticoids are among the most potent anti-inflammatory agents that can be used in the treatment of rhinitis. Their mechanisms of action are multiple and complex and a number of reports describe significant systemic effects of locally administered glucocorticoids. In order to evaluate the short-term systemic effects of intranasally administered glucocorticoids, 14 normal healthy subjects were treated with two doses of either budesonide (BUD) or fluticasone propionate (FP) for 2 weeks. Before treatment, at regular intervals during the treatment, 1 week and finally 6 weeks after termination of treatment, the effects on glucocorticoid receptor (GR) and methallothionein (MTIIa) mRNA expression levels were examined in peripheral lymphocytes using a solution hybridization assay. Serum cortisol, osteocalcin and urinary cortisol levels were also determined. An insulin tolerance test (ITT) was performed at the end of the second week of treatment and at the end of the 6-week washout period with no statistically significant change in cortisol response. In peripheral lymphocytes, GR mRNA levels were significantly down-regulated. MTIIa mRNA levels increased significantly. Serum osteocalcin decreased significantly during treatment with both BUD and FP. Serum cortisol decreased after 1 week of treatment whereas urinary cortisol was not affected until the second week of treatment. In conclusion, intranasal glucocorticoids at clinically recommended doses have not only significant systemic effects on adrenal function, but also have an effect on specific gene expression in peripheral lymphocytes. These effects are receptor-dependent, reversible, and according to serum and urinary cortisol levels and ITT, leave the hypothalamic-pituitary-adrenal function intact. Finally, these short-term systemic effects were not associated with any of the noticeable side-effects usually observed during long-term treatment with glucocorticoids. Journal of Endocrinology (1995) 144, 301–310

scholarly journals Comparison of morphine and fentanyl in attenuation of Intra operative stress response under general anesthesia: A randomized double blinded study

2014 ◽  
Vol 5 (4) ◽  
pp. 65-68
Author(s):  
R Krishna Prabu ◽  
P Rani ◽  
NP Madhu
Keyword(s):  
Body Weight ◽  
Stress Response ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Serum Cortisol ◽  
Blood Samples ◽  
Significant Difference ◽  
Blinded Study ◽  
Cortisol Levels ◽  
Double Blinded

Background: This randomized double blinded study was done to compare the effect of intravenous morphine and fentanyl in attenuation of stress response during surgeries under general anesthesia in adults. The attenuation of stress response was analyzed with changes in serum cortisol and glucose levels one hour after induction of anesthesia. Methods: Fifty consented healthy volunteers in age group 20-50, under ASA I and ASA II posted for elective surgery were included in the study. Two groups of 25 each, group M who received 0.2 mg/kg body weight of morphine and group F who received 2 microgram/kg body weight of fentanyl before anaesthetic induction were compared. The members of two groups were randomly allocated and double blinded using sealed envelope technique. Blood samples were collected for baseline glucose and cortisol in all the subjects. One hour after the administration of study drugs, which was given at the time of induction blood samples were collected for analysis of glucose and cortisol. The changes in blood glucose and serum cortisol levels were compared at the end of the study using independent samples ‘t’ test. Results: There was no significant difference in blood sugar levels in both groups at the end of 1 hour. But there was significant increase in serum cortisol levels in group F compared to group M. Conclusion: This study concludes that morphine is better than fentanyl in attenuation of Intraoperative stress by effectively controlling serum cortisol levels. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9796 Asian Journal of Medical Sciences 2014 Vol.5(4); 65-68

scholarly journals Dexamethasone suppression test predicts later development of an impaired adrenal function after a 14-day course of prednisone in healthy volunteers

2010 ◽  
Vol 162 (5) ◽  
pp. 943-949 ◽  
Author(s):  
Stefanie Neidert ◽  
Philipp Schuetz ◽  
Beat Mueller ◽  
Mirjam Christ-Crain
Keyword(s):  
Clinical Score ◽  
Dexamethasone Suppression Test ◽  
Adrenal Function ◽  
Receiver Operating Curve ◽  
Acth Test ◽  
Glucocorticoid Treatment ◽  
Basal Cortisol ◽  
Suppression Test ◽  
Cortisol Levels ◽  
Dexamethasone Suppression

BackgroundSuppression of the adrenal function after glucocorticoid treatment is common, potentially dangerous, and unpredictable. Identification of patients at risk is of clinical importance. We hypothesized that the dexamethasone suppression test predicts the development of corticosteroid-induced impaired adrenal function.MethodsWe included 39 healthy male volunteers. After a 1-μg ACTH test, all participants underwent an overnight 0.5-mg dexamethasone suppression test. Participants then took prednisone, 0.5 mg/kg body weight, for 14-day. After the withdrawal of prednisone, a 1-μg ACTH test was performed and a clinical score was assessed on days 1, 3, 7, and 21.ResultsOn days 1, 3, 7, and 21, 100, 50, 26.5 and 32.4% of the participants had a suppressed adrenal function. The risk of developing suppressed adrenal function decreased from 44 to 0% in patients with cortisol levels after the administration of dexamethasone in the lowest and highest quartiles respectively. Receiver operating curve (ROC) analysis performed to predict a suppressed adrenal function on day 7 after the withdrawal of prednisone showed an area under the curve (AUC) of 0.76 (95% confidence interval (CI) 0.58–0.89) for cortisol after the administration of dexamethasone, which was in the range of the AUC of 0.78 (95% CI 0.6–0.9) for pre-intervention cortisol after the administration of ACTH. Basal cortisol before intake of prednisone (AUC 0.62 (95% CI 0.44–0.78)) and the clinical score (AUC 0.64 (95% CI 0.45–0.79)) had significantly lower AUCs.ConclusionCirculating cortisol levels after a dexamethasone suppression test and a pre-intervention-stimulated cortisol level are predictive of later development of a suppressed adrenal function after a 14-day course of prednisone, and are superior to a clinical score or basal cortisol levels. This may allow a more targeted concept for the need of stress prophylaxis after cessation of steroid therapy.

scholarly journals A study of serum cortisol levels in patients with lichen planus

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Swaroopa Subhash ◽  
R. S. Bindu ◽  
Pradeep S. Nair ◽  
Anuja Elizabeth George
Keyword(s):  
Lichen Planus ◽  
Serum Cortisol ◽  
Normal Subjects ◽  
Serum Cortisol Level ◽  
Oral Lesions ◽  
Age And Gender ◽  
Significant Difference ◽  
The Mean ◽  
Cortisol Levels ◽  
And Gender

Objectives: Primary objective was to compare between the serum cortisol levels in patients with lichen planus (LP) and normal subjects. The secondary objective was to compare between the serum cortisol levels of LP patients with and without oral lesions. Materials and Methods: This is a cross-sectional analytical study comparing the serum cortisol levels in patients with LP with that of age- and gender-matched normal subjects who attended a tertiary referral centre. Results: There were a total of 52 patients with LP in this study. The mean age was 48.1 ± 12.6 years. Male/female ratio was 1:1.9. Fifteen (28.8%) patients gave a history of recent stress in the 1 month before the onset of illness. Classical LP (34, 65.4%) was the most common type. Oral cavity was involved in 24 patients (46.2%). The mean serum cortisol level of patients with LP was higher than the same noted in age- and gender-matched normal subjects and this was statistically significant (P < 0.001). Statistically significant difference (P = 0.02) was noted between the serum cortisol levels of patients with different types of LP. No significant difference in the cortisol levels was observed between LP patients with and without oral lesions. Limitations: The main limitation of the study was the small sample size. Conclusion: This study showed a significant increase in serum cortisol levels in patients with LP when compared to normal subjects, while no significant difference was noted in cortisol levels between LP patients with and without oral lesions.

scholarly journals AB0353 ADRENAL INSUFFICIENCY AFTER GLUCOCORTICOID TREATMENT OF GIANT CELL ARTERITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1201.2-1201
Author(s):  
A. Hočevar ◽  
R. Jese ◽  
J. Kramarič ◽  
M. Tomsic ◽  
Z. Rotar
Keyword(s):  
Adrenal Insufficiency ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Cortisol Level ◽  
Adrenal Function ◽  
Glucocorticoid Therapy ◽  
Glucocorticoid Treatment ◽  
Systemic Glucocorticoid ◽  
The Mean ◽  
Corticotropin Stimulation

Background:Adrenal insufficiency is frequently neglected and underappreciated, potentially severe complication of systemic glucocorticoid therapy.Objectives:We aimed to evaluate the prevalence of glucocorticoid induced adrenal insufficiency in giant cell arteritis (GCA).Methods:We analysed adrenal function data in a cohort of GCA patients diagnosed between July 2014 and July 2019, in whom discontinuation of methylprednisolone therapy was planned. Adrenal function was tested by Corticotropin stimulation test (CST). To perform the CST, methylprednisolone was substituted with hydrocortisone (20mg qd in three divided doses) for one to four weeks before the test. Adrenal insufficiency was defined as cortisol level <450 nmol/l measured 30 minutes after the corticotropin injection; additionally, the result of the CST was defined as borderline when the cortisol level 30 minutes after corticotropin injection was between 450 nmol/l and 500 nmol/l.Results:Adrenal function was tested in 74/215 GCA patients before definite methylprednisolone withdrawal (after a median 13.5 (12.9 – 22.4) months of glucocorticoid therapy). The mean (SD) methylprednisolone dose, prior to substitution with hydrocortisone and subsequent CST, was 3.1 (1.6) mg. Adrenal insufficiency was detected in 36/74 patients (48.6%); additionally, 10/74 patients (13.5%) had a borderline CST result. Seventeen patients with either adrenal insufficiency or borderline CST result, had a repeated CST after median (IQR) 11.6 (8.9; 12.6) months. Adrenal insufficiency persisted in 11/17 (64.7%) patients, and 1/17 patients had a borderline CST. A third CST was performed in 4/12 patients with abnormal second CST after median (IQR) 8.3 (6.9; 10.6) months. Adrenal function recovered in one patient, while the adrenal insufficiency persisted in the remaining 3 patients.Conclusion:Adrenal insufficiency is a common and potentially long-lasting glucocorticoid induced adverse event in GCA patients.Disclosure of Interests:None declared

A study of serum cortisol levels in acute head injury patients

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tangeda Padmaja Rao
Keyword(s):  
Head Injury ◽  
Serum Cortisol ◽  
Adrenal Function ◽  
Serum Cortisol Level ◽  
Mild Head Injury ◽  
Traumatic Head Injury ◽  
Severe Injuries ◽  
Acute Head Injury ◽  
Traumatic Head ◽  
Cortisol Levels

AbstractIntroductionAdrenal insufficiency has a great impact on the prognosis of patients with traumatic brain injury. In healthy persons during normal day-to-day activity, the concentration of plasma cortisol is high in the morning, decreases during the day and rises again during night. But this diurnal rhythm is abolished in long-term unconscious patients and in those with disturbed sleep cycles. In addition, patients with central nervous system disease, who are conscious but have lesions in the temporal lobe, and the pretectal or hypothalamus area, demonstrate abnormal rhythms.MethodsThis cross-sectional study recruited 33 consecutive patients attending emergency medical departments of Prathima Institute of Medical Sciences Hospital between July 2017 and April 2018 with mild to severe traumatic head injury within 6 h of injury. The selected patients were mainly divided into three groups depending on the Glasgow Coma Scale (GCS) [mild head injury (14–15); moderate head injury (9–13); severe head injury (3–8)]. In each group, 11 patients were selected. GCS was calculated at the time of admission. The adrenal function of the patients was assessed by using the serum cortisol tests.ResultsIn this comparative study of acute head injury among three groups, males are more prone to injury than females, with 81%, 90% and 72% in mild, moderate and severe injuries, respectively. The result mainly shows that the mean cortisol levels estimated were significantly increased in mild head injury and were with greater increase in cases of moderate & severe head injuries. Statistically significant positive correlation was observed between serum cortisol & GCS levels.ConclusionsIn this study of serum cortisol levels in head injury patients, we observed that there is increase in the serum cortisol level immediately after trauma. The increase is linearly related with the severity of head injury. Hence performing serum cortisol test is recommended for the assessment of adrenal function in patients with traumatic head injury.

scholarly journals Association of Psoriasis Severity with Serum Prolactin, Thyroid Hormones, and Cortisol before and after Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Reza M. Robati ◽  
Parviz Toossi ◽  
Mohammad Rahmati-Roodsari ◽  
Sara Khalilazar ◽  
Ehsan Abolhasani ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Serum Cortisol ◽  
Severity Index ◽  
Thyroid Stimulating Hormone ◽  
Serum Prolactin ◽  
Significant Difference ◽  
Before And After ◽  
Pasi Score ◽  
Cortisol Levels ◽  
Normal Controls

Background. Prolactin (PRL) level is proposed to be associated with the severity of psoriasis although the previous studies reported different results.Objective. To find the association between PRL levels and severity of psoriasis before and after treatment. In addition, we aimed to find a difference in prolactin, thyroid stimulating hormone (TSH), thyroid hormones (T3and T4), and cortisol levels between patients with psoriasis and normal controls.Methods. First, the levels of hormones were measured in 30 patients with psoriasis and 30 matched controls. The severity was assessed by psoriasis area and severity index (PASI). Then, patients were treated, and PASI was assessed every week until achieving PASI-75 response. At this time, the hormones were measured again and compared to the baseline.Results. No statistical significant difference was observed in the mean PRL, T3, T4, TSH, and cortisol levels between cases and controls. Comparing to the baseline, a significant decrease in PRL levels and a significant increase in T3and serum cortisol levels were observed after treatment (P<0.05), while the changes in other hormones were not significant.Conclusion. After treatment, PRL significantly decreased, and T3and cortisol levels significantly increased. No correlation between hormone levels and improvement of PASI score existed.

scholarly journals Action of exogenous oxytocin on stress modulation in crossbred Red Angus cows

2016 ◽  
Vol 37 (5) ◽  
pp. 3209
Author(s):  
Janne Paula Neres de Barros ◽  
Rita de Cássia Campbell Machado Botteon ◽  
Bruno Ferreira Spíndola ◽  
Erica Bertha Führich Raupp Oliveira ◽  
João Telhado Pereira ◽  
...  
Keyword(s):  
Bos Taurus ◽  
Bos Indicus ◽  
Serum Cortisol ◽  
Well Being ◽  
Negative Effects ◽  
Human Contact ◽  
Significant Difference ◽  
Response To Stress ◽  
Cortisol Levels ◽  
Red Angus

Cattle (Bos taurus and Bos indicus) are organised on the basis of leadership and dominance in such a manner that a disturbance by an external stressor causes negative effects on their health, productivity, well-being, and behaviour. One of these effects is the excessive release of glucocorticoids, which results in increased alertness. We evaluated the action of exogenous oxytocin (OT) on serum cortisol levels in crossbred Red Angus heifers. Twelve Red Angus crossbred heifers were moved daily from the pasture to the corral in weeks 1 and 2 for adaptation to human contact and handling in the cattle crush. In weeks 3 and 4, they were divided into two groups of six (T1 and T2). The T1 group was administered 20 IU (2 mL) of OT via intramuscular injection and the T2 group was administered 2 mL of saline solution 0.85% (SS). In weeks 5 and 6, they were only contained in the cattle crush for evaluation. On days 01, 07, 14, 21, 28, 35, and 42, blood samples were collected by jugular venepuncture in vacuum tubes without anticoagulants. Then, serum cortisol levels were measured using a radioimmunoassay. In the period of adaptation, during weeks 1 and 2, serum cortisol levels decreased in both the groups, with higher levels in the SS group; the same result was obtained in weeks 5 and 6. During treatment, however, there was a significant difference between the two groups in week 4, with a reduction in cortisol levels in the OT group. This result suggests a modulator effect of OT on neuroendocrine response to stress.

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