scholarly journals Effects of Serum Cortisol Levels on Perinatal Prognosis in Patients with Hypertensive Disorder

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Gaoxiang Huo ◽  
Yeqiang Qin ◽  
Xiucui Bao ◽  
Xiaoling Yao ◽  
Zhangwei Pu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cortisol Level ◽  
Gestational Hypertension ◽  
Serum Cortisol ◽  
The Other ◽  
Serum Cortisol Level ◽  
Control Group ◽  
Hypertensive Disorder ◽  
Cortisol Levels ◽  
Case Number

Objective: To investigate the effect of serum cortisol level on perinatal prognosis in patients with hypertensive disorder during pregnancy. Methods: In this study, different degrees of patients with hypertensive disorder during pregnancy who were admitted from August 2018 to August 2019 in our hospital were selected as the research subjects, and divided into groups according to the severity of the patients' conditions. The 120 patients were divided into gestational hypertension group, preeclampsia group and eclampsia group, with 40 cases each, and another 40 healthy pregnant women were selected. The detection of serum cortisol levels was carried out for the above 4 groups of pregnant women. Results: The serum cortisol level in the control group was (260.35 ± 10.96) nmol / L. The case number of neonatal asphyxia was 1 (2.50%), the case number of premature births was 1 (2.50%), the number of fetal growth restriction was 1 (2.50%), the number of deaths was 0, and the other three groups were higher than this. It showed as gestational hypertension <preeclampsia <eclampsia. The Apgar score of pregnant women in the control group was (9.13 ± 0.29), the ZL index was (1.07 ± 0.07), and the other three groups were lower than this. It showed as gestational hypertension> preeclampsia> eclampsia. There were significant differences between groups (all P<0.05). Conclusion: Early detection of serum cortisol levels in pregnant women is beneficial to timely improve the symptoms of gestational hypertension, thereby suppressing the effects of serum cortisol on perinatal infants and improving the prognosis of newborns.

scholarly journals Changes and Clinical Value of Serum Cortisol Levels in Patients with Hypertensive Disorder in Pregnancy

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Gaoxiang Huo ◽  
Yeqiang Qin ◽  
Xiucui Bao ◽  
Xiaoling Yao ◽  
Zhangwei Pu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Control Group ◽  
Hypertensive Disorder ◽  
Clinical Value ◽  
Hypertensive Disorders ◽  
Research Objects ◽  
Cortisol Levels

Objective: To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy. Methods: In this study, 90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects. 90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology, including 30 cases in each of the hypertension group, the preeclampsia group, and the eclampsia group. Another 30 healthy pregnant women were selected as the control group. The serum cortisol levels of pregnant women in the above four groups were measured. Results: Compared with the control group, the serum cortisol levels in the other three groups were significantly increased. In perinatal outcome, compared with the control group, the three groups of patients had an increase in Apgar score, preterm birth, stillbirth rate, growth restriction rate and neonatal asphyxia rate. There were significant differences between groups (P <0.05), and showed as gestational hypertension <preeclampsia <eclampsia. Conclusion: With the exacerbation of hypertensive disorders during pregnancy, the serum cortisol level continues to increase, which has a serious adverse effect on the prognosis of the perinatal infants.

scholarly journals Study of serum cortisol levels in complicated and uncomplicated Plasmodium vivax malaria patients

2020 ◽  
Vol 9 (1) ◽  
pp. 254
Author(s):  
Sandeep B. R. ◽  
M. G. Bhutto ◽  
Suresh Babu K. P.
Keyword(s):  
Plasmodium Vivax ◽  
Cortisol Level ◽  
Vivax Malaria ◽  
Serum Cortisol ◽  
Treatment Modalities ◽  
Serum Cortisol Level ◽  
Control Group ◽  
Significant Difference ◽  
Plasmodium Vivax Malaria ◽  
Cortisol Levels

Background: Malaria results in pathological changes in various body organs, as the parasite invade and multiply in circulating red blood cells. Despite of advances in diagnostic and treatment modalities, worldwide incidences of malaria are significant. Current study was conducted to investigate serum cortisol level changes as a promising biomarker for risk prediction in malaria and to study adrenal insufficiency in malaria patients.Methods: Current investigation was a prospective observational study, conducted on complicated and uncomplicated Plasmodium vivax malaria patients. Serum cortisol levels in patients were investigated through immunoassay using direct chemiluminescent technology and were statistically correlated with Plasmodium vivax malaria infection.Results: Results of present investigation revealed that on day 1 there was significant difference in mean serum cortisol levels between the Plasmodium vivax malaria patients and control group and cortisol levels were significantly higher in complicated Plasmodium vivax malaria patients compared to uncomplicated cases on day 1 and 7. Cortisol levels were observed to be normal on day 1 and 7 in uncomplicated malaria cases and in patients with bleeding manifestations, renal failure and jaundice. In 10 out of 15 cases of cerebral malaria, significant increase in serum cortisol levels were observed on day 1, while on day 7 levels were normal in all 15 cases.Conclusions: Rise in serum cortisol level had a positive correlation with temperature and thus can be useful to predict the severity of disease in Plasmodium vivax malaria patients. No cortisol insufficiency was observed in during active and convalescent stages of illness.

scholarly journals Effects of Surgical Stress on Serum Cortisol Level: A Comparative Study between Elective and Emergency Surgery

1970 ◽  
Vol 2 ◽  
pp. 28-33
Author(s):  
SM Selimuzzaman ◽  
Noorzahan Begum ◽  
Nadira Islam ◽  
Shelina Begum
Keyword(s):  
Surgical Treatment ◽  
Cortisol Level ◽  
Surgical Stress ◽  
Serum Cortisol ◽  
Study Groups ◽  
Serum Cortisol Level ◽  
Control Group ◽  
Surgical Interventions ◽  
Group I ◽  
Healthy Control

The study was designed to observe the effects of surgical stress on serum level of cortisol in patients undergoing surgical treatment and to find out any differences in hormonal response between elective and emergency surgical procedures. A total number of 60 male subjects aged between 18 and 45 years were included in the study. Of them, 20 were healthy control (Group I), 20 underwent elective surgical treatment (Group II) and emergency surgical interventions were applied in rest 20 subjects (Group III). Study Groups were further divided into subgroups A (preoperative samples were collected 1- hour before operation), B (postoperative samples were collected 1-hour after the end of the operation) and C (postoperative samples were collected 24-hours after operation).Serum cortisol level was estimated by invitro-immunolytic test.Statistical analysis was done by paired, unpaired ‘t' test and regression analysis. The preoperative mean serum cortisol concentration in elective surgical cases was almost similar to that of healthy control. On the contrary, in the emergency surgical cases, a significantly increased mean cortisol level were observed (I vs IIIA and IIA vs IIIA; P < 0.05). The serum cortisol concentrations were increased both in elective and emergency surgical cases after operations but the magnitude of rise was more marked in emergency group of patients (IIB vs IIIB; P < 0.05). Therefore, this study reveals that surgical intervention causes increase in serum cortisol which is more marked in emergency procedure. Key Words: Stress; Cortisol; Surgery DOI:10.3329/jbsp.v2i0.981 J Bangladesh Soc Physiol. 2007 Dec;(2): 28-33.

scholarly journals Placental changes in hypertensive pregnancy: a comparison with normotensive pregnancy

2018 ◽  
Vol 7 (9) ◽  
pp. 3808
Author(s):  
Jashan Chhatwal ◽  
Dev Nanda Chaudhary ◽  
Neena Chauhan
Keyword(s):  
Pregnant Women ◽  
Growth And Development ◽  
Cellular Proliferation ◽  
Gestational Hypertension ◽  
Control Group ◽  
Hypertensive Disorder ◽  
Singleton Pregnancy ◽  
Chi Square ◽  
Histological Changes ◽  
Hypertensive Pregnancy

Background: Hypertensive pregnancy may be responsible for vascular damage, enhanced systemic inflammation and insulin resistance in the placenta as oxygen and nutrient transfer is impaired and oxidative stress is generated affecting the placental growth and development. Placental growth pattern in hypertensive pregnancies shows a variable pattern owing to placental insufficiency. Present study was done to investigate the morphological and histological changes in placenta in hypertensive pregnancy.Methods: A total of 42 pregnant women with hypertensive disorder with gestational age 28-42 weeks and singleton pregnancy were enrolled as cases in the study. A total of 42 matched normotensive pregnant women were enrolled as controls. All the women were followed up till delivery. At delivery, placental specimen were collected and assessed for morphological, morphometric and histological changes. Findings were compared with normotensives. Data was compared using Independent sample’s ‘t’-test and Chi-square test.Results: Mean age of cases was 27.60±4.37 years, majority were gravida 1/2 (66.7%), 45.2% had moderate to severe edema, 50% had urinary albumin levels >100 mg/dl. A total of 8 (19.0%) had gestational hypertension, 16 (38.1%) had preeclampsia, 10 (23.8%) had severe preeclampsia and 8 (19.0%) had eclampsia. Mean placental weight and diameter of cases was significantly higher than that of control group. Mean placental thickness was also higher but difference was not significant statistically. Calcification, infarction and hematoma were seen in 45.2%, 16.7% and 11.9% of cases as compared to 28.6%, 4.97% and 0% of controls. Histologically, syncytial knots, cytotrophoblastic cellular proliferation, hyalinized area, proliferation of medium sized blood vessels, stromal fibrosis and fibrinoid necrosis in significantly higher proportion of cass as compared to controls (p<0.05). Mean fetoplacental ratio was 5.01±0.99 and 5.24±0.61 in controls (p=0.195).Conclusions: Hypertension during pregnancy affects the placental growth and development.

scholarly journals Perioperative serum cortisol levels at different operative accesses to femoral segment arteries

2012 ◽  
Vol 93 (5) ◽  
pp. 717-720
Author(s):  
A V Maximov ◽  
A K Feiskhanov ◽  
M V Plotnikov ◽  
E V Begicheva ◽  
E V Tuisheva
Keyword(s):  
Cortisol Level ◽  
Vital Capacity ◽  
Serum Cortisol ◽  
Group Iv ◽  
Serum Cortisol Level ◽  
Surgical Trauma ◽  
Group I ◽  
Reconstructive Operations ◽  
Cortisol Levels ◽  
The Difference

Aim. To compare invasiveness of reconstructive operations on arteries of aortofemoral segment using different accesses to surgical site. Methods. The analysis of the post-operative period was carried out in 40 patients who underwent aortofemoral bifurcation bypass surgery. Patients were assigned to 4 groups, each containing 10 patients. In group I surgeries were performed using mini-access of 5-7 cm, group II - mini-laparotomic access of 8-12 cm, group III - retroperitoneal mini-access, group IV - standard laparotomy. For invasiveness objectification, serum cortisol levels, forced lungs vital capacity and postoperative pain levels were measured. Results. All surgeries were performed as planned without inoperative complications. No deaths were registered. After mini-access surgeries intestinal peristalsis was defined by auscultation as soon as on 18-24 hour after the operation. Prolonged (more than 3 days) post-operative ileus was diagnosed in 3 patients, all operated using standard laparotomy. Serum cortisol level was typically elevated at the end of the surgery, but the difference was only statistically significant in patients from the group IV compared to baseline level as well as to patients with mini-access surgeries. Serum cortisol level reduced to normal at the second 24-hours after the surgery. Patients in which standard laparotomy was used reported more intense pain at the second day. Forced lungs vital capacity at day 4 was significantly reduced in patients of groups I, III and IV, with the significantly worse reduction in patients who overcame standard laparotomy compared to others. Conclusion. Mini-access reconstructive surgeries on aortofemoral segment arteries provide significant reduction of surgical trauma, which is proved by objective measurements.

scholarly journals Yoga is an effective technique of stress reduction within the medical population: a biochemical study in MBBS students of BRD Medical College, Gorakhpur, Uttar Pradesh, India

2020 ◽  
Vol 8 (4) ◽  
pp. 1326
Author(s):  
Vikash K. Tiwari ◽  
Shashi Pandey ◽  
Ragini Mishra
Keyword(s):  
Cortisol Level ◽  
Stress Reduction ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Control Group ◽  
P Value ◽  
First Year ◽  
Medical College ◽  
Stress Marker ◽  
Yoga Group

Background: Medicine is a profession with high-stress prevalence. There are many stress markers but cortisol is one of the commonly used stress marker. Stress begins in the first year of medical carrier and increases with subsequent years of medical education. There is a decrease in overall academic performance and many health-related adverse effects due to stress. In this study, yoga was performed in the first year MBBS students of BRD Medical College, Gorakhpur and the impact of yoga in stress reduction was studied using serum cortisol as stress a marker.Methods: Study groups, yoga and control contained 26 and 27 subjects including male and female MBBS students. Yoga group practiced selected yogic asana, pranayama, and yoga nidra for 3 months. The control group as a stress marker had been kept in touch and allowed to go on their usual activity as before. Morning (8.00 AM to 9.00 AM) serum cortisol level was used as a stress marker in both group, pre and post-study.Results: There was a significant reduction in morning serum cortisol level (stress level) in yoga group (p-value = 0.0271) but there was no significant change in morning serum cortisol level of the control group (p-value = 0.8573).Conclusions: Yoga is an effective stress reduction technique for medical students. Yoga classes should be introduced in the first year of the medical carrier under the supervision of expert physiologists. This may lead to the implantation of a healthy lifestyle in our future healthcare providers. Yogic practice by health care providers may have long term positive impacts on our healthcare system.

The Impact of High Cortisol Level in Increasing Incidence of Infection Cases Among Acute Stroke Patients

2020 ◽  
Vol 17 (7) ◽  
pp. 3079-3084
Author(s):  
Indah Ari Handaayani ◽  
Muhammad Hamdan ◽  
Paulus Sugianto ◽  
Achmad Firdaus Sani ◽  
Mohammad Saiful Ardhi ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Cortisol Level ◽  
Venous Blood ◽  
Serum Cortisol ◽  
Operational Definition ◽  
Serum Cortisol Level ◽  
Stroke Patients ◽  
Cortisol Levels ◽  
High Level ◽  
The Impact

Infection in the stroke was a treatment major problem, because it determines the prognosis. In the acute phase of stroke, high level cortisol may lead to a decreased immune system and patients tend to be more susceptible to infection. The correlation of serum cortisol level among acute stroke patients with incidence of infection was not fully investigated. The aim of this study was to determine the relationship between initial serum cortisol levels and the incidence of infection in acute stroke patients. A prospective cohort study was conducted on 32 of acute stroke patients who admitted in RSUD Dr. Soetomo Surabaya during the period December 2015 to February 2016. Total of 2 cc to the venous blood within 48 hours in onset of stroke being examined of serum cortisol. During the 7 days of hospitalization, the patient was observed for signs of infection, both clinically and the investigation in accordance with the operational definition. In the infected group there were 8 people (50%) with high cortisol levels (p = 0.015; RR 15,000; 95% IK 1.583-143,171); 6 people were (50%) using urine catheter (p = 0.049; RR 6,667; 95% IK 1.067-30.085); And 6 people were (54.5%) using NGT (p = 0,035; RR 7,200; 95% IK 1.311-39,557). In multivariate analysis obtained that Odds Ratio (OR) 15,468 based on high cortisol and OR 7,469 based on NGT usage. High cortisol levels and the use of NGT had the effect on the incidence of infection in acute stroke.

scholarly journals Continuous Etomidate Infusion for the Management of Severe Cushing Syndrome: Validation of a Standard Protocol

2018 ◽  
Vol 3 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Ty B Carroll ◽  
William J Peppard ◽  
David J Herrmann ◽  
Bradley R Javorsky ◽  
Tracy S Wang ◽  
...  
Keyword(s):  
Cortisol Level ◽  
Cushing Syndrome ◽  
Effective Means ◽  
Case Series ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Retrospective Case ◽  
Life Threatening ◽  
Cortisol Levels ◽  
Infusion Protocol

Abstract Objective Demonstrate the safety and efficacy of a standardized intravenous etomidate infusion protocol in normalizing cortisol levels in patients with severe and life-threatening hypercortisolism. Methods A retrospective case series of seven patients representing nine episodes of severe hypercortisolism at two large academic medical centers was conducted. Patients were included in this series if they received an etomidate infusion for the treatment of severe and life-threatening hypercortisolism. The etomidate infusion was administered via a newly developed protocol designed to safely reduce cortisol levels until more long-term medical or definitive surgical therapy could be instituted. Results Seven patients representing nine episodes received etomidate treatment. In eight of nine episodes of therapy, rapid control of hypercortisolemia was achieved, generally defined as a serum cortisol level of 10 to 20 µg/dL. Patients with a median baseline cortisol of 105 µg/dL (range, 32 to 245 µg/dL) achieved a median nadir serum cortisol of 15.8 µg/dL (range, 6.9 to 27 µg/dL) after a median of 38 hours (range, 26 to 134 hours). Conclusions A standardized continuous intravenous etomidate infusion protocol is a safe and effective means of achieving a serum cortisol level of 10 to 20 µg/dL in patients with severe hypercortisolemia.

scholarly journals Is ECLIA Serum Cortisol Concentration Measurement, an Accurate Indicator of Pain Severity in Dogs with Locomotor Pain?

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 2036
Author(s):  
Adela Katalin Markovszky ◽  
Corinna Weber ◽  
Otília Biksi ◽  
Mihai Danes ◽  
Eugenia Dumitrescu ◽  
...  
Keyword(s):  
Cortisol Level ◽  
Cruciate Ligament ◽  
Life Quality ◽  
Serum Cortisol ◽  
Stress Axis ◽  
Serum Cortisol Level ◽  
Control Group ◽  
Disc Disease ◽  
Cranial Cruciate Ligament ◽  
Normal Limits

The purpose of determining serum cortisol level is to reflect the activity of stress axis, ethological alterations, acute and chronic pain, life quality, or psychogenic stress. Although it is stated that stress can produce a measurable influence on the cortisol level, a certified value of this pain biomarker in dogs was not generally accepted yet. This study aimed to investigate if serum cortisol measured follows allopathic treatments only, or it is associated with physiotherapy, point out pain level in dogs with orthopedic disease, which could reveal the healing progress. The diagnostic identified: hip dysplasia, cranial cruciate ligament rupture, or intervertebral disc disease. Ortolani and Barden tests, together with clinical examination, drawer sign, and tibia compression test, were done in dogs exhibiting postures, and motion alteration, and X-Ray confirmed. A total of 30 dogs were grouped in healthy (n = 10) and pain groups (n = 20), the blood sampling is done at the beginning of the investigation, and after ten days of the study. Dogs were handled in two ways: G1—treated with Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) only and respectively, G2—by therapy and physiotherapy. The analysis was performed on a Roche Cobas Analyzer (Roche, USA), serum cortisol being determined by Electrochemiluminescence immunoassay (ECLIA), and statistics using ANOVA, following Tukey’s Multiple Comparison Test. The results revealed that, out of ten specimens in the Control group, nine were within the normal limits: 5–65 ng × mL−1 (24.76 ± 19.48678), and one sample under the set limit. In G1, it was observed that the plasmatic P1 values were below the levels of P2, in six situations. In G2, although the status of all subjects improved radically with the removal or evident reduction of pain, confirmed clinically and imagistically, the P2 values in five dogs were higher than the initial P1 values, and in contradiction with the observed clinical reality. Comparing results, the mean difference in G1 was 0.41, and in G2 = 2.54, with an SD for G1 = 13.38, and G2 = 16.66, registering moderate development. Standard deviation illustrated that the values of treated groups were highly spread throughout the interval, and the serum cortisol assay did not generate significant statistical differences between groups in our case. This inferred the doubt whether the used detection method or values registered correctly indicates the pain levels in dog species.

scholarly journals Critical Illness – Related Corticosteroid Insufficiency

2015 ◽  
Vol 4 (1) ◽  
pp. 59
Author(s):  
Hamdollah Karamifar ◽  
Hossein Moravej ◽  
Zohreh Karamizadeh ◽  
Gholamhossein Amirhakimi
Keyword(s):  
Critical Illness ◽  
Corticosteroid Therapy ◽  
Steroid Therapy ◽  
Cortisol Level ◽  
Pediatric Intensive Care ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Critically Ill Children ◽  
Cortisol Levels ◽  
Corticosteroid Insufficiency

In some acute critical illnesses, the function of Hypothalamus-Pituitary-Adrenal axis can be impaired. This event is called "Critical Illness-Related Corticosteroid Insufficiency" (CIRCI). We conducted a study to determine which of the CIRCI patients need steroid therapy. This study was performed on patients who were admitted in Pediatric Intensive Care Unit (PICU) in Nemazee Hospital, affiliated to Shiraz University of Medical Sciences, Iran.In first 24 hour of PICU admission, Serum cortisol levels were measured immediately before, 30 and 60 minutes after IV administration of 250 μg of synthetic adrenocorticotropic hormone (Synacthen®).Their clinical conditions and paraclinical data were followed and recorded. Twenty four patients were enrolled in the study. Twelve patients (50%) had CIRCI. CIRCI was defined as Random Serum Cortisol (RSC)<10 μg/dl or elevation of serum cortisol level after Synacthen administration below 9 µg/dl.The results of serum cortisol level usually were ready one day after blood sampling. Based on general condition, blood pressure and serum electrolyte levels, all CIRCI patients were improved when serum cortisol levels were determined. Therefore, steroid therapy was not started for them. Finally, all of the CIRCI patients improved and after a few days, all of them were discharged from the hospital with good conditions. Findings of our study showed that corticosteroid therapy is not needed as a routine treatment for CIRCI patients. This is in agreement with some other studies. but in contrast to some articles who recommended corticosteroid therapy for patients with CIRCI. There is lack of consensus about optimal approach to CIRCI in children, therefor; well-designed RCTs and systematic reviews are needed to determine proper treatment recommendations for these critically ill children before administration.

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