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Serum Cortisol Concentration (serum + cortisol_concentration)

Distribution by Scientific Domains

Medical Sciences	83%

Selected Abstracts

(229) Serum Cortisol Concentrations and Adrenal Reserve May Be Altered by Severe Chronic Pain

PAIN MEDICINE, Issue 3 2001
Forest Tennant
It has been postulated that chronic pain over-stimulates the hypothalamus-pituitary-adrenal axis to produce an extended stress response. If this assumption is true, patients with severe, chronic pain should demonstrate abnormalities of the pituitary-adrenal axis. To evaluate this premise, we screened 40 adult, chronic pain patients in the first week of treatment with serum cortisol concentrations taken between 8:00 and 10:00 AM. Criteria for inclusion in this study required that pain be present for at least one year and be constant, incurable, interfere with sleep, and cause the patient to be bed or house-bound without opioid treatment. Sixteen (16) of the subjects were challenged with cosyntropin, 0.25mg, given intramuscularly immediately after blood was drawn for determination of baseline serum cortisol concentration. Normal serum cortisol concentrations was considered to range from 5.0 to 25.0 ug/dl at baseline, and normal cortisol reserve was considered to be at least a doubling of the baseline concentration determined one hour after cosyntropin administration. Ten (25%) of the patients had evaluated serum cortisol concentrations above 25ug/dl with the highest being 54.4 ug/dl. Nine (20%) demonstrated low serum cortisol concentrations under 5 ug/dl, and 5 of 16 (31.25%) given cosyntropin challenge demonstrated inadequate adrenal reserve by failing to double their baseline cortisol concentration. All patients with high or low serum cortisol concentration demonstrated a normal cortisol concentration following pain control with a long-acting opioid including methadone, extended-length morphine or oxycodone, or transdermal fentanyl. This study suggests that severe, chronic pain may produce profound abnormalities of serum cortisol and cortisol reserve, and normalization of these alterations may require pain treatment with long-acting opioids. [source]

Effects of nicotine and caffeine, separately and in combination, on EEG topography, mood, heart rate, cortisol, and vigilance

PSYCHOPHYSIOLOGY, Issue 5 2000
David G. Gilbert
Effects of nicotine and caffeine, separately and in combination, were assessed in 12 male habitual smokers in a repeated-measures design. Caffeine (0-mg vs. two 150-mg doses administered in a decaffeinated/sugar-free cola drink post-baseline and 90 min later) was crossed with nicotine (ad libitum own dosing vs. 1.0-mg machine-delivered dose vs. 0.05-mg machine-delivered dose). Participants smoked a total of five cigarettes at 30-min intervals over a 2-hr period. Caffeine and nicotine had large effect sizes on electroencephalogram (EEG) power; however, these effects were modulated by the eyes open versus closed condition, the other drug, and electrode site. EEG effects of open versus closed eyes tended to be of the same size and direction as those of nicotine and caffeine. However, whereas nicotine increased EEG power in some higher frequency bands in some conditions, caffeine decreased EEG power across almost all conditions. Serum cortisol concentration, vigor, and pleasantness were increased by nicotine, but not by caffeine. Level of depressive mood depended on an interaction of caffeine and nicotine. Vigilance performance was enhanced significantly by caffeine and was increased almost significantly by nicotine. The findings were interpreted in terms of common and differential mechanisms of the two drugs. [source]

Normalization of Serum Cortisol Concentration With Opioid Treatment of Severe Chronic Pain

PAIN MEDICINE, Issue 2 2002
Forest Tennant MD
Serum cortisol concentrations may be altered in severe, chronic pain due to excess stimulation of the hypothalamic-pituitary-adrenal axis. Among 40 consecutive patients with severe, chronic pain 26 (65.0%) demonstrated abnormal serum cortisol concentration. After 90 days of treatment, only 7 (17.5%; p<0.01) continued to show abnormal serum cortisol concentration indicating that serum cortisol and other serologic abnormalities may serve as biologic markers of severe, chronic pain. [source]

Cortisol levels in umbilical vein and umbilical artery with or without antenatal corticosteroids

PEDIATRICS INTERNATIONAL, Issue 1 2005
Masahiro Manabe
Abstract,Background:,The developmental changes of the umbilical cortisol levels in neonates at gestational age of 23,41 weeks were studied and the effect of antenatal steroid administration on the umbilical cortisol levels were examined. Methods:,Cortisol levels in the umbilical vein (UV) and the umbilical artery (UA) were studied in 35 neonates at the gestational age (GA) of 23,41 weeks with or without antenatal administration of corticosteroids. Serum cortisol concentrations were measured by the high performance liquid chromatography method. Results:,The correlation between cortisol levels in UV and birthweight (BW) was weak and negative in premature infants. UV cortisol levels in the neonates with antenatal corticosteroid were lower than those in the neonates without antenatal corticosteroid, but the relation was not significant. The developmental changes of UV cortisol levels were the same as those in Murphy's study (spontaneous-onset labor). The cortisol levels in UV and UA had a significantly positive correlation and both had almost equal concentrations. There were no correlations between cortisol levels in UV and placental weight, Apgar Score at 1 and 5 min. Conclusions:,In the neonates whose birthweight was less than 2000 g without antenatal corticosteroid, there was a negative correlation between cortisol levels in UV and BW but there was no correlation between cortisol levels in UV and GA. That the neonates with antenatal corticosteroid would have a suppressed adrenocortical function after birth could not be proved. [source]

Influence of estradiol on cortisol secretion in ovariectomized cynomolgus macaques (Macaca fascicularis)

AMERICAN JOURNAL OF PRIMATOLOGY, Issue 1 2003
R.C. Stavisky
Abstract In an investigation of cortisol secretion in fully mature, ovariectomized cynomolgus monkeys (Macaca fascicularis), we compared monkeys that were given either placebo (OVX, n = 26) or 17, estradiol (E2 ) (EST, n = 26) in a daily oral dose. Serum cortisol concentrations were measured prior to the experimental manipulation and 3, 6, 9, and 12 months following initiation of treatment. Pretreatment cortisol values did not differ between groups. Assessment of the treatment period values revealed that cortisol concentrations were significantly higher (,10%) in the EST than in the OVX monkeys. Cortisol also varied significantly across periods of sampling. This time-dependent variation was attributable to elevations in months 6 and 9 (when daylight was generally long), relative to months 3 and 12 (when daylight was relatively short). The modest stimulatory effect of estrogen on corticosteroid production observed in this study is consistent with what has been seen in women, and contrasts with the more robust effects observed in New World monkeys. The possible relationship between season and cortisol secretion observed here has not been previously described in monkeys. Am. J. Primatol. 60:17,22, 2003. © 2003 Wiley-Liss, Inc. [source]

Cortisol response to two different doses of intravenous synthetic ACTH (tetracosactrin) in overweight cats

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 12 2000
J. P. Schoeman
Fifteen middle-aged to older, overweight cats attending a first-opinion clinic were investigated to rule out hyperadrenocorticism as a cause of their weight problem, using two different protocols for the adrenocortlcotropic hormone (ACTH) stimulation test. The cats received intravenous synthetic ACTH (tetracosactrin) at an initial dose of 125 ,g; a second test was performed between two and three weeks later, using a dose of 250 vg intravenously. The mean basal serum cortisol concentration was 203 nmol/litre (range 81 to 354 nmol/litre). The highest mean serum cortisol concentration occurred at 60 minutes following the 125 ,g dose and at 120 minutes following the 250 ,g dose. There was, however, no statistically significant difference between these peak cortisol concentrations attained using either dose of tetracosactrin. A significantly higher mean serum cortisol concentration was attained after the higher dose at the 180 minutes time point, indicating a more prolonged response when compared with the lower dose. The cats were followed up for one year after the initial investigations and none were found to develop hyperadrenocorticism during this time. [source]

Normalization of Serum Cortisol Concentration With Opioid Treatment of Severe Chronic Pain

PHYSIOLOGIC ABNORMALITIES AS BIOLOGIC MARKERS IN SEVERE, INTRACTABLE PAIN

PAIN MEDICINE, Issue 2 2002
Article first published online: 4 JUL 200
Forest Tennant, MD, Dr PH; Laura Herman RN BSN FNP Veract Intractable Pain Centers, 338 S. Glendora Ave., West Covina, CA 91790 It is recognized that biologic markers of severe, intractable pain (SIP) can help distinguish degrees of pain and assist in monitoring treatment effectiveness. Fifty (50.0%) adult ambulatory SIP patients, at the time of referral described their pain as constant, excruciating, produced a bed or house-bound state, and was uncontrolled by non-opioid medications and low dosages of the weak opioids, hydrocodone or codeine. Patients were treated with a long-acting opioid preparation consisting of methadone, oxycodone, morphine, or transdermal fentanyl in addition to a short-acting opioid for breakthrough pain. These patients were screened before treatment and after three months of opioid treatment by: (1) blood pressure; (2) pulse rate; (3) morning cortisol and pregnenolone serum concentrations; and (4) erythrocyte sedimentation rate (ESR). The percentage of patients with physiologic abnormalities before and after three months of treatment were as follows: (1) hypertension above 140/90 mm/Hg; 28 (56.0%) vrs 14 (28.0%); (2) tachycardia above 84/minute; 21 (42.0%) vrs 9 (18.0%); (3) elevated serum cortisol concentration; 12 (24.0%) vrs 2 (4.0%); (4) low serum cortisol serum concentration; 7 (14.0% vrs 1 (2.0%); (5) low pregnenolone serum concentration; 18 (36.0%) vrs 3 (6.0%); and (6) elevated ESR; 10 (20.0%) vrs 3 (6.0%) (p<.05). Mean blood pressure, pulse rate, ESR, and serum concentrations of cortisol and pregnenolone in patients who demonstrated a physiologic abnormality all positively and significantly (p<.05) altered these markers toward normal. This study indicates that some physiologic abnormalities, particularly those related to pituitary-adrenal over-stimulation with excess output of catecholamines and glucocorticoids, may serve as biologic markers which can help to identify SIP and monitor treatment effectiveness. [source]

(229) Serum Cortisol Concentrations and Adrenal Reserve May Be Altered by Severe Chronic Pain

Cortisol levels and measures of body composition in middle-aged and older men

CLINICAL ENDOCRINOLOGY, Issue 1 2007
Thomas G. Travison
Summary Introduction, Similarities in the symptomatic expressions of excess adiposity and hypercortisolaemic conditions suggest that elevated glucocorticoid exposure may influence the pathogenesis of obesity. Circulating cortisol levels are not typically elevated in obese subjects, but data from large prospective samples are rare. We undertook an analysis to determine both cross-sectional and longitudinal associations between body composition and serum cortisol concentrations in a randomly chosen group of 999 community-dwelling men, aged 40,79 years. Methods, Data were obtained from the two follow-up waves of the Massachusetts Male Ageing Study (T2: 1995,97; T3: 2002,04). Partial correlation and multivariate regression analyses were used to estimate cross-sectional (T2) and longitudinal associations between serum cortisol concentrations and a range of measures of subjects' body composition, including weight, body mass index (BMI), waist circumference (WC), waist-to-hip girth ratio (WHR), and percentage body fat (measured by bioelectrical impedance at T3); similar analyses were conducted to assess the association between change (T2 to T3) in serum cortisol and simultaneous change in body composition parameters. Results, We observed weak negative associations between cortisol concentrations and all body composition parameters, with the exception of percentage body fat. Longitudinal results demonstrated similar relationships but associations were of lesser magnitude. T2 cortisol concentrations were not associated with change in body composition over time, whereas T2 body size was positively associated with longitudinal changes in cortisol concentrations, providing limited evidence that weight change drives changes in cortisol concentrations, rather than vice versa. Results were unchanged when age and other covariate effects were controlled. Conclusions, Circulating cortisol concentrations are somewhat lower in obese than in nonobese community-dwelling men. There is some evidence that excess adiposity presages increases in cortisol concentrations, rather than the reverse. However, this observation should be greeted with caution, as age-related weight loss , and not gain , was associated with simultaneous increases in serum cortisol concentrations. [source]