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Case Reports 2007; 28(6): 745-748 PubMed PMID: 18063931 Citation  Keywords:  Adrenal Insufficiency:blood, Adrenocorticotropic Hormone:blood, Empty Sella Syndrome:blood, Female, Hormone Replacement Therapy, Humans, Hydrocortisone:blood, Hypoglycemia:blood, Hyponatremia:blood, Methylprednisolone:therapeutic use, Middle Aged, Pituita.   

: Isolated ACTH deficiency is an uncommon cause of secondary adrenocortical insufficiency and accompaniment with primary empty sella has been reported in several cases. We present a case of isolated ACTH deficiency associated with empty sella. A sixty-two year old woman was admitted to our endocrine clinic with complaints of weakness, fatigue, weight loss, nausea, vomiting, and lack of appetite for about one month. Physical examination indicated orthostatic hypotension and epigastric tenderness. Laboratory investigations revealed hypoglycemia, hyponatremia and anemia, in addition low plasma cortisole and ACTH levels. Serum cortisole responses to short and prolonged ACTH stimulation were tested and partial and accurate responses were obtained, respectively. Plasma ACTH and serum cortisole levels failed to respond after intravenous injection of human corticotropin releasing hormone. Other hypophysial hormone levels were within the normal reference ranges. Although cranial and abdominal computerized tomography images were evaluated as normal, cranial magnetic resonance imaging of the pituitary gland revealed 'primary empty sella turcica'. Replacement therapy with methylprednisolon resulted in the improvement of hypoglycemia, hyponatremia and clinical symptoms. Based on these results, the patient was diagnosed as isolated ACTH deficiency and was scheduled for follow up by our outpatient clinic. Our report is consistent with other reports pointing out that primary empty sella may be responsible for pathogenesis of isolated ACTH deficiency....

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Journal Article 2007; 28(5): 610-613 PubMed PMID: 17984936 Citation  Keywords:  Adjustment Disorders:blood, Adrenocorticotropic Hormone:blood, Adult, Anxiety Disorders:blood, Circadian Rhythm:physiology, Crime Victims:psychology, Dehydroepiandrosterone:blood, Depressive Disorder:blood, Female, Humans, Hydrocortisone:blood, MMPI, Male.   

OBJECTIVES: Evidence in the literature suggests stress-related changes of hypothalamus-pituitary-adrenal (HPA) axis in mobbing. We investigated the association between HPA activity and psychological profiles in mobbing, using a multidisciplinary approach.

DESIGN: Forty-eight victims of mobbing were evaluated by a working group of the Departments of Occupational Medicine, Psychiatry and Internal Medicine. After an informed consent, a detailed occupational history, a psychiatric interview with Minnesota Multiphasic Personality Inventory 2 (MMPI-2) administration and a blood sample (8:00 AM) for the determination of basal adrenocorticotropin (ACTH), cortisol and dehydroepiandrosterone sulphate (DHEAS) plasma levels were collected. Twenty-six patients received an overnight dexamethasone (dex) test.

RESULTS: Mean ACTH, cortisol and DHEAS levels were within normal ranges. The dex-test response was normal, with a significant hormone suppression (ACTH p<0.001, cortisol p<0.001, DHEAS p<0.001). The correlations between basal hormones and the psychometric scales of MMPI-2 revealed that cortisol was significantly and negatively related to Psychasthenia (Pt, p=0.003) and Depression (D, p=0.006), while DHEAS showed a significant negative correlation to Hysteria (Hy, p=0.008). Basal ACTH levels were not significantly related to psychometric scales.

CONCLUSION: A significant inverse correlation between morning plasma cortisol levels and psychometric parameters in victims of mobbing with adjustment disorders was observed. A larger group of patients is necessary to identify and validate a cut-off cortisol level that may become an innovative biological parameter for the diagnosis and follow-up in victims of mobbing....

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Journal Article 2007; 28(4): 449-455 PubMed PMID: 17693983 Citation  Keywords:  5-Hydroxytryptophan:administration & dosage, Adolescent, Adult, Analysis of Variance, Antidepressive Agents, Second-Generation:administration & dosage, Autistic Disorder:blood, Case-Control Studies, Child, Humans, Hydrocortisone:blood, Male, Prolactin:blo.   

: Some studies have suggested that disorders in the central serotonergic function may play a role in the pathophysiology of autistic disorder. In order to assess the central serotonergic turnover in autism, this study examines the cortisol and prolactin responses to administration of L-5-hydroxy-tryptophan (5-HTP), the direct precursor of 5-HT in 18 male, post-pubertal, Caucasian autistic patients (age 13-19 y.; I.Q.>55) and 22 matched healthy volunteers. Serum cortisol and prolactin were determined 45 and 30 minutes before administration of 5-HTP (4 mg/kg in non enteric-coated tablets) or an identical placebo in a single blind order and, thereafter, every 30 minutes over a 3-hour period. The 5-HTP-induced increases in serum cortisol were significantly lower in autistic patients than in controls, whereas there were no significant differences in 5-HTP-induced prolactin responses between both study groups. In baseline conditions, no significant differences were found in serum cortisol and prolactin between autistic and normal children. The results suggest that autism is accompanied by a central serotonergic hypoactivity and that the latter could play a role in the pathophysiology of autism....

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Comparative Study 2007; 28(4): 433-437 PubMed PMID: 17693981 Citation  Keywords:  Adolescent, Adult, Endocrine System:physiology, Female, Humans, Hydrocortisone:blood, Male, Odorants, Olfactory Pathways:physiology, Sex Characteristics, Testosterone:blood,.   

OBJECTIVES: This study aimed to verify the influence of odor on the endocrine system (Cortisol, Testosterone).

MATERIAL AND METHODS: Three odors (Musk, Rose and Floral) and air were given to 16 healthy volunteers (8 males, 8 females), and cortisol (C) and testosterone (T) levels were measured before and after stimulation.

RESULTS: Each odor decreased levels of C, indicating that odor can attenuate stress. In males, T decreased with Musk, but increased with Floral. In females, T significantly increased with Musk, but decreased with Rose and Floral.

CONCLUSIONS: These results indicate that influences on hormone levels depend on the type of odor, and sex differences exist in response to odors....

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Comparative Study 2007; 28(4): 445-448 PubMed PMID: 17693971 Citation  Keywords:  Adolescent, Adult, Autistic Disorder:physiopathology, Circadian Rhythm:physiology, Cognition:physiology, Empathy, Female, Humans, Hydrocortisone:metabolism, Logic, Male, Psychopathology, Saliva:metabolism, Sex Characteristics, Social Adjustment,.   

OBJECTIVE: Little is known regarding the relationship between cortisol (a stress hormone) levels and psychological cognitive styles. Baron-Cohen proposed two fundamental cognitive styles, which are measured by the Empathy Quotient (EQ) and the Systemizng Quotient (SQ). Previous studies have examined the influences of prenatal testosterone exposure on EQ and SQ scores. This study aimed to examine the relationships between morning cortisol levels and EQ and SQ scores, and the 'brain types' which were determined by two quotients in both sexes. These relationships are potentially important in the developmental psychopathology of autism and neuroeconomics of empathy.

METHODS: We assessed morning cortisol levels with LC/MS (liquid chromatography-mass spectrometry) and ESQ in healthy male and female university students.

CONCLUSIONS: Results indicate clear sex differences between brain types: i.e. E-type males and S-type females (participants with atypical cognitive styles) have significantly higher cortisol levels than S-type males and E-type females (participants with typical cognitive styles). Implications for the role of sex in social adaptation of autistic patients are discussed....

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Clinical Trial 2007; 28(2): 106-109 PubMed PMID: 17435679 Citation  Keywords:  Adult, Cognition:physiology, Depressive Disorder:blood, Electrocardiography, Female, Gyrus Cinguli:physiopathology, Heart Rate, Humans, Hydrocortisone:blood, Male, Middle Aged, Neuropsychological Tests, Task Performance and Analysis,.   

OBJECTIVE: According to recent findings detecting a cognitive conflict is related to activation of anterior cingulate cortex (ACC) and central autonomic network. Several recent findings also suggest the hypothesis that the cognitive conflict is related to specific nonlinear chaotic changes of the neural signal. This conflict related activation elicits autonomic responses which can be assessed by psychophysiological measures such as heart rate variability calculated as beat to beat R-R intervals (RRI).

METHOD: The present study used Stroop word-colour test as an experimental approach to psychophysiological study of cognitive conflict in connection with RRI measurement, assessment of serum cortisol and calculation of largest Lyapunov exponents in nonlinear data analysis of RRI time series in 30 patients with unipolar depression.

RESULTS: Significant correlation -0.45 (p<0.01) between largest Lyapunov exponents during conflicting Stroop task and serum cortisol levels has been found.

CONCLUSIONS: The study indicates that a defect of neural inhibition during conflicting Stroop task is closely related to decreased serum cortisol levels which probably reflect defense psychological mechanisms....

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Clinical Trial 2007; 28(2): 145-148 PubMed PMID: 17435673 Citation  Keywords:  Adult, Alcohol Drinking:blood, Ethanol:pharmacology, Exercise:physiology, Human Growth Hormone:blood, Humans, Hydrocortisone:blood, Male,.   

OBJECTIVE: To evaluate the effects of moderate amounts of ethanol on the GH and cortisol responses to physical exercise.

METHODS: Ten normal men underwent three bicycle ergometer tests. Test were carried out in basal conditions (control test) or after drinking 0.5 or 0.75 g/kg BW ethanol. Tests lasted 15 min in all subjects; the workload was increased at 3 min intervals from time 0 until exhaustion. Non-endocrine physiological parameters (NEPP), such as heart rate, blood pressure, ventilation, frequency of breathing, tidal volume, oxygen consumption, carbon oxide production and respiratory exchange ratio were measured from time 0 until exhaustion. Serum GH and cortisol levels were evaluated in blood samples taken at 5-10 min intervals over a 50 min period from time 0.

RESULTS: Neither basal values, nor exercise-induced changes in NEPP were altered by ethanol drinking. Both GH and cortisol levels significantly rose during the exercise control test. The hormonal responses did not change after 0.5 g/kg BW ethanol, whereas they significantly decreased after 0.75 g/kg BW ethanol.

CONCLUSIONS: Modification of the GH and cortisol responses to exercise represents an "endocrine window" of the effects that even moderate ethanol drinking produces in the CNS. The data show that 0.75 g/kg BW ethanol is the minimal amount producing significant inhibitory effects on the GH and cortisol responses to physical exercise. In view of the important roles played by GH and cortisol during physical activity, even moderate ethanol drinking must be avoided before sport....

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Journal Article 2007; 28(2): 199-203 PubMed PMID: 17435662 Citation  Keywords:  Adult, Aged, Case-Control Studies, Dehydroepiandrosterone Sulfate:blood, Female, Humans, Huntington Disease:blood, Hydrocortisone:blood, Middle Aged, Testosterone:blood,.   

OBJECTIVE: The neuronal loss in several brain regions that characterize the progression of Huntington's disease (HD), is expected to influence the activities of hypothalamus-adrenal and hypothalamus-gonadal axes, and the changes may relate to common features of the disease, like depression and dementia. While in male HD patients low plasma testosterone levels have been reported, information on female patients is lacking.

METHODS: We assessed the plasma levels of the androgens total testosterone (TT) and dehydroepiandrosterone sulfate (DHEAS), as well as of cortisol in 41 female patients with HD, confirmed by determination of the CAG repeat number in the IT-15 gene, and searched for associations to the disease symptomatology. We also included a group of 18 females with expanded CAG repeat number in the HD gene (subjects at risk), and a group of 66 age-matched healthy females. Hormone levels of the pre- and post-menopausal subgroups were also compared separately.

RESULTS: Significant negative correlations to age were found for TT and DHEAS in both control (age range 20-71 years) and patient (age range 26 to 78 years) groups, and the calculated decline per year was around 1% for TT and 1.5% for DHEAS. There were no significant differences in hormone levels among patients, subjects at risk and controls, either in premenopausal or in postmenopausal state. The subgroup of patients with depression in their symptomatology had significantly lower TT and DHEAS levels compared to patients without depression, or to controls.

CONCLUSIONS: While TT and DHEAS seem to decline with age in female patients with HD to the same extend as for healthy females, the presence of depression, but not dementia, in their symptomatology, is connected to lower ovary-adrenal androgen levels....

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