MORNING SERUM CORTISOL LEVEL AFTER TRANSSPHENOIDAL SURGERY FOR PITUITARY ADENOMA PREDICTS HYPOTHALAMIC-PITUITARY-ADRENAL FUNCTION DESPITE INTRAOPERATIVE DEXAMETHASONE USE

2015 ◽  
Vol 21 (8) ◽  
pp. 897-902 ◽  
Author(s):  
Ekaterina Manuylova ◽  
Laura Maria Calvi ◽  
G. Edward Vates ◽  
Catherine Hastings ◽  
Ismat Shafiq
Keyword(s):  
Pituitary Adenoma ◽  
Cortisol Level ◽  
Transsphenoidal Surgery ◽  
Serum Cortisol ◽  
Adrenal Function ◽  
Serum Cortisol Level ◽  
Hypothalamic Pituitary Adrenal ◽  
Morning Serum Cortisol

Use of morning serum cortisol level after transsphenoidal resection of pituitary adenoma to predict the need for long-term glucocorticoid supplementation

2009 ◽  
Vol 111 (3) ◽  
pp. 540-544 ◽  
Author(s):  
Nicholas F. Marko ◽  
Vivek A. Gonugunta ◽  
Amir H. Hamrahian ◽  
Ali Usmani ◽  
Marc R. Mayberg ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Cortisol Level ◽  
Postoperative Period ◽  
Serum Cortisol ◽  
Early Postoperative Period ◽  
Serum Cortisol Level ◽  
Total Serum ◽  
Total Cortisol ◽  
Hpa Function

Object Accurate assessment of the hypothalamic-pituitary-adrenal (HPA) axis is critical for appropriate management of the disease in patients with pituitary adenoma after transsphenoidal resection. The authors examine the role of the morning total serum cortisol level in the early postoperative period as a predictor of long-term HPA function. Methods Morning total serum cortisol was measured in 83 patients on postoperative Day 1 (or Day 2 if the patient received glucocorticoids during surgery) after transsphenoidal surgery for pituitary adenoma. These results were compared with those of definitive assays of HPA function performed at 1–3 months postoperatively, including cortrosyn/synacthen stimulation test (CST), insulin tolerance test (ITT), and metyrapone test (MTT). The ability of the early-postoperative morning cortisol level to predict HPA function was determined using standard confusion matrix calculations and receiver-operator control curve analysis. Results The authors found that an early postoperative morning total cortisol level ≥ 15 μg/dl is a sensitive and accurate predictor of normal HPA function in the postoperative period (sensitivity 80.5%, specificity 66.7%, positive predictive value 96.9%). Conclusions A morning total cortisol level ≥ 15 μg/dl in the early postoperative period after transsphenoidal surgery for pituitary adenomas is a good predictor of normal HPA function. This test has good sensitivity and accuracy and correlates well with the results of additional, definitive assays of HPA function (CST, ITT, and MTT) performed at 1–3 months postoperatively. Accordingly, it is the authors' practice to avoid exogenous perioperative glucocorticoid supplementation in patients with normal preoperative HPA function and postoperative morning total cortisol levels ≥ 15 μg/dl 1–2 days after transsphenoidal pituitary adenomectomy.

scholarly journals Examination of associations between chaos in the home environment, serum cortisol level, and dietary fat intake among parents of preschool-age children

2017 ◽  
Vol 42 (7) ◽  
pp. 788-791 ◽  
Author(s):  
Laura M. MacRae ◽  
Gerarda Darlington ◽  
Jess Haines ◽  
David W.L. Ma ◽  
Keyword(s):  
Home Environment ◽  
Cortisol Level ◽  
Dietary Fat ◽  
Serum Cortisol ◽  
Preschool Age ◽  
Serum Cortisol Level ◽  
Fat Intake ◽  
Regression Analyses ◽  
Preschool Age Children ◽  
Morning Serum Cortisol

This research investigated associations between home-environment chaos, fat intake, and morning serum cortisol level in 44 parents of preschool-age children. Chaos was measured using the Confusion, Hubbub, and Order Scale, and fat intake was quantified using the Block fat screener. Linear regression analyses demonstrated that chaos and cortisol were both associated with fat intake ([Formula: see text] = 0.53, p = 0.001; [Formula: see text] = 0.03, p = 0.0002), and there was a nonsignificant association between chaos and cortisol.

Diagnostic performance of morning serum cortisol as an alternative to short synacthen test for the assessment of adrenal reserve; a retrospective study

2020 ◽  
pp. postgradmedj-2020-138514
Author(s):  
Rajeev Kumar ◽  
Peter Carr ◽  
Ws Wassif
Keyword(s):  
Retrospective Study ◽  
Cortisol Level ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Number Of Patients ◽  
Morning Serum Cortisol ◽  
Insufficient Response ◽  
Synacthen Test ◽  
The Uk ◽  
Short Synacthen Test

ObjectiveThe short synacthen test (SST) is widely used across the UK to assess adrenal reserve. The main objective of our study was to determine the morning serum cortisol level that will predict adrenal insufficiency (AI) thus reducing our reliance on SST.DesignThis was a single centre retrospective study of 393 SST tests measuring 0 and 60 min cortisol levels after administration of 250 μg of synacthen (synthetic ACTH).Patients and methodsAll the SST tests for patients suspected of primary or secondary AI between April 2016 and October 2018 were included in this study. We used serum to determine circulating cortisol by a newer generation competitive electrochemiluminescence immunoassay (ECLIA) (Roche Diagnostics). A post-ACTH cortisol response of ≥420 nmol/L at 60 min was considered adequate to rule out AI. The data were analysed to ascertain the relationship between 0 min and 60 min serum cortisol.ResultsA total of 393 SST results were included in this study. Overall, a total of 332 (84.5%) subjects achieved sufficient serum cortisol level at 60 min, while 61 subjects (15.5%) showed insufficient response. Using the logistic regression, we determined that a morning basal serum cortisol level of ≥354 nmol/L was able to predict normal adrenal function with 100% sensitivity. We were unable to find a lower cut-off value below which SST will not be required. By using this proposed cut-off point, approximately 37% of the SSTs tests could be avoided.ConclusionsBasal morning serum cortisol can be safely used as a first step in the evaluation of patients with suspected AI. This will enhance the number of patients being screened for this condition.

Higher morning serum cortisol level predicts increased fibrinogen but not shortened APTT

2007 ◽  
Vol 26 (2) ◽  
pp. 103-105 ◽  
Author(s):  
Giuseppe Lippi ◽  
Massimo Franchini ◽  
Gian Luca Salvagno ◽  
Martina Montagnana ◽  
Gian Cesare Guidi
Keyword(s):  
Cortisol Level ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Morning Serum Cortisol

scholarly journals Effect of yoga and meditation on serum cortisol level in first-year medical students

2018 ◽  
Vol 6 (5) ◽  
pp. 1699
Author(s):  
Kislay Kumar ◽  
Vinay Singh ◽  
Devesh Kumar ◽  
A. B. Asthana ◽  
Divya Mishra
Keyword(s):  
Medical Students ◽  
Cortisol Level ◽  
Stress Level ◽  
High Stress ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Control Group ◽  
P Value ◽  
Yoga Group ◽  
Morning Serum Cortisol

Background: Yoga is a traditional technique to conserve and purify body, mind and soul. It is a mind-body bridge which involves relaxation, meditation and a set of physical exercises performed in association with breathing. In this new era of evolution, most of the population are depressed or in stress, irrespective of their age and gender.Methods: This study is performed on 1st yr. medical students whose stress level is in higher side due to academic burden. An 55 medical students were selected as participants through counseling and were divided into yoga group (n= 27) and control group (n=28). Their morning serum cortisol level was assessed, and yoga group were instructed to practice yoga (1hr/day for 12 weeks) under supervision of yoga instructor. No such instruction was given to control group.Results: Serum cortisol level is the marker of stress and inflammation. Higher cortisol level means high stress level. Yoga and meditation is documented to reduce stress level in regular practitioners.  Statistical analysis has shown decrease in morning serum cortisol level (572.18±168.03 to 544.98±139.89, 4.8% decrease, P value ˂0.05, significant) in yoga group after study. Control group have shown marked increase in cortisol level (558.89±162.69 to 577.26±254.5, 3.4% increase, P value = 0.74, not significant) after three months of study.Conclusions: This study concludes that practicing Yoga has a significant effect on the reduction of stress and anxiety level in medical students.

Nighttime serum cortisol level for diagnosis of hypercortisolism in hospitalized patients

2019 ◽  
Author(s):  
Liana Khatsimova ◽  
Uliana Tsoy ◽  
Natalia Kuritsyna ◽  
Elena Grineva ◽  
Elena Litvinenko ◽  
...  
Keyword(s):  
Cortisol Level ◽  
Serum Cortisol ◽  
Hospitalized Patients ◽  
Serum Cortisol Level

Serum Cortisol Abnormalities after Craniocerebral Trauma

Neurosurgery ◽  
1979 ◽  
Vol 5 (5) ◽  
pp. 559-565 ◽  
Author(s):  
Paul Steinbok ◽  
Gordon Thompson
Keyword(s):  
Head Injury ◽  
Cortisol Level ◽  
Diurnal Rhythm ◽  
Elevated Serum ◽  
Craniocerebral Trauma ◽  
Serum Cortisol ◽  
Feedback Mechanism ◽  
Serum Cortisol Level ◽  
Skull Fractures ◽  
Middle Fossa

Abstract Serial estimations of serum cortisol were performed in 49 patients with craniocerebral trauma. Abnormalities of serum cortisol, including alterations in diurnal rhythm and elevations of serum cortisol level, occurred in 21 patients. The frequency and severity of the abnormalities correlated with the severity of the head injury, and there was a trend suggesting that middle fossa basal skull fractures predisposed to cortisol abnormalities. A further 6 patients were studied to assess the effects of exogenous dexamethasone, and in all patients there was suppression of elevated serum cortisol levels by the dexamethasone. The findings suggest that hypercortisolemia after head injury is related to an alteration rather than an abolition of the normal feedback mechanism.

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.

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