Stress-Reducing Psychological Interventions as Adjuvant Therapies for Diabetic Chronic Wounds

Background: Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus and a leading cause of lower limb amputation. Interventions to reduce psychological stress may have the potential to improve self-care and greatly reduce the morbidity and mortality associated with DFU. This review is focused on the consequences of psychological stress in wound healing and reflects on the effects of currently used psychological stress-reducing interventions in patients with DFU, proposing new applications for currently used stress-reduction interventions. Results: Stress is a natural and fundamental survival mechanism that becomes harmful when chronic. DFU is associated with high levels of anxiety and chronic psychological stress. Chronic stress induced cortisol and adrenaline release impairs wound healing, independently of the stressor. Psychological stress-reducing interventions, such as relaxation with guided imagery, biofeedback-assisted relaxation, mindfulness-based strategies, and hypnosis can lead to a reduction in perceived stress and improve wound healing, by reducing wound inflammation and pain, while improving glycemic control. All stress reduction interventions also lead to pain relief and improved patient’s quality of life.

Activation of µ-opioid receptors in the rostral ventrolateral medulla blocks the sympathetic counterregulatory response to glucoprivation

Activation of neurons in the rostral ventrolateral medulla (RVLM) following glucoprivation initiates sympathoadrenal activation, adrenaline release, and increased glucose production. Here, we aimed to determine the role of RVLM µ-opioid receptors in the counterregulatory response to systemic glucoprivation. Experiments were performed in pentobarbital sodium anesthetized male Sprague-Dawley rats ( n = 30). Bilateral activation of RVLM µ-opioid receptors with [d-Ala2, N-Me-Phe4, Gly5-ol]-enkephalin (DAMGO) (8 mM, 50 nl) depressed adrenal sympathetic nerve activity for ~60 min ( n = 6; Δ49.9 ± 5.8%, P < 0.05). The counterregulatory response to glucoprivation (measured by adrenal sympathetic efferent nerve activity) induced by 2-deoxyglucose (2-DG) ( n = 6; Δ63.6 ± 16.5%, P < 0.05) was completely blocked 60 min after DAMGO microinjections ( n = 6; Δ10.2 ± 3.5%, P < 0.05). Furthermore, DAMGO pretreatment attenuated the increase in blood glucose levels after 2-DG infusion ( n = 6; 6.1 ± 0.7mmol/l vs. baseline 5.2 ± 0.3mmol/l, P > 0.05) compared with 2-DG alone ( n = 6; 7.6 ± 0.4mmol/l vs. baseline 6.0 ± 0.4mmol/l, P < 0.05). Thus, activation of RVLM µ-opioid receptors attenuated the neural efferent response to glucoprivation and reduced glucose production.

Takotsubo Cardiomyopathy Associated with Polycythemia Vera

Takotsubo cardiomyopathy is characterized by transient apical ballooning with preserved basal ventricular function triggered by physical or emotional stressors. We present a case of a 75-year-old man referred to our facility for the management of acute myocardial infarction later diagnosed as takotsubo cardiomyopathy. We believe platelet-mediated adrenaline release from massive thrombocytosis might have been the precipitating factor for the pathogenesis of takotsubo cardiomyopathy.

Direct effect of hypothalamic neuropeptides on the release of catecholamines by adrenal medulla in sheep – study ex vivo

Stress causes the activation of both the hypothalamic-pituitary-adrenocortical axis and sympatho-adrenal system, thus leading to the release from the adrenal medulla of catecholamines: adrenaline and, to a lesser degree, noradrenaline. It has been established that in addition to catecholamines, the adrenomedullary cells produce a variety of neuropeptides, including corticoliberine (CRH), vasopressin (AVP), oxytocin (OXY) and proopiomelanocortine (POMC) – a precursor of the adrenocorticotropic hormone (ACTH). The aim of this study was to investigate adrenal medulla activity in vitro depending, on a dose of CRH, AVP and OXY on adrenaline and noradrenaline release. Pieces of sheep adrenal medulla tissue (about 50 mg) were put on 24-well plates and were incubated in 1 mL of Eagle medium without hormone (control) or supplemented only once with CRH, AVP and OXY in three doses (10−7, 10−8 and 10−9 M) in a volume of 10 μL. The results showed that CRH stimulates adrenaline and noradrenaline release from the adrenal medulla tissue. The stimulating influence of AVP on adrenaline release was visible after the application of the two lower doses of this neuropeptide; however, AVP reduced noradrenaline release from the adrenal medulla tissue. A strong, inhibitory OXY effect on catecholamine release was observed, regardless of the dose of this hormone. Our results indicate the important role of OXY in the inhibition of adrenal gland activity and thus a better adaptation to stress on the adrenal gland level.

Examining Risk-Taking Behavior and Sensation Seeking Requirement in Extreme Athletes

Extreme sports are sport branches which include actions, adventures, risks and difficulties more rather than other sports. Special materials are used in sport branches such as surfing, kite surfing, sailing, snowboarding, paragliding, diving, mountaineering, motor sports and adrenaline release is more rather than in other sport branches. On the contrary, the situation for being eager to seek excitement and take risks with a view to having new experiences has been observed. It has been considered whether sensation seeking requirement and risk-taking behavior had effects upon each other. The aim of the study was to analyze sensation seeking and risk-taking behavior in extreme athletes. Total 101 extreme athletes including 31 females, 70 males with an age average of 22.03 ± 6.77 participated in the research. In order to determine athletes’ sensation seeking levels, “Arnett Inventory of Sensation Seeking” developed by Arnett (1994) and in order to determine their risk-taking behavior, “Risk Involvement and Perception Scale” developed by Siegel et al. (1994) were used. In evaluation of research data, frequency analysis, independent t test, in determination of relation between risk-taking and sensation seeking, correlation test were utilized.In conclusion, significant differences were found in risk-taking behavior, sensation seeking requirement and gender variable among the extreme athletes. In the male athletes sensation seeking requirement and risk-taking behavior had higher averages than the female athletes. Among the extreme athletes, significant relations were determined between risk-taking behavior and sensation seeking requirement. When risk-taking behavior values were high, sensation seeking requirement values were regarded to be high.

Dynamics of changes in lipid metabolism indices in organs and tissues of experimental animals under adrenaline stress

<p>Diseases of human population, especially in the countries with high level of urbanization, are more often associated now with the influence of different stresses, including emotional one, which is accompanied by adrenaline release.<br />It has been investigated the effect of adrenaline on triacylglycerol (TA G) and cholesterol (CL ) content in different tissues of Wistar rats. It has been determined that under short-term adrenaline load (single injection of adrenaline<br />followed by sample collection after 30 min) TA G level in blood plasma ecreased and simultaneously increased in liver. At the same time CL concentration in blood plasma decreased, while increased in liver and muscles. Double injection of adrenaline followed by sample collection after 30 min caused a decrease in TA G concentration in blood plasma and its increase in liver. Twenty four hours after double adrenaline injection it has been observed decreased TA G and CL levels in blood plasma, whereas it has not differed significantly from control in muscles and liver. Such changes of lipid metabolism under adrenaline stress should be taken into account during evaluation of pathologic process in certain organs.</p>