Search Results (767)

Background: Central precocious puberty (CPP), defined as the onset of secondary sexual characteristics before age 8 in girls, is increasingly prevalent worldwide. CPP is often caused by early activation of the HPG axis, leading to accelerated growth and bone maturation. However, the diagnostic accuracy of standard bone age (BA) methods remains uncertain in this context. Objective: To compare the diagnostic accuracy of the Greulich–Pyle atlas (GPA) and Tanner–Whitehouse 3 (TW3) methods in estimating skeletal age in girls with CPP and to assess the predictive value of serum hormone levels for estimating chronological age (CA). Methods: An observational, cross-sectional diagnostic study was conducted, involving n = 109 girls aged 6–12 years with confirmed CPP (Ethics Committee approval: CHUC_2023_86; 13 July 2023). Left posteroanterior hand–wrist (PA–HW) radiographs were assessed using the GPA and TW3 methods. Anthropometric measurements were recorded, and serum concentrations of estradiol, LH, FSH, DHEA-S, cortisol, TSH, and free T4 were obtained. Comparisons between CA and BA estimates were conducted using repeated-measures ANOVA, and ANCOVA was applied to examine the hormonal predictors of CA. Results: Both GPA and TW3 overestimated CA between 7 and 12 years, with the GPA showing larger deviations (up to 4.8 months). The TW3 method provided more accurate estimations, particularly at advanced pubertal stages. Estradiol (η²_p = 0.188–0.197), LH (η²_p = 0.061–0.068), and FSH (η²_p = 0.008–0.023) emerged as the strongest endocrine predictors of CA, significantly enhancing the explanatory power of both radiological methods. Conclusions: The TW3 method demonstrated superior diagnostic accuracy over GPA in girls with CPP, especially between 7 and 12 years. Integrating estradiol, LH, and FSH into BA assessment significantly improved the accuracy, supporting a more individualized and physiologically grounded diagnostic approach. Full article

This study investigated the association between temperament and retrospective growth rates in 84 Nili Ravi buffalo heifers aged 18 to 24 months. Temperament was assessed using chute score and exit velocity, measured twice at a seven-day interval, and classified as calm (≤3) or nervous (>3). Retrospective average daily weight gain data were retrieved from farm records, and blood samples were collected to measure cortisol levels. ANOVA was used to analyze data, considering temperament, age group, season, and year of birth as fixed effects, with birth weight as a covariate. Results showed that 48 heifers were calm and 36 were nervous. Calm heifers exhibited significantly higher average daily gains than nervous heifers during the post-weaning period, with an increase of 240 g/day from 4 to 6 months and 190 g/day from 6 to 12 months (p < 0.001). However, this difference was not significant at 18–24 months (p = 0.144). Calm heifers have numerically lower cortisol levels (0.96 vs. 1.27 μg/dL; p = 0.11). These findings suggest that calmer heifers grow faster in early life, emphasizing the importance of temperament in breeding programs aimed at improving growth performance and welfare. Full article

Background: Chronic stress in childhood and adolescence leads to excessive cortisol secretion, adipokines production and obesity with all the negative mental and physical effects on the health of individuals and adulthood. Objectives: The aim of the present non-randomized controlled trial was to investigate the effect of a stress management protocol with diaphragmatic breathing (DB) and physiotherapy exercise on stress, body composition, cardiorespiratory and metabolic markers of children and adolescents with morbid obesity. Methods: The study included 31 children and adolescents (5–18 years old) with morbid obesity (22 in the intervention arm and 9 controls). All participants completed anxiety questionnaires and a self-perception scale. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), blood pressure (BP) and SpO₂ were measured. Fasting glucose, uric acid, triglycerides, HbA1c, (AST/SGOT), (ALT/SGPT), HDL, LDL, insulin, ACTH, cortisol, HOMA-IR, 17-OH, S-DHEA, SHBG were assessed, and anthropometric measurements were also performed. Results: In the intervention group, 4 months after the treatment, an improvement was noted in the BMI, BMI z-score, waist-to-height ratio, FEV1, SpO₂, pulse and systolic BP. HDL increased, ALT/SGPT and insulin resistance improved. Positive changes were observed in temporary and permanent stress and self-esteem of children in the intervention group, including anxiety, self-perception, physical appearance, etc. Conclusions: A combined exercise and DB protocol has a positive effect on stress, by improving body composition, reducing insulin resistance, and ameliorating physical and mental health and quality of life of pediatric patients with morbid obesity. Full article

Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. Full article

Stress is a major factor that threatens the body’s homeostasis or well-being. Excessive stress causes psychological anxiety and tension, which disrupts the balance of the autonomic nervous system that maintains the body’s balance, resulting in hormonal imbalance and brain changes. In this study, we investigated the effects of Withania somnifera (Ashwagandha) extract on depression, neurobehavior, and hippocampal changes in model mice exposed to stress. Using an excessive restraint stress-induced depression model, we measured the behavioral changes and the levels of brain-derived neurotrophic factor (BDNF) and antioxidant genes in five groups: control, stress, low-dose W. somniferous extract (20 mg/kg/day), high-dose W. somniferous extract (40 mg/kg/day), and L-theanine (50 mg/kg/day, positive control). Stressed mice showed poorer performance in the open field and elevated plus maze tests compared with the control group. The impaired performance was restored following W. somniferous extract administration. In addition, W. somniferous extract restored the decreased expression of BDNF in the hippocampus caused by restraint stress, improved the balance of stress hormones (i.e., cortisol, dopamine, and norepinephrine), and also regulated BDNF, inflammatory genes, and antioxidant genes in brain tissue. Therefore, W. somniferous extract can induce antidepressant and anti-stress effects by maintaining brain BDNF expression and preventing hippocampal tissue alterations caused by restraint stress. Full article

Background/Objective: One third of “non-functioning adrenal tumours” (NFAs) have mild autonomous cortisol secretion (MACS). An updated analysis of the hormonal biomarkers profile, including risk factors and the rate of post-surgery adrenal insufficiency (PSAI), the duration of restoring the normal adrenocortical function in MACS/NFA and potential impacts on clinical comorbidities. Methods: Comprehensive review based on PubMed search (January 2020–January 2025). Results: The studies (n = 14) included 2623 patients (N = 1158 underwent unilateral adrenalectomy), aged 18–93 (mean = 57.49 years), with a female-to-male ratio = 1.54. Post-adrenalectomy (n = 9, N = 753) analysis: the PSAI risk correlated with the severity of baseline hypercortisolism. PSAI incidence: 50% of MAC. The rate after 4–6 weeks follow-up was 71.9% (adrenal Cushing’s syndrome) vs. 50% (MACS) vs. 14.4% (NFA). PSAI duration was up to 35 months. Early PSAI diagnosis was reflected by post-operative cortisol assay on day 1 (cut-off ≤ 5 µg/dL) and an ACTH (Cosyntropin) stimulation test (CST) (cortisol cut-off ≤ 14 µg/dL). Pre-operatory PSAI predictors: higher serum cortisol-DST (1 mg dexamethasone testing) and lower baseline plasma ACTH (not all studies agreed). Conclusions: A stratified strategy is encouraged following a unilateral adrenalectomy in MACS; PSAI is expected in almost half of patients, with a potential improvement of hypertension. Serum cortisol assays serve as most useful biomarker as pre-operatory PSAI predictor (after DST) and, potentially, in addition with baseline ACTH. Post-surgery basal cortisol measurement (± CST) helps the decision of glucocorticoids replacement since first post-operative day and during follow-up, serial testing at 3 months is a useful tool. Full article

We present a novel method to estimate blood cortisol concentration from sweat cortisol measurements, incorporating a kinetic model to simulate cortisol transport dynamics. Cortisol dysregulation is observed in conditions like Cushing’s syndrome, characterized by excessive cortisol production, and stress-related disorders, which can lead to metabolic disturbances, anxiety, and impaired overall health. Sweat-sensing technology offers a non-invasive and continuous alternative to blood sampling. However, the limited research exploring the sweat–blood cortisol relationship in patients shows a moderate correlation ($R<0.6$), hindering its clinical application for long-term monitoring. In this paper, we propose a novel kinetic model describing cortisol transport from blood to sweat. The model was validated using data from 44 patients before and after cardiac surgery. A high Pearson correlation coefficient of 0.95 (95% CI: 0.92–0.97) was observed between our model’s estimated and experimental blood cortisol concentrations. Moreover, the method enables personalized estimation of physiological parameters, accurately reflecting patients’ status under varying clinical conditions. The method paves the way for the clinical application of long-term, non-invasive monitoring of cortisol using sweat-sensing technology. Enabling the personalized estimation of physiological parameters could potentially support clinical decision-making, helping doctors diagnose and monitor patients with health conditions involving cortisol dysregulation. Full article

This study evaluates the influence of general anesthesia (GA) and spinal anesthesia (SA) on physiological and oxidative stress in parturients undergoing elective cesarean section, one of the most frequently performed surgical procedures worldwide. A total of 101 pregnant women were included, categorized into GA (n = 51) and SA (n = 50) groups. Blood samples were collected at three time points: one hour before surgery (Measurement 1), at umbilical cord clamping (Measurement 2), and two hours post-surgery (Measurement 3). Biomarkers of oxidative stress, complete blood count, and levels of biochemical parameters were measured. In second and/or third measurement, biochemical blood analysis showed increased prolactin and cortisol levels, followed by spike of glucose and insulin in the GA group. However, levels of tri-iodothyronine were reduced in both groups in the third measurement. Glutathione S-transferase (GST) activity was increased in both groups in third measurement. The results showed increased concentrations of total SH groups and decreased concentrations of non-protein SH groups in the GA group during Measurement 2. Lymphocyte count was found to be predictor of GST levels. The results indicate more a pronounced endocrine response in GA group and speak in favor of spinal anesthesia. Both kinds of anesthesia are equally safe in terms of the oxidative status of the tissue. Full article

Background and Objectives: Adrenal insufficiency (AI) is an endocrine disorder characterized by inadequate cortisol production, leading to non-specific symptoms that delay diagnosis. The Low Dose Synacthen Test (LDST) is commonly used to evaluate adrenal function, but traditional cortisol cut-offs may not accurately reflect adrenal function in all patients. This study aims to identify baseline cortisol cut-offs to accurately rule in and out AI, reassess the value of cortisol increment during LDST, and evaluate the accuracy of 30 and 60 min cortisol measurements in diagnosing AI. Materials and Methods: We conducted a cross-sectional analysis of patients who underwent LDST at Farhat Hached University Hospital. Diagnostic accuracy of baseline cortisol levels and cortisol increment was assessed using ROC curve analysis to determine optimal cut-offs for predicting LDST outcomes. Results: Among 163 patients (mean age 42.9 years, 63% female), baseline cortisol ≤ 5.35 μg/dL had 100% specificity but 41.5% sensitivity for LDST failure. Conversely, baseline cortisol ≥ 12.4 μg/dL had 100% sensitivity with 45.9% specificity. Single measurements at 30 and 60 min correctly classified 92.64% and 93.87% of cases, respectively. ROC analysis of 30 and 60 min cortisol increments showed high diagnostic accuracy (AUC 0.923 and 0.914, respectively). The optimal cortisol increment cut-off was 6.35 μg/dL for ruling in AI (99% specificity). Conclusions: We propose a novel AI diagnostic algorithm based on a single 30 min cortisol measurement, complemented by revised baseline cortisol cut-offs and cortisol increment as additional criteria. This approach may enhance diagnostic accuracy and minimize unnecessary testing, warranting further clinical validation. Full article

Background and Objectives: Regional and systemic analgesic techniques, such as erector spinae plane (ESP) block and opioid administration, implemented during cancer surgery, have been shown to influence immune responses and potentially affect cancer outcomes. Surgical stress and analgesic techniques used in cancer surgery—such as regional nerve blocks or systemic opioids—not only affect pain control but also influence immune and inflammatory pathways that may impact cancer progression. To understand the biological consequences of these interventions, metabolomic profiling has emerged as a powerful approach for capturing systemic metabolic and immunological changes, which are particularly relevant in the oncologic perioperative setting. In this study, we examined the impact of the ESP on the metabolomic profile, as well as levels of VEGF, cortisol, and CRP, in addition to its analgesic effects in breast cancer surgery. Materials and Methods: Ninety patients were placed into three different analgesia groups (morphine, ESP, and control groups). Demographic data, ASA classification, comorbidities, surgery types, and pain scores were documented. Blood samples were taken at preoperative hour 0, postoperative hour 1, and postoperative hour 24 (T0, T1, and T24). VEGF, cortisol, and CRP levels were measured, and metabolomic analysis was performed. Results: Study groups were comparable regarding demographic findings, comorbidities, and surgery types (p > 0.05). NRS scores of group ESP were lowest in the first 12 h period (p < 0.01) and ESP block reduced opioid consumption (p < 0.01). VEGF and cortisol levels of group morphine were similar to ESP at T24 (p > 0.05). Group ESP had lower VEGF and cortisol levels than the control at T24 (p = 0.025, p = 0.041, respectively.). The CRP level of group morphine was higher than both ESP and control at T24 (p = 0.022). Metabolites involved in primary bile acid, steroid hormone biosynthesis, amino acid, and glutathione metabolism were changed in group ESP. Conclusions: Metabolites in bile acid biosynthesis and steroid hormone pathways, which play a key role in immune responses, were notably lower in the ESP group. Accordingly, VEGF and cortisol peaks were more moderate in group ESP. In conclusion, we think that ESP block, which provides adequate analgesia, is an acceptable approach in terms of modulating immune responses in breast cancer surgery. Full article

Neonatal calves possess an immature and naïve immune system and are reliant on the intake of maternal colostrum for the passive transfer of immunoglobulins. Maternal antibodies delivered to the calf via colostrum, are crucial to prevent calfhood diseases and death. Failure of transfer of passive immunity (FTPI) is a condition in which calves do not acquire enough maternal antibodies, mostly in the form of IgG, due to inadequate colostrum quality or delayed colostrum feeding. The diagnosis and risk factors for FTPI have been widely studied in dairy cattle; however, in beef calves, the research interest in the topic is relatively recent, and the most adequate diagnostic and preventative methods are still in development, making it difficult to define recommendations for the assessment and prevention of FTPI in cow–calf operations. The objective of this scoping review is to identify the published literature on best practices for colostrum management and transfer of passive immunity (TPI) in neonatal beef calves. The literature was searched using three electronic databases (CAB Direct, Scopus, and PubMed) for publications from 2003 to 2025. The search process was performed during the period from May to July 2023, and was repeated in January 2025. All screening processes were performed using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia). A total of 800 studies were initially identified through database searches. After removing duplicates, 346 studies were screened based on their titles and abstracts, leading to the exclusion of 260 studies. The remaining 86 studies underwent full-text screening, and 58 studies were considered eligible for data extraction. Hand-searching the references from published review papers on the subject yielded an additional five studies, bringing the total to 63 included articles. The prevalence of FTPI has been estimated to be between 5.8% and 34.5% in beef calves. Factors studied related to colostrum management include quality and quantity of colostrum intake, the timing and method of colostrum feeding, and the microbial content of the colostrum. Studies on risk factors related to the calf include the topics calf sex, twin status, calf vigor, weight, month of birth, cortisol and epinephrine concentrations, and the administration of nonsteroidal anti-inflammatory drugs to calves after difficult calving. The dam-related risk factors studied include dam body condition score and udder conformation, breed, parity, genetics, prepartum vaccinations and nutrition, calving area and difficulty, and the administration of nonsteroidal anti-inflammatory drugs at C-section. Most importantly for beef systems, calves with low vigor and a weak suckling reflex are at high risk for FTPI; therefore, these calves should be given extra attention to ensure an adequate consumption of colostrum. While serum IgG levels of < 8 g/L or < 10 g/L have been suggested as cutoffs for the diagnosis of FTPI, 16 g/L and 24 g/L have emerged as cutoffs for adequate and optimal serum IgG levels in beef calves. Several field-ready diagnostics have been compared in various studies to the reference standards for measuring indicators of TPI in beef calves, where results often differ between models or manufacturers. Therefore, care must be taken when interpreting these results. Full article

Animal-assisted services (AAS) have been shown in multiple studies to improve a range of human psychological and physical health benefits. The aim of this pilot study is to investigate simultaneously two psycho-physiological indicators of the valence of interactions in the context of dog-assisted activities in children diagnosed with autism spectrum disorder. Ten children and four dogs experienced in AAS were involved, lasting 90 days, in weekly one-hour sessions. Before and after each session, saliva was taken in both dogs and children for determination of salivary oxytocin and cortisol levels. In addition, at the end of the program, a questionnaire was administered to both parents and dog handlers to assess the impact of AAS in children and dogs. Our results revealed no statistically significant change in cortisol and oxytocin levels in dogs enrolled throughout the sessions, while an increasing trend was noted for salivary oxytocin in 50% of the dogs and for salivary cortisol in all dogs at the end of the AAS, when compared to the pre-AAS. Salivary cortisol measurement in children with an autistic neurotype highlighted a statistically significant increase at the end of the AAS when compared to the pre-AAS, but this was not observed for oxytocin level evaluations. Regarding the perception of the children’s parents about the effects of the program, our data reported an improvement in sociability of the children in 100 percent of the cases. Furthermore, dog handlers reported an absence of signs of stress in their dogs during the sessions. Although the perceived effectiveness and quality of AAS has been demonstrated in the literature, the need to carefully select the dogs involved, considering their skills and needs, is critical to ensure their well-being in various therapeutic settings. Full article

Environmental impact plays a pivotal role in forming the welfare of shelter dogs exposed to chronic stress. Standard methods of animal health monitoring, such as psychological evaluation or cortisol measurements, do not fully reflect modulation of the immune system. Functional cellular changes may be subtle and observed only at the molecular level. Therefore, the aim of this study was to characterize the immune function of shelter dogs kept on different timetables in comparison with client-owned dogs. We focused on potential alterations of antigen processing by neutrophils and monocytes in animals undergoing different durations of stress. Hematological and biochemical parameters were evaluated, and changes in TLR4 and MHC Class II expression on neutrophils and monocytes isolated from peripheral blood were determined. Additionally, we measured the percentage of apoptotic cells within these leukocyte populations. Our study revealed that stressful conditions can alter the molecular pattern of surface receptors on neutrophils and monocytes, as well as the leukocytes apoptosis rate. The obtained data also indicated that the dogs’ duration of stay in the shelter plays an important role in immunomodulation and triggering their adaptation mechanisms. These results bring a new perspective and will be crucial in developing improved guidelines for monitoring and promoting the welfare of shelter dogs. Full article

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with chronic inattention, hyperactivity, and impulsivity and is linked with significant functional impairment. Despite being highly prevalent, diagnosis of ADHD continues to rely on subjective assessment reports of behavior and is often delayed or inaccurate. This review summarizes current advances in biomarkers and neuropsychological tests for the improvement of ADHD diagnosis and treatment. Key biomarkers are neuroimaging methods (e.g., structural and functional MRI), electrophysiological measures (e.g., EEG, ERP), and biochemical measures (e.g., cortisol, vitamin D). Additionally, novel experimental measures, e.g., eye-tracking, pupillometry, and microbiome analysis, hold the promise to be objective and dynamic measures of ADHD symptoms. The review also comments on the impact of the burden of ADHD on quality of life, e.g., emotional well-being, academic achievement, and social functioning. Additionally, differences between individuals, such as age, sex, comorbidities, and the impact of social and family support, are also addressed in relation to ADHD outcomes. In summary, we highlight the potential of these emerging biomarkers and tools to revolutionize ADHD diagnosis and guide personalized treatment strategies. These insights have significant implications for improving patient outcomes. Full article

Salivary cortisol is widely used to assess stress and circadian rhythms, yet its control variables in neonates, particularly regarding postnatal age, remain poorly understood. To elucidate age-specific effects of clinical variables on cortisol levels, 91 neonates with a mean (standard deviation) gestational age of 34.2 (3.8) weeks and postnatal age of 38.3 (35.4) days were categorised into Early, Medium, and Late groups by quartiles (days 10 and 56). Interactions with postnatal age were evaluated by comparing Early-to-Medium or Early-to-Late differences in regression coefficients between independent variables and cortisol levels. In the whole cohort, maternal hypertensive disorders of pregnancy and morning sampling were associated with reduced cortisol levels (both p = 0.001). Mean regression coefficients (95% CI) between variables and cortisol levels were as follows: for postconceptional age, Early, −0.102 (−0.215, 0.010) and Late, 0.065 (−0.203, 0.332) (p = 0.035); for feeding duration, Early, 0.796 (−0.134, 1.727) and Late, −0.702 (−2.778, 1.376) (p = 0.010); for time elapsed since feeding, Early, −0.748 (−1.275, −0.221) and Late, −0.071 (−1.230, 1.088) (p = 0.036); and for blood lactate, Early, 0.086 (0.048 to 0.124), Medium, 0.022 (−0.063, 0.108), and Late, −0.018 (−0.106, 0.070) (p = 0.008 and <0.001 vs. Medium and Late, respectively). The influence of postconceptional age, oral feeding, and anaerobic metabolism on salivary cortisol levels was observed during the birth transition period but not beyond 10 days of life. Given the age-specific dependence of cortisol levels on clinical variables, including postconceptional age, feeding, and oxygen metabolism, caution is warranted when interpreting findings from studies on salivary cortisol in newborn infants. Full article