IntroductionThe vestibular acute stress induces reversible alert-like reactions that involve the sympathetic adrenal-medullar system and hypothalamic-pituitary-adrenal axis responses. The present study aimed to evaluate salivary α-amylase and salivary cortisol production in relation with cardiovascular reactivity induced by acute stress in healthy subjects.Material and methodsForty-eight young healthy male volunteers were examined under basal conditions and at various times after reaching the maximal nystagmic reaction following air caloric vestibular test. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded at the same time as measurement of the salivary α-amylase and salivary cortisol. At the end of the caloric vestibular test session, perceived stress scale questionnaires were administered to measure the self-perceived stress impact induced by the task, and individual scores were compared with those measured on the enrollment day.ResultsFollowing caloric vestibular test-evoked vertigo, salivary α-amylase and cortisol showed distinct trends in their production after acute stress: Student’s t-test was used to compare the α-amylase vs cortisol slopes of the respective interpolated regression lines, and the difference was significant (t = -3.283; p<0.001); an increase in salivary cortisol production corresponded with a decrease in the salivary α-amylase concentration. In addition, salivary biomarker modifications were associated with consistent changes in the heart rate, systolic blood pressure and mean arterial pressure.ConclusionsUsing the air caloric vestibular test task as a stressor, the present study demonstrated a connection between the acute hormonal stress response to vestibular stimulation and cardiovascular output. However, further research is needed before we can define the potential importance of the consistent cardiovascular activity changes evoked by vestibular stimulation and the possible functional consequences for cardiovascular regulation and orthostatic tolerance in humans.

Autoimmune thyroid diseases (AITDs), including Graves' Disease and Hashimoto's Thyroiditis (chronic autoimmune thyroiditis), are the most common organ-specific autoimmune disorders, occurring mostly in middleaged women. AITDs are often associated with other autoimmune diseases such as vitiligo or systemic sclerosis (scleroderma), but there have been only few reports of AITDs concurring with CREST syndrome (Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasias), a limited form of scleroderma. Furthermore, these disorders have been associated with lymphoid malignancies, but only rarely with other cancers such as lung or breast. We report the case of a 59 year-old female patient who presented at the Endocrinology clinic for vertigo, dysphoria and fatigue. Clinical examination and serologic determinations revealed the diagnosis of an overlap syndrome between euthyroid autoimmune thyroiditis and CREST syndrome. Further investigations led to the detection of an incipient gastric adenocarcinoma which was promptly treated with total gastrectomy.

No abstract

Sustained stress has been correlated with increases in cortisol levels and decreased levels of brain transmitters including serotonin or dopamine. As a result of better understanding of human pathophysiology and pain physiology, the fields of surgery and anesthesia have seen major advances in the last years.However, a high percentage of patients develop depressive symptoms following major surgery and pathogenic perspective is very complex and require an holistic approach.

No abstract