Hormonal Response to Surgical Stress in Schoolchildren

Castejón-Casado, J.; Moreno-Prieto, M.; Valladares-Mendías, J.C.; Alaminos, Miguel; López-Candel, E; Ramírez-Navarro, A.

doi:10.1055/s-2001-12195

Cited by 9 publications

(7 citation statements)

References 9 publications

(16 reference statements)

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“…The study confirms the results reached in previous research in children [8,14], where b-endorphin was found to greatly increase in the blood during the perioperative period. The increment measured for each child across the three times was highly significant and showed a similar trend.…”

supporting

confidence: 92%

“…In general, drugs such as opioids [22] or benzodiazepines [36] strongly attenuate the b-endorphin response, whereas anaesthetics reduce it to a lesser degree [10,14,36]. The primary aim of this study was to confirm the increase of IR b-endorphin in the blood of children under perioperative conditions, as found in previous articles [2,8,14]. The secondary objective was to perform a systematic search for the factors which may influence the increment of this peptide during the perioperative period.…”

Section: Introductionmentioning

confidence: 78%

“…b-endorphin increases in the cardiovascular compartment during the perioperative period. The release of plasmatic IR b-endorphin has been documented for adults in several reports [22,30,32], and a few and more recent studies have proven this in children [2,8,14]. The release of b-endorphin in the blood is due both to neural input from the surgical wound [21], and to the production of cytokines from the injured tissues [38].…”

Section: Introductionmentioning

confidence: 99%

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Increase of Plasmatic β-Endorphin Immunoreactive Material in Children in the Perioperative Period: The Influence of the Site of Surgery

Bachiocco¹,

Mastrolia²,

Gentili³

et al. 2008

Eur J Pediatr Surg

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supporting

confidence: 92%

Section: Introductionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Increase of Plasmatic β-Endorphin Immunoreactive Material in Children in the Perioperative Period: The Influence of the Site of Surgery

Bachiocco¹,

Mastrolia²,

Gentili³

et al. 2008

Eur J Pediatr Surg

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“…Cortisol is a glucocorticoid, secreted from cortex of suprarenal gland; its role in gluconeogenesis, metabolism of fat, CNS, muscle and renal function, vascular reactivity and the immune response has been studied extensively and is well known. It is also considered to be a surgical stress indicator [2]. The serum level increases in operated patients and directly correlates with the extent of surgical trauma [1].…”

Section: Introductionmentioning

confidence: 99%

Systemic stress responses in patients undergoing surgery for benign prostatic hyperplasia

Ružić¹,

Tomašković²,

Trnski³

et al. 2004

BJU International

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and group 3, prostate > 80 g, treated with a suprapubic transvesical prostatectomy (TP). Blood samples were taken from each patient on the day before and the day after surgery, and the acute-phase reactants and antioxidants measured; cortisol concentrations were also measured in 24-h urine samples the day before and 3 days after surgery. RESULTSThere were significantly higher levels of cortisol, CRP and TAS, and significantly lower levels of fibrinogen and SOD in all study groups after surgery than before. Surgery and associated conditions, e.g. excitement, fear, blood loss, etc., lead to traumatic and oxidative stress, followed by a strong systemic stress response during and after surgery. Low fibrinogen levels after surgery had a different pattern from the other acute-phase reactants, as a result of increased fibrinolytic activity after TURP and TP. CONCLUSION

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“…Indeed, in rats, ACTH returns to basal levels 24 hours after laparotomy, 18 and normalization of ACTH and cortisol values has been shown to occur within 24 hours in a prospective cohort of 78 children undergoing elective or emergency surgery. 19 Changes in ACTH have potential significance for the mechanism of action of RYBG. Recent studies indeed demonstrated abnormalities of the hypothalamic-pituitary-adrenal axis (HPA) in central obesity.…”

Section: The Role Of Adrenocorticotropic Hormonementioning

confidence: 99%

The Early Effect of the Roux-en-Y Gastric Bypass on Hormones Involved in Body Weight Regulation and Glucose Metabolism

Rubino¹,

Gautier²,

Gentileschi³

et al. 2004

Annals of Surgery

576

372

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Objective: To evaluate the early effect of Roux-en-Y (RYGB) gastric bypass on hormones involved in body weight regulation and glucose metabolism. Significant Background Data: The RYGB is an effective bariatric procedure for which the mechanism of action has not been elucidated yet. Reports of hormonal changes after RYGB suggest a possible endocrine effect of the operation; however, it is unknown whether these changes are the cause or rather the effect of surgically induced weight loss. We speculated that if the mechanism of action of the RYGB involves an endocrine effect, then hormonal changes should occur early after surgery, prior to substantial body weight changes. Methods: Ten patients with a mean preoperative body mass index (BMI) of 46.2 kg/m 2 (40 -53 kg/m 2 ) underwent laparoscopic RYGB. Six patients had type 2 diabetes treated by oral hypoglycemic agents. Preoperatively and 3 weeks following surgery, all patients were tested for fasting glucose, insulin, glucagon, insulinlike growth factor 1 (IGF-1), leptin, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1), cholecystokinin (CCK), adrenocorticotropic hormone (ACTH), corticosterone, and neuropeptide Y (NPY). Results: Changes in mean BMI were rather minimal (43.2 kg/m 2 ; P ϭ not significant), but there was a significant decrease in blood glucose (P ϭ 0.005), insulin (P ϭ 0.02), IGF-1 (P Ͻ 0.05), leptin (P ϭ 0.001), and an increase in ACTH levels (P ϭ 0.01). The other hormones were not significantly changed by surgery. All the 6 diabetic patients had normal glucose and insulin levels and did not require medications after surgery. The RYGB reduced GIP levels in diabetic patients (P Ͻ 0.01), whereas no changes in GIP levels were found in nondiabetics. Conclusions: Roux-en-Y gastric bypass determines considerable hormonal changes before significant BMI changes take place. These results support the hypothesis of an endocrine effect as the possible mechanism of action of RYGB. S urgery represents the most effective therapeutic modality for morbid obesity.1,2 Interestingly, the Roux-en-Y gastric bypass (RYGB), a procedure that includes the creation of a small proximal gastric pouch and the bypass of the duodenum and proximal jejunum from the transit of food, not only determines permanent reduction of excess body weight, but also induces resolution of type 2 diabetes mellitus in more than 80% of morbidly obese patients. 3Body weight is the result of complex physiologic mechanisms that control food intake and energy expenditure. Regulation of body weight involves several systems such as the adipose tissue, 4 the hypothalamus, 5 and the adrenal glands, 6 which are linked by neural and hormonal signals. Recent investigations have identified several key molecules that regulate food intake, including ghrelin, neuropeptide Y (NPY), 7 and melanocortins 8 and have focused on the relationship between obesity and leptin levels. The effectiveness of gastric bypass in inducing remarkable weight loss and control of diabetes represents an "experimental mod...

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Hormonal Response to Surgical Stress in Schoolchildren

Cited by 9 publications

References 9 publications

Increase of Plasmatic β-Endorphin Immunoreactive Material in Children in the Perioperative Period: The Influence of the Site of Surgery

Increase of Plasmatic β-Endorphin Immunoreactive Material in Children in the Perioperative Period: The Influence of the Site of Surgery

Systemic stress responses in patients undergoing surgery for benign prostatic hyperplasia

The Early Effect of the Roux-en-Y Gastric Bypass on Hormones Involved in Body Weight Regulation and Glucose Metabolism

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