Current issues in understanding sexual victimization
Rachel E. Lovell, Jennifer Langhinrichsen-Rohling in Sexual Assault Kits and Reforming the Response to Rape, 2023
Neurobiology is complex. The brain is full of structures with different functions that impact heart rate, respiration, memory, thinking, and behavior during an assault. Their interactions are multifaceted, involved, unconscious, and reflexive. What is simple is to understand that a traumatic event or threat floods the brain with numerous chemicals that affect how a victim perceives, decides, and remembers. These hormones or chemicals include adrenaline, cortisol, oxytocin, and others. This flood of chemicals significantly impacts how the brain processes information, affecting structures of the brain, including the hippocampus, amygdala, and prefrontal cortex. The structures of the brain compete with one another and get disorganized, inhibiting the proper functioning in terms of memory formation and consolidation and thinking and reasoning (Campbell, 2012; LeDoux & Pine, 2016; Schwabe, 2017).
The patient with acute endocrine problems
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
The hormones have a wide influence on body processes, such as reproduction, maintenance of fluid and electrolyte balance, cellular growth and metabolism (Dixon and Salamanson 2006). The hormonal regulation helps to initiate adaptive responses to emergency demands and therefore assist to maintain an optimum internal environment. The endocrine glands respond to specific signals, and hormone production by each endocrine gland is finely balanced. The regulation of hormone release is controlled by negative and positive feedback. Both feedback systems help to maintain balance between physiological production and bodily demand (Lawal 2008). The negative feedback control loops are inhibitory (oppose the change) while positive feedbacks are stimulatory (potentiate the change). Most homeostatic feedback systems are negative feedback, e.g., blood glucose control, and an example of a positive feedback mechanism is uterine contraction during childbirth. Endocrine disorder is characterised by either underproduction or overproduction, and common endocrine imbalance are discussed below.
Basic medicine: physiology
Roy Palmer, Diana Wetherill in Medicine for Lawyers, 2020
There are two main sorts of gland in the body. Exocrine glands, such as the salivary and sweat glands, secrete their juice into a duct, whereas endocrine or ductless glands secrete hormones directly into the bloodstream. Hormones are proteins that act as chemical messengers, travelling in the blood to modulate the activity of a target organ that possesses the relevant hormone receptor. Endocrine tissue is found in many different organs, but it is concentrated in certain glands of which the pituitary is the most important. The pituitary gland is located inside the skull just below the brain and contains two main lobes. The anterior lobe secretes tropic hormones that control the activity of several other glands, including the thyroid, adrenal, breast, ovary and testis; it also secretes growth hormone, which affects the growth of many organs. The posterior pituitary secretes vasopressin and oxytocin, which act on the kidney and uterus, respectively. Pituitary insufficiency therefore has widespread effects. Pituitary secretion is controlled by a feedback system: rising blood levels of hormones secreted by the target organ in response to the pituitary hormone inhibit the secretion of that tropic hormone.
Towards a trans inclusive practice: thinking difference differently
Published in Sexual and Relationship Therapy, 2023
Sarah Ellis, John Reilly-Dixon
Firstly, no one is denying the material, biological and empirical reality of reproductive sex. That is the easy part. However, a person’s sex is composed of multiple variables. Hormones (progesterone, testosterone, oestrogen) and their relevant receptors in the tissues. Chromosomal genetic material, reproductive organs, genitalia, and secondary sexual characteristics. Each of which influences the other across the bio-physiological and anatomical levels. For sex (or any system) to be binary there must be two, and only two outcomes from it. Most people who subscribe to the binary idea point to the anatomical level of penis/vulva as definitive here. And yet—those structures are effects of some or all the other variables, and since not every penis or vulva are identical then variance (as difference) exists here too. What about chromosomes, XX/XY? This again is not definitive since there are people who have variations in this area, and more over the possible variations within the chromosomal systems do not exhibit definitive linear correlation relationships with any given endocrinological or anatomical outcomes (Ainsworth, 2015, Serano, 2022). So, given all the above, is sex a binary?
Free thyroxine measurement in clinical practice: how to optimize indications, analytical procedures, and interpretation criteria while waiting for global standardization
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Federica D’Aurizio, Jürgen Kratzsch, Damien Gruson, Petra Petranović Ovčariček, Luca Giovanella
Thyroid dysfunctions are among the most common hormonal diseases. Laboratory evaluation is integral in the diagnosis and management of thyroid dysfunction, and thyroid function tests (TFT) are frequently ordered in both inpatient and outpatient settings. The thyroid-stimulating hormone (TSH) test is a reliable initial test with superior sensitivity and specificity compared with other thyroid hormone tests, in most cases [1]. Notably, serum TSH measurement is within the reference interval (RI) in most cases, especially in primary care, and further testing of thyroid hormones may not contribute to patient management [2,3]. However, measurement of free thyroxine (FT4) levels is pivotal in challenging conditions such as central hypothyroidism and hyperthyroidism, non-thyroid illness, and exogenous interferences. Moreover, FT4 assessment is needed to properly manage treated thyroid disorders. After TSH, FT4 is the most commonly ordered TFT, with approximately 18 million tests performed in 2008 in the United States compared with approximately 59 million TSH tests [1,4]. The accuracy of an FT4 test, however, is highly dependent upon the assay employed. The assays used in most clinical laboratories have some limitations and pitfalls. While the inter-assay precision of FT4 assays is generally good, the accuracy of that result may be poor. Indeed, in a survey of 13 FT4 methods, more than 50% of the results in four of the methods did not meet the allowable inaccuracy criteria [5]. To address this important issue, a working group for the international standardization of the FT4 assay was formed [6–8].
Determinants and dynamics of pancreatic islet architecture
Published in Islets, 2022
Melissa T. Adams, Barak Blum
Glucose homeostasis in vertebrates is made possible by the islets of Langerhans. These small clusters of endocrine cells reside in the pancreas, surrounded by exocrine tissue. In contrast to the exocrine tissue, which secretes digestive enzymes into the gut through the pancreatic duct system, the islets of Langerhans secrete endocrine hormones into the blood. Through four decades of research, it has become clear that islets are not just unstructured endocrine cell aggregates but rather highly organized micro-organs. They have species-specific three-dimensional architecture, which is critical to their proper function in response to nutritional stimuli. Islet architecture facilitates endocrine cell polarity and connection with the microvasculature to guarantee secretion of insulin into the capillaries, physical and electrical cell-cell coupling to assure synchronous hormone secretion, and directionality of intra-islet paracrine signaling and connection with the nervous system for feedback regulation.1–4 Islet architecture is disrupted in all types of diabetes mellitus.5,6 It is also disrupted in cadaveric islets during isolation and culture prior to islet transplantation as well as after infusion into the portal vein, limiting transplantation outcomes.7–9 Moreover, recapitulating native islet architecture remains a key challenge for in vitro generation of islets from stem cells.10