Psychological responses to stress and exercise on students’ lives
Romain Meeusen, Sabine Schaefer, Phillip Tomporowski, Richard Bailey in Physical Activity and Educational Achievement, 2017
The small pituitary gland is situated above the hypothalamus and releases hormones to activate or inhibit the release of other hormones. The paraventricular nucleus in hypothalamus parvocellular neurons releases corticotrophin-releasing hormone that stimulates the release of adrenocorticotrophic hormone (ACTH) by the pituitary gland (Goncharova, 2013). This hormone is released into the blood and reaches the adrenal glands, adrenal medulla and adrenal cortex, situated near the kidney (Goncharova, 2013). The adrenal medulla produces adrenaline (epinephrine) and noradrenaline (norepinephrine) which play a pivotal role in preparing the body for a stress situation. These hormones signal increased metabolism (i.e. glycogenolysis and beta oxidation), cardiovascular activity, increasing heart rate and blood pressure and immune cell activity. On the other hand, the adrenal cortex releases glucocorticoid, mainly cortisol in humans, that has anabolic functions (i.e. gluconeogenesis) (Khani & Tayek, 2001), and mostly catabolic functions (i.e. beta oxidation) (Brillon, Zheng, Campbell, & Matthews, 1995). Furthermore, cortisol seems to inhibit proinflammatory immune cell activation and HPA axis activation.
Complications of Hypovolemic and Septic Shock
Stephen M. Cohn, Matthew O. Dolich in Complications in Surgery and Trauma, 2014
Sheehan syndrome was described in 1937 as a disruption of the hypothalamic–pituitary axis secondary to peripartum hemorrhagic shock. Findings include hypothyroidism, adrenocortical insufficiency, failure of lactation, and cessation of menses, resulting from ischemic necrosis of the pituitary gland. In some cases, computed tomography or magnetic resonance imaging actually demonstrate an empty sella turcica. The lesser-known Simmonds syndrome is pituitary dysfunction in either gender following traumatic hemorrhage. A great deal of interest has centered on adrenocortical insufficiency from either hypovolemic or septic shock. The most obvious clinical manifestation of adrenocortical insufficiency is refractory hypotension, perpetrating a vicious cycle. Adrenocortical insufficiency has been variously defined as a baseline serum cortisol concentration <10–25 μm/dL or an increase of <9 μm/dL within 1 h following administration of 250 μm of cosyntropin. In some cohorts, more than half of the patients with sepsis or hemorrhagic shock have at least occult adrenocortical insufficiency on the basis of laboratory values.21 Severe hyperacute adrenal insufficiency is present at the time of admission in 16% of trauma patients with evidence of ongoing hemorrhage.22 Most recently, studies suggest the existence of relative adrenal insufficiency, defined by shock that improves following administration of steroid replacement therapy, regardless of serum laboratory values.
Endocrine system
Aida Lai in Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Nelson’s syndrome Occurs after bilateral adrenalectomyCharacteristic pituitary adenoma and high ACTH levelsSigns: – pigmentationManagement: – surgical resection of pituitary gland– radiotherapy
Sheehan’s syndrome and sickle cell disease: the story of Natasha*
Published in Neuropsychological Rehabilitation, 2018
Barbara A. Wilson, Anita Rose, Gerhard Florschutz
Sheehan’s syndrome (SS) is one of the pituitary disorders. The pituitary gland at the base of the brain secretes eight hormones. There is a decrease in the secretion of one or more of these in people with SS. The syndrome is usually caused by a severe loss of blood during or after childbirth leading to decreased functioning of the pituitary gland. The syndrome was named after the British pathologist, Harold Leeming Sheehan, who, in 1937, described a specific association with postpartum shock or haemorrhage and necrosis of the pituitary gland. Although rare in countries with good obstetric care, SS is still frequent in those countries with poor healthcare services. Diri et al. (2014) say that it is a common cause of hypopituitarism in underdeveloped or developing countries. Kelestimur et al. (2005) in a study of 91 patients found that there were 12 cases in the UK and three in the USA. In comparison with patients whose pituitary dysfunction was due to a benign tumour, those with SS tended to be younger and have a poorer quality of life. For a recent discussion about the prevalence of SS see Diri, Karaca, Tanriverdi, Unluhizarci, and Kelestimur (2016). They say that the prevalence of SS is difficult to estimate because there are so many undiagnosed patients. Sheehan, himself, in 1965 estimated the worldwide prevalence was 100–200 per 100,000 women. Although this may have since decreased because of better obstetric care, the frequency of home birth is still high in some regions of the world making SS a frequent problem in under-resourced countries.
Complete and Uneventful Recovery in a Case of Lymphocytic Hypophysitis Causing a Third Nerve Palsy
Published in Neuro-Ophthalmology, 2023
Jamie M. Nord, Paras P. Shah, Rashmi Verma
Lymphocytic hypophysitis (LH) was first described in 1962.1 It is a neuroendocrine disorder characterised by autoimmune inflammation of the pituitary gland with pituitary dysfunction. The disease is more common in women and typically manifests during pregnancy or the postpartum period. In fact, 60% of women are diagnosed in relation to pregnancy, likely due to altered pituitary perfusion with increased accessibility to the immune system.2 Additionally, 70–80% of patients with LH have another autoimmune disease, with the most common being autoimmune thyroid disease.3 Patients typically present with symptoms due to mass effect, adenohypophyseal hypofunction, hyperprolactinaemia, and possible neurohypophysis involvement.4 Although presumptive diagnoses can sometimes be made based on history and imaging, a definitive diagnosis requires biopsy.5
Clinical relevance of insulin-like growth factor-1 to cardiovascular risk markers
Published in The Aging Male, 2020
Ko Harada, Yoshihisa Hanayama, Mikako Obika, Koichi Itoshima, Ken Okada, Fumio Otsuka
After being categorized into three groups, 64 patients (15.0%) had functional pituitary diseases including prolactinomas and Cushing’s disease, 98 patients (23.0%) had nonfunctional pituitary diseases including pituitary adenomas, Rathke’s cleft cysts, and panhypopituitarism, and 265 patients (62.1%) did not have pituitary diseases, and were categorized as “non-pituitary cases”. The average IGF-1 levels in pituitary disease, nonfunctional pituitary disease, and non-pituitary cases were 168.8 ± 122.4, 94.8 ± 51.5 and 113.0 ± 49.0, respectively (Figure 3(A)). The group with functional pituitary diseases had significantly higher IGF-1 levels than those in other groups (p < .01). Laboratory data, including the levels of IGF-1, Hb, Hct, CRP, PCT, D-dimer and FDP, of all the cases and each group are shown in Supplemental Table 1. Among the non-pituitary cases requiring IGF-1 estimation, symptoms related to acromegaly including hypertension (18%), diabetes (8%), and sleep apnea (6%), and symptoms associated with adult growth hormone deficiency such as fatigue (30%) and depression (7%) were common; anorexia nervosa (4%) was also observed; comparison of IGF-1 levels between these groups demonstrated significantly lower IGF-1 levels in patients with anorexia nervosa than in those with any other symptoms (p < .05) (Figure 3(B)).
Related Knowledge Centers
- Blood Pressure
- Chickpea
- Metabolism
- Thyroid
- Brain
- Hypothalamus
- Endocrine Gland
- Hormone
- Development of The Human Body
- Sex Organ