cortisol-succinate--sodium-salt and Chronic-Disease

Prolonged inactivity associated with bed rest in a clinical setting or spaceflight is frequently associated with hypercortisolemia and inadequate caloric intake. Here, we determined the effect of 28 days of bed rest (BR); bed rest plus hypercortisolemia (BRHC); and bed rest plus essential amino acid (AA) and carbohydrate (CHO) supplement (BRAA) on the size and function of single slow- and fast-twitch muscle fibers. Supplementing meals, the BRAA group consumed 16.5 g essential amino acids and 30 g sucrose at 1100, 1600, and 2100 h, and the BRHC subjects received 5 daily doses of 10-15 mg of oral hydrocortisone sodium succinate throughout bed rest. Bed rest induced atrophy and loss of force (mN) and power (muN.FL.s(-1)) in single fibers was exacerbated by hypercortisolemia where soleus peak force declined by 23% in the type I fiber from a prevalue of 0.78 +/- 0.02 to 0.60 +/- 0.02 mN post bed rest (compared to a 7% decline with bed rest alone) and 27% in the type II fiber (1.10 +/- 0.08 vs. 0.81 +/- 0.05 mN). In the BRHC group, peak power dropped by 19, 15, and 11% in the soleus type I, and vastus lateralis (VL) type I and II fibers, respectively. The AA/CHO supplement protected against the bed rest-induced loss of peak force in the type I soleus and peak power in the VL type II fibers. These results provide evidence that an AA/CHO supplement might serve as a successful countermeasure to help preserve muscle function during periods of relative inactivity.

Topics: Adult; Amino Acids, Essential; Bed Rest; Chronic Disease; Cushing Syndrome; Dietary Sucrose; Humans; Hydrocortisone; Male; Muscle Contraction; Muscle Fibers, Fast-Twitch; Muscle Fibers, Slow-Twitch; Muscle Strength; Muscle, Skeletal; Muscular Atrophy; Time Factors; Treatment Outcome

BACKGROUND. Many extremely low birth weight infants (<1000 g) show biochemical evidence of adrenal insufficiency in the first week of life, correlating with subsequent development of chronic lung disease (CLD).. We conducted a randomized, double-masked, placebo-controlled pilot study to test whether early treatment with low-dose hydrocortisone for 12 days (1 mg/kg/day for 9 days followed by.5 mg/kg/day for 3 days), begun before 48 hours of life, would increase the likelihood of survival without CLD.. Forty patients were enrolled at two centers. Birth weight and gestation were similar for treatment and placebo groups: 732 +/- 135 g versus 770 +/- 135 g and 25.2 +/- 1.3 weeks versus 25.4 +/- 1.5 weeks. More infants treated with hydrocortisone achieved study success, defined as survival without supplemental oxygen at 36 weeks' postconception (12/20 [60%] vs 7/20 [35%]). Lower birth weight, histologic chorioamnionitis, and preeclampsia were significant risk factors, whereas study center, prenatal steroids, sex, and ethnicity were not significant. Hydrocortisone treatment decreased days on >40% oxygen, days on >25% oxygen, days on ventilator, and oxygen at discharge. Among infants exposed to chorioamnionitis, hydrocortisone treatment also was associated with increased enteral intake during the first month of life and with increased weight at 36 weeks' postconception. Five treated infants and 6 placebo infants developed sepsis; 3 in each group died.. First, early treatment with low-dose hydrocortisone in this population of extremely low birth weight infants increased the likelihood of survival without CLD. Second, the benefit was particularly apparent in infants with chorioamnionitis. Third, a larger multicenter trial is needed to verify the primary outcome and to better evaluate risks and benefits.

Topics: Adrenal Insufficiency; Chronic Disease; Double-Blind Method; Female; Humans; Hydrocortisone; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Logistic Models; Lung Diseases; Male; Pilot Projects; Statistics, Nonparametric; Time Factors; Treatment Outcome

Steroid is the key drug in the asthma therapy but not well known to play the role on the airway inflammatory cells. We examined sputum cells of acute excerbated 11 chronic adult asthmatics before and 2-3 hours after intravenous steroid and aminophylline therapy. There was no changes in the percent count of living cell, epithelial cell, metachlomatic cell, macrophage and neutrophil before and after treatment. Lymphocyte was 3.3 +/- 6.5% before and 2.6 +/- 2.0% after treatment. CD4 and CD25 double positive cell (CD4+/CD25+) was 0.7 +/- 0.5 and 1.2 +/- 0.9% and CD8+/CD25+ cell was 0.4 +/- 0.4 and 0.6 +/- 0.5% before and after treatment respectively. These changes were not significant. Eosinophil percent count did not decrease significantly but EG1+/EG2+ cell decreased from 6.7 +/- 7.8 to 4.3 +/- 5.2% significantly (p < 0.05). In the light of no decrease of activated T lymphocytes (CD25+ cells), we concluded that failure of tissue eosinophil response to lymphokines might result in a decrease in activated eosinophil count.

Topics: Adult; Aged; Aminophylline; Anti-Inflammatory Agents; Asthma; Bronchi; Cell Count; Chronic Disease; Female; Humans; Hydrocortisone; Infusions, Intravenous; Male; Middle Aged; Sputum

Intravenous infusions of hydrocortisone sodium succinate (HSS) were given at 0.625 mg kg-1 hour-1 and 0.312 mg kg-1 hour-1 to six dogs. Plasma cortisol concentrations were measured by radioimmunoassay at 0, 15, 30, 45 and 60 minutes and then every 30 minutes for a further five hours. Chronic hypocortisolaemia was induced and maintained with mitotane and the HSS infusions were repeated after 31 and 50 days. No statistically significant difference was observed in the plasma cortisol concentrations after either period of hypocortisolaemia, but the plasma cortisol concentrations tended to be higher in most of the dogs.

Topics: Animals; Chronic Disease; Dog Diseases; Dogs; Female; Hydrocortisone; Infusions, Intravenous; Male