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OBJECTIVE The objective of this study was to assess the role of midazolam in reducing surgical stress as measured using subjective and objective variables. STUDY DESIGN The study was a double-blind randomized controlled trial. Thirty-eight male patients undergoing surgical removal of third molars under general anesthesia were recruited for this study,(More)
BACKGROUND The aim of the present study was to obtain a naturalistic measure of diurnal hypothalamic-pituitary-adrenal (HPA) axis output in CFS patients unaffected by medication or comorbid psychiatric disorder likely to influence the axis. METHOD Cortisol and cortisone levels were measured in saliva samples collected from 0600 h to 2100 h at 3-h(More)
OBJECTIVE Enhancement of negative feedback control of the HPA axis in patients with chronic fatigue syndrome (CFS) has been reported using the low dose dexamethasone suppression test. We have developed the use of prednisolone (5mg) as a more physiologically appropriate alternative to dexamethasone in the investigation of mild degrees of glucocorticoid(More)
OBJECTIVES Disturbances of neuroendocrine function, particularly the hypothalamo-pituitary-adrenal (HPA) axis, have been implicated in the pathophysiology of chronic fatigue syndrome (CFS). However, few studies have attempted to measure blood levels of pituitary or adrenal hormones across a whole 24-hour period in CFS, and those that did so have used(More)
BACKGROUND Samples submitted for urinary steroid profile analysis are often untimed, but influence of collection time on interpretation is unknown. We report circadian rhythms of the major steroid metabolites and derived ratios in urine collected at 3-h intervals over 24 h, after first establishing that disturbance of sleep associated with collection does(More)
OBJECTIVE The aim of this study was to obtain comprehensive information on basal hypothalamic-pituitary-adrenal (HPA) axis activity in chronic fatigue syndrome (CFS) patients who were not affected by medication or comorbid psychiatric disorder likely to influence the HPA axis. METHOD Steroid analysis of urine collections from 0600 to 2100 h at 3-h(More)
BACKGROUND Prednisolone is better than dexamethasone to probe subtle changes in HPA axis sensitivity but cortisol assay as an endpoint risks cross-reaction with prednisolone. We compared capillary gas chromatography, which distinguishes urinary cortisol and prednisolone metabolites, and salivary cortisol immunoassay. METHODS Twenty adult volunteers (10 m)(More)
OBJECTIVES Reduced basal hypothalamic-pituitary-adrenal (HPA) axis output in chronic fatigue syndrome (CFS) has been inferred from low cortisol levels in blood, saliva, and urine in some studies. Because > 95% of cortisol is metabolized before excretion, we assessed cortisol output by assay of both cortisol metabolites and free cortisol in 24-hour urine(More)
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