Thesis (M.D.)--University of Hong Kong, 1990. / Also available in print.

Numerous studies have suggested rapid weight gain following diagnosis and initial treatment of childhood craniopharyngioma (CP) due to the damage sustained by the hypothalamus. Hypothalamic lesions formed by the treatment of the tumor and/or by invasiveness of the tumor itself are known to cause intractable weight gain, known as hypothalamic obesity. In contrast, hypothalamic obesity manifested in pediatric low-grade glioma (PLGG) patients is not as prominently addressed in literature; likely due to the expansive set of histological tumor subtypes that makes generalization challenging. Specifically, there is a lack of analysis that examines the difference in treatment, endocrinopathies, and weight gain between CP and PLGG patients. The purpose of this study was to compare hypothalamic damage in subjects diagnosed with pediatric hypothalamic low-grade glioma versus subjects diagnosed with childhood craniopharyngioma. We hypothesized that CP patients will have a more rapid post diagnosis weight gain and a greater degree of obesity compared with PLGG patients due to the more invasive nature of the tumor and the aggressive surgical treatments involved. We performed a retrospective review of the clinical records of patients who received a diagnosis of childhood craniopharyngioma or pediatric low-grade glioma at Dana-Farber Cancer Institute between 1980 and 2009. We identified 45 patients, who met criteria for evaluation, 28 were previously diagnosed with childhood craniopharyngioma and 17 were diagnosed with hypothalamic pediatric low-grade glioma. We analyzed the impact of treatment, the presence of endocrinopathies, and weight gain after diagnosis. We concluded that there was no statistically significant difference in the rate or magnitude of post diagnosis weight gain, disproving our initial hypotheses.

No description available.

Introdução: A exposição frequente dos profissionais de enfermagem a estressores relacionados ao trabalho tem sido amplamente descrita na literatura. Entretanto, a magnitude e intensidade do estresse dependem não somente dos estressores, mas também da interação destes com a avaliação cognitiva da situação estressora, com os recursos de enfrentamento e com a reação psiconeuroendócrina do estresse. Embora diversos estudos tenham descrito as reações psicológicas do estresse e seu enfrentamento nos profissionais de enfermagem, pouco se sabe sobre as características da reação neuroendócrina. Isto é particularmente importante, dado que padrões atípicos de secreção diurna de cortisol, principal hormônio do estresse, estão associados ao aumento da susceptibilidade ao desenvolvimento de doenças cardiovasculares, imunológicas e transtornos mentais. Assim, questiona-se a frequência de padrões atípicos de cortisol e sua relação com manifestações psicológicas nestes profissionais. Objetivo: Analisar o padrão diurno de secreção de cortisol dos profissionais de enfermagem de unidades hospitalares. Método: Foram incluídos 56 profissionais de enfermagem randomicamente selecionados, alocados nas unidades ambulatório, clínica médica, clínica cirúrgica, centro cirúrgico, pronto socorro infantil e adulto, unidade de terapia intensiva adulto e pediátrica de um hospital universitário. Para avaliação do padrão diurno de secreção de cortisol foram coletadas amostras de saliva em dois dias úteis consecutivos de trabalho e, para as manifestações psicológicas, foram aplicados os instrumentos escala de estresse percebido (EEP), questionário de sofrimento mental (SRQ-20), inventário de depressão de Beck (IDB) e escala de estresse no trabalho (EET). Os dados foram armazenados e analisados utilizando o programa estatístico SPSS versão 14.0 e o nível de significância adotado foi de 5%. Resultados: Quanto ao padrão de secreção de cortisol, 42,5% dos profissionais de enfermagem apresentaram padrão atípico de secreção de cortisol, sendo que 19,5% eram técnicos de enfermagem. Quanto às variáveis psicológicas, 54,5% perceberam-se com alto nível de estresse (EEP), 51,2% referiram que o estresse estava relacionado ao trabalho (EET), 15,5% apresentaram distmia e depressão (IDB) e 56,8% apresentam sinais de sofrimento mental (SRQ-20). Não houve associação entre padrão de secreção de cortisol e as variáveis psicológicas. Conclusão: Mais de um terço da amostra de profissionais de enfermagem apresentou padrões atípicos de secreção de cortisol, além de relatarem elevados níveis de estresse, estresse relacionado ao trabalho e sofrimento mental. Estes dados sugerem que estes profissionais podem estar expostos a uma sobrecarga não apenas mental, mas biológica, estando expostos ao risco para o adoecimento. / Background: Frequent exposure of nurses to work-related stressors has been widely described in the literature. However, the magnitude and intensity of the stress depends not only on stressors, but also their interaction with the cognitive appraisal of stressful situation, the resources and coping with the psychoneuroendocrine stress response. Although several studies have described the psychological reactions of stress and coping with it in nursing, little is known about the characteristics of the neuroendocrine response of stress. This is particularly important since atypical patterns of diurnal cortisol secretion are associated with increased susceptibility to the development of cardiovascular, immunological diseases and mental disorders. Thus, we arised the question about the frequency of atypical patterns of cortisol and its relationship with psychological manifestations in nursing professionals. Objective: To analyze the diurnal pattern of cortisol secretion of nursing professionals at a hospital setting. Methods: Fifty six (n = 56) nursing professionals were randomly selected allocated to the outpatient clinic, medical clinic, surgical clinic, surgical center, pediatric unit, adult and pediatric emergency department and intensive care unit of a university hospital. To evaluate the diurnal pattern of cortisol secretion, saliva samples were collected on two consecutive working days. For the psychological manifestations of stress the following instruments were applied: the Perceived Stress Scale (PSS), the Self-report Questionnaire (SRQ-20), the Beck Depression Inventory (BDI) and the work-related stress scale (WSS). Data were stored and analyzed using SPSS version 14.0 and the level of significance was 5%. Results: Regarding the pattern of cortisol secretion 42.5% of nurses had atypical pattern of cortisol secretion and 19.2% were from nursing technical professional category. Regarding psychological variables, 54.5% perceived themselves at high stress level, 51.2% reported that stress were work-related 15.5% had depression and dysthymia and 56.8% showed signs of mental distress. There was no association between pattern of cortisol secretion and the psycological variables. Conclusion: More than one third of the sample exhibited atypical pattern of cortisol secretion as well as high levels of stress, work-related stress and mental distress. These data suggest that these workers may be exposed not just to psychological overload, but also to biological burden and could be exposed to a risk for the illness.

Thesis (M.A.)--State University of New York at Binghamton, Psychology Department, 2006. / Includes bibliographical references.

Although the use of atypical antipsychotic drugs is successful in the treatment of schizophrenia, they cause complications in the long term use that is mainly weight gain. In this study, circulating levels of hypothalamic neuropeptides/hormones, which are related to appetite regulation / neuropeptide Y (NPY), alpha melanocyte stimulating hormone (&alpha / -MSH), cocaine and amphethamine regulated transcript (CART) and plus leptin in male schizophrenic patients who were treated with an atypical antipsychotic drug, risperidone, which is a serotonin antagonist, for 4 weeks was investigated. Based on the hypothesis that the risperidone treatment might alter the circulating levels of those neuropeptides through the serotonergic antagonism, it results in the weight gain. Leptin plasma levels were increased in the risperidone treated patients accompanying by weight gain vs controls and NPY, &alpha / -MSH, CART levels were decreased in the patients before the treatment but they were not changed after treatment. To determine alterations of those candidate genes mRNA expression levels, male Wistar rats were orally administered with risperidone for 4-weeks. Rat studies show that the mRNA expression and plasma levels of POMC, AgRP, and NPY were decreased but CART mRNA levels were increased while their plasma levels were decreased unexpectedly. In conclusion, the serotonergic antagonism of risperidone on POMC neurons may cause increase in appetite / and hence, increased weight gain and leptin levels, even in a short term trial.

Thesis (Ph. D.)--University of Massachusetts Amherst, 2009. / Open access. Includes bibliographical references (p. 89-87). Print copy also available.

No description available.

Hypothalamic AMP-activated protein kinase (AMPK) regulates energy homeostasis in response to nutritional and hormonal signals. However, its role in glucose production regulation remains to be elucidated. Here, we tested the hypothesis that bidirectional changes in hypothalamic AMPK activity alter glucose production in rodents. First, we found that knocking down hypothalamic AMPK activity in an in vivo rat model led to a significant suppression of glucose production independent of changes in food intake and body weight. Second, we showed that activation of hypothalamic AMPK negated the ability of hypothalamic glucose- and lactate- sensing to lower glucose production. Collectively, these data indicate that changes in hypothalamic AMPK activity are sufficient and necessary for hypothalamic nutrient-sensing mechanisms to alter glucose production in vivo, and highlight the novel role of hypothalamic AMPK in the maintenance of glucose homeostasis in addition to energy balance.

Hypothalamic AMP-activated protein kinase (AMPK) regulates energy homeostasis in response to nutritional and hormonal signals. However, its role in glucose production regulation remains to be elucidated. Here, we tested the hypothesis that bidirectional changes in hypothalamic AMPK activity alter glucose production in rodents. First, we found that knocking down hypothalamic AMPK activity in an in vivo rat model led to a significant suppression of glucose production independent of changes in food intake and body weight. Second, we showed that activation of hypothalamic AMPK negated the ability of hypothalamic glucose- and lactate- sensing to lower glucose production. Collectively, these data indicate that changes in hypothalamic AMPK activity are sufficient and necessary for hypothalamic nutrient-sensing mechanisms to alter glucose production in vivo, and highlight the novel role of hypothalamic AMPK in the maintenance of glucose homeostasis in addition to energy balance.