PubMed · 8043674
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M J Quinn, J A Hasbargen, B J Hasbargen. 1994. When does peritonitis occur?. https://pubmed.ncbi.nlm.nih.gov/8043674/
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Onset of acute atherothrombotic events (acute myocardial infarction, unstable angina, ischemic stroke) exhibit a circadian pattern that parallels the diurnal pattern of endogenous fibrinolytic activity. Hormone replacement therapy in postmenopausal women has been shown to enhance fibrinolytic capacity by lowering plasminogen activator inhibitor-1 (PAI-1) and tissue plasminogen activator inhibitor (tPA) antigen values. We evaluated the impact of 4 weeks of estrogen alone (Premarin 0.625 mg/day) and 2 weeks of estrogen plus progesterone (Provera 2.5 mg/day) on PAI-1 and tPA in 17 postmenopausal women at multiple time points to assess hormone impact on the diurnal pattern of fibrinolytic potential. At baseline, both PAI-1 and tPA exhibited circadian variability. Estrogen alone selectively lowered 8 A.M. PAI-1 (35.8 +/- 7.1 ng/ml at baseline, 19.8 +/- 3.7 ng/ml on estrogen; p = 0.0002 vs baseline). There was no significant change in the noon or 4 P.M. values, and the diurnal pattern was attenuated. The 8 A.M. PAI-1 remained low at 17.1 +/- 3.6 ng/ml (p = 0.0001 vs baseline) with total loss of the circadian rhythm. Estrogen supplementation reduced tPA antigen at all time points, and the diurnal pattern, although blunted, persisted. Addition of progesterone to estrogen did not reverse effects of the estrogen alone phase of either PAI-1 or tPA values. This hormone-associated reduction of PAI-1 was observed despite increased triglycerides, a known inducer of PAI-1 levels. These observations suggest that hormone replacement therapy may protect postmenopausal women from excess early morning acute ischemic events.
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Adrenocortical response to stress in neonates was assessed by estimating salivary concentrations of cortisol, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulfate (DHEA-S). Behavioral responses to stress were also scored clinically, according to the method of Lewis and Thomas [15]. The modulation of these measures by hearing maternal heartbeat was also evaluated. Levels of cortisol and DHEA in saliva in neonates correlated well with those of serum showing significant variation in painful stress. Hearing the maternal heartbeat significantly reduced the grade of variation, but the recorded sound of the Japanese drum with the same rhythm showed no significant effect. Scores of the behavioral response to stress also decreased significantly in neonates who were presented with the maternal heartbeat in comparison with those hearing no sound or the beat of a Japanese drum.