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Öğe Activities of the hypothalamo-pituitary-adrenal axis and autonomic nervous system following a strong earthquake(Wiley, 2024) Yilmaz, Yucehan; Ucar, Cihat; Yildiz, SedatThis study aimed to investigate the effects of post-traumatic stress, caused by a strong earthquake, on the hypothalamo-pituitary-adrenal axis (HPA) and autonomous nervous system activity (ANS). Activities of the HPA (as salivary cortisol) and ANS (as heart-rate variability [HRV]) were measured following the 2020 Elazig (Turkiye) earthquake (6.8 Richter Scale, classified as strong). A total of 227 participants (103 men (45%) and 124 women (%55)) provided saliva samples twice, namely, 1 week and 6 weeks after the earthquake. Of these participants, HRV was measured in 51 participants by 5 min continuous electrocardiogram (ECG) recording. Frequency- and time-domain parameters of the HRV were calculated to assess the activity of ANS and low/high frequency (LF/HF) ratio was used as surrogate for sympathovagal balance. Salivary cortisol levels decreased from week 1 towards week 6 (17.40. 1.48 and 15.32. 1.37 ng/mL, respectively, p < 0.05). There were no gender differences (17.99. 2.63 and 16.90. 1.60 ng/mL, respectively for females and males, p > 0.05) for salivary cortisol levels. There were no differences in time- and frequency domain parameters of the HRV including LF/HF ratio (2.95 +/- 0.38 ms(2) and 3.60 +/- 0.70 ms(2), respectively for week 1 and 6, p > 0.05). The data show that HPA axis activity, but not that of the ANS, remains higher 1 week after the earthquake but decreases afterwards towards the sixth week, suggesting that the HPA axis might be responsible for the long-term effects of a traumatic event like a strong earthquake.Öğe Analysis of long-term antibody response in COVID-19 patients by symptoms grade, gender, age, BMI, and medication(Wiley, 2022) Ozgocer, Tuba; Dagli, Seyda N.; Ceylan, Mehmet R.; Disli, Faruk; Ucar, Cihat; Yildiz, SedatThe first aim of the study was to analyze the change in antibody titer at 15-day intervals until 60 days postsymptom onset (PSO). The second aim was to analyze the relationship between antibody titer and symptom grade, gender, age, body mass index (BMI), medications, vitamin supplements, and herbal therapies. Blood samples were collected from 43 patients (5 mild, 21 moderate, 17 severe diseases), 18 women (41.9%), and 25 men (58.1%), on 15, 30, 45, and 60 days PSO after COVID-19 infection. The serum antibody titers were determined by measuring the COVID-19 immunoglobulin G (IgG) antibodies by enzyme-linked immunoassay (ELISA). Associations between the duration of symptoms, demographic and clinical parameters, medications and vitamins used, and herbal therapies were evaluated by interviewing the participants. Within the first 15 days of illness, 81.4% of the patients were positive. From Day 45 PSO, seropositivity was 89.5%. The anti-SARS-CoV-2 antibody titers were statistically higher in men than women at all times (p < 0.01). Antibody titer was higher in older participants compared to younger participants (p < 0.02). Plaquenil or favipiravir use did not affect antibody response (p > 0.05). Men had a higher fever (p = 0.006), shortness of breath (p = 0.004), and chest pain (p = 0.03) than women. We found powerful antibody response by 60 days PSO, as well as higher antibody response and severity of symptoms in the men gender. Data also showed that SARS-CoV-2 antibodies are higher in individuals with older age, whereas BMI, concomitant chronic disease, and medications had no effect on antibody titers.Öğe Analysis of the effects of hypothalamic-pituitary-adrenal axis activity in menstrual cycle on ankle proprioception, dynamic balance scores and visual-auditory reaction times in healthy young women(Jmni, 2021) Senol, Deniz; Ucar, Cihat; Toy, Seyma; Kisaoglu, Aysegul; Ozbag, Davut; Ersoy, Yuksel; Yildiz, SedatObjectives: Menstrual cycle (MC) can affect not only the female reproductive system, but also functions such as neuromuscular performance. For this reason. the aim of this study is to investigate the effect of hypothalamic-pituitary-adrenal axis (HPA) activity in MC on proprioception, balance and reaction times. Methods: For cortisol analysis, saliva samples were taken from the same women (n=43) in the four phases of MC. While State Trait Anxiety Inventory-I (STAI-I) was applied in each phase to support cortisol analysis, pain was measured with visual analogue scale (VAS). Proprioception, dynamic balance, visual and auditory reaction times (VRT-ART) measurements were made in the four phases of MC. Results: Cortisol, STAI-I and VAS scores, angular deviations in proprioception measurements, dynamic balance scores, VRT and ART measurements were found to show statistically significant difference between MC phases (p<0.05). As a result of the post hoc test conducted to find out which MC phase the statistical difference resulted from, it was found that statistically significant difference was caused by the mensturation (M) phase (p<0.05). Conclusions: It was found that neuromuscular performance and postural control was negatively affected by HPA axis activity in M phase of MC and by pain, which is a significant menstrual symptom.Öğe Anxiety and Salivary Cortisol Levels in Children Undergoing Esophago-Gastro-Duodenoscopy Under Sedation(Lippincott Williams & Wilkins, 2019) Kara, Duygu; Bayrak, Nevzat Aykut; Volkan, Burcu; Ucar, Cihat; Cevizci, Mehmet Nuri; Yildiz, SedatObjectives: Esophagogastroduodenoscopy (EGD) can cause fear and anxiety in children. Cortisol, which is the most important glucocorticoid hormone in humans, can increase under physiological stress. The purpose of this study was to measure the salivary cortisol level (SCL) and anxiety level in patients undergoing EGD and evaluate their effects on the procedure. Methods: Children undergoing EGD under sedoanalgesia with propofol for various reasons were included. Their basal SCLs were compared with those of healthy age- and sex-matched controls. Moreover, SCL of the patient group at 30 minutes before EGD and 2 hours after the procedure were measured. Their anxiety scores were calculated using the modified Yale Preoperative Anxiety Scale before EGD. Duration of endoscopy, sedation, and recovery and total propofol doses were recorded. Results: Demographic properties of the patient group (n = 119; 10.9 +/- 3.2 years; 43.7% boys) and control group (n = 85; 11.8 +/- 2.8 years; 45.1% boys) were not significantly different. Basal SCLs of both groups were similar (16.9 +/- 0.7 vs 19.7 +/- 1.8 ng/mL, P = 0.16). SCL before EGD in the patient group was significantly higher than basal and post-EGD values (P < 0.001 for each). Pre-EGD SCL was positively correlated with anxiety level, propofol dose, and duration of sedation, procedure, and recovery. Anxiety levels of patients were positively correlated with propofol dose and duration of sedation and recovery, and negatively correlated with age. Conclusions: Childhood EGD is a significant stress factor, which was reflected by the pre-procedural SCL in this study. Increased anxiety resulted in increased propofol doses and sedoanalgesia-related procedural durations, which may cause potential complications.Öğe Cesarean delivery is associated with suppressed activities of the stress axes(Taylor & Francis Ltd, 2022) Ucar, Cihat; Bulbul, Mehmet; Yildiz, SedatMaternal pre- and post-delivery stress levels might be different for vaginal or cesarean deliveries. This study aimed to investigate the effects of type of delivery (vaginal or cesarean) and time of delivery (pre- and post-delivery) on the stress axes of the body, namely the hypothalamic-pituitary adrenal axis (HPA) and autonomic nervous system (ANS). Ninety-one pregnant women were volunteered to participate this prospective study. In these women, pre- and post-delivery HPA and ANS activities were measured noninvasively by salivary cortisol and heart rate variability (HRV), respectively. HRV was measured by 5-min electrocardiogram recording and time- and frequency-domain parameters were computed. Salivary cortisol concentration and HRV parameters were higher in women having vaginal delivery than those having cesarean delivery (p < 0.05). Cortisol levels did not differ between pre- and post-delivery (p > 0.05) but the time-domain parameters of HRV decreased post-delivery (p < 0.05). No interactions were observed between the types and times of delivery (p > 0.05). HPA and ANS axes had different activity patterns throughout the delivery process and they were higher during vaginal delivery, suggesting that they are integral parts of normal birth process and that cesarean delivery perturbs the activity of both axes.Öğe Comparison of Cortisol Awakening Response, Estradiol and Progesterone Levels Between Normally Cycling and Premenopausal Women(Wiley, 2017) Ozgocer, Tuba; Ucar, Cihat; Yildiz, Sedat[Abstract Not Available]Öğe Cortisol Awakening Response and Heart Rate Variability in the Menstrual Cycle of Sportswomen(Routledge Journals, Taylor & Francis Ltd, 2021) Kayacan, Yildirim; Makaraci, Yucel; Ozgocer, Tuba; Ucar, Cihat; Yildiz, SedatPurpose: This study aimed to examine the activities of heart rate variability (HRV) and cortisol secretion as markers of the autonomous nervous system (ANS) and the hypothalamic-pituitary-adrenal axis (HPA) during the menstrual cycle in female athletes.Method: Saliva samples of the participants (n = 28) were collected successively at 0, 15, 30, and 60 min after awakening to assess cortisol awakening response (CAR) during each of four phases of the menstrual cycle (the menstruation, ovulation, luteal, and premenstrual phases). Diurnal saliva samples were collected at noon, in the evening (17:00) and 22:00 for cortisol analysis. HRV was measured in the menstrual and premenstrual phases at rest (12:00-14:00).Results: There was no difference betweenCARparameters in the menstrual phases.CARparameters and diurnal cortisol levels were significantly correlated with each other throughout the menstrual cycle. Mean cortisol was a strong predictor of the area under the curve (AUC: S = 0.042; R-Sq = 98.4%). Time-dependent parameters of HRV (standard deviation of the N-N interval [SDNN;P= .049] and the root mean square of the successive R-R differences [rMSSD;P= .038]) were significantly higher in the menstrual phase. There were no correlations betweenCARand HRV parameters.Conclusions: We suggest that the hypothalamic-pituitary-adrenal axis activity and the autonomic nervous system work in a separate manner that is not affected by the menstrual phases in sportswomen. The present study contributed to a better understanding of the relationship between the dynamics of cortisol release and the autonomic nervous system in different phases of the menstrual cycle in female athletes.Öğe Cortisol awakening response is blunted and pain perception is increased during menses in cyclic women(Pergamon-Elsevier Science Ltd, 2017) Ozgocer, Tuba; Ucar, Cihat; Yildiz, SedatBackground and aims: The incidence of menstrual symptoms is reported to be as high as 90% in cyclic women. These symptoms, including anxiety and pain, might be associated with cortisol, as its receptors are widely distributed in the brain areas associated with behavior. Therefore, the current study aimed to assess the cortisol awakening response (CAR) throughout the menstrual cycle and correlate it with pain perception and trait anxiety. Materials and methods: CAR was assessed by measuring salivary cortisol at 0, 15, 30, and 60 min following awakening in the same women (n = 59, age 22.2 +/- 0.37 years) at various stages of the menstrual cycle (menses, midcycle, luteal and premenstrual phases). Progesterone and estradiol concentrations were also determined in saliva samples to assess cyclic changes. Self-reported pain, trait anxiety, and menstrual symptoms were assessed by visual analog scale (VAS), state-trait anxiety inventory (STAI-T), and the Daily Record of Severity of Problems (DRSP), respectively. Results: Estradiol was significantly elevated during the midcycle period and remained high during the early luteal phase (p < 0.05). Progesterone was increased during the luteal phase (p < 0.05). Post awakening cortisol values increased during midcycle, luteal phase, and premenstrual phase (p < 0.05, classical CAR), but not during the menses (p > 0.05, blunted or flat CAR). Positive and significant correlations were found between cortisol and estradiol (R-2 = 0.322; p = 0.000), cortisol and progesterone (R-2 = 0.156; p = 0.000), and estradiol and progesterone (R-2 = 0.349; p = 0.001). Premenstrual symptom scores were higher in the menses and premenstrual phases than in the midcycle and luteal phases (p < 0.001). Pain perception was the highest during the menses followed by the premenstrual phase (p < 0.01). Conclusions: CAR was blunted during the menses, suggesting that cortisol might play a phase-specific role in the regulation of the cycle. Additionally, premenstrual symptoms, including pain, were more severe when ovarian steroid levels reduced (i.e., menses and the premenstrual phase). (C) 2016 Elsevier Ltd. All rights reserved.Öğe Cortisol awakening response is lower during menstrual stage in cyclic women with premenstrual syndrome(Wiley-Blackwell, 2016) Ozgocer, Tuba; Ucar, Cihat; Yildiz, Sedat[Abstract Not Available]Öğe Cortisol Awakening Response, Ovarian Steroids and Premenstrual Symptoms in Healthy Premenopausal Women(Wiley-Blackwell, 2016) Ozgocer, Tuba; Ucar, Cihat; Yildiz, Sedat; Barutcu, Ozlem[Abstract Not Available]Öğe Cytokines and Biochemical Parameters in rats Challenged Neonatally with Lipopolysaccharide and Fed Long-term with Fat-based diet(Wiley, 2017) Ucar, Cihat; Ozgocer, Tuba; Yildiz, Sedat[Abstract Not Available]Öğe Daily cortisol awakening response and menstrual symptoms in young females(Wiley, 2022) Ozgocer, Tuba; Ucar, Cihat; Yildiz, SedatMenstrual symptoms include some rhythmical changes and stress perception but women differ in duration and severity of these symptoms. It is not known whether these differences are associated with cortisol awakening response (CAR). The aim of the current study was to follow young women daily for the CAR and menstrual parameters throughout the whole menstrual cycle. Healthy and regularly cycling young women (n = 16, 17 to 31-year-old) participated in the current study. The daily records of severity of problems (DRSP) was filled in daily by the participants. CAR was also assessed daily form the salivary samples collected at a 0-, 15-, 30- and 60-min post-awakening. In terms of daily awakening cortisol profiles, women had either 2-20 (n = 3), or 20-200 (n = 8) or 200-2000 (n = 5) ng/ml cortisol according to the median levels throughout their cycle. CAR was weakly and negatively correlated with DRSP scores but strongly and positively with oestradiol (R-2 = 0.300; p = 0.000) and progesterone (R-2 = 0.490; p = 0.000) concentrations. Individuals with higher oestradiol and progesterone concentrations did not have high DRSP scores. In conclusion, CAR had a very high between-subject difference but had a low within-subject difference throughout the days of menstrual cycle, suggesting that CAR is a relatively stable personal trait. Moreover, the interplay between cortisol, progesterone and oestradiol appears to be important for the severity of menstrual symptoms.Öğe Decreased Sleep Duration Reduces Hypothalamo-pituitary-adrenal Axis Activity Without Affecting Autonomic Nervous System(Wiley-Blackwell, 2016) Ucar, Cihat; Ozgocer, Tuba; Yildiz, Sedat[Abstract Not Available]Öğe Diurnal cortisol pattern rather than cortisol awakening response is higher during menstruation in cyclic women(Wiley-Blackwell, 2016) Ozgocer, Tuba; Ucar, Cihat; Yildiz, Sedat[Abstract Not Available]Öğe Does Psychodrama Affect Perceived Stress, Anxiety-Depression Scores and Saliva Cortisol in Patients with Depression?(Korean Neuropsychiatric Assoc, 2018) Erbay, Lale Gonenir; Reyhani, Ismail; Unal, Suheyla; Ozcan, Cemal; Ozgocer, Tuba; Ucar, Cihat; Yildiz, SedatObjective Little is known about the effects of psychodrama group therapy on the level of stress, anxiety and depression of the group members, and the biological markers of stress. The aim of this study test cortisol level as a biological reflection of some mental characteristics gained by the psychodrama method in coping with stress. Methods Depressive patients aged between 18 and 65 years, who diagnosed with depression according to DSM-5, without psychiatric comorbidity, who do not use drugs and were available for psychodrama were enrolled into the study. These patients were evaluated using the Perceived Stress Scale, State-Trait Anxiety Inventory and Beck Depression Inventory. In order to observe the circadian rhythm of cortisol, samples were collected from the participants before lunch, before dinner and before going to sleep on the day before psychodrama and on the 0, 15th, and 30th minutes after awakening in the morning of the psychodrama day; as well as just before and after the psychodrama session. Saliva cortisol level just before the initial session of psychodrama group therapy was compared with the saliva cortisol level just after the last psychodrama session at the end of 16 weeks. Results Statistically significant difference was determined between the scores of perceived stress scale, STAI-1, STAI-2, beck depression inventory and salivary cortisol level before and after psychodrama session. There was significant decrease in both the scale scores and salivary cortisol after vs. before psychodrama. Conclusion This results is important as it shows the biological aspect of clinical improvement. Further studies would provide us with better understanding of the effects of psychodrama group psychotherapy on depressive mood and biological projections by means of short-term and long-term follow-up studies.Öğe Does psychodrama affect perceived stress, anxiety-depression scores and saliva cortisol in patientswith depression?(Korean neuropsychıatrıc assoc, rn 522, g-fıve central plaza 1685-8 seocho 4-dong, seocho-gu, seoul, 137-882, south korea, 2018) Erbay, Lale Gonenir; Reyhani, Ismail; Unal, Suheyla; Ozcan, Cemal; Ozgocer, Tuba; Ucar, Cihat; Yildiz, SedatObjective Little is known about the effects of psychodrama group therapy on the level of stress, anxiety and depression of the group members, and the biological markers of stress. The aim of this study test cortisol level as a biological reflection of some mental characteristics gained by the psychodrama method in coping with stress. Methods Depressive patients aged between 18 and 65 years, who diagnosed with depression according to DSM-5, without psychiatric comorbidity, who do not use drugs and were available for psychodrama were enrolled into the study. These patients were evaluated using the Perceived Stress Scale, State-Trait Anxiety Inventory and Beck Depression Inventory. In order to observe the circadian rhythm of cortisol, samples were collected from the participants before lunch, before dinner and before going to sleep on the day before psychodrama and on the 0, 15th, and 30th minutes after awakening in the morning of the psychodrama day; as well as just before and after the psychodrama session. Saliva cortisol level just before the initial session of psychodrama group therapy was compared with the saliva cortisol level just after the last psychodrama session at the end of 16 weeks. Results Statistically significant difference was determined between the scores of perceived stress scale, STAI-1, STAI-2, beck depression inventory and salivary cortisol level before and after psychodrama session. There was significant decrease in both the scale scores and salivary cortisol after vs. before psychodrama. Conclusion This results is important as it shows the biological aspect of clinical improvement. Further studies would provide us with better understanding of the effects of psychodrama group psychotherapy on depressive mood and biological projections by means of short-term and long-term follow-up studies.Öğe The Effect of Daily Activities on the Activity of Stress Axes in Preschool Children(Wiley, 2023) Cevizci, Hediye; Barutcu, Ozlem; Cevizci, Nuri; Ozgocer, Tuba; Ucar, Cihat; Yildiz, Sedat; Gul, Mustafa[Abstract Not Available]Öğe Effect of increase in cortisol level due to stress in healthy young individuals on dynamic and staticbalance scores(Kare publ, concord ıstanbul, dumlupınar mah, cıhan sk no 15, b blok 162 kadıkoy, ıstanbul, 00000, turkey, 2018) Cay, Mahmut; Ucar, Cihat; Senol, Deniz; Cevirgen, Furkan; Ozbag, Davut; Altay, Zuhal; Yildiz, SedatOBJECTIVE: Stress is a condition caused by various factors and characterized by imbalance in body functioning, impair in nervous system, and tension. The purpose of this study was to examine the effects of cortisol level, which increases in healthy young individuals due to stress, on dynamic and static balance scores as well as to present the results caused by high levels of stress. METHODS: In this study, 107 healthy medicine faculty students in their second year (who will take the same committee exam) aged between 19 and 23 years were included. The first balance measurements and saliva samples were taken 40 days before the committee exam, and this period was acknowledged as the relaxed period. The same students were considered for balance measurements again on the day of committee exam; saliva samples were collected, and cortisol concentration was determined. This period was acknowledged as the stressful period. The State-Trait Anxiety Inventory (STAI) was given to the participants in their relaxed and stressful periods. Dynamic balance scores were measured with Star Excursion Balance Test (SEBT). Static balance scores were measured with One Leg Standing Balance Test (OLSBT). RESULTS: The mean cortisol level was found to increase approximately 9 times in stressful periods compared with that in relaxed periods. STAI, which shows state anxiety, showed an increase supporting this increase. In stressful periods, dynamic balance scores showed obvious decrease in all directions. In addition, in stressful periods, an obvious decrease was observed in static balance scores compared with those in relaxed periods. CONCLUSION: This study showed that stress negatively affected dynamic and static balance, even for short periods of time. We believe that our study will form a positive source and basis when correlated with long terms stress and balance measurements.Öğe The effect of stress-induced cortisol increase on the sense of ankle proprioception(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Senol, Deniz; Ucar, Cihat; Cay, Mahmut; Ozbag, Davut; Canbolat, Mustafa; Yildiz, SedatObjectives: The aim of this study is to analyze the effect of stress-induced cortisol increase on the sense of ankle proprioception. Patients and methods: Between April 2016 and May 2016, a total of 60 students (30 males, 30 females; mean age: 19.2 +/- 1.5 years; range, 19 to 20 years) from Inonu University, Faculty of Medicine, Department of Freshmen were included in the study. Separate measurements were made for the right and left ankle to make ankle proprioception measurements a month before the committee exam during their relaxed period using a device designed with digital inclinometer. The sense of ankle proprioception was measured at 10 degrees dorsiflexion (DF), 11 degrees plantar flexion (PF), and 25 degrees PF angles with open eyes and closed eyes using active reproduction test. Salivary samples were taken for stress assessment and State Trait Anxiety Inventory-I (STAI-I) was conducted. The same tests were repeated on the day of committee exam. Results: Test results showed no statistically significant difference between the right and left ankle proprioception measurements of 10 degrees DF, 11 degrees PF, and 25 degrees PF angles with open eyes (p>0.05). However, a statistically significant difference was found between the right and left ankle proprioception scores at the same angles with closed eyes (p<0.05). According to the Wilcoxon analysis conducted for the comparison of the relaxed and stressed periods of cortisol and STAI-I inventory, a statistically significant difference was found (p<0.05). The Spearman's Rho analysis showed no significant correlation between the right and left ankle proprioception scores and cortisol and STAI-I with open eyes, while there was a statistically significantly positive direction and low correlation between the same angles with closed eyes. Conclusion: Our study results show that the increase in the stress-related cortisol is negative for the ankle proprioception sense.Öğe Effects of Fasting in the Month of Ramadan on Circadian Cortisol Levels(Wiley-Blackwell, 2015) Ozgocer, Tuba; Ucar, Cihat; Yildirim, Hilal; Cakan, Pinar; Yildiz, Sedat[Abstract Not Available]
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