Hypothalamo-pituitary-adrenal (HPA)-axis activation is a response of the organism to psychological and physical stress, resulting in elevated levels of glucocorticoids, mainly @entity701 in @entity1 . In our previous studies we found post-mortem blood and cerebrospinal fluid (CSF) @entity701 levels to be up to 20-fold higher than in vivo levels. Since clinical observations point to similar strong elevations of @entity701 in fatally ill @entity1 , we suggested that the high post-mortem @entity701 levels might be due to the stress during the process of dying. We hypothesized that if the @entity701 rise during dying is due to the psychological stress of the impending @entity204 , then the rise in @entity701 should be inversely proportional to the degree of @entity303 , and that high-dose @entity1286 giving analgesia, sedation, and sleep would suppress this response. Therefore, we measured the @entity701 levels by radioimmunoassay (RIA) in the post-mortem CSF of 85 @entity195 @entity1 and 52 controls. In addition, post-mortem serum @entity701 of 17 subjects from the @entity195 group and nine from the control group were measured. The @entity195 @entity1 were subdivided according to their degree of @entity303 , as scored on the Reisberg Scale, before their @entity204 . All groups were further analyzed for the effect of @entity1286 treatment, as well as for the effects of the confounding factors like age, gender, time, and season of @entity204 . @entity195 @entity1 had significantly higher @entity701 levels than controls, both in CSF (mean (nmol/l)+/-SEM: 482+/-32 vs 285+/-30, respectively, p<0.001) and in serum (2854+/-279 vs 1533+/-395, p=0.011). Mean CSF @entity701 level of the severely demented @entity195 group was even significantly higher than that of mildly demented group (508+/-35 vs 225+/-65, p=0.024) and controls (p<0.001). @entity701 levels correlated positively with the degree of @entity303 in the @entity195 group (r=0.236, p=0.035). High-dose @entity1286 did not cause a suppression of @entity701 rise, neither in controls nor in @entity195 @entity1 . Our results indicate that the extreme elevations of @entity701 levels during dying are rather due to the organic stress of the organism than to psychological stress of the @entity1 , and is not suppressed by high-dose @entity1286 .

Stress of dying is not suppressed by high-dose XXXX or by @entity303 .

@entity1 :: ('9606', 'Species') :: ['humans', 'patients', 'patient'] @entity303 :: ('MESH:D003704', 'Disease') :: ['dementia'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['Cortisol', 'cortisol'] @entity1286 :: ('MESH:D009020', 'Chemical') :: ['morphine'] @entity195 :: ('MESH:D000544', 'Disease') :: ['Alzheimer'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity1286 :: (MESH:D009020,Chemical) :: ['morphine']
