Validating a Non-Invasive Method for Assessing Cortisol Concentrations in Scraped Epidermal Skin from Common Bottlenose Dolphins and Belugas.

Society is showing a growing concern about the welfare of cetaceans in captivity as well as cetaceans in the wild threatened by anthropogenic disturbances. The study of the physiological stress response is increasingly being used to address cetacean conservation and welfare issues. Within it, a newly described technique of extracting cortisol from epidermal desquamation may serve as a non-invasive, more integrated measure of a cetacean's stress response and welfare. However, confounding factors are common when measuring glucocorticoid hormones. In this study, we validated a steroid hormone extraction protocol and the use of a commercial enzyme immunoassay (EIA) test to measure cortisol concentrations in common bottlenose dolphin (Tursiops truncatus) and beluga (Delphinapterus leucas) epidermal samples. Moreover, we examined the effect of sample mass and body location on cortisol concentrations. Validation tests (i.e., assay specificity, accuracy, precision, and sensitivity) suggested that the method was suitable for the quantification of cortisol concentrations. Cortisol was extracted from small samples (0.01 g), but the amount of cortisol detected and the variability between duplicate extractions increased as the sample mass decreased. In common bottlenose dolphins, epidermal skin cortisol concentrations did not vary significantly across body locations while there was a significant effect of the individual. Overall, we present a contribution towards advancing and standardizing epidermis hormone assessments in cetaceans.

Blubber and serum cortisol concentrations as indicators of the stress response and overall health status in striped dolphins.

The impacts of environmental changes and anthropogenic threats in marine mammals are a growing concern for their conservation. In recent years, efforts have been directed to understand how marine mammals cope with stressors and to assess and validate stress biomarkers, mainly levels of glucocorticoid hormones (e.g. cortisol) in certain body tissues. The aims of this study were to assess the impact of different causes of stranding (chronically affected and bycaught striped dolphins) on cortisol concentrations in serum and in blubber; and to evaluate the association between cortisol levels in these tissues. Blubber and blood samples were collected from striped dolphins (n = 42) stranded on the Mediterranean coast between 2012 and 2018. Cortisol concentrations were measured by using enzyme immunoassay. A high correlation was found between circulating and blubber cortisol concentrations (R2 = 0.85, p < 0.01). Necropsies and pathological studies concluded that a third of the dolphins were bycaught in fishing nets and released by fishermen (Bycaught animals group), while the other two thirds were euthanized, or died, due to a disease or chronic condition (e.g. calves separated from the mother or animals infected with dolphin morbillivirus or Brucella ceti) that impeded survival (Chronically affected animals group). Cortisol concentrations (mean ± SD) were six times higher in chronically affected animals (35.3 ± 23 ng cortisol/g blubber and 6.63 ± 3.22 µg cortisol/dl serum) compared to those bycaught in fishing nets (6.2 ± 4.3 ng cortisol/g blubber and 1.15 ± 1.51 µg cortisol/dl serum). Results suggests that serum and blubber cortisol concentrations can contribute in inferring the overall health and welfare of free-ranging cetaceans. However, further research is required to understand better the kinetics of blubber cortisol incorporation and removal, the factors involved in these processes, and the local conversion of cortisol in the blubber.

Randomized controlled trial of an intervention to improve drug appropriateness in community-dwelling polymedicated elderly people.

BACKGROUND: Polypharmacy is frequent in the elderly population and is associated with potentially drug inappropriateness and drug-related problems. OBJECTIVES: To assess the effectiveness and safety of a medication evaluation programme for community-dwelling polymedicated elderly people. DESIGN: Randomized, open-label, multicentre, parallel-arm clinical trial with 1-year follow-up. SETTING: Primary care centres. PARTICIPANTS: Polymedicated (≥8 drugs) elderly people (≥70 years). STUDY INTERVENTION: Pharmacist review of all medication according to the Good Palliative-Geriatric Practice algorithm and the Screening Tool of Older Person's Prescriptions-Screening Tool to Alert Doctors to the Right Treatment criteria and recommendations to the patient's physician. CONTROL INTERVENTION: Routine clinical practice. MEASUREMENTS: Recommendations and changes implemented, number of prescribed drugs, restarted drugs, primary care and emergency department consultations, hospitalizations and death. RESULTS: About 503 (252 intervention and 251 control) patients were recruited and 2709 drugs were evaluated. About 26.5% of prescriptions were rated as potentially inappropriate and 21.5% were changed (9.1% discontinuation, 6.9% dose adjustment, 3.2% substitution and 2.2% new prescription). About 2.62 recommendations per patient were made and at least one recommendation was made for 95.6% of patients. The mean number of prescriptions per patient was significantly lower in the intervention group at 3- and 6-month follow-up. Discontinuations, dose adjustments and substitutions were significantly higher than in the control group at 3, 6 and 12 months. No differences were observed in the number of emergency visits, hospitalizations and deaths. CONCLUSION: The study intervention was safe, reduced potentially inappropriate medication, but did not reduce emergency visits and hospitalizations in polymedicated elderly people.