Patologías frecuentes que presentan los trabajadores de la fábrica de cemento COBOCE Irpa Irpa con relación a las condiciones de trabajo, primer trimestre del año 2011 / Frequent pathologies workers have cement Irpa Irpa Coboce regarding working conditions, first quarter of 2011

La salud de los trabajadores es un derecho universal, como también lo es para el desarrollo económico. Tanto a nivel global como regional, las enfermedades laborales han ido en aumento, el riesgo de contraerlas es el peligro más frecuente que enfrentan los trabajadores en su fuente de trabajo.Un problema muy importante es la ausencia de datos reales y exactos sobre las enfermedades laborales relacionadas al trabajo. Es necesario que las empresas velen por la salud de los trabajadores, brindándoles condiciones adecuadas de trabajo. El presente trabajo busca identificar las enfermedades más frecuentes de los trabajadores de la fábrica de cemento COBOCE Irpa Irpa, la muestra fue representada por 120 trabajadores, a los cuales se les aplicó una entrevista. Los resultados del estudio reflejan que las patologías más frecuentes son: estrés, miopía y astigmatismo, lumbago, depresión, resfríos frecuentes y en porcentajes menores, hipoacusia y dermatitis entre otras, éstas están precedidas por sintomatología como ser: irritación de los ojos, disminución de la agudeza visual y auditiva, dolor de espalda, dificultad para respirar, tos e irritación en la piel

Causas y manifestaciones clínicas de estres más frecuentes en las/os estudiantes de la Facultad de Enfermería Elizabeth Seton, II semestre 2010 / Causes and clinical manifestations of stress more frequently in the / os students of Elizabeth Seton School of Nursing, II semester 2010

El estrés es hoy en día, una problemática a la que se está prestando una atención creciente. Sin embargo, el estrés académico no recibe la suficiente atención en el ámbito de la investigación. Por ello, en este trabajo se pretende estudiar las causas y manifestaciones clínicas más frecuentes del estrés en estudiantes de la universidad.El presente estudio se realizó desde un enfoque cuantitativo, descriptivo, transversal, prospectivo, utilizando como método la encuesta, aplicando un cuestionario a las estudiantes de los diferentes semestres de la Facultad de Enfermería, en el que se contemplan las variables: causas, grados de estrés y sus manifestaciones. Los resultados muestran que un 82% de las/os estudiantes presentan algún grado de estrés, siendo el estrés leve con mayor frecuencia (40%), estrés moderado (27%), estrés grave (15%) y sólo un (18%) no presenta sintomatología de estrés. Las causas más comunes y relevantes en todos los semestres fueron frustraciones de orden personal y/o familiar, además de las “excesivas” obligaciones académicas. Las manifestaciones clínicas de estrés más frecuentes son las conductuales, cognitivas y físicas que repercuten en su rendimiento académico, generándose así un círculo de causa académicas: estrés  manifestaciones clínicas menor rendimiento  mayor estrés.

[Fast track surgery]. / Chirurgie fast track.

Fast track (FT) surgery is a multimodal concept aiming to reduce postoperative pain and stress-induced organ dysfunction. Key elements are perioperative fluid restriction, epidural analgesia, early oral nutrition and early mobilization. Therefore, multidisciplinary teamwork is required in order to obtain the optimal outcome of reduced postoperative complications and a hospital stay of only three or four days after open colectomy. Most of the patients undergoing colorectal surgery qualify for FT surgery. Meanwhile, FT principles are applied in a variety of open and laparoscopic procedures. The aim of this review is to highlight the principles of FT and to answer the question why FT surgery should nowadays be considered as standard care.

Malocclusion induces chronic stress.

We examined the effect of occlusal disharmony in senescence-accelerated (SAMP8) mice on plasma corticosterone levels, spatial learning in the water maze, fos induction, hippocampal neuron number, expression of glucocorticoid receptors (GR) and glucocorticoid receptor messenger ribonucleic acid (GRmRNA) in hippocampus and inhibitor of glucocorticoid (metyrapone). Bite-raised aged mice had significantly greater plasma corticosterone levels than age-matched control mice as well as impaired spatial memory and decreased Fos induction and a number of neurons in hippocampus. GR and GRmRNA expressions were significantly decreased in aged bite-raised mice compared with age-matched control mice. Pretreatment with metyrapone inhibited not only the bite-raised induced increase in plasma corticosterone levels, but also the reduction in the number of hippocampal neurons and impaired spatial learning. These datas suggest that the bite-raised condition may enhance the aging process in hippocampus, thereby leading to impairment of spatial memory by stress.

Appearance matters: artificial marking alters aggression and stress.

Artificial marking of animals for identification is frequently employed by researchers in the behavioral, biomedical, agricultural, and environmental sciences. The impact of artificial marking on experimental results is rarely explicitly considered despite evidence demonstrating that changes in phenotypic appearance can modify animal behavior and reproductive success. Here we present evidence that artificial marking of individuals within a social group has frequency-dependent effects on the behavior and physiology of domestic fowl (Gallus gallus domesticus). We demonstrate that when only 20 or 50% of individuals within a group were artificially marked, the marked birds received more aggression and had lesser body mass than the unmarked individuals within the same group. Furthermore, in groups in which only a small proportion of the individuals were marked, we report altered plasma epinephrine and dopamine levels in marked individuals. These effects of marking were imperceptible when all birds in a group were marked. This finding has important implications for animal research because, when only a subset of group members is artificially marked and used for data collection, the results obtained may not be representative of the population.

[Peri-operative stress response and peri-operative analgesia in children].

Peri-operative surgical stress (SS) is characterized by increased secretion of pituitary hormones and sympathetic activation and is correlated with changed blood levels of stress hormones and metabolites. Adverse effects of perioperative stress include mortality and morbidity and a negative nitrogen balance. Although peri-operative analgesia and stress response-free period are commonly considered as synonyms, pain seems not to be the only factor determining the hormonal-metabolic response to surgery. Other factors playing a role in the creation of SS in newborns include blood loss, site of surgery, superficial and visceral trauma, surgery duration, hypothermia, infection, prematurity and factors related to cardiac surgery. Potent semi-synthetic opioids attenuate the SS better than morphine. However, supplementation of general anesthesia (GA) with local anesthetics either by way of regional or local anesthesia seems to decrease SS more effectively than GA with IV opioids. Hemodynamic monitoring may not suffice for SS or analgesia quality estimation. The most accessible laboratory measure for the monitoring of the stress response for non-cardiac surgery and pre-bypass phase of cardiac surgery may be blood glucose. Blood glucose increases with stress and when analgesia is inadequate; it is easily measured and treated almost immediately once an excessive response is identified. This individualized approach and real-time feedback may be far better than using either excessive opioid doses (hoping to ablate stress response) or minimal opioid dosages.

Epidemiology and treatment of painful procedures in neonates in intensive care units.

CONTEXT: Effective strategies to improve pain management in neonates require a clear understanding of the epidemiology and management of procedural pain. OBJECTIVE: To report epidemiological data on neonatal pain collected from a geographically defined region, based on direct bedside observation of neonates. DESIGN, SETTING, AND PATIENTS: Between September 2005 and January 2006, data on all painful and stressful procedures and corresponding analgesic therapy from the first 14 days of admission were prospectively collected within a 6-week period from 430 neonates admitted to tertiary care centers in the Paris region of France (11.3 millions inhabitants) for the Epidemiology of Procedural Pain in Neonates (EPIPPAIN) study. MAIN OUTCOME MEASURE: Number of procedures considered painful or stressful by health personnel and corresponding analgesic therapy. RESULTS: The mean (SD) gestational age and intensive care unit stay were 33.0 (4.6) weeks and 8.4 (4.6) calendar days, respectively. Neonates experienced 60,969 first-attempt procedures, with 42,413 (69.6%) painful and 18,556 (30.4%) stressful procedures; 11,546 supplemental attempts were performed during procedures including 10,366 (89.8%) for painful and 1180 (10.2%) for stressful procedures. Each neonate experienced a median of 115 (range, 4-613) procedures during the study period and 16 (range, 0-62) procedures per day of hospitalization. Of these, each neonate experienced a median of 75 (range, 3-364) painful procedures during the study period and 10 (range, 0-51) painful procedures per day of hospitalization. Of the 42,413 painful procedures, 2.1% were performed with pharmacological-only therapy; 18.2% with nonpharmacological-only interventions, 20.8% with pharmacological, nonpharmacological, or both types of therapy; and 79.2% without specific analgesia, and 34.2% were performed while the neonate was receiving concurrent analgesic or anesthetic infusions for other reasons. Prematurity, category of procedure, parental presence, surgery, daytime, and day of procedure after the first day of admission were associated with greater use of specific preprocedural analgesia, whereas mechanical ventilation, noninvasive ventilation and administration of nonspecific concurrent analgesia were associated with lower use of specific preprocedural analgesia. CONCLUSION: During neonatal intensive care in the Paris region, large numbers of painful and stressful procedures were performed, the majority of which were not accompanied by analgesia.

Combat stress or hemorrhage? Evidence for a decision-assist algorithm for remote triage.

INTRODUCTION: In the setting of remote military triage, when physical access to the patient is not possible, traditional physiological measurements available to a combat medic may not differentiate between a wounded soldier and an active soldier. We tested the hypothesis that changes in high-frequency R-R interval spectral power (RRI HF) and pulse pressure (PP) would differ between progressive central hypovolemia (simulated hemorrhage) and exercise to evaluate their potential for remotely distinguishing active from bleeding soldiers. The RRI HF and PP were used because of their ability to track central hypovolemia. METHODS: There were 12 (8 female/4 male) healthy, normotensive, nonsmoking subjects (age 27 +/- 2 yr; height 169 +/- 3 cm; weight 68 +/- 5 kg) who were exposed to progressive lower body negative pressure (LBNP) and a supine cycle ergometer protocol. ECG and blood pressure were measured continuously. Exercise workloads were determined by matching the heart rate (HR) responses to each LBNP level. Data were analyzed in time and frequency domains. RESULTS: HR increased from 67 +/- 3 bpm at rest to 101 +/- 4 bpm by -60 mmHg LBNP and was matched within 5% during exercise. By the final stage, RRI HF decreased by a similar magnitude during both LBNP (-78 +/- 7%) and exercise (-85 +/- 6%). PP decreased by 30 +/- 4% with LBNP compared with an increase of 20 +/- 6% during exercise. CONCLUSION: Monitoring PP in combination with RRI HF would distinguish a bleeding from an active soldier. Technologies that incorporate telemetry to track these derived vital signs would provide a combat medic with remote decision support to assess soldier status on the battlefield.

Effect of bad collocation of wing tag on feather amelanosis, heterophil-to-lymphocyte ratio, fluctuating asymmetry, and tonic immobility duration in white-faced black spanish hens.

The purpose of the present study was to analyze the effects of bad collocation of the wing tag on feather amelanosis, the heterophil-to-lymphocyte ratio, fluctuating asymmetry, and tonic immobility duration at 140 d of age in hens from the White-Faced Black Spanish breed. A total of 52 females were used. There was a significant difference (P < 0.05) for the heterophil-to-lymphocyte ratio and the tonic immobility duration between groups of females with bad or good collocation of the wing tag, with the ratio being higher and the duration being longer in the former group. Females with bad collocation of the wing tag had significant heterophilia and lymphopenia (P < 0.05). There was a significant difference (P < 0.05) in the fluctuating asymmetry of the middle and hind toe lengths, the combined asymmetry of the 4 toes, the fluctuating asymmetry of the earlobe area, and the combined asymmetry of toe and leg lengths and earlobe and wattle areas, with the asymmetry of birds with bad collocation of the wing tag being larger than that of birds with good collocation of the wing tag. Results indicate that bad collocation of the wing tag negatively affects measures of stress, such as the heterophil-to-lymphocyte ratio, fluctuating asymmetry, and tonic immobility duration.

Mind-body medicine and cancer.

Mind-body medicine, grounded in a respectful, therapeutic partnership, should be a central element in the care of every person diagnosed with cancer. This article reviews some of the physiologic foundations of mind-body medicine, the introduction of mind-body approaches to cancer care in the 1970s, the specific mind-body approaches that have been used, and the evidence that supports their use. The importance of group support for enhancing the effectiveness of these approaches is discussed. Guidelines are offered for integrating mind-body approaches and perspectives in the care of people who have cancer.

[Sedation an acute respiratory distress syndrome]. / Sédation du patient présentant un syndrome de détresse respiratoire aiguë.

AIM: To assess the role of sedation and myorelaxant agents in acute respiratory distress syndrome (ARDS) and to propose an updated management according to recent literature. EXTRACTION OF DATA: From Medline and Cochrane database of English and French language articles. Keywords were: acute respiratory distress syndrome, acute lung injury, general anaesthetics, inhalation, intravenous anaesthetics and intensive care. Selection of original articles, reviews and expert reports. Case reports have been included. TOPIC: ARDS is a clinical picture in which respiratory constraints are major because of hypoxemia. To insure correct haematosis, mechanical ventilation has to be considered. It constitutes, then, the most frequent indication of sedation in the intensive care unit. The objectives are to help the ventilation of lungs and to improve gas exchange, by controlling agitation, fight against ventilation and to reduce mechanical ventilation associated injuries. In this situation, use of myorelaxant agents is aimed at facilitating synchronization of the patient with his/her ventilator and serves to improve oxygenation during the early inflammatory phase of ARDS. Several mechanisms may enflame this improvement of oxygenation. One of the most probable effect on optimization is the possibility of optimize protective ventilation at the cares phase of ARDS and to reduce mechanical ventilation-associated injuries. CONCLUSION: With regard to benefits and inconvenient, sedation is considered as a treatment of ARDS. Its goals are the well being of patient and his/her adaptation to ventilator, but also the prevention on mechanical ventilation associated injuries. Hence, most authors suggest using a deep sedation at the early phase of ARDS. In this contact, use of myorelaxant agent is an intersecting adjuvant if sedation is not enough. The benefit is terms of survival and outcome remains to show.

Urinary catecholamine responses in F-15 pilots: evaluation of the stress induced by long-distance flights.

Included in the Cooperative Cope Thunder exercises from Japan to Alaska is one of the longest distance flight missions carried out by Japan Air-Self Defense Force F-15 pilots. The magnitude of the flight stress of these pilots is considered to be quite high. The purpose of this study was to evaluate the flight stress induced by the long-distance flights. The subjects were eight pilots who participated on a volunteer basis. Samples of urine were collected approximately 30 minutes before (preflight) and 20 minutes after (postflight) the flights. The ratios (post-:preflight) of noradrenaline levels were 1.20 +/- 0.09 (Japan-Alaska) and 1.32 +/- 0.12 (Alaska-Japan), and those of adrenaline were 4.03 +/- 1.06 and 3.68 +/- 0.98. These results strongly suggest that psychological stress during the long-distance flights is increased in the fighter pilots.

Diabetes mellitus as a risk factor for cancer: stress or viral etiology?

Diabetes mellitus (DM) is a metabolic disorder. Currently over 230 million patients demonstrate already an epidemic scale of the disease. It is a lifelong progressive disease with a high mortality worldwide: every 10 seconds one patient dies on DM-related consequences. Whereas cardio-vascular complications are well-known for DM, it is relatively new consideration that diabetic patients are highly predisposed to cancer. Particularities of molecular pathomechanisms of cancer in diabetes are currently largely unclear. Disturbed glucose/insulin homeostasis is DM-specific stress factor resulting in increased production of Reactive Oxygen Species (ROS) and oxidative damage to chromosomal and mitochondrial DNA frequently observed in diabetic patients. Long-term accumulation of DNA mutations is well-acknowledged as triggering cancer. DNA-repair is highly energy consuming process which provokes increased mitochondrial activity. Particularly dangerous is a provoked activity of damaged mitochondria which leads to the "vicious circle" lowing energy supply and potentiating ROS production. Mitochondrial dysfunction is the well-acknowledged risk factor for neuro/degenerative diseases--one of possible pathomechanisms for various complications developed secondary to diabetes. At the same time, mitochondrial dysfunction might be implicated in pathomechanisms of diabetes-provoked cancer. There is a growing body of evidence that DM predisposes to almost all cancer types with some particular preferences. Frequently suffering from compromised immune response, diabetic patients is high-risk group for infectious disorders including viral infections. In its turn, viral infections are known to be implicated in cancer pathology. This review considers both stress and viral infections as possible etiology of cancer in diabetes.

Stress induces a switch of intracellular signaling in sensory neurons in a model of generalized pain.

Stress dramatically exacerbates pain in diseases such as fibromyalgia and rheumatoid arthritis, but the underlying mechanisms are unknown. We tested the hypothesis that stress causes generalized hyperalgesia by enhancing pronociceptive effects of immune mediators. Rats exposed to nonhabituating sound stress exhibited no change in mechanical nociceptive threshold, but showed a marked increase in hyperalgesia evoked by local injections of prostaglandin E(2) or epinephrine. This enhancement, which developed more than a week after exposure to stress, required concerted action of glucocorticoids and catecholamines at receptors located in the periphery on sensory afferents. The altered response to pronociceptive mediators involved a switch in coupling of their receptors from predominantly stimulatory to inhibitory G-proteins (G(s) to G(i)), and for prostaglandin E(2), emergence of novel dependence on protein kinase C epsilon. Thus, an important mechanism in generalized pain syndromes may be stress-induced coactivation of the hypothalamo-pituitary-adrenal and sympathoadrenal axes, causing a long-lasting alteration in intracellular signaling pathways, enabling normally innocuous levels of immune mediators to produce chronic hyperalgesia.

Differential effects comparing exercise and pharmacologic stress on left ventricular function using gated Tc-99m sestamibi SPECT.

OBJECTIVE: Although post-ischemic stunning has emerged as an important marker for severe coronary artery disease (CAD), differences in stress methods may have different effects on left ventricular (LV) volumes and function. METHODS: To assess differential effects comparing exercise and pharmacologic stress on the LV measurements, (99m)Tc-sestamibi gated single-photon emission computed tomography (SPECT) acquired more than 30 min after stress and at rest was evaluated in 38 patients undergoing adenosine triphosphate (ATP) stress (ATP group) and 38 age-and sex-matched patients subjected to exercise stress (Ex group) among 268 patients with normal SPECT findings. RESULTS: Coronary risk factors and LV volumetric measurements at baseline were similar in the two groups. Compared with volumetric measurements at rest, end-diastolic volume (EDV) increased (72 +/- 21 ml to 74 +/- 21 ml; P = 0.01), end-systolic volume increased (25 +/- 12 ml to 28 +/- 13 ml; P = 0.001), and ejection fraction (EF) decreased after stress (66% +/- 8% to 63% +/- 9%; P < 0.002) in the ATP group. In the Ex group, by contrast, no such change was observed. In addition, changes in EDV (3 +/- 6 vs. -1 +/- 5 ml; P = 0.01) and the stress-to-rest ratio of EDV (1.04 +/- 0.09 vs. 0.99 +/- 0.08; P < 0.02) after stress were greater in the ATP than in the Ex group. CONCLUSIONS: Differential effects of stress methods on LV volumes persist more than 30 min after the stress. These findings should be kept in mind when interpreting post-ischemic stunning.

Stress and burnout in anaesthesia.

PURPOSE OF REVIEW: Recently, many researchers have been studying stress and burnout in anaesthesia. Some researchers have examined the effects of stress in the workplace. Others have identified some job characteristics that have an impact on anaesthetist's well-being. Yet, few studies use the same measure of stress and/or define the concept of stress in the same way, making comparison and aggregation of results difficult, and therefore minimizing the general impact of these research findings. RECENT FINDINGS: The following review focuses on the increasing recent research on stress and burnout in anaesthesia regarding the existing stress models and shows where the progress has been made, and where difference of opinion and divergence of approach remain. SUMMARY: From the referred studies, the review challenges the more practical problems of prevention of stress and burnout and provides some avenues for future investigations.