[Emotional stress as a clinical model to study the pathogenesis of the initial phase of the general adaptation syndrome].

INTRODUCTION: General adaptation syndrome (GAS), the basis of the development of which is stress phenomenon, is an essential component of the pathogenesis of many diseases and syndromes. However, the patho genesis of GAS hitherto is considered exclusively from the endocrinological viewpoint. This relates primarily to the initial phase of the GAS, a clinical model for the study of which may be psycho-emotional stress (PES), which we studied using three groups of volunteers. METHODS: The first one consists of 25 students who were waiting for unaccustomed physical activity (17 men) and play debut on the stage (8 women). The second group consists of 48 children (2-14 years) who expected for "planned" surgery. The third group of volunteers is made up of 80 students (41 women and 39 men) during the first exam. The concentration of cortisol, endotoxin (ET), the activity of antiendotoxin immunity (AEI) and the haemostatic system parameters were determined in the blood serum of volunteers in various combinations. RESULTS: We found laboratory evidence for PES at 92% of students of the first group, 58% of children of the second one and in 21% of students of the third group of volunteers (mostly women). The concentration of ET increased at 13 (52%) volunteers of the first group with a significant increase of average indicators in the whole group (from 0.84 ± 0.06 to 1.19 ± 0.04 EU/ml). At children of the second group, the average concentration of ET increased even more significantly (from 0.42 ± 0.02 to 1.63 ± 0.11 EU/ml), which was accompanied by the activation of the hemostasis system. A degree of the activation was directly dependent on the level of ET in the general circulation and on an activity of AEI. Examination stress in the third group of volunteers is accompanied by activation of plasma hemostasis (increased initial thrombosis rate and reduced the time it starts, lag-period) in 26% of female students and 15% of male students. CONCLUSION: We suggest that it is possible to use the PES as a clinical model for studying the initial phase of the GAS, examine the role of excess of intestinal ET in the general blood circulation (endotoxin aggression) in the induction of systemic inflammation, which is very likely participated in the initiation of the GAS.

[Effect of adrenocorticotropic hormone (ACTH4-10) on information network of the cardiovascular systems].

The polyparametric description of adaptation syndromes in students using a uniform set of parameters of cardiovascular system and their relationships is presented. An analog of adrenocorticotropic hormone (ACTH4-10) is shown to exert varying effects on the development of different adaptation syndromes. Adaptation syndromes characterized by moderately active physiological processes (as judged by EGG, rheovasogram, respiration rate) and lowered vascular tonus were associated with marked improvement of the health status.

Síndrome de Bournout: desgaste emocional en cirujanos dentistas / Burnout syndrome. Emotional distress in surgeon dentists

Numerosos estudios realizados en años recientes sugieren que existen profesiones sometidas a altos niveles de estrés entre éstas se menciona a los odontólogos. Se analiza cómo el ambiente en que el cirujano dentista desempeña su trabajo, puede verse influenciado por las demandas ambientales que ponen en riesgo su salud, pudiéndose presentar el síndrome de Burnout

Shaking up immunity: psychological and immunologic changes after a natural disaster.

OBJECTIVE: The 1994 Northridge earthquake created life disruption and psychological distress for employees of the nearby Sepulveda VA Medical Center. We were interested in the immunologic correlates of disruption and distress under these stressful circumstances. METHOD: Sixty-eight employees were examined beginning 11 days post-earthquake and were observed until about 4 months after the earthquake, during which time three psychological and immunologic assessments were done. Subjects experienced life disruption from the earthquake itself, damage to home and possessions, injury to self and others, and damage to and functional disruption of workplace. Questionnaires assessed degree of life disruption (personal and work-related), mood, earthquake-specific distress, and repression (alexithymia, coping style or "Type C", and "immunosuppression-prone" traits). Immune measures included lymphocyte subsets-total T (CD3+), helper T (CD4+), cytotoxic T (CD3 + CD8+), B (CD19+), and natural killer (NK; CD3 - CD16 + CD56+)-as well as lymphoid cell mitogenesis (PHA and PWM), and NK cell cytotoxicity. RESULTS: Along with a lessening degree of distress over time, a number of immunologic measures declined over the assessment period (CD3+, CD8+, CD16 + 56+ cells. T cell blastogenesis, and NK cell cytotoxicity). Furthermore, subjects reporting low distress had higher numbers of CD3+ and CD8+ cells and a higher proliferative response to PHA. Those with distress corresponding to life disruption had highest levels of CD3+ and CD8+ cells. Measures of repression did not relate directly to immunity. CONCLUSION: These results suggest that appropriateness of psychological reaction to the realistic degree of life stress was least disruptive of an aspect of immunity.

Conviviendo con el stress / Stress living

En el presente trabajo monográfico, los autores, plantean la reacción del stress, analizandolo desde varios factores; en cuanto a su origen y su acción positiva o negativa para el hombre. Tratan de divulgar en forma secilla y breve los procesos fisiopatológicos, fisiológicos y sociales que contribullen a desencadenar en nuestros soma y psique los múltiples estímulos strógenos

Stressful conditions of work: the participative ergonomics approach.

The nature of working stress requires a multi-disciplinary approach for its study. Ergonomics, by its nature multidisciplinary, takes a perspective in which the individual is central and the work and working environment represent the influences to be adjusted. This perspective considers human capacities to have a permissible range of values, within which work demands must be matched. Work demands are more than the physical or mental loads directly related to task performance, since the organisational structure imposes loads. These arise, inter alia, from the relative match between the organisation within the workplace and the structure of the society outside. What people expect from work, and what they get, are also important dimensions of matching the job to the person. The observed stresses, therefore, are not always directly linked to consequences, since there are interactions in what is a multi factor situation. Various aspects of stress are discussed in the paper. Physical stresses and their long and short term impacts are, in many cases, well studied and their effects are known. Work organisation factors such as shift work and repetitive tasks are other stressors, the repetitive work situation is discussed. The whole problem of mental stress is examined more fully than the earlier, perhaps more self evident, stress aspects. Mental stress syndromes are becoming more evident, and it is clear that the interventions are not always satisfactory. In investigations of these situations the involvement of the subjects is vital, the stress effects are often only demonstrated by the subjects' reports.(ABSTRACT TRUNCATED AT 250 WORDS)