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.

[Survey the stress resources on academic staff members in Guilan University, Guilan University of Medical Sciences and Islamic Azad University]

One of the most important issues which affected on efficiency of academic staff members and particularly on teaching and learning process is stress. Survey the stress resources on academic staff members in Guilan University, Guilan Medical Sciences University and Islamic Azad University. Since first month of 2007 to the end of the 2008, 186 academic staff members in Guilan University, Guilan University of Medical Sciences and Islamic Azad University were selected base on Kerjesy and Morgan and cluster sampling. Robbins and MacKay questionnaire were used for collecting information related to the different variables in the present research. This questionnaire consisted of two different parts which included 20 items about signals of vocational stress which was covered three months ego and 50 items which investigated vocational stress and vocational experiences in one year ego. In general, academic staff members had stress signals and resources in medium rate. But this signal in male staff is more than female. Although, in some part of the results, there was no significant difference among three mentioned universities, but there was a significant difference in other findings of individual characteristics such as gender, study and number of children with vocational stress resources in two different gender of staff members. According to the results, majority of academic staff members had stress in medium rate. There was a significant difference between male and female academic staff members, So that, male academic staffs showed more stress with respect to the type of university, study and stress resources

Estrès psicosocial como factor predisponente de patologìa aguda en una poblaciòn rural / Psychosocial stress as predisposing factors for acute conditions in a rural

Este trabajo pretende evaluar la relaciòn que existe entre estrès psicosocial y enfermedad aguda.

Tako-Tsubo syndrome in an anaesthetised patient undergoing arthroscopic knee surgery.

We present a case of stress-induced myocardial stunning, also known as Tako-Tsubo syndrome, in an anaesthetised patient undergoing arthroscopic replacement of the cruciate ligament. The patient's (44 y male, ASA class II) had a history of hypertension with no other known disease. He underwent a femoral nerve block with 20 ml of 0.5% ropivacaine before receiving a balanced general anaesthesia (propofol induction, sevoflurane maintenance, 10 microg/kg sufentanil). Ten min after the beginning of surgery during endoscopic intra-articular manipulation, the patient suffered from bradycardia and hypotension; following the administration of ephedrine and atropine, he developed tachycardia, hypertension and ST segment depression. Subsequently, his systemic blood pressure dropped necessitating inotropic drug support and--later--intraaortic balloon counterpulsation; a TEE revealed no evidence of hypovolemia, anterior and antero-septal hypokinesia with an ejection fraction of 25%. Surgery was finished whilst stabilising the patient haemodynamically. Postoperative cardiac enzymes showed little elevation, an emergency coronary angiogram apical akinesia with typical ballooning and basal hyperkinesias, compatible with Tako-Tsubo syndrome. The patient's postoperative course was uneventful. We theorize that stress caused by sudden surgical pain stimulus (introduction of the endoscope into the articulation), superficial anaesthesia and insufficient analgesia created a stressful event which probably might have caused a catecholamine surge as basis of Tako-Tsubo syndrome.

Effect of confinement stress on behaviour, performance, clinicopathological and histopathological, alterations of Nile tilapia, challenged with Aeromonas hydrophila with regard to the blue light as stress inhibitor

The present study was carried out to assess the effects of blue light as antistressor and its effect on susceptibility of Nile tilapia [Oreochromis niloticus] to Aeromonas hydrophila [A. hydrophila] infection. A total number of [120] O. niloticus was divided into 3 experimental groups [40 fish / group]. Group 1 [G1], was exposed to normal day light and considered as control group. Group 2 [G2], was exposed to blue light. Group 3 [G3], was exposed to white light [fluorescent illumination]. After 15 days of light exposure, fish in groups 2 and 3 were confined into small area and then challenged with A. hydrophila infection. The obtained data revealed that during exposure to blue light, the fish of [G2] recorded significant lower proportion in behavioural parameters including factors of fright behaviour [creeping, of oblique plan position and air-gulping] than those of [G3]. On the other hand, [G2] showed lower behaviour alterations for fright behaviour during confinement and infection than those of [G3]. Contrarily, it also had significantly higher proportions of aggressive behaviour during exposure to light, confinement and infection than [G3]. So blue light improved behaviour and fish become more comfortable in [G2] than [G3]. Moreover, fish of [G2] showed higher significant growth performance during exposure to blue light and little reduction in growth performance during exposure to both confinement and infection than those of [G3]. The clinicopathological studies revealed significant increase in the stress response indicators after exposure to confinement stress in [G3]. Marked elevation in the serum cortisol, glucose levels and significant leukocytosis associated with heterophilia and lymphopenia was observed in [G3]. On the other hand, non significant changes were observed in the measured stress parameters in group [G2] which exposed to the blue light. Exposure of stressed fish to A. hydrophila infection induced significant leukocytosis with heterophilia, monocytosis and lymphopenia in both [G2 and G3]. Analysis of serum biochemical constituents showed significant elevation in ALT, AST, BUN, creatinine and glucose while significant reduction in the total proteins, albumen and globulin was achieved. These changes were more pronounced and early detected in A. hydrophila infected stressed fish exposed to white light compared to those exposed to blue light. From pathological point of view, fish group which exposed to blue light and infection revealed early positive immune response [activation of melanomacrophage center of spleen] but with time dependent adverse pathological lesions. The lesions were noticed in spleen and gills after 2 weeks. Regeneration of the most observed lesions were detected after 4 weeks. On the other hand, the fish group exposed to white light and infection showed more advanced lesions including diffuse necrosis in hepatic tissue with additional changes in the kidneys. So, the blue light has a protective effect aganist stress in Nile tilapia

Life events as risk factors for myocardial infarction: a pilot case-control study in Kolkata, India.

This case-control study was conducted in the Cardiology Department of Medical College, Kolkata, India, during 2000-2001, to explore the link between stressful life events and subsequent myocardial infarction (MI). One hundred consecutive confirmed MI patients were selected as a case group. One hundred age-, sex- and income-matched controls were selected from visitors other than relatives who attended these patients. The subjects were interviewed and asked to rate 61 life events with a number between 0 and 20. They also noted which of these they had experienced in the last one year. The main exposure variables included life events as per E.S. Paykel, smoking, alcohol consumption, chewing of tobacco, marital status, literacy, employment, and monthly per-capita income. The results showed that an MI patient was likely to experience 4.16 stressful life events, which were twice as much as the control group (2.24). The total stress score was the highest for serious personal illness followed by illness of family members and unemployment for the MI patients. For the controls, conflict between husband and wife, death of friends, and personal illness had the highest total stress score. The mean stress score for the MI patients was 35.5 compared to 17.35 among the controls. The MI subjects were more likely to have experienced stressful life events than the controls.

relationship between different occupations and risk factors of heart diseases

Cardiovascular diseases have been known as the first cause of morbidity and mortality in Iran and many other countries. The noise of workplace and the shift work are among the risk factors of these diseases. This study was conducted to assess the relationship between different occupations and risk factors of heart diseases. This study was done on 4872 men and women, ageed over 19, in Isfahan. For each subject a questionnaire was filled in order to collect necessary information about the anthropometric characteristics and some cardiovascular risk factors and clinical tests were done in order to determine the status of participants blood factors. Men were divided according to the noise of workplace and the shift work non -shift work, and women were divided based on whether they were housekeepers or not. Results of this study showed that in men with high-noise workplace, the prevalence of hypertriglyceridemia [p=0.02] and hypertension [p=0.01] was more than others but there was not any significant difference in other risk factors. Also in subjects with shift work, the prevalence of hypertriglyceridemia [p=0.03] and obesity [p=0.001] was high whereas there was not any significant difference in other risk factors. In housekeeping women mean value of waist circumference [p=0.001], body mass index BMl [p=0.000] serum triglyceride [p=0.000], cholesterol [p=0.0001], LDL cholesterol [p=0.001], 2hpp [p=0.001], diastole blood pressure [p=0.001], systole blood pressure [p=0.01] and also the prevalence of obesity [p=0.0001], high LDL cholesterol [p=0.001], hypertriglyceridemia [p=0.001], hypercholesterolemia [p=0.0001] and hypertension [p=0.003] were significantly higher than those in employed women. Considering the result of this study, the noise of workplace causes increase in the prevalence of hypertriglyceridemia and hypertension and the prevalence of hypertriglyceridemia and obesity increased because of the shift work. It seems that two factors of noise and shift work cause these changes by inducing stress. Housekeepers had a high level of most of the CVD risk factors in comparison with employed women. It seems that two factors of noise and shift work by producing stress and reduction of physical activity in housekeepers can prone the subject to CVD

Stress hormones in the research on cardiovascular effects of noise.

In recent years, the measurement of stress hormones including adrenaline, noradrenaline and cortisol has been widely used to study the possible increase in cardiovascular risk of noise exposed subjects. Since endocrine changes manifesting in physiological disorders come first in the chain of cause-effect for perceived noise stress, noise effects in stress hormones may therefore be detected in populations after relatively short periods of noise exposure. This makes stress hormones a useful stress indicator, but regarding a risk assessment, the interpretation of endocrine noise effects is often a qualitative one rather than a quantitative one. Stress hormones can be used in noise studies to study mechanisms of physiological reactions to noise and to identify vulnerable groups. A review is given about findings in stress hormones from laboratory, occupational and environmental studies.

Etiology, pathogenesis and treatment of habitual dislocations of the T.M. Joints [original work].

Definite treatment of any pathological condition, is based on the understanding of its correct pathogenesis and etiology. Without this basic understanding correct and lasting treatment is not possible. When there is no knowledge of exact pathogenesis and etiology, various theories and treatments are suggested by various workers. This is what exactly happened in the case of habitual dislocations of the T.M. Joints. This in term has happened because the dental surgeons and so called oral surgeons, never expanded their vision, beyond their restricted field of 20 deciduous teeth and 32 permanent teeth. Lack of understanding of basic physiological functions, of various tissues in the body and their effects on various systems as a whole was neglected. For this study four patients were selected from many, who could visit my clinic regularly and co-operate to follow all the instructions over a period of at least 5 years. The analysis of their symptoms and signs, had a different story to tell than what was described in the literature so far.

Protective effect of L-carnitine on gastric mucosal barrier in rats exposed to cold-restraint stress.

AIM: The protective effect of L-carnitine on stress-induced gastric mucosal injury was investigated in rats exposed to cold-restraint stress (CRS). METHODS: The animals were divided into four groups. Groups 1 and 3 received saline by intragastric gavage for 10 days. Groups 2 and 4 received L-carnitine (50 mg/Kg/day) in the same manner. Groups 3 and 4 were exposed to CRS in the form of immobilization at 4 degrees C for 4 h on day 10. Ulcer index, gastric acid secretion and hemoglobin leakage, and gastric mucosal mucin and PGE2 content were measured. RESULTS: In rats exposed to CRS, as compared to control rats (group 1), ulcer index was higher, gastric acid production was lower, hemoglobin leakage into the gastric lumen was increased, and gastric mucosal mucin and PGE content were reduced. L-carnitine treatment prior to CRS led to attenuation of changes in ulcer index, gastric acid secretion, amount of hemoglobin leakage into the gastric lumen and gastric PGE2 content. In rats receiving L-carnitine but not exposed to CRS, gastric acid secretion, mucin and PGE2 content of gastric mucosa were similar to those in control rats. CONCLUSION: L-carnitine decreases CRS-induced gastric mucosal injury.

Estrés ocupacional / Psychological stress

En el presente artículo se mencionan algunos de los elementos que actúan en la aparición del estrés, sus efectos en el sujeto y las estrategias de afrontamiento que se suele implementar. Por último se dan sugerencias tendientes a evitar la aparición del mismo

Fatores de risco para a doença periodontal / Risk factors for periodontal disease

As doenças periodontais säo infecçöes intimamente relacionadas à colonizaçäo de microorganismos patogênicos na área subgengival. Contudo, o estabelecimento e progressäo da doença parece resultar da interrelaçäo entre as defesas do hospedeiro com a flora bacteriana. Determinadas condiçöes, de ordem local ou sistêmica, podem modoficar o curso da doença. Estas condiçöes têm sido denominadas de fatores de risco. O presente trabalho visa abordar determinados fatores de risco significantes, como o fumo e a diabetes mellitus, além de outros abordados na literatura periodontal como contribuintes para a progressäo da doença periodontal. Enfatizará também a importância deste conhecimento näo só para o periodontista, como para o clínico geral em seu dia-a-dia

Efeitos protetores do choque térmico na sepse e na síndrome da resposta inflamatória sistêmica / Protective effects of heat shock on sepsis and on the systemic inflammatory response syndrome

Sepse, disfunção orgânica múltipla e a síndrome da angústia respiratória aguda são as maiores causas e mortalidade nas unidades de terapia intensiva. Estudos em animais de laboratório demonstram que esta forma de lesão pode ser atenuada ou mesmo abolida se um fenômeno, conhecido como resposta ao estresse ou resposta ao choque térmico, for ativado. A resposta ao choque térmico, caracterizada pela suspensão transitória da produção da maioria das proteínas e pela ativação das proteínas do choque térmico (heat shock proteins - HSP), mostrou-se protetora a células e a animais de laboratório, se desencadeada antes, ou imediatamente após uma lesão letal...

Effects of prenatal exposure to a mild chronic variable stress on body weight, preweaning mortality and rat behavior

Early stimulation has been shown to produce long-lasting effects in many species. Prenatal exposure to some strong stressors may affect development of the nervous system leading to behavioral impairment in adult life. The purpose of the present work was to study the postnatal harmful effects of exposure to variable mild stresses in rats during pregnancy. Female Holtzman rats were submitted daily to one session of a chronic variable stress (CVS) during pregnancy (prenatal stress; PS group). Control pregnant rats (C group) were undisturbed. The pups of PS and C dams were weighed and separated into two groups 48 h after delivery. One group was maintained with their own dams (PS group, N = 70; C group, N = 36) while the other PS pups were cross-fostered with C dams (PSF group, N = 47) and the other C pups were cross-fostered with PS dams (CF group, N = 58). Pups were undisturbed until weaning (postnatal day 28). The male offspring underwent motor activity tests (day 28), enriched environment tests (day 37) and social interaction tests (day 42) in an animal activity monitor. Body weight was recorded on days 2, 28 and 60. The PS pups showed lower birth weight than C pups (Duncan's test, 0.05). The PS pups suckling with their stressed mothers displayed greater preweaning mortality (C: 23 percent, PS: 60 percent; 2 test, 0.05) and lower body weight than controls at days 28 and 60 (Duncan's test, 0.05 and 0.01, respectively). The PS, PSF and CF groups showed lower motor activity scores than controls when tested at day 28 (Duncan's test, 0.01 for PS group and ;0.05 for CF and PSF groups). In the enriched environment test performed on day 37, between-group differences in total motor activity were not detected; however, the PS, CF and PSF groups displayed less exploration time than controls (Duncan's test, 0.05). Only the PS group showed impaired motor activity and impaired social behavior at day 42 (Duncan's test, 0.05). In fact, CVS treatment during gestation plus suckling with a previously stressed mother caused long-lasting physical and behavioral changes in rats. Cross-fostering PS-exposed pups to a dam which was not submitted to stress counteracted most of the harmful effects of the treatment. It is probable that prenatal stress plus suckling from a previously stressed mother can