Correlación entre estrés, niveles de cortisol y estrategias de afrontamiento en pacientes con cáncer sometidos a tratamiento / Correlation between stress, cortisol levels and coping strategies in cancer patients undergoing treatment

INTRODUCCIÓN: El cáncer es una de las principales causas de morbilidad y mortalidad en el mundo, según la Organización Mundial de la Salud (OMS), en 2012 14 millones de casos nuevos y 8,2 millones de muertes. Se demostró que los pacientes en tratamiento, cirugía, quimioterapia y radioterapia tienen niveles altos de cortisol que influye en su calidad de vida. OBJETIVO: Identificar la relación entre el estrés, a nivel de cortisol y las estrategias de afrontamiento en pacientes con cáncer sometidos a tratamiento. MATERIAL Y MÉTODOS: Estudio transversal, descriptivo y correlacional realizado junio a diciembre del 2019. RESULTADOS EPIDEMIOLÓGICOS: 68.2% mujeres 31.8 % hombres, entre 17 y 76 años, con diagnósticos de: Ca mama (30.3%), de próstata (18.3), colon (15.2), pulmón (13.6), cervical (12.1% gástrico (9.1%) cáncer de piel (1.5%). Estadísticos: El 35,3% informaron cortisol a niveles normales y 64.5% niveles altos; el estrés obtuvo un promedio de 13.9 (DE = 4.64). Sobre el nivel de cortisol y el tipo de tratamiento, se observaron diferencias significativas (X2 = 1,546, p = .04), es decir, el paciente que tienen un tratamiento mixto el cortisol es más alto. CONCLUSIONES: Es importante reevaluar las estrategias centradas en el problema, analizar implicaciones y proponer estudios en el contexto en que se desenvuelven, en futuro desarrollar una intervención incluyendo actividades de enfermería en la quimioterapia y radioterapia, apoyando estrategias de afrontamiento efectivas. En este sentido y derivado de la minimización de amenazas centradas en el problema, es importante tener un enfoque integral más profundo

INTRODUCTION: Cancer is one of the leading causes of morbidity and mortality worldwide, according to the World Health Organization (WHO), in 2012 14 million new cases and 8.2 million deaths. (WHO, 2019). Patients in treatment, surgery, chemotherapy and radiation therapy have been shown to have high levels of cortisol that influence their quality of life. OBJECTIVE: to identify the relationship between stress, cortisol level and coping strategies in cancer patients undergoing treatment. MATERIAL AND METHODS: Cross-sectional, descriptive and correlational study conducted June to December 2018. In 65 male and female patients under treatment. RESULTS: 68.2% were women 31.8% men, between 17 and 76 years. With diagnoses Ca breast (30.3%), prostate cancer (18.3), colon (15.2), lung (13.6), cervical (12.1% gastric (9.1%) skin cancer (1.5%). Statistics: 35.3% reported cortisol at normal levels and 64.5% high levels; stress averaged 13.9 (DE s 4.64). On the level of cortisol and the type of treatment, significant differences were observed (X2 X 1,546, p .04), i.e. the patient who has a mixed treatment cortisol is higher. CONCLUSIONS: It is important to reevaluate the strategies focused on the problem, analyze implications and propose studies in the context in which they operate, in the future develop an intervention including nursing activities in chemotherapy and radiotherapy, supporting effective coping strategies. minimizing threats focused on the problem, it is important to have a deeper comprehensive approach

[Role of hormonal regulation and stress in the interaction of sleep and biorhythms in aging].

The present work describes bibliographic analysis of ontogenetic changes in hormonal regulation of sleep and circadian biorhythms. It is suggested that two-stage, age-related dynamics of such changes may be related to differential occurrence registered by us earlier, of maxima of morbidity and mortality caused by a number of disorders, in middle-age and in senile period. It is proposed to concentrate future efforts on elaboration of mathematical models of ontogenetic regulation, on the basis of systems biomedicine.

[How does collective violence shape the health status of its victims? Conceptual model and design of the ISAVIC study]. / ¿Cómo influye la violencia colectiva en la salud? Modelo conceptual y diseño del estudio ISAVIC.

OBJECTIVES: Epidemiologic research on collective violence (violence exerted by and within groups in pursuit of political, social or economic goals) is very scarce despite its growing recognition as a major public health issue. This paper describes the conceptual model and design of one of the first research studies conducted in Spain aiming to assess the impact of collective violence in the health status of its victims (study known as ISAVIC, based on its Spanish title Impacto en la SAlud de la VIolencia Colectiva). METHODS: Starting with a comprehensive but non-systematic review of the literature, the authors describe the sequelae likely produced by collective violence and propose a conceptual model to explain the nature of the relationships between collective violence and health status. The conceptual model informed the ISAVIC study design and its measurement instruments. RESULTS: The possible sequelae of collective violence, in the physical, emotional and social dimensions of health, are described. Also, the review distinguishes the likely impact in primary and secondary victims, as well as the interplay with the social environment. The mixed methodological design of the ISAVIC study supports the coherence of the conceptual model described. CONCLUSIONS: The ISAVIC study suggests that collective violence may affect the main dimensions of the health status of its victims, in intimate relation to the societal factors where it operates. It is necessary to validate these results with new studies.

[Neurobiological consequences of child sexual abuse: a systematic review]. / Revisión sistemática de las consecuencias neurobiológicas del abuso sexual infantil.

OBJECTIVE: The results of several studies suggest that there is a critical timeframe during development in which experiences of maltreatment and sexual abuse may lead to permanent or long-lasting neurobiological changes that particularly affect the hypothalamus-pituitary-adrenal axis response. The aim of the present study was to provide an updated review on the main neurobiological consequences of child sexual abuse. METHODS: We selected articles published between January 1999 and January 2010 in English or Spanish that focused on the neurobiological consequences of child sexual abuse available through Medline, Scopus and Web of Science. We also examined the references in published articles on the consequences of sexual victimization in childhood. RESULTS: In this review we included 34 studies on neurobiological consequences, indicating different kinds of effects, namely: neuroendocrine, structural, functional and neuropsychological consequences, which affect a large number of victims. CONCLUSIONS: The existing body of work on the neurobiological consequences of maltreatment shows the need to consider maltreatment and child sexual abuse as health problems that affect different areas of victims' lives, which would in turn favor the development of intervention and treatment programs that take these multiple effects into account.

[Dysaptation in troops called up for military service to the Northern Fleet].

Analyzed the results of the survey and inspection of about 75 000 conscripts who came to the acquisition of forces and troops of the fleet in terms of the Kola Polar region in 2001-2010. Cases of identified mental disorders in the number of young recruits in the period of examination by military medical committee designated as the primary dysaptation, and later--as delayed. The authors concluded that at present time we can expect the total number of recruits 4.45% of persons with mental dysaptation, including 0.52% of the primary and 3.93% with delayed. Over the last 10 years, an average of 4.45% of conscripts who came to the acquisition of forces (troops) of the Northern Fleet, dismissed by reason of mental dysaptation. The main contribution to the structure of the causes of limited recognition of the young recruits fit and unfit for military service were neurotic disorders and personality pathology. The authors suggest a specific position on a number of documents that need proof in order to improve the quality of maintenance training and combat activities of troops and naval forces.

[Peculiarities of the immune status of soldiers taken ill with extramural pneumonia during battle action].

The article deals with violations of general resistance of the organism of military men, who get extramural pneumonia during the battle action. The author analyzed the data of immune status in three groups of soldiers. Statistical analysis of materials led to the conclusion that violations of immunity in the main group depend on the circumstances and nature of military service. This fact indicates that the significant clinical and pathogenetic differences in the development, course and outcome of an extramural pneumonia against the background of chronic adaptation syndrome. Pathogenic peculiarities of patients with pneumonia against the background of the impact of extreme factors of the military conflicts are presented in a prolonged dysfunction of all parts of the immune system.

Causes of mortality and morbidity of wild koalas, Phascolarctos cinereus (Goldfuss), in Victoria, Australia.

Between 1975 and 1980, necropsy investigations were conducted on 44 wild koalas (24 males, 20 females) from several localities in Victoria, Australia. An additional 11 (5 males, 6 females) were presented for clinical appraisal and treatment. Traumatic injuries resulting from motor vehicle accidents and intra-specific conflict were the commonest reason for submission (19 of 55; 35%). Keratoconjunctivitis (8 of 55; 15%), ascending urinary tract infections (6 of 20 females; 30%), ascending genital tract inflammation (10 of 20 females; 50%) and sarcoptic mange (2 of 55; 4%) were recognized as specific diseases or disease syndromes. A peracute syndrome characterized by lassitude, depression, anorexia and coma was identified in moribund koalas submitted from the wild and also in hospitalized animals. The condition, termed koala stress syndrome, was thought to be initiated by intercurrent disease or trauma, long term hospitalization and frequent manipulation and treatments. Hematological observations in 54 apparently healthy wild koalas from five different populations and on 17 sick or injured animals are also presented. Certain blood parameters are discussed in relation to the health status of the populations or individuals. Areas for further research into koala diseases are also discussed.