Biomarcadores de estrés laboral en residentes: artículo de revisión

Across the years, multiple definitions for stress have been generated, but a satisfactory consensus has not yet been reached; in general, it is perceived as a threat that risks the internal harmony. This condition generates in response a series of physiological changes (adaptive response) that seek to maintain the balance; with the underlying activation of axes such as the hypothalamus-pituitaryadrenal, whose released substances have an impact on several systems, which would explain the development of some diseases and justify the use of biomarkers for the objective measurement of stress. The resident physicians in training have been identified as a population at risk for presenting stress, specifically job stress or burnout, which is possible to measure subjetively by applying questionnaires such as the Maslach Burnout Inventory Human Services Survey (MBI), which demonstrated a high prevalence of this condition; however, there is not a consensus yet regarding objective measurement strategies. The present review aims to explore the available literature on biomarkers as tools for measuring job stress in residents.A través del tiempo, se han generado múltiples definiciones para estrés, pero aún no se logra un consenso satisfactorio; en general, es percibido como una amenaza que pone en riesgo la armonía interna. Esta condición genera como respuesta una serie de cambios fisiológicos (respuesta adaptativa) que buscan mantener el equilibrio; con la activación subyacente de ejes como el hipotálamo-hipófisis-suprarrenal, cuyas sustancias liberadas tienen impacto en varios sistemas, lo que explicaría el desarrollo de ciertas enfermedades y justifica el uso de biomarcadores para la medición objetiva del estrés. Los médicos residentes en formación se han identificado como una población en riesgo para presentar estrés, específicamente estrés laboral o burnout (en inglés), el cual es posible medir de manera subjetiva mediante la aplicación de cuestionarios como el Maslach Burnout Inventory Human Services Survey (MBI), y a través del cual se ha identificado alta prevalencia de la condición; sin embargo, aún no existe consenso respecto a las estrategias de medición objetiva. La presente revisión pretende explorar la literatura existente sobre los biomarcadores como herramientas de medición de estrés laboral en residentes

Biomarcadores de estrés laboral en residentes: artículo de revisión

Across the years, multiple definitions for stress have been generated, but a satisfactory consensus has not yet been reached; in general, it is perceived as a threat that risks the internal harmony. This condition generates in response a series of physiological changes (adaptive response) that seek to maintain the balance; with the underlying activation of axes such as the hypothalamus-pituitaryadrenal, whose released substances have an impact on several systems, which would explain the development of some diseases and justify the use of biomarkers for the objective measurement of stress. The resident physicians in training have been identified as a population at risk for presenting stress, specifically job stress or burnout, which is possible to measure subjetively by applying questionnaires such as the Maslach Burnout Inventory Human Services Survey (MBI), which demonstrated a high prevalence of this condition; however, there is not a consensus yet regarding objective measurement strategies. The present review aims to explore the available literature on biomarkers as tools for measuring job stress in residents.A través del tiempo, se han generado múltiples definiciones para estrés, pero aún no se logra un consenso satisfactorio; en general, es percibido como una amenaza que pone en riesgo la armonía interna. Esta condición genera como respuesta una serie de cambios fisiológicos (respuesta adaptativa) que buscan mantener el equilibrio; con la activación subyacente de ejes como el hipotálamo-hipófisis-suprarrenal, cuyas sustancias liberadas tienen impacto en varios sistemas, lo que explicaría el desarrollo de ciertas enfermedades y justifica el uso de biomarcadores para la medición objetiva del estrés. Los médicos residentes en formación se han identificado como una población en riesgo para presentar estrés, específicamente estrés laboral o burnout (en inglés), el cual es posible medir de manera subjetiva mediante la aplicación de cuestionarios como el Maslach Burnout Inventory Human Services Survey (MBI), y a través del cual se ha identificado alta prevalencia de la condición; sin embargo, aún no existe consenso respecto a las estrategias de medición objetiva. La presente revisión pretende explorar la literatura existente sobre los biomarcadores como herramientas de medición de estrés laboral en residentes

The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% 47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% 32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% 27.9-42.8] and 33.3% 25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license