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The medical perspective on burnout

100%
Kakiashvili T., Leszek J., Rutkowski K.
International Journal of Occupational Medicine and Environmental Health
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2013
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vol. 26
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issue 3
401-412
EN
Objective: The aim of this study was to review recent medical findings related to burnout, its diagnosis, treatment, characteristic pathophysiological features, and preventive measures. Materials and Methods: A systematic review of the scientific literature in PubMed/Medline was performed. The most recent and important findings were reported. Results: Burnout was found to be a risk factor for myocardial infarction and coronary heart disease. It was also related to reduced fibrinolytic capacity, decreased capacity to cope with stress and hypothalamic-pituitary-adrenal (HPA) axis hypoactivity. Severe burnout symptoms are associated with a lower level or smaller increase of the cortisol awakening response (CAR), higher dehydroepiandrosterone-sulphate (DHEAS) levels, lower cortisol/DHEAS ratios and stronger suppression as measured by the dexamethasone suppression test (DST). More and more literature works suggest that the evaluation of the HPA axis should be brought to the attention of primary care physicians. There is no universal agreement on specific treatment and diagnostic measures to evaluate the wide range of HPA axis disorders. The cost-effective evaluation of adrenal hormones via saliva samples by a primary care physician may significantly alter the course of therapy in numerous chronic disease patients. Psychiatric disorders may have similar symptoms, but they have distinctive hormonal profiles. Having burnout recognized as a medical condition would help in differentiating burnout from similar clinical syndromes, such as depression or anxiety, and provide appropriate treatment to burnout patients. Proper treatment is essential for a fast and full recovery. Conclusion: Chronic stress-related disorders often fall outside the category of a "true" disease and are often treated as depression or not treated at all. The evaluation of adrenal hormones via saliva samples helps to predict burnout. Burnout screening techniques, dietary and nutritional guidelines and lifestyle changes for supporting the HPA function need to be developed. The presented material includes hormonal, dietary, and pharmaceutical perspectives.
2
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Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel

75%
Wolkow A., Ferguson S., Aisbett B., Main L.
International Journal of Occupational Medicine and Environmental Health
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2015
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vol. 28
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issue 2
183-208
EN
Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation.
3
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Impact of special aviation gymnastics instruments training on selected hormones in cadets' blood serum and plasma

75%
Wochyński Z., Sobiech K.
International Journal of Occupational Medicine and Environmental Health
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2017
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vol. 30
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issue 4
655-664
EN
Objectives This study has aimed at investigating the impact of the Special Aviation Gymnastics Instruments (SAGI) training scheme on the blood serum cortisol, testosterone, insulin, and plasma adrenaline, noradrenaline, and dopamine in comparison with a control group. Material and Methods Fifty-five cadets, aged 20 years old, participated in the study. Cadets were divided into 2 groups: A (N = 41) – the SAGI-trained, and B (N = 14) – the control group. In both groups, blood was the examined material, sampled twice: before the training session (BT) and after the training session (AT), at the beginning (training session I), during (training session II), and after completion of the SAGI training session (training session III). Commercially available kits were used for assaying serum cortisol, testosterone, and insulin as well as plasma adrenaline, noradrenaline, and dopamine. Cadets’ physical fitness was assessed by means of Aero-Synthetic Efficiency Tests. Results In group A, a significant decrease in serum cortisol (training session III) and insulin in three training sessions AT in comparison with the values BT was seen. A statistically significant increase in testosterone and catecholamines was noted in all 3 training sessions AT in comparison with the values BT. In group B, a statistically significant increase in cortisol (training session II), testosterone, and catecholamines was observed in all 3 training sessions AT vs. the values in training session BT. In group B, serum levels of all assayed hormones were higher in training session III than those in group A. Conclusions In the examined group, the SAGI training produced fewer hormonal changes dependent on the intensity and exercise type and physical efficiency improvement than in the control group. Int J Occup Med Environ Health 2017;30(4):655–664
4
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Kortyzol – hormon o charakterze antyanabolicznym

63%
Jonczyk P.
Edukacja Biologiczna i Środowiskowa
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2014
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issue 4
17-26
PL
Kortyzol to syntetyzowany w korze nadnerczy hormon steroidowy, który pełni wiele istotnych funkcji w organizmie człowieka, przede wszystkim umożliwiając adaptację ustroju do zmieniających się warunków środowiska. W sytuacjach stresowych modyfikuje on m.in. metabolizm węglowodanów, białek i tłuszczów, pracę układu sercowo-naczyniowego, gospodarkę wodną, równowagę mineralną, funkcje układu immunologicznego oraz ośrodkowego układu nerwowego (OUN). W pracy opisano etapy jego syntezy, regulację wydzielania, sposoby transportu, a także mechanizm działania oraz fizjologiczne funkcje w organizmie.
EN
Cortisol is a steroid hormone synthesized in the adrenal cortex that performs many important functions in the human body. First of all it regulates the adaptation to changing environmental conditions. In stressful situations it modifies, among others, metabolism of carbohydrates, proteins and fats, the activity of cardiovascular system, water and mineral balance, the immune system and the central nervous system (CNS). The article describes the steps of the synthesis, regulation of secretion, transport methods, as well as the mechanism of action and physiological functions in the body.
5
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Liofilizowane owoce róży obniżają poziom kortyzolu u studentów po stresie egzaminacyjnym

45%
Kalemba-Drożdż M., Cierniak A., Grzywacz-Kisielewska A.
Państwo i Społeczeństwo
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2023
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vol. XXIII
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issue 1
83-97
EN
Introduction: Plant extracts rich in phenolic compounds may modify the stress level. The aim of this project is to investigate whether freeze-dried rosehips (Rosa rugosa), taken orally by students, affect cortisol concentration before and after a highly stressful exam. Materials and methods: The double-blind study included healthy volunteers recruited from medical and health sciences students. Participants in the study group took capsules containing 400 mg of freeze-dried ground rosehips for five consecutive days preceding the exam (stressor). At that time, the control group was taking a placebo (120 mg of glucose). Participants completed a questionnaire on their gender, lifestyle, medical history, physical activity, diet, stimulants, medications and dietary supplements. Saliva samples for determining the level of cortisol in saliva were taken three times: in the morning before the beginning of the experimental phase, in the morning before the stressor, and one hour after the stressor subsided. The level of cortisol in saliva was determined using ELISA. Results: It was found that taking freeze-dried rosehips for five days significantly reduced the level of cortisol in students after the exam compared to the placebo group. There were no differences in the level of cortisol before the exam, regardless of the preparation taken. No other analyzed factor influenced the concentration of the stress hormone in students. Conclusions: Freeze-dried rosehips can help reduce the effects of stress.
PL
Wprowadzenie: Ekstrakty roślinne bogate w polifenole mogą modyfikować poziom stresu. Celem projektu było zbadanie, czy liofilizowane owoce róży (Rosa rugosa) przyjmowane doustnie przez studentów wpływają na poziom kortyzolu przed i po silnie stresującym egzaminie. Materiał i metody: Badanie o charakterze podwójnie ślepej próby objęło zdrowych ochotników rekrutowanych pośród studentów kierunków medycznych. Uczestnicy w grupie badanej przyjmowali kapsułki zawierające po 400 mg liofilizowanych mielonych owoców róży przez pięć kolejnych dni poprzedzających egzamin (stresor). W tym czasie grupa kontrolna przyjmowała placebo. Uczestnicy wypełnili ankietę dotyczącą ich płci, stylu życia, historii chorób, aktywności fizycznej, stosowanej diety, używek, leków i suplementów diety. Próbki śliny do oznaczenia poziomu kortyzolu zostały pobrane trzykrotnie: rano przed rozpoczęciem fazy eksperymentalnej, rano przed stresorem oraz godzinę po ustąpieniu stresora. Poziom kortyzolu w ślinie oznaczono metodą immunoenzymatyczną. Wyniki: Stwierdzono, że przyjmowanie liofilizowanych owoców róży przez pięć dni istotnie zmniejsza poziom kortyzolu u studentów po egzaminie w porównaniu z grupą przyjmującą placebo. Nie wykazano różnic w poziomie kortyzolu przed egzaminem niezależnie od przyjmowanego preparatu. Żaden inny analizowany czynnik nie wpływał na stężenie hormonu stresu u studentów. Wnioski: Liofilizowane owoce róży mogą pomagać w osłabieniu skutków stresu.
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