[Thyroid gland findings in stillborn and newborn infants].
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1. Continual exposure to work-related stressors compounds nurses' workloads, increases their stress levels, and places increased demands on their abilities to adapt. 2. Nurses need to learn and routinely use coping measures to prevent exhaustion and burnout. 3. An in-house stress management program can help nurses learn to cope with constant exposure to work-related stressors, halt the cyclic process of stress, prevent burnout, and decrease turnover.
Radioimmunoassay was used to measure the blood plasma content of endogenous opioid peptides (beta-andorphine, methionin- and leucine-enkephalins), R substance, calcium-regulating hormones (parathyroid hormone and carcitonin), ionized calcium and cortisol in 152 children aged 6 months to 12 years with atopic dermatitis. The data obtained were compared to those obtained in healthy children. The stress-activating and stress-limiting systems were established to be activated in all the patients. It is concluded that the intensity of the adaptation compensatory process depends on the clinical form, disease standing, and spreading of skin impairment.
The effect of supraphysiological doses of corticosteroids on mucosal ulceration of stomach was studied in rats. Cortisol (30 mg/100 g) blocked the PACS. During the PACS block, ulcerogenic properties of stressor increased. This effect was reduced by subsequent corticosterone replacement therapy. The new concept of supraphysiological doses of corticosteroids effect is discussed. The stomach ulceration seems to result from the corticosteroid insufficiency.
Any change in the social or physical environment that threatens the needs or interests of a mammal, induces a state of tension ('stress') in the animal. Driven by this tension, the animal changes its behaviour. At the same time, alterations occur in bodily functions. All organs and regulatory systems (central and peripheral nervous systems, endocrine and immune systems) participate in these behaviour-physiological response and are affected in their activities. The character of the reactions (e.g. fight, flight, passivity) is mainly determined by the animals appraisal of the environmental change and of the possible impact of its response. Aim of the reactions is neutralising the threat and gaining control over the environment (adaptation). When this is achieved, the tension recedes. In case the response is unsuccessful, the state of tension persists ('chronic stress'). Prolonged exposure of brain and/or bodily functions to stress can result in pathological states.
The historical roots of the term are treated as well as the story of Selye's theory of biological stress as a nonspecific response of the body. In the discussion of preceding approaches to describe processes which today one would name stress, the importance of Francois Magendie and John Brown as precursors is accentuated. Additionally, neurophysiological and psychological aspects are discussed.
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Two groups of 10 patients with an identical mean injury score (25 + 5) were treated from day 3 after injury until day 10 with a whole protein high caloric (WPHC) diet (group A) or with a peptide diet (PD) (group B). Intake of calories, protein, water, Na+ and K+ was measured daily as well as excretion of urine, Na+ and K+. Gastric reflux, bowel movement and plasma levels of Na+ and K+ were registered and the nitrogen balance and Na+/K+ quotient in urine were calculated daily. Clinically both diets were well tolerated, with low gastric reflux and no diarrhea. The calculated caloric demand could be covered in group A on day 7 post-injury (or day 4 of enteral nutrition) and in group B on day 11 post-injury (or day 7 of enteral nutrition). The caloric intake in group A remained significantly higher on days 4-10. There was no difference in nitrogen balance. Total enteral Na+ and fluid intake were significantly lower in group A, but some additional parenteral Na+ had to be given to keep plasma Na+ levels in the normal range. There was no difference in urine output between the 2 groups; therefore, there was a significant fluid retention in group B. Interestingly, the Na+/K+ quotient in urine was significantly higher in group A. The low Na+ intake might influence the back flow of interstitial edema in the 'flow phase'. This diet seems to be adequate, especially for the nutrition of burn patients and of patients with cardiac disease, and can cover the high caloric needs of polytraumatised patients within a few days.
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