scholarly journals Burnout Syndrome in Physicians—Psychological Assessment and Biomarker Research

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 209 ◽  
Author(s):  
Tanya Deneva ◽  
Youri Ianakiev ◽  
Donka Keskinova

Background and objectives: Burnout is a syndrome typically occurring in work environments with continuous and chronic stress. Physicians are at increased risk for burnout, as a result of 24-h work, delayed work–life balance gratification, and the challenges associated with patient care. The aim of the present study was to evaluate the psychological parameters of burnout symptoms in relation to biomarkers of stress among physicians with different medical specialties. Materials and methods: A total of 303 physicians were contacted as potential participants. A comparison group of 111 individuals working outside medicine was used as a control to verify the results. The physicians were specialists in internal medicine, general surgery, pathology, and primary care. Serum cortisol, salivary cortisol, adrenocorticotropic hormone (ACTH), insulin (IRI), and prolactin levels were analyzed by chemiluminescence enzyme immunoassay (Access 2, Beckman Coulter). Fasting glucose in serum and glycated hemoglobin (HbA1C) in whole blood were measured using the automatic analyzer AU 480 Beckman Coulter system. Symptoms of burnout were measured with the Maslach Burnout Inventory (MBI). Results: The group with burnout presented significantly higher levels of serum and saliva cortisol, ACTH, prolactin, fasting glucose, and HbA1C compared with the control group. The correlation analysis between biomarkers showed a positive correlation with moderate strength between serum and saliva cortisol (r = 0.516, p = 0.01),as well as serum and saliva cortisol with ACTH (r = 0.418; r = 0.412, p = 0.01) and HbA1C (r = 0.382; r = 0.395, p = 0.01). A weak positive correlation was found between serum and saliva cortisol with prolactin (r = 0.236; r = 0.267, p < 0.01) and glucose (r = 0.271; r = 0.297, p < 0.01). In the multiple logistic regression model, saliva cortisol, HbA1C, and age were significantly associated with burnout (chi-square = 16.848, p < 0.032). Conclusion: Our findings demonstrated the interest of exploring biomarkers of stress related to burnout in health professionals.

Author(s):  
Hung-Chih Chen ◽  
Hung-Yu Lin ◽  
Michael Chia-Yen Chou ◽  
Yu-Hsun Wang ◽  
Pui-Ying Leong ◽  
...  

The purpose of this study is to evaluate the relationship between hydroxychloroquine (HCQ) and diabetic retinopathy (DR) via the national health insurance research database (NHIRD) of Taiwan. All patients with newly diagnosed type 2 diabetes (n = 47,353) in the NHIRD (2000–2012) were enrolled in the study. The case group consists of participants with diabetic ophthalmic complications; 1:1 matching by age (±1 year old), sex, and diagnosis year of diabetes was used to provide an index date for the control group that corresponded to the case group (n = 5550). Chi-square test for categorical variables and Student’s t-test for continuous variables were used. Conditional logistic regression was performed to estimate the adjusted odds ratio (aOR) of DR. The total number of HCQ user was 99 patients (1.8%) in the case group and 93 patients (1.7%) in the control group. Patients with hypertension (aOR = 1.21, 95% CI = 1.11–1.31) and hyperlipidemia (aOR = 1.65, 95% CI = 1.52–1.79) significantly increased the risk of diabetic ophthalmic complications (p < 0.001). Conversely, the use of HCQ and the presence of rheumatoid diseases did not show any significance in increased risk of DR. HCQ prescription can improve systemic glycemic profile, but it does not decrease the risk of diabetic ophthalmic complications.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Guangsen Hou ◽  
Yong Tang ◽  
Luping Ren ◽  
Yunpeng Guan ◽  
Xiaoyu Hou ◽  
...  

Background. Our aim was to investigate the association between the genetics of the angiopoietin protein-like 8 (ANGPTL8) rs2278426 (C/T) polymorphism with prediabetes (pre-DM) and type 2 diabetes (T2DM) in a Han Chinese population in Hebei Province, China. Methods. We enrolled 1,460 participants into this case-control study: healthy controls, n = 524; pre-DM, n = 460; and T2DM: n = 460. Ligase assays on blood samples from all participants were used to identify polymorphisms. Differences in genotype and allele distributions were compared by the chi-square test and one-way analysis of variance, and a post hoc pairwise analysis was performed using the Bonferroni test. The logistic regression technique was adjusted for age, sex, and body mass index. Results. The frequency of the TT (10.9%) genotype was significantly higher in pre-DM patients than in controls (odds ratio [OR] = 1.696, 95% confidence interval [CI] = 1.026–2.802, P = 0.039 ). In the T2DM group, the CT (48%) and TT (15%) genotypes were significantly higher compared with those in the control group (CT : OR = 1.384, 95% CI = 1.013–1.890, P = 0.041 ; TT : OR = 2.530, 95% CI = 1.476–4.334, P = 0.001 ). The frequency of the T allele was significantly higher in the pre-DM (32.8%) and T2DM (39%) groups compared with the control group (26.9%) and was significantly associated with an increased risk of pre-DM (OR = 1.253, 95% CI = 1.017–1.544, P = 0.034 ) and T2DM (OR = 1.518, 95% CI = 1.214–1.897, P = 0.001 ). Furthermore, insulin levels in the pre-DM and T2DM groups were significantly decreased in those with the TT genotype compared with the CC and CT genotypes. Conclusion. ANGPTL8 rs2278426 may be involved in the mechanism of insulin secretion and could lead to an increased risk of pre-DM and T2DM.


2020 ◽  
Vol 9 (9) ◽  
pp. 3005
Author(s):  
Soo-Hwan Byun ◽  
Chanyang Min ◽  
Hyo-Geun Choi ◽  
Seok-Jin Hong

We evaluated the incidence of temporomandibular disorder (TMD) in patients with rheumatoid arthritis (RA) and examined the association between TMD and RA, through longitudinal follow-up. Population data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. From 514,866 subjects, 3122 with RA were matched with 12,488 controls in a 1:4 ratio. The crude and adjusted models (for obesity, smoking, alcohol consumption, blood pressure, blood glucose, total cholesterol, and Charlson Comorbidity Index scores) were calculated. Chi-square tests, Kaplan-Meier (KM) analysis, and two-tailed analyses were used for statistical analysis. Stratified Cox proportional hazard models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for TMD in the RA group, compared to those in the control group. The adjusted HR for TMD in RA was 2.52 (95% CI = 1.70–3.74), compared to the control group. The results were consistent with the subgroup analyses, according to age and sex, except in men older than 60 years of age. KM analysis showed similar results. Hence, we found that patients with RA have a higher risk of TMD, and should be observed for symptoms of the initial stage of TMD to prevent the risk of aggravation.


2020 ◽  
Vol 4 (s1) ◽  
pp. 71-71
Author(s):  
Liza Carolina Sanchez-Plazas ◽  
Ricardo L. Garcia ◽  
Kelly Komatz

OBJECTIVES/GOALS: The objectives are to assess the impact of cumulative grief on the development of Compassion Fatigue (CF) and Burnout Syndrome (BS) in HCPs who care for dying children. We will also evaluate the relationship between CF and cortisol patterns in HCPs. METHODS/STUDY POPULATION: Cross-sectional study to be conducted in a Pediatric Hospital in Puerto Rico. A sample of 50 pediatric nurses will be selected to collect the data to evaluate the occurrence of CF and BS among HCP caring for children during end of life (EoL). Study subjects will include nurses who care for dying children in the Intensive Care Units and Oncology ward. Nurses working in the pediatric ward will be included as the control group. Three validated instruments (Spanish Version) will be administered (Professional Quality of Life vIV, Maslach Burnout Inventory- HSS, briefCOPE scale). Cortisol samples in saliva and hair will also be taken to determine levels in these HCPs. RESULTS/ANTICIPATED RESULTS: Our expected outcome is that CF and BS will be more frequent in HCPs caring for children during EoL compared with controls and that EoL nurses will have higher scores on CF scale and more frequent dysregulated cortisol patterns. DISCUSSION/SIGNIFICANCE OF IMPACT: Understanding how HCPs cope with grief caused by child death and the occurrence of CF and BO in our hispanic population allowing us to develop support strategies based on the specific HCPs needs. This knowledge will help improve HCPs’ well-being and may diminish the physiologic impact on cortisol.


2019 ◽  
Vol 7 (15) ◽  
pp. 2488-2496 ◽  
Author(s):  
Golpar Golmohammadzadeh ◽  
Abbas Mohammadpour ◽  
Nematollah Ahangar ◽  
Mohammad Shokrzadeh

BACKGROUND: The second leading cause of cancer-related death in women is breast cancer. Xenobiotic Metabolizing Enzymes (XMEs) contribute to the detoxification of numerous cancer therapy-induced products. In the metabolism of xenobiotic, cytochrome P450s or monooxygenases perform an important function by catalysing the hydroxylation reaction. In this study, the susceptibility and genetic polymorphisms of CYP450 isoenzymes was investigated that may have an etiological role in breast cancer. AIM: The main purpose of this study was to evaluate the association of CYP1A1 (rs4646421), CYP1B1 (rs1056836), CYP2C8 (rs1058930), and CYP19A1 (rs749292) polymorphisms with the risk of breast cancer in Mazandaran province. MATERIAL AND METHODS: This cross-sectional case-control study were recruited 72 patients and 51 healthy individuals and was performed between March 2018 to May 2018 in the Oncology Department at Imam Hospital in Sari city, Iran. Peripheral blood samples were collected in EDTA tube, and DNA extraction was performed using the salting-out method and WizPrep extraction kits. Breast cancer patients with known clinicopathological characters and healthy women as control group were genotyped for genes polymorphisms by PCR-RFLP technique, using restriction enzymes. Chi-square, Fisher exact test and Logistic regression model, were applied for statistical analysis. RESULTS: The results of the experiments showed that there was a significant relationship between two groups and the age of the patients is significantly higher than the control group (p = 0.044). According to the chi-square and Fisher exact test, education, pregnancy, menopause status and oppose were significant between the two groups. Based on using a logistic regression model in two normalized and age-adjusted models to finding relationship between the genotypes of each gene and breast cancer risk, it was determined that in the CYP2C8 genotype, those who have the CG allele have a 7.74 degree increased risk of breast cancer (CI = 95% 0.95-62.5) and in the CYP19A1 gene, individuals with GA genotype, increased risk of breast cancer (CI = %95 1.52-27.21), about the CYP1B1 gene, people with two genotypes of CG + GG had higher risk of breast cancer (CI = %95 1.19-5.71) and allele G has decreased risk of breast cancer in this gene (P = 0.0271), also allele G in CYP2C8 gene had the protective effect (P = 0.02). In the age-adjusted model, for the CYP2C8 gene, GG genotype increased risk of breast cancer (CI = %95 1.11-75.84) as well as, the CG + GG genotype in CYP1B1 gene (CI = %95 1.31-6.57). CONCLUSION: Our results confirm the association between CYP2C8 (rs1058930), CYP19A1 (rs749292) and CYP1B1 (rs1056836) gene polymorphisms and increased risk of breast cancer in women in Mazandaran province.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Krystyna Golonka ◽  
Magda Gawlowska ◽  
Justyna Mojsa-Kaja ◽  
Tadeusz Marek

Introduction. The consequences of chronic work-related stress are related to various emotional, cognitive, and behavioral symptoms. Occupational burnout as a complex syndrome is characterized by exhaustion, cynicism, and lower professional efficacy. Moreover, the growing amount of research on the neural correlates of burnout broadens the existing knowledge on the mechanisms underlying this syndrome. Aim of the Study. The aim of the study is to explore possible differences in brain activity between burnout and nonburnout employees. Frequency-specific EEG power analyses in a resting-state condition in burnout subjects and controls are presented. Materials and Methods. Burnout employees (N=46; 19 men) were matched with the control group (N=49; 19 men; mean age: 36.14 years, SD=7.89). The Maslach Burnout Inventory–General Survey (MBI-GS) and the Areas of Worklife Survey (AWS) scale were used to measure burnout symptoms and work conditions, respectively. A 256-channel EEG (EGI System 300) was used to collect psychophysiological data. A repeated measures ANOVA was performed with condition (eyes-open vs. eyes-closed) and region (6 levels: extracted scalp regions) factors; burnout (2 levels: burnout vs. no burnout) was the grouping factor. Results. A significant difference was observed only in the alpha frequency band: the burnout group revealed significantly lower alpha power in the eyes-open condition compared to the controls (p<0.05). The correlation analysis revealed that gender may significantly change the pattern of relations between EEG spectral characteristics and burnout symptoms. Conclusions. Reduced alpha power in burnout individuals suggests cortical hyperactivity and may be related to greater mental effort and the possible development of compensatory mechanisms by burnout subjects.


2016 ◽  
Vol 19 (1) ◽  
pp. 205-216 ◽  
Author(s):  
Juliana Alvares Duarte Bonini Campos ◽  
Valéria Schneider ◽  
Fernanda Salloume Sampaio Bonafé ◽  
Raquel Velez Oliveira ◽  
João Maroco

ABSTRACT: Objective: The aims of this study were to estimate the association between an at-risk drinking pattern and sociodemographic variables, and to compare the mean scores of the factors associated with the Burnout Syndrome, according to the alcohol consumption pattern in staff members from two Brazilian prisons. Methods: A cross-sectional study was developed with 339 participants (response rate = 63.8%). The instruments used were a sociodemographic questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the Maslach Burnout Inventory - General Survey (MBI-GS). Results: The participants' average age was 40.2 (SD = 8.8) years, and 81.0% were male. Among 78.5% of participants (95%CI 74.1 - 82.8) reported consuming alcoholic beverages. The prevalence of at-risk drinking behavior in the sample was 22.4% (95%CI 18.0 - 26.9), and of the Burnout Syndrome was 14.6% (95%CI 10.8 - 18.4). We observed a significant association between at-risk drinking behavior with gender, higher risk for men (OR = 7.32, p < 0.001), smoking, increased risk for smokers (OR = 2.77, p < 0.001), and religious practice, showing lower risks for religion practitioners (OR = 0.364, p < 0.001). We noticed significantly higher mean scores (p < 0.001) of emotional exhaustion and cynicism, and lower scores of professional achievement among individuals who reported consuming alcoholic beverages. Conclusion: Men who smoke were more likely to develop an at-risk drinking pattern, while religion is presented as a protective factor. Individuals who consume alcohol were more affected by the different factors of the Burnout Syndrome.


2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Shin Yuh Ang ◽  
Satvinder S. Dhaliwal ◽  
Tracy Carol Ayre ◽  
Thendral Uthaman ◽  
Kuan Yok Fong ◽  
...  

Background. The aim of the study was to evaluate the prevalence and extent of burnout among nurses in Singapore and investigate the influence of demographic factors and personal characteristics on the burnout syndrome.Methods. A cross-sectional survey design was adopted. All registered nurses working in Singapore General Hospital were approached to participate. A questionnaire eliciting data on demographics, burnout (measured using the Maslach Burnout Inventory, MBI), and personality profile (measured using the NEO Five-Factor Inventory, NEO-FFI) was used.Results. 1830 nurses out of 3588 responded (response rate: 51%). Results from 1826 respondents were available for analysis. The MBI identified 39% to have high emotional exhaustion (EE, cut-off score of >27), 40% having high depersonalization (DP, cut-off score of >10), and 59% having low personal accomplishment (PA, cut-off score of <33). In multivariable analysis, age, job grade, and neuroticism were significantly associated with each of the 3 components of the MBI. Staff nurses less than 30 years with high to very high neuroticism were more likely to experience high EE, high DP, and low PA.Conclusion. Younger nurses in Singapore are at increased risk of burnout. Personality traits also played a significant role in the experience of burnout.


Author(s):  
Mehul Prajapati ◽  
Labani M. Ghosh

Background: Study aimed to evaluate the relationship between vitamin B12 and acute cerebral stroke in this study.Methods: Blood samples drawn within 24 hours after the stroke from hospitalized patients (n=100) and from 100 control cases matched for age, sex and other modifiable risk factors of stroke were analyzed. With a competitive, ECLIA, serum levels of vitamin B12 were measured. The quantitative data of the groups was compared using Analysis of Varience and Tukeys HSD post hoc test for comparison. Chi-square tests were used.Results: Median serum vitamin B12 levels were significantly lower in the patients than in the control subjects, 188.71 and 256.25 pg/ml respectively (p=0.0001). This difference was independent from other risk factors. The mean age in case group was 62.49 (SD: 12.45 years) and 56.62 (SD: 13.05 years) in control group with p=0.001. Therefore, prevalence of stroke is more between 6th and 7th decade of life. Mean serum vitamin B12 levels were lower in males (201.8pg/ml) than the females (268.pg/ml) in the case group.Conclusions: Low vitamin B12 is associated with an increased risk of stroke, and its relationship is independent from the other known modifiable stroke risk factors.


2016 ◽  
Vol 35 (2) ◽  
pp. 166-174 ◽  
Author(s):  
Fatimah Basil Al-Mukaynizi ◽  
Afrah AlKhuriji ◽  
Zaineb Babay ◽  
Mohammad Addar ◽  
Sooad AlDaihan ◽  
...  

Summary Background: An insertion/deletion (I/D) polymorphism in the angiotensin converting enzyme (ACE) gene has been associated with recurrent miscarriage (RM) in several populations. We initiated this study to determine the association, if any, between the I/D polymorphism of ACE gene and RM in Saudi females. Method: This study was conducted on 61 Saudi females suffering from RM (mean age: 34.1±6.2 years; range 15–45) attending clinics at King Khalid University Hospital, and 59 age matched females who had at least 2 children, as controls. Blood samples were drawn in EDTA tubes by venipuncture. DNA was extracted using the Puregene DNA purification kits. Insertion/Deletion (I/D) polymorphism of ACE gene was investigated by amplifying the genomic DNA by PCR using gene-specific primers. A single 190 bp or 490 bp band was obtained in the homozygous cases for the D allele or I allele, respectively, while the presence of both 190 and 490 bp bands indicated heterozygosity (ID). Statistical analysis: Deviation from Hardy-Weinberg equilibrium was determined (http://ihg.gsf.de/cgi-bin/hw/hwa1.pl). A standard chi-square (χ2) test was used for comparing the genotype and allele frequencies in the two groups and Students‘t’ test and χ2 test were employed to compare values between the two groups. P<0.05 was considered statistically significant. Results: The frequencies of DD, ID, and II genotypes were 56.7%, 29.5% and 4.9%, respectively, in females with RM and 54.2%, 42.3% and 3.3% respectively in the control group, but the difference was not statistically significant. Conclusion: In some populations, meta-analyses showed an association between I/D polymorphism and RM risk, and the D allele was implicated as an increased risk factor for RM. However, this association was not apparent in the Saudi females.


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