Burnout was most strongly associated with shifts >12 h and with both current and previous depression. Reported suboptimal patient care was also associated with working shifts of >or=12 h. Burnout may be adversely affecting junior doctors' health and their patients' care.

No abstract

Our results show that the relationship between industrial uses of all forms of asbestos is generating an increase in mesothelioma-related diseases and deaths among Mexican workers. As a public health policy, Mexico should prohibit the use of asbestos in all production processes with the aim of controlling the epidemic and preventing the occurrence of new cases of MPM.

Background: Diagnosis of malignant pleural mesothelioma (MPM) remains a challenge, especially when resources in pathology are limited. The study aimed to evaluate cost-effective tumor markers to predict the probability of MPM in plasma samples in order to accelerate the diagnostic workup of the tissue of potential cases.Methods: We conducted a case-control study stratified by gender, which included 75 incident cases with MPM from three Mexican hospitals and 240 controls frequency-matched by age and year of blood drawing. Plasma samples were obtained to determine mesothelin, calretinin, and thrombomodulin using enzyme-linked immunosorbent assays (ELISAs). We estimated the performance of the markers based on the area under the curve (AUC) and predicted the probability of an MPM diagnosis of a potential case based on the marker concentrations.Results: Mesothelin and calretinin, but not thrombomodulin were significant predictors of a diagnosis of MPM with AUCs of 0.90 (95% CI: 0.85-0.95), 0.88 (95% CI: 0.82-0.94), and 0.51 (95% CI: 0.41-0.61) in males, respectively. For MPM diagnosis in men we estimated a true positive rate of 0.79 and a false positive rate of 0.11 for mesothelin. The corresponding figures for calretinin were 0.81 and 0.18, and for both markers combined 0.84 and 0.11, respectively.Conclusions: We developed prediction models based on plasma concentrations of mesothelin and calretinin to estimate the probability of an MPM diagnosis. Both markers showed a good performance and could be used to accelerate the diagnostic workup of tissue samples in Mexico.

Although solvent mixture concentrations and noise levels were low, our results demonstrate that there may be a concurrent ototoxicity and neurotoxicity condition and emphasize the importance of including BAEP analysis for comprehensive assessments. Future studies that include otoacoustic emissions assessments to monitor cochlear function and central auditory processing tests are imperative.

This study quantified asbestos use in Mexico in the past decade and evaluated available data on mortality due to malignant mesothelioma in Mexico between 1979 and 2000. Mortality data were analyzed from secondary databases of the Mexican Social Security System and the Ministry of Health. Data on the import and export of asbestos in Mexico were obtained from the Ministry of Trade and Industrial Development of Mexico. Deaths due to pleural mesothelioma significantly increased in this period. Although the import of asbestos declined, the number of Mexican products that contain asbestos tripled. Export of Mexican asbestos-containing products to Central America grew rapidly in the last ten years of the study. Mexico continues the appreciable use of asbestos and has experienced a significant increase in the occurrence of the sentinel asbestos-related disease, malignant mesothelioma. Given the many limitations to the control of hazardous work exposures in Mexico, a ban on asbestos is advocated as the most feasible means of limiting an epidemic of asbestos-related disease.

No abstract

Lead exposure is a significant problem of radiator repair work, a small industry that is abundant in Mexico and other developing countries.