The objective of this study was to investigate whether serum cytokine levels correlate with depression and anxiety in colorectal cancer (CRC) patients. Twenty patients hospitalized for surgical resection of CRC were included in the study group and twenty healthy volunteers comprised the control group. Depression and anxiety were analyzed using the Hospital Anxiety and Depression Scale (HADS), and serum levels of IL-1β, IL-6, IL-8, IL-10, IL-12, TNF-α, and TGF-β were measured by Cytometric Bead Array. We found that more than half of CRC patients presented clinically significant levels of anxiety or depression, and 65% of them manifested a combination of severe anxiety and depression. CRC patients had increased serum levels of IL-1β, IL-6, IL-8, and TNF-α but lower IL-10 concentrations. Correlation analysis between HADS score and cytokine levels revealed a positive association of anxiety and/or depression with IL-1β, IL-6, IL-8, and TNF-α and a negative correlation with IL-10. These results indicate that circulating proinflammatory cytokines are involved in the pathophysiology of anxiety and depression in CRC patients. A better understanding of the molecular mechanisms involved in these psychological disorders will allow the design of therapeutic interventions that lead to an improved quality of life and overall survival of CRC patients.

Allergic rhinitis (AR) is a public health problem with high prevalence worldwide. We evaluated levels of specific IgE, IgA, and IgG4 antibodies to the Dermatophagoides pteronyssinus (Dpt) house dust mite and to its major allergens (Der p1 and Der p2) in serum and saliva samples from allergic and nonallergic children. A total of 86 children were analyzed, from which 72 had AR and 14 were nonallergic healthy children. Serum IgE and serum/salivary IgG4 levels to Dpt, Der p1, and Der p2 were higher in allergic children whereas serum/salivary IgA levels to all allergens were higher in nonallergic children. IgE levels positively correlated with IgG4 and IgA to all allergens in allergic children, while IgA levels negatively correlated with IgG4 to Dpt and Der p1 in nonallergic children. In conclusion, mite-specific IgA antibodies predominate in the serum and saliva of nonallergic children whereas mite-specific IgE and IgG4 are prevalent in allergic children. The presence of specific IgA appears to have a key role for the healthy immune response to mucosal allergens. Also, specific IgA measurements in serum and/or saliva may be useful for monitoring activation of tolerance-inducing mechanisms during allergen specific immunotherapeutic procedures, especially sublingual immunotherapy.

According to hygiene hypothesis, a lower exposure to infection is associated with increased prevalence of allergic diseases. This study aimed to investigate the association between atopy and Toxoplasma gondii (Tg) infection by analyzing the antibody and cytokine responses to house dust mite allergens and T. gondii antigens in Brazilian subjects. A total of 275 individuals were assessed and divided into atopics (n=129) and non-atopics (n=146) based on markers of allergy (positive skin prick test and ELISA-IgE to mite allergens) or Tg-seropositive (n=116) and Tg-seronegative (n=159) groups according to infection markers (positive ELISA-IgG to T. gondii). Tg-seropositive individuals presented lower allergenic sensitization (37%) to mite allergens than Tg-seronegative subjects (54%). A significant association was found between atopy and negative serology to T. gondii (OR: 2.0; 95% CI: 1.23–3.26; P<0.05). Proliferative responses and cytokine production after antigenic stimulation showed predominant synthesis of Th1-cytokines as IFN-γ in Tg-seropositive patients, whether atopics or non-atopics. Conversely, Th2-cytokines as IL-5 prevailed in atopics compared to non-atopics, regardless the seropositivity to T. gondii. Levels of IL-10, IL-13, IL-17, and TGF-β were not able to discriminate the groups. Hence, a negative association between atopy and infection by T. gondii was demonstrated for the first time in Brazilian subjects, focusing on the antibody and cytokine responses and indicating that the immunomodulation induced by the parasite may play a protective role in the development of allergic diseases.

Depression and anxiety, the most important psychological disorders in cancer patients, have now been considered as psychoneuroimmunological disorders, in which peripheral immune activation, through the release of proinflammatory cytokines, is implicated in the variety of behavioral, neuroendocrine and neurochemical alterations associated with these disorders. Along with the tumor itself, cancer treatment can also contribute to exacerbate the production of proinflammatory cytokines. This study aimed to investigate whether proinflammatory cytokine levels are related to depression and anxiety in CRC patients in different stages of the antitumor therapy We evaluated 60 patients in three stages of antitumor therapy (Pre-chemotherapy, Under-chemotherapy and Post-chemotherapy, n=20 in each group) and 20 healthy volunteers by the Hospital Anxiety and Depression Scale (HADS). Serum levels of cytokines were measured by CBA. Depression and/or anxiety were found at clinically relevant levels in CRC patients during all antitumor therapy. Patients in pre-chemotherapy group exhibited the highest concentrations of pro-inflammatory cytokines and the lowest levels of IL-10. In latter stages of treatment, cytokines reached levels similar to the control group. Correlation analysis between HADS score and cytokine serum levels revealed positive associations of anxiety and/or depression with IL-1β, IL-6, IL-8, and TNF-α, and a negative correlation with IL-10, suggesting that cytokines are involved in the pathophysiology of these psychological disorders in CRC patients. A better understanding of the molecular mechanisms involved in these psychological disorders will allow the design of new therapeutic strategies to assist in alleviating such symptoms in cancer patients.

No abstract

RESUMO: Trata-se de um estudo transversal conduzido num Serviço de Atenção Domiciliar do interior paulista. Teve como objetivos identificar o uso de Equipamento de Proteção Individual, dispositivos de segurança, descarte de materiais perfurocortantes e fatores que dificultam e/ou facilitam o seu uso por profissionais da equipe de enfermagem. A população foi composta por 45 participantes e todos relataram usar Equipamento de Proteção Individual, sendo que 100% referiram usar luvas e os procedimentos frequentes para o uso foram curativos e administração de medicamentos. Apesar de relatarem que não há dificuldade para utilizar os Equipamentos de Proteção Individual e que se preocupam com sua própria segurança, observou-se que a adesão não foi integral. Assim, são necessários estudos futuros capazes de avaliar como ocorre de fato a assistência à saúde dos usuários nos domicílios, para que estratégias de prevenção possam ser identificadas e incorporadas à prática desses profissionais. DESCRITORES: Equipe de enfermagem; Equipamento de proteção individual; Exposição à agentes biológicos; Serviços de assistência domiciliar. USO DE EQUIPAMENTO DE PROTEÇÃO INDIVIDUAL EM UM SERVIÇO DE ATENÇÃO DOMICILIAR USE OF PERSONAL PROTECTIVE EQUIPMENT IN A HOME CARE SERVICEABSTRACT: A cross-sectional study was conducted at a home care service in the state of São Paulo. The objective of the study was to identify the use of personal protective equipment, safety devices, the disposal of sharp objects, and other factors that make difficult and/or facilitate such use by professionals of the nursing team. The population was made up of 45 participants who reported using personal protective equipment. They all reported using gloves, frequent procedures that required their use were dressings and administration of medications. Although it was reported that the participants did not have difficulty in using personal protective equipment, and that they were concerned about their own safety, full adherence was lacking. Therefore, further studies that are able to evaluate how home care services really occur are necessary, so that prevention strategies can be identified and incorporated into professionals' practice. Estudio transversal realizado en un Servicio de Atención Domiciliaria del interior paulista, con el objetivo de identificar el uso de Equipos de Protección Personal, mecanismos de seguridad, descarte de materiales punzocortantes y factores que dificultan y/o facilitan su utilización en profesionales del equipo de enfermería. La población se compuso de 45 participantes, todos informaron usar Equipos de Protección Personal, el 100% afirmó usar guantes y los procedimientos para su uso frecuente fueron vendajes y administración de medicamentos. A pesar de informarse que no existe dificultado para utilizar Equipos de Protección Personal y que se preocupan por la propia seguridad, se observó que la adhesión no fue integral. Consecuentemente, existe necesidad de estudios a futuro, capaces de evaluar cómo transcurre de hecho la atención de la sa...

Este artigo tem como objetivo refletir sobre a atuação do enfermeiro em oncologia, sob a perspectiva da genética e da genômica, e sobre seu papel como membro integrante da equipe multiprofissional e interdisciplinar de aconselhamento genético oncológico. Trata-se de uma reflexão, fruto de leitura minuciosa da literatura da área, acrescida da experiência dos autores e discussões em grupo de pesquisa. No transcorrer desse trabalho, foi possível constatar que o enfermeiro precisa considerar o cuidado de saúde baseado em genômica e apropriar-se de competências essenciais. Essas competências abrangem a habilidade de mobilizar recursos genômicos na coleta da história familiar e nas orientações sobre testes genéticos a famílias em risco para síndromes neoplásicas hereditárias. O profissional de enfermagem pode atuar como referência para os demais membros da equipe de saúde, com potencial para integrar seus conhecimentos no cuidado, no ensino e em pesquisas em oncologia, sob a ótica da genética e da genômica.

Trata-se de um estudo transversal com objetivo de identificar e caracterizar os acidentes com material biológico relatado por profissionais de enfermagem de um serviço de atenção domiciliar do interior paulista. Dos 30 sujeitos que trabalhavam no serviço, no período da coleta de dados, 28 concordaram participar e 12 (42,8%) relataram ter sofrido pelo menos um acidente com material biológico durante o exercício profissional no serviço. A maioria das exposições foi percutânea (91,7%), o sangue foi o fluido mais frequentemente envolvido (75%). Em relação ao procedimento, 75% dos indivíduos estava administrando medicamento no momento do acidente e 50% admitiu que estava reencapando agulhas ocas. O presente estudo permitiu identificar as situações relatadas pelos profissionais para a ocorrência dos acidentes com material biológico durante a assistência domiciliar, as quais podem subsidiar medidas preventivas e direcionar futuros estudos que envolvam esse tipo de acidente nos domicílios.