Chitosan/genipin modified electrode for voltammetric determination of interleukin-6 as a biomarker of sepsis.

Ultrasensitive electroanalytical monitoring of interleukin-6 levels in serum samples has emerged as a valuable tool for the early diagnosis of inflammatory diseases. Despite its advantages, there is a lack of strategies for the label-free voltammetric determination of cytokines. Here, a novel chitosan/genipin modified fluorine tin oxide electrode was developed providing an in-situ hydrogel formation (FTO/CSG). This platform was applied for the detection of interleukin-6, a major pro-inflammatory cytokine. Transmission electron microscopy (TEM), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS) indicated genipin serves as an efficient green cross-linker to build the immunosensing platform (FTO/CSG/anti-IL-6). EIS showed an increase in charge transfer resistance from 326 to 1360 kΩ after the immobilization of anti-IL-6 antibodies. By square wave voltammetry, this method achieved a detection limit of 0.03 pg mL-1 with a wide linear range of 0.05-1000 pg mL-1. Additionally, it displayed a high selectivity index when tested in the presence of three inflammatory cytokines as interfering proteins: IL-12, IL-1ß, and TNF-α. The sample matrix effect showed a peak current variation lower than 5 %. The novel method was applied for the quantification of IL-6 in serum samples of septic mice. No statistical differences were observed between the standard ELISA and the proposed method using a confidence level of 95 %.

An evolutionary recent IFN/IL-6/CEBP axis is linked to monocyte expansion and tuberculosis severity in humans.

Monocyte counts are increased during human tuberculosis (TB) but it has not been determined whether Mycobacterium tuberculosis (Mtb) directly regulates myeloid commitment. We demonstrated that exposure to Mtb directs primary human CD34+ cells to differentiate into monocytes/macrophages. In vitro myeloid conversion did not require type I or type II IFN signaling. In contrast, Mtb enhanced IL-6 responses by CD34+ cell cultures and IL-6R neutralization inhibited myeloid differentiation and decreased mycobacterial growth in vitro. Integrated systems biology analysis of transcriptomic, proteomic and genomic data of large data sets of healthy controls and TB patients established the existence of a myeloid IL-6/IL6R/CEBP gene module associated with disease severity. Furthermore, genetic and functional analysis revealed the IL6/IL6R/CEBP gene module has undergone recent evolutionary selection, including Neanderthal introgression and human pathogen adaptation, connected to systemic monocyte counts. These results suggest Mtb co-opts an evolutionary recent IFN-IL6-CEBP feed-forward loop, increasing myeloid differentiation linked to severe TB in humans.

Avaliação urodinâmica em idosas com incontinência urinaria: um relato de experiência a partir da consulta de enfermagem / Urodynamic evaluation in elderly women with urinary incontinence: a report of experience from the nursing consultation

Importância da consulta de enfermagem a mulheres idosas com incontinência urinaria em avaliação urodinâmica, proporcionando uma melhor compreensão do perfil clinico destas pacientes, desenvolvendo um cuidado assistencial sistemático dinâmico e adequado ao ambiente do exame em que a mulher idosa está inserida. Nesta experiência, valorizou-se o acolhimento, a acessibilidade à informação, conhecimento prévio ao exame e o cuidado empoderador, envolvendo a paciente em uma participação ativa nas ações de cuidados realizados, minimizando-se a ansiedade e o medo pela realização do exame EUD. Enfatiza-se a importância de novas pesquisas nessa área com vistas a contribuir para a visibilidade da sistematização da assistência de enfermagem para valorização do enfermeiro e de seu papel na compreensão de necessidades de saúde a serem atendidas por meio do planejamento de intervenções de enfermagem