[Relation between sleep deprivation and nursing errors during the night shift]. / Il legame tra la privazione del sonno e gli errori commessi dagli infermieri durante il turno di notte.

INTRODUCTION: Nurses who work at night often experience high levels of sleepiness, which are the biological consequence of the circadian rhythm, which induces sleep at particular hours of the night, increasing the risk of errors and accidents. OBJECTIVE: According to the latest data declared by the World Organization of Healthcare (WHO), at least 134 million patients are victims every year adverse events that occur due to the lack of safety in the health care and and 2.6 million those who die from it, but most of these deaths are avoidable. The study aims to investigate the relationship between sleep deprivation and errors in patient care by the nursing staff who works the night shift. In the aviation and transportation sectors, studies conducted revealed as sleep deprivation increases the risk of mistakes. Few researches have investigated nighttime nursing. METHODS: A literature search was conducted by interrogating banks PubMed and Cochrane data limiting article selection to the last 10 years. Only one study met our benchmarks: "Sleep deprivation and error in Nurses who work the night shift "of 2014, by Arlene L. Johnson, whose questionnaire it was adapted to the Italian situation and administered to a sample of 41,000 nurses, to which 3358 responded. RESULTS: 94.7% of the interviewees, during the night shift, carry out ordinary activities. 16.8 of respondents made mistakes in the last two night shifts; in 59.5% of the cases only one mistake was made. Lack of sleep (3-5 hours of sleep during the 24 hours of the day before the interview) seems to determine a higher frequency of errors. This trend is particularly marked a nurses working in critical wards (23.9%). Even the number of nights, affects the propensity to make mistakes, with an error rate of 20.5%.

EBV infection of primary colonic epithelial cells causes inflammation, DDR and autophagy dysregulation, effects that may predispose to IBD and carcinogenesis.

EBV is a gammaherpesvirus strongly associated to human cancer. The virus has been shown to play a role also in inflammatory diseases, including IBD, in the context of which colon cancer more frequently arise. In this study, we show for the first time that EBV infects primary colonic epithelial cells (HCoEpC), promotes pro-inflammatory cytokine secretion and activates molecular pathways bridging inflammation and cancer, such as ERK1/2. These effects, occurring in the course of the lytic phase of the viral life cycle, led to DDR and autophagy dysregulation. Such cellular responses, playing a key role in the maintenance of proteostasis and genome integrity, are essential to prevent carcinogenesis. Interestingly, we found that the use of the demethylating agent 5-AZA could counteract most of the effects induced by EBV infection in HCoEpC, suggesting that DNA hyper-methylation may strongly contribute to viral-driven inflammation and colon cancer predisposition.