Psychological stress factors and salivary cortisol in nursing students throughout their training / Factores de estrés psicológico y cortisol salivar en alumnos de enfermería a lo largo de la formación / Fatores de estresse psicológico e cortisol salivar em alunos de enfermagem ao longo da formação

ABSTRACT Objective: to analyze psychological stress factors and salivary cortisol concentration in nursing undergraduates throughout their training. Method: a cross-sectional, analytical, and comparative study carried out in an evening course using a sociodemographic questionnaire, an Instrument to Assess Stress in Nursing Students, and salivary cortisol analysis. The study included descriptive and comparative analyses and a multiple linear regression model. Results: 187 participants answered the questionnaires, and 129 had their cortisol quantified. The domains Practical Activities Execution, Professional Communication, and Professional Training represented the stress factors with the highest mean values for 3rd, 4th, and 5th-year students compared to 1st and 2nd year. For the 5th year, it was the domains Professional Communication and Professional Training compared to the 3rd year and Environment compared to the 1st and 3rd year. A significant result was obtained between the times of cortisol collections for males (p < 0.0001), females (p < 0.0001), and for 1st (p = 0.0319) 2nd (p = 0.0245), and 5th (p < 0.0001) years. Conclusion: Students in years 3 through 5 had higher exposure to stressors, and there were adjustments in cortisol production rhythmicity for students in years 1, 2, and 5.

RESUMEN Objetivo: analizar los factores de estrés psicológico y la concentración de cortisol salivar de estudiantes de enfermería a lo largo de su formación. Método: es un estudio transversal, analítico y comparativo realizado en un curso nocturno mediante cuestionario sociodemográfico, Instrumento para Evaluación del Estrés en Estudiantes de Enfermería y análisis del cortisol salivar. Se llevaron a cabo diversos análisis descriptivos, comparativos y modelo de regresión linear múltiple. Resultados: 187 respondieron a los cuestionarios y a 129 se les cuantificó el cortisol. Los dominios Realización de Actividades Prácticas, Comunicación Profesional y Formación Profesional representaron los factores de estrés con los valores medios más altos en los estudiantes de 3er, 4º y 5º año en comparación con los de 1er y 2º año. Para el 5º año fueron los dominios Comunicación Profesional y Formación Profesional en comparación con el 3er año y Medio Ambiente en comparación con el 1er y 3er año. Se obtuvo un resultado significativo entre los momentos de las recogidas de cortisol de los hombres (p < 0,0001), de las mujeres (p < 0,0001), y del 1er (p = 0,0319), 2º (p = 0,0245) y 5º (p < 0,0001) año. Conclusión: los alumnos de 3er a 5º año tuvieron una mayor exposición a los estresores y hubo ajustes en la ritmicidad de la producción de cortisol en los alumnos de 1er, 2º y 5º año.

RESUMO Objetivo: analisar os fatores de estresse psicológico e a concentração de cortisol salivar de graduandos de Enfermagem ao longo da formação. Método: estudo transversal, analítico e comparativo realizado em curso noturno por meio de questionário sociodemográfico, Instrumento para Avaliação de Estresse em Estudantes de Enfermagem e análise do cortisol salivar. Foram feitas análises descritivas, comparativas e modelo de regressão linear múltipla. Resultados: um total de 187 responderam aos questionários, e 129 tiveram o cortisol quantificado. Os domínios Realização das Atividades Práticas, Comunicação Profissional e Formação Profissional representaram os fatores de estresse com os maiores valores médios para alunos do 3º, 4º e 5º anos em comparação ao 1º e 2º anos. Para o 5º ano, foram os domínios Comunicação Profissional e Formação Profissional em relação ao 3º ano e Ambiente em comparação ao 1º e 3º anos. Obteve-se resultado significativo entre os horários das coletas de cortisol para homens (p < 0,0001), mulheres (p < 0,0001) e para o 1º (p = 0,0319) 2º (p = 0,0245) e 5º (p < 0,0001) anos. Conclusão alunos do 3º ao 5º ano tiveram maior exposição aos fatores de estresse, e houve ajustes na ritmicidade de produção do cortisol para alunos do 1º, 2º e 5º anos.

A Flow Injection Chemiluminescence Method for Determination of Hydrocortisone in Human Serum by Trivalent Silver Complex / 分析化学

A flow-injection chemiluminescence ( FI-CL ) reaction system with diperiodatoargentateⅢ was developed for the determination of hydrocortisone in human serum. The weak chemiluminescence signal from the reaction between DPA and sulfuric acid system can be greatly enhanced in the presence of hydrocortisone. The optimal conditions of the CL system were 1. 0 mol/L H2SO4, 2. 5×10-4 mol/L diperiodatoargentateⅢ, and flow rate of 4. 20 mL/min. Under the optimal conditions, the CL intensity was linearly to the concentration of hydrocortisone from 3 . 0 × 10-10 g/mL to 1 . 0 × 10-7 g/mL and the detection limit was 2 . 2 × 10-10 g/mL ( 3σ) . The relative standard deviation ( RSD ) was 0 . 6% ( n =11 ) for 5 . 0 × 10-8 g/mL hydrocortisone solution. The proposed method was successfully applied to the direct determination of hydrocortisone in serum samples with the recoveries of 93 . 0%-110 . 0%, and the relative standard deviations were 0 . 3%-3 . 2%. The possible chemiluminescence mechanism was investigated by measuring fluorescence spectra and UV-vis absorption spectra of the system.

The Comparative Study of Treatment Method on Adriamycin-Induced Extravasation Injury

PURPOSE: Local skin necrosis after extravasation of adriamycin, a widely used chemotherapeutic agent, is a common problem in cancer patients. The extravasation of chemotherapeutic agents yields severe inflammatory responses, crust formation, skin necrosis, and ulceration. Even though several treatment options have been proposed for extravasation injury, there is still controversy regarding the management of such lesions. Thus the aim of this study was to compare the efficacy of saline injection (Group 1), hydrocortisone injection (Group 2), propranolol injection (Group 3) and early surgical excision as a treatment (Group 4) in a rat extravasation model. METHODS: The authors planned forty mature male Sprague-Dawley rats were divided into 4 groups and each group contained 10 rats. Administration of adriamycin (1.0 mg/mL) 1.5 mL by subcutaneous injection on the dorsal side of the rats was followed by protocol. The treatment options were applied 2 hours after adriamycin injection. At the end of the 5th day, the presence and size of ulcers at the injection site were checked. Three weeks after injection, a histopathologic examination was performed for each treatment and control group. T-tests were used to analyze the differences between the measurements. RESULTS: Propranolol significantly improved tissue recovery compared with control group and other groups. These data suggest that there is little role for saline and hydrocortisone in the treatment of adriamycin extravasation injury. CONCLUSION: In this study, we compared some treatment methods in adriamycin extravasation model. The findings support the propranolol injection may prevent extravasation injury. However this study was performed in the laboratory using rats, and the results could be different in clinical application. Further investigations and more clinical application are needed.