Summary In different inflammatory disease models, heat‐shock proteins (hsp) and hsp‐derived peptides have been demonstrated to possess anti‐inflammatory properties. While some studies have shown that hsp can directly interact with antigen‐presenting cells, others report that bacterial hsp can induce specific T cells with regulatory phenotypes. Effective characterization of the immunomodulatory effects of hsp 70, however, has historically been confounded by lipopolysaccharide (LPS) contamination. In this study, we compared the effects of LPS‐free Mycobacterial tuberculosis hsp 70 (TBhsp70) and its possible contaminants on dendritic cells (DC). We demonstrate herein that LPS‐free TBhsp70 inhibits murine DC maturation in vitro, while LPS‐contaminated TBhsp70 induces DC maturation. Mock recombinant preparations have no effect. In contrast to LPS, TBhsp70 does not induce tumour necrosis factor‐α production by DC, but interleukin‐10. In vivo, only LPS‐contaminated TBhsp70 induces up‐regulation of CD86 in splenic mature DC. Finally, TBhsp70 inhibited phytohaemagglutinin‐induced T‐cell proliferation. Our results support the hypothesis that TBhsp70 does not have inflammatory potential, but rather has immunosuppressive properties.

BACKGROUND AND OBJECTIVES: There are many ways to manage burned patients pain, which require the use of available and specific resources for the treatment of this pain. This study aimed at reflecting about the participation of the nursing team in the management of burned patient's pain. CONTENTS: Burn-related pain has a major impact in patients' lives and the nursing professional should have an appropriate participation in its management. CONCLUSION: The participation of the nursing team is critical to the process and may influence the success and effectiveness of pain relief; however, there is the need for investments in technical-scientific knowledge and awareness of these caregivers.

Rev Dor. São Paulo, 2011 jul-set;12(3):265-69 RESUMO JUSTIFICATIVA E OBJETIVOS: A dor traz prejuí-zos na recuperação do paciente submetido à cirurgia ortopédica. O objetivo deste estudo foi descrever as informações relacionadas à experiência dolorosa de pacientes em pós-operatório de cirurgias ortopédicas na sala de recuperação pós-anestésica (SRPA) que podem contribuir para a assistência de Enfermagem. CONTEÚDO: Trata-se de estudo com abordagem qualitativa, as fontes para a coleta das informações foram as bases de dados da plataforma da BIREME, os objetos foram artigos que atenderam aos seguintes critérios de inclusão previamente estabelecidos, a coleta ocorreu mediante busca on-line, a abordagem das informações foi realizada pelo método da Hermenêutica Dialética. SUMMARY BACKGROUND AND OBJECTIVES:Pain is noxious for the recovery of patients submitted to orthopedic surgery. This study aimed at describing information on the pain experience of patients in the postoperative period of orthopedic surgeries in the post-anesthetic recovery unit (PACU), which may be useful for the Nursing assistance. CONTENTS: This is a qualitative study using BIREME's platform databases to collect information. The aims were articles meeting the following and previously established inclusion criteria and data were collected by online search. Information was approached by the Dialectic Hermeneutics method. After this approach, the following categories were surveyed: "Regional anesthesia decreases postoperative pain in orthopedic surgeries", "Therapy for postoperative pain of orthopedic surgeries", "Evaluation helps pain management in the postoperative period of orthopedic surgeries". CONCLUSION: Postoperative pain control is important for orthopedic patients and regional anesthesia may provide preventive analgesia for the immediate postoperative period. The nursing team shall establish the nursing diagnosis and interventions shall be preceded by the evaluation of intensity, quality and factors interfering with pain felt by orthopedic patients.

OBJECTIVE: Follow-up studies of girls with premature adrenarche have reported the development of polycystic ovary syndrome, insulin resistance, and dyslipidemia and a propensity to cardiovascular disease. The aim of this study was to analyze the presence of these conditions in patients previously treated at the Universidade Federal do Triângulo Mineiro. METHODS: A total of 130 medical records reported premature adrenarche. One hundred and twenty-two patients were invited to participate, of whom 54 accepted; 34 patients were selected, as they had reached their final height. Anthropometric, blood glucose, insulin, and lipid and hormonal profile (LH, FSH, estradiol, 17α-OH-progesterone, androstenedione, dehydroepiandrosterone sulfate, testosterone) data were obtained, the HOMA-IR index was calculated, and pelvic ultrasonography was performed. To characterize polycystic ovary syndrome and metabolic syndrome, the Rotterdam and International Diabetes Federation criteria, respectively, were used. Data were analyzed according to measures of dispersion, frequency and correlations of interest. RESULTS: The age of the participants ranged from 15.2 to 28.2 years/months; 23.5% of the patients were overweight, 11.8% were obese, 29.4% had a large waist circumference, and 8.8% were hypertensive. None of the patients had altered glucose levels, and insulin levels and HOMA-IR were elevated in 29.4% and 38.2% of the participants, respectively; 14.7% of the patients exhibited acanthosis nigricans . The lipid profiles of the participants were variable, and one patient (2.9%) had metabolic syndrome. Polycystic ovary syndrome was found in 41.2% of patients. CONCLUSION: The percentage of patients with polycystic ovary syndrome who also had overweight, obesity and insulin resistance corroborates the literature data about the need for follow-up aiming at interventions, especially for conditions associated with cardiometabolic risk.

Ageing of the endocrine system (endocrinosenescence) has been closely related to immunosenescence. Dehydroepiandrosterone sulphate (DHEAS), a steroid hormone produced by the adrenals with reported enhancing immunomodulatory properties, consistently decline during ageing in parallel to detrimental increase in peripheral glucocorticoids. We investigated here the adjuvant effects of DHEAS during intraperitoneal immunization to Mycobacterium tuberculosis heat shock protein 70 (mycHSP70) in old (24 months) as well as young (3 months) BALB/c mice. Both young and old mice had significantly higher Immunoglobulin G (IgG) levels following immunization. Young mice co-immunized with mycHSP70-DHEAS presented an early increase in specific IgG levels and showed increased Interferon-gamma production compared to old mice. Also, T cells of immunized young animals were consistently more resistant to the immunosuppressive effects of glucocorticoids and to DHEAS. DHEAS was not effective in modulating antigen-specific T-cell proliferation, Interleukin-2 production or percentage of recent activated T-cell subsets (CD4 + CD69 + and CD8 + CD69 +). Our data further indicate mycHSP70 as a putative good antigen in vaccine to tuberculosis. Our data also suggest that DHEAS produced adjuvant effects upon humoral and some cellular immune responses of young, but not old mice and indicate that immunization with DHEAS is capable of changing T-cell responses to steroids.