Salivary Biomarkers May Be Useful to Assess Stress State in Patients with Lung Cancer Undergoing Chemotherapy

ABSTRAC

外来化学療法を受けるがん患者のセルフケア能力に関連する要因の検討

近年、医療費の削減や患者のQOL向上の観点から、がん治療の場は入院治療から外来治療へ移行している。化学療法は有害事象の出現が多いため、外来治療を受ける患者にはセルフケア能力が求められる。そのため、外来化学療法中のがん患者のセルフケア能力を高めることは医療者の責務である。本研究目的は、外来化学療法中のがん患者のセルフケア能力に関連する要因を検討することであった。外来化学療法中のがん患者103名に、セルフケア能力とセルフケアとの関連が示唆されている患者属性及び主観的健康統制感(健康や病気の原因に関する信念体系)に関する質問紙調査を実施し、93名を分析対象とした。結果、65歳以上の者、配偶者がいる者、患者仲間がいる者、健康や病気の原因を自分自身や家族に求める者の方がセルフケア能力は高かった。このことから、セルフケア支援では健康管理の主体は自分自身にあるという認識を患者に促すことが必要であると示唆された。Recently, in order to reduce medical expenses and improve patients\u27 QOL, cancer treatment has shifted from the hospital to outpatient care. Adverse events often develop during chemotherapy. Therefore, self-care is required of outpatients receiving chemotherapy, and medical staff has to improve self-care agency of outpatients receiving cancer chemotherapy. This study investigated factors related to self-care agency of outpatients receiving cancer chemotherapy. A questionnaire survey was conducted with outpatients (N=103) receiving cancer chemotherapy. The questionnaire inquired about self-care agency, attributes of patients, and health locus of control, defined as the belief system about the cause of health and disease (HLC). Previous studies have indicated that attributes of patients\u27 and HLC are related to self-care. In this study, we analyzed the 93 people. Results indicated that self-care agency was higher in patients aged 65 and older, patients with a spouse, those having other patients as friends, and patients that tended to attribute the causes of the disease, or health to themselves, or to their families. In supporting self-care, the importance of facilitating patients\u27 awareness that health management should be conducted independently by the patients themselves is suggested

Effects of back massage on psychological status and salivary biomarkers

Massage therapy promotes psychosocial relaxation and reduce stress. In addition, this therapy has been reported to improve immune function. Although evaluation of psychosocial status has been performed with subjective psychological tests such as State-Trait Anxiety Inventory （STAI）, subjective psychological tests are of limited value if the subjects fail to report reliably. Salivary biomarkers have been recently suggested as useful objective indicators for assessing psychosocial status. To determine whether salivary biomarkers are useful objective indices for assessing eff ects of back massage on psychological status in 25 young healthy female volunteers, we measured heart rate and salivary biomarkers（ α-amylase, cortisol and chromogranin-A） and assessed STAI score before and after back massage. Back massage significantly reduced heart rate from 73.4±11.8 to 69.8±11.2 and STAI from 41.0±6.0 to 32.3±4.9. In contrast salivary chromogranin-A signifi cantly increased from 2.93±2.21 to 5.29±5.46 pmol/mg protein whilst salivary α-amylase and cortisol did not change. Therefore, salivary biomarkers tested may not indicate changes in psychological relaxation following back massage. Massage therapy has been reported to not only reduce psychosocial stress but also enhance immune functions in cancer patients. In the present study, massage therapy significantly increased chromogranin-A release. As several reports clearly show that chromogranin-A has antibacterial and antifungal activities, back massage may increase host defense with salivary chromogranin-A release against oral microbial invasion

Whole-Body Counter(WBC) and food radiocesium contamination surveys in Namie, Fukushima Prefecture

<div><p>Purpose</p><p>This study examined the internal Cs exposure of residents and the Cs present in food products produced in Namie. Whole-body counter (WBC) was used for the measurement of internal exposure per each whole body of examinees.</p><p>Methods</p><p>The food products which appeared to be used for consumption, were brought by residents and commercially available food items were excluded. Most of them were wild plants or food items produced by residents. Four years of data from April 2012 to March 2013 (fiscal 2012) and April 2015 to March 2016 (Fiscal 2015) were analyzed and studied.</p><p>Results</p><p>The average radioactivity measured by WBC was approximately 5 Bq for Cs-134, and 20 Bq for Cs-137 and the average committed effective dose was approximately 1 <i>μ</i>Sv. The average for the residents with detectable radioactivity was 25 <i>μ</i>Sv, and the human health effects are considered to be extremely low risk. However, the radioactivity of the affected individuals showed a higher value than the theoretical attenuation rate. The majority (83.2%) of individuals exhibiting radioactivity were over 50 years old. The number of food products brought in for detection decreased as the study period progressed, but the number of food products with radioactivity had increased. While the items with a higher detection rate of radioactivity included fruits such as citron and persimmon, shiitake mushrooms exhibited the highest radioactivity. Moreover, the radioactivity of seven items in these 10 items decreased from fiscal 2012 to fiscal 2015. Mushrooms had high radioactivity and were produced over a wide area.</p><p>Conclusion</p><p>We suggest that the elderly try to enjoy life and eat wild plants in moderation while inspecting food products. Therefore, we will continue to work in raising awareness of radiation and its potential presence in food products and thus the continuing necessity of monitoring radioactivity in food in the future.</p></div

Number of the study participants and results of whole body counter.

<p>Number of the study participants and results of whole body counter.</p

Map of Fukushima Prefecture.

<p>Residents of Namie were evacuated to other areas after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Residents of Nihonmatsu City were analyzed in this study.</p

Mean value of radioactivity detected in residents with WBC measurements.

<p>Large variations were not observed for Cs-134 but a tendency of increasing radioactivity with each year was observed for Cs-137. A statistically significant difference was observed for the mean values of Cs-137 radioactivity in 2012 and 2015. [p<0.05] Significant differences were not shown between other groups.</p