Prevention Of Sepsis Research Articles

Beneficial Immune Regulation by Biological Response Modifier Glucans in COVID-19 and Their Envisaged Potentials in the Management of Sepsis.

Sepsis is a life-threatening condition caused by an abnormal immune response induced by infection with no approved or specific therapeutic options. We present our perspectives for the therapeutic management of sepsis through a four-way approach: (1) infection control through immune enhancement; (2) immune suppression during the initial hyper-inflammatory phase; (3) balanced immune-modulation to counter the later immune-paralysis phase; and (4) advantageous effects on metabolic and coagulation parameters throughout. COVID-19 is a virus-triggered, accelerated sepsis-like reaction that is associated with the rapid progress of an inflammatory cascade involving a cytokine storm and multiorgan failure. Here, we discuss the potential of the biological response modifiers, β-glucans (BRMGs), in the management of sepsis based on their beneficial effects on inflammatory-immune events in COVID-19 clinical studies. In COVID-19 patients, apart from metabolic regulation, BRMGs, derived from a black yeast, Aureobasidium pullulans strain AFO-202, have been reported to stimulate immune responses. BRMGs, produced by another strain (N-163) of A. pullulans, have been implicated in the beneficial regulation of inflammatory markers and immunity, namely IL-6, C-reactive protein (CRP), D-Dimer, ferritin, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), leucocyte-to-C-reactive protein ratio (LeCR), and leukocyte-to-IL-6 ratio (LeIR). Agents such as these β-glucans, which are safe as they have been widely consumed by humans for decades, have potential as adjuncts for the prevention and management of sepsis as they exert their beneficial effects across the spectrum of processes and factors involved in sepsis pathology, including, but not limited to, metabolism, infection, inflammation, immune modulation, immune enhancement, and gut microbiota.

Text-Based vs. Graphical Information Formats in Sepsis Prevention and Early Detection: A Randomized Controlled Trial on Informed Choice.

Sepsis is associated with 11 million global deaths annually. Although serious consequences of sepsis can generally be avoided with prevention and early detection, research has not yet addressed the efficacy of evidence-based health information formats for different risk groups. This study examines whether two evidence-based health information formats—text based and graphical—differ in how well they foster informed choice and risk and health literacy and in how well they support different sepsis risk groups. Based on a systematic literature review, two one-page educative formats on sepsis prevention and early detection were designed—one text based and one graphical. A sample of 500 German participants was randomly shown one of the two formats; they were then assessed on whether they made informed choices and on their risk and health literacy. For both formats, >70% of participants made informed choices for sepsis prevention and >75% for early detection. Compared with the graphical format, the text-based format was associated with higher degrees of informed choice (p = 0.012, OR = 1.818) and risk and health literacy (p = 0.032, OR = 1.710). Both formats can foster informed choices and risk and health literacy on sepsis prevention and early detection, but the text-based format appears to be more effective.

Ibuprofen-Induced Toxic Epidermal Necrolysis: A Case Report

Introduction: Toxic epidermal necrolysis (TEN) is a medical emergency that most commonly occurs as an adverse effect of certain drugs. Here, we describe a case of a 41-year-old man with no comorbid illness who developed TEN. Case Presentation: The patient had been prescribed ibuprofen for myalgia and developed skin lesions after the single dose. The lesions were erythematous papules and macules distributed all over the body after ibuprofen intake. TEN was diagnosed based on the patient’s clinical presentation and laboratory findings. He was treated with intravenous dexamethasone, intravenous immunoglobulin, and cyclosporine. Daily dressing changes and skin care was done with saline, chlorhexidine, and liquid paraffin. The patient was intubated and tracheostomized, and he gradually improved and survived. Later, he developed septicemia in the intensive care unit and was treated successfully. Discussion: The management of TEN includes cessation of the causative cause, multidisciplinary ICU care, prevention and early detection of sepsis, fluid and electrolyte balance, adequate analgesia and temperature control, proper organ support, aggressive nutritional management, and good psychological support. The pharmacological therapy for TEN includes corticosteroids, intravenous immunoglobulin, and cyclosporine. The key elements of management are aseptic care and proper dressing of the skin. Conclusion: TEN is associated with high mortality if not managed in a systemic and protocolized way.

The Sepsis Bundle Effect: An Evaluation of Culture Results and Utilization in Pediatric Appendicitis.

Sepsis prevention pathways, which often include blood and urine cultures, are common in children's hospitals. Fever and tachycardia, signs often seen in patients with appendicitis, frequently trigger these pathways. We hypothesized that cultures were frequently obtained in children with appendicitis. We conducted a single-center retrospective cohort study evaluating children with image-confirmed appendicitis from 4/1/2019 to 10/1/2020, coinciding with the initiation of sepsis prevention pathways. Factors associated with culture acquisition, as well as culture results, treatment, and outcomes were evaluated. Six hundred and fifty eight children presented with acute appendicitis during the 1.5-year period, with a median age of 10.67 years (interquartile range (IQR) 8.17-14.08). Cultures were obtained in 22.9%, including blood culture (BCx) in 8.1% and urine culture (UCx) in 17.9%. Culture acquisition decreased by 17.6% after sepsis protocol initiation. Blood culture acquisition correlated with fever (P = .003) and younger age (P = .03), whereas the attainment of BCx and UCx was associated with female sex (P = .04, P < .0001), complicated appendicitis (P = .0001, P = .03), and unknown diagnosis (P < .0001, P < .0001). There were five positive UCx (4.24%); however, all remained asymptomatic despite a short antibiotic duration dictated by institutional appendicitis protocol. The one positive BCx (1.89%) was suspected contamination and not treated. The findings of this cohort suggest a low incidence of positive culture as well as lack of impact on clinical management in image-proven appendicitis and the initiation of a sepsis bundle without automatic culture acquisition may result in decreased culture attainment.

CASP-Model Sepsis Triggers Systemic Innate Immune Responses Revealed by the Systems-Level Signaling Pathways.

Colon ascendens stent peritonitis (CASP) surgery induces a leakage of intestinal contents which may cause polymicrobial sepsis related to post-operative failure of remote multi-organs (including kidney, liver, lung and heart) and possible death from systemic syndromes. Mechanisms underlying such phenomena remain unclear. This article aims to elucidate the mechanisms underlying the CASP-model sepsis by analyzing real-world GEO data (GSE24327_A, B and C) generated from mice spleen 12 hours after a CASP-surgery in septic MyD88-deficient and wildtype mice, compared with untreated wildtype mice. Firstly, we identify and characterize 21 KO MyD88-associated signaling pathways, on which true key regulators (including ligands, receptors, adaptors, transducers, transcriptional factors and cytokines) are marked, which were coordinately, significantly, and differentially expressed at the systems-level, thus providing massive potential biomarkers that warrant experimental validations in the future. Secondly, we observe the full range of polymicrobial (viral, bacterial, and parasitic) sepsis triggered by the CASP-surgery by comparing the coordinated up- or down-regulations of true regulators among the experimental treatments born by the three data under study. Finally, we discuss the observed phenomena of “systemic syndrome”, “cytokine storm” and “KO MyD88 attenuation”, as well as the proposed hypothesis of “spleen-mediated immune-cell infiltration”. Together, our results provide novel insights into a better understanding of innate immune responses triggered by the CASP-model sepsis in both wildtype and MyD88-deficient mice at the systems-level in a broader vision. This may serve as a model for humans and ultimately guide formulating the research paradigms and composite strategies for the early diagnosis and prevention of sepsis.

Epidemiological profile of deaths from sepsis in the state of Piauí

Context: sepsis is a dysfunction resulting from an infection in the organs caused by irregular inflammation in the body, and in severe cases it causes vasodilation and a decrease in blood pressure. Therefore, this research had as its guiding question: what is the epidemiological profile of deaths from sepsis in the state of Piauí? Objective: with this, the objective of this article was to map the epidemiological profile of deaths from sepsis in the state of Piauí-PI, contributing with knowledge to public health managers, so that they can organize strategies to combat sepsis, detecting and performing the treatment of the pathology in a preliminary way. Methodology: this is a retrospective epidemiological survey, carried out on the DATASUS[3] platform in May 2022, referring to deaths from sepsis in the state of Piauí-PI, belonging to the period from January 2018 to December 2021, in which data such as: age group, sex and color/race of individuals over 20 years of age were included. Results: with this research, it was possible to analyze the epidemiological profile of patients with sepsis in the State of Piauí-PI. Thus, regarding the age group, it was observed that the profile most affected by deaths from septicemia corresponds to those who are over 65 years of age, and those who are most likely to suffer from the pathology are those who are 80 years of age or older, with an incidence of 28.37%. Thus, regarding the number of deaths recorded during the four years researched in relation to sex, it was found that the female represented a percentage of 50.46%, while the male represented 49.49%. And, as for color/race, it was evidenced that the patients who most die from septicemia are those who declare themselves as brown followed by yellow and white. Considerations: in view of this, it is expected with this study that the epidemiological authorities remain on alert in the prevention of sepsis, because during the study it was possible to observe that the mortality rate is higher in elderly patients.

Nursing Care in the Management and Prevention of Sepsis in the Neonatal ICU Department

The human being can acquire infectious diseases during life, which leads the organism to trigger a systemic and exacerbated response to them and generate significant metabolic dysfunctions, this concept defines sepsis, with this sepsis can develop, a pathology that leads to high mortality rate for the sick, this is also known as generalized infection or sepsemia. When it comes to the neonate, he has an even greater fragility for this pathology in view of the immunological fragility of this patient, thus bringing the need for an accuracy and a judicious look on the part of the nursing team in the execution of their actions of prevention and management of the disease. sepsis in the neonatal ICU. This study is a qualitative bibliographic research, with an exploratory and descriptive approach, where SciELO and LILACS databases were used to research scientific material, it aimed to evaluate the interventions of nursing professionals in the management and early diagnosis of sepsis in a neonatal ICU. According to the analysis of the speeches, it is understood that the objectives were achieved, as they revealed that the interventions of the nursing professional are of fundamental importance in the management of diagnosis and early treatment of sepsis in a neonatal ICU.

On race, human variation, and who gets and dies of sepsis

COVID‐19 has highlighted a brutal reality known for decades, that Black, Indigenous, and People of Color bear a disproportionate burden of US annual sepsis cases. While plentiful research funds have been spent investigating genetic reasons for racial disparities in sepsis, an abundance of research shows that sepsis incidence and mortality maps to indicators of colonial practices including residential segregation, economic and marginalization sepsis, and denial of care. Here we argue that sepsis risk is an immunological embodiment of racism in colonial states, that the factors contributing to sepsis disparities are insidious and systemic. We show that regardless of causative pathogen, or host ancestry, racialized people get and die of sepsis most frequently in a pattern repeatedly reiterated worldwide. Lastly, we argue that while alleviation of sepsis disparities requires radical, multiscale intervention, biological anthropologists have a responsibility in this crisis. While some of us can harness our expertise to take on the ground action in sepsis prevention, all of us can leverage our positions as the first point of contact for in depth human biology instruction on most college campuses. As a leading cause of death worldwide, and a syndrome that exhibits the interplay between human physiology, race and environment, sepsis is at the nexus of major themes in biological anthropology and is a natural fit for the field's curriculum. In adopting a discussion of race and sepsis in our courses, we not only develop new research areas but increase public awareness of both sepsis and the factors contributing to uneven sepsis burden.

Comparative study in acute pancreatitis to find out the effectiveness of early addition of ulinastatin to current standard care in Indian subjects

Background: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) causing distant organ involvement and hampering its function and ending up with multiple organ dysfunction syndrome (MODS). It remains a common disorder with devastating consequences .Although most episodes are mild and self-limiting, up to a one-fifth of patients develop a severe attack that can be fatal. Inspite of technical advances in medical and surgical field’s acute pancreatitis remains a major cause of morbidity and mortality. Aims and Objectives: Our aim is to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects with acute pancreatitis. The aim of this study is to compare effectiveness of with or without injection Ulinastatin in acute pancreatitis with respect to: 1) Duration of analgesic requirement, 2) Prevention of early sepsis and complication, 3) Duration of hospital stay. Material and methods: This prospective study was conducted between December 2018 to December 2019 on patients admitted to Dhiraj Hospital Piparia Vadodara. 60 patients with episodes of acute pancreatitis were enrolled for the study.

Trichinella spiralis cystatin alleviates polymicrobial sepsis through activating regulatory macrophages

BackgroundSepsis is a life-threateningorgandysfunction caused by the cytokine storm induced by the severe bacterial infection. Excessive inflammatory responses are responsible for the lethal organ damage during the early stage of sepsis. Helminth infection and helminth-derived proteins have been identified to have the ability to immunomodulate the host immune system by reducing inflammation against inflammatory diseases. Trichinella spiralis cystatin (Ts-Cys) is a cysteine protease inhibitor with strong immunomodulatory functions on host immune system. Our previous studies have shown that excretory-secretory proteins of T. spiralis reduced sepsis-induced inflammation and Ts-Cys was able to inhibit macrophages to produce inflammatory cytokines. Whether Ts-Cys has a therapeutic effect on polymicrobial sepsis and related immunological mechanism are not yet known. MethodsSepsis was induced in BALB/c mice using cecal ligation and puncture (CLP), followed by intraperitoneal injection of 15 µg recombinant Ts-Cys (rTs-Cys). The therapeutic effect of rTs-Cys on sepsis was evaluated by observing the 72-hour survival rates of CLP-induced septic mice and the acute injury of lung and kidney through measuring the wet/dry weight ratio of lung, the levels of blood urea nitrogen (BUN) and creatinine (Cr) in sera and the tissue section pathology. The potential underlying mechanism was investigated using mouse bone marrow-derived macrophages (BMDMs) by observing the effect of rTs-Cys on LPS-stimulated macrophage polarization. The expression of genes associated with macrophage polarization in BMDMs and tissues of septic mice was measured by Western Blotting and qPCR. ResultsIn this study, we demonstrated the treatment with rTs-Cys alleviated CLP-induced sepsis in mice with significantly reduced pathological injury in vital organs of lung and kidney and reduced mortality of septic mice. The further study identified that treatment with rTs-Cys promoted macrophage polarization from classically activated macrophage (M1) to alternatively activated macrophage (M2) phenotype via inhibiting TLR2/MyD88 signal pathway and increasing expression of mannose receptor (MR), inhibited pro-inflammatory cytokines (TNF-α, IL-6 and IL-1β) and increased regulatory anti-inflammatory cytokines (IL-10 and TGF-β) in sera and tissues (lung and kidney) of mice with polymicrobial sepsis. ConclusionsOur results demonstrated that rTs-Cys had a therapeutic effect on sepsis through activating regulatory macrophages possibly via suppressing TLR2/MyD88 signal pathway. We also identified that rTs-Cys-induced M2 macrophage differentiation was associated with increased expression of MR on the surface of macrophages. Our results underscored the importance of MR in regulating macrophages during the treatment with rTs-Cys, providing another immunological mechanism in which helminths and their derived proteins modulate the host immune system. The findings in this study suggest that rTs-Cys is a potential therapeutic agent for the prevention and treatment of sepsis and other inflammatory diseases.

A Study to Assess the Knowledge Regarding “Prevention of Puerperal Sepsis” in Early Puerperium among Postnatal Mothers Admitted in the Maternity Unit of NMCH, Jamuhar, Rohtas

Introduction: According to survey conducted by World Health Organization (WHO) in 1998 only a small proportion of women in developing countries i.e. less than 30% receive adequate postpartum care and in very poor countries and regions only 5% of women receive such care where as in developed countries 90% of mothers receive postpartum care. World health organization reported about 358000 maternal deaths occurring during labour and childbirth and 15% were related with puerperal sepsis in 2019. Background: Postpartum period or puerperium is the period following childbirth and of great importance for both mother and baby as it is an aspect of maternity care which receives less attention compared to pregnancy and delivery. Also, the others are less aware of their health while taking care of newborn baby and also many alarming complications can arise due to lack of knowledge in preventive measures. So it is necessary to assess the knowledge of postnatal mothers regarding the prevention of puerperal sepsis, in a selected hospital. It was conducted at selected hospital in NMCH jamuhar, Rohtas among 60 postnatal mothers selected by using convenient sampling technique and who met the inclusion criteria. Objectives: To assess the level of knowledge of postnatal mothers regarding prevention of puerperal sepsis in early puerperium. To find out the association between the knowledge of postnatal mothers regarding prevention of puerperal sepsis in early puerperium with selected demographic variables. The population of sample consists of postnatal mothers in NMCH, jamuhar, Rohtas. Methodology: A non-experimental descriptive approach is using for this study as it is considered as suitable one to assess the knowledge regarding prevention of puerperal sepsis among postnatal mothers. The research design for present study is descriptive Design. Results: In order to collect the scientific data we used self structured questionnaire index. According to the Majority of sample (8.33%) postnatal mothers were having poor knowledge change, (88.33%) postnatal mothers were having average knowledge change and (3.33%) postnatal mothers were having good knowledge change. With the help of self structure questionnaire knowledge has been assess that majority of the participant average knowledge about puerperal sepsis. Conclusion: the study concluded that assess the level of knowledge of postnatal mothers regarding prevention of puerperal sepsis in early puerprium. The level of knowledge significantly different between postnatal mothers.

Role of macrophage polarization in the development of sepsis

Sepsis is a systemic reaction syndrome caused by various infectious factors,and its core mechanism is immue disorder. Macrophages, known as the most important component of innate immunity, play an important role in the occurrence and development of sepsis. Macrophage polarization has been shown to be closely related to inflammation and immunity. In the occurrence and development of sepsis,the mechanisms are complex and unclearly. The release of inflammatory factors and the occurrence of inflammatory responses will be regulated by changes in macrophage polarization phenotype. Multiple signaling pathways such as Toll-like receptor 4/nuclear transcription factor-κB (TLR4/NF-κB), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), Janus kinase/signal transduction and transcription activator (JAK/STAT), adenosine-activated protein kinase-peroxisome proliferation-activated receptor γ (AMPK-PPARγ), Notch, C-Jun amino terminal kinase (JNK), nuclear factor E2-related factor 2 (Nrf2), etc. are involved in the regulation of macrophage polarization,and interact with each other.Regulation of macrophage polarization will be a new target for the prevention and treatment of the occurrence, development and prognosis of sepsis. This paper summarized the latest progress of macrophage polarization phenotype in the occurrence and development of sepsis, aiming to provide new ideas and methods for clinical prevention and treatment of sepsis.

The Effect of Instructional Guidelines Regarding Puerperal Sepsis Prevention on the Knowledge and Practice of Postpartum Mothers

The Effect of Instructional Guidelines Regarding Puerperal Sepsis Prevention on the Knowledge and Practice of Postpartum Mothers

South African study of blast phase chronic myeloid leukaemia: A poor prognostic outlook.

BackgroundChronic myeloid leukaemia (CML) is a haematological malignancy characterised by the translocation t(9;22)(q34;q11.2), resulting in a constitutively active tyrosine kinase. Globally, overall survival of blast crisis phase (BC) CML is one year. Newer tyrosine kinase inhibitors and allogeneic stem cell transplantation offer remission; however, refractory and relapsed disease remain the biggest challenges.ObjectiveIn South Africa, literature is lacking on BC-CML. This study aimed to determine the disease characteristics and overall survival in South Africa.MethodsThis retrospective, laboratory-based study reviewed all new BC-CML diagnoses via flow cytometry at Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, South Africa, between April 2016 and October 2019. BC-CML was defined as the presence of > 20% blasts with a CML history or the BCR-ABL1 fusion gene (p210/p190) in the appropriate clinical or pathological context. Survival outcomes were inferred from clinical and laboratory data.ResultsTwenty-two new cases of BC-CML were diagnosed (median age: 34 years). There were 20 (91%) cases with the fusion transcripts p210 and two (9%) cases with p190 BCRABL1. For blast lineage, 14 cases were myeloid (63.6%), six were lymphoid (27.3%), and two were ambiguous (9.1%). There was a 72.7% mortality (16 cases); sepsis, refractory and relapsed disease were the major causes. Patients who achieved remission had lower blast percentages, simple karyotypes, and a trend towards higher white cell and platelet counts at presentation.ConclusionOptimised management of early-stage CML, prevention and aggressive management of sepsis, with advocation for newer therapies are needed to improve the overall survival of BC-CML in South Africa.

A Rare Case of Splenic Infarcts in Sickle Cell Anemia

Sickle cell disease (SCD) is a genetic disorder which causes debilitating systemic syndrome which is characterized by chronic anemia, acute painful episodes, organ infarction and chronic organ damage. Early screening, systemic clinical follow up, prevention of sepsis and organ damage have led to increased life expectancy among people with SCD.

Prevalence, Clinical Characteristics, and Outcomes of Sepsis Caused by Severe Acute Respiratory Syndrome Coronavirus 2 Versus Other Pathogens in Hospitalized Patients With COVID-19.

IMPORTANCE:The prevalence and causes of sepsis in patients hospitalized with COVID-19 are poorly characterized.OBJECTIVES:To investigate the prevalence, clinical characteristics, and outcomes of sepsis caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) versus other pathogens in patients hospitalized with COVID-19.DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional, retrospective chart review of 200 randomly selected patients hospitalized with COVID-19 at four Massachusetts hospitals between March 2020 and March 2021.MAIN OUTCOMES AND MEASURES:The presence or absence of sepsis was determined per Sepsis-3 criteria (infection leading to an increase in Sequential Organ Failure Assessment score by ≥ 2 points above baseline). Sepsis episodes were assessed as caused by SARS-CoV-2, other pathogens, or both. Rates of organ dysfunction and in-hospital death were also assessed.RESULTS:Sepsis was present in 65 of 200 COVID-19 hospitalizations (32.5%), of which 46 of 65 sepsis episodes (70.8%) were due to SARS-CoV-2 alone, 17 of 65 (26.2%) were due to both SARS-CoV-2 and non-SARS-CoV-2 infections, and two of 65 (3.1%) were due to bacterial infection alone. SARS-CoV-2–related organ dysfunction in patients with sepsis occurred a median of 1 day after admission (interquartile range, 0–2 d) and most often presented as respiratory (93.7%), neurologic (46.0%), and/or renal (39.7%) dysfunctions. In-hospital death occurred in 28 of 200 COVID-19 hospitalizations (14.0%), including two of 135 patients without sepsis (1.5%), 16 of 46 patients with sepsis (34.8%) due to SARS-CoV-2 alone, and 10 of 17 patients with sepsis (58.8%) due to both SARS-CoV-2 and bacterial pathogens.CONCLUSIONS:Sepsis occurred in one in three patients hospitalized with COVID-19 and was primarily caused by SARS-CoV-2 itself, although bacterial infection also contributed in a quarter of sepsis cases. Mortality in COVID-19 patients with sepsis was high, especially in patients with mixed SARS-CoV-2 and bacterial sepsis. These findings affirm SARS-CoV-2 as an important cause of sepsis and highlight the need to improve surveillance, recognition, prevention, and treatment of both viral and bacterial sepsis in hospitalized patients with COVID-19.

Recognising Sepsis as a Health Priority in Sub-Saharan African Country: Learning Lessons from Engagement with Gabon's Health Policy Stakeholders.

Sepsis has been recognised as a global health priority by the United Nations World Health Assembly, which adopted a resolution in 2017 to improve sepsis prevention, diagnosis, and management globally. This study investigated how sepsis is prioritised in Gabon. From May to November 2021, we conducted a qualitative study in healthcare stakeholders at the local, regional, and national levels. Stakeholders included the Ministry of Health (MOH), ethics/regulatory bodies, research institutions, academic institutions, referral hospitals, international funders, and the media. Twenty-three multisectoral stakeholders were interviewed. Respondents indicated that sepsis is not yet prioritised in Gabon due to the lack of evidence of its burden. They also suggest that the researchers should focus on linkages between sepsis and the countries’ existing health sector priorities to accelerate sepsis prioritisation in health policy. Stakeholder awareness and engagement might be accelerated by involving the media in the generation of communication strategies around sepsis awareness and prioritisation. There is a need for local, regional and national evidence to be generated by researchers and taken up by policymakers, focusing on linkages between sepsis and a country’s existing health sector priorities. The MOH should set sepsis reporting structures and develop appropriate sepsis guidelines for identification, management, and prevention.

Patient, Public, and Healthcare Professionals' Sepsis Awareness, Knowledge, and Information Seeking Behaviors: A Scoping Review.

OBJECTIVES:Sepsis awareness and understanding are important aspects of prevention, recognition, and clinical management of sepsis. We conducted a scoping review to identify and map the literature related to sepsis awareness, general knowledge, and information-seeking behaviors with a goal to inform future sepsis research and knowledge translation campaigns.DESIGN:Scoping review.SETTING:Using Arksey and O’Malley’s methodological framework, we conducted a systematic search on May 3, 2021, across four databases (MEDLINE, EMBASE, CINAHL, and Education Research Complete). Title/abstract and full-text screening was done in duplicate. One researcher extracted the data for each included article, and a second researcher checked data accuracy. The protocol was registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/YX7AU).SUBJECTS:Articles related to sepsis awareness, knowledge, and information seeking behaviors among patients, public, and healthcare professionals.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Of 5,927 unique studies, 80 reported on patient (n = 13/80;16.3%), public (n = 15/80;18.8%), or healthcare professional (nurses, physicians, emergency medical technicians) (n = 48/80; 60%) awareness and knowledge of sepsis. Healthcare professional awareness and knowledge of sepsis is high compared with patients/public. The proportion of patients/public who had heard of the term sepsis ranged from 2% (Japan) to 88.6% (Germany). The proportions of patients/public who correctly identified the definition of sepsis ranged from 4.2% (Singapore) to 92% (Sweden). The results from the included studies appear to suggest that patient/public awareness of sepsis gradually improved over time. We found that the definition of sepsis was inconsistent in the literature and that few studies reported on patient, public, or healthcare professional knowledge of sepsis risk factors. Most patient/public get their sepsis information from the internet, whereas healthcare professionals get it from their role in healthcare through job training or educational training.CONCLUSIONS:Patient, public, and healthcare professional awareness and knowledge of sepsis vary globally. Future research may benefit from a consistent definition as well as country-specific data to support targeted public awareness campaigns.

Epidemiology and outcomes of pneumococcal sepsis in children with nephrotic syndrome in a developing country.

BackgroundPneumococcal infections are common in children with nephrotic syndrome. Knowledge of the commonly available serotypes and antibiotic susceptibility will help in prevention and appropriate management of pneumococcal sepsis, especially in resource-limited countries.MethodsDemographic, clinical, and laboratory data on children with nephrotic syndrome and pneumococcal infections were extracted from the electronic medical records.ResultsSixty-three isolates of pneumococci obtained from 60 children with nephrotic syndrome, over a period of 14 years, were included in the study. This represented 18% of all pneumococcal infections occurring in children during the same period. Commonly available vaccines covered up to 58% of all the serotypes causing infection. Severe disease, with shock, intensive care admission and/or meningitis, was observed in 38% children and mortality was observed in 10%. Resistance to commonly used antibiotics was not observed, except for erythromycin.ConclusionsPneumococcal sepsis was observed to be common in children with nephrotic syndrome and results in significant morbidity and mortality. Commonly used antibiotics were observed to be effective in management of the infections.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00467-022-05550-0.

Effects of a Short-Term Lipopolysaccharides Challenge on Mouse Brain and Liver Peroxisomal Antioxidant and β-oxidative Functions: Protective Action of Argan Oil.

During sepsis, the imbalance between oxidative insult and body antioxidant response causes the dysfunction of organs, including the brain and liver. Exposing mice to bacterial lipopolysaccharides (LPS) results in a similar pathophysiological outcome. The protection offered by argan oil was studied against LPS-induced oxidative stress, dysregulation of peroxisomal antioxidants, and β-oxidation activities in the brain and liver. In a short-term LPS treatment, lipid peroxidation (malonaldehyde assay) increased in the brain and liver with upregulations of proinflammatory tumor necrosis factor (Tnf)-α and anti-inflammatory interleukin (Il)-10 genes, especially in the liver. Although exposure to olive oil (OO), colza oil (CO), and argan oil (AO) prevented LPS-induced lipid peroxidation in the brain and liver, only AO exposure protected against liver inflammation. Remarkably, only exposure to AO prevented LPS-dependent glutathione (GSH) dysregulation in the brain and liver. Furthermore, exposure to AO increased more efficiently than OO and CO in both organs, peroxisomal antioxidant capacity via induction of catalase (Cat) gene, protein and activity expression levels, and superoxide dismutase (Sod1) mRNA and activity levels. Interestingly, LPS decreased protein levels of the peroxisomal fatty acid-ATP binding cassette (ABC) transporters, ABCD1 and ABCD2, and increased acyl-CoA oxidase 1 (ACOX1) protein expression. Moreover, these LPS effects were attenuated for ABCD1 and ACOX1 in the brain of mice pretreated with AO. Our data collectively highlight the protective effects of AO against early oxidative stress caused by LPS in the brain and liver and their reliance on the preservation of peroxisomal functions, including antioxidant and β-oxidation activities, making AO a promising candidate for the prevention and management of sepsis.