scholarly journals Advances in sepsis diagnosis and management: a paradigm shift towards nanotechnology

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Amit Pant ◽  
Irene Mackraj ◽  
Thirumala Govender
Keyword(s):  
Critical Role ◽  
Sepsis Management ◽  
Diagnosis And Management ◽  
Resistance Surface ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Extracorporeal Blood Purification ◽  
Highly Sensitive ◽  
Life Threatening

AbstractSepsis, a dysregulated immune response due to life-threatening organ dysfunction, caused by drug-resistant pathogens, is a major global health threat contributing to high disease burden. Clinical outcomes in sepsis depend on timely diagnosis and appropriate early therapeutic intervention. There is a growing interest in the evaluation of nanotechnology-based solutions for sepsis management due to the inherent and unique properties of these nano-sized systems. This review presents recent advancements in nanotechnology-based solutions for sepsis diagnosis and management. Development of nanosensors based on electrochemical, immunological or magnetic principals provide highly sensitive, selective and rapid detection of sepsis biomarkers such as procalcitonin and C-reactive protein and are reviewed extensively. Nanoparticle-based drug delivery of antibiotics in sepsis models have shown promising results in combating drug resistance. Surface functionalization with antimicrobial peptides further enhances efficacy by targeting pathogens or specific microenvironments. Various strategies in nanoformulations have demonstrated the ability to deliver antibiotics and anti-inflammatory agents, simultaneously, have been reviewed. The critical role of nanoformulations of other adjuvant therapies including antioxidant, antitoxins and extracorporeal blood purification in sepsis management are also highlighted. Nanodiagnostics and nanotherapeutics in sepsis have enormous potential and provide new perspectives in sepsis management, supported by promising future biomedical applications included in the review.

scholarly journals Knowledge assessment of Sepsis Diagnosis and Management during COVID-19 pandemic among House Officers & Medical Officers in Ibrahim Malik Teaching Hospital in Khartoum State, Sudan, 2021

2021 ◽  
Author(s):  
ElMuiz Abdelrahman ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Ibrahim Mahgoub ◽  
Mohammed Eltahier Abdalla Omer ◽  
Yassin Abdelrahim Abdalla ◽  
...  
Keyword(s):  
Medical Knowledge ◽  
Knowledge Score ◽  
P Value ◽  
Sepsis Management ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Sepsis Diagnosis ◽  
Significant Difference ◽  
Life Threatening ◽  
The Mean

Abstract Background: Sepsis is life-threatening and frequently a final common pathway to death for many infectious diseases worldwide and may lead to death if left untreated. The objective is to assess the scientific medical knowledge upon sepsis among House officers and Medical officers in terms of diagnosis and management.Method: An observational cross sectional Hospital-based study was conducted through self-administered retrospective questionnaires based on the objective of the study. We enrolled 155 participants through Convenience sampling. The questionnaire contains parts of validated Sepsis criteria in terms of diagnosis and management. Analysis was done by using SPSS version 20. Data are presenter as frequencies and percentages using figures and tables. P value less than 0.05 considered significant Mann Whitney U test use to compare level of knowledge adherence between trained participants and non-trained participants.Results: The mean knowledge score about sepsis diagnosis was 2.6 out of 10 (SD= 1.8), and about sepsis management was 2.8 out of 8 (SD=1.8) the mean overall score was 5.5 out of 18.No significant difference found between participants who were trained upon diagnosis and management of sepsis and those who were not.Conclusion: Study findings illustrated that the capacity to perceive and manage sepsis among House Officers and Medical Officers doctors is poor and there are dangerous gaps in their investigation and management of such septic patients.

scholarly journals The role of systemic inflammation in heart failure

2021 ◽  
Vol 102 (4) ◽  
pp. 510-517
Author(s):  
E V Khazova ◽  
O V Bulashova
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Systemic Inflammation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
C Reactive Protein ◽  
Ventricular Ejection Fraction ◽  
Reactive Protein ◽  
Highly Sensitive

The discussion continues about the role of systemic inflammation in the pathogenesis of cardiovascular diseases of ischemic etiology. This article reviews the information on the role of C-reactive protein in patients with atherosclerosis and heart failure in risk stratification for adverse cardiovascular events, including assessment of factors affecting the basal level of highly sensitive C-reactive protein. Research data (MRFIT, MONICA) have demonstrated a relationship between an increased level of C-reactive protein and the development of coronary heart disease. An increase in the serum level of highly sensitive C-reactive protein is observed in arterial hypertension, dyslipidemia, type 2 diabetes mellitus and insulin resistance, which indicates the involvement of systemic inflammation in these disorders. Currently, the assessment of highly sensitive C-reactive protein is used to determine the risk of developing myocardial infarction and stroke. It has been proven that heart failure patients have a high level of highly sensitive C-reactive protein compared with patients without heart failure. The level of C-reactive protein is referred to as modifiable risk factors for cardiovascular diseases of ischemic origin, since lifestyle changes or taking drugs such as statins, non-steroidal anti-inflammatory drugs, glucocorticoids, etc. reduce the level of highly sensitive C-reactive protein. In patients with heart failure with different left ventricular ejection fraction values, it was found that the regression of the inflammatory response is accompanied by an improvement in prognosis, which confirms the hypothesis of inflammation as a response to stress, which has negative consequences for the cardiovascular system.

Critical Role of Lysophospholipids in the Pathophysiology, Diagnosis, and Management of Ovarian Cancer

2002 ◽  
pp. 259-283 ◽  
Author(s):  
Gordon B. Mills ◽  
Astrid Eder ◽  
Xianjun Fang ◽  
Yutaka Hasegawa ◽  
Muling Mao ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Critical Role ◽  
Diagnosis And Management

scholarly journals Efficacy of CytoSorb in a Pediatric Case of Severe Multisystem Infammatory Syndrome (MIS-C): A Clinical Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Gabriella Bottari ◽  
Valerio Confalone ◽  
Nicola Cotugno ◽  
Isabella Guzzo ◽  
Salvatore Perdichizzi ◽  
...  
Keyword(s):  
Clinical Case ◽  
Myocardial Dysfunction ◽  
Interleukin 10 ◽  
Refractory Shock ◽  
Sublingual Microcirculation ◽  
Reactive Protein ◽  
Extracorporeal Blood Purification ◽  
Life Threatening ◽  
Inflammatory Syndrome ◽  
First Time

Background: Multisystem inflammatory syndrome in children (MIS-C) has emerged during the COVID-19 pandemic as a new SARS-CoV-2-related entity, potentially responsible for a life-threatening clinical condition associated with myocardial dysfunction and refractory shock.Case: We describe for the first time in a 14-year-old girl with severe MIS-C the potential benefit of an adjuvant therapy based on CytoSorb hemoperfusion and continuous renal replacement therapy with immunomodulatory drugs.Conclusions: We show in our case that, from the start of extracorporeal blood purification, there was a rapid and progressive restoration in cardiac function and hemodynamic parameters in association with a reduction in the most important inflammatory biomarkers (interleukin 6, interleukin 10, C-reactive protein, ferritin, and D-dimers). Additionally, for the first time, we were able to show with analysis of the sublingual microcirculation a delayed improvement in most of the important microcirculation parameters in this clinical case of MIS-C.

scholarly journals Role Of C-Reactive Protein in Diagnosis of Acute Appendicitis

2021 ◽  
Vol 10 (4) ◽  
pp. 210-214
Author(s):  
Mirza Tassawar Hussain ◽  
Muhammad Kashif Khan ◽  
Syed Shamsuddin ◽  
Aabid Ali ◽  
Erum Khan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
C Reactive Protein ◽  
Diagnostic Dilemma ◽  
Senior Registrar ◽  
Predictive Values ◽  
Reactive Protein ◽  
Highly Sensitive ◽  
Sensitivity Specificity

Background: Appendicitis is a common surgical emergency and diagnostic dilemma. Making the correct diagnosis is often difficult as the clinical presentation varies according to the age of the patient and the position of appendix. The objective of this study was to identify clinical applicability of C- reactive protein, as a diagnostic test for appendicitis. Methods: This prospective study was carried out in Federal government Polyclinic hospital, Islamabad from January to July 2019, 114 patients underwent appendectomy for clinically diagnosed acute appendicitis. The decision to operate the patient was given by senior registrar. The blood samples for C-reactive protein were drawn before taking the patient to the operating theatre. Removed appendices were sent for histopathological confirmation of diagnosis. The C-reactive protein was then compared with the results of histopathology to determine its validity. The data was entered and analysed in SPSS 23. Results: The sensitivity, specificity, positive and negative predictive values of C-reactive protein in patients with clinical diagnosis of acute appendicitis were found to be 94%, 78%, 93% and 74 % respectively. Conclusion: CRP is helpful in making diagnosis of acute appendicitis. It is highly sensitive but has a relatively low specificity.  

scholarly journals Pathologic Difference between Sepsis and Bloodstream Infections

2019 ◽  
Vol 3 (4) ◽  
pp. 654-663 ◽  
Author(s):  
Luis E Huerta ◽  
Todd W Rice
Keyword(s):  
Mitochondrial Dysfunction ◽  
Organ Dysfunction ◽  
Host Response ◽  
Laboratory Tests ◽  
Bloodstream Infections ◽  
Therapeutic Interventions ◽  
Coagulation Cascade ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Life Threatening

Abstract Background Sepsis, defined as life-threatening organ failure caused by a dysregulated host response to infection, is a major cause of morbidity and mortality in hospitalized patients. Understanding the features that distinguish sepsis from bloodstream infections (and other types of infection) can help clinicians appropriately and efficiently target their diagnostic workup and therapeutic interventions, especially early in the disease course. Content In this review, sepsis and bloodstream infections are both defined, with a focus on recent changes in the sepsis definition. The molecular and cellular pathways involved in sepsis pathogenesis are described, including cytokines, the coagulation cascade, apoptosis, and mitochondrial dysfunction. Laboratory tests that have been evaluated for their utility in sepsis diagnosis are discussed. Summary Sepsis is defined not only by the presence of an infection, but also by organ dysfunction from a dysregulated host response to that infection. Numerous pathways, including proinflammatory and antiinflammatory cytokines, the coagulation cascade, apoptosis, and mitochondrial dysfunction, help determine if a bloodstream infection (or any other infection) progresses to sepsis. Many biomarkers, including C-reactive protein, procalcitonin, and lactic acid have been evaluated for use in sepsis diagnosis, although none are routinely recommended for that purpose in current clinical practice. While some laboratory tests can help distinguish the 2, the presence of organ dysfunction is what separates sepsis from routine infections.

scholarly journals Left Atrial Thrombus Present: Is That about It?

2017 ◽  
Vol 01 (01) ◽  
pp. 035-039
Author(s):  
Jitin Narula ◽  
Neeraj Kumar ◽  
Sanjay Kumar ◽  
Saurabh Jaiswal ◽  
Ritwick Bhuyan
Keyword(s):  
Inferior Vena Cava ◽  
Left Atrial ◽  
Inferior Vena ◽  
Vena Cava ◽  
Highly Sensitive ◽  
Life Threatening ◽  
Dimensional Echocardiography ◽  
Intracardiac Masses ◽  
Two Dimensional Echocardiography

AbstractTwo-dimensional echocardiography is extremely useful in detecting localized as well as floating intracardiac bodies. Transesophageal echocardiography (TEE) is highly sensitive in localizing intracardiac masses especially those present in the posterior structures of the heart, such as the left atrium (LA) and the left atrial appendage (LAA), which are extremely difficult to image using the transthoracic echocardiography. Dislodgement of intracardiac masses (thrombus, tumor) can be associated with high risk of life-threatening hemodynamic perturbations or embolic phenomenon. Cardiac manipulations should thus be minimized in patients with intracardiac masses. We discuss the case of LAA thrombus dislodgement during inferior vena cava cannulation. Intraoperative TEE demonstrated a fixed thrombus in the LAA, and despite careful attention by the surgeon, trivial cardiac manipulation during inferior vena cava cannulation leads to the dislodgment of the LAA thrombus and its free floatation in the LA. This case report highlights the crucial role of a vigilant TEE examination in patients with intracardiac thrombi. Identification of echocardiographic risk factors for prediction of dislodgement of LAA is of utmost importance to avoid inadvertent complications.

scholarly journals Role of presepsin compared to C-reactive protein in sepsis diagnosis and prognostication

2017 ◽  
Vol 5 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Mohamed El-Saied El-Shafie ◽  
Khaled M. Taema ◽  
Moataz M. El-Hallag ◽  
Abdallah Mohamed Abdallah Kandeel
Keyword(s):  
C Reactive Protein ◽  
Sepsis Diagnosis ◽  
Reactive Protein

scholarly journals Streptavidin-coated gold nanoparticles: critical role of oligonucleotides on stability and fractal aggregation

2017 ◽  
Vol 8 ◽  
pp. 1-11 ◽  
Author(s):  
Roberta D'Agata ◽  
Pasquale Palladino ◽  
Giuseppe Spoto
Keyword(s):  
Gold Nanoparticles ◽  
Critical Role ◽  
Medical Diagnostics ◽  
Nanoparticle Dispersion ◽  
One Dimensional ◽  
Fundamental Properties ◽  
Biochemical Sensing ◽  
Highly Sensitive ◽  
First Time

Gold nanoparticles (AuNPs) exhibit unique properties that can be modulated through a tailored surface functionalization, enabling their targeted use in biochemical sensing and medical diagnostics. In particular, streptavidin-modified AuNPs are increasingly used for biosensing purposes. We report here a study of AuNPs surface-functionalized with streptavidin-biotinylated oligonucleotide, focussing on the role played by the oligonucleotide probes in the stabilization/destabilization of the functionalized nanoparticle dispersion. The behaviour of the modified AuNP dispersion as a consequence of the competitive displacement of the biotinylated oligonucleotide has been investigated and the critical role of displaced oligonucletides in triggering the quasi one-dimensional aggregation of nanoparticles is demonstrated for the first time. The thorough understanding of the fundamental properties of bioconjugated AuNPs is of great importance for the design of highly sensitive and reliable functionalized AuNP-based assays.

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