Articles: sepsis.
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Implementation of a regional sepsis program to improve compliance with sepsis care bundles and optimize septic patient management and outcomes in the Emergency Department (ED). The program included a multifaceted intervention in 8 EDs: creation of a regional sepsis team, meetings, education (yearly 6-h course and site visits) and sepsis alert. Clinical practice was evaluated in each ED during 1 month every year over 3 years. ⋯ Patients referred to ED for infection had a better prognosis compared to those with a non-specific reason (OR = 0.56; 95% CI 0.32-0.97, p = 0.038). A regional sepsis educational program appears to improve compliance with the SSC bundle. Pre-hospital identification of sepsis appears to improve further management.
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Observational Study
Identification of DNA damage repair-related genes in sepsis using bioinformatics and machine learning: An observational study.
Sepsis is a life-threatening disease with a high mortality rate, for which the pathogenetic mechanism still unclear. DNA damage repair (DDR) is essential for maintaining genome integrity. This study aimed to explore the role of DDR-related genes in the development of sepsis and further investigated their molecular subtypes to enrich potential diagnostic biomarkers. ⋯ A notable difference in the immune microenvironment landscape was discovered between sepsis patients and healthy controls. Furthermore, all 3 genes were significantly associated with various immune cells. Our findings identify potential new diagnostic markers for sepsis that shed light on novel pathogenetic mechanism of sepsis and, therefore, may offer opportunities for potential intervention and treatment strategies.
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This paper provides an overview of the efficacy of vitamin C for preventing and treating respiratory infections. Studies in a wide variety of animals have shown vitamin C to be protective against infections. In controlled trials in the general human population, vitamin C at a dose greater than 1 g/day did not prevent common colds. ⋯ It is unlikely that vitamin C would reduce the risk of pneumonia in the general population; however, 4 trials reported a treatment benefit for pneumonia patients, although the findings encourage further research rather than providing firm evidence of efficacy. Vitamin C has been tested for efficacy in COVID‑19 and sepsis with conflicting results. Given the evidence that vitamin C reduces the severity and duration of the common cold, paired with its good safety profile and low cost, it is not unreasonable for patients to test whether therapeutic vitamin C supplementation at a dose of 6-8 g/day is beneficial at the individual level.
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The role that sleep patterns play in sepsis risk remains poorly understood. ⋯ Findings from this cohort study suggest that a healthy sleep pattern may reduce the risk of developing sepsis, particularly among younger individuals.
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Sepsis is a time-sensitive condition, and many rural emergency department (ED) sepsis patients are transferred to tertiary hospitals. The objective of this study was to determine whether longer transport times during interhospital transfer are associated with higher sepsis mortality or increased hospital length-of-stay (LOS). ⋯ Longer total transfer time showed no association with 28-day hospital free days in rural sepsis patients. Future work will seek to better understand how rural ED sepsis care can be optimized to maximize outcomes in transferred patients.