Osteomyelitis: Symptoms, Causes, and Treatment

Osteomyelitis is an infection of the bone, a rare but serious condition. Bones can become infected in a number of ways: Infection in one part of the body may spread through the bloodstream into the bone, or an open fracture or surgery may expose the bone to infection.

What Causes Osteomyelitis?

In most cases, a bacteria called Staphylococcus aureus, a type of staph bacteria, causes osteomyelitis.

Certain chronic conditions like diabetes may increase your risk for osteomyelitis.

Who Gets Osteomyelitis?

Only 2 out of every 10,000 people get osteomyelitis. The condition affects children and adults, although in different ways. Certain conditions and behaviors that weaken the immune system increase a person’s risk for osteomyelitis, including:

• Diabetes (most cases of osteomyelitis stem from diabetes)
• Sickle cell disease
• HIV or AIDS
• Rheumatoid arthritis
• Intravenous drug use
• Alcoholism
• Long-term use of steroids
• Hemodialysis
• Poor blood supply
• Recent injury

Bone surgery, including hip and knee replacements, also increase the chance of bone infection.

Osteomyelitis in Children and Adults

In children, osteomyelitis is usually acute. Acute osteomyelitis comes on quickly, is easier to treat, and overall turns out better than chronic osteomyelitis. In children, osteomyelitis usually shows up in arm or leg bones.

In adults, osteomyelitis can be either acute or chronic. People with diabetes, HIV, or peripheral vascular disease are more prone to chronic osteomyelitis, which persists or recurs, despite treatment. Whether chronic or acute, osteomyelitis often affects an adult’s pelvis or vertebrae of the spine. It can also occur in the feet, especially in a person with diabetes.

Symptoms of Osteomyelitis

Acute osteomyelitis develops rapidly over a period of seven to 10 days. The symptoms for acute and chronic osteomyelitis are very similar and include:

• Fever, irritability, fatigue
• Nausea
• Tenderness, redness, and warmth in the area of the infection
• Swelling around the affected bone
• Lost range of motion

Osteomyelitis in the vertebrae makes itself known through severe back pain, especially at night.

Osteomyelitis Treatment

Figuring out if a person has osteomyelitis is the first step in treatment. It’s also surprisingly difficult. Doctors rely on X-rays, blood tests, MRI, and bone scans to get a picture of what’s going on. A bone biopsy helps determine the type of organism, typically bacteria, causing the infection so the right medication can be prescribed.

Treatment focuses on stopping infection in its tracks and preserving as much function as possible. Most people with osteomyelitis are treated with antibiotics, surgery, or both.

Antibiotics help bring the infection under control and often make it possible to avoid surgery. People with osteomyelitis usually get antibiotics for several weeks through an IV, and then switch to a pill.

More serious or chronic osteomyelitis requires surgery to remove the infected tissue and bone. Osteomyelitis surgery prevents the infection from spreading further or getting so bad that amputation is the only remaining option.

Preventing Osteomyelitis

The best way to prevent osteomyelitis is to keep things clean. If you or your child has a cut, especially a deep cut, wash it completely. Flush out any open wound under running water for five minutes, then bandage it in sterile bandages.

If you have chronic osteomyelitis, make sure your doctor knows about your medical history so you can work together to keep the condition under control. If you have diabetes, pay close attention to your feet and contact your doctor at the first sign of infection.

The sooner you treat osteomyelitis, the better. In cases of acute osteomyelitis, early treatment prevents the condition from becoming a chronic problem that requires ongoing treatment. Besides the pain and inconvenience of repeated infections, getting osteomyelitis under control early provides the best chance for recovery.

Blood infection or bacterial sepsis

What is bacterial sepsis?

Bacterial sepsis is what doctors call it when bacteria gets into the bloodstream and causes a serious infection in an organ such as the kidneys or lungs, or in the bone, for example. Sepsis can be treated with antibiotics, particularly if it’s caught early, but even then, it can be lethal. Thanks to two vaccines — one of them fairly new — this kind of infection is becoming increasingly rare.

How could my child get sepsis?

It doesn’t happen often, but sometimes a particularly virulent strain of bacteria can make its way into a child’s bloodstream. The bacteria most commonly responsible are Haemophilus influenzae and Streptococcus pneumoniae (also called pneumococcus), and fortunately they stand little chance of infecting a child who’s up to date on her vaccinations. The Hib vaccine has pretty much wiped out the childhood diseases caused by H. influenzae, and the recently introduced pneumoccocal vaccine (Prevnar) has been shown in some studies to reduce the risk of pneumococcus infections by more than 90 percent.

That means that unvaccinated children are now the most susceptible to blood infections, particularly those who are between 2 months and 36 months of age, when the immune system has not yet fully developed. (Also at risk are children with certain conditions like sickle cell disease or HIV infection.) Babies under 2 months are protected from such bugs by antibodies they get from their mother in the womb. (When newborns do get blood infections, the usual cause is bacteria — such as group B strep — that they picked up from their mother during birth.) “Then the risk begins to drop at age 2,” says Gary Overturs, a professor of pediatrics at the University of New Mexico at Albuquerque, “and is almost gone by the time your child is 3, since by then her immune system is strong enough to fight off most bloodstream infections.”

In rarer cases, a child may develop a blood infection from other bacteria such as Staphylococcus aureus and Group A streptococcus, which can sometimes enter the blood through a cut in the skin, or Neisseria meningitides, which comes in through the respiratory tract, or salmonella, which gets into the blood through the gut.

How can I tell if my child has bacterial sepsis?

It’s difficult. While some babies with a blood infection become fussy or lethargic, sometimes the only symptom is a fever. That’s why it’s so important to see a doctor if your child is younger than 3 months and has a rectal temperature higher than 100.4 degrees F, even if she has no other signs of illness. If your baby is between 3 and 12 months old, take her in if her fever is higher than 102 degrees F. If your baby seems inconsolable, won’t make eye contact, or is difficult to arouse, bring her in even if her fever is not that high.

Bloodstream infections from cuts, boils, or other skin disturbances are usually signaled by fever, pain, and severe redness around the wound. If you notice any of these symptoms, get your child to the doctor. This kind of bacterial sepsis can lead to serious problems in the bones and joints.

How is sepsis diagnosed and treated?

When your baby has a fever, her doctor will examine her carefully for the source. She could have an ear, throat, or lung infection that you weren’t aware of. If the doctor finds no signs of any of these, he’ll be on high alert for sepsis. Though most fevers are the result of viral infection, your baby will need to have a spinal tap (to check for bacterial meningitis), a blood draw (to check for sepsis), and perhaps a catheter to get a clean urine sample (to check for a urinary tract infection). All of these things are invasive and can be stressful, but the dangers of serious illness are great enough that most doctors believe they’re worth it. “Only 2 or 3 percent of feverish babies with no other symptoms will actually have sepsis,” says Overturs. “But when they’re tiny, it’s important to find out as quickly as possible.” (If your baby has a wound that appears to be infected, the doctor will take a culture of it, if possible.)

The results of the blood test will come back in about 24 hours. While you’re waiting, your baby will be given antibiotics. The doctor will decide whether your baby will stay in the hospital for IV antibiotics, receive an injection, or take oral antibiotics at home and come back the next day. According to Overturs, about half the babies with suspected sepsis are hospitalized. Once the doctor confirms the diagnosis, your baby will continue taking antibiotics. Again, she can do this either in or out of the hospital. The infection should clear up in a week or so, but it’s very important to make sure your child takes the whole course of antibiotics and returns for any follow-up visits.

Is there any way to prevent sepsis?

First, make sure your child’s vaccinations are up to date. Try to keep your child’s cuts clean, don’t let her pick at boils or sores, and watch for signs of infection. Catching an infection early is the best medicine.

Bloodstream Infection – an overview

Bloodstream Infections

BSI are among the most serious infections caused by P. aeruginosa, with mortality rates reaching 60%. The nationwide Surveillance and Control of Pathogens of Epidemiological Importance (SCOPE), which included data from 49 U.S. hospitals, reported that from 1995 to 2002 the incidence of P. aeruginosa nosocomial BSI was 2.1 per 10,000 hospital admissions. P. aeruginosa was the third most common gram-negative bacteria causing nosocomial BSI and accounted for 4.3% of all cases. In the ICUs, P. aeruginosa was the fifth most common isolate implicated in BSI, accounting for 4.7% of all cases, and was the seventh most common isolate in non-ICU wards, accounting for 3.8% of cases.⁴⁸ Outside the United States, P. aeruginosa is implicated in even more cases of nosocomial BSI.⁴⁹ In a surveillance study that collected data from 16 Brazilian hospitals from 2007 to 2010 and used the same methodology as the just-mentioned SCOPE study, 8.9% of all nosocomial BSI were caused by P. aeruginosa.

Risk factors for P. aeruginosa BSI include immunodeficiency, prior hospitalization, previous antimicrobial exposure, advanced age, prior surgery, and invasive devices.^50-52 Many of these risk factors represent an association with BSI, irrespective of the implicated pathogen.

Mortality rates for nosocomial BSI caused by P. aeruginosa BSI are among the highest. The great majority of reported crude mortality percentages from large surveillance studies range from 39% to 60%. These percentages are similar to those caused by Candida species.^48,49 Some studies, however, report lower mortality rates, ranging from 12% to 30%.^53-55 The large range in mortality rates from different studies reflects the multitude of factors that affect outcomes associated with BSI. For P. aeruginosa BSI, advanced age, high Acute Physiology and Chronic Health Evaluation II (APACHE II) score, sepsis, poor functional status, polymicrobial bacteremia, and inappropriate initial antimicrobial therapy have all been associated with an increased risk for mortality.^51,54-57

Multidrug resistance (MDR) is also a risk factor for increased mortality. Rates of mortality among MDR P. aeruginosa strains are twofold to threefold higher compared with non-MDR strains. ^53,58 Because inappropriate initial empirical therapy is a major contributor to these higher mortality rates, combination therapy for empirical treatment is warranted when MDR rates are high (see later).⁵⁹

The predominant distinguishing feature of P. aeruginosa BSI is the occurrence of ecthyma gangrenosum. Although not pathognomonic for P. aeruginosa, the presence of these characteristic skin lesions should raise high suspicion for this pathogen (see “Skin and Soft Tissue Infections”).

Treatment of P. aeruginosa BSI centers around the controversy of monotherapy versus combination therapy. A few earlier studies support the use of combination therapy since mortality rates were lower when two antimicrobial agents, instead of a single agent, were used to treat BSI caused by P. aeruginosa.⁶⁰ The main limitation of these studies is that in many the monotherapy study arm consisted of only an aminoglycoside, which is suboptimal for the treatment of P. aeruginosa BSI.⁶¹ In a meta-analysis, which also concluded that combination therapy is superior to monotherapy, four of the five included studies used aminoglycosides in the monotherapy study arm.⁶² There are numerous other limitations with older studies that support the use of combination therapy, including lack of double blinding and randomization, different sources of BSI, retrospective lack of adjustment for time to start of appropriate antimicrobial therapy, and duration of follow-up. Confounding by indication, whereby the severely ill patients receive combination therapy, is another limitation of studies addressing this issue. Another reason that is often cited for supporting combination therapy is the potential synergy between the two antimicrobial agents, usually a β-lactam and an aminoglycoside. Although in vitro and animal studies show benefit of this combined regimen, clinical studies have provided conflicting data.^60,63 Preventing the emergence of antimicrobial resistance is another reason often cited for supporting the use of combination therapy, but there are minimal data to support this statement. Administering the appropriate dose, at the correct frequency and for the optimal duration, is likely more important in preventing the emergence of resistance than combination therapy. Prompt initiation of the appropriate antimicrobial agents is also key to a successful outcome, as is removal of invasive devices if implicated.

Overall, the great majority of more recent studies do not show a survival benefit between combination therapy and monotherapy for definitive therapy.^64-68 However, the main conclusion by most investigators is that large randomized clinical trials are needed to definitively answer the question of efficacy between combination therapy and monotherapy.

Use of combination therapy should be strongly considered in the severely ill patient for the empirical treatment of P. aeruginosa BSI, especially in those health care institutions with patients with a high rate of multidrug resistance. Using combination therapy will thus ensure that at least one antimicrobial agent is effective against the infecting P. aeruginosa strain. De-escalating to a single antimicrobial agent, once antimicrobial susceptibility profiles are available, should then be considered. Narrowing to a single agent is especially relevant when the combination therapy includes an aminoglycoside, because this regimen is associated with increased nephrotoxicity.^67,68 Other adverse events that are more likely to occur with combination therapy, compared with monotherapy, include an increased risk for Clostridium difficile infection, further alterations in the protective effects of the human microbiota against colonization by other multidrug-resistant organisms, and fungal infections.

Antimicrobial agents effective against P. aeruginosa and appropriate doses are listed in Table 221-3. Polymyxins (colistin, polymyxin B) should be reserved for MDR P. aeruginosa, when other alternatives are not available, because this class of agents is inferior to other available antipseudomonal agents. ⁶⁹ High-dose continuous infusion of β-lactams has also been successfully used in the treatment of BSI caused by MDR P. aeruginosa. Moriyama and associates reported three patients infected with MDR P. aeruginosa strains who were successfully treated with a continuous infusion of ceftazidime (6.5 to 16.8 g/day) or aztreonam (8.4 g/day) and tobramycin.⁷⁰ The rationale behind this approach is that antibacterial activity of β-lactams depends on the time that the antimicrobial concentration is above the minimal inhibitory concentration of the bacteria. Using continuous infusion ensures that the concentration of the β-lactam will be above the minimal inhibitory concentration for the entire dosing interval, whereas intermittent dosing may cause the concentration to fall below the minimal inhibitory concentration. Future clinical studies, however, are required to further validate this treatment regimen.

Rochester students’ award-winning device instantly detects sepsis via sweat : NewsCenter

December 1, 2021

Early sepsis can turn into full-blown septic shock within an hour after the first symptoms emerge. A team of undergraduate students at the University of Rochester have developed a new device to instantaneously diagnose sepsis based on biomarkers in a person’s sweat. (Photo courtesy of 2021 iGEM team)

Rochester undergraduates have developed a fast, noninvasive, affordable, and eco-friendly way to diagnose sepsis, a life-threatening medical complication.

Sepsis definition and facts

What is sepsis?
Sepsis is an extreme response to an infection; when the body’s immune response to an infection starts doing more damage to the body than to the infection, the body is in sepsis. Sepsis can cause shock and life-threatening organ dysfunction.

What causes sepsis?
Bacterial infections—such as urinary tract or skin infections or infections in the intestines—cause most cases of sepsis, although sepsis can also be a result of viral infections.

What are the symptoms of sepsis?
Although the symptoms of sepsis may look like other health conditions, the main symptoms include fever or chills, rapid breathing, vomiting, fast heart rate, and confusion or disorientation.

Every year, approximately 1.7 million American adults develop sepsis, a life-threatening complication that arises when the body has an overwhelming immune response to an infection. According to the Centers for Disease Control and Prevention, sepsis causes more than 20 percent of all deaths worldwide and one in every three deaths in US hospitals.

A crucial aspect of treating sepsis is to catch it at an early stage when a patient’s infection is still curable. Current methods to diagnose sepsis, however, rely on tests that can take days to yield results, while early sepsis can turn into full-blown septic shock within only one hour after the first symptoms emerge.

In order to address this problem, a team of 12 undergraduate students at the University of Rochester developed a novel device that instantaneously diagnoses sepsis based on biomarkers in a person’s sweat. The device offers a noninvasive way to monitor sepsis in real-time and uses materials that are environmentally friendly and affordable, making the device easily deployable in low-income countries.

The team recently entered their device in the International Genetically Engineered Machine (iGEM) competition, where it was nominated for best diagnostics project, best hardware, and best education awards and won a gold medal, making the team the second-most-awarded iGEM team in North America.

“After researching statistics on sepsis and talking to a variety of medical experts, we got a sense of its immense medical and economic impacts and the need to develop better options for sepsis diagnosis,” says iGEM team member Amanda Adams ’22, a biomedical engineering major. “Our goal was to create a biosensor that could provide up-to-date information about a patient’s condition. Getting to work in a student-led team where we were directly responsible for the entire project from planning it to presenting it was very rewarding.”

The Rochester iGEM team’s Bio-Spire device collects a tiny amount of sweat from a patient’s skin, then wicks the sweat past an integrated set of electrodes covered in biomarker detectors. (Photo courtesy of Rochester’s 2021 iGEM team)

Worldwide synthetic biology competition

In 2020, Rochester launched an undergraduate class composed of students who compete in a worldwide synthetic biology competition with the goal to solve a real-world problem using innovative biological ideas. (Synthetic biology involves creating new biological parts or systems using materials already found in nature.) During the iGEM competition, held in mid-November, the undergraduates present to a panel of judges the projects they have spent the year designing and implementing.

“This year’s iGEM team tackled a problem that has a huge impact on society,” says Anne S. Meyer, an associate professor of biology, and one of the advisors for Rochester’s iGEM team. “The students realized that a patient’s sweat contains specific biomarkers that can report on whether or not the patient has sepsis. So, monitoring the levels of these biomarkers in patient sweat would be an easy and noninvasive way to diagnose sepsis in real time to get instant information.”

Overcoming the limitations of current sepsis diagnostic tools

Doctors use many different tools to diagnose patients, one of which is the presence and concentration of certain biomarkers—molecules such as proteins or sugar that are associated with a particular disease, condition, or biological process. There are several ways to measure biomarker concentrations, including test strips and lab-on-a-chip devices, but many of these approaches only show biomarker concentrations at one specific point in time. These methods can also be expensive, and many take hours to perform.

“The Rochester team’s real-time sepsis diagnosis device is a game-changer because all of its parts can be created in an accessible, inexpensive way.”

“This means that doctors often need to wait for the results of a test, and the results may not even be accurate if the patient developed a condition after the sample was taken,” Adams says.

The Rochester students consulted with sepsis survivors, scientists, and clinicians at the University of Rochester Medical Center to design a sepsis-sensing device, which they named “Bio-Spire,” a combination of “biology” and “perspire.” Bio-Spire is a biosensor that continuously monitors the levels of biomarkers in sweat. Unlike blood, sweat is a noninvasive medium to collect, and unlike saliva or urine, biomarkers in sweat can be continuously analyzed. The levels of biomarkers in blood and in sweat are correlated, so changes in the amount of biomarkers in sweat are indicative of changes in the blood.

That is, a change in biomarker levels in a patient’s sweat can signify a deterioration of the patient’s condition—and may signify sepsis.

LEFT: Amanda Adams ’22 prepares solutions composed of lactoferrin, one of the biomarker proteins found elevated in sepsis patients. The solutions were used to create synthetic sweat to test the team’s Bio-Spire device. RIGHT: Adela Yan ’22 applies surgical glue to the microfluidic portion of the device before attaching it to a sheet of glass, which will form part of the finished sleeve. (University of Rochester photos / Amanda Adams and Ena Haseljic).

Designing a ‘game-changer’ diagnostic device

Bio-Spire is designed to collect a tiny amount of sweat from a patient’s skin and wick the sweat past an integrated set of electrodes covered in biomarker detectors. The biomarker detectors consist of short pieces of DNA receptors attached to a small sheet of graphene—an ultra-thin layer of material that is highly conductive. The students synthetically created their own graphene and DNA in an environmentally-friendly manner by using engineered biological components.

When the sleeve-like device is placed on a patient’s arm, biomarkers associated with sepsis bind to the DNA receptors, changing the conductivity of the graphene sheet and triggering an electrical resistance in the electrodes, which is then recorded on a computer. The students created software that displays the concentrations of sepsis biomarkers in real time, permitting health care workers to receive up-to-the-minute updates on a patient’s condition.

“The Rochester team’s real-time sepsis diagnosis device is a game-changer because all of its parts can be created in an accessible, inexpensive way,” Meyer says. “Plus, it is the fastest sepsis diagnostic device ever created.”

In addition to developing the device, the team worked to increase awareness of sepsis and synthetic biology in the local community and beyond through a variety of education and outreach programs, including interactive science lessons with children’s summer camps in Rochester. The team also collaborated with an iGEM team from the Ohio State University to virtually publish a children’s book called A Trip to the Hospital: Randall’s Lesson on Sepsis, which is available on Amazon and Apple Books.

“We are excited by the promising results of this project and honored to be recognized for our efforts in addressing such an important, interdisciplinary issue in the medical community,” Adams says.

Because iGEM is an open-source competition, the team’s work is documented and available on their Bio-Spire Wiki page. This format allows future students or developers to take up the design and build upon the ideas.

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Tags: Anne S. Meyer, Arts and Sciences, award, Department of Biology, Department of Biomedical Engineering, featured-post-side, Hajim School of Engineering and Applied Sciences, health care, quality education, undergraduate research

Category: Featured

Warning as sepsis can kill in 12 hours

Sepsis is a bigger killer than heart attacks, lung cancer or breast cancer.

The blood infection is a fast killer too. A person can be a very healthy fit individual one day and be dead the next morning.

“Sepsis does not discriminate. Everyone, including the youngest and fittest of us, is potentially susceptible,” said Prof Steve Kerrigan.

An associate professor in pharmacology at the Royal College of Surgeons in Ireland, Prof Kerrigan is the inventor of InnovoSep, a potential breakthrough in the fight against sepsis.

Otherwise known as blood poisoning, sepsis is a silent killer because it is unpredictable, rapid and can go undiagnosed due to its non-specific signs and symptoms.

There were more than 15,000 recorded cases of sepsis in Ireland in 2016, and 3,000 resulted in death. Six out of 10 hospital deaths are sepsis-related.

Prof Kerrigan last night addressed a free public lecture at the the Royal College of Surgeons in Dublin in a bid to make people aware of the disease.

“Sepsis can kill in 12 hours, and that is why it is so critical that everyone in the community is empowered with the information to ask: ‘could it be sepsis’? These four words could save your life,” he said.

The symptoms of sepsis mimic those of the flu — high temperature, rapid heart rate, rapid breathing, pain, pale or mottled skin, and generally feeling very sick.

The main difference between sepsis symptoms and flu is sepsis will come on very quickly whereas flu comes on over days.

“Within possibly six hours you are going to be feeling incredibly sick. If you think the symptoms have come on way too fast when you dial 999, ask could this be sepsis?

“I can guarantee the emergency services will respond very quickly when you ask that question because they know time is against you,” he said.

Prof Kerrigan said there was a window of opportunity where sepsis can be controlled but it is crucial that no time is wasted in getting people to hospital.

There is a 10% increase in mortality for every hour where treatment with antibiotics is delayed.

Prof Kerrigan leads a group that has discovered InnovoSep, a non-antibiotic approach for treating or preventing a severe bloodstream infection.

“This treatment has huge potential but it’s also important for people to be aware that there are simple things we can do to reduce the risk of sepsis occurring,” he said.

“Every cut, scrape or break in the skin can cause infection. All wounds need to be cleaned quickly with clean water. If you have a wound that can’t close, then you most likely need stitches and you should get to a hospital.”

Prof Kerrigan said InnovoSep prevented the bloodstream from spinning out of control and damaging the body’s organs by inhibiting the blood vessels.

Because the treatment prevents damage to the organs it allows patients to recover much quicker.

“We discovered the drug about five years ago, and it is in pre-clinical trials right now. Human trials are expected to start within 18 months to two years,” he said.

Currently, there is no approved specific treatment for sepsis and the clinical management is focused on reducing the infection using aggressive intravenous antibiotic therapy.

– This article first appeared in today’s Irish Examiner

3 Factors That Could Raise Your Risk of Bloodstream Infection – Consumer Health News

WEDNESDAY, Oct. 11, 2017 (HealthDay News) — Serious bloodstream infections are more common among smokers who are both obese and inactive, a new Norwegian study reveals.

The bloodstream infection is known as sepsis. People who develop sepsis have an over 20 percent risk of death from the infection, the researchers noted. Each year, sepsis claims the lives of 6 million people worldwide.

To see what might boost the risk of this deadly infection, the investigators reviewed the records of nearly 2,000 Norwegian sepsis patients.

The findings showed that smoking combined with obesity and an inactive lifestyle was a major threat for blood poisoning. People with those three factors faced nearly a five times higher risk of sepsis than their non-smoking, normal-weight peers.

The body mass index (BMI) of people used in that calculation was 35. Body mass index is a rough estimate of body fat based on height and weight measurements.

A BMI below 25 is considered normal weight, and anything over 30 is considered obese, according to the U.S. National Institutes of Health. Someone with a BMI of 35 who is 5 feet, 9 inches tall weighs about 240 pounds.

When looking at obesity alone, people with a BMI between 30 and 35 had a 30 percent increased risk of sepsis, according to the report.

“People with a BMI over 40 had three times as high a risk as those of normal weight,” study co-author Julie Paulsen, a Ph.D. candidate at Norwegian University of Science and Technology, said in a school news release.

Smoking alone appeared to boost risk by 50 percent when compared with people who never smoked, the research team also found.

And being completely inactive was tied to a nearly doubled sepsis risk, when compared with those who exercised strenuously for at least an hour a week.

Obese people were also more likely to die from sepsis. People with a BMI of 40 or more had three times the risk of dying from the infection, the study showed.

Although the researchers couldn’t prove a cause-and-effect relationship, they pointed out that this study suggests that lifestyle-related measures can reduce the risk of serious infections.

The report was published recently in the International Journal of Epidemiology.

More information

There’s more about sepsis at theU.S. National Institute of General Medical Sciences.

Why People with Cancer Are More Likely to Get Infections

People with cancer may have a higher risk of infection because of changes in the immune system that control their body’s defense systems. Cancer and cancer treatments can affect the immune system and other body systems in different ways. People with cancer might be more likely to get infections because of:

• The cancer itself
• Certain types of cancer treatment
• Poor nutrition
• Other health problems or medications that aren’t related to cancer

Your cancer care team will talk to you about any increased risk for infection you may have, and what can be done to help prevent infection. If the risk is due to cancer treatment, it is usually temporary because the immune system recovers after a period of time, but this depends on your situation. You can learn more in Watching for and Preventing Infections in People With Cancer.

If you have questions about whether you need to take special precautions to prevent infections, it is best to discuss your risk of getting an infection with a doctor who understands your situation and medical history.

How your body protects itself from infection

Your body has many ways to protect itself from infections. It helps to understand how your body normally does this, and how cancer and cancer treatment can change this process. This may help you better understand why infections can develop so quickly and be so serious in people with cancer.

Skin and mucous membranes

The skin is your body’s largest organ and an important barrier against infections. It’s your first line of defense in protecting internal tissues from harmful germs. When there’s a break in your skin, it’s easier for germs to get into your body and cause infection.

Mucous membranes, which form the moist, pink lining layer of the mouth, throat, nose, eyelids, urethra, vagina, and digestive system, also act as partial barriers against infection. These membranes normally help protect us from germs in the air we breathe, our environment, and in our food and drink. Cancer treatments (such as chemotherapy, targeted therapy, immunotherapy, radiation therapy, or surgery) and certain procedures (like putting in catheters or IVs, or getting shots) can injure cells in the skin or cause damage to the skin or mucous membranes. This makes it easier for germs to enter the body.

The immune system

If germs get through the skin or mucous membranes, the job of protecting the body shifts to your immune system. Your immune system is a group of cells, tissues, and organs that work together to help find and attack germs that invade the body and cause infections.

White blood cells, a part of the immune system, are the main type of cell responsible for protecting the body against infections. There are different types of white blood cells, and they each have a role in defending the body against infections. Normally, most of our white blood cells are neutrophils. Neutrophils are key infection-fighters and form an important defense against most types of infections. The other types of white blood cells (lymphocyte, monocytes, and macrophages) also help fight infections.

Cancer itself can increase infection risk

Some types of cancer can change the way the immune system blood cells work. For instance, lymphomas (Hodgkin and non-Hodgkin), multiple myeloma, and most types of leukemia start in immune system blood cells. Other types of cancer can also affect the immune system and its cells. They can change the immune system cells so that cells that once protected your body begin to interfere with the normal way your immune system works. Cancer cells can get into the bone marrow cells where blood cells are made. The cancer cells then compete with the normal bone marrow cells for space and nutrients. If too many normal bone marrow cells are destroyed or pushed out of the bone marrow, the few cells that are left won’t be able to make enough white blood cells (WBCs) to help the body fight infection.

Cancer can also damage other parts of the immune system. A tumor that grows on the skin or in mucous membranes can break natural barriers and allow germs to get in. Tumors that are large might reduce blood flow to normal tissues by pressing on them or their blood supply. Tumors in the lungs may block normal mucus drainage, which can lead to infections. And, other types of tissues that have been damaged by cancer can be more prone to infections.

Cancer treatments can increase infection risk

Certain cancer treatments can interfere with the way the immune system works. The damage can be short- or long-term. For example, if a person with cancer has their spleen removed due to cancer, this causes long-term damage because the spleen is part of the immune system. On the other hand, radiation therapy, immunotherapy, and chemotherapy, either alone or in combination can lead to short-term (temporary) immune system damage because they affect immune system blood cells for a fairly short period of time. A bone marrow or stem cell transplant uses very high-dose treatments to kill cancer cells that also damage immune system cells for weeks to months.

Surgery

Any type of major surgery can weaken the immune system. Anesthesia (the drugs used to make the patient sleep) may play a role. It might take from 10 days to many months for the immune system to recover completely. Surgery also breaks the skin and can damage mucous membranes and tissue under the skin, causing it to be exposed to germs. The wound caused by surgery (the incision) is a common place for infection. Because surgery is often used to diagnose, stage, or treat people with cancer, it’s important to know that surgery can increase the risk of certain infections. Things that raise the risk of infection after surgery include:

• How long the person is in the hospital
• The extent of the surgery (how much cutting was done)
• How long the operation took
• The amount of bleeding during surgery
• The person’s nutritional status
• Prior cancer treatment, such as chemotherapy or radiation or medical problems such as diabetes, or heart or lung problems

People with cancer may get antibiotics before and for a short time after having surgery to help protect them from infection.

Chemotherapy

Chemotherapy (often called chemo) is the most common cause of a weakened immune system in people getting cancer treatment. Chemotherapy can cause
neutropenia (a decrease in the number of neutrophils, a type of white blood cell, in your blood). This means your body may not be able to fight infections as well as it should. The effects on the immune system depend on many things, including:

• Which chemo drugs are used
• Chemo dose (how much of each drug is given at once
• How often chemo is given
• Past cancer treatments
• The person’s age (older people are more likely to get infections, with or without cancer)
• The person’s nutritional status
• The type of cancer
• How much cancer there is (the stage of the cancer)

Some drugs affect the bone marrow and immune system more than others. After treatment ends, your blood cell counts usually go back to normal over time.

Radiation therapy

Radiation therapy
can also cause low white blood cell counts, which increases the risk for infections.

Factors in how radiation therapy affects the immune system, include:

• The total radiation dose
• The radiation schedule
• The part of the body being treated with radiation
• How much of the body is treated with radiation
• Whether or not you are receiving chemotherapy in addition to radiation therapy.

Total body irradiation or TBI (where a person’s entire body is treated with radiation) is the only type of radiation likely to cause very low white blood cell counts. This type of radiation may be used during a bone marrow or stem cell transplant. Radiation is most often given to just one part of the body, so the whole immune system isn’t damaged by it. Still, depending on the dose and the part of the body being treated with radiation, the skin or mucous membranes may be damaged, so you’re less able to keep germs out. Today, radiation treatments are most often given over many sessions rather than in one large dose. This helps decrease the amount of skin and tissue damage, immune suppression, and the risk of infections.

Targeted therapy

Some types of targeted therapy can affect how the immune system works. They target a certain part of a cancer cell or a certain protein or enzyme that is on the surface of a cancer cell. Finding these targets helps the immune system see the cancer cells easier so it can attack them.

Immunotherapy

Immunotherapy is used in certain types of cancer to help the immune system recognize and attack cancer cells. This can be done by giving treatments that help your own immune system work harder or smarter, or by giving you man-made immune system proteins or altered cells that are trained to find and attack cancer cells. Immunotherapy is sometimes used by itself to treat cancer, or used along with or after another type of treatment. These treatments help the body have better immune reactions against cancer cells, but sometimes they change the way the immune system works. Because of this, people who get immunotherapy may be at risk for having a weaker immune system and getting infections.

Stem cell transplant (bone marrow transplant)

Stem cell transplant (SCT) is the term used to include bone marrow transplant (BMT), peripheral blood stem cell transplant (PBSCT), and umbilical cord blood stem cell transplant (UCBSCT). Stem cell transplants are used to replace bone marrow cells that have been destroyed by cancer or by the chemo and/or radiation used to treat the cancer. These transplants allow doctors to use very high doses of chemo and/or total body irradiation (TBI) to try to kill all the cancer cells in the body.

In the process of killing the cancer cells, the blood-forming stem cells of the patient’s normal bone marrow are also killed. Because of this, stem cells (either from the blood or bone marrow) are removed from the patient and saved before the high-dose chemo is given. Or, stem cells may be taken from a donor or banked umbilical cord blood. Once the cancer cells are killed, the saved or donated stem cells are given to the patient so that blood cells can be made and the immune system rebuilt. High-dose chemo used with TBI causes more severe immune weakness that lasts for a longer time. It can also damage the skin and mucous membranes and make them less able to keep germs out of the body. This increases the risk of infection.

Poor nutrition and infection risk

All cells need nutrients to grow and work. Lack of vitamins, minerals, calories, and protein can weaken your immune system and make it less able to find and destroy germs. This means people who are poorly nourished (malnourished) are more likely to develop infections. People who are malnourished either do not take in enough calories and nutrients, or the body can’t use the food it takes in. Either way, it can weaken your immune system.

People with cancer often need extra calories and protein to support their immune system cells and other tissues. For example, recovery from surgery increases the body’s need for nutrients.

People with cancer might be poorly nourished for many reasons:

• The cancer itself can make it hard to eat or digest food. This is common in people with cancers of the digestive system, mouth, or throat.
• Cancer treatments, like radiation therapy and chemotherapy, can cause nausea and a loss of appetite.
• Cancer cells use up nutrients, leaving less to meet the needs of normal, healthy tissues.

People with cancer often need help from dietitians or doctors to get enough calories and nutrients. Dietary supplements, tube feedings, or even intravenous (IV, through a vein) feedings may be needed to help in some cases.

It’s important to know that avoiding or eating certain kinds of foods will not affect white blood cell counts (one reason your immune function may not be normal). However, your doctor might have you meet with a dietitian to plan what you should eat and to get help managing eating problems. Nutrition counseling should include the importance of getting enough calories, protein, and vitamins. This is tailored to each person’s food intake and nutrition problems.

Learn more about what to eat during cancer treatment in Nutrition for the Person With Cancer.

Low white blood cell counts and infection risk

Certain cancer treatments (such as chemotherapy, radiation therapy, surgery, stem cell or bone marrow transplant, or steroids) or the cancer itself can suppress or weaken the immune system. These treatments can lower the number of white blood cells (WBCs) and other immune system cells. Treatment can also cause these cells to not work as well as they should. This is called immunosuppression. It’s much easier to get an infection when there aren’t enough WBCs to destroy germs, especially the type of WBCs called neutrophils.

Neutrophils are a very important defense against most types of infection. When looking at your risk of getting an infection, doctors look at the number of neutrophils you have. A low neutrophil count is called neutropenia
. The doctor may say you are neutropenic.

90,000 Body piercings can cause loss of vision and blood poisoning

Moscow, December 4. For the sake of new sensations and impressions, people of different generations think about piercing, but do not suspect about the danger of punctures on the body.

Piercing is one of the ways to decorate the body with piercings and jewelry. And it attracts not only young people, but also adults who need new sensations. But in pursuit of the unknown, most do not think about the health risks, writes INFOX.

The main danger of piercing is considered to be blood poisoning. A puncture with a poorly handled instrument can lead to sepsis, HIV, hepatitis, or tuberculosis. Severe allergies, swelling or suppuration may appear on the material of jewelry that is inserted into the puncture site. It is not recommended to decorate the body in this way for people with a tendency to form keloid scars. They don’t disappear on their own.

When deciding to make a piercing in the eyebrow, it is possible to go blind if the master touches a nerve passing nearby.Also, many vessels are collected near the eye, so a hematoma may appear. You can lose normal diction or damage your teeth with a lip piercing. With a puncture of the tongue, loss of sensitivity is possible, the occurrence of candidiasis. But it is easy to disrupt salivation by piercing the cheeks.

Cartilage puncture is also unsafe. It sometimes deforms the ear, impairs hearing, or leads to paralysis of the facial nerve. The procedure for piercing the navel can become painful. One awkward movement during healing and infection can be brought in.Breastfeeding problems can be caused by piercing the nipples. And with insufficient care, inflammation can occur during healing.

Piercing is strictly prohibited for people with diseases of the kidneys, heart, blood, bronchial asthma, allergy to the material of the products, with autoimmune diseases, as well as with skin pathologies. Before the procedure, you should make sure that the master has a medical book, a license, a certificate of training, a certificate of listening to a lecture on infections.And you need to make sure that the master disinfected the tools, hands and the puncture site.

90,000 Neutropenia – diagnosis, symptoms, causes and treatment at the Medskan clinic

The main symptoms of neutropenia

The rate of onset of neutropenia depends on the severity of the infection, as well as the degree of decrease in the level of these blood cells. Usually, patients first of all develop stomatitis, tonsillitis, pharyngitis.Due to the lack of movement of leukocytes, inflammation has a fibro-necrotic nature.

A gray plaque forms on the mucous membranes, which indicates the development of a bacterial process. Infectious agents enter the general bloodstream and spread rapidly throughout the body. The patient develops a headache, apathy, nausea, body temperature can reach 40 degrees. Also, the characteristic symptoms of neutropenia include:

• Rapid formation of ulcers .Initially, they spread along the mucous membranes of the cheeks. In the future, this can lead to gangrene of the facial tissues. Then the gastrointestinal tract is affected: necrosis of the mucous membrane of the stomach, intestines, esophagus occurs;
• Due to the defeat of the gastrointestinal tract, appears severe pain and bloating . Deep disorders are manifested by hemorrhages. The risk of developing jaundice increases;
• Lung inflammation . With neutropenia, it proceeds atypically; if untreated, it passes to neighboring organs.Tears and gangrene form on the lungs. Inflammation can be determined by severe coughing, shortness of breath, chest pain when breathing;
• Damage to the genitourinary system . The infection affects the bladder, urethra, or uterus. In this case, the patient has pain in the lower abdomen, sharp cramps during urination. For women, the appearance of whitish vaginal discharge is characteristic;
• Disorders in the work of the heart . Due to the general intoxication of the body, venous and arterial hypotension develops.When listening to the heart – functional murmurs are present;
• Kidney damage . Against the background of the activity of infectious agents, the body removes protein. Also, blood, epithelial cells of the renal tubules are found in the urine;
• Development of septic complications . Pathogenic agents spread rapidly throughout the body and cause numerous disorders. Blood poisoning can occur due to the saprophytic flora. In this case, the disease is very difficult, the body temperature rises to 41-42 degrees.Pockets of black rash appear all over the body.

Neutropenia is a serious illness that, if safety measures are not followed, can lead to serious complications and even death. If all the doctor’s recommendations are followed, the patient will be able to protect himself from such consequences. A mild degree of neutropenia is determined only by the results of a general blood test. Supportive medications are given to keep more serious symptoms from getting worse.

Each patient with this pathology should be as attentive as possible to their health.Especially if he is in a high-risk group. It is imperative to consult a doctor if these symptoms appear:

• Body temperature rose to 38 degrees;
• Chills or profuse sweating;
• Redness, pain, swelling with minor damage to the skin;
• Shortness of breath, cough;
• Itching, discharge from the genitals;
• Painful and frequent urination;
• Increasing abdominal pain;
• Sore throat, oral cavity.

Diagnostic Methods

Neutropenia often develops in patients who are prone to infections. People who have undergone radiation or chemical therapy are at increased risk. Neutropenia can be detected by a general blood test. Based on the results, the doctor will be able to determine the infectious process in the body. Additionally, the diagnostics includes the following examinations:

• Bacterial blood culture – identifies pathological agents;
• General analysis of urine – determines the function of the kidneys;
• Myelograms – studies of the composition of the bone marrow;
• Pulmonary X-ray – diagnoses pneumonia.

Treatment

There is no specific treatment regimen for neutropenia: the disease has a varied course, causes. The intensity of therapy will depend on the patient himself: his condition, age, degree of damage and the spread of the inflammatory process. Mild forms of neutropenia do not require any treatment. Exacerbations of infections are treated in the same way as in all patients.

Patients with severe neutropenia need to be under constant medical supervision – they are admitted to the hospital.Antiviral, antibacterial, antifungal drugs with increased doses are prescribed. When choosing a medicine, it is necessary to analyze the sensitivity of microflora to active substances. Until the results are obtained, the patient is injected intravenously with broad-spectrum antibiotics. If his condition has not improved after 3 days of drug therapy, increase the dose of the antibiotic or change the drug.

Patients with neutropenia, in whom the disease has developed against the background of chemotherapy or radiation exposure, are shown to take antibiotics until the number of neutrophils reaches 500 mg / μl of blood.If the fungal process joins the infectious process, it is necessary to take fungicides. To minimize the risk of bacterial contamination, the patient is prescribed trimethoprim sulfamethoxazole. Colony-stimulating factors are increasingly being used to treat neutropenia. To maintain immunity, it is necessary to take glucocorticosteroids, vitamin complexes.

If, against the background of neutropenia, the destruction of the spleen has occurred, its surgical removal is indicated. However, the operation is categorically contraindicated in case of septic complications and severe forms of pathology.In the most advanced cases, a bone marrow transplant may be required.

Forecast and prevention

The prognosis for neutropenia depends on how quickly and fully the therapy was started. At the first signs of fever, you must immediately consult a doctor and select a comprehensive treatment. To minimize the likelihood of infection, neutropenic patients should keep the following guidelines in mind:

• Shower daily with a washcloth and soap;
• Use antibacterial hand soap;
• Use an alcohol-based handrub outside the home;
• Brush your teeth after every meal;
• Try to minimize any contact.Completely limit contact with people who have recently been sick or have signs of infection;
• Wear a mask when visiting public places;
• Do not visit the dentist unless urgently needed;
• Do not eat raw foods, eat a low-microbial diet;
• Give yourself some cutlery, hygiene items;
• Don’t do any beauty treatments;
• Do not use a razor – possible cuts;
• Wash your hands after every contact with animals;
• Refuse to work in the garden, do not come into contact with the soil;
• Do not touch the trays of animals, their waste products.

Neutropenia is a dangerous condition that poses a huge threat to life. It requires compliance with special safety measures, as well as the appointment of competent treatment. If you are at risk of developing neutropenia or already have this disease, you need to be under constant medical supervision. You can contact the Medskan medical center, where you will be given a comprehensive diagnosis and an individual treatment regimen will be developed.

90,000 What can a person get infected with from insects, mammals and birds

text Petr Kharatyan
illustrations Galya Panchenko

Tuberculosis

Drawing: Galya Panchenko

Tuberculosis is a chronic infectious disease caused by one of three types of bacillus visible under a microscope: human, cattle or avian.Each of them is extremely dangerous for the host of the corresponding species, but can cause disease in representatives of other species. You can get infected through the respiratory tract, less often through the digestive tract or damaged skin. Tuberculosis primarily affects the lungs: prolonged cough with phlegm and blood (in later stages), fever, night sweats. Sick animals, air contaminated by them, products made from them can be a source of human infection.

Anthrax

Drawing: Galya Panchenko

The most striking symptoms of anthrax in humans are bluish-red nodules appearing on the skin, at the site of bacillus insertion, and then growing dark red bubbles containing liquid.After the bubble bursts, the area of ​​tissue on which it was located becomes dead, and the same nodules appear around, and then bubbles. Against this background, general blood poisoning quickly occurs, the temperature rises. The patient dies without an ambulance. Sources of infection are blood, meat and skin of dead animals. Anthrax affects domestic, agricultural and wild animals, as well as people.

Leptospirosis

Drawing: Galya Panchenko

Leptospirosis (or infectious jaundice) is a disease of domestic, agricultural and some wild animals, as well as humans.Leptospira, bacteria that cause leptospirosis, live mainly in the water of rivers and lakes and enter the body through the digestive tract, mucous membranes or damaged skin. They are also found in the natural fluids of sick and even recovered animals. The main reservoir of leptospira in nature is rodents. Symptoms of the disease are severe chills, loss of consciousness, delirium, fever, headaches, muscle pain. If jaundice begins, an itchy rash appears on the skin. The liver and kidneys are affected.

Tularemia

Drawing: Galya Panchenko

Tularemia is a disease of rodents, fur-bearing animals, agricultural and domestic animals, as well as humans.The most common vectors of tularemia pathogen are blood-sucking insects and ticks. Rodents are also a source of this dangerous infection. Tularemia is caused by a small polymorphic bacillus capable of long-term existence outside the body (in water at 13-15 ° C – 3 months; in frozen meat – up to 90 days). A person can become infected while bathing, through the skin or mucous membranes. Lymph nodes, lungs and spleen are mainly affected, there are fevers, dizziness, nausea, delirium, headache.

Brucellosis

Drawing: Galya Panchenko

The most common sources of brucellosis for humans are hares. Pets, farm animals, wolves, foxes, sparrows, pigeons, etc. also get sick. A person can become infected with brucellosis through the digestive tract, skin and mucous membranes, after which he has a fever and chills, the temperature rises (up to 41 ° C), lymph nodes increase; almost all internal organs are affected, and especially strongly – the joints, which can lead to disability and even, in rare cases, to death.

Rabies

Picture: Galya Panchenko

Rabies is an acute infectious disease caused by a virus invisible under an ordinary microscope, which is transmitted to healthy animals or people with the saliva of a sick animal – when bitten. Almost all animals, even birds, can be infected with rabies. With rabies, the central nervous system is affected, which causes increased aggressiveness, paresis, paralysis, convulsions, etc.n. The disease may not appear for a long time – from 12 days to several months. If a person bitten by a rabid animal is not urgently vaccinated, he can die in less than two weeks.

Plague

Drawing: Galya Panchenko

Plague bacillus is a bacterium that is the causative agent of bubonic, pulmonary and septic forms of plague. Its main vectors in natural foci are rodents, cats and camels, as well as a variety of fleas.With plague, the lungs, lymph nodes and other internal organs are affected, and sepsis develops. “Justinian’s Plague” (541-750) and “Black Death” (1346-1353) are the most famous plague pandemics. The first claimed tens of millions of lives, the second – a third of the population of Europe. Both plagues are believed to have come to the Mediterranean from Africa.

Toxoplasmosis

Figure: Galya Panchenko

The causative agent of toxoplasmosis is the parasitic protozoan – toxoplasma.A person can become infected both from a person and from an animal, and also be only a carrier of Toxoplasma. Transmission of the pathogen can occur through the digestive and respiratory tracts, in utero, through contact with patients, sexually; natural fluids of a sick body are also contagious. Toxoplasma is carried by arthropods: flies, fleas, some ticks, etc. In the acute form, the patient’s liver enlarges and the temperature rises strongly, as in typhoid, or the nervous system is affected (convulsions, vomiting, paralysis, etc.symptoms). There is an assumption that up to 65% of all humanity is infected with toxoplasmosis parasites.

90,000 Hemorrhoids can cause blood poisoning. Haemorrhoids. Recovery without surgery

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90,000 Influenza medicine and heart medicine save from sepsis

Tricagrelor and oseltamivir maintain platelet levels during bacterial blood poisoning, increasing the chances of recovery.

Sepsis, or blood poisoning, is an inflammatory response to bacterial contamination.The inflammation can be so severe that it incapacitates certain organs and leads to death. Fatal cases are not uncommon – 20-30% of all patients with sepsis. Among the bacteria that cause it most often is Staphylococcus aureus, Staphylococcus aureus .

Sepsis is usually treated with antibiotics. However, antibiotics are not always able to save the patient, even if they neatly kill all bacteria in laboratory tests. Another way is suggested in Science Translational Medicine by researchers at the University of California, San Diego.Studying the medical history of almost fifty patients with staphylococcal sepsis, they drew attention to the fact that the outcome of the disease depends on the number of platelets. Those who had few of them (in this case – no more than 100 thousand in 1 mm ³ blood) with a high probability died. Speaking as a percentage, among patients with sepsis and a platelet count of less than 100 thousand, 31% died, while among patients with a platelet count of more than 100 thousand, only 6% died.

Platelets are needed not only for blood clotting, they also release antimicrobial peptides that stimulate the immune system to more actively destroy bacteria.At the same time, Staphylococcus aureus secretes a special protein – alpha-toxin, which, firstly, makes holes in cell membranes, killing cells (strictly speaking, platelets are not exactly cells, but for us this is not so important now). And secondly, the alpha toxin activates our own enzyme, which cuts sialic acid from the platelet surface. Without sialic acid on the surface, platelets look defective and are deprived of the right to remain in the blood: when they are brought to the liver, it retains them in itself, removing them from the bloodstream.Accordingly, such platelets can no longer stimulate the immune system to fight bacteria. But if a person has a lot of platelets, in principle, then there remains a chance to defeat sepsis – which is demonstrated by statistics on patients with different levels of platelets in the blood.

You can try to find drugs that would prevent the bacterial alpha-toxin from harming platelets. And there are such drugs – these are tricagrelor and oseltamivir, also known as Tamiflu. Tricagrelor blocks platelet clumping, thereby preventing blood clots; it is prescribed for patients with cardiovascular diseases.Tamiflu does not need to be introduced – it is one of the most popular drugs against influenza.

As it turned out, tricagrelor also inhibits the activity of alpha-toxin – it cannot penetrate the platelet membrane and cannot stimulate the enzyme that cuts sialic acid off the platelet. Oseltamivir simply prevents this enzyme from working, so platelets remain in the blood even if there is a lot of alpha toxin floating around.

Experiments with septic mice have shown that both drugs maintain a fairly high level of platelets in the blood.They had less bacteria in their blood than mice that had not been given either tricagrelor or oseltamivir. Among sick animals that were given these drugs, after 10 days of infection, 60% remained alive, while among those who were sick without drugs, only 20% remained alive after 10 days.

Both tricagrelor and oseltamivir have side effects, and clinical trials have yet to find out what doses of both are needed to maintain platelet levels in sepsis without causing serious side effects.It would also be interesting to see if tricagrelor and oseltamivir would help with sepsis caused by other bacteria. In any case, it is unlikely that it will take much time – both drugs have long been used in medicine, and experts, in principle, know how they behave in the human body.

Sinusitis – Zvezda Medical Center

Sinusitis – how and why?

This disease is heard by everyone, although many do not know what it is, why it occurs and how to deal with it.Meanwhile, this is a serious disease that requires diagnosis and quality treatment.

Among the causes of sinusitis, the most important are hypothermia, chronic rhinitis, the presence of chronic foci of inflammation in the body and deformation of the anatomical structures of the nose. As a result of these changes, the mucous membrane becomes inflamed in the maxillary sinus and the outflow of its contents is disturbed, which complicates the course of the disease.

The first symptoms are nasal congestion, yellow or green mucus, painful sensations in the cheekbones, which spread higher and turn into headaches.These signs are accompanied by general malaise, a slight increase in temperature and increased fatigue. In addition, sinusitis can cause serious complications and life-threatening complications – general blood poisoning, meningitis, periostitis, inflammation of the intraorbital tissue.

How to protect yourself?

For reliable protection against sinusitis, comprehensive prophylaxis is needed that affects most of the body’s functions. So, you need to strengthen the immune system with generally available properties – use more fruits and vegetables in food, perform hardening procedures, this will strengthen the body’s defenses.In addition, it is extremely important not to overcool and get wet less.

Do not forget about moderate physical activity, which also strengthens the immune system. You can go jogging, walking or skiing. In this case, you do not need to overexert, starting with minimal loads and gradually increasing them, do exercises to the best of your ability and consult a doctor before performing them.

It is required to cure all foci of inflammation, especially to pay attention to the oral cavity and pharynx – tonsillitis, adenoid growths, carious teeth, inflamed gums.Allergies and colds cause swelling of the mucous membrane, increased secretion and prevent the normal outflow of mucous contents from the maxillary sinuses. Therefore, it is necessary to treat such pathologies in time and not start their course.

Smoking has a negative effect on the upper respiratory tract – it irritates, and then causes inflammation, which can go to the paranasal sinuses, including the maxillary sinuses. Frequent alcohol consumption also negatively affects the immune system.The fight against bad habits is an integral part of the prevention of sinusitis.

Separately, I would like to say about the excessive use of vasoconstrictor drops. The result of their frequent use is a thickening of the mucous membrane and deterioration of the outflow of secretions from the paranasal sinuses.

In addition, it is useful to rinse the nasal cavity with frequent rhinitis. To do this, use a solution that is prepared by adding half a teaspoon of salt to a glass of boiled water – you need to pick it up so that it does not pinch the mucous membrane or use ready-made solutions with sea salt.Rinse using a syringe without a needle or a syringe, injecting liquid into the nostril and bending over the bathtub. This will force the fluid out through the other nostril (possibly through the mouth). After rinsing, it is worth blowing your nose. It should be borne in mind that frequent washing can also cause problems, therefore, before carrying out both this and other procedures, you should first consult a doctor.

Thus, the basis for the prevention of sinusitis consists of the following components:

• sports activities,
• timely treatment of colds, allergies and chronic respiratory diseases,
• fight against bad habits,
• do not abuse vasoconstrictor drops,
• nutritious food with vitamins and nutrients,
• rinsing for frequent rhinitis.