Linking Sepsis with chronic arterial hypertension, diabetes mellitus, and socioeconomic factors in the United States: A scoping review.

RATIONALE: Sepsis is a syndrome of life-threatening organ dysfunction caused by a dysregulated host immune response to infection. Social risk factors including location and poverty are associated with sepsis-related disparities. Understanding the social and biological phenotypes linked with the incidence of sepsis is warranted to identify the most at-risk populations. We aim to examine how factors in disadvantage influence health disparities related to sepsis. METHODS: A scoping review was performed for English-language articles published in the United States from 1990 to 2022 on PubMed, Web of Science, and Scopus. Of the 2064 articles found, 139 met eligibility criteria and were included for review. RESULTS: There is consistency across the literature of disproportionately higher rates of sepsis incidence, mortality, readmissions, and associated complications, in neighborhoods with socioeconomic disadvantage and significant poverty. Chronic arterial hypertension and diabetes mellitus also occur more frequently in the same geographic distribution as sepsis, suggesting a potential shared pathophysiology. CONCLUSIONS: The distribution of chronic arterial hypertension, diabetes mellitus, social risk factors associated with socioeconomic disadvantage, and sepsis incidence, are clustered in specific geographical areas and linked by endothelial dysfunction. Such population factors can be utilized to create equitable interventions aimed at mitigating sepsis incidence and sepsis-related disparities.

Identifying the needs of critical and acute cardiac care nurses within the first two years of practice in Egypt using a nominal group technique.

Nursing in Egypt faces many challenges and working conditions in health care settings are generally poor. Little is known about the needs of new nurses transitioning in Egypt. The literature focuses on the first year of practice and only a small body of research has explored the transition needs within acute care speciality settings. This paper reports on the important professional needs of new graduate nurses working in an acute cardiac setting in Egypt during the first two years of practice and differences between their perceived most important needs. The total population participated and two group interviews were conducted (n = 5; n = 6) using the nominal group technique. Needs were identified and prioritised using both rankings and ratings to attain consensus. Content analysis was conducted to produce themes and enable cross-group comparison. Rating scores were standardised for comparison within and between groups. Both groups ranked and rated items as important: 1) education, training and continued professional development; 2) professional standards; 3) supportive clinical practice environment; 4) manageable work patterns, and 5) organisational structure. It is important that health care organisations are responsive to these needs to ensure support strategies reflect the priorities of new nurses transitioning in acute care hospitals within Egypt.

Selective immunotoxic lesions of basal forebrain cholinergic cells: effects on learning and memory in rats.

Male Long-Evans rats were given injections of either 192 IgG-saporin, an apparently selective toxin for basal forebrain cholinergic neurons (LES), or vehicle (CON) into either the medial septum and vertical limb of the diagonal band (MS/VDB) or bilaterally into the nucleus basalis magnocellularis and substantia innominata (nBM/SI). Place discrimination in the Morris water maze assessed spatial learning, and a trial-unique matching-to-place task in the water maze assessed memory for place information over varying delays. MS/VDB-LES and nBM/SI-LES rats were not impaired relative to CON rats in acquisition of the place discrimination, but were mildly impaired relative to CON rats in performance of the memory task even at the shortest delay, suggesting a nonmnemonic deficit. These results contrast with effects of less selective lesions, which have been taken to support a role for basal forebrain cholinergic neurons in learning and memory.

Endocrinology review - adrenal and thyroid disorders.

The endocrine system comprises part of the body's communication system that links the brain to its organs and functions to control metabolism, growth development and reproduction. Control of this system is predominantly through a complex feedback system that works to maintain homeostasis. When there is disruption to an endocrine gland or to the feedback system, it can lead to endocrine disturbance. Due to the complexity of the endocrine system, diagnosis and interpretation of endocrine pathology can be challenging.

The adrenal gland: common disease states and suspected new applications.

The adrenal gland, while small in size, provides a major punch to human metabolism. The interplay between the adrenal cortex hormones aldosterone and cortisol provides needed regulation to human metabolism. Aldosterone regulates the body sodium content affecting blood pressure thru fluid-volume regulation by the kidney. Cortisol, also from the adrenal cortex, contributes to regulation of glucose and protein metabolism. Diseases like addison's disease and Cushing's syndrome that affect the normal levels of these hormones can lead to serious pathologies that need to be detected thru clinical laboratory testing. The inner core of the adrenal gland, called the medulla, houses the catecholamine epinephrine, a fast acting neuropeptide hormone that can influence body action and energy levels quickly. The pheochromocytomas pathology of the adrenal medulla adversely affects the medulla hormones and needs to be recognized by clinical laboratory testing. The overview of the adrenal gland and its potential pathologies needs to be looked at anew in relation to post-traumatic stress disorder to find any linkage that may aid in the treatment and cure of our affected military soldiers. This interrelationship between cortisol and epinephrine in PTSD should be closely evaluated to determine if the suspected linkages are significant.