New sepsis test ‘could save thousands of lives’

A new rapid test for sepsis which could cut the time taken to get a result from up to 72 hours, to within three minutes has been developed by scientists.

1. 19 February 2019 at 10:39am

The new test could cut the results time from up to 72 hours, to less than three minutes. Credit: University of Strathclyde

The test could save thousands of lives from the common and potentially deadly condition which is triggered by an infection, and experts hope it will be available on the NHS within three to five years.

At present, it can take up to 72 hours to diagnose sepsis, which kills an estimated 52,000 people in the UK every year.

Sepsis hit the headlines following the death of 12-month-old William Mead, from Cornwall, who died in December 2014 after health professionals failed to recognise he had the condition.

A sepsis infection can start anywhere in the body and can occur after chest or water infections, abdomen problems - such as burst ulcers - or even from cuts and bites.

It is caused by the way the body responds to germs, such as bacteria. The body’s response to an infection may injure its own tissues and organs.

If untreated, sepsis can lead to shock, multiple organ failure and death.

• What is sepsis and what are the symptoms?

William Mead died of Sepsis in December 2014. Credit: Family handout

The new low-cost test, developed by researchers at Strathclyde University, uses a biosensor device to see whether the protein biomarker interleukin-6 (IL-6) is present in the bloodstream

IL-6 is a molecule secreted by the immune system and is often found in high levels in people with sepsis.

During research at Strathclyde, the new test picked up IL-6 within two-and-a-half minutes.

Experts hope the test will be used at the bedside in hospitals and in GP surgeries.

Its needle shape means it can also be implanted and used on patients in intensive care.

Dr Damion Corrigan said the new test could save lives. Credit: University of Strathclyde

Dr Damion Corrigan, from the department of biomedical engineering at Strathclyde, said: “With sepsis, the timing is key.

“For every hour that you delay antibiotic treatment, the likelihood of death increases.

“At the moment, the 72-hour blood test is a very labour intensive process but the type of test we envisage could be at the bedside and involve doctors or nurses being able to monitor levels of sepsis biomarkers for themselves.

“If GP surgeries had access they could also do quick tests which could potentially save lives.

“It could also be available in A&E departments so that anyone coming in with a question mark could be quickly ruled in or out.

“I would hope the test could improve survival rates by ensuring people get treatment more quickly.

“It’s not just saving lives, a lot of people who survive sepsis suffer life-changing effects, including limb loss, kidney failure and post-traumatic stress disorder.

“The test could stop a lot of suffering.”

An estimated 52,000 people die as a result of sepsis each year Credit: Lynne Cameron/PA

Dr Ron Daniels, chief executive of the UK Sepsis Trust, said earlier diagnosis and treatment across the UK could save at least 14,000 lives a year.

Symptoms of sepsis include a high or abnormally low temperature, fast heart rate and rapid breathing.

He said: “Any kind of test that enables us to identify sepsis earlier, before symptoms even present themselves, could help save even more lives and bring us closer to our goal of ending preventable deaths from sepsis.

“Systems like this are so important as, with every hour before the right antibiotics are administered, risk of death increases.

“No test is perfect in the identification of sepsis, so it’s crucial we continue to educate clinicians to think sepsis in order to prompt them to use such tests.”

According to The UK Sepsis Trust, early symptoms of sepsis usually develop quickly and can include:

• high temperature (fever)
• chills and shivering
• a fast heartbeat
• fast breathing

Symptoms of more severe sepsis can include:

• feeling dizzy or faint
• confusion or disorientation
• nausea and vomiting
• diarrhoea
• not passing water for prolonged periods
• cold, clammy and pale or mottled skin

The UK Sepsis Trust says it can be difficult to distinguish from flu and advises people "don't be afraid to say 'I think this might be sepsis'."

Getting antibiotics and fluid early can halt the progression of the infection.

Last updated Tue 19 Feb 2019

https://www.itv.com/news/2019-02-19/new-sepsis-test-could-save-thousands-of-lives/

Vitamin C May Be a Potent Adjunct to Cancer Treatment

Vitamin C is one of the most well-established traditional antioxidants known and its potent health benefits have been clearly demonstrated over time — especially for the prevention and treatment of infectious diseases.


March 06, 2017


Story at-a-glance -

• Research shows vitamin C is selectively cytotoxic to cancer cells when administered intravenously in high doses, and has a number of heart and cardiovascular benefits
• When given intravenously at high doses, vitamin C produces a pro-oxidant effect, thereby generating hydrogen peroxide, which is ultimately what kills the cancer cells
• Normal tissues are not harmed by the high levels of hydrogen peroxide generated because healthy cells have several ways of effectively removing it, thereby preventing buildup to toxic levels. Cancer cells lack this ability

---

By Dr. Mercola

Vitamin C is one of the most well-established traditional antioxidants known and its potent health benefits have been clearly demonstrated over time — especially for the prevention and treatment of infectious diseases.

Research has also shown that vitamin C is selectively cytotoxic to cancer cells when administered intravenously (IV) in high doses, and has a number of heart- and cardiovascular benefits.

From my perspective, vitamin C is a very useful supplement that should be part of most cancer treatment protocols. Vitamin D is another crucial anti-cancer component I’ve written about on numerous occasions.

How Vitamin C Kills Cancer Cells

In order for vitamin C to effectively kill cancer cells, you need to have a very high concentration of vitamin C in your blood, and the only way to obtain these extreme levels is through IV administration, although using oral liposomal vitamin C can approach effectiveness at a fraction of the price, improved convenience and cost.

By bypassing the digestive tract, IV administration results in blood levels up to 500 times higher than what you can achieve through the oral route.

The mechanism behind vitamin C’s ability to selectively target cancer cells has to do with the generation of hydrogen peroxide, which is ultimately what kills the cancer cells. As reported by the University of Iowa:1


“In a new study2,3 … Buettner and his colleagues have homed in on the biological details of how high-dose vitamin C kills cancer cells. The study shows that vitamin C breaks down easily, generating hydrogen peroxide, a so-called reactive oxygen species that can damage tissue and DNA.


The study also shows that tumor cells are much less capable of removing the damaging hydrogen peroxide than normal cells …


‘Thus, cancer cells are much more prone to damage and death from a high amount of hydrogen peroxide,’ says Buettner, a professor of radiation oncology and a member of Holden Comprehensive Cancer Center at the University of Iowa.


‘This explains how the very, very high levels of vitamin C used in our clinical trials do not affect normal tissue, but can be damaging to tumor tissue.’”

The reason normal tissues are not harmed by the high levels of hydrogen peroxide generated is that healthy cells have several ways of effectively removing it, thereby preventing buildup to toxic levels.

One of the primary pathways of removal is the enzyme catalase, and the study found that cells with reduced catalase activity were indeed more prone to die when exposed to high amounts of vitamin C.

This provides a hint at which cancers are likely the best candidates for high-dose vitamin C therapy — tumors with low catalase levels are likely to be the most responsive, whereas tumors with high catalase levels would be the least responsive. Next, the research team wants to develop methods to measure catalase in tumors.

Vitamin C Lowers Inflammation in Cancer Patients, and More

Another way vitamin C benefits cancer is by lowering inflammation in your body, as shown in a 2012 study.4,5,6

As a general rule, chronic inflammation is a hallmark of cancer, and here they found that IV vitamin C treatment helps lower pro-inflammatory cytokines and C-reactive protein — two inflammatory markers — and that these improvements correlate with a reduction in tumor size.

It also helps lower the risk of metastasis. A positive response was noted in 75 percent of patients. This study was done by scientist at the Riordan Clinic, which is the successor to Linus Pauling and his work on vitamin C. There is likely no clinic in the world with as much experience with vitamin C as the Riordan Clinic.

Riordan carried out a 15-year-long research project called RECNAC (cancer spelled backwards), which showed vitamin C was selectively cytotoxic against cancer cells.

Other research7,8 done by scientists at the Lewis Cantley of Weill Cornel Medicine in New York found high doses of vitamin C helps kill and eliminate colorectal cancer cells with certain genetic mutations. Other studies9 have shown high-dose vitamin C can help slow the growth of prostate-, pancreatic-, liver- and colon cancer cells.

Human studies also show IV vitamin C can help improve symptoms associated with cancer and cancer treatment, such as fatigue, nausea, vomiting, pain and loss of appetite, and improve overall quality of life.

Vitamin C for Infectious Diseases

Vitamin C may be best known for its ability to combat infectious disease. Dr. Thomas Levy’s book, “Curing the Incurable,” details these benefits.

A perfect real-world example is the dramatic case of Allan Smith, who contracted a serious case of swine flu and was brought back from the brink of death using a combination of IV and oral vitamin C.

The case report was sent to me by Levy, who noted that, to his knowledge, vitamin C “has never failed to cure an acute viral syndrome.” According to Albert Szent-Gyorgyi (who won the Nobel Prize in 1937 for his discovery of vitamin C), “health” occurs when there is an ample flow and interchange of electrons in your cells.

Impaired or poor electron flow and interchange equals “disease,” and when the flow and interchange ceases entirely, your cells die. Oxidation, caused by free radicals in your body, involves the loss of electrons.

Antioxidants, both from your diet and endogenously produced, counter the disease process caused by oxidation (loss of electrons) by supplying electrons. Vitamin C is a major antioxidant, and according to Levy, perhaps the most important electron donor to maintain optimal electron flow in your cells.

In 2005, the Orthomolecular Medicine News Service (a non-profit and non-commercial informational resource), published findings that vitamin C is an effective treatment against the dreaded bird flu and other viruses.10

As with cancer, extremely high doses are needed though — upwards of 200,000 to 300,000 milligrams (mg) of vitamin C, given intravenously. The reason for this is because the avian flu appears to “consume vitamin C very rapidly, similar to an acute viral hemorrhagic fever, somewhat like an Ebola infection.”

A number of other studies and clinical experiences also attest to vitamin C as a potent treatment strategy against all sorts of infectious diseases, including influenza,11 encephalitis and measles.12

 Vitamin C for Sepsis

Vitamin C in combination with thiamine (B1) and hydrocortisone has also been shown to be dramatically helpful in the treatment of severe sepsis and septic shock. Sepsis is a life-threatening condition triggered by a systemic infection, caused by bacteria, viruses or parasites that ultimately affects the function of vital organs. Hospital-acquired infections that progress to sepsis is a significant cause of death.

As many as half of all in-hospital deaths are related to sepsis,13 and recent research published in the Canadian Medical Association Journal proposes sepsis should be recognized as a distinct cause of death in hospitals around the world.14 The cost of treating sepsis is high, topping $24 billion in 2014, with nearly 25 percent of all hospital charges attributed to the treatment of sepsis. As reported by Dr. Malcolm Kendrick, the study in question:15


“… demonstrates that if you give vitamin C (along with hydrocortisone and thiamine) for just over two days in patients admitted with sepsis (blood poisoning) the mortality rate falls from 40 percent to 8.5 percent. The mortality rate in low income countries is normally around 60 percent. Now, this was a small study, but it seems robust. It represents an almost five-fold reduction in mortality … ”

Vitamin C Is Also Good for Your Heart, Blood Vessels, Lungs and Eyes

Other studies focused on vitamin C shows it helps:

Decrease risk of post-operative atrial fibrillation after heart surgery, thereby reducing the risk of stroke and heart failure. It also reduced the length of hospitalization after heart surgery. Oral administration reduced the length of hospital stay by 7 percent (less than half a day), whereas IV shortened it by 16 percent (1.5 days)16,17

Reduce high blood pressure — likely by protecting your body's supply of nitric oxide (NO), a molecule that relaxes blood vessels. In one study,18 both the systolic and diastolic (top and bottom) readings were inversely associated with ascorbic acid levels. Specifically, women with the highest levels of ascorbic acid had about 4.6 mm Hg lower systolic and just over 6 mm Hg lower diastolic blood pressure compared to those with the lowest ascorbic acid levels

Reduce your risk of chronic obstructive pulmonary disease (COPD), especially among smokers. In one study, heavy smokers with the highest vitamin C intake had a 77 percent lower risk of COPD than those with the lowest intake.19 The mechanism for this effect is thought to be related to vitamin C’s ability to improve levels of vascular endothelial growth factor, and boost proliferation of alveolar cells in your lungs

Prevent heart attacks, primarily by reducing inflammation20

Protect your vision by improving the function of your retinal cells, and reduce your risk for cataracts by fighting oxidative stress

Important Contraindication for IV Vitamin C TreatmentWhile the evidence strongly supports the use of IV vitamin C in high doses for infections, inflammation and even cancer, it’s important to get your glucose-6-phosphate dehydrogenase (G6PD) checked beforehand. G6PD is an enzyme your red blood cells need to maintain membrane integrity. High-dose IV vitamin C is actually a strong PRO-oxidant, and giving a pro-oxidant to a G6PD-deficient individual can cause hemolysis (rupturing) of their red blood cells.

So, administering IV vitamin C is not for the novice! I strongly recommend getting it done by an experienced practitioner who uses the Riordan protocol or some other protocol that ensures its done in a safe manner. Fortunately, G6PC deficiency is relatively uncommon.

People of Mediterranean- and African decent are at greater risk, but it’s rare even in those groups. Still, while it’s not a great concern that will prevent its use in most people, should you happen to be that rare person with a G6PC deficiency, the ramifications of barreling ahead with high dose IV vitamin C could be disastrous.

General Vitamin C Dosage Suggestions

Dr. Ronald Hunninghake — chief medical officer at the Riordan Clinic who has supervised 60,000 IV administrations of vitamin C — discusses the use of vitamin C for health and cancer protocols in the featured video. For cancer, research by the Riordan Clinic suggests you need a vitamin C blood level of around 300 to 400 mg/dl to achieve selective cytotoxicity against cancer cells.

To reach that post-IV saturation level, you’d need to administer somewhere between 25 to 50 grams of vitamin C intravenously. That’s up to 300 times the normal amount of vitamin C you’d get from eating a healthy diet. It’s important to understand that these extremely high levels are really only indicated for the treatment of cancers and infectious diseases, not for everyday, general health.

This is because vitamin C starts to have a pro-oxidant effect at these extreme levels — this is in fact what causes the hydrogen peroxide to be created in the first place. In other words, the hydrogen peroxide is a pro-oxidant effect of the vitamin C, so it needs to be used judiciously. You can learn more about using vitamin C as an adjunct to your cancer protocol on the Riordan Clinic’s website.21

For everyday health, I believe your best bet is to eat a varied whole food diet, rich in vitamin C and other antioxidants, to avoid causing a nutritional imbalance.

For example, taking large doses of vitamin C (ascorbic acid) on a regular basis lowers your copper level, so if you are already deficient in copper and take high doses of vitamin C, you can compromise your immune system. So, while temporarily taking mega-doses of vitamin C supplements to combat a case of the cold or flu is unlikely to cause a problem, for long-term, daily use, you’re probably going to be better off simply squeezing some lemon juice into a glass of water and/or eating a vitamin C-rich diet.

Also remember that vitamin C is a water-soluble vitamin, so when you do take a supplement, it’s best to divide your daily dose and take it three times a day. Also, if you’re sensitive to vitamin C, you may experience diarrhea. This is an indication that you need to lower your dosage.

Lastly, evidence suggests liposomal vitamin C provides better absorption, so it’s my personal favorite. I always bring some liposomal vitamin C with me when I travel in case I or someone I travel with gets sick, and then I use two to four capsules every hour until better.

http://articles.mercola.com/sites/articles/archive/2017/03/06/vitamin-c-cancer-treatment.aspx

When sepsis strikes

Sepsis is a potentially life-threatening condition triggered by an infection, and must be detected and treated early.

This post is on Healthwise

April 12, 2015

BY DR MILTON LUM

Severe sepsis or septic shock can only be treated in a hospital and may require admission to the intensive care unit. – Filepic

Sepsis is a potentially life-threatening condition triggered by an infection, and must be detected and treated early.

Everyone suffers from infections from time to time. Various parts of the body can be involved, for example, the respiratory tract, skin and urinary tract.

The organisms are usually bacteria and viruses, but may occasionally be parasites or fungi.

The body’s response to an infection is to limit it to one site. White blood cells travel to the infection site, and a series of reactions occur to fight the infection and prevent its spread.

The process, called inflammation, is aimed at removing the harmful organisms and damaged cells, and start the healing process.

Inflammation can be acute or chronic. The former lasts a few days, though sometimes, a few weeks. The latter can last several months, or even, years, and is due to failure to eliminate the cause of the acute inflammation, or it could be due to a chronic persistent microbe of low intensity. An example of the former is acute upper respiratory tract infection, and the latter, tuberculosis.

When the immune system is weak or the infection is virulent, the infection spreads through the bloodstream to other parts of the body and causes widespread inflammation.

Sepsis is more common among the very young and very old. Photo: AFP

The body’s response injures its own tissues and organs. There may be a marked decrease in blood pressure that affects oxygen transport to vital organs like the heart, kidneys and brain. If untreated or treated inadequately, sepsis leads to multiple organ failure and death.

Infections associated with sepsis are infections of the lung, urinary tract, gallbladder, abdomen, pelvis, skin, and even, flu, in some cases.

The most common infection sites that lead to sepsis are the lungs, urinary tract, abdomen and pelvis.

However, there are instances where the source and cause of the sepsis cannot be identified.

According to the Malaysian Registry of Intensive Care, head injury, sepsis and community-acquired pneumonia were the three most common diagnoses leading to admission to intensive care units (ICU) in Health Ministry hospitals in 2011.

The in-hospital mortality rates of these patients were 25.2%, 58.9% and 40.6% respectively.

Risk factors

Everyone is at risk of sepsis. Some patients with sepsis do not require hospitalisation, although they feel ill. When sepsis is severe, immediate hospitalisation is necessary.

Sepsis is more common in those at risk – the very young and very old; the pregnant; those who have chronic conditions such as diabetes; those who just had surgery, accidental injuries and/or with invasive devices such as drips, catheters and ventilators; those whose immunity are weakened, such as HIV patients or those on treatment that weakens the immunity (long-term steroids, cancer chemotherapy); and those who are hospitalised for some other condition.

Hospital-associated infections are more serious, as many of the bacteria are resistant to many commonly-used antibiotics.

Managing sepsis

The features of sepsis include fever, chills, shivering, tiredness, poor appetite, rapid heart rate and rapid breathing.

The features of severe sepsis, which is life-threatening, include difficulty breathing; abnormal heart function; cold, clammy skin; abrupt change in mental state (confusion, disorientation); slurred speech; loss of consciousness; markedly decreased urine output; and decreased platelets.

The blood pressure in septic shock is very low and does not respond adequately to fluid replacement.

The diagnosis of sepsis is clinical, and the tests include that of blood and body fluids, such as urine, wound secretions, respiratory secretions and stool; imaging, including x-ray, ultrasound, computerized tomography (CT) scan; and kidney, heart and lung function tests.

Early diagnosis is essential to determine the type of infection, its location, and its impact on body functions.

Early treatment is necessary to stop the sepsis from progressing, reduce damage and decrease the risk of death. Treatment is dependent on the site and cause of the initial infection, the organ affected and the damage caused.

Severe sepsis or septic shock can only be treated in a hospital and may require admission to the ICU. This is because the chances of death in severe sepsis and septic shock is about four and six in every 10 affected persons respectively.

The mainstay of treatment for sepsis, severe sepsis or septic shock is antimicrobials upon diagnosis, even before the infectious agent is identified.

Initially, broad-spectrum antimicrobials, which are effective against a variety of organisms, are administered intravenously.

After getting the blood results, the antimicrobials may be changed to one that is more appropriate to the specific cause.

Although antibiotics are not effective against viruses, parasites or fungi, it is likely that they will be started anyway because it would be too dangerous to delay treatment.

Once the specific cause is identified, the appropriate antimicrobial will be given.

Antiviral agents may be given at the outset if there is strong suspicion that it is the cause of the sepsis.

The source of the infection, when identified, will be treated. Collections of pus will be drained. Surgery may be needed to remove pus and infected tissue.

Oxygen is administered through a mask or tubes in the nostrils if blood oxygen levels are low.

Those who have severe difficulty breathing would have a tube inserted into their trachea that is connected to a machine that helps breathing mechanically (i.e. a ventilator).

Medicines called vasopressors are prescribed for low blood pressure to help increase it by stimulating the muscles that pump blood around the body and narrowing or constricting blood vessels.

Extra fluids may also be given intravenously to help increase blood pressure.

Sufficient intake of food and liquids is essential. The former is done by inserting a thin tube up the nose and down into the stomach, or by inserting a drip to provide food and fluids.

Intravenous fluids are usually given in severe sepsis or septic shock to prevent dehydration and kidney failure. A catheter will be inserted into the bladder to monitor urinary output so that renal failure can be detected early.

Painkillers may be needed. Medicines to keep the patient drowsy or asleep may be prescribed to ensure sufficient rest and make the patient more comfortable.

Other treatments that could be instituted include blood transfusion, steroids, insulin and dialysis for impaired kidney function.

The duration of treatment depends on each patient’s individual circumstances.

It is advisable for anyone with features of an infection to seek medical attention, particularly if there are risk factors.

Anyone who develops features of sepsis after surgery, hospitalisation or an infection is advised to seek immediate medical care.

Early diagnosis and treatment will lead to full recovery. Late diagnosis and treatment may lead to disability, and even, death.

http://www.thestar.com.my/Lifestyle/Health/2015/04/12/When-sepsis-strikes/

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