scholarly journals Sepsis-3 definitions predict ICU mortality in a low–middle-income country

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Bruno Adler Maccagnan Pinheiro Besen ◽  
Thiago Gomes Romano ◽  
Antonio Paulo Nassar ◽  
Leandro Utino Taniguchi ◽  
Luciano Cesar Pontes Azevedo ◽  
...  
2021 ◽  
Vol 13 (1) ◽  
pp. e2021052
Author(s):  
Zied Hajjej ◽  
Kalthoum Ben Mahmoud ◽  
Aicha Rebai ◽  
Hedi Gharsallah ◽  
Iheb Labbene ◽  
...  

Background: Since the first publication, of 2016, Sepsis-3 definitions have not been universally accepted, rather, they have become a source of controversy. Because clinical and laboratory parameters used had been derived mainly from patients hospitalized in United States’ Intensive Care Units (ICU). Purpose: the aim of this study was to evaluate the performance of the Sepsis‑3 definitions for the prediction of ICU-mortality in a Tunisian ICU population as compared to 2003 Consensus Definitions (Sepsis-2 definitions) Methods: It was a retrospective study conducted in an 18-bed medical surgical intensive care unit at the military hospital of Tunis (Tunisia).  From January 2012 to January 2016, all patients admitted to the ICU for sepsis, severe sepsis or septic shock as defined according to 2003 Consensus Definitions (Sepsis-2 consensus) were eligible for this study. The new Sepsis-3 definition was secondly used to classify included patients. The primary area of interest was ICU mortality defined as death before ICU discharge Results: A total of 1080 patients were included during the recruitment period. . When the Sepsis-2 definitions were used there had been a difference in mortality only between septic shock and sepsis patients. While Sepsis-3 definitions show that mortality increased from 16 % among no-dysfunction-infected patients to 30 % among patients with qSOFA ≥ 2 and 44% or 46% for sepsis or septic shock patients, respectively. Conclusions: Sepsis-3 was better than sepsis-2 definitions at stratifying mortality among septic patients admitted to an ICU of a middle income country (Tunisia).


2019 ◽  
Author(s):  
Quan-Hoang Vuong

Valian rightly made a case for better recognition of women in science during the Nobel week in October 2018 (Valian, 2018). However, it seems most published views about gender inequality in Nature focused on the West. This correspondence shifts the focus to women in the social sciences and humanities (SSH) in a low- and middle-income country (LMIC).


Author(s):  
Bridget Pratt

Health research funded by organizations from HICs and conducted in low- and middle-income countries has grown significantly since 1990. Power imbalances and inequities frequently (but not always) exist at each stage of the international research process. Unsurprisingly then, a variety of ethical concerns commonly arise in the context of international health research, such as inequities in funding, the semi-colonial nature of international research models, the brain drain of low- and middle-income country researchers, and inequities in partnerships between HIC and low- and middle-income country researchers. In this chapter, these (and other) ethical concerns are introduced and the following ethical concepts to address the concerns are then discussed: responsiveness, standard of care, benefit sharing, community engagement, and social value. Existing guidance and remaining debates about how to specify each of the concepts are summarized. The chapter concludes by highlighting the existence of epistemic injustices within the field of international research ethics.


Author(s):  
Margo S Harrison

Abstract Background A secondary analysis was conducted of two separate datasets to observe the association between maternal age and interpregnancy interval (IPI). Methods The IPI in a middle-income country (Guatemala) was compared with that of a very-high-income country (USA) among women with two pregnancies. Results A regression model found that with each increasing year of age, the IPI increases by 1.26 months (p<0.001) in Guatemala. A regression model found that IPI decreased as women aged in the USA. Conclusions It is hypothesized that as countries progress in their development indices, women may delay childbearing, which may result in reduced IPI, as was the case in the USA compared with Guatemala in these datasets.


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