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What most people misunderstand about sepsis

Kraig Pakulski 0 11 Article rating: No rating

By Dr. Jamin Brahmbhatt, CNN

(CNN) — The death of NASCAR Cup Series champion Kyle Busch, whose family said he had severe pneumonia that progressed to sepsis, has renewed questions about a condition many people have heard of but few fully understand.

Sepsis is more common and more unpredictable than most people realize.

As a urologist, I frequently care for patients who arrive in the emergency room with infected kidney stones. The symptoms often started days earlier: flank pain, fevers, chills, nausea or a general feeling that something was not right. By the time they get to the emergency room, some look visibly ill: heart rate up, blood pressure low, tired and sometimes confused.

This is no longer just an infection. This is sepsis, the body’s extreme response to infection.

Pneumonia isn’t the only infection that can lead to sepsis. A skin infection that keeps spreading and raises your heart rate. A urinary tract infection that suddenly lowers your blood pressure. An infected kidney stone that raises your temperature – these are not just infections anymore. They could be sepsis.

How common sepsis really is

About 1.7 million adults in the United States develop sepsis each year, and at least 350,000 die during hospitalization or are discharged to hospice, according to the US Centers for Disease Control and Prevention. Sepsis contributes to more than one-third of hospital deaths in this country.

Yet public awareness remains surprisingly low. Many people still do not recognize the symptoms or realize that common infections can trigger it.

When your medical team suspects sepsis, the clock starts. We start IV fluids and broad-spectrum antibiotics within the first hour, and then we look for the source of the original infection.

I have seen patients walk in barely able to talk who are then sitting up and asking for water a few hours later. But not every case follows the same course. Some arrive early , get aggressive treatment and still end up in the ICU.

Sepsis can be unpredictable, and that’s why early recognition matters so much.

What sepsis does to the body

Many people think of infections as staying in one part of the body. Pneumonia affects the lungs. A urinary infection affects the bladder. A skin infection stays in the skin.

Sometimes that is true. But when sepsis develops, the body’s response can become much larger than the original infection.

Sepsis is like a kitchen fire that triggers sprinklers throughout an entire building. The original problem may start in one area, but suddenly the emergency response spreads much farther than intended or needed. The body is trying to contain the threat. But in some situations, the inflammatory response becomes wide enough that blood pressure falls, oxygen levels suffer and organs begin to fail.

That is what makes sepsis dangerous. The infection matters, but the body’s response matters just as much, if not more.

Where sepsis begins

Busch’s death has put the spotlight on pneumonia, but it is only one possible cause of sepsis.

Pneumonia happens when infection and inflammation affect the lungs, making it harder for oxygen to move through the body. Many cases improve with treatment, and recovery is common. But severe pneumonia can progress and, in certain situations, contribute to sepsis.

Sepsis can also develop from urinary infections, kidney stones, issues inside the abdomen, skin wounds and surgical sites.

In urology, infected obstructed kidney stones are one of the more dangerous examples. Bacteria become trapped behind a blockage, and the body cannot cl

NASCAR mourns Kyle Busch at a solemn Coca-Cola 600

Kraig Pakulski 0 9 Article rating: No rating

By Kyle Feldscher, CNN

Concord, North Carolina (CNN) — It’s a solemn day as tens of thousands of NASCAR fans are trekking to Charlotte Motor Speedway to remember Kyle Busch at the first race after since his sudden death.

The Coca-Cola 600 outside of the Queen City has been circled on race fans’ calendars for months as one of the premier races on the NASCAR schedule. However, it has turned into a sort of group memorial for 95,000 fans and hundreds of NASCAR drivers, crew members, and other officials as they mourn the passing of a legend taken far too soon.

The skies above Charlotte Motor Speedway are finally showing some blue after days of rain that followed the announcement of Busch’s death, just days after his final victory at Dover last weekend in the NASCAR Craftsman Truck Series.

Busch’s family announced on Saturday that the 41-year-old NASCAR legend died from complications of severe pneumonia that progressed into sepsis. Sepsis is the body’s “overwhelming and life-threatening response” to an infection, according to the Centers for Disease Control and Prevention.

The condition can lead to tissue damage, organ failure and death. Sepsis can be triggered by any type of infection, even a minor one, and occurs when germs enter a person’s body and multiply, causing illness and damage to organs and tissues.

The loss has led to a sudden onset of grief at one of NASCAR’s signature weekends. Busch’s rapid decline stunned the racing world, inside and outside the track.

Busch was coughing up blood and experiencing shortness of breath on Wednesday while getting ready for Sunday’s Coca-Cola 600 at Charlotte Motor Speedway.

According to a 911 call obtained by CNN in response to a request for recordings related to Busch’s medical emergency, a caller – whose name is redacted in the recording – asks for an ambulance to come to a training facility in Concord, North Carolina.

The caller states that Busch was lying on the bathroom floor and was awake at the time of the call. The caller requested that the ambulances approach the building with sirens off and gave directions on the quickest route to Busch.

The 911 call, made at 5:30 p.m. ET Wednesday, came almost exactly 24 hours before NASCAR, Busch’s family and Richard Childress Racing announced Busch’s death.

Busch’s No. 8 was painted on the infield of Charlotte Motor Speedway and became a place for drivers to come and spend a few minutes grieving their fallen competitor. The No. 8 car won’t be seen in NASCAR for some time; Richard Childress Racing announced it would suspend use of the number until Busch’s 11-year-old son, Brexton, was ready to start NASCAR racing. Brexton is training to follow in his father’s footsteps and is already an accomplished youth racer.

The atmosphere at a NASCAR speedway on race day is usually more like a tailgate ahead of a big college football game, only on steroids. Outside and inside the track, campers have been posted for days enjoying beverages and grilled meats of all kinds. The music is usually blaring, flags are waving and a festive mood fills the air.

It’s a little different in North Carolina this week. Days of rain have delayed the on-track racing multiple times and the campgrounds are full of mud.

But mostly, it’s Busch’s death that lingers over the place as the crowds and crews prepare themselves for the emotional moments that will come when the race begins around 6 p.m. ET.

A hint of what’s to come came yesterday when Busch’s team car — now adorned with No. 33 — was unloaded first off the trucks. Video from the scene showed the rollout turning into an almost ceremonial moment, as the garage stopped and watched in silence as the Chevrolet was whee

¿Qué pasará cuando la guerra realmente termine?

Kraig Pakulski 0 8 Article rating: No rating

Análisis por David Goldman, CNN

El presidente Donald Trump dijo el sábado que la paz con Irán está cerca y que el estrecho de Ormuz será reabierto.

Ya veremos. Trump se ha convertido en el presidente que repetidamente anuncia la paz. Tras múltiples anuncios fallidos en los últimos tres meses, el mercado ha comenzado a ignorar el relato minuto a minuto de Trump y ahora espera señales concretas de un acuerdo con Irán.

Irán ha mantenido una postura dura sobre una reapertura total del estrecho, su principal herramienta de presión durante una guerra en la que fue superado militarmente. Pero Teherán ha utilizado lanchas rápidas, minas y drones mejorados para bloquear el paso de petroleros por el estrecho, privando a la economía global de una quinta parte de su suministro de petróleo.

Pero si realmente este es el fin de la guerra y el estrecho está a punto de reabrirse, ¿qué ocurrirá después?

¿Cuándo volverán los precios a los niveles previos al conflicto?

No será pronto. Casi con certeza no ocurrirá este año. Tal vez nunca.

Una vez el estrecho realmente reabra, comenzará una pesadilla logística.

Primer paso: despejar los cuellos de botella en el estrecho. Eso tomará mucho tiempo, ya que los petroleros se mueven aproximadamente a la misma velocidad que una bicicleta.

Primero deberán salir unos 166 petroleros atrapados en el golfo Pérsico, que transportan cerca de 170 millones de barriles de petróleo, según Matt Smith, principal analista petrolero de Kpler. Eso permitirá el ingreso de petroleros vacíos al estrecho para cargar petróleo y volver a salir.

El regreso a la capacidad total de tránsito de petroleros podría tardar hasta tres meses, según Victoria Grabenwöger, analista sénior de petróleo de Kpler.

Segundo paso: reducir las reservas acumuladas. Los barcos vacíos primero retirarán petróleo de los depósitos que fueron llenados porque los productores no tenían dónde más almacenarlo.

La buena noticia es que las refinerías actuaron de forma pragmática y nunca llenaron completamente sus reservas. Eso debería reducir parte del tiempo que de otro modo tomaría reiniciar el bombeo. Pero los inventarios, que siguen más altos de lo habitual, igualmente retrasarán el regreso de la producción petrolera a plena capacidad.

Tercer paso: reiniciar la producción. Gran parte de los pozos petroleros de Medio Oriente fueron cerrados durante la guerra. Reactivar la producción no es como encender un interruptor. Es un complejo desafío de ingeniería que implica procesos físicos delicados y semanas de trabajo.

La producción deberá reiniciarse lentamente para evitar el colapso de los depósitos de crudo, lo que obligaría a perforaciones adicionales y reparaciones importantes. También será necesario equilibrar nuevamente el agua y el gas inyectados en los pozos, un proceso complicado.

Debido a que los pozos en la región son grandes y están muy cerca unos de otros, reiniciar la producción requerirá una coordinación significativa entre compañías y países para mantener estable la presión del agua y el gas inyectados en múltiples pozos.

Cuarto paso: realizar reparaciones. Varias refinerías, productores de gas natural y algunas compañías petroleras sufrieron daños durante la guerra. Algunas reparaciones de infraestructura crítica dañada podrían tardar años, dijeron empresas del sector.

Hay mucho petróleo que debe volver al mercado: 12 millones de barriles diarios de producción de crudo y 3 millones de barriles diarios de productos refinados fueron suspendidos en Medio Oriente, principalmente en Arabia Saudita e Iraq, según Kpler. Y eso no será fácil.

Todo eso asume que la guerra realmente terminó y que no habrá nuevas interrupciones en el estrecho. Y todos sabemos lo que pasa cuando se hacen suposiciones.

Los últimos meses han estado llenos de anuncios fallidos de paz, lo que ha mantenido

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