Encephalitis

Challenges for nurses in caring for patients with acute encephalitis: lack of knowledge, time and rehabilitation

AIM

To explore the experiences of registered nurses providing care to adult patients affected by encephalitis, from admission into hospital through to discharge.

STUDY DESIGN

A qualitative phenomenological methodology was used. Sample and setting: Eight registered nurses in a city centre teaching hospital.

METHODS

Data collection took place using in-depth, semi-structured interviews. Data were analysed and themes identified using framework analysis.

FINDINGS

Three key findings were identified: nurses felt that they lacked knowledge of encephalitis, lacked time to give these patients the care they needed, and they lacked access to rehabilitation for patients with encephalitis.

CONCLUSION

This study provides the first evidence on nurses' experiences of providing care to patients affected by encephalitis. It has shown that they often lack the knowledge and time to give adequate support to patients. They also lack access to rehabilitation for these patients.

Proteomics Study on the Cerebrospinal Fluid of Patients with Encephalitis

OBJECTIVE

Label-free quantitative proteomics was applied to analyze differentially expressed proteins (DEPs) in the cerebrospinal fluid (CSF) of patients with encephalitis. The database was used to screen for possible biomarkers in encephalitis, followed by validation and preliminary investigation of the role of some DEPs in the pathogenesis of encephalitis using enzyme-linked immunosorbent assay (ELISA).

METHODS

We performed label-free quantitative proteomics on 16 cerebrospinal fluid samples (EM group, encephalitis with mental and behavioral disorders patients, n = 5; NED group, encephalitis without mental and behavioral disorders patients, n = 6; N group, healthy individuals, n = 5). The extracted CSF proteins were examined by mass spectrometry and enzymatic digestion and detected using protein profiling and data analysis. Interproscan was used to perform Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the DEPs. ELISA was used to verify the changes in the levels of some DEPs in the CSF.

RESULTS

A total of 941 proteins were found to be significantly differentially expressed, including 250 upregulated DEPs and 691 downregulated DEPs. GO analysis suggested that there were six enriched functions that intersect among the EM, NED, and N groups, including synapse organization, membrane, integral component of membrane, membrane part, G-protein-coupled receptor signaling pathway, and transmembrane signaling receptor activity. KEGG analysis revealed that there were three signaling pathways that intersect among the EM, NED, and N groups, including fructose and mannose metabolism, inositol phosphate metabolism, and Jak-STAT signaling pathway. Furthermore, four downregulated encephalitis-related neurological synapse proteins were identified after screening for differentially expressed proteins, including NRXN3, NFASC, LRRC4B, and NLGN2. The result of ELISA further verified that the expression of NLGN2 and LRRC4B was obviously higher in the NED group than in the N group.

CONCLUSIONS

These findings demonstrated that NLGN2 and LRRC4B proteins were upregulated in the NED group and could be potential biomarkers for the diagnosis of encephalitis, but still needs a lot of multiomics studies to be used in clinical.